Ulcerative colitis severity classification. Adapted from Truelove and Witts criteria.
\\n\\n
IntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\\n\\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\\n\\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\\n\\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\\n\\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\\n\\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\\n\\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\\n\\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\\n\\nFeel free to share this news on social media and help us mark this memorable moment!
\\n\\n\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/237"}},components:[{type:"htmlEditorComponent",content:'
After years of being acknowledged as the world's leading publisher of Open Access books, today, we are proud to announce we’ve successfully launched a portfolio of Open Science journals covering rapidly expanding areas of interdisciplinary research.
\n\n\n\nIntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\n\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\n\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\n\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\n\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\n\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\n\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\n\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\n\nFeel free to share this news on social media and help us mark this memorable moment!
\n\n\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"5448",leadTitle:null,fullTitle:"Recent Advances in Carbon Capture and Storage",title:"Recent Advances in Carbon Capture and Storage",subtitle:null,reviewType:"peer-reviewed",abstract:"Carbon capture and storage (CCS) has been considered as a practical way in sequestering the huge anthropogenic CO2 amount with a reasonable cost until a more pragmatic solution appears. The CCS can work as a bridge before fulfilling the no-CO2 era of the future by applying to large-scale CO2 emitting facilities. But CCS appears to lose some passion by the lack of progress in technical developments and in commercial success stories other than EOR. This is the time to go back to basics, starting from finding a solution in small steps. The CCS technology desperately needs far newer ideas and breakthroughs that can overcome earlier attempts through improving, modifying, and switching the known principles. This book tries to give some insight into developing an urgently needed technical breakthrough through the recent advances in CCS research, in addition to the available small steps like soil carbon sequestration. This book provides the fundamental and practical information for researchers and graduate students who want to review the current technical status and to bring in new ideas to the conventional CCS technologies.",isbn:"978-953-51-3006-2",printIsbn:"978-953-51-3005-5",pdfIsbn:"978-953-51-6697-9",doi:"10.5772/62966",price:119,priceEur:129,priceUsd:155,slug:"recent-advances-in-carbon-capture-and-storage",numberOfPages:266,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"128901fc967a8eb538f277c98fd917e3",bookSignature:"Yongseung Yun",publishedDate:"March 8th 2017",coverURL:"https://cdn.intechopen.com/books/images_new/5448.jpg",numberOfDownloads:26544,numberOfWosCitations:42,numberOfCrossrefCitations:21,numberOfCrossrefCitationsByBook:2,numberOfDimensionsCitations:68,numberOfDimensionsCitationsByBook:2,hasAltmetrics:1,numberOfTotalCitations:131,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 12th 2016",dateEndSecondStepPublish:"May 3rd 2016",dateEndThirdStepPublish:"August 7th 2016",dateEndFourthStepPublish:"November 5th 2016",dateEndFifthStepPublish:"December 5th 2016",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"144925",title:"Dr.",name:"Yongseung",middleName:null,surname:"Yun",slug:"yongseung-yun",fullName:"Yongseung Yun",profilePictureURL:"https://mts.intechopen.com/storage/users/144925/images/system/144925.jpg",biography:"Dr. Yongseung Yun majored in Chemical Engineering and received his Ph.D. degree at the University of Utah, USA, in 1990. He obtained his M.A. from KAIST, Korea, in 1981 and his B.A. from the Yonsei University, Korea, in 1979. He currently works as vice president at the Institute for Advanced Engineering in Korea.\nHe has been working on gasification technology development since 1994, starting from coal gasification to municipal solid wastes gasification, and petroleum coke gasification. He currently heads the 25 ton/day gasification project in Korea to produce blue hydrogen. He has worked as the president of KAWET from 2013 to 2019 and has been the vice president of the Korea DME Association since 2008. Dr. Yun has also served as the editor for the Korean Industrial Chemistry News of KSIEC from 2009 to 2016.",institutionString:"Institute for Advanced Engineering",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"4",institution:{name:"Institute for Advanced Engineering",institutionURL:null,country:{name:"Korea, South"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"788",title:"Hydropower Engineering",slug:"hydropower-engineering"}],chapters:[{id:"53646",title:"Development of a State-of-the-Art Dry Low NOx Gas Turbine Combustor for IGCC with CCS",doi:"10.5772/66742",slug:"development-of-a-state-of-the-art-dry-low-nox-gas-turbine-combustor-for-igcc-with-ccs",totalDownloads:2239,totalCrossrefCites:4,totalDimensionsCites:8,hasAltmetrics:0,abstract:"The successful development of the coal-based integrated gasification combined cycle (IGCC) with carbon capture and storage (CCS) requires gas turbines capable of achieving dry low nitrogen oxide (NOx) combustion of hydrogen-rich syngas fuels for low emissions and high plant efficiency. This chapter describes the development of a “multi-cluster combustor” as a state-of-the-art dry low NOx combustor for hydrogen-rich syngas fuels. The combustor consists of multiple clusters of pairs of one fuel nozzle and one air hole that are installed coaxially. The essence of the design concept is the integration of two key technologies: rapid mixing of fuel and air for low NOx and flame lifting for flashback-resistant combustion. The combustor has been developed in three steps: burner development, combustor development, and feasibility demonstration