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| 1 | Treatment strategies in obstructed defecation and fecal incontinence显示文摘妨碍的澄清(OD ) 和大便失禁(FI ) 正在质问临床的问题,它通常在颜色的实践被遇到表面的外科医生和胃的肠学。这些混乱社会上并且心理上地沮丧病人并且极大地损害他们生命的质量。位于下面解剖并且 pathophysiological 变化是复杂的,不完全地经常理解并且不能总是被决定。作为后果,许多医药、外科、行为的途径被描述了,没有灵丹妙药。在过去的十年,在一理解和在肛门直肠的生理学实验室(ARP ) 的评估的合理、类似的方法的混乱,辐射学研究,和新外科的技术导致了有希望的结果这些进展。在这简短评论,我们在妨碍的澄清和大便失禁的临床、治疗学的方面上讨论治疗策略和最近的更改。 | Marat Khaikin Steven D Wexner | 2006 | World Journal of Gastroenterology2006，12，20： | 15 |
| 2 | Current status of laparoscopy for the treatment of rectal cancer显示文摘Surgery for rectal cancer in complex and entails many challenges.While the laparoscopic approach in general and specific to colon cancer has been long proven to have short term benefits and to be oncologically safe,it is still a debatable topic for rectal cancer.The attempt to benefit rectal cancer patients with the known advantages of the laparoscopic approach while not compromising their oncologic outcome has led to the conduction of many studies during the past decade.Herein we describe our technique for laparoscopic proctectomy and assess the current literature dealing with short term outcomes,immediate oncologic measures(such as lymph node yield and specimen quality) and long term oncologic outcomes of laparoscopic rectal cancer surgery.We also briefly evaluate the evolving issues of robotic assisted rectal cancer surgery and the current innovations and trends in the minimally invasive approach to rectal cancer surgery. | Noam Shussman Steven D Wexner | 2014 | World Journal of Gastroenterology2014，20，41： | 13 |
| 3 | Neutropenic enterocolitis显示文摘Neutropenic colitis is a severe condition usually affecting immunocompromised patients. Its exact pathogenesis is not completely understood. The main elements in disease onset appear to be intestinal mucosal injury together with neutropenia and the weakened immune system of the afflicted patients. These initial conditions lead to intestinal edema, engorged vessels, and a disrupted mucosal surface, which becomes more vulnerable to bacterial intramural invasion. Chemotherapeutic agents can cause direct mucosal injury(mucositis) or can predispose to distension and necrosis, thereby altering intestinal motility. This article aims to review current concepts regarding neutropenic colitis' pathogenesis, diagnosis, and management. | Fabio G Rodrigues Giovanna Dasilva Steven D Wexner | 2017 | World Journal of Gastroenterology2017，23，1： | 10 |
| 4 | Idiopathic fistula-in-ano显示文摘Fistula-in-ano is the most common form of perineal sepsis.Typically,a fistula includes an internal opening,a track,and an external opening.The external opening might acutely appear following infection and/or an abscess,or more insiduously in a chronic manner.Management includes control of infection,assessment of the fistulous track in relation to the anal sphincter muscle,and finally,definitive treatment of the fistula.Fistulotomy was the most commonly used mode of management,but concerns about post-fistulotomy incontinence prompted the use of sphincter preserving techniques such as advancement flaps,fibrin glue,collagen fistula plug,ligation of the intersphincteric fistula track,and stem cells.Many descriptive and comparative studies have evaluated these different techniques with variable outcomes.The lack of consistent results,level I evidence,or long-term follow-up,as well as the heterogeneity of fistula pathology has prevented a definitive treatment algorithm.This article will review the most commonly available modalities and techniques for managing idiopathic fistula-in-ano. | Sherief Shawki Steven D Wexner | 2011 | World Journal of Gastroenterology2011，17，28： | 7 |
| 5 | What every gastroenterologist needs to know about common anorectal disorders显示文摘Anorectal complaints are very common and are caused by a variety of mostly benign anorectal disorders.Many anorectal conditions may be successfully treated by primary care physicians in the outpatient setting,but patients tend not to seek medical attention due to embarrassment or fear of cancer.As a result,patients frequently present with advanced disease after experiencing significant decreases in quality of life.A number of patients with anorectal complaints are referred to gastroenterologists.However,gastroenterologists' knowledge and experience in approaching these conditions may not be sufficient.This article can serve as a guide to gastroenterologists to recognize,evaluate,and manage medically or non-surgically common benign anorectal disorders,and to identify when surgical referrals are most prudent.A review of the current literature is performed to evaluate comprehensive clinical pearls and management guidelines for each topic.Topics reviewed include hemorrhoids,anal fissures,anorectal fistulas and abscesses,and pruritus ani. | Moonkyung Cho Schubert Subbaramiah Sridhar Robert R Schade Steven D Wexner | 2009 | World Journal of Gastroenterology2009，15，26： | 5 |
| 6 | Current management of fecal incontinence:Choosing amongst treatment options to optimize outcomes显示文摘The severity of fecal incontinence widely varies and can have dramatic devastating impacts on a person’s life.Fecal incontinence is common,though it is often underreported by patients.In addition to standard treatment options,new treatments have been developed during the past decade to attempt to effectively treat fecal incontinence with minimal morbidity.Non-operative treatments include dietary modifications,medications,and biofeedback therapy.Currently used surgical treatments include repair(sphincteroplasty),stimulation(sacral nerve stimulation or posterior tibial nerve stimulation),replacement(artificial bowel sphincter or muscle transposition)and diversion(stoma formation).Newer augmentation treatments such as radiofrequency energy delivery and injectable materials,are minimally invasive tools that may be good options before proceeding to surgery in some patients with mild fecal incontinence.In general,more invasive surgical treatments are now reserved for moderate to severe fecal incontinence.Functional and quality of life related outcomes,as well as potential complications of the treatment must be considered and the treatment of fecal incontinence must be individualized to the patient.General indications,techniques,and outcomes profiles for the various treatments of fecal incontinence are discussed in detail.Choosing the most effective treatment for the individual patient is essential to achieve optimal outcomes in the treatment of fecal incontinence. | Julie Ann M Van Koughnett Steven D Wexner | 2013 | World Journal of Gastroenterology2013，19，48： | 3 |
| 7 | 美国与中国两组结直肠克罗恩病患者临床表现及病情严重程度比较显示文摘目的 探讨美国与中国结直肠克罗恩病患者临床病理特征及病情严重程度的差异.方法 自1985年3月至2004年9月,收集美国Cleveland Clinic Florida 68例(美国组)和中国北京解放军总医院85例(中国组)结直肠克罗恩病患者.比较两组患者一般资料、肠外病变、发病部位、临床表现、病理特征的差异.结果美国组和中国组女性患者分别占60.3%和36.5%(P=0.003),有家族史者分别占11.8%和1.2%(P=0.016);两组出现脓肿、直肠阴道瘘及肠外病变的概率分别为19.1%和0(P<0.001)、51.5%和0(P<0.001)、39.7%和20.0%(P=0.013);上述差异均有统计学意义.美国组有30例(44.1%)病变累及全结肠,而中国组仅4例(4.7%)(P<0.001);美国组回盲部以远各肠段受侵率均显著高于中国组(均P<0.05).结论 与中国患者相比,美国结直肠克罗恩病患者以女性多见,多有家族史,病变常累及远侧结直肠,临床表现及病理改变更为严重. | 罗成华 Steven D Wexner 刘庆森 李丽 赵荣华 于军辉 | 2010 | 中华胃肠外科杂志2010，13，6： | 1 |
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