Epidemiology and screening: what's new?

Bonelli, Luigina

doi:10.1111/codi.12815

Cited by 4 publications

(3 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, we can speculate that younger patients’ failure to fully respect the recommendations to avoid straining and physical activity may partly explain this result. A similar result, even if not confirmed at the multivariate analysis, emerged in another multicenter trial [ 24 ].…”

Section: Discussionsupporting

confidence: 58%

“…Main limitations of the study are: (1) retrospective design; (2) single-institution series: The results could be different in other patient populations, although our results are similar to those of a multicenter trial which includes our experience [ 24 ]; (3) variable technique and equipment: To better evaluate this limitation, we have analyzed the impact of the adoption of different devices and techniques on the results; (4) in our center, rubber band ligation or sclerosing injections are not used as a first-line approach, so it is possible that in a practice that includes these ambulatory treatments the results of THD may be different because of patient selection.…”

Section: Discussionmentioning

confidence: 63%

“… n.a. Ratto et al [ 24 ] 803 (grades: 2–3–4) 34.3 ± 5.9 (24–47) 6 13 2.2 0.5 0.1 11.1 ± 9.2 (3–57) 9.3 3.0 6.9 0 5.6 LaBella et al [ 25 ] 108 (grades 2–3–4) n.a. 6 8 13 0 0 12 10.3 0 10.3 0 10.3 Rubbini et al [ 26 ] 106 (grades 3–4) 25 (16–65) n.a.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Transanal hemorrhoidal dearterialization (THD) for hemorrhoidal disease: a single-center study on 1000 consecutive cases and a review of the literature

et al. 2017

View full text Add to dashboard Cite

BackgroundThe transanal hemorrhoidal dearterialization (THD) Doppler procedure is a minimally invasive technique to treat symptomatic hemorrhoids. The aim of the study was to assess the clinical efficacy and the satisfaction of patients in a large series treated with THD and to review the relevant literature.MethodsIn this retrospective, single-institution, study consecutive patients with grade 2, 3, or 4 hemorrhoidal disease were treated with the THD Doppler procedure. Dearterialization was performed in all cases and mucopexy in case of prolapse. The dearterialization procedure evolved from “proximal artery ligation” to “distal Doppler-guided dearterialization.” Follow-up was scheduled at 15 days, 1, 3, 12 months, and once a year thereafter. Complications were recorded. Clinical efficacy was assessed comparing both frequency of symptoms and disease grading (Goligher’s classification) at baseline versus last follow-up. Uni-/multivariate analysis evaluated factors affecting the outcome.ResultsThere were 1000 patients (619 men; mean age: 48.6 years, range 19–88 years). Acute postoperative bleeding was observed in 14 patients (1.4%), pain/tenesmus in 31 patients (3.1%), and urinary retention in 23 patients (2.3%). At mean follow-up duration of 44 ± 29 months, the symptomatic recurrence rate was 9.5% (95 patients; bleeding in 12 (1.2%), prolapse in 46 (4.6%), and bleeding and prolapse in 37 (3.7%) patients). The recurrence rate was 8.5, 8.7, and 18.1% in patients with grade 2, 3, and 4 hemorrhoids, respectively. Seventy out of 95 patients with recurrence needed surgery (reoperation rate: 7.0%). At final follow-up and taking into account the reoperations, 95.7% of patients had no hemorrhoidal disease on examination. Younger age, grade 4 disease, and high artery ligation affected the outcome negatively.ConclusionsOur results show that the THD Doppler procedure is safe and effective in patients with hemorrhoidal disease and associated with low morbidity and recurrence rates and a high rate percentage of treatment success.

show abstract

Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 63%

See 1 more Smart Citation

Transanal hemorrhoidal dearterialization (THD) for hemorrhoidal disease: a single-center study on 1000 consecutive cases and a review of the literature

et al. 2017

View full text Add to dashboard Cite

show abstract

Laserhämorrhoidoplastie mit dem 1470-nm-Diodenlaser in der Behandlung des zweit- bis viertgradigen Hämorrhoidalleidens – eine Kohortenstudie mit 497 Fällen

