Colorectal Disease最新文献

{"title":"AUGUR-AIM: Clinical validation of an artificial intelligence indocyanine green fluorescence angiography expert representer","authors":"Philip D. Mc Entee,&nbsp;Patrick A. Boland,&nbsp;Ronan A. Cahill","doi":"10.1111/codi.70097","DOIUrl":"https://doi.org/10.1111/codi.70097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Recent randomized controlled trials and meta-analyses have demonstrated a reduction in the anastomotic leak rate when indocyanine green fluorescence angiography (ICGFA) is used versus when it is not in colorectal resections. We have previously demonstrated that an artificial intelligence (AI) model, AUGUR-AI, can digitally represent in real time where experienced ICGFA users would place their surgical stapler based on their interpretation of the fluorescence imagery. The aim of this study, called AUGUR-AIM, is to validate this method across multiple clinical sites with regard to generalizability, usability and accuracy while generating new algorithms for testing and determining the optimal mode of deployment for the software device.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This is a prospective, observational, multicentre European study involving patients undergoing resectional colorectal surgery with ICGFA as part of their standard clinical care enrolled over a 1-year period. Video recordings of the ICGFA imagery will be computationally analysed both in real time and post hoc by AUGUR-AI, with the operating surgeon blinded to the results, testing developed algorithms iteratively versus the actual surgeon's ICGFA interpretation. AI-based interpretation of the fluorescence signal will be compared with the actual transection site selected by the operating surgeon and usability optimized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AUGUR-AIM will validate the use of AUGUR-AI to interpret ICGFA imagery in real time to the level of an expert ICGFA user, building on our previous work to include a larger, more diverse patient and surgeon population. This could allow future progression to develop the AI model into a usable clinical tool that could provide decision support, including to new/infrequent ICGFA users, and documentary support of the decision made by experienced users.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143830971","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":"Enhancing the clinical relevance of prehabilitation research in colorectal surgery","authors":"Xiujie Yu,&nbsp;Ling Li","doi":"10.1111/codi.70099","DOIUrl":"https://doi.org/10.1111/codi.70099","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831278","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":"What influences emergency general surgeons' treatment preferences for patients requiring nutritional support? A discrete choice experiment","authors":"Daniel L. Ashmore,&nbsp;Jenna L. Morgan,&nbsp;Timothy R. Wilson,&nbsp;Vanessa Halliday,&nbsp;Matthew J. Lee","doi":"10.1111/codi.70081","DOIUrl":"https://doi.org/10.1111/codi.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Identifying and managing malnourished emergency general surgery (EGS) patients can be difficult. There are many tools available, a range of barriers to overcome and variety of guidelines at a surgeon's disposal. This study aimed to determine the impact of key variables on surgeon preference to start nutritional support in EGS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A discrete choice experiment was used to determine the impact of six variables on surgeons' treatment preferences for commencing nutritional support in EGS. Twenty-five hypothetical scenarios regarding a patient with adhesional small bowel obstruction were disseminated electronically. Binomial logistic regression was used to identify significant associations. Ethical approval was obtained (UREC 050436).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In all, 148 participants responded providing 3700 scenario responses. Completion rate was 52.1% (148/284) with an approximately even split of consultants and non-consultants (50.7% vs. 49.3%) and intestinal failure (IF) experience (46.6% experienced vs. 53.4% not experienced). Consultants favoured starting nutritional support (77.7%; 1443/1875) more often than non-consultants (71.8%; 1310/1825). Forming an anastomosis, hypoalbuminaemia, underweight (body mass index &lt;18.5 kg/m²), unintentional weight loss (&gt;10%), ≥5 days without oral intake until now and ≥5 days likely to be without oral intake from now were statistically more likely to be associated with treatment preference, but obesity (body mass index &gt;30 kg/m²) was not. Overall, experience of IF (OR 1.093, 95% CI 0.732–1.631; <i>P</i> = 0.663) and seniority of surgeon (OR 0.711, 95% CI 0.473–1.068; <i>P</i> = 0.100) significantly influenced the results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There are many variables that impact the decision to start nutritional support in EGS, but seniority of the surgeon and IF experience do not.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831279","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":"Editorial April 2025: The protocolisation of evidence synthesis: The good, the bad and the ugly","authors":"Yasuko Maeda,&nbsp;Sue Clark","doi":"10.1111/codi.70100","DOIUrl":"https://doi.org/10.1111/codi.70100","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831006","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":"Protocol update for the UK cohort study to investigate the prevention of parastomal hernia (the CIPHER study)","authors":"Barnaby C. Reeves,&nbsp;Lucy Ellis,&nbsp;Emily Farrow,&nbsp;Amr Abushawaly,&nbsp;Sam Granger,&nbsp;Ben Griffiths,&nbsp;Niroshini Rajaretnam,&nbsp;Neil J. Smart","doi":"10.1111/codi.70091","DOIUrl":"https://doi.org/10.1111/codi.70091","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831005","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":"Development and validation of an anastomotic risk score for use in a randomized clinical trial on defunctioning stoma use in low anterior resection for rectal cancer","authors":"Martin Rutegård,&nbsp;Ida Hed Myrberg,&nbsp;Caroline Nordenvall,&nbsp;Kalle Landerholm,&nbsp;Fredrik Jörgren,&nbsp;Peter Matthiessen,&nbsp;Jennifer Park,&nbsp;Josefin Segelman,&nbsp;Pamela Buchwald,&nbsp;Jenny Häggström","doi":"10.1111/codi.70089","DOIUrl":"https://doi.org/10.1111/codi.