Colorectal Disease最新文献

{"title":"Complications of diverticulosis, frequency and risk factors: Results from a large database with long-term follow-up","authors":"Jabir Elkrinawi,&nbsp;Roba Ganayem,&nbsp;Sarah Weissmann,&nbsp;Waleed Alamour,&nbsp;Zlata Lerner,&nbsp;Osama Alamour,&nbsp;Abed Abu Ganim,&nbsp;Naim Abu-Freha","doi":"10.1111/codi.70185","DOIUrl":"https://doi.org/10.1111/codi.70185","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diverticulosis of the Colon (DC) is a common finding at colonoscopies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We aimed to investigate the differences between complicated DC (CDC) and uncomplicated DC (UDC) and to explore the risk factors for CDC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed data from a cohort of 149,094 patients, including 123,024 UDC patients and 26,070 CDC patients. Demographics, comorbidities and clinical outcomes were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with CDC were significantly younger (64.3 ± 15 years vs. 67.5 ± 12.7 years), 55.6% vs. 53.2% females and 8.9% of Arab ethnicity. Smoking was more prevalent in the CDC group (28.2% vs. 26.1%). Diabetes Mellitus and obesity were less prevalent in the CDC group. Treatment with statins (29.2% vs. 40.4%) was also less commonly used in the CDC group. In the multivariate analysis, female gender and smoking were found to be risk factors for CDC (OR 1.215 and OR 1.150, <i>p</i> &lt; 0.001, respectively). Age, Diabetes Mellitus, Obesity, Acetylsalicylic Acid and statin treatment were found to be protective against complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Young age, female sex and smoking were associated with complicated diverticulosis, and uncomplicated diverticulosis seems to be protected by specific diseases. Understanding these differences may help guide risk stratification and improve management strategies for diverticulosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 8","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144716794","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":"Endometriosis and its role in pouch patients: A matched-pair analysis","authors":"Jessica Stockheim,&nbsp;Mikhael Belkovsky,&nbsp;Lukas Schabl,&nbsp;Stefan D. Holubar,&nbsp;Scott R. Steele,&nbsp;Tracy Hull,&nbsp;Hermann Kessler","doi":"10.1111/codi.70183","DOIUrl":"https://doi.org/10.1111/codi.70183","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Patients requiring ileoanal pouch (IPAA) are often women of reproductive age. Outcomes in pouch patients with endometriosis have not been described. This study aimed to assess the association of endometriosis on pelvic pouch function, quality of life and pouch survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Patients who underwent IPAA between 1985 and 2022 with endometriosis were retrospectively reviewed and matched in a 1:3 ratio based on gender, diagnosis, pouch type, age at pouch creation, BMI and ASA score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-two patients with endometriosis and IPAA were matched with 66 patients without endometriosis, with ulcerative colitis being the most common diagnosis in both groups (86%). Histopathological verification of endometriosis was available in 45.5% of cases. Intraoperative variables and surgery-related postoperative complications were similar between groups, except for a higher incidence of thromboembolism in the endometriosis group (18% vs. 3%, <i>p</i> = 0.04). There was no significant difference in pouchitis (73% vs. 46%, <i>p</i> = 0.06), while pouch dysfunction occurred significantly more frequently in endometriosis patients (18% vs. 3%, <i>p</i> = 0.03; OR 7.11, 1.53–33.10, <i>p</i> = 0.01). Hysterectomy, with or without salpingo-oophorectomy, was performed in 45% of endometriosis patients, primarily due to endometriosis and pain and most commonly (90%) following IPAA. The timing of endometriosis diagnosis (before or after IPAA) did not significantly influence perioperative outcomes. Overall quality of life was favourable in both groups (0.7 vs. 0.8, <i>p</i> = 0.35).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pouch function was inferior in endometriosis patients, yet with a comparable overall quality of life. The timing of endometriosis did not appear to be a significant factor. Endometriosis should not be considered a contraindication for IPAA. A multidisciplinary approach addressing pain management, infertility treatment and potential hysterectomy should be considered early in patient care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 8","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144716795","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 hidden anomaly: Resolving an anal duplication case after 30 fistula surgeries—A video vignette","authors":"Ender Ergüder,&nbsp;Javid