Colorectal Disease最新文献

{"title":"Diagnostic accuracy of quantitative faecal immunochemical test in symptomatic patients for the investigation of colorectal cancer once accounting for anaemia severity and iron deficiency","authors":"James Lucocq,&nbsp;Emma Barron,&nbsp;Heather Holmes,&nbsp;Peter D. Donnelly,&nbsp;Neil Cruickshank","doi":"10.1111/codi.70024","DOIUrl":"https://doi.org/10.1111/codi.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this study was to determine the diagnostic accuracy of the faecal immunochemical test (FIT) for colorectal cancer (CRC) in symptomatic patients with different levels of anaemia severity or the presence of iron deficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Symptomatic patients (2018–2021) from primary care were followed up prospectively for CRC for 2 years. The positive predictive values (PPV) for CRC of FIT subgroups were compared between anaemia severity groups and iron deficiency groups once stratified for symptom type and demographics. The diagnostic accuracy of FIT for CRC was investigated for different definitions of iron deficiency anaemia (IDA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 17 538 symptomatic patients were investigated, including 310 with CRC (1.8%). In FIT &lt; 100 μg haemoglobin (Hb)/g subgroups, the PPV for CRC was unchanged between anaemia severity levels (<i>p</i> &gt; 0.05). In groups with FIT &lt; 100 μg Hb/g, the PPV for CRC was unchanged in the presence of IDA, non-iron-deficiency anaemia and iron deficiency without anaemia (<i>p</i> &gt; 0.05). In the anaemia and IDA subgroups investigated, FIT 10–19 μg Hb/g had a PPV of &lt;3% for CRC and increasing the FIT cut-off to 20 μg Hb/g could have hypothetically saved 28.6% of colonoscopies. Including transferrin saturation in the definition of IDA increased the detection of CRC in FIT-negative patients (sensitivity 9.1% vs. 3.9%) but with a low CRC pick-up rate (PPV = 0.6%; 165 colonoscopies per CRC). Investigating FIT-negative functional IDA would increase the detection of CRC by 1.3% but with a PPV of 0.5%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The diagnostic accuracy of FIT is excellent regardless of the severity of anaemia, iron deficiency, symptom type or demographics. The FIT cut-off can be increased safely to 20 μg Hb/g irrespective of anaemia severity or iron deficiency. Altering the definition of IDA does not pragmatically increase the detection of CRC in negative/low FIT patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362510","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":"Current surgical practices and attitudes toward pilonidal sinus disease among Russian surgeons: A national survey","authors":"Darya Shlyk,&nbsp;Vladimir Balaban,&nbsp;Mingze He,&nbsp;Maria Pikuza,&nbsp;Petr Tsarkov","doi":"10.1111/codi.70020","DOIUrl":"https://doi.org/10.1111/codi.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Pilonidal sinus disease (PSD), also known as pilonidal disease, is a common chronic disorder in coloproctology and general surgery. It predominantly affects young male patients and is typically located in the sacrococcygeal region. Nowadays, various approaches are used to address this condition, but no consensus on a gold standard has been established. The aim of this study was to analyse and assess current PSD practice, diagnostic and surgical approaches, training and attitudes among Russian surgeons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A comprehensive online survey comprising 35 structured questions was developed by the Russian Society of Colorectal Surgeons and distributed to its members. The survey targeted colorectal and general surgeons and collected data on demographics, professional experience, surgical training, PSD management practices and both elective and abscess surgery techniques. Categorical data are reported as frequencies and percentages.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 158 respondents, the vast majority were coloproctologists and general surgeons (<i>n</i> = 152, 96%) with over 10 years of experience (<i>n</i> = 110, 69.6%) and performing 10–50 operations per year. The most popular surgical procedures were excision with midline closure (68%), open healing (62%) and marsupialization (59%). PSD-associated abscesses were managed through incision and drainage by 81 surgeons (51%). About half of surgeons had access to laser therapy for treating PSD, but sinus laser-assisted closure was used by only 16%. Most surgeons had received training in PSD surgery under specialist supervision and felt sufficiently trained.