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The selective use of defunctioning stomas in anterior resection for rectal cancer hinges on accurately predicting anastomotic leakage. The aim of this study was to develop a prediction model for use in a prospective randomized clinical trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Colorectal Cancer Database (CRCBaSe) Sweden was used to identify patients who underwent low anterior resection for rectal cancer 2007–2021. Eligibility criteria mirrored the forthcoming SELective defunctioning Stoma Approach in low anterior resection for rectal cancer (SELSA) trial, including patients &lt;80 years of age and with American Society of Anaesthesiologists' (ASA) physical status grade of &lt;III; further, patients without a defunctioning stoma were excluded. The outcome comprised anastomotic leakage within 30 days or in-hospital. Candidate predictors included age, sex, ASA grade, cardiovascular disease, diabetes, body mass index (BMI), tumour stage, tumour height, and neoadjuvant therapy. Seven models were developed and internally validated using bootstrapping. A threshold of a predicted leakage risk of ≤10% was chosen for trial implementation. Validation was conducted using chart-reviewed data from a nested cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 2727 eligible patients, 199 (7.3%) were registered with an anastomotic leakage. All models demonstrated similar performance, with prediction instability observed for risks exceeding 12.5%. The preferred model included three significant predictors: male sex (OR 2.00; 95% CI: 1.45–2.75), BMI &gt;30 kg/m² (OR 1.82; 95% CI: 1.21–2.74), and radiotherapy (OR 1.90; 95% CI: 1.35–2.69). The bootstrapped area under the curve (AUC) was 0.64 (95% CI: 0.62–0.65), with a negative predictive value of 94.6% (95% CI: 93.7%–95.6%). For the validation cohort, the corresponding estimates were 0.66 (95% CI: 0.59–0.74) and 89.5% (95% CI: 86.2%–92.5%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Accuracy of anastomotic leakage prediction using registry-based data is moderate; however, the model's ability to rule out a &gt;10% risk is considered appropriate for trial use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818632","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":"Minimally invasive transanal approach for SM1 rectal adenocarcinoma — A video vignette","authors":"Lucas José Caram,&nbsp;Esteban Gonzalez Salazar,&nbsp;Juan Campana,&nbsp;Ricardo Mentz,&nbsp;Gustavo Rossi","doi":"10.1111/codi.70090","DOIUrl":"https://doi.org/10.1111/codi.70090","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801411","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":"Does endoscopic management have a role in chronic radiation proctopathy: A systematic review","authors":"Chyu Lai Yan Naing,&nbsp;Jayden Gittens,&nbsp;Matthew Fok,&nbsp;Hayley Fowler,&nbsp;Dale Vimalachandran,&nbsp;Rachael E. Clifford","doi":"10.1111/codi.70086","DOIUrl":"https://doi.org/10.1111/codi.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Chronic radiation proctopathy (CRP) is a significant side-effect of radiotherapy, and poses a challenge in clinical management, necessitating effective and standardized therapeutic approaches. The aim of this review is to investigate the role of endoscopic interventions for CRP, focusing on argon plasma coagulation (APC) and formalin application.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A literature search was undertaken for studies that investigated the clinical responses to endoscopic management in patients with CRP. A systematic review was performed in accordance with PRISMA guidelines, and a meta-analysis of proportions was conducted with a random-effects model. ROBINS-I and the Cochrane Collaboration's tool were used to assess risk of bias in cohort studies and randomized control trials, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 82 studies met the inclusion criteria, including 11 randomized control trials, 20 systematic reviews, one cohort study and 50 case series. A robust 89% (95% CI 84%–92%, <i>p</i> &lt; 0.01 and 95% CI 84%–93%, <i>p</i> = 0.03) pooled response rate was demonstrated for both APC and formalin therapies, respectively. Adverse effects were generally minimal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Endoscopic therapies, particularly APC and formalin, exhibit commendable clinical response rates in the management of CRP. However, the lack of standardized treatment protocols highlights the need for larger prospective studies. Clear guidelines, informed by defined outcomes and quality-of-life assessments, are imperative for enhancing patient outcomes and minimizing the morbidity associated with CRP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801410","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":"Nitpicking the pit picking","authors":"Matthew J. Lee","doi":"10.1111/codi.70095","DOIUrl":"https://doi.org/10.1111/codi.70095","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801780","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":"Modified robotic assisted Frykman–Goldberg procedure with mesh implant for severe pelvic organ prolapse--A Video Vignette","authors":"S. Veleda Belanche,&nbsp;J. López-Herreros,&nbsp;J. Sánchez González,&nbsp;J. L. Maestro de Castro,&nbsp;E. Choolani Bhojwani,&nbsp;V. Simó Fernández","doi":"10.1111/codi.70087","DOIUrl":"https://doi.org/10.1111/codi.70087","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793413","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}