Ahmadov,&nbsp;Sezai Leventoğlu,&nbsp;Bülent Menteş","doi":"10.1111/codi.70168","DOIUrl":"https://doi.org/10.1111/codi.70168","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 7","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681080","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":"Sphincter repair in faecal incontinence secondary to obstetric injury – A video vignette","authors":"Teresa Calderón Duque,&nbsp;Esther Cano Pecharromán,&nbsp;Leticia Martín Paniagua,&nbsp;Felipe García Sánchez,&nbsp;Mahur Esmailli Ramos,&nbsp;Tomás Balsa Marín","doi":"10.1111/codi.70167","DOIUrl":"https://doi.org/10.1111/codi.70167","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 7","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672063","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":"Intraoperative assessment of anastomotic microcirculation during right hemicolectomy with real-time laser speckle contrast imaging is safe and feasible","authors":"Rupan Paramasivam,&nbsp;Claudia Jaensch,&nbsp;Anders Husted Madsen,&nbsp;Mai-Britt Worm Ørntoft","doi":"10.1111/codi.70162","DOIUrl":"https://doi.org/10.1111/codi.70162","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Successful anastomotic healing is essential in colorectal surgery and depends on adequate microcirculation at the resection site to prevent anastomotic leakage (AL). Traditionally, surgeons subjectively assess this. Laser speckle contrast imaging (LSCI) provides an objective, dye-free, and non-contact method for measuring the bowel end microcirculation that could perioperatively support the surgeon's assessment. This study aimed to determine the feasibility of LSCI and evaluate surgeons' subjective opinions on its potential to assist in surgical decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This feasibility trial was conducted within the IDEAL framework as a non-interventional multicentre study. Patients undergoing elective right hemicolectomy were included. LSCI measurements were conducted twice perioperatively: before and after anastomosis formation. Surgeons were blinded to all measurements. Postoperatively, LSCI images and a questionnaire were presented to the surgeon asking whether these images, if presented perioperatively, would have influenced the selection of the optimal anastomotic site.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>High-quality LSCI measurements were obtained in all 20 patients operated on by 17 different surgeons, with clear and interpretable perfusion images captured without compromising sterility or extending operating time significantly. The device was non-invasive and added an average of 2 minutes to the total operation time. Fifteen of the 17 surgeons indicated that measures could have influenced surgical decision-making. In 50% of the cases, the surgeon reported a change in the resection site, by an average of 1.2 cm, based on LSCI images.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrated that LSCI effectively displays colonic perfusion in real-time without disrupting the surgical procedure. The potential clinical value of LSCI with additional visual feedback lies in assisting surgeons in selecting the most optimal anastomotic site, thereby potentially improving healing and surgical outcome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 7","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70162","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144647410","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":"Haemorrhoidal artery ligation: Is Doppler guidance useful? A systematic review and meta-analysis of randomized controlled trials","authors":"Roberta Tutino,&nbsp;Arcangelo Picciariello,&nbsp;Mauro Santarelli,&nbsp;Veronica De Simone,&nbsp;Pierluigi Lobascio,&nbsp;Gianfranco Cocorullo,&nbsp;Marco Massani,&nbsp;Giusi Graziano,&nbsp;Giulio Aniello Santoro,&nbsp;Gaetano Gallo","doi":"10.1111/codi.70163","DOIUrl":"https://doi.org/10.1111/codi.70163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Haemorrhoidal arterial ligation (HAL) with or without mucopexy (recto-anal repair, RAR) is a minimally invasive technique for the treatment of haemorrhoidal disease. It is still debated if it should be performed with Doppler guidance (DG-HAL) or without. The primary aim of this study was to find evidence that the use of Doppler guidance reduces the risk of recurrence. The secondary aim was to evaluate the benefit of Doppler guidance on postoperative complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (2020). The population, intervention, comparison, outcomes and study design (PICOS) framework was used for eligibility criteria. Data were extracted independently by two reviewers for initial screening and for eligibility to be included in the meta-analysis of randomized controlled trials. Random effects meta-analysis, leave-one-out