BACKGROUND AND AIMS: Irritable bowel syndrome (IBS) is a prevalent disorder with a complex and heterogeneous physiopathology, including a dysregulation of gut-brain axis. Treatment for IBS is targeted to the predominant symptom and requires a multidisciplinary approach. This review aims to evaluate the efficacy and safety of sacral nerve stimulation in non-constipated IBS patients Methods: A literature search was carried out on MEDLINE, The Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science databases for all relevant articles. Quality of included papers was assessed using standardized guidelines Results: Of 129 initial citations, 7 articles met our predefined inclusion criteria, including five randomized trials, a pilot study and a descriptive follow-up study. Five of 7 studies reported a positive effect of sacral nerve stimulation on symptoms and quality of life improvement in non-constipated IBS patients. No study reported serious adverse events. CONCLUSIONS: Despite initial promising results of sacral nerve stimulation in non-constipated IBS patients, studies with larger sample sizes and longer follow-up are required.
Irritable Bowel Syndrome , Humans , Irritable Bowel Syndrome/diagnosis , Irritable Bowel Syndrome/therapy , Follow-Up Studies , Quality of Life , Pilot Projects , Treatment Outcome
Clostridium septicum endophthalmitis is an extremely rare infection with only a few cases reported in the literature. It has an endogenous origin and is associated with gastrointestinal and haematological malignancies. We present the case of a 62-year-old male who presented this infection as the first manifestation of a colon adenocarcinoma.
Clostridium Infections/microbiology , Clostridium septicum/isolation & purification , Colonic Neoplasms/complications , Endophthalmitis/microbiology , Clostridium Infections/diagnosis , Clostridium septicum/genetics , Clostridium septicum/physiology , Endophthalmitis/etiology , Humans , Male , Middle Aged
BACKGROUND: Rectal cancer surgery is a technically complex procedure. Moreover, short-term outcomes show high rate of complications especially in elderly and laparoscopic surgery has not demonstrated to be able to reduce this complication rate. Robotics has several advantages in pelvic surgical procedures, which could have an impact in complication rates in elderly patients. AIMS: The aim of our study is to demonstrate whether robotic surgery has any influence on the reduction of complications in the aged population undergoing rectal cancer. METHODS: We performed a retrospective analysis of a prospective database of 151 patients who underwent robotic surgery for rectal cancer. We divided our population into three groups: under 65-year-old, between 65- and 80-year-old and above 80-year-old. We recorded complications in each group intra and post procedure. RESULTS: The present study included 151 patients (94 males). Of them, 77 patients were under 66 year old, 63 patients were between 66 and 79 year old and 11 patients were 80 year old and above. The analysis showed conversion rates of 10.38%, 13.69%, 27.27%, and the complication rate of 23.4%, 23.8%, and 27.3% in each group. Univariate analysis showed no differences between the three groups. Nevertheless, there were statistical differences from BMI, ASA and neoadjuvant therapy. In multivariant analysis only neoadjuvant therapy was significant. CONCLUSIONS: Robotic approach does not decrease complications in elderly population and conversion is similar in these age groups. So we should not rule out robotic surgery in elderly patients, although we must select each case with a multidisciplinary approach.
Laparoscopy , Rectal Neoplasms , Robotic Surgical Procedures , Aged , Aged, 80 and over , Humans , Male , Postoperative Complications/epidemiology , Rectal Neoplasms/surgery , Retrospective Studies , Robotic Surgical Procedures/adverse effects , Treatment Outcome
No disponible
Humans , Male , Adult , Neoplasms, Vascular Tissue/surgery , Liver Neoplasms/surgery , Diagnosis, Differential
No disponible
Humans , Male , Middle Aged , Splenosis/complications , Splenosis/diagnosis , Diagnosis, Differential , Wandering Spleen/complications , Wandering Spleen/diagnosis , Gadolinium , Radionuclide Imaging , Splenectomy/methods , Splenectomy/trends , Technetium , Wandering Spleen/physiopathology , Transaminases/analysis , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Liver/injuries , Liver , Splenectomy