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest that PSD surgery in Russia has not yet shifted from midline excisions to off-midline flap procedures and minimally invasive surgery. This study calls for attention to this underprioritized group of patients and underscores the importance of developing national guidelines in Russia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362578","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":"Long-term bowel function following delayed coloanal anastomosis: Analysis of a multicentric cohort study (GRECCAR)","authors":"Maxime K. Collard,&nbsp;Jean-Jacques Tuech,&nbsp;Charles Sabbagh,&nbsp;Amine Souadka,&nbsp;Jérome Loriau,&nbsp;Eric Rullier,&nbsp;Frédéric Marchal,&nbsp;Adeline Germain,&nbsp;Stéphane Benoist,&nbsp;Jean-Luc Faucheron,&nbsp;Gilles Manceau,&nbsp;Anne Dubois,&nbsp;Anaïs Laforest,&nbsp;Isabelle Sourrouille,&nbsp;Aurore Protat,&nbsp;Diane Mège,&nbsp;Zaher Lakkis,&nbsp;Michel Prudhomme,&nbsp;Simon Derieux,&nbsp;Mehdi Ouaissi,&nbsp;Aurélien Venara,&nbsp;Cécile Brigand,&nbsp;Bernard Lelong,&nbsp;Karine Pautrat,&nbsp;Leon Maggiori,&nbsp;Gil Lebreton,&nbsp;Philippe Rouanet,&nbsp;Marc Pocard,&nbsp;Emilie Duchalais,&nbsp;Quentin Denost,&nbsp;Yann Parc,&nbsp;Jérémie H. Lefevre,&nbsp;for the GRECCAR Group","doi":"10.1111/codi.70013","DOIUrl":"https://doi.org/10.1111/codi.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Alteration of bowel function after delayed coloanal anastomosis (DCAA) might be a limitation to its utilization. Our aim was to assess the long-term bowel function of DCAA in a large multicentric cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>All patients who underwent DCAA interventions at 29 GRECCAR-affiliated hospitals between 2010 and 2021 were retrospectively included. Low anterior resection syndrome (LARS) score or confection of a stoma due to poor bowel function was assessed in eligible patients. Good bowel function was defined by the preservation of bowel continuity with no LARS or a minor LARS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 385 eligible patients to assess long-term bowel continuity, 63% (<i>n</i> = 243) responded to the questionnaire or had a definitive stoma because of poor bowel function. After a median follow-up of 32 months, good bowel function was reported by 60% (<i>n</i> = 146) of patients (with no LARS 36% and minor LARS 24%), whereas 40% of patients (<i>n</i> = 146) had a poor bowel function including major LARS (36%) and definitive stoma due to poor bowel function (4%). No variables tested were predictive of a poor bowel function after DCAA, including a history of pelvic radiotherapy (<i>P</i> = 0.722), salvage DCAA after failure of a previous anastomosis (<i>P</i> = 0.755), presence of a diverting stoma (<i>P</i> = 0.556), occurrence of an anastomotic leakage (<i>P</i> = 0.416) and time interval from the DCAA to the bowel function assessment (<i>P</i> = 0.350).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>No LARS or minor LARS was reached for 60% of patients after DCAA. Less than 5% of patients received a definitive stoma due to a poor bowel function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111913","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":"Sexual dysfunction after colorectal and anal cancer—treatment in nurse-led sexological clinics","authors":"Anette Højer Mikkelsen,&nbsp;Anne Thyø,&nbsp;Anne-Dorte Seyer-Hansen,&nbsp;Asbjørn Mohr Drewes,&nbsp;Birgitte Schantz Laursen,&nbsp;Peter Christensen,&nbsp;Tina Schwennesen,&nbsp;Therese Juul","doi":"10.1111/codi.70018","DOIUrl":"https://doi.org/10.1111/codi.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Sexual dysfunction after colorectal and anal cancer is common but rarely identified and treated, although effective treatment options do exist. Therefore, we recently established nurse-led clinics for the treatment of sexual dysfunction after pelvic organ cancer at two Danish university hospitals. The aim of this paper is to present patients' clinical characteristics, the treatments offered and improvements in sexual function recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>In this cohort study, colorectal and anal cancer patients were referred to the clinics at any time point after their cancer treatment. Specialized treating nurses identified and registered organic sexual disorders and psychological concerns at the first visit, and initiated treatments. Treatments were algorithm-based and rooted in a biopsychosocial approach. Patient-reported outcome measures were completed at baseline and 3 months after discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 127 referred patients, 78% were men. The mean age was 60.6 years (SD 10.4 years) and the women were a mean 7.3 years younger than the men (<i>p</i> = 0.001). Eighty per cent were rectal cancer patients. The most prevalent disorder was erectile dysfunction in men (95%) and dyspareunia in women (71%). Psychological concerns were registered in 53% of men and 54% of women. Pharmacological treatments, mainly phosphodiesterase-5 inhibitors, were