Complex anal fistulas require careful evaluation. Prior to any attempts at definitive repair, the anatomy must be well defined and the sepsis resolved. Several muscle-sparing approaches to anal fistula are appropriate, and are often catered to the patient based on their presentation and previous repairs. Emerging technologies show promise for fistula repair, but lack long-term data.

No abstract

Background Colorectal cancer (CRC) progression is mediated by cancer stem cells (CSCs). We sought to determine if expression of the CSC marker aldehyde dehydrogenase 1 (ALDH1) in CRC tumors varies by AJCC stage or correlates to clinical outcomes. Methods Primary and metastatic CRC samples from 96 patients were immunostained with antibodies to ALDH1 and imaged to evaluate marker expression. The percentage of ALDH1+ cells was correlated to clinical outcomes. Results ALDH1 was overexpressed in CRC tumors compared to non-neoplastic tissue. Marker expression was highest in non-metastatic tumors; loss of expression was associated with advanced stage and metastatic disease. No significant correlation was found between ALDH1 expression and metastasis, recurrence or survival. Conclusions ALDH1 was highly expressed in non-metastatic CRC, but expression was lost with advancing stage. ALDH1 could be an effective therapeutic target in early CRC but not late stage disease. No correlation was found between ALDH1 and disease prognosis.

No abstract