for practical plants. The combustor was tested with a practical syngas fuel in a multi-can combustor configuration in an IGCC pilot plant in the final step. The combustor achieved the dry low NOx combustion of the syngas fuel in the pilot plant and the test results demonstrated the feasibility for achieving dry low NOx combustion of the syngas fuel in practical plants.",signatures:"Tomohiro Asai, Yasuhiro Akiyama and Satoschi Dodo",downloadPdfUrl:"/chapter/pdf-download/53646",previewPdfUrl:"/chapter/pdf-preview/53646",authors:[{id:"189146",title:"Dr.",name:"Tomohiro",surname:"Asai",slug:"tomohiro-asai",fullName:"Tomohiro Asai"},{id:"194813",title:"MSc.",name:"Yasuhiro",surname:"Akiyama",slug:"yasuhiro-akiyama",fullName:"Yasuhiro Akiyama"},{id:"194814",title:"MSc.",name:"Satoschi",surname:"Dodo",slug:"satoschi-dodo",fullName:"Satoschi Dodo"}],corrections:null},{id:"54027",title:"Modeling and Evaluation of a Coal Power Plant with Biomass Cofiring and CO2 Capture",doi:"10.5772/67188",slug:"modeling-and-evaluation-of-a-coal-power-plant-with-biomass-cofiring-and-co2-capture",totalDownloads:2123,totalCrossrefCites:2,totalDimensionsCites:5,hasAltmetrics:0,abstract:"Coal-fired power plants are the largest source of anthropogenic carbon dioxide (CO2) emissions into the atmosphere, with more than 9.5 billion tonnes of CO2 emitted annually. In order to mitigate the emissions of CO2 from coal-fired plants, several measures were proposed, such as increasing the efficiency of the plants, cofiring biomass with coal, and capturing and storing CO2 deep underground. Among these measures, the use of biomass, which is considered one of the most cost-effective renewables and, in addition, carbon neutral, combined with CO2 capture and storage will play an important role toward reducing the fossil-based CO2 emissions. In this study, we investigated in detail the performances of pulverized coal combustion plants with direct cofiring of biomass and integrated with an amine-based postcombustion capture technology. All the systems were modeled and simulated using the process simulation software Aspen Plus. The results indicate that cofiring 10% of biomass in a coal-based power plant only slightly affects the energy performance of the plant, reducing the net efficiency by 0.3% points. The addition of an amine capture system to both the coal-fired and biomass cofiring plants further reduces the efficiency of the plants by more than 10% points. Analyzing the effect of various CO2 capture process parameters on the heat, solvent and cooling water requirements, and on the overall plant performance, it was found that the concentration of amine in the solution is the most important parameter. The results showed that the net electrical efficiency increases for systems using higher amine concentrations. Further, we investigated the effect of systems with lower heat requirement for solvent regeneration on the plant gross/net power output and also analyzed the plant performances under a flexible CO2 capture efficiency.",signatures:"Dumitru Cebrucean, Viorica Cebrucean and Ioana Ionel",downloadPdfUrl:"/chapter/pdf-download/54027",previewPdfUrl:"/chapter/pdf-preview/54027",authors:[{id:"172806",title:"Dr.",name:"Dumitru",surname:"Cebrucean",slug:"dumitru-cebrucean",fullName:"Dumitru Cebrucean"},{id:"172808",title:"Dr.",name:"Viorica",surname:"Cebrucean",slug:"viorica-cebrucean",fullName:"Viorica Cebrucean"},{id:"172884",title:"Prof.",name:"Ioana",surname:"Ionel",slug:"ioana-ionel",fullName:"Ioana Ionel"}],corrections:null},{id:"53169",title:"Membrane Separation Technology in Carbon Capture",doi:"10.5772/65723",slug:"membrane-separation-technology-in-carbon-capture",totalDownloads:4040,totalCrossrefCites:9,totalDimensionsCites:28,hasAltmetrics:1,abstract:"This chapter introduces the basics of membrane technology and the application of membrane separation in carbon capture processes. A number of membranes applicable in pre-combustion, post-combustion or oxy-fuel combustion have been discussed. An economic comparison between conventional amine-based absorption and membrane separation demonstrates the great potential in membrane technology.",signatures:"Guozhao Ji and Ming Zhao",downloadPdfUrl:"/chapter/pdf-download/53169",previewPdfUrl:"/chapter/pdf-preview/53169",authors:[{id:"190003",title:"Associate Prof.",name:"Ming",surname:"Zhao",slug:"ming-zhao",fullName:"Ming Zhao"},{id:"190139",title:"Dr.",name:"Guozhao",surname:"Ji",slug:"guozhao-ji",fullName:"Guozhao Ji"}],corrections:null},{id:"52867",title:"Emerging New Types of Absorbents for Postcombustion Carbon Capture",doi:"10.5772/65739",slug:"emerging-new-types-of-absorbents-for-postcombustion-carbon-capture",totalDownloads:2553,totalCrossrefCites:1,totalDimensionsCites:8,hasAltmetrics:0,abstract:"Carbon capture is the most probable technology in combating anthropogenic increase of CO2 in the atmosphere. Works on developing emerging absorbents for improving carbon capture performance and reducing process energy consumption are actively going on. The most worked‐on emerging absorbents, including liquid‐liquid biphasic, liquid‐solid biphasic, enzymatic, and encapsulated absorbents, already show encouraging results in improved energy efficiency, enhanced CO2 absorption kinetics, increased cyclic CO2 loading, or reduced regeneration temperature. In this chapter, the latest research and development progress of these emerging absorbents are reviewed along with the future directions in moving these technologies to higher‐technology readiness levels.",signatures:"Quan Zhuang, Bruce Clements and Bingyun Li",downloadPdfUrl:"/chapter/pdf-download/52867",previewPdfUrl:"/chapter/pdf-preview/52867",authors:[{id:"189578",title:"Dr.",name:"Quan",surname:"Zhuang",slug:"quan-zhuang",fullName:"Quan Zhuang"},{id:"195678",title:"Dr.",name:"Bruce",surname:"Clements",slug:"bruce-clements",fullName:"Bruce Clements"},{id:"195679",title:"Dr.",name:"Bingyun",surname:"Li",slug:"bingyun-li",fullName:"Bingyun Li"}],corrections:null},{id:"52853",title:"Bio-inspired Systems for Carbon Dioxide Capture, Sequestration and Utilization",doi:"10.5772/65861",slug:"bio-inspired-systems-for-carbon-dioxide-capture-sequestration-and-utilization",totalDownloads:2153,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"This chapter reviews the study and development of biological, enzymatic and bio-molecular systems for