prescribed to 87% of men, and local oestrogens were prescribed to 54% of women. Instructions in the use of sexual aids were given to 22% of men and 42% of women. Furthermore, sexual counselling/therapy was offered to 44% of men and 92% of women to address sexuality related psychological problems. Three months after discharge, a clinically relevant improvement of ≥1 point was found in 68% of patients in at least one of three single items measuring ‘Meaningful sex life’, ‘Sexual needs met’ and ‘Overall rating of sex life’ on a five-point Likert-scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>At nurse-led clinics, specialized nurses can effectively identify and treat sexual problems in patients with sexual dysfunction following colorectal/anal cancer. Organic dysfunctions were prevalent, and psychological problems characterized most patients. This highlights that treatment needs to be multidisciplinary and that patients benefit from specialized care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111204","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":"Laparoscopic recurrent lateral pelvic lymph node dissection accompanied by combined resection of the internal iliac artery and pelvic nerve—A video vignette","authors":"Daisuke Tomita,&nbsp;Kosuke Hiramatsu,&nbsp;Yasuhiro Takahashi,&nbsp;Shuichiro Matoba,&nbsp;Hiroya Kuroyanagi","doi":"10.1111/codi.70019","DOIUrl":"10.1111/codi.70019","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078795","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":"Anorectal prolapse after anorectal reconstruction: Incidence and risk factors according to the ARM-Net Consortium","authors":"Pernilla Stenström,&nbsp;Francesca Maestri,&nbsp;Dalia Aminoff,&nbsp;Ivo de Blaauw,&nbsp;Johanna Ludwiczek,&nbsp;Paola Midrio,&nbsp;Alessio Pini Prato,&nbsp;Alejandra Vilanova-Sanchez,&nbsp;Anna Morandi,&nbsp;Iris van Rooij,&nbsp;The ARM-Net Consortium","doi":"10.1111/codi.70010","DOIUrl":"10.1111/codi.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>There is a knowledge gap regarding which patients with anorectal malformations (ARMs) are at highest risk of anorectal prolapse (AP), and which risk factors predispose to AP in ARM. The aims of the study were to define the frequency of AP after ARM reconstruction, and explore risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Data from the ARM-Net registry inserted between 2007 and 2023 were used. Inclusion criteria were the reconstruction performed, no stoma at 1-year follow-up and all data available at 1-year follow-up. The statistics used were univariable and multivariable logistic regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After exclusions the incidence of AP was 163 in 1117 patients (14.6%) in data inserted by 31 centres from 12 countries. The AP incidence was unevenly distributed between the centres (interquartile range 6.3%–21.7%). AP was more frequent in boys than girls (20.9% vs. 8.1%; <i>P</i> &lt; 0.001). In both sexes the incidence of AP was higher in complex ARM subtypes (<i>P</i> &lt; 0.001). AP was most frequent after laparotomy- and laparoscopic-assisted reconstructions (50.0% and 37.5%, respectively). Spinal and sacral anomalies constituted risk factors for AP in univariable analyses, while tethered cord did not. Adjusted risk factors for AP were severity of ARM subtype (40% in long-channel cloaca and bladder neck fistula, OR 3.1, 95% CI 1.0–10.2), laparotomy-assisted posterior sagittal anorectoplasty (50%, OR 3.7, 95% CI 1.6–8.4) and larger neo-anus at 1-year follow-up (Hegar 13.6 vs. 13.1; OR 1.2, 95% CI 1.1–1.4). Constipation was not a risk factor for AP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Anorectal prolapse is a frequent postoperative sequela. Adjusted analyses indicate that severity of ARM, abdominal open access during reconstruction and larger size of anus are risk factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078794","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":"Bilateral gracilis muscle flaps for nonhealing perineal wounds—A video vignette","authors":"Justin Dourado,&nbsp;Victoria Rose DeTrolio,&nbsp;Ebram Salama,&nbsp;Anjelli Wignakumar,&nbsp;Steven D. Wexner","doi":"10.1111/codi.70015","DOIUrl":"10.1111/codi.70015","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074109","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":"The first video comparison of lateral pelvic lymph node dissection in rectal cancer: Laparoscopic approach using articulating instruments (ArtiSential) versus robotic Xi platform—A video vignette","authors":"In Kyeong Kim,&nbsp;Jung Hoon Bae,&nbsp;In Kyu Lee,&nbsp;Yoon Suk Lee","doi":"10.1111/codi.70012","DOIUrl":"10.1111/codi.70012","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073184","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":"Long-term outcomes of ‘temporary’ defunctioning in patients with severe perianal Crohn's disease","authors":"M. A. J. Becker,&nbsp;A. J. M. Pronk,&nbsp;K. Gecse,&nbsp;R. Hompes,&nbsp;W. A. Bemelman,&nbsp;C. J. Buskens","doi":"10.1111/codi.17289","DOIUrl":"10.1111/codi.17289","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to analyse long-term outcomes in patients undergoing temporary faecal diversion for therapy-refractory Crohn's perianal fistulas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective study, Crohn's patients who underwent defunctioning for perianal disease between 2012 and 2022 were included. The primary endpoints were successful ostomy reversal and proctectomy/proctocolectomy rates. Secondary endpoints were clinical fistula closure, development of proximal colonic disease recurrence, and the influence of medication, patient and disease characteristics on ostomy reversal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 53 patients were included, 35 colostomies and 18 ileostomies. Previous L2 disease was more frequently seen in the ileostomy group (colostomy 29%, ileostomy 83%; <i>P</i> = 0.004). Clinical closure of the fistula was seen in 26%. 21% (11/53 patients) underwent an attempt at ostomy reversal during a median overall follow-up of 90.1 months (interquartile range 17.5–82.5) of which nine ostomies (colostomy 23%, ileostomy 6%; <i>P</i> = 0.244) were closed successfully. In 35%, a proctectomy/proctocolectomy was required to control ongoing perianal sepsis. Factors associated with ostomy reversal were fistula closure (<i>P</i> &lt; 0.001) and L1/L3 disease (<i>P</i> = 0.043). In patients with ostomy reversal attempt (<i>n</i> = 11), successful reversal was associated with colostomy (<i>P</i> = 0.055) and use of anti-tumour necrosis factor (anti-TNF) (<i>P</i> = 0.055) despite being previously classified as anti-TNF refractory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Ostomy reversal rates are low, so defunctioning ostomies should be carefully considered because in most patients the ostomy will be permanent. In one-third of the patients, a proctectomy/proctocolectomy is required to treat ongoing perianal sepsis. If a patient is eligible for ostomy reversal, reversal should preferably be done under anti-TNF to optimize chances of success.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064305","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":"Oral antibiotic prophylaxis induces changes in the microbiology of surgical site infection after colorectal surgery. A matched comparative study","authors":"Miriam Flores-Yelamos,&nbsp;Montserrat Juvany,&nbsp;Josep M. Badia,&nbsp;Ana Vázquez,&nbsp;Marta Pascual,&nbsp;David Parés,&nbsp;Alexander Almendral,&nbsp;Enric Limón,&nbsp;Miquel Pujol,&nbsp;Aina Gomila-Grange,&nbsp;Members of the VINCat Colorectal Surveillance Team","doi":"10.1111/codi.70008","DOIUrl":"10.1111/codi.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Oral antibiotic prophylaxis (OAP) lowers rates of surgical site infection (SSI) and may aid anastomotic healing in colorectal surgery. The aim of this study was to analyse the understudied impact of OAP on SSI microbiology after colorectal surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A post hoc analysis was performed on a previous prospective, multicentre study of elective colorectal surgery. For 1000 patients with SSI, this study compared the microbiology of SSIs in procedures without OAP (SSI/OAP–) and with OAP (SSI/OAP+).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 340 patients in the SSI/OAP– group and 660 in the SSI/OAP+ group. The use of OAP increased the presence of Gram-positive cocci (GPC) (OR 1.542, 95% CI 1.153–2.062) and fungi (OR 2.037, 95% CI 1.206–3.440), but reduced rates of Gram-negative bacteria (GNB) (OR 1.461, 95% CI 1.022–2.088) and anaerobe isolation (OR 0.331, 95% CI 0.158–0.696). Specifically, it led to increases in the isolation of <i>Enterococcus faecium</i> (OR 1.450, 95% CI 0.812–2.591), methicillin-resistant <i>Staphylococcus aureus</i> (OR 2.000, 95% CI 1.043–3.834) and <i>Candida</i> spp. (OR 2.037, 95% CI 1.206–3.440). In colon surgery with OAP, GPC infections were more likely (OR 1.461, 95% CI 1.022–2.088). In rectal surgery, organ/space SSIs had a higher risk of harbouring GPC (OR 1.860, 95% CI 1.153–2.999) and a lower risk of GNB (OR 0.321, 95% CI 0.200–0.515).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>OAP reduced the presence of anaerobes and GNB in SSIs, but increased the isolation of GPCs and fungi, with <i>E. faecium</i> and <i>Candida</i> being of particular concern. This information should guide empirical antibiotic therapy for postoperative colorectal SSIs in patients who have received preoperative OAP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064307","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}