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| 1 | Endoscopy and polyps-diagnostic and therapeutic advances in management显示文摘Despite multiple efforts aimed at early detection through screening, colon cancer remains the third leading cause of cancer-related deaths in the United States, with an estimated 51000 deaths during 2013 alone. The goal remains to identify and remove benign neoplastic polyps prior to becoming invasive cancers. Polypoid lesions of the colon vary widely from hyperplastic, hamartomatous and inflammatory to neoplastic adenomatous growths. Although these lesions are all benign, they are common, with up to one-quarter of patients over 60 years old will develop pre-malignant adenomatous polyps. Colonoscopy is the most effective screening tool to detect polyps and colon cancer, although several studies have demonstrated missed polyp rates from 6%-29%, largely due to variations in polyp size. This number can be as high as 40%, even with advanced (> 1 cm) adenomas. Other factors including sub-optimal bowel preparation, experience of the endoscopist, and patient anatomical variations all affect the detection rate. Additional challenges in decision-making exist when dealing with more advanced, and typically larger, polyps that have traditionally required formal resection. In this brief review, we will explore the recent advances in polyp detection and therapeutic options. | Scott R Steele Eric K Johnson Bradley Champagne Brad Davis Sang Lee David Rivadeneira Howard Ross Dana A Hayden Justin A Maykel | 2013 | World Journal of Gastroenterology2013，19，27： | 16 |
| 2 | Diagnosis and Management of Symptomatic Hemorrhoids显示文摘 | Erica B. Sneider Justin A. Maykel | 2010 | Surgical Clinics of North America2010，，1： | 1 |
| 3 | Single-incision laparoscopic colectomy: training the next generation显示文摘 | Seth Miller Marlin Wayne Causey Aneel Damle Justin Maykel Scott Steele | 2013 | Surgical Endoscopy2013，，5： | 1 |
| 4 | Colonic Diverticulosis and Diverticular Hemorrhage显示文摘 | Justin Maykel Frank Opelka | 2004 | Clinics in Colon and Rectal Surgery2004，，03： | 1 |
| 5 | Anal squamous cell carcinoma: An evolution in disease and management显示文摘Anal cancer represents less than 1% of all new cancers diagnosed annually in the United States. Yet, despite the relative paucity of cases, the incidence of anal cancer has seen a steady about 2% rise each year over the last decade. As such, all healthcare providers need to be cognizant of the evaluation and treatment of anal squamous cell carcinoma. While chemoradiation remains the mainstay of therapy for most patients with anal cancer, surgery may still be required in recurrent, recalcitrant and palliative disease. In this manuscript, we will explore the diagnosis and management of squamous cell carcinoma of the anus. | Marc C Osborne Justin Maykel Eric K Johnson Scott R Steele | 2014 | World Journal of Gastroenterology2014，20，36： | 1 |
| 6 | Clostridium difficile Infection After Colorectal Surgery: A Rare but Costly Complication显示文摘 | Rachelle N. Damle Nicole B. Cherng Julie M. Flahive Jennifer S. Davids Justin A. Maykel Paul R. Sturrock W. Brian Sweeney Karim Alavi | 2014 | Journal of Gastrointestinal Surgery2014，，10： | 1 |
| 7 | Routine colonic endoscopic evaluation following resolution of acute diverticulitis:Is it necessary?显示文摘Diverticular disease incidence is increasing up to 65% by age 85 in industrialized nations,low fiber diets,and in younger and obese patients.Twenty-five percent of patients with diverticulosis will develop acute diverticulitis.This imposes a significant burden on healthcare systems,resulting in greater than 300000 admissions per year with an estimated annual cost of $3 billion USD.Abdominal computed tomography(CT) is the diagnostic study of choice,with a sensitivity and specificity greater than 95%.Unfortunately,similar CT findings can be present in colonic neoplasia,especially when perforated or inflamed.This prompted professional societies such as the American Society of Colon Rectal Surgeons to recommend patients undergo routine colonoscopy after an episode of acute diverticulitis to rule out malignancy.Yet,the data supporting routine colonoscopy after acute diverticulitis is sparse and based small cohort studies utilizing outdated technology.While any patient with an indication for a colonoscopy should undergo appropriate endoscopic evaluation,in the era of widespread use of high-resolution computed tomography,routine colonic endoscopic evaluation following resolution of acute uncomplicated diverticulitis poses additional costs,comes with inherent risks,and may require further study.In this manuscript,we review the current data related to this recommendation. | Amit K Agarwal Burzeen E Karanjawala Justin A Maykel Eric K Johnson Scott R Steele | 2014 | World Journal of Gastroenterology2014，20，35： | 0 |
| 8 | An NSQIP evaluation of practice patterns and outcomes following surgery for anorectal abscess and fistula in patients with and without Crohn’s disease显示文摘Background:Patients with Crohn’s disease(CD)are believed to have more aggressive anorectal abscess and fistula disease.We assessed the types of procedures performed and perioperative complications associated with the surgical management of anorectal abscess and fistula disease in patients with and without CD.Methods:The American College of Surgeons National Surgical Quality Improvement Program database(ACS-NSQIP,2005-2010)was used to calculate 30-day outcomes using regression modeling,accounting for demographics,comorbidities and surgical procedures.ICD-9 codes for anorectal abscess or fistula were used for initial selection.Patients were then stratified,based on the presence or absence of underlying CD.Local procedures included incision and drainage of abscesses,fistulotomy and seton placement.Cutaneous fistulas were considered simple,while all others were classified as complex(-vaginal,-urethral and-vesical).Results:A total of 7,218 patients(mean age 45 years;64%male)met inclusion criteria,with underlying CD in 345(4.8%).CD patients were more likely to have a seton placed(9.9 vs 8.2%,P<0.001)and be on steroids(15.4 vs 4.3%,P<0.001).Thirty-seven percent of CD patients underwent local procedures,while 46%had a proctectomy and8%underwent diversion.Fistulotomy was more common in those without underlying CD(16 vs 11%,P<0.001).The overall complication rate after local treatment was 4.9%,with no difference between patients with and without CD(7.7 vs 4.9%,P=0.144).This was not affected by fistula type-simple(7.9 vs 3.9%,P=0.194)vs complex(33 vs 7.1%,P=0.21)—or when stratified by wound(3.8 vs 2.4%;P=0.26)or systemic complications(3.8 vs 2.5%;P=0.53).Yet,complications following emergency procedures were higher in patients with CD(21.4 vs 5.9%,P=0.047).Factors significantly associated with increased complications were Crohn’s disease(OR=8.2),lack of functional independence(OR=2.0),pre-operative weight loss(OR=2.6)and pre-operative acute renal failure(OR=5.6).Steroids were also associated with a 1.7-fold increase in complications,independent from CD.Conclusions:While most patients with anorectal abscess/fistula are treated with local procedures,proctectomy and diversion use is fairly common in those with underlying CD.Although complication rates following elective local procedures for anorectal abscess/fistula are similar in patients with and without CD,they are higher in patients on steroids and in CD patients undergoing emergent procedures. | Marlin Wayne Causey Daniel Nelson Eric K.Johnson Justin Maykel Brad Davis David E.Rivadeneira Brad Champagne Scott R.Steele | 2013 | Gastroenterology Report2013，1，1： | 0 |
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