carbon dioxide capture and further sequestration or even utilization. Regardless of the interest on the use of the captured CO2 as C1 synthon on the manufacture of added-value compounds, there is a tremendous unbalance between the requirements of the contemporary society (leading to a massive production of carbon dioxide) and the framework of commercialization of the products from CO2 utilization. In this context, viable options are storage as a solid in the form of calcium or magnesium carbonate and conversion into other energetic frameworks. In addition, it is important to highlight that the conventional energy resources are progressively being replaced by renewable resources. While the change in energetic paradigm is not accomplished, systems that capture and convert carbon dioxide are highly sought. To this end, bio-inspired systems will be presented, starting from the use of compounds from the chiral pool, such as amino acids, saccharides and related bio-polymers, involved in the physical and chemical capture, sequestration and/or utilization of CO2. Additionally, enzymatic systems are presented in the context of sequestration of CO2 in the form of solid carbonates or even utilization of this C1 synthon in the preparation of fuels and commodity chemicals. Carbonic anhydrase is by far the most studied enzyme, as it catalyses the inter-conversion between CO2 and hydrogencarbonate in an effective mode. The biological option comprises the utilization of methanogens, acetogens and other organisms leading to the formation of added-value compounds. Most of the described systems are based on microbial electro-synthesis model and microbial carbon-capture cell prototypes.",signatures:"Gonçalo V. S. M. Carrera, Luís C. Branco and Manuel Nunes da\nPonte",downloadPdfUrl:"/chapter/pdf-download/52853",previewPdfUrl:"/chapter/pdf-preview/52853",authors:[{id:"18681",title:"Dr.",name:"Luis C.",surname:"Branco",slug:"luis-c.-branco",fullName:"Luis C. Branco"},{id:"190418",title:"Dr.",name:"Gonçalo",surname:"Carrera",slug:"goncalo-carrera",fullName:"Gonçalo Carrera"},{id:"190549",title:"Prof.",name:"Manuel",surname:"Nunes Da Ponte",slug:"manuel-nunes-da-ponte",fullName:"Manuel Nunes Da Ponte"}],corrections:null},{id:"52597",title:"Synergistic Effect on CO2 Capture by Binary Solvent System",doi:"10.5772/65763",slug:"synergistic-effect-on-co2-capture-by-binary-solvent-system",totalDownloads:1672,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"CO2 absorption into a binary solvent system was studied using a batch‐mode gas/liquid absorption apparatus. The binary system composed of potassium carbonate (K2CO3) and piperazine (PZ) showed a strong synergistic effect, whereby the binary solvent performed better than either of the individual solvents for CO2 absorption. The other pairs of solvents tested (K2CO3/monoethanolamine (MEA) and K2CO3/NaOH) showed no synergistic effects. The results indicate that this synergistic effect only occurs with specific pairs of solvents. The mechanism for the synergistic effect is postulated that the activated CO2 on PZ migrates to K2CO3, or a more reactive intermediate complex between K2CO3 and PZ is formed.",signatures:"Quan Zhuang and Bruce Clements",downloadPdfUrl:"/chapter/pdf-download/52597",previewPdfUrl:"/chapter/pdf-preview/52597",authors:[{id:"189578",title:"Dr.",name:"Quan",surname:"Zhuang",slug:"quan-zhuang",fullName:"Quan Zhuang"},{id:"195678",title:"Dr.",name:"Bruce",surname:"Clements",slug:"bruce-clements",fullName:"Bruce Clements"}],corrections:null},{id:"53670",title:"Maximizing Soil Carbon Sequestration: Assessing Procedural Barriers to Carbon Management in Cultivated Tropical Perennial Grass Systems",doi:"10.5772/66741",slug:"maximizing-soil-carbon-sequestration-assessing-procedural-barriers-to-carbon-management-in-cultivate",totalDownloads:1699,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"The natural capacity of the terrestrial landscape to capture and store carbon from the atmosphere can be used in cultivated systems to maximize the climate change mitigation potential of agricultural regions. A combination of inherent soil carbon storage potential, conservation management, and rhizosphere inputs should be considered when making landscape‐level decisions about agriculture if climate change mitigation is an important goal. However, the ability to accurately predict soil organic carbon accumulation following management change in the tropics is currently limited by the commonly available tools developed in more temperate systems, a gap that must be addressed locally in order to facilitate these types of landscape‐level decisions. Here, we use a case study in Hawaii to demonstrate multiple approaches to measuring and simulating soil carbon changes after the implementation of zero‐tillage cultivation of perennial grasses following more than a century of intensive sugarcane cultivation. We identify advancements needed to overcome the barriers to potential monitoring and projection protocols for soil carbon storage at our site and other similar sites.",signatures:"Jon M. Wells, Susan E. Crow, Manyowa N. Meki, Carlos A. Sierra,\nKimberly M. Carlson, Adel Youkhana, Daniel Richardson and Lauren\nDeem",downloadPdfUrl:"/chapter/pdf-download/53670",previewPdfUrl:"/chapter/pdf-preview/53670",authors:[{id:"169383",title:"Dr.",name:"Norman",surname:"Meki",slug:"norman-meki",fullName:"Norman Meki"},{id:"190329",title:"Dr.",name:"Susan",surname:"Crow",slug:"susan-crow",fullName:"Susan Crow"},{id:"195113",title:"Mr.",name:"Jon",surname:"Wells",slug:"jon-wells",fullName:"Jon Wells"},{id:"195114",title:"Dr.",name:"Carlos A.",surname:"Sierra",slug:"carlos-a.-sierra",fullName:"Carlos A. Sierra"},{id:"195115",title:"Dr.",name:"Kimberly M.",surname:"Carlson",slug:"kimberly-m.-carlson",fullName:"Kimberly M. Carlson"},{id:"195116",title:"Dr.",name:"Adel",surname:"Youkhana",slug:"adel-youkhana",fullName:"Adel Youkhana"},{id:"195117",title:"Mr.",name:"Daniel T.",surname:"Richardson",slug:"daniel-t.