Colorectal Disease最新文献

{"title":"Laparoscopic intersphincteric resection combined with rectal eversion and modified Bacon procedure plus left lateral pelvic lymph node dissection: A video vignette.","authors":"Yuanyi Rui, Qi Guo, Bo Yi, Hao Tian, Qiang Zhao, Yangchun Zheng","doi":"10.1111/codi.70462","DOIUrl":"https://doi.org/10.1111/codi.70462","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 5","pages":"e70462"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764467","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 sigmoid colectomy using the Hugo™ RAS system-A video vignette.","authors":"Ananthakrishnan Balakrishnan, Naveena A N Kumar, Akhil Palod, Nawaz Usman, Preethi S Shetty","doi":"10.1111/codi.70467","DOIUrl":"https://doi.org/10.1111/codi.70467","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 5","pages":"e70467"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764610","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 Garg phenomenon in supralevator anal fistulas: Avoiding overtreatment of the additional supralevator rectal opening to preserve continence.","authors":"Nicola Clemente, Abdallah Hmitti, James C W Khaw","doi":"10.1111/codi.70465","DOIUrl":"10.1111/codi.70465","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 5","pages":"e70465"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764624","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":"Sexual dysfunction is highly prevalent in patients with active perianal fistulizing Crohn's disease: Outcomes from a large national prospective cohort study.","authors":"Michiel T J Bak, Annemarie C de Vries, Laurents P S Stassen, Moniek M Ter Kuile, Andrea E van der Meulen-de Jong, Oddeke van Ruler","doi":"10.1111/codi.70466","DOIUrl":"10.1111/codi.70466","url":null,"abstract":"<p><strong>Background: </strong>Sexual function is one of the determinants of quality of life (QoL) and is prevalent in approximately half of the patients with inflammatory bowel disease. However, the sexual function in patients with perianal fistulizing Crohn's disease (pCD) needs to be further elucidated. This study aimed to evaluate the sexual function, the correlation with health-related QoL (HR-QoL), and to identify risk factors for sexual dysfunction (SD) in patients with active pCD.</p><p><strong>Methods: </strong>Patients with active pCD were identified from a prospective multicentre cohort study in 41 Dutch hospitals. Respondents to sexual function (FSFI for females or IIEF-5 for males) and HR-QoL questionnaires were included in this study. The primary outcome was the prevalence of SD (FSFI <26.55, IIEF-5 <22). Potential risk factors for SD were identified using multivariable logistic regression.</p><p><strong>Results: </strong>211 patients were included (52% females, median age 37 years, median pCD duration 4 years). Overall, SD was reported by 69% (females 75%, males 63%, p = 0.046). A weak correlation of SD was observed with the CAF-QoL scale (r = 0.25) and the sIBDQ (r = -0.24). Older age (aOR 1.0; 95% CI 1.0-1.1), a longer pCD duration (aOR 0.9; 95% CI 0.8-0.9) and a decreased pCD-related QoL (aOR 1.0; 95% CI 1.0-1.1) were independently associated with SD. In subgroup analysis of patients with a known partner status (66.1%), having a partner (aOR 0.3; 95% CI 0.1-0.9) was identified as a protective factor.</p><p><strong>Conclusion: </strong>Sexual dysfunction is common in both male and female patients with active pCD. A weak correlation between HR-QoL and sexual dysfunction suggests that these questionnaires do not fully assess sexual function, highlighting the need for separate evaluation. Factors such as age, reduced pCD-related QoL, longer pCD duration and having a partner were associated with sexual dysfunction. Given its prevalence, routine sexual function assessment by the treating team is recommended, with referral to a sexologist or other expert when needed.</p>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 5","pages":"e70466"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764573","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":"Modulation of the gut microbiota as a novel strategy to prevent anastomotic leak after colorectal surgery: Systematic scoping review.","authors":"Jack A Helliwell, Peter Sciberras, Alexios Dosis, Joshua Burke, Caroline H Chilton, Henry M Wood, David G Jayne","doi":"10.1111/codi.70472","DOIUrl":"https://doi.org/10.1111/codi.70472","url":null,"abstract":"<p><strong>Background: </strong>Anastomotic leak (AL) remains a major source of morbidity following colorectal surgery. Increasing evidence implicates the gut microbiome in the pathogenesis of AL, with certain microbial species disrupting tissue repair through collagen degradation. Perioperative modulation of the microbiome may offer a novel