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Garfinkle R, Wong-Chong N, Petrucci A, Sylla P, Wexner SD, Bhatnagar S, Morin N, Boutros M. Assessing the readability, quality and accuracy of online health information for patients with low anterior resection syndrome following surgery for rectal cancer. Colorectal Dis 2019; 21:523-531. [PMID: 30609222 DOI: 10.1111/codi.14548] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/17/2018] [Indexed: 02/08/2023]
Abstract
AIM Management of low anterior resection syndrome (LARS) requires a high degree of patient engagement. This process may be facilitated by online health-related information and education. The aim of this study was to systematically review current online health information on LARS. METHOD An online search of Google, Yahoo and Bing was performed using the search terms 'low anterior/anterior resection syndrome' and 'bowel function/movements after rectal cancer surgery'. Websites were assessed for readability (eight standardized tests), suitability (using the Suitability Assessment of Materials instrument), quality (the DISCERN instrument), accuracy and content (using a LARS-specific content checklist). Websites were categorized as academic, governmental, nonprofit or private. RESULTS Of 117 unique websites, 25 met the inclusion criteria. The median readability level was 10.4 (9.2-11.7) and 11 (44.0%) websites were highly suitable. Using the DISCERN instrument, seven (28.0%) websites had clear aims, two (8.0%) divulged the sources used and four (16.0%) had high overall quality. Only eight (32.0%) websites defined LARS and ten (40.0%) listed all five major symptoms associated with the LARS score. There was variation in the number of websites that discussed dietary modifications (80.0%), self-help strategies (72.0%), medication (68.0%), pelvic floor rehabilitation (60.0%) and neuromodulation (8.0%). The median accuracy of websites was 93.8% (88.2-96.7%). Governmental websites scored highest for overall suitability (P = 0.0079) and quality (P < 0.001). CONCLUSIONS Current online information on LARS is suboptimal. Websites are highly variable, important content is often lacking and material is too complex for patients.
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Affiliation(s)
- R Garfinkle
- Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - N Wong-Chong
- Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - A Petrucci
- Division of General Surgery, Hôpital Cité de la Santé, Montreal, Quebec, Canada
| | - P Sylla
- Division of Colorectal Surgery, Mount Sinai Hospital and School of Medicine, New York, New York, USA
| | - S D Wexner
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, USA
| | - S Bhatnagar
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - N Morin
- Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - M Boutros
- Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, Quebec, Canada
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Wong-Chong N, Caycedo-Marulanda A. Transanal total mesorectal excision with retro-ileal colorectal anastomosis: combining old and new techniques. Colorectal Dis 2018; 20:642-643. [PMID: 29704431 DOI: 10.1111/codi.14242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 03/05/2018] [Indexed: 02/08/2023]
Affiliation(s)
- N Wong-Chong
- Division of Colon and Rectal Surgery, McGill University, Montreal, Quebec, Canada
| | - A Caycedo-Marulanda
- Division of Colon and Rectal Surgery, Health Sciences North, Sudbury, Ontario, Canada
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Zittan E, Ma GW, Wong-Chong N, Milgrom R, McLeod RS, Silverberg M, Cohen Z. Ileal pouch-anal anastomosis for ulcerative colitis: a Canadian institution's experience. Int J Colorectal Dis 2017; 32:281-285. [PMID: 27704203 DOI: 10.1007/s00384-016-2670-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/21/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND We aimed to summarize the outcomes of ulcerative colitis (UC) patients receiving an ileal pouch-anal anastamosis (IPAA) over an 11-year period at a high-volume Canadian inflammatory bowel disease (IBD) center. METHODS A retrospective chart review was performed for subjects with UC who underwent IPAA between 2002 and 2013. Patient charts were reviewed for demographic data, clinical characteristics, preoperative medical treatment, and surgical outcomes. Univariate and multivariate logistic regression modeling were used to determine significant factors in postoperative outcomes. RESULTS Seven hundred fifty-eight were included from the IBD database. The median age at the time of surgery was 37.1 (±12.1). Mean preoperative disease duration was 8.1 years (±8.7). Three hundred sixty-nine patients (48.7 %) had systemic corticosteroids (>15 mg/day) within 30 days prior to surgery. Of these, 286 patients had high dose (>30 mg/day) corticosteroids within 7 days of their first surgery. One hundred nine (14.0 %) IPAA procedures were performed laparoscopically. Pelvic pouches were created in traditional 2 (n = 460) and 3 (n = 285) stages; the remainder (n = 13) was performed in non-traditional staged operations. Early complications, defined as occurring within the same stay in hospital, consisted of pelvic abscess (n = 135, 17.8 %), small bowel obstruction (n = 134, 17.7 %), wound infection (n = 108, 14.3 %), and deep vein thrombosis (n = 33, 4.4 %). The overall pouch leak rate was 92 (12.1 %). There was one death in our study. The median length of stay was 10.3 days (SD6.0). Late complications, defined as occurring after discharge from hospital, consisted of anal stricture (n = 55, 7.3 %), pouch fistula (n = 26, 3.4 %), and functional pouch failure (n = 7, 0.9 %). CONCLUSIONS IPAA has been found to be a safe and effective method of surgical management of UC patients in a high-volume IBD center.
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Affiliation(s)
- E Zittan
- Division of Gastroenterology, University of Toronto, Toronto, Canada.,Zane Cohen Centre for Digestive Disease, Mount Sinai Hospital, Toronto, Canada
| | - Grace W Ma
- Division of General Surgery, University of Toronto, Toronto, Canada. .,Division of General Surgery, Mount Sinai Hospital, Unit 451, 600 University Avenue, Toronto, ON, M5G 1X5, Canada.
| | - N Wong-Chong
- Division of General Surgery, University of Toronto, Toronto, Canada.,Division of General Surgery, Mount Sinai Hospital, Unit 451, 600 University Avenue, Toronto, ON, M5G 1X5, Canada
| | - R Milgrom
- Division of Gastroenterology, University of Toronto, Toronto, Canada.,Zane Cohen Centre for Digestive Disease, Mount Sinai Hospital, Toronto, Canada
| | - R S McLeod
- Division of General Surgery, University of Toronto, Toronto, Canada.,Division of General Surgery, Mount Sinai Hospital, Unit 451, 600 University Avenue, Toronto, ON, M5G 1X5, Canada
| | - M Silverberg
- Division of Gastroenterology, University of Toronto, Toronto, Canada.,Zane Cohen Centre for Digestive Disease, Mount Sinai Hospital, Toronto, Canada
| | - Z Cohen
- Division of General Surgery, University of Toronto, Toronto, Canada.,Division of General Surgery, Mount Sinai Hospital, Unit 451, 600 University Avenue, Toronto, ON, M5G 1X5, Canada
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