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g highly variable daily hearing aid use. Interventions that use behavior change techniques may be needed to ensure intentions are consistently turned into successful actions, if the benefits of newborn hearing screening and early intervention are to be fully realized.
Acute anorectal abscesses of cryptoglandular origin are commonly managed by incision and drainage, which results in fistula development in up to 73% of cases, requiring subsequent definitive fistula surgery. However, given that fistula tracts may already be present at the initial presentation, primary closure of the tract as secondary prevention of fistula formation, using ligation of intersphincteric fistula tract, may be useful.

This study aims to examine the feasibility and outcomes of performing intersphincteric exploration with ligation of intersphincteric fistula tract or attempted closure of internal opening for acute anorectal abscesses.

This is a retrospective study of patients with acute anorectal cryptoglandular abscesses who underwent surgery between January 2014 and December 2016.

The patients were treated at a tertiary referral center in Thailand.

Eighty-six patients with acute anorectal abscesses without previous surgery were included.

Intersphincteric dissection was performed. Furt, se encontró formación de trayectos fistulosos. La cirugía definitiva con esta estrategia, proporciona resultados prometedores. Consulte Video Resumen en http//links.lww.com/DCR/B451.
Anal lesions in cases of Crohn's disease can give rise to adenocarcinoma of the anal canal; however, the oncologic outcomes in these patients have not yet been thoroughly investigated.

This study aimed to clarify the influence of Crohn's disease on the oncologic outcomes in patients with adenocarcinoma of the anal canal.

This was a retrospective observational study from a prospectively collected database.

The study was conducted at a single institution.

This study included 102 patients with adenocarcinoma of the anal canal, including 34 (33.3%) with Crohn's disease-associated lesions and 68 (66.7%) with non-Crohn's disease-associated lesions.

Prognostic factors were detected using a Cox regression analysis, and the oncologic outcomes were calculated using the Kaplan-Meier method.

Crohn's disease-associated patients were significantly younger (45 vs 62 y; p < 0.001), had a high incidence of external/anal gland-type disease (61.8% vs 5.9%, p < 0.001) and had large tumors (7.1 ± 3.0 vs 4.7 ± es en pacientes asociados con la enfermedad de Crohn con tumores grandes. Por lo tanto, es importante realizar una vigilancia cuidadosa de las lesiones anales en pacientes con enfermedad de Crohn. Consulte Video Resumen en http//links.lww.com/DCR/B449.
Ever since transanal total mesorectal excision was introduced by Sylla and Lacy in 2010, it has become more popular among colorectal surgeons. However, some surgeons hesitate to use it, because this novel approach differs greatly from laparoscopic total mesorectal excision and requires a long learning curve.

This study analyzed the learning curve of transanal total mesorectal excision procedure and compared the different phases of transanal total mesorectal excision with laparoscopic total mesorectal excision.

This is retrospective case-control study.

We used data from the approved colorectal cancer database of the Sixth Affiliated Hospital of Sun Yat-sen University.

The patients involved in this study underwent transanal total mesorectal excision performed by a single surgeon (L.K.) or underwent laparoscopic transanal total mesorectal excision performed by experienced surgeons.

Transanal or laparoscopic resection of mid-low rectal cancer was conducted.

Perioperative complication and resection mue durante la fase 2, los resultados del grupo transanal fueron comparables a los del grupo laparoscópico. Los resultados muestran que durante la fase 3, el tiempo operatorio, la pérdida de sangre intraoperatoria y la estancia hospitalaria postoperatoria fueron menores que en el grupo laparoscópico. La recurrencia local ocurrió en 3 pacientes durante la fase 1 y en 1 paciente durante la fase 2.LIMITACIONESEste estudio fue un estudio retrospectivo pequeño y se centró en un solo cirujano que realizaba la escisión mesorrectal total transanal.CONCLUSIÓNLos resultados a corto plazo e histopatológicos son similares en comparación entre el grupo transanal y el grupo laparoscópico emparejado. La escisión mesorrectal total transanal también proporcionó buenos resultados oncológicos. Consulte Video Resumen en http//links.lww.com/DCR/B450.
Human papillomavirus has been implicated in the carcinogenesis of squamous cell carcinoma of the anal canal. p16 expression and the presence of human papillomavirus DNA have been used to define human papillomavirus-positive patients, but neither approach has been validated against the standard of human papillomavirus E6/7 mRNA expression at this disease site.

This study aimed to evaluate the acceptability of p16 immunohistochemistry as a surrogate to E6/7 mRNA expression in identifying human papillomavirus-mediated squamous cell carcinoma of the anal canal.

This was a retrospective analysis of a previously constructed tissue microarray.

This study was conducted at a tertiary academic center.

Biopsies and resection specimens from patients diagnosed with squamous cell carcinoma of the anal canal at the study institution from 2005 to 2015 were reviewed for sample adequacy.

