Iranian Journal of Colorectal Research
Volume:10 Issue: 3, Sep 2022

Inflammation, even overt or subtle, has an important role in the pathogenesis of various diseases. Hemogram derived markers are novel inflammatory predictors and have been studied by the authors in different settings, including gastrointestinal conditions. Of those, mostly used indices are mean platelet volume (MPV), red cell distribution width (RDW), neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio. Besides the well-established roles of these markers in various hematological issues, including differentiating anemia, platelet activation and infections, recent literature suggest that they could be associated with the inflammatory burden in gastrointestinal conditions from inflammatory disease to functional disorders and malignancies. In present work, we aimed to review the literature to reveal the association between these markers and gastrointestinal diseases to establish their diagnostic and prognostic role in disorders of the gastrointestinal system. In present work, we aimed to review the literature to reveal the association between these markers and gastrointestinal diseases to establish their diagnostic and prognostic role in disorders of the gastrointestinal system.

Pilonidal sinus disease (PSD) describes an inflammation of the subcutaneous fatty tissue causing a pilonidal sinus which can lead to pus collection and tenderness. The study objective was to investigate the relationship between serum hormones, PSD and associated factors in patients referring to Khalij Fars hospital in Bushehr city, Iran in 2017.

A cross-sectional study consisted of 50 patients with pilonidal sinus disease who underwent surgery in Khalij Fars hospital in Bushehr city, Iran between February and May 2017 was conducted. The patients with SPD who consented to participate in the study were enrolled in the research and subjected to review their physical signs and medical history. Hormone levels (including the serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone, dehydroepiandrosterone (DHEA), and prolactin) were measured.

The level of sex hormones in female patients was significantly higher in comparison with males except for testosterone (3.9±1.73 in male; 0.35±0.17 in females). The frequency of patients with normal serum levels of LH, testosterone, and prolactin was higher in females than those in the male group, whereas the rate of those with normal levels of FSH, DHEAS, and Prolactin in male patient group was higher, compared with the female group (P<0.05).

As there are a few studies conducted on hormonal status of patients with pilonidal sinus by genders, we conducted the current study, to compare serum levels between male and female patients. Raised serum prolactin, LH, and testosterone levels in women might be contributed to increasing androgen levels and causing excessive hair growth/ hirsutism.

Lichen planus (LP) is an immune-mediated inflammatory disease affecting the skin, nails, and mucous membranes. Its etiology remains unknown, but there are several well-recognized trigger factors, including viral and bacterial antigens, as well as drugs and metals. The prevalence of hepatitis C virus (HCV) infection is the highest among patients with LP. It has been suggested that HCV may contribute to the development of LP, but the relationship between the two is not fully understood. It is still controversial whether HCV leads to LP directly through replication within infected cells or indirectly through the activation of immunological mechanisms. Molecular studies have identified HCV RNA in samples from patients with LP. An autoimmune theory has also been proposed, given that several studies have identified viral replication and activation of the immune response associated with the synthesis of autoantibodies.

We present a clinical case of a rare morphological form of LP against the background of HCV, clearly illustrating the relationship between these diseases.

The study of the relationship between LP and HCV is necessary to understand the pathogenesis of LP, since this dermatosis is an urgent problem in modern dermato-venerology. Apparently, skin lesions result from an immune response to viral components and are not a direct result of HCV.

Robotic surgery has gone beyond the investigational stage and is now currently being used as the minimally invasive surgery of choice in different disciplines mainly gynecological surgery, urologic surgery and some colorectal surgery procedures. knowing that robotic devices are being continuously evolved and studied, it is expected to be widely disseminated as they become less and less expensive. As robotic surgery grows and disseminate, it is important to keep track of the true incidence of complications, being it related to the system itself or being it related to the known traditional postoperative complication that usually occur after traditional surgery or other minimally invasive modalities. Hence, transparency in reporting such complications is of utmost importance to ensure continued safe innovation and in addition informing patients seeking surgical care about these possible complications. Herein, we report a case of closed loop small bowel obstruction 1 year post robotic hysterectomy done for benign disease.