-richardson",fullName:"Daniel T. Richardson"},{id:"195118",title:"Ms.",name:"Lauren",surname:"Deem",slug:"lauren-deem",fullName:"Lauren Deem"}],corrections:null},{id:"52999",title:"Relationship Between Mineral Soil Surface Area and Carbon Sequestration Rate for Biosolids Added to Soil",doi:"10.5772/65862",slug:"relationship-between-mineral-soil-surface-area-and-carbon-sequestration-rate-for-biosolids-added-to-",totalDownloads:1770,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Biosolid degradation in soil comprises important biological and geochemical processes that operate in the soil matrix and on the soil surface. The microbial ecology is assumed to be associated with mineral soil surface area because of the large surface area of soil. Biological degradation rates for 27 fields (10°C and 10% moisture) ranged from 0.01 to 0.30 yr−1 and were determined by applying a degradation rate model (DRM). A 1-year-long laboratory study was also conducted to determine biosolid microbial degradation rates (21°C and 20% moisture) for soils from eight of the fields. Changes in degradation rates were correlated with changes in mineral soil surface area (1–10 m2/g) with larger degradation rates associated with soils with larger surface areas. The annual soil sequestration rate was calculated to increase from 1 to 6% for field conditions and from 4 to 14% for laboratory conditions when the soil total surface area increased from 1 to 10 m2/g. Therefore, land application of biosolids is an effective way to enhance carbon sequestration in soils and reduce greenhouse gas (GHG) emissions.",signatures:"Dongqi Wen, Wenjuan Zhai and Kenneth E. Noll",downloadPdfUrl:"/chapter/pdf-download/52999",previewPdfUrl:"/chapter/pdf-preview/52999",authors:[{id:"190612",title:"Prof.",name:"Kenneth",surname:"Noll",slug:"kenneth-noll",fullName:"Kenneth Noll"},{id:"194849",title:"Dr.",name:"Dongqi",surname:"Wen",slug:"dongqi-wen",fullName:"Dongqi Wen"},{id:"203320",title:"Dr.",name:"Wenjuan",surname:"Zhai",slug:"wenjuan-zhai",fullName:"Wenjuan Zhai"}],corrections:null},{id:"54238",title:"CO2 Conversion to Chemicals and Fuel for Carbon Utilization",doi:"10.5772/67316",slug:"co2-conversion-to-chemicals-and-fuel-for-carbon-utilization",totalDownloads:3448,totalCrossrefCites:2,totalDimensionsCites:6,hasAltmetrics:0,abstract:"Recent direction dealing with climate change has changed more to focus on carbon utilization rather than the direct carbon capture and storage. Conceptually converting CO2 to sellable chemicals or fuels should be more benign to environment by substituting the fossil raw materials like oil, natural gas, or coal. Instead of converting CO2 fully to valuable chemicals or fuels, it is much easier to employ a portion of CO2 with existing raw materials in many natural gas conversion processes. Dimethyl ether (DME) and gas-to-liquids (GTL) are most prominent processes that can be modified to accommodate CO2 as a reacting raw material. There are already several successful technology developments in using CO2-rich natural gas for DME and liquid fuels, although they are not yet fully reached the commercialized level. This chapter highlights recent developments in utilizing CO2-containing natural gas and landfill gas to yield valuable chemicals and fuels like diesel or DME.",signatures:"Wonjun Cho, Hyejin Yu and Yonggi Mo",downloadPdfUrl:"/chapter/pdf-download/54238",previewPdfUrl:"/chapter/pdf-preview/54238",authors:[{id:"189710",title:"Dr.",name:"Wonjun",surname:"Cho",slug:"wonjun-cho",fullName:"Wonjun Cho"},{id:"204311",title:"Dr.",name:"Heijin",surname:"Yu",slug:"heijin-yu",fullName:"Heijin Yu"},{id:"204312",title:"Dr.",name:"Yonggi",surname:"Mo",slug:"yonggi-mo",fullName:"Yonggi Mo"}],corrections:null},{id:"54199",title:"Challenges Associated with CO2 Sequestration and Hydrocarbon Recovery",doi:"10.5772/67226",slug:"challenges-associated-with-co2-sequestration-and-hydrocarbon-recovery",totalDownloads:2338,totalCrossrefCites:1,totalDimensionsCites:3,hasAltmetrics:1,abstract:"In the near- and midterm future, carbon capture and storage (CCS), also called CO2 geo-sequestration, is likely to play a significant role in the reduction of atmospheric greenhouse gas. By expanding the set of possible sequestration targets, it is expected that CCS will enable larger quantities of CO2 to be sequestered, mitigating human activity-driven climate change. In general, oil and gas reservoirs are ideal geologic storage sites for CO2 because they have successfully held hydrocarbon molecules for millions of years. In addition to the significant and reliable storage capacity of hydrocarbon reservoirs, there is a considerable body of knowledge related to the behavior of hydrocarbon bearing reservoirs, and significant amounts of data are often acquired during their exploitation, factors which improve the economics and safety of any CCS project. By making use of existing and future oil and gas projects, CCS can become a major contributor in the fight against global warming, as well as a sizeable contributor to energy production worldwide. The CCS sequestration targets discussed in this study are sandstones, coal beds, shales, and carbonates. 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The so-called carbon capture and storage (CCS) projects are technically feasible but have not been well established from an economic efficiency perspective. This chapter uses economic theory to describe the costs, benefits, and economically efficient level of CCS provision. Achieving the economically efficient level of CCS provision requires consideration of both the private and public costs and benefits of CCS and will also likely require some degree of government intervention in the form of economic incentives and/or direct regulation.",signatures:"John C. 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It is mainly used to treat patients with familial adenomatous polyposis (FAP) and ulcerative colitis (UC). It is also performed to treat selected patients with Crohn’s disease (CD), indeterminate colitis, and synchronous colorectal cancer (CRC) [1]. Among these pathologies, ulcerative colitis is the primary postoperative histopathological diagnosis, as Fazio data show, in 2013 [2].
IPAA surgery, first described by Parks and Nicholls in 1978 [3], aims to definitively cure disease and prevent malignant degeneration while providing adequate continence and avoiding a permanent stoma.
The majority of patients experience long-term success but are not absent from significant surgical complications. The main ones are pelvic sepsis, pouchitis, pouch failure, fecal incontinence, female infertility, and sexual dysfunction. Others, like stenosis, pouch dysplasia/cancer, IPAA prolapse, preileal IPAA pouchitis, and anemia, are rare [4].
