Colorectal Disease最新文献

{"title":"Comment on ‘Clinical frailty scale predicts overall survival after colon cancer surgery in people aged 80 years and older: A prospective multicentre observational study’","authors":"Han Yu, Xingwu Liu","doi":"10.1111/codi.70273","DOIUrl":"https://doi.org/10.1111/codi.70273","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273021","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":"Analysis of preoperative predictors for pouchitis after surgery for ulcerative colitis: A multicentre retrospective study of the clinical outcome of surgery for ulcerative colitis in Japan (COSUC study)","authors":"Hiroaki Kasashima,&nbsp;Tatsunari Fukuoka,&nbsp;Kiyoshi Maeda,&nbsp;Koya Hida,&nbsp;Shingo Ochi,&nbsp;Yoshiaki Takano,&nbsp;Yasuyuki Miyakura,&nbsp;Junichiro Kawamura,&nbsp;Shintaro Kohama,&nbsp;Takeshi Naitoh","doi":"10.1111/codi.70267","DOIUrl":"https://doi.org/10.1111/codi.70267","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pouchitis is a prevalent complication following ileal pouch–anal anastomosis (IPAA) for ulcerative colitis (UC) and significantly impacts patient outcomes. The identification of risk factors and development of predictive models would help to guide perioperative management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicentre retrospective study analysed data from 1136 UC patients who underwent IPAA between 2005 and 2019 as part of the Clinical Outcome of Surgery for Ulcerative Colitis (COSUC) study. Potential risk factors, including demographic, clinical and surgical variables, were assessed using univariable and multivariable logistic regression. A predictive model was developed and validated using separate cohorts, with performance evaluated via receiver operating characteristic (ROC) curve analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pouchitis occurred in 67 patients (5.9%). Univariable analysis identified younger age (&lt;40 years), lower body mass index (BMI) and preoperative use of steroids and immunosuppressants as significant risk factors. Multivariable analysis confirmed preoperative steroid use as the only independent predictor (HR 1.98, <i>p</i> = 0.016). The predictive model achieved an area under the curve (AUC) of 0.63 in the training cohort and 0.67 in the validation cohort. Using a 9.6% probability cut-off, the model demonstrated moderate sensitivity and high specificity in identifying high-risk patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Preoperative corticosteroid use was identified as the only independent risk factor for pouchitis after IPAA in UC patients. A risk model incorporating age, BMI and immunosuppressive therapy was developed and may aid in perioperative risk stratification. However, given the study's retrospective design and limited variable scope, further validation in prospective cohorts is necessary to confirm its clinical utility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70267","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273022","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":"Sarcopenia kinetics and colorectal cancer outcomes: Post-operative development of sarcopenia is a poor prognostic indicator of survival following colorectal cancer surgery","authors":"Nicholas Kesby,&nbsp;Philip Chia,&nbsp;Jessica Yang,&nbsp;Pierre H. Chapuis,&nbsp;Kheng-Seong Ng","doi":"10.1111/codi.70258","DOIUrl":"10.1111/codi.70258","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sarcopenia is defined by a paucity of skeletal muscle mass, strength and function. The relationship between pre-operative sarcopenia and poor surgical outcomes in colorectal cancer (CRC) is well described. This study investigates the novel concept of ‘sarcopenia kinetics’—the change in sarcopenia status over time. Specifically, it aims to assess the association between sarcopenia kinetics and surgical outcomes in patients who have undergone CRC resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An observational cohort study of consecutive patients who underwent surgery between 2016 and 2020 at a tertiary referral centre in Sydney, Australia, was performed. Pre-operative and post-operative CT scans were reviewed to calculate pre-operative and post-operative skeletal muscle indices (SMI). Sarcopenia was defined by the lowest quartile of sex-specific pre-operative SMI. Survival analysis was performed on the basis of change in SMI and sarcopenia classification, with primary end points of overall survival (OS) and disease-free survival (DFS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 545 patients underwent surgery for CRC during the study period. Of these patients, 186 met inclusion criteria, having accessible pre-operative and post-operative CT scans. The study population was 36% female, with a mean age of 76.0 years (SD 11.7). Over a 4.4-year median follow-up, 55 (28%) developed recurrence, and 85 (43%) died, with a 1-year OS of 87.1% (95% CI 81.4–91.2), 5-year OS of 58.6% (95% CI 50.8–65.6) and 5-year DFS of 50.4% (95% CI 42.8–57.5). Post-operative decrease in SMI was associated with poorer OS (HR 1.81 [95% CI 1.16–2.82], <i>p</i> = 0.008). Patients who became sarcopenic post-operatively