Profile of Crohn's disease patients who underwent anorectal examination under anesthesia

Introduction: Crohn's disease (CD) is an inflammatory bowel disease, and in ~ 30% of cases it is associated with perianalmanifestations. To identify the extent of the damage and to implement an appropriate treatment, anorectal examination under anesthesia (EUA) is fundamental. Objective: To describe the profile of patients who underwent anorectal EUA in university and private hospitals in the state of Bahia, Brazil. Methodology: A retrospective, descriptive study with 46 patients who underwent anorectal EUA between March, 2016 and November, 2019. Results: A total of 62 anorectal EUAs were performed in 46 patients. With an average age of 36.8 years, the female gender was predominant (52.2%) among these patients. Anal fistulas were the most frequent findings (83.8%), and in most cases they were treated with a seton placement (69.4%). The main recommended surgical indication was a proper evaluation and identification of perianal disease, followed by drainage of the abscess and therefore immunobiological therapy (59.6%). Conclusion: In the present study, the profile of CD patients was similar to those found in the literature, with a high rate of complex anal fistulas. Additional studies are still necessary to further comprehend and treat this particular and debilitating manifestation of the disease. (AU)

FILAC - Fistula - Tract Laser Closure: a sphincter-preserving procedure for the treatment of complex anal fistulas / FILAC ­ Fechamento do trajeto da fístula à laser: procedimento de preservação esfincteriana para o tratamento das fístulas anais complexas

ABSTRACT Several surgical options are described for the treatment of anorectal fistulas, particularly in complex cases where recurrence rates and the possibility of postoperative incontinence are still high. The aim of this study is to describe the use of FILAC technique (Fistula - Tract Laser Closure) minimally invasive and preservation sphincter technique. FILAC has been described in the literature as an option in the management of anorectal fistula.

RESUMO Várias opções cirúrgicas são descritas para o tratamento de fístulas anorretais, especialmente em casos complexos, onde as taxas de recorrência e a possibilidade de incontinência pós-operatória ainda são elevadas. O objetivo deste estudo é descrever o uso da técnica FILAC (Fechamento do trajeto da fístula à laser), técnica minimamente invasiva com preservação esfincteriana. FILAC tem sido descrito na literatura como uma opção no manejo da fistula pcolerianal.

TAMIS with partial excision of mesorectum and primary closure of rectal wound using vloc / TAMIS com excisão parcial do mesorreto e fechamento primário da ferida retal usando vloc

Background: Transanal Minimally Invasive Surgery has proven to be a viable alternative in the treatment of rectal tumors; however, rectal wound closure can be challenging. We describe our experience with this procedure using the vloc suture device. Resume: Eight successful Transanal Minimally Invasive Surgery with primary wound closure using vloc were performed in 5 men, 62 years mean age; all cases had pre-operative diagnosis of adenoma with high-grade dysplasia. The surgical anatomic-pathologic results showed 6 adenomas with high-grade dysplasia and 2 well differentiated adenocarcinomas, limited to the upper third of the submucosa (pT1SM1) without lymphatic or vascular invasion. All lesions were resected with negative margins. No patient reported during follow-up rectal pain, fecal incontinence or bleeding. Conclusion: The use of vloc in rectal wound closure during Transanal Minimally Invasive Surgery is secure and facilitates the procedure. (AU).

Tema: Cirurgia Minimamente Invasiva Transanal (TAMIS) tem provado ser uma alternativa viável para o tratamento de tumores do reto, porém o fechamento da ferida rectal pode ser desafiadante. Nós descrevemos nossa experiência com este procedimento utilizando o dispositivo de sutura vloc. Resumo: Oito TAMIS foram realizados com sucesso com o fechamento primário da ferida usando vloc, cinco homens, com idade média de 62 anos, todos os casos tiveram diagnóstico pré-operatório de adenoma com displasia de alto grau. Os resultados anátomo-patológicos pós-operatório demonstraram: 6 adenomas com displasia de alto grau e 2 adenocarcinomas bem diferenciados, limitado ao terço superior da submucosa (pT1SM1), sem invasão linfática ou vascular. Todas as lesões foram ressecados com margens negativas. Nenhum paciente relatou durante o seguimento dor rectal, incontinência fecal ou sangramento. Conclusão: O uso de vloc no fechamento da ferida retal durante TAMIS é seguro e facilita o procedimento. (AU).

Linfoma primário de cólon: relato de caso / Primary colorectal lymphoma: case report

O linfoma colorretal primário é uma doença rara (0.2 a 0.6 por cento de todas as neoplasias colônicas), apresentando pior prognóstico quando comparado com o linfoma gástrico primário ou com o adenocarcinoma do cólon. É uma doença com sintomatologia inespecífica, o que dificulta o diagnóstico precoce. O objetivo deste relato é mostrar um caso de linfoma primário do cólon, revisar critérios diagnósticos e tratamento.

The primary colorectal lymphoma is a rare disease (0.2 to 0.6 percent of all colonic neoplasias), that has a worse prognosis than primary gastric lymphoma or colon adenocarcinoma. The poor signals makes the early diagnosis difficult. The objectives of this report is to describe a case of primary colon lymphoma, revise diagnosis criteria and treatment.