Background Despite the low incidence rate, ureteral injuries can lead to significant morbidity. Urinary organs can be injured during open or laparoscopic surgery. This study aimed to assess whether a ureteral injury exists between laparoscopic and open surgery over 20 years in Shiraz. Methods This is a retrospective study and 779 patients of rectal cancer were evaluated in Shiraz from 2000 to 2021 by collecting data from the patients’ electronic charts. We evaluated the type of surgery, gender, age, body mass index (BMI), stage, appearance and size of the tumor, preoperative (chemo)-radio-therapy, recurrence, and metastasis. Ureteral injury was analyzed and urinary incontinence was recorded.Results A total number of 131 (22.2%) in laparoscopy surgeries and 42 (30.6%) in laparotomy surgeries had abdominoperineal (A-P) resection. The total number of 254 (43%) in laparoscopy surgeries and 61 (44.5%) of patients had low anterior resection in laparotomy surgeries. The incidence of ureteral injuries was 2.2% for open procedures and 1.5% for laparoscopic and 2.2% for conversion procedures. The rate of urinary incontinence was 65 (11.0%) in laparoscopy and 9 (6.6%) in laparotomy group. Conclusion It is concluded that the ureteral injury after laparotomy is more than laparoscopic surgeries. Although the number of side effects of these surgeries is low, it can be concluded that the possibility of damage to the ureter is less in laparoscopic surgery and that of damage to the nerves of the pelvic floor is more.

 Diffuse cavernous haemangioma of rectum (DCHR) is rare in clinical practice. Rarely, DCHR may be associated with Klippel-Trenaunay syndrome and are commonly misdiagnosed, and treated as hemorrhoids. The usual presentation is with painless bleeding per rectum. Despite many diagnostic modalities available today, the correct diagnosis is difficult to arrive at. Although the management of these cases has evolved over years, it still remains a challenge for the surgeons because of the nature and extent of involvement and risk of bleeding during the surgery. The advocated surgical interventions vary from abdomino-perineal resection (APR) to sphincter preserving surgery. Recently, transarterial embolization (TAE) has been found to be useful as a nonsurgical method of treatment in select cases of DCHR. DCHR with extension upto dentate line in young patients can be managed by sphincter preserving surgery with the advent of modern staplers, avoiding the abdominoperineal resection and a permanent stoma. We present two cases of this rare entity, DCHR, managed in our department by ultralow anterior resection with stapled anastomosis, with a review of the literature emphasizing on management.

Background:

 Villous adenoma polyps are mostly considered to associate with a high risk for colorectal cancer (CRC) development. Hippo signaling pathway role have been investigated in CRC by regulating cell proliferation and apoptosis, however, the role of this pathway in different adenoma polyps and its relationship to CRC development is not fully discovered yet.

Quantitative real-time polymerase chain reaction (qRT-PCR) was used to examine the mRNA expression levels of, YAP, TAZ, TEAD1 in 30 pairs of villous adenomas polyps’ tissues, and adjacent normal tissues. In addition, the correlation between clinicopathologic features and the YAP, TAZ, and TEAD1 expression in villous adenoma polyps’ patients and ROC curve analyses were evaluated in this study.

The mRNA expression levels of YAP, TAZ, and TEAD were found to be overexpressed in villous adenoma polyps’ tissues compared to adjacent normal tissues (**P < 0.01, ****P <0.0001). statistical analysis showed that the expression levels of YAP, TAZ, and TEAD were associated with lymph node metastasis while only TAZ was associated with the TNM stage (I-II). Moreover, YAP, TAZ, and TEAD may have the potential to distinguish villous adenoma polyps from the adjacent normal tissues by the large area under the ROC curve (0.74, 0.70, 0.68, respectively).

Our study highlights that the upregulation of YAP, TAZ, and TEAD genes in the Hippo pathway can affect the progression of villous adenoma polyps to CRC and can be a potential target for further investigation of a novel biomarker for patients with villous adenoma polyps.