Weyand¹,

Theis²,

Fofana

et al. 2017

Zentralbl Chir

View full text Add to dashboard Cite

Laser haemorrhoidoplasty (LHP) with the 1470 nm diode laser in minimally invasive surgery for advanced haemorrhoid disease has been studied with respect to clinical variables, such as pain and complications, and intraoperative characteristics such as mucopexia, number of treated knots and energy consumed per patient. The study also included patient satisfaction, symptom relevance and cost effectiveness. Between November 2010 and November 2016, 497 patients (age 55 ± 14 years) were submitted to laser haemorrhoidoplasty with a 1470 nm diode laser in the centre for minimally invasive proctology in Siegen District Hospital. All operated patients were included in the study. Perioperative clinical and technical data up to 6 weeks and follow-up data up to 6 months were analysed prospectively. The mean duration of operation was 14 min (± 5.2). A mean of 2.7 knots of 2.7 size were treated per patient. The mean postoperative pain was 2.5/10 (VAS). Long-term symptom relevance was 86%, and patient satisfaction 91%. Complications occurred in 49 patients (9.9%): bleeding 1.8%, infection 1%, urine retention 1.8%, oedema/thrombosis/prolapse 6.6%. 8.8% of patients suffered a relapse within 6 months. There were significant differences in pain on the day of the operation, and the parameters mucopexia, 3 treated segments and energy level > 500 J (p < 0.05). Complications were more common when mucopexia was performed, with 3 treated knots and energy consumed per patient > 500 J. The only significant difference was for energy level > 500 J (p < 0.05). LHP is a safe, low pain and minimally invasive surgical procedure with long-term good patient acceptance and satisfaction and is suited for routine work. The energy applied should be reduced to a minimum. Complication rates are largely comparable with those of other minimally invasive conventional methods. Additional prospective studies must be performed, particularly in comparison to the Parks method, which gives similar functional results. With circular confluent findings, LHP cannot replace stapler hemorrhoidopexia.

show abstract

Evaluation of the Effectiveness and Cost-Effectiveness of Personalized Surveillance After Colorectal Adenomatous Polypectomy

McFerran

O’Mahony

Fallis

et al. 2017

Epidemiologic Reviews

View full text Add to dashboard Cite

Lifetime risk of developing colorectal cancer is 5%, and 5-year survival at early stage is 92%. Individuals with precancerous lesions removed at primary screening are typically recommended surveillance colonoscopy. Because greater benefits are anticipated for those with higher risk of colorectal cancer, scope for risk-specific surveillance recommendations exists. This review assesses published cost-effectiveness estimates of postpolypectomy surveillance to consider the potential for personalized recommendations by risk group. Meta-analyses of incidence of advanced neoplasia postpolypectomy for low-risk cases were comparable to those without adenoma, with both rates under the lifetime risk of 5%. This group may not benefit from intensive surveillance, which risks unnecessary harm and inefficient use of often scarce colonoscopy capacity. Therefore, greater personalization through deintensified strategies for low-risk individuals could be beneficial. The potential for noninvasive testing, such as fecal immunochemical tests, combined with primary prevention or chemoprevention may reserve colonoscopy for targeted use in personalized risk-stratified surveillance. This review appraised evidence supporting a program of personalized surveillance in patients with colorectal adenoma according to risk group and compared the effectiveness of surveillance colonoscopy with alternative prevention strategies. It assessed trade-offs among costs, benefits, and adverse effects that must be considered in a decision to adopt or reject personalized surveillance.

show abstract

Epidemiology and screening: what's new?

Cited by 4 publications

References 32 publications

Transanal hemorrhoidal dearterialization (THD) for hemorrhoidal disease: a single-center study on 1000 consecutive cases and a review of the literature

Transanal hemorrhoidal dearterialization (THD) for hemorrhoidal disease: a single-center study on 1000 consecutive cases and a review of the literature

Laserhämorrhoidoplastie mit dem 1470-nm-Diodenlaser in der Behandlung des zweit- bis viertgradigen Hämorrhoidalleidens – eine Kohortenstudie mit 497 Fällen

Evaluation of the Effectiveness and Cost-Effectiveness of Personalized Surveillance After Colorectal Adenomatous Polypectomy

Contact Info

Product

Resources

About