Colorectal Disease最新文献

{"title":"Reassessing adjuvant chemotherapy in rectal cancer: Implications of early mortality exclusion and methodological rigour","authors":"Yingying Li, Qingming Wang","doi":"10.1111/codi.70108","DOIUrl":"https://doi.org/10.1111/codi.70108","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple robotic stapler firings to transect the rectum are not associated with anastomotic leakage","authors":"Stefano Cardelli,&nbsp;Luca Stocchi,&nbsp;Amit Merchea,&nbsp;Dorin T. Colibaseanu,&nbsp;Michelle F. DeLeon,&nbsp;Nitin Mishra,&nbsp;Kevin J. Hancock,&nbsp;David W. Larson","doi":"10.1111/codi.70094","DOIUrl":"https://doi.org/10.1111/codi.70094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The relationship between the number of stapler firings (SFs) during robotic rectal transection and the risk of colorectal/coloanal anastomotic leakage (AL) is controversial. This study investigates whether the number of robotic SFs is associated with an increased risk of AL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Retrospective review of adult patients who underwent robotic total mesorectal excision (TME) and partial mesorectal excision (PME) with double-stapled colorectal or coloanal anastomosis for both benign and malignant colorectal diseases between 2015 and 2023 across three enterprise-wide hospitals. Primary outcome: the effect of multiple SFs on postoperative AL rate among patients who underwent one, two, or three or more SFs. Secondary outcome: the effects of other potential risk factors on postoperative AL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 503 patients who underwent robotic colorectal resection with a double-stapled anastomosis, 56 (11%) developed a postoperative AL. The number of SFs was not associated with the AL rate (<i>p</i> = 0.51): the univariable and multivariate analyses found no correlation between the AL rate and the increasing number of SFs required, compared with one SF as the reference (adjusted two SFs, OR = 1.1, 95% CI: 0.6–2.2, <i>p</i> = 0.77 vs. adjusted three or more SFs, OR = 0.98, 95% CI: 0.4–2.3, <i>p</i> = 0.96). On multivariate analysis, AL was strongly associated with male gender (OR = 2.5, 95% CI: 1.3–4.9, <i>p</i> = 0.005) and with TME versus PME (OR = 2.8, 95% CI: 1.5–5.5, <i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The number of robotic SFs for rectal transection is not correlated with postoperative AL.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic peritonectomy of quadrants 5, 6 and 7 because of peritoneal carcinomatosis of colorectal origin—A video vignette","authors":"María del Pilar Gutiérrez-Delgado,&nbsp;Alberto Titos-García,&nbsp;Joaquin Carrasco-Campos,&nbsp;Ivan González-Poveda,&nbsp;Santiago Mera-Velasco","doi":"10.1111/codi.70101","DOIUrl":"https://doi.org/10.1111/codi.70101","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pilot study of gut mucosal and faecal microbiota in rectal cancer: associations with histological response and adverse events following preoperative chemoradiotherapy","authors":"Shigenobu Emoto,&nbsp;Ryo Inoue,&nbsp;Shin Murai,&nbsp;Yuriko Inagaki,&nbsp;Hiroaki Nozawa,&nbsp;Kazuhito Sasaki,&nbsp;Koji Murono,&nbsp;Kensuke Kaneko,&nbsp;Yuichiro Yokoyama,&nbsp;Shinya Abe,&nbsp;Yuzo Nagai,&nbsp;Takahide Shinagawa,&nbsp;Yuichi Tachikawa,&nbsp;Satoshi Okada,&nbsp;Takamitsu Tsukahara,&nbsp;Kai Ohashi,&nbsp;Masashi Ohno,&nbsp;Akira Andoh,&nbsp;Soichiro Ishihara","doi":"10.1111/codi.70106","DOIUrl":"https://doi.org/10.1111/codi.70106","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Preoperative chemoradiotherapy (CRT) is administered for locally advanced rectal cancer (LARC); however, its efficacy and toxicity vary among patients. This study aimed to elucidate the relationship between the gut microbiota and the effectiveness and adverse events of CRT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective study included 21 patients with LARC with no history of antibiotic or probiotic administration for 6 months. Tumour mucosa, non-tumour mucosa and faecal samples were collected before and after CRT, and bacterial DNA was extracted. Metataxonomic analysis targeting the V3 and V4 regions of the 16S rRNA gene was conducted to determine the diversity and composition of the microbiota. Linear discriminant analysis effect size (LEfSe) was used to explore potential bacterial taxa predicting pathological complete response (pCR) and treatment-associated diarrhoea, which are major adverse events of CRT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 21 patients, five achieved pCR and seven experienced severe treatment-associated diarrhoea. There were no significant differences in α-diversity and β-diversity of the microbiota between the groups at any sampling sites before or after CRT. Exploratory analysis using LEfSe identified <i>Peptostreptococcus</i>, <i>Coprococcus</i> and <i>Phoceaicola</i> in the tumour mucosa before CRT as significant indicators for achieving pCR. Additionally, <i>Collinsella</i>, <i>Haemophilus</i> and <i>Desulfovibrionaceae</i> are associated with treatment-associated diarrhoea. Microbiome composition changed before and after CRT, with a notable decrease in the genus <i>Fusobacterium_C</i> and other taxa. β-diversity in the tumour area also changed significantly (<i>P</i> = 0.03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study suggests an association between the gut microbiota, the therapeutic effectiveness of CRT and the occurrence of treatment-associated diarrhoea in rectal cancer. These results indicate the potential for predicting treatment efficacy and adverse events based on the microbiota composition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Splenic flexure takedown: A step-by-step robotic versus laparoscopic comparison—A video vignette","authors":"Antonio Jesús Garcia-Moriana,&nbsp;Miriam Alvarez-Aguilera,&nbsp;Maria L. Reyes-Diaz,&nbsp;Irene Ramallo-Solis,&nbsp;Fernando De la Portilla,&nbsp;Rosa