IPAA results depend on several factors, such as the pathology underlying and specific features, gender, age, IBM, patient comorbidities, surgical techniques, and surgeon experience.
So, before to propose or avoid RPC with IPAA, there are aspects to take into account:
What is the underlying pathology, and if the RPC indication is absolute or relative;
if the patient needs a total proctocolectomy or if it is possible to spare part of the rectum;
rule out the presence of relative or absolute contraindication for IPAA and also,
evaluation of all elements that increase the risk of IPAA failure.
There is specific colorectal pathology that, during its natural development, requires a colectomy or a proctocolectomy, with or without restorative gest. Let us analyze the characteristics of the different underlying pathology and how they can influence the surgical decision.
FAP is an inherited disease classically characterized by the development of hundreds to thousands of adenomas in the rectum and colon during the second decade of life (Figure 1). A less aggressive variant of FAP is the so-called attenuated FAP (aFAP), where the rectum is frequently spared.
Familial adenomatous polyposis – colon details.
Although FAP is responsible for less than 1% of colorectal malignancies, untreated individuals with FAP carry a 100% risk of colorectal cancer by 40–50 years.
Thus, for patients with FAP, the single way to prevent colorectal cancer is surgery.
Nowadays, it is widely accepted that RPC-IPAA is the procedure of choice to treat patients with classical FAP.
We can choose for aFAP, total abdominal colectomy with ileorectal anastomosis (TAC-IRA), or proctocolectomy with stapled ileal pouch distal rectal anastomosis (CP-IPDRA).
FAP highlights:
young population; absolute indication for surgery; if present rectal involvement, proctocolectomy is required; higher risk of desmoid in some family; RPC-IPAA is the procedure of choice to treat patients with classical FAP; RPC-IPAA easier in FAP than in UC [5].
UC is a chronic inflammatory condition characterized by continuous mucosal inflammation of the colon and rectum.
Nowadays, surgery is required in a limited number of patients with UC, either in an elective or in an emergency setting.
In patients with UC and indication for surgery, RPC is widely considered the gold standard surgical procedure. However, TAC-IRA is justified for some particular cases.
Emergent colectomy in UC is indicated in acute severe UC, not responding to medical therapy, or when complications occur such as severe bleeding, toxic megacolon, and colon perforation [6].
Acute UC is considered severe when the patient has at least 10 stools per day, tachycardia, fever, anemia, and increased erythrocyte sedimentation rate (ERS)/C reactive protein (CRP). The severity of ulcerative colitis classification by Truelove and Witts distinguishes acute severe ulcerative colitis from fulminant ulcerative colitis [7]. All authors do not recognize this division, but it makes it possible to infer the probability of failure with corticosteroid therapy and the need for a total colectomy (Table 1).
Disease severity | Features |
---|---|
Slight | <4 stools/day with +/− blood, normal ESR, Without sepsis signs |
Mild | 4–6 stools/day with occasional blood loss, minimal signs of sepsis, CRP ≤30 mg/L |
Severe | ≥6 bloody stools/day with any of the following parameters:
|
Fulminant | 10 stools/day with continued bleeding, abdominal distension and tenderness, need of blood transfusions, toxic megacolon in X-ray. |
Ulcerative colitis severity classification. Adapted from Truelove and Witts criteria.
CRP = C reactive protein; ERS = erytrocyte sedimentation rate; Hgb = hemoglobin.
Acute severe UC, not responding to medical therapy, is one of the few cases that require emergent colectomy in UC. As shown in the management of flowchart in ASUC situations (Figure 2), about 30% of cases do not respond to corticosteroid therapy, and 50% of the ASUC will require surgery during the following year [8].
Management of flowchart in acute severe ulcerative colitis.
According to Saha et al., the policy of early colectomy, within 7 days, in patients with ASUC who fail to respond to intensive steroid-based therapy improves perioperative outcomes with significantly low inhospital mortality and morbidity [9].
On the other hand, when complications occur in severe ASUC, such as severe bleeding, toxic megacolon, and perforation, emergency surgery is mandatory. In these particular situations, the timing of colectomy is of utmost importance to reduce the postoperative complication rates.
Severe bleeding, toxic megacolon, and perforation are the main complications of ASUC (Figures 3 and 4).
Severe bleeding in acute severe ulcerative colitis not a responder to corticosteroids and infliximab. Surgery was performed in the emergency room.
X-ray and surgical specimen of toxic megacolon reports. There are more frequent in extensive ulcerative colitis than in ulcerative proctosigmoiditis. Surgical mortality is 1–8% that rises to 40% in colon perforation with peritonitis.
They are rare, but their presence increases surgery morbidity and mortality. If the UC surgery is urgent or emergent, the decision to perform surgery should be made in a multidisciplinary team, including the gastroenterologist and colorectal surgeon. In those cases, surgery is usually performed in three-step. Total colectomy, the first step, is made in an emergency room. The other steps electively, after confirmed diagnosis in the resected specimen.
Elective RPC for UC is indicated in chronic refractory UC (Figure 5) and also in the presence of high-grade dysplasia (HGD) or colorectal malignancies.
Endoscopic images of chronic refractory ulceratice colitis.
The introduction of biologic therapy has added further complexity to medical management decisions, surgery, and the relative timing of these choices. Appropriate medical management of UC may induce and maintain remission and may prevent surgery. However, medical management also carries risks of adverse effects, and recent data suggest that delay of surgery during ineffective medical therapy can increase the chances of adverse surgical outcomes. To make individualized, timely treatment decisions, early collaboration between gastroenterologists and surgeons is essential, and more data on predictors of treatment response and positive outcomes are needed. Early identification of patients who would benefit from biologic therapy or surgery is challenging, and the definition of chronic refractory ulcerative colitis (CRUC) difficult. In CRUC (Figure 4), several therapeutic options have already been tried, such as infliximab, adalimumab, cyclosporine, azathioprine with 6-mercaptopurine, tacrolimus, or fecal transplantation, without success. When the therapeutic side effects are unbearable, or despite treatment, the patient has no quality of life, and RPC with IPAA may be the best solution.
