Iranian Journal of Colorectal Research
Volume:2 Issue: 3, Sep 2014

Anal fissure is a painful tear or crack in the distal part of anal canal. It usually involves the epithelium, but in the long term it may extend to the whole anal mucosa. Platelet Lysate (PL) hydrogel is a hemoderivitive pharmaceutical formulation that contains plenty of growth factors. These growth factors can induce tissue regeneration and revascularization as well as fibroblast proliferation.. This study aimed to evaluate the effectiveness of PL hydrogel in the treatment of the anal fissure or retardation of its development..Patients and The patients with chronic and acute anal fissure were randomly divided into groups of A and B. Group A received PL hydrogel and Rectol, while group B received placebo and Rectol. Then, they were followed and evaluated for two weeks.. Although it was anticipated that platelet growth factors would be effective in anal fissure healing process, no significant difference was observed between the control group and the case group after the treatment. Nevertheless, a significant difference was observed within the two groups after the treatment.. PL hydrogel does not seem to have beneficial effects compared to the placebo or Rectol on the healing of anal fissure..

Abdominoperineal resection (APR) along with permanent colostomy is the standard method of low rectal cancer operation and resection. The laparoscopic APR provides better visualization of pelvic structures compared to the open approach. Disadvantages of the laparoscopic approach have been reported as longer operation duration and requirement of expensive equipment Although this issue has been investigated extensively worldwide, data is limited from Iran.. The aim of this study was to compare short-term outcome of Laparoscopic Abdominoperineal Resection (APR) with open APR in patients with low rectal cancer in Shiraz, southern Iran..Patients and This was a non-randomized controlled trial study performed in Shahid Faghihi Hospital affiliated to Shiraz University of Medical Sciences from 2007 to 2012. We included all patients with rectal cancer who underwent laparoscopic or open APR with permanent colostomy. Both groups were evaluated regarding oncology results. Volume of intraoperative bleeding, short-term complications, operation to diet interval and duration of hospitalization were recorded and further compared between the laparoscopy and open APR groups.. Overall, 24 patients were included in this study of whom 11 underwent laparoscopy and 13 underwent open APR. The two study groups were comparable regarding age (P = 0.747), gender (P = 0.605), tumor stage (P = 0.116), tumor histopathology grade (P = 0.421) and distance from the anal verge (P = 0.711). The duration of operation was comparable between the groups (P = 0.336). Those who underwent laparoscopy had significantly lower intraoperative bleeding (485.5 ± 139.8 vs. 658.3 ± 183.2; P = 0.024), shorter operation-diet interval (2.27 ± 0.46 vs. 3.15 ± 0.37; P < 0.001) and shorter duration of hospitalization compared to the open APR group (4.09 ± 0.53 vs. 4.76 ± 0.59; P = 0.008).. Laparoscopic APR is associated with minimal perioperative bleeding, shorter operation-diet interval and shorter durations of hospitalization compared to open approach in patients with low rectal cancer who had not received neoadjuvant chemo radiotherapy. Oncologic results in this operation were comprisable to open procedure because the mesorectal, anus and sphincter complex excision are performed in the same method.. Therefore, laparoscopy could be the method of choice for APR..

Diarrheal disease is still a health problem, especially in developing countries, where it is considered one of the foremost causes of death in children, accounting for approximately two million deaths annually worldwide. Enteroinvasive Escherichia coli (EIEC) is known to cause shigellosis-like symptoms in both adults and children.. The aim of this study was to identify EIEC in children with diarrhea using Real-time PCR assays in Shiraz, Iran..Patients and A total of 285 stool samples were collected from patients with diarrhea in Shiraz, in 2012. Diarrheagenic E. coli (DEC) strains were isolated by standard biochemical analysis. We used Real time PCR and PCR to detect the presence of ipaH gene in EIEC. Susceptibility testing to 18 antimicrobial agents was determined by diffusion methods according to clinical and laboratory standards institute (CLSI, 2011) guidelines.. In total, 285 stool samples were tested in which 49 (17%) were contaminated with E. coli by biochemical tests. In the present study, EIEC was detected in seven (14.3%) children with diarrhea. Of seven patients, five children were younger than 12 months and two were 13-24 months old. In total, four EIEC strains were isolated from watery diarrhea and three EIEC strains from bloody diarrhea. In the present study, EIEC strain exhibited high frequency of drug resistance to penicillin (100%), trimethoprim/sulfamethoxazole (71%) and tetracycline (71%).. We reported the first study performed in Shiraz to identify EIEC intestinal pathogens in children with diarrhea. This type of pathogen should be considered when designing preventive strategies for children in Iran..

Appendiceal Neoplasms are relatively uncommon. Although Carcinoid tumor is the most prevalent tumor of appendix, mucinous tumors and metastatic tumors can also be identified in appendectomy specimens after careful pathologic examination.. The main goal of this study is the evaluation of appendectomy specimens for appendiceal neoplasms and subsequent subtyping of those tumors.. Retrospective assessment of 4800 appendectomy specimens, performed from 2010 to 2014, was done. The specimens were collected from Namazee and Faghihi hospitals, affiliated to Shiraz University of Medical Sciences. The clinical and histopathologic data were collected and analyzed by satisfactory statistical methods.. The age of patients was 32 years with a male to female ratio of 3:1. The overall incidence of appendiceal neoplasms was 86 in 4800 specimens (1.8%). The most common neoplasm was carcinoid tumor. Others reported tumors were mucinous cyst adenoma, mucocele, mucinous adenocarcinoma, leukemic infiltration, and a case of appendiceal involvement by bladder transitional cell carcinoma.. Although appendiceal tumors are not as prevalent as colon cancer, careful examination of appendectomy specimens can identify neoplastic processes. Beyond carcinoid tumors and mucinous neoplasms, leukemia lymphoma and other metastatic tumors can involve the appendix..

One of unexpected and incidental pathologic reports in endoscopy is Gastrointestinal Stromal Tumor (GIST) with an incidence of 1.5/100000 annually and incidental pathologic finding during bariatric surgery as around 2% herein.. We reported a 45-year-old female with morbid obesity for five years scheduled for laparoscopic sleeve gastrectomy. During the operation, no mass was detected and postoperative pathology reported a GIST with positive report of CD117 and negative for S100.. Laparoscopic resection of early stage gastric GIST is a useful approach and has become a proper technique in the recent years..

This report represents successful treatment of a seven-year-old boy with megarectum, who complained of intractable constipation and encopresis, by vertical reduction rectoplasty..