Concordance between p16 positivity by immunohistochemistry and E6/7 mRNA expression by in situ hybridization was evaluated. Sensio resultó en una sensibilidad del 96% y una especificidad del 100%. El valor predictivo positivo de la inmunohistoquímica de p16 para la expresión de ARNm de E6 / 7 fue del 100%.LIMITACIONESEl estudio estuvo limitado por su naturaleza retrospectiva y por el tamaño pequeño de la muestra. https://www.selleckchem.com/products/gdc-0575.html Solamente evaluó los parámetros de diagnóstico, en lugar de las implicaciones pronosticas.CONCLUSIONESEn este estudio, el método clínico prevalente de inmunohistoquímica p16, mostró una excelente concordancia con el estándar de oro de la expresión de ARNm de E6 / 7 y demostró su potencial para servir, como sustituto para identificar el carcinoma de células escamosas del canal anal, inducido por el virus del papiloma humano. Consulte Video Resumen en http//links.lww.com/DCR/B448.
Anastomotic leakage might be directly or indirectly related to the prognosis of patients with rectal cancer.

This study aimed to investigate whether anastomotic leakage affects the oncologic outcomes in patients with rectal cancer.

This was a retrospective analysis of prospectively collected data.

This study was conducted at a teaching hospital between January 2009 and December 2013.

Patients who underwent curative resection for primary rectal cancer were included.

Kaplan-Meier analyses were used to evaluate disease-free survival and overall survival.

The overall incidence of anastomotic leakage was 2.7% (107/3865). Local recurrence was more frequent in patients with anastomotic leakage than in those without (14.0% vs 6.7%; p = 0.007). By multivariate analysis, anastomotic leakage was associated with increased local recurrence rate (p = 0.014) and poorer overall survival (p = 0.011). In subgroup analysis, compared with other pathologic risk factors, anastomotic leakage was associated with higherio está limitado por su naturaleza retrospectiva.CONCLUSIONESHubo una sólida asociación entre la fuga anastomótica y la recurrencia local, mientras que también afecta potencialmente la supervivencia a largo plazo, del grupo de pacientes. La administración de terapia adyuvante retrasada o cancelada debido a una fuga anastomótica, puede explicar en parte, la menor supervivencia en aquellos pacientes con cáncer rectal avanzado. Consulte Video Resumen en http//links.lww.com/DCR/B459.
Colorectal endoscopic submucosal dissection is typically performed by specialized knife, such as a dual knife. However, it is not covered by Taiwan's National Health Insurance. In the literature review, using a traditional snare tip for endoscopic submucosal dissection has been reported for stomach lesions only.

The purpose of this study was to evaluate the outcomes of colorectal endoscopic submucosal dissection using a snare tip.

We retrospectively reviewed the clinical using of a snare tip compared with a dual knife for colorectal endoscopic submucosal dissection. Postoperative short- and long-term outcomes were investigated after the procedure.

This study was conducted at a single tertiary care institution.

Patients who could not afford the expense of a specialized knife were included.

Dissection time, dissection speed, and perioperative complications were used for short-term outcome measurement. Recurrence-free rate was used for long-term outcome measurement.

Twenty-one lesions were in the s dissection in a selected population without the support of specialized knives, such as the dual knife. Although the dissection speed is slower using a snare tip, it is still a recommended technique for developing country or low-income patients.
Rectourethral fistula is an uncommon pathology, usually iatrogenic, occurring as a complication of surgical or ablative treatments for prostate or rectal cancer. Among other surgical techniques, restorative ultralow rectal anterior resection may be an option of last resort to achieve fistula closure avoiding the need for a permanent stoma. This article aims to describe a transanal minimally invasive-assisted Turnbull-Cutait technique for radiated rectourethral fistulas with a complementary video.

Turnbull-Cutait pull-through with delayed coloanal anastomosis technique with a proctectomy by transanal minimally invasive surgery and loop ileostomy was performed in 3 patients who developed delayed rectourethral fistula after prostate cancer treatment. Ileostomy was reversed after fistula closure confirmation.

The first patient had brachytherapy with no surgery. The second patient had radical prostatectomy and adjuvant radiotherapy, developing the fistula after a pelvic abscess drained transrectally. The thibination of already existing techniques, enabling the creation of safe colorectal anastomosis in high-risk cases. Given the difficulty obtaining healing with sphincter preservation in cases of postradiation rectourethral fistula, this technique aids in fistula closure and restoration of the intestinal continuity, and potentially represents an added resource in the surgical armamentarium for this challenging pathology.
Visceral fat is considered a risk for postoperative complications in colon cancer surgery. However, the association with anastomotic leakage as the most worrisome complication is not clear mainly because of underpowered studies.

The purpose of this study was to analyze the effect of visceral fat as a continuous variable on anastomotic leakage in a large cohort of colon cancer resections.

This was a retrospective, multicenter cohort study.

This study used data of the Dutch Surgical Colorectal Audit of the years 2011 through 2014 from 8 Dutch teaching hospitals. Visceral fat was assessed on the routine preoperative abdominal CT scan.

A total of 2370 patients underwent colon cancer resection with primary anastomosis. There were 2011 patients operated electively and 359 in an emergency setting.

The effect of visceral fat on anastomotic leakage after multivariable analysis was measured.

Visceral fat was associated with anastomotic leakage in the elective colon resection group (n = 2011) but not in emergency colon resections (n = 359).
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