M. Jimenez-Rodriguez","doi":"10.1111/codi.70107","DOIUrl":"https://doi.org/10.1111/codi.70107","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total pelvic exenteration for locally advanced rectal cancer: Video-illustrated technique—A video vignette","authors":"Peng Zhang,&nbsp;Ming Chen,&nbsp;Anqi Wang,&nbsp;Xu Zhang,&nbsp;Jia Zang,&nbsp;Zhijing Zou,&nbsp;Jian Zhang,&nbsp;Haiyang Zhou","doi":"10.1111/codi.70105","DOIUrl":"https://doi.org/10.1111/codi.70105","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic complete mesocolic excision right hemicolectomy and en bloc cholecystectomy with intracorporeal anastomosis—A video vignette","authors":"Gregory E. Ekatah,&nbsp;Dolly Dowsett,&nbsp;Nick Penny,&nbsp;Irshad Shaikh","doi":"10.1111/codi.70093","DOIUrl":"https://doi.org/10.1111/codi.70093","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of enteroperineal fistulas following pelvic exenteration: Insights from a high-volume referral centre","authors":"Darius Kang Lie Aw,&nbsp;Kilian G. M. Brown,&nbsp;Jessica El-Hayek,&nbsp;Mollie Cahill,&nbsp;Kirk K. S. Austin,&nbsp;Peter Jun Myung Lee,&nbsp;Chris Byrne,&nbsp;Michael J. Solomon","doi":"10.1111/codi.70085","DOIUrl":"https://doi.org/10.1111/codi.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Total pelvic exenteration (TPE) has emerged as the standard treatment for advanced anorectal, genitourinary and soft-tissue pelvic tumours. Long-term complications, particularly empty pelvis syndrome (EPS) leading to enteroperineal fistula (EPF), remain inadequately addressed. The surgical management of EPF poses significant challenges, with limited published data and no official guidelines. This study aimed to investigate the incidence and outcomes of EPFs after TPE and to describe the management of reoperative surgery in this patient cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Patients who underwent TPE at Royal Prince Alfred Hospital, Sydney, Australia, between 2009 and 2024 were identified. Clinical data from a prospectively maintained database on reoperative surgery for EPFs were obtained. Patients were excluded if reoperative surgery was clearly unrelated to previous exenteration. Comparisons were then made between the two strategies used for surgical management of EPFs, namely small bowel resection with anastomosis and intestinal bypass with distal limbs exclusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 491 patients who underwent TPE, 22 (4.5%) developed an EPF requiring reoperative procedures. The 30-day major complication rate was 18.2%. Postoperative complications were prevalent (95.2%) across both groups. The median time to EPF surgery post-TPE was 21.7 months. Notably, intensive care unit (ICU) admission was 2 days shorter and length of stay was 14 days shorter in the bypass group than in the small bowel resection with anastomosis group, although both differences were not statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Strategies for preventing EPFs remain elusive; however, surgical management is feasible with acceptable short-term outcomes. The optimal strategy should be tailored to individual patient characteristics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 5","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A population-based study of palliative rectal cancer patients with an unremoved primary tumour: Symptoms, complications and management","authors":"Gustav Kejving,&nbsp;Gustav Sandén,&nbsp;Ingrid Ljuslinder,&nbsp;Jörgen Rutegård,&nbsp;Petrus Vinnars,&nbsp;Martin Rutegård","doi":"10.1111/codi.70104","DOIUrl":"https://doi.org/10.1111/codi.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Palliative rectal cancer patients typically retain their primary tumour, as trials have concluded no survival benefit of tumour resection in non-curative patients. This patient group is understudied regarding the natural course of the remaining tumour, particularly concerning the need of surgical management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This was a retrospective study on rectal cancer patients diagnosed between 2007 and 2020 in Region Västerbotten, Sweden. Data were obtained from the Swedish Colorectal Cancer Registry and chart review. Patients were excluded if treated with curative intent, underwent primary tumour resection, had a synchronous colorectal cancer, had locally recurrent colorectal cancer, or refused treatment. Patients were followed from diagnosis until death or end of follow-up. Indications for palliative treatment, tumour-related complications and surgical and oncological management were investigated, with a stratified analysis for study period and patient age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Some 156 patients remained after applying exclusion criteria. The majority had metastasized and incurable disease (76%). Almost half suffered local complications (44%) and 48% underwent surgical intervention, due to the unremoved primary tumour. Tumour perforation occurred in 7% with a significantly higher risk in patients aged ≤75 years (<i>p</i> = 0.009). Bowel obstruction afflicted 23%, while 40% underwent stoma diversion. Almost half received chemotherapy (48%) and radiotherapy (42%), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Rectal cancer patients with an unremoved primary tumour face a substantial risk of local complications, often necessitating surgical intervention. Therefore, the benefits of surgical resection should be carefully considered, especially for patients with a longer estimated survival. Further research is needed to accurately identify patients where tumour removal might be beneficial.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted single-incision laparoscopic ileocecectomy with intracorporeal anastomosis is feasible – A video vignette","authors":"Jin K. Kim,&nbsp;Robert D. Bennett","doi":"10.1111/codi.70103","DOIUrl":"https://doi.org/10.1111/codi.70103","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}