The presence of high-grade dysplasia (HGD) or colorectal cancer is another indication for elective RPC with IPAA in IC.
Colorectal surveillance in UC obeys specific rules (Figure 6) [10], and chromoendoscopy has an essential role in dysplasias identification (Figure 7) [11, 12]. In UC surveillance, the chromoendoscopy allows to split the cases in visible dysplasia and invisible dysplasia (Figure 7) [13, 14].
Colorectal surveillance in UC (33 biopsies allow 90% accuracy in dysplasia diagnosis).
Role of chromoendoscopy in dysplasia endoscopic visiblility.
Nowadays, dysplasia management in UC takes into account the grade and number of dysplasia, whether visible or not, and the presence of primary sclerosing cirrhosis (PSC) (Figures 8 and 9) [11, 15, 16].
Management of visible dysplasia in ulcerative colitis.
Management of invisible dysplasia in ulcerative colitis.
In a systematic review of the literature, Fumery et al. found that among patients with UC-LGD under surveillance, the annual incidence of progression to CRC was 0.8%. Concomitant primary sclerosing cholangitis, invisible dysplasia, distal location, and multifocal LGD are high-risk features associated with dysplasia progression [17].
In UC patients with high-grade dysplasia or colorectal cancer (CRC), the colon and rectum should be removed with
The risk of colorectal cancer in UC is increased compared with the general population (Table 2) [19, 20, 21, 22, 23, 24]. Moreover, it is estimated to be around 18% after 30 years of UC duration [20].
Risk factor | Magnitude of the risk | References |
---|---|---|
Primary sclerosing cholangitis | OR: 4.0 | Soetikno RM et al. |
Disease duration | ||
Cumulative incidence 20 years | 2.5–8.0% | Eaden et al. [20] |
Cumulative incidence 30 years | 7.5–18.0% | Lakatos PL et al. |
Extent of inflammation | ||
Pancolitis | SIR: 5.1–14.8 | Eaden et al. [20] |
Left-sided colitis | SIR: 2.1–2.8 | Soderlund S et al. |
Pseupolyposis | OR: 2.1–2.5 | Velayos FS Rutter MD |
Family history of CRC | RR: 2.4–9.2 | Velayos FS Rutter MD |
Degree of inflammation | ||
Endoscopy | OR: 2.5 | Rutter MD |
Histology | OR: 5.1 |
CRC risk factors in ulcerative colitis.
Occasionally, total abdominal colectomy with ileorectal rectal anastomosis (TAC-IRA) can be considered.
Some of the patients with an acute severe colitis inaugural picture have indeterminate colitis or Crohn colitis. When they indicate emergency surgery, the first step is the colectomy. The realization of an elective restorative proctectomy with an IPAA must be individually analyzed. Patients with CD after IPAA, when compared with UC, have a fivefold higher risk of failure, twofold risk of strictures, and a sixfold risk of fistulae. This risk is much higher if the diagnosis is performed only after IPAA. However, function in those who retain the pouch seemed similar to that of patients with UC. CD does not increase the risk of pouchitis. IPAA could be offered to a selected population of CD patients after proper preoperative counseling (Figure 10).
Nine years after IPAA in a patient with Crohn’s disease.
Ileal pouch rectal anastomosis seems to be another viable alternative to permanent ileostomy in Crohn’s proctocolitis patients. IPRA offers durable preservation of bowel continuity and proper function and quality of life (QOL) in selected CC patients who might otherwise require a permanent ileostomy [25].
When the rectum can be partially spare, total abdominal colectomy with ileorectal anastomosis (TAC-IRA), a less complicated colorectal surgical procedure than RCP-IPAA, is an option. These solutions must be considered in attenuated familial adenomatous polyposis (aFAP) and synchronous colorectal cancer, and infrequently in UC and Crohn’s disease.
The assessment of the rectum state is a parameter to consider when the surgical plan procedure is made. In FAP, behind the number of polyps present in the rectum (less than 10), the aggressiveness and development of extracolonic symptoms of the disease are other aspects to take into account. The mutation site on the APC gene is associated with the FAP phenotype, including desmoid tumor (DT) development. The more distal the mutation (closer to 3′ end), the higher the risk of the patient being affected by the desmoid tumor [1, 9, 17]. Typical disease symptoms were observed in families who harbored mutations between exon 4 (codon 169) and codon 1393 of exon 15. Mutations beyond codon 1403 were associated with a more varied phenotype concerning the development of extracolonic symptoms, namely desmoid tumor (DT). Their presence is related to aggressiveness disease and usually dictates the outcome of the patient. Despite the possibility of DT arising in any location, DT related to FAP is mostly on the abdominal region: intra-abdominal, on the abdominal wall, and transabdominal. Some of them take a benign course, with slow evolution, stabilization of growth, or even remission. Others show aggressive behavior with rapid growth and mass effect on surrounding structures, particularly in intra-abdominal DT. Possible complications of intra-abdominal DT are intestinal obstruction, ischemia, hemorrhage, and perforation or ureteric obstruction [1, 4, 8]. When DT develops in FAP patients, they can be the reason for the pouch failure case, and they are the second most common cause of mortality [20].
In synchronous CRC, the rectal tumor stage and location define the surgery to perform. If the rectum can be spare, TAC-AIR is the choice. RPC-IPAA with total mesorectum excision and with or without neoadjuvant chemoradiotherapy may be the solution in selected patients with medium or distal rectal cancer, depending on if the tumor is localized or locally advanced.
In IBD with proctocolitis involvement, rectum spare is controversial, mainly is ulcerative colitis. The decision-based in the absence of activity in the rectal mucosa.
When the rectum cannot be spare, it is mandatory to rule out the presence of relative or absolute contraindication for IPAA. There are absolute contraindications for IPAA: They are the presence of poor anal sphincter function with fecal incontinence in all pathologies, the distance between the tumor and pectin line inferior to 1 cm or sphincter involvement in distal rectal cancer, and the presence of perianal disease beyond proctocolitis in Crohn disease. The aggressive phenotype in FAP, indeterminate proctocolitis, and Crohn’s disease, with involvement limited to the colon and rectum, are the relative contraindications. Morbid obesity increased technical difficulties and can be considered a relative contraindication, as the willingness in young women to get pregnant.
