Essential updates 2020/2021: Colorectal diseases (benign)—Current topics in the surgical and medical treatment of benign colorectal diseases

Abstract

The development of new drugs for inflammatory bowel disease (IBD) is remarkable, and treatment strategies using multiple agents and various techniques are required; however, the treatment strategy is likely to be complex. Therefore, appropriate evaluation of traditional surgical treatment strategies and accurate knowledge of the efficacy and limitations of novel treatments are required. Total infectious complications were found to be associated with the use of corticosteroids and anti‐tumor necrosis factor‐α agents, but not with immunomodulators, anti‐integrin agents, and 5‐aminosalicylic acid. Regarding surgical procedures for IBD, conceived anastomosis methods, including Kono‐S for Crohn's disease stenosis, are associated with better outcomes than conventional techniques. Autologous cell transplantation for Crohn's fistulae has been shown to have a favorable outcome. Diverticulitis is increasing and will be treated more frequently in the future. Risk factors for the incidence of diverticulitis and differences in pathogenesis according to right or left side diverticulitis have been reported. Antibiotic therapy may be omitted for uncomplicated diverticulitis. Moreover, regarding surgical procedures, both bowel resection and anastomosis are associated with favorable short‐term outcomes, higher stoma closure rate, and superior medical economy compared to Hartmann's procedure. Risk factors for recurrence after diverticulitis surgery may provide better postoperative follow‐up. In this review, we explore the current topics of colorectal benign diseases, focusing on IBD and diverticulitis, based on clinical trials and meta‐analyses from 2020‐2021. This review consolidates the available knowledge and improves the quality of surgical procedures and perioperative management for IBD and diverticulitis.

Ileostomy volvulus as an underreported problem causing small bowel obstruction in patients living with ostomy: a case report and literature review

“…Preoperative steroid dosing, high stoma output, and the presence of malignant tumors were also noted by studies as potential risk factors. Kitahara et al [13] reported an association between a lowered corticosteroid dose a month prior to surgery and an increased risk of SOO, but this is also a common guideline for medically refractory UC preoperatively and may simply reflect the risk of patients with worsening UC [22]. Nonetheless, Kameyama et al [10] found that the perioperative steroid dose did not affect SBO incidence.…”

Impact of the COVID-19 pandemic on prescription refills for immune-mediated inflammatory disorders: a time series analysis (January 2019 to January 2021) using the English Prescribing Dataset

“…15 From a primary care perspective, early recognition, along with its extra-articular manifestations, can lead to faster time to treatment and better health outcomes, in addition to preserved joint functionality. [16][17][18] IIDs are also used in chronic conditions of the bowels [19][20][21] (eg, Crohn's disease, ulcerated colitis, diverticulitis) as well as for antirejection therapy 22 when organ transplants or grafts have been used as they suppress the autoimmune destruction. These medicines are important because they provide a lifeline towards functional mobility and improves the quality of life 23 24 for patients by relieving their pain as well as retarding disease progression.…”

“…IIDs are also used in chronic conditions of the bowels19–21 (eg, Crohn’s disease, ulcerated colitis, diverticulitis) as well as for antirejection therapy22 when organ transplants or grafts have been used as they suppress the autoimmune destruction. These medicines are important because they provide a lifeline towards functional mobility and improves the quality of life23 24 for patients by relieving their pain as well as retarding disease progression.…”