meta-analysis and meta-regression were performed to assess the main outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven randomized controlled trials, published between 2008 and 2023, were selected. They included 514 patients (mean age 49.13 years, 46% men) with different haemorrhoidal degrees. The HAL technique was performed in 255 patients and DG-HAL in 259 patients. The meta-analysis revealed that the DG-HAL procedure was associated with a significant risk of recurrence (<i>P</i> = 0.007) and similar postoperative pain (<i>P</i> = 0.623) compared to the HAL procedure. In a subgroup analysis of patients treated with a combined RAR procedure, no differences were found between the DG-HAL-RAR and HAL-RAR regarding the risk of recurrence (<i>P</i> = 0.36) and postoperative pain (<i>P</i> = 0.31).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In conclusion, this meta-analysis did not find superiority of DG-HAL over HAL with or without RAR in reducing postoperative complications and recurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 7","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70163","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635397","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":"Reflections on a challenging but productive year at ACPGBI","authors":"Justin Davies,&nbsp;Laura Hancock","doi":"10.1111/codi.70166","DOIUrl":"https://doi.org/10.1111/codi.70166","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 7","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615202","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":"ACPGBI position statement on robotic-assisted colorectal surgical training","authors":"Charles Evans,&nbsp;Taner Shakir,&nbsp;Charlotte El-Sayed,&nbsp;Deena P. Harji,&nbsp;Danilo Miskovic,&nbsp;Irshad Shaikh,&nbsp;Jim Khan,&nbsp;James Kinross,&nbsp;Richard Justin Davies,&nbsp;The Dukes' Club and The Association of Coloproctology of Great Britain and Ireland (ACPGBI) Robotic Clinical Advisory Group","doi":"10.1111/codi.70161","DOIUrl":"https://doi.org/10.1111/codi.70161","url":null,"abstract":"<p>The uptake of robotic-assisted colorectal surgery (RACS) across the UK and Ireland has increased exponentially over the last 5 years. It is anticipated that most ‘conventional’ laparoscopic procedures will eventually move to a robotic approach within a National Health Service that is committed to embracing robotic-assisted surgery. Working in collaboration with the surgical Royal Colleges, a more structured framework is necessary for robotic training. Inequality in robotic access and the impact that RACS is having on current colorectal surgical trainees need to be addressed, The Association of Coloproctology of Great Britain and Ireland (ACPGBI) has set out a framework to help support training in RACS at basic, advanced and trainer levels. Safer, better-trained robotic surgeons will ensure improved patient outcomes, which is the overriding goal of the ACPGBI.</p>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 7","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144606484","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":"Research priorities for faecal incontinence in adults: A James Lind Alliance priority setting partnership","authors":"Alexander O'Connor,&nbsp;Sam Alexandra Rose,&nbsp;Emma V. Carrington,&nbsp;Anna Clements,&nbsp;Julie A. Cornish,&nbsp;Marcus J. Drake,&nbsp;Louise J. Dunford,&nbsp;Jennie Grainger,&nbsp;Douglas Hallett,&nbsp;Kate Lough,&nbsp;Tatenda Marunda,&nbsp;Aziza Sesay,&nbsp;Dipesh H. Vasant,&nbsp;Tara Willson,&nbsp;Thomas Dudding","doi":"10.1111/codi.70154","DOIUrl":"https://doi.org/10.1111/codi.70154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Faecal incontinence (FI) is common, yet clinical guidelines rely on low-quality evidence or expert opinion. A high proportion of research is focused on areas that may not be considered a priority by patients or clinicians. This project aimed to identify the top 10 research priorities for FI in adults in equal collaboration with patients, carers and healthcare professionals in a James Lind Alliance priority setting partnership (PSP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This PSP followed established methodology supported by a multidisciplinary steering group including those with lived experience of FI. Evidence uncertainties were gathered through a survey with free-text responses, summarised in indicative summary questions and prioritised in a second survey. An independently facilitated priority setting workshop used a nominal group technique to reach consensus on the order of research priorities, with a focus on the top 10. At all stages the views of healthcare professionals and individuals with a lived experience of FI were considered equally.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After the initial survey, 512 respondents submitted 991 evidence uncertainties. These produced 54 indicative summary questions. In the second survey, 373 respondents generated a shortlist of 26 questions. Finally, the top 10 research priorities were determined by consensus at a face-to-face workshop and include unanswered questions concerning prevention, investigation, education, self-management and treatment of FI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This PSP has identified a comprehensive list of top research priorities, including items of importance to both healthcare professionals and individuals with a lived experience of FI. Researchers and funders should use these priorities to inform future work.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 7","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70154","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144598557","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":"Impact of preoperative radiotherapy on patient-reported outcomes in rectal cancer","authors":"Robert Siegel,&nbsp;Nora Tabea Sibert,&nbsp;Clara Breidenbach,&nbsp;Cihan Gani,&nbsp;Philipp Alexander Neumann,&nbsp;Stefan Rolf Benz,&nbsp;Stefan Post,&nbsp;Thomas Seufferlein,&nbsp;Vanessa Kolb,&nbsp;Matthias Behrend,&nbsp;Richard David Blossey,&nbsp;Jörg Bunse,&nbsp;Marc Dahlke,&nbsp;Ricarda Diller,&nbsp;Nikos Emmanouilidis,&nbsp;Thomas J. Ettrich,&nbsp;Jörg Fahlke,&nbsp;Sven Flemming,&nbsp;Björn Freitag,&nbsp;Martin Fuchs,&nbsp;Lars Haeder,&nbsp;Stephan Hollerbach,&nbsp;Jens Höppner,&nbsp;Mia Kim,&nbsp;Christian Klink,&nbsp;Jürgen Knuth,&nbsp;Stefan Koeppen,&nbsp;Jörg Köninger,&nbsp;Ernst Wolfgang Kolbe,&nbsp;Florian Kühn,&nbsp;Shueb Mussa,&nbsp;Robert Oehring,&nbsp;Sebastian Petzoldt,&nbsp;Pompiliu Piso,&nbsp;Christian Prause,&nbsp;Christian Prinz,&nbsp;Christoph Reißfelder,&nbsp;Maren Riechmann,&nbsp;Jörg-Peter Ritz,&nbsp;Jens Rolinger,&nbsp;Robert Rosenberg,&nbsp;Hubert Scheuerlein,&nbsp;Dustin Schilawa,&nbsp;Paul Magnus Schneider,&nbsp;Thilo Schwandner,&nbsp;Marco Siech,&nbsp;Daniel Steinemann,&nbsp;Oliver Stöltzing,&nbsp;Elke von Haeften,&nbsp;Dominik Weihs,&nbsp;Armin Wiegering,&nbsp;Christina Barbara Zielinski,&nbsp;Christoph Kowalski","doi":"10.1111/codi.70158","DOIUrl":"https://doi.org/10.1111/codi.70158","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To prospectively evaluate the effect of preoperative radiotherapy followed by surgery versus surgery alone on patient-reported outcomes (PROs) 1 year after surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Prospective observational cohort study in 127 colorectal cancer centres. Patients with rectal cancer completed European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core (EORTC-QLQ-C30) and Colorectal module (-CR29) questionnaires (thus providing PROs) before initialization of treatment [baseline (T0)] and at 12 months after surgery [follow up (T1)]. The PRO data together with sociodemographic information were linked to clinical data. Relevant confounders were identified using directed acyclic graphs. The effect of preoperative radiotherapy on selected PROs 12 months after surgery was estimated using adjusted tobit regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1635 patients with rectal cancer for whom both baseline and follow-up PROs were available, 565 (35%) received preoperative radiotherapy. Twelve months after surgery, patients with surgery alone reported better scores for global health status/Quality of Life, urinary incontinence, faecal incontinence (patients without stoma), dyspareunia (female patients) and impotence (male patients) than did patients receiving preoperative radiotherapy. The statistically significant effects ranged between 33.20 (<i>p</i> &lt; 0.001, <i>R</i>² = 0.19) for impotence and 39.01 (<i>p</i> = 0.001, <i>R</i>² = 0.10) for dyspareunia. For global health status/QoL and urinary incontinence, no statistically significant effect could be found.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Radiotherapy in addition to surgery negatively affects selected PROs 1 year after surgery in patients with rectal cancer. Compared with surgery alone, patients report profoundly impaired bowel and sexual function after preoperative radiotherapy. However, global health status/QoL was not affected statistically significantly. These results are an important argument for limiting preoperative radiotherapy to patients with a high risk of recurrence of rectal cancer and may facilitate informed decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>German Clinical Trial Registry Number DRKS00008724 (https://drks.de/search/de/trial/DRKS00008724).</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 7","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144598506","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}