demonstrated the poorest OS (HR 2.36 [95% CI 1.22–4.58], <i>p</i> = 0.011) and DFS (HR 2.61 [95% CI 1.42–4.80], <i>p</i> = 0.002) when compared with patients who were never sarcopenic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Sarcopenia kinetics, on the basis of SMI change and change in sarcopenia status, are associated with OS and DFS in patients undergoing CRC surgery. Decreasing SMI is associated with poorer OS, while patients who become sarcopenic post-operatively have the poorest outcomes. Sarcopenia kinetics have utility as a prognostic indicator and may represent a modifiable risk factor warranting further investigation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250105","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":"‘Failure to rescue’ from anastomotic leak following colorectal cancer resection: An observational study from a binational registry","authors":"Cameron I. Wells,&nbsp;Wal Baraza,&nbsp;Greg O'Grady,&nbsp;Ian P. Bissett","doi":"10.1111/codi.70262","DOIUrl":"10.1111/codi.70262","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>‘Failure to rescue’ (FTR) has been recognised as a critical factor influencing patient outcomes in colorectal surgery, particularly following major complications such as anastomotic leak (AL). This retrospective study aimed to evaluate the rate and impact of FTR following AL in patients undergoing colorectal cancer resection, and identify independent predictors of FTR-AL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The Bowel Cancer Outcomes Registry was used to identify all patients undergoing colorectal resection with primary anastomosis from 2007 to 2024. The primary outcome of interest was FTR-AL, defined as in-hospital or 30-day mortality following AL. Univariate and multivariate logistic regression models were used to identify independent predictors of FTR-AL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 31,610 patients were included, with AL occurring in 1,569 (5.0%). AL was associated with higher rates of almost all other medical and surgical complications. Associations between AL and its sequelae included return to theatre (OR 45.1, 95% CI 39.9–51.0), enterocutaneous fistula (OR 35.4, 95% CI 17.7–74.4) and sepsis (OR 30.9, 95% CI 25.4–37.7). Overall, in-hospital or 30-day mortality was 1.4%. The rate of FTR-AL was 5.9%, and 21.4% of all deaths occurred following AL. FTR-AL was independently predicted by older age (adjusted OR 1.08, 95% CI 1.04–1.12, <i>p</i> &lt; 0.001), ASA score of 4–5 (adjusted OR 6.75, 95% CI 2.27–20.14, <i>p</i> &lt; 0.001) and sepsis (adjusted OR 3.32, 95% CI 1.65–6.65, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AL contributes to over one in five deaths following colorectal cancer surgery. Elderly and comorbid patients, and those who develop sepsis, are at higher risk of FTR-AL. Further efforts should be directed towards the early detection of AL.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257541","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":"Sequential laparoscopic and perineal approach for aggressive pelvic angiomyxoma – A video vignette","authors":"Rita María Alvo,&nbsp;Esteban González Salazar,&nbsp;Federico Suldrup,&nbsp;Lucas Caram,&nbsp;Juan Campana,&nbsp;Ricardo Esteban Mentz,&nbsp;Gustavo Rossi","doi":"10.1111/codi.70266","DOIUrl":"10.1111/codi.70266","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257494","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":"Clinical nodal staging to assess the risk of local recurrence after rectal cancer resection: A nationwide cross-sectional study","authors":"Mirthe Ubink,&nbsp;Eline G. M. van Geffen,&nbsp;Tania C. Sluckin,&nbsp;Sanne-Marije J. A. Hazen,&nbsp;Karin Horsthuis,&nbsp;Joost Nederend,&nbsp;Regina G. H. Beets-Tan,&nbsp;Martijn P. W. Intven,&nbsp;Cornelis Verhoef,&nbsp;Miranda Kusters,&nbsp;Pieter J. Tanis,&nbsp;the Dutch Snapshot Research Group","doi":"10.1111/codi.70257","DOIUrl":"10.1111/codi.70257","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>In rectal cancer, neo-adjuvant (chemo)radiotherapy (n(C)RT) should be used selectively, due to related toxicity. The decision to offer n(C)RT is mainly based on preoperative MRI staging. cN category has limited accuracy and its use when deciding on n(C)RT is controversial. This population-based study aimed to assess the association between cN category and local recurrence (LR) rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Data from a national cross-sectional cohort of patients who underwent curative resection of primary rectal cancer in the Netherlands in 2016 were used. Patients were subdivided by neo-adjuvant treatment strategy: no n(C)RT, short-course RT with short interval to surgery (SCRT-SI) or downstaging therapy (SCRT with long interval to surgery, CRT, total neoadjuvant therapy or chemotherapy only). The 4-year LR rate was calculated per (y)cN category and corrected for known pre-operative confounders in Cox-regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 2148 included patients, 1000 received no n(C)RT, 449 SCRT-SI and 699 downstaging therapy. Median follow-up was 50 months (interquartile range [IQR] 38–55). The 4-year LR rates for cN0, cN1 and cN2 were 6.3%, 5.0% and 6.2% without n(C)RT, and 0%, 2.4% and 0% after SCRT-SI. In patients treated with downstaging therapy, not primary cN, but restaging ycN category was significantly associated with LR rate (9.1%, 17.4% and 18.5%; <i>p</i> = 0.006) in univariable analysis. In multivariable analysis, no association was observed between ycN and LR (<i>p</i> = 0.088).