RCP with IPAA is, in fact, a complicated colorectal surgical procedure even in the hands of experienced high-volume surgeons. In an extensive series of 1789 patients undergoing proctocolectomy, IPAA was attempted but abandoned intraoperatively in 4.1% [26].
So, the relative indication for that type of elective surgery must be carefully considered. Several aspects must take into account for surgery plan mainly in UC cases:
the pathology underlying and specific features;
if the surgery is elective or urgent;
patient age;
patient comorbidities;
patient anal sphincter and rectum status;
and the experience of the surgeon.
Moreover, weigh the risk and frequency of IPAA morbidity and the patient is will after informed consent, which are also factors that influence the surgical decision.
RPC-IPAA is “the gold standard” procedure to treat patients with classical FAP and elective surgery in UC, although other surgical solutions are possible (Table 3).
Operation | Advantages | Disadvantages |
---|---|---|
Rectal mucosectomy with ileal pouch-anal canal Anastomosis | Complete excision of large intestinal disease Transanal defecation and fecal continence preserved No ileostomy | Two operations required At risk for pouchitis Nocturnal fecal spotting present |
Stapled ileal pouch-distal rectal anastomosis | Transanal defecation and fecal continence preserved No ileostomy Easier technically | At risk for pouchitis and cancer from residual rectal mucosa |
Continent ileostomy | Complete excision of large intestinal disease Fecal continence preserved No external appliance | Stoma present Intubation of pouch required At risk for pouchitis and need for valve revision |
Brooke ileostomy | Complete excision of large intestinal disease One operation | Stoma present, risk of parastomal hernia Incontinent for feces Need of external appliance |
Ileorectal anastomosis | Transanal defecation and fecal continence preserved No ileostomy | Diseased rectum remains to produce symptoms, require treatment, and predispose to cancer |
Bowel transit reconstruction types after a proctocolectomy/total colectomy.
RPC-IPAA is a complex procedure that pouch results also depend on technical surgical details and surgeon experience.
RPC with IPAA is a procedure that can be made in one, two, or three stage, by laparoscopic or open surgery.
The laparoscopic approach, if feasible, allows better cosmetics and outcomes.
One-stage or two-stage procedure is recommended for elective surgery and three-stage for emergent surgery.
Stage 1—An ileal pouch is made, and anastomosed to the anus is made after de proctocolectomy without a protective ileostomy. The operation is made in elective surgery and completed in a single stage (one surgery).
Stage 2—After a PC and IPAA confection, the anastomosis is protected by a loop ileostomy, and ileostomy closure is posterior realized (two surgeries).
Stage 3—At the emergency room, the first step is the total abdominal colectomy and ileostomy. The second step is the IPAA with the anastomosis protected by a loop ileostomy. The third surgery is the ileostomy closure (three surgeries).
Due to anastomotic complications (infection, fistulization, development of Crohn’s disease, disease recurrence, or poor function), an ileostomy may be required (stage 2) to prevent complications or if the pouch fails postoperatively. The authors are not unanimous about the need to do a derivative ileostomy by routine during IPAA construction (stage 1 vs. stage 2).
Lovegrove et al. found to be associated with ileostomy omission: stapled anastomosis (odds ratio [OR], 6.4), no preoperative corticosteroid use (OR, 3.2), familial adenomatous polyposis diagnosis (OR, 2.6), cancer diagnosis (OR, 3.4), female sex (OR, 1.6), and age at surgery younger than 26 years (OR, 2.1) (
The most used pouch configurations are the J-pouch and de S-pouch, wherein most centers opt for J-pouch. S-pouch is usually reserved for patients with high IBM, short mesentery, or handsewn anastomosis necessity. Wu et al. recommend using an S-pouch when constructing an IPAA with a handsewn technique. A total of 502 patients included 169 patients with an S-pouch (33.7%). The frequencies of short-term complications in the two groups were similar (
The IPAA can be made with transanal mucosectomy and handsewn anastomosis or preserving the anal transitional zone mucosa in a small rectal cuff and stapled anastomosis.
Dafni et al. refer that stapled IPAA and younger age at the onset of UC correlated with better functional results, and the HRQOL scores were high [31].
Kirat et al. studied the influence of stapler size used at IPAA on the anastomotic leak, stricture, long-term functional outcomes, and quality of life. They analyzed the stapled IPAA performed between 1983 and 2007: A (stapler size 28–29 mm) (
Surgical complications in RPC with IPAA are not unusual as functional deterioration of pouch and quality of life (QOL). Fazio et al. encountered in their data early perioperative complications in 33.5% of patients with a mortality rate of 0.1%. On the other hand, he refers to good functional outcomes and QOL in 95% [2]. Nevertheless, these results by Fazio, mainly the functional outcomes of the IPAA, are not reached in all centers, probably depending on the surgeon experience and the high patient volume. The most leading and frequent IPAA complications are described as follows:
Pelvic sepsis occurs in 9% of the procedure, and its presence increases the risk of pouch failure. Pelvic sepsis is a common early complication with far-reaching consequences of long-term pouch dysfunction, but prompt intervention (either radiological or surgical) reduces the risk of pouch failure. According to Lavryk et al., 4031 patients who underwent IPAA in 1983–2014 (patients with Crohn’s disease or cancer were excluded), 357 (8.8%) developed IPAA-related pelvic sepsis with or without anastomotic dehiscence [33].
The inflammation of the IPAA can appear in acute (60%) or chronic (60%) form.
Kayal et al. state 53% that acute pouchitis occurred in 205 patients (53%), 60 of whom (30%) progressed to chronic pouchitis [34].
Hashavia et al. followed prospectively 201 UC patients who underwent IPAA (1981–2009 for a mean of 108 months). A total of 138 (69%) of these had either a regular pouch or episodes of acute pouchitis and 63 (31%) developed chronic pouchitis [35].
