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The Surgical Clinics of North America Dec 2023Anorectal emergencies are rare presentations of common anorectal disorders, and surgeons are often called on to assist in their diagnosis and management. Although most... (Review)
Review
Anorectal emergencies are rare presentations of common anorectal disorders, and surgeons are often called on to assist in their diagnosis and management. Although most patients presenting with anorectal emergencies can be managed nonoperatively or with a bedside procedure, surgeons must also be able to identify surgical anorectal emergencies, such as gangrenous rectal prolapse. This article provides a review of pertinent anatomy; examination techniques; and workup, diagnosis, and management of common anorectal emergencies including thrombosed hemorrhoids, incarcerated hemorrhoids, anal fissure, anorectal abscess, rectal prolapse, and pilonidal abscess and unique situations including rectal foreign body and anorectal sexually transmitted infections.
Topics: Humans; Hemorrhoids; Rectal Prolapse; Abscess; Emergencies; Rectal Diseases; Anus Diseases; Fissure in Ano
PubMed: 37838461
DOI: 10.1016/j.suc.2023.05.014 -
The Surgical Clinics of North America Jun 2024Rectal prolapse, or procidentia, is a common pathology for the practicing colorectal surgeon. It is associated with lifestyle limiting symptoms for the patient and... (Review)
Review
Rectal prolapse, or procidentia, is a common pathology for the practicing colorectal surgeon. It is associated with lifestyle limiting symptoms for the patient and frequently co-exists with other types of pelvic prolapse making multidisciplinary management key. It is primarily managed with surgical reconstruction. A number of operative approaches exist, and the optimum procedure is varied dependent upon patient characteristics.
Topics: Humans; Rectal Prolapse
PubMed: 38677820
DOI: 10.1016/j.suc.2023.12.002 -
European Journal of Obstetrics,... Sep 2023Pelvic floor dysfunction (PFD) is a common complication in gynecologic cancer survivors (GCS) and is now a worldwide medical and public health problem because of its... (Review)
Review
Pelvic floor dysfunction (PFD) is a common complication in gynecologic cancer survivors (GCS) and is now a worldwide medical and public health problem because of its great impact on the quality of life of GCS. PFD after comprehensive gynecologic cancer treatment is mainly reflected in bladder function, rectal function, sexual dysfunction and pelvic organ prolapse (POP), of which different types of gynecologic cancer correspond to different disease incidence. The prevention strategies of PFD after comprehensive gynecologic cancer treatment mainly included surgical treatment, physical therapy and behavioral guidance, etc. At present, most of them still focus on physical therapy, mostly using Pelvic Floor Muscle Training (PFMT) and multi-modal PFMT treatment of biofeedback combined with electrical stimulation, which can reduce the possibility of PFD after surgery in GCS to some extent. This article reviews the clinical manifestations, causes and current research progress of prevention and treatment methods of PFD after comprehensive treatment for GCS.
Topics: Female; Humans; Urinary Incontinence; Cancer Survivors; Pelvic Floor; Quality of Life; Pelvic Floor Disorders; Pelvic Organ Prolapse; Exercise Therapy; Neoplasms
PubMed: 37499277
DOI: 10.1016/j.ejogrb.2023.07.010 -
Diseases of the Colon and Rectum Jan 2024
Topics: Humans; Rectal Prolapse; Rectum
PubMed: 37682805
DOI: 10.1097/DCR.0000000000002769 -
Cell Reports Nov 2023Intestinal colonization by antigenically foreign microbes necessitates expanded peripheral immune tolerance. Here we show commensal microbiota prime expansion of CD4...
Intestinal colonization by antigenically foreign microbes necessitates expanded peripheral immune tolerance. Here we show commensal microbiota prime expansion of CD4 T cells unified by the Kruppel-like factor 2 (KLF2) transcriptional regulator and an essential role for KLF2+ CD4 cells in averting microbiota-driven intestinal inflammation. CD4 cells with commensal specificity in secondary lymphoid organs and intestinal tissues are enriched for KLF2 expression, and distinct from FOXP3+ regulatory T cells or other differentiation lineages. Mice with conditional KLF2 deficiency in T cells develop spontaneous rectal prolapse and intestinal inflammation, phenotypes overturned by eliminating microbiota or reconstituting with donor KLF2+ cells. Activated KLF2+ cells selectively produce IL-10, and eliminating IL-10 overrides their suppressive function in vitro and protection against intestinal inflammation in vivo. Together with reduced KLF2+ CD4 cell accumulation in Crohn's disease, a necessity for the KLF2+ subpopulation of T regulatory type 1 (Tr1) cells in sustaining commensal tolerance is demonstrated.
Topics: Mice; Animals; CD4-Positive T-Lymphocytes; Interleukin-10; T-Lymphocytes, Regulatory; Transcription Factors; Inflammation; Microbiota; Kruppel-Like Transcription Factors
PubMed: 37889750
DOI: 10.1016/j.celrep.2023.113323