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Evaluation of nationwide clinical practice did not reveal significant associations between cN category and LR rate after rectal cancer resection within three neo-adjuvant treatment groups, which questions its validity for clinical decision-making.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70257","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250101","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":"Robotic total pelvic exenteration (TPE) with perineal urethrectomy—A video vignette","authors":"Alexandra Ruiyan Hu,&nbsp;Amrish K. S. Rajkomar,&nbsp;Marlon Perera,&nbsp;Patrick W. Owens,&nbsp;Satish K. Warrier","doi":"10.1111/codi.70270","DOIUrl":"10.1111/codi.70270","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250169","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":"ASGIIFT (Autologous Skin Graft Intersphincteric Implantation in anal Fistula Treatment): Additional step in LIFT procedure for complex transsphincteric anal fistula – A video vignette","authors":"Damir Karlović,&nbsp;Lucia Klarica,&nbsp;Dorian Kršul,&nbsp;Nikola Simičić,&nbsp;Marko Zelić","doi":"10.1111/codi.70272","DOIUrl":"10.1111/codi.70272","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250098","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":"Mechanical bowel preparation plus oral antibiotics reduces surgical site infection and anastomotic leak rates in elective colorectal cancer surgery: A systematic review and meta-analysis of randomised controlled trials","authors":"Rathin Gosavi,&nbsp;Raelene Tan,&nbsp;William Teoh,&nbsp;Raymond Yap,&nbsp;Paul McMurrick,&nbsp;Geraldine Ooi,&nbsp;Vignesh Narasimhan","doi":"10.1111/codi.70263","DOIUrl":"10.1111/codi.70263","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Surgical site infection (SSI) and anastomotic leak (AL) are major contributors to postoperative morbidity in elective colorectal surgery. Although the addition of oral antibiotics (oAB) to mechanical bowel preparation (MBP) is recommended by several professional societies, uncertainty remains about its effectiveness and hence uptake globally is inconsistent, particularly in patients undergoing surgery for colorectal cancer (CRC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis (PROSPERO CRD420251055720) of randomised controlled trials comparing MBP plus oAB with MBP alone in adult patients undergoing elective colorectal cancer resection. The primary outcomes were overall SSI. Secondary outcomes included CDC-defined SSI subtypes, AL and <i>Clostridium difficile</i> infection. A prespecified subgroup analysis was performed for trials limited to rectal cancer resections. Risk of bias was assessed using the RoB 2.0 tool, and the certainty of evidence was evaluated with GRADE methodology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine trials comprising 3046 patients with colorectal cancer met inclusion criteria. Compared with MBP alone, the addition of oAB significantly reduced the risk of SSI (RR: 0.55, 95% CI: 0.44–0.68; <i>I</i>² = 8%; <i>p</i> &lt; 0.001) and AL (OR: 0.45, 95% CI: 0.32–0.65; <i>I</i>² = 0%; <i>p</i> &lt; 0.001). This benefit persisted across CDC-defined superficial incisional (RR: 0.53, 95% CI: 0.34–0.82; <i>p</i> = 0.005), deep incisional (RR: 0.40, 95% CI: 0.22–0.71; <i>p</i> = 0.002) and organ/space infections (RR: 0.55, 95% CI: 0.39–0.78; <i>p</i> &lt; 0.001). In rectal cancer patients (<i>n</i> = 1172), the pooled risk of SSI remained lower with MBP plus oAB (RR: 0.48, 95% CI: 0.29–0.79; <i>I</i>² = 41%; <i>p</i> = 0.004) and AL (OR: 0.40, 95% CI: 0.25–0.65; <i>I</i>² = 0%; <i>p</i> &lt; 0.001). Sensitivity analyses confirmed the robustness of these findings. The certainty of evidence was rated as moderate to high for all primary outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The addition of oral antibiotics to mechanical bowel preparation significantly reduces the risk of SSI and anastomotic leak in elective colorectal cancer surgery. The benefits are consistent in rectal cancer-specific cohorts, supporting the integration of oral antibiotics into standard bowel preparation protocols for patients undergoing colorectal cancer resection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243780","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":"Recto-vaginal fistula repair with a Gracilis flap interposition: A video vignette","authors":"Osama Zaman,&nbsp;Doraisami Mohan,&nbsp;Zahid Siddiqui,&nbsp;Emmanuel Ogbonna,&nbsp;Christiana Langma,&nbsp;Salomone Di Saverio,&nbsp;Akinfemi Akingboye","doi":"10.1111/codi.70268","DOIUrl":"10.1111/codi.70268","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 10","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243845","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}