Pouch failure rates range from 5.5 to 8.5%, depending upon the length of follow-up [36]. In Fazio data, 3707 patients underwent primary pouch, and 328 (8.1%) redo pouch surgery (primary surgery in other centers). Pouch failure occurred in 197 (5.5%) of the 3707. During a median follow-up of 84 months, 119 patients (3.2%) required excision of the pouch, 32 (0.8%) had a nonfunctioning pouch, and 46 patients (1.2%) had redo IPAA [2].
Mild fecal incontinence is a common complication of IPAA and seems to worsen with time [37].
Mild and severe fecal incontinence during the day: 17 and 3.7% of patients, respectively.
(Incontinence during the night: 13.1 and 4.5%; urge incontinence during the day: 7.3%).
At 12 months post-IPAA, it has been reported that 19% of patients suffered occasional daytime incontinence, and 49% suffered nocturnal incontinence [7]. Consequently, this can have a significantly negative impact on the quality of life of patients. The evidence to support the use of SNS for fecal incontinence after IPAA remains very limited.
Studies have shown that fertility in women with UC is comparable to the background population but drops following restorative proctocolectomy [38].
This problem can be restricted, opting for a laparoscopic approach and using
Laparoscopy was associated with a significantly reduced time to conceive compared with the open approach [39].
Females with RPC for UC have an increased incidence of
Sexual dysfunction can appear after RCP with IPAA. Postoperative impotence and retrograde ejaculation have been observed in approximately 1.5–4% of men, respectively. Transient dyspareunia occurs in about 7% of women [41].
About 1% of patients develop dysplasia or carcinoma after surgery, which occurs in the retained rectum, anal transitional zone, or ileal pouch, depending upon the procedure performed.
Mark-Christensen et al. analyzed 1723 patients with IPAA operated for ulcerative colitis in the period 1980–2010 that matched to 8615 individuals from the background population. They concluded that pouch cancer following IPAA is sporadic, questioning the need for general, rather than selective, surveillance. The overall cancer risk is comparable to that of the background population (Figure 11). The increased risk of hepatobiliary cancer is likely an effect of coexisting liver disease and not causally related to IPAA [42].
Nine years passed between RCP with IPAA for FAP. The residual polyps were appearing in IPAA, easily handled by endoscopic surveillance with polypectomy.
RCP with IPAA in the hands of experienced high-volume surgeons is a safe procedure associated with good functional results, provided that the risk-benefit is appropriately weighted.
RPC with IPAA is the golden standard procedure for FAP and selected UC when the rectum cannot be spared, and the patient has a normal anal sphincter function.
RPC with IPAA can also be performed in some patients with indeterminate colitis, Crohn’s disease, and synchronous CRC.
IPAA has morbidity and functional results that worsen with time, mainly if the underlying pathology is Crohn’s disease or indeterminate colitis.
To propose an RPC with IPAA, it is necessary:
to confirm a normal anal sphincter function and the need for total proctocolectomy;
know the underlying pathology and specific features;
assess the risk of pouch morbidity and disfunction taking into account beyond the underlying pathology:
patient age, gender, IBM, and comorbidities.
indication for the surgery.
the time between the onset of the disease and surgery.
experience of the center in RPC with IPAA and patient’s will.
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All published Book Chapters are licensed under a Creative Commons Attribution 3.0 Unported License. Monographs are licensed under the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license granted to all others. Our Copyright Policy aims to guarantee that original material is published while at the same time giving significant freedom to our Authors. IntechOpen upholds a flexible Copyright Policy meaning that there is no copyright transfer to the publisher and Authors hold exclusive copyright to their work.
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Although POP can occur in younger women, it is commonly seen in aging population with a prevalence of 45–50%. Older terms describing pelvic organ prolapse (e.g., cystocele, urethrocele, rectocele) have been replaced because they do not provide complete information regarding the structures on the other side of the vaginal bulge, especially in women who have had previous pelvic organ prolapse surgery. Therefore, a thorough history and performing a careful physical examination with dignity and care, using some basic tools that aid in the accurate evaluation of anatomical and functional defects, should be conducted. A standardized assessment system has been used to document findings which should explain everything in understandable terms.",book:{id:"7957",slug:"lower-urinary-tract-dysfunction-from-evidence-to-clinical-practice",title:"Lower Urinary Tract Dysfunction",fullTitle:"Lower Urinary Tract Dysfunction - From Evidence to Clinical Practice"},signatures:"Priyanka Bhadana",authors:[{id:"287080",title:"Associate Prof.",name:"Priyanka",middleName:null,surname:"Bhadana",slug:"priyanka-bhadana",fullName:"Priyanka Bhadana"}]},{id:"51296",title:"Peritoneal Dialysis Catheters",slug:"peritoneal-dialysis-catheters",totalDownloads:2396,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"In peritoneal dialysis, a well-functioning catheter is of great importance because a dysfunctional catheter may be associated with exit-site infection, peritonitis, reduced efficiency of dialysis, and overall quality of treatment, representing one of the main barriers to optimal use of peritoneal dialysis. This chapter reviews the literature on indications and contraindications for peritoneal dialysis, peritoneal dialysis catheter design and materials, the techniques of insertion, complications, and method of removal of dialysis catheters.",book:{id:"5312",slug:"some-special-problems-in-peritoneal-dialysis",title:"Some Special Problems in Peritoneal Dialysis",fullTitle:"Some Special Problems in Peritoneal Dialysis"},signatures:"O. Obinwa, J. McLoughlin, D. Kavanagh and C. 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It is not only a serious medical condition but also an undeniable psychosocial problem creating embarrassment and negative self‐perception, and it has a severe impact on a patient's quality of life. Today, there are wide different treatment options in urinary incontinence from surgery to conservative modalities. Among these, conservative management approaches are recommended as the first‐line treatment to manage with urinary incontinence. The choice of the most suitable option to treat for urinary incontinence differs according to the underlying pathophysiological mechanism defining subtypes of urinary incontinence and severity of symptoms. In this chapter, we addressed the different components of physiotherapy management of urinary incontinence, including pelvic floor muscle training, electrical stimulation, biofeedback, vaginal cones, mechanical devices and magnetic stimulation. 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