Journal/Magazine Articles
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This collection contains original research articles, review articles and case reports published in local and international peer reviewed journals by the staff members of the Faculty of Medicine
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Item Technical variations and feasibility of transanal ileal pouch-anal anastomosis for ulcerative colitis and inflammatory bowel disease unclassified across continents.(Springer-Verlag, 2018) Zaghiyan, K.; Warusavitarne, J.; Spinelli, A.; Chandrasinghe, P.; Di Candido, F.; Fleshner, P.PURPOSE: Initial reports of transanal ileal pouch-anal anastomosis (taIPAA) suggest safety and feasibility compared with transabdominal IPAA. The purpose of this study was to evaluate differences in technique and results of taIPAA in three centers performing taIPAA across two continents. METHODS: Prospective IPAA registries from three institutions in the US and Europe were queried for patients undergoing taIPAA. Demographic, preoperative, intraoperative, and postoperative data were compiled into a single database and evaluated. RESULTS: Sixty-two patients (median age 38 years; range 16-68 years, 43 (69%) male) underwent taIPAA in the three centers (USA 24, UK 23, Italy 15). Most patients had had a subtotal colectomy before taIPAA [n = 55 (89%)]. Median surgical time was 266 min (range 180-576 min) and blood loss 100 ml (range 10-500 ml). Technical variations across the three institutions included proctectomy plane of dissection (intramesorectal or total mesorectal excision plane), specimen extraction site (future ileostomy site vs. anus), ileo-anal anastomosis technique (stapled vs. hand sewn) and use of fluorescence angiography. Despite technical differences, anastomotic leak rates (5/62; 8%) and overall complications (18/62; 29%) were acceptable across the three centers. CONCLUSIONS: This is the first collaborative report showing safety and feasibility of taIPAA. Despite technical variations, outcomes are similar across centers. A large multi-institutional, international IPAA collaborative is needed to compare technical factors and outcomes.Item Asia Pacific Association of Gastroenterology Working Group on Inflammatory Bowel Disease.The Asia-Pacific consensus on ulcerative colitis.(Wiley-Blackwell, 2010) Ooi, C.J.; Fock, K.M.; Makharia, G.K.; Goh, K.L.; Ling, K.L.; Hilmi, I.; Lim, W.C.; Kelvin, T.; Gibson, P.R.; Gearry, R.B.; Ouyang, Q.; Sollano, J.; Manatsathit, S.; Rerknimitr, R.; Wei, S.C.; Leung, W.K.; de Silva, H.J.; Leong, R.W.Item Is Endoscopic examination alone adequate in determining the extent of disease in ulcerative colitis?(College of Surgeons of Sri Lanka, 2006) Mahendra, B.A.G.G.BACKGROUND : Endoscopic and histological examination of the mucosa are the mainstay in the diagnosis of ulcerative colitis. Assessing the extent of disease is important in the management of these patients. Sometimes an endoscopic examination alone is performed without biopsy and histological examination. OBJECTIVE: To compare the extent of disease in ulcerative colitis as assessed endoscopically versus that determined histologically. METHOD: 41 patients with ulcerative colitis were identified. In each of these patients endoscopy was performed and the appearance was recorded. In each patient 1-6 mucosal biopsies (mean - 3.2) were obtained for histological evaluation. A total of 136 biopsies were examined histologically and compared with the endoscopic appearance of the corresponding area of the bowel. The sensitivity of endoscopy in detecting the presence of true inflammation was also studied for the different regions of the bowel. RESULTS: 125 biopsies showed histological involvement. The endoscopy and histology were both positive in 68. The endoscopy was negative whilst the histology was positive in 57 biopsies. Endoscopy and histology were both negative in 10 biopsies and endoscopy alone was positive in only one biopsy.The kappa value of agreement was 0.136 denoting poor agreement between endoscopy and histology.Endoscopic examination had a high sensitivity in detecting proctitis. When more proximal regions of the bowel were biopsied, the sensitivity of endoscopic examination in detecting histological inflammation gradually declined. CONCLUSION: Since endoscopy and histology show poor agreement it is recommended that both should be performed to assess the true extent of disease in ulcerative colitis.Item Management of ulcerative colitis(State Pharmaceuticals Corporation, 1998) de Silva, H.J.; Seneviratne, S.L.No abstract availableItem An Appendiceal skips lesion in ulcerative colitis,(VC)(Sri Lanka Medical Association, 1998) Hewavisenthi, S.J.de S.; Deen, K.I.Report to create awareness that skip lesions may occur even in ulcerative colitis (VC).Item Optimum dose of olsalazine for maintaining remission in ulcerative colitis(British Medical Assosiation, 1994) Travis, S.P.L.; Tysk, C.; de Silva, H.J.; Sandberg-Gertzen, H.; Jewell, D.P.; Jarnerot, G.To evaluate the optimum dose of olsalazine for maintaining remission in ulcerative colitis, 198 patients in remission for more than three months were randomly assigned to receive 0.5 g, 1.0 g, or 2.0 g/day for 12 months. A dose-ranging effect was detected in the per protocol analysis, with remission rates of 60% (0.5 g), 70% (1.0 g), and 78% (2.0 g) (p = 0.03, trend in proportions). The higher dose was most effective in patients with proctitis (90% remission on 2 g/day, p = 0.03) or those in remission for less than 12 months before the trial (88% remission on 2 g/day, p = 0.0006). There was little dose-ranging effect in patients with extensive colitis or those in remission for more than 12 months. Diarrhoea necessitated treatment withdrawal in 12%. The optimal dose of olsalazine for maintaining remission in ulcerative colitis is 1 g/day. For patients with proctitis or recent relapse, 2 g/day may be preferable, although the dose seems to be less important in patients with more extensive disease or those in long term remissionItem Cytokine production by human colonic intraepithelial lymphocytes in controls and ulcerative colitis(Hindawi Publishing Cooperation, 1994) Hoang, P.; Dalton, H.R.; de Silva, H.J.; Jewell, D.P.Using an ELISA technique, concentrations of gamma-interferon and interleukin-2 were assayed in the supernatants of colonic intraepithelial lymphocytes cultured with or without phytohaemagglutinin (PHA). IntraepitheHal lymphocytes produced low concentrations of gamma-interferon and interleukin-2 when stimulated with PHA, but significantly more than when unstimulated (p < 0.05). There was no difference in production of these cytokines by IEL from control or inflammatory bowel disease.Item The Traeatment of ulcerative colitis : from cure to a new disease(Sri Lanka Medical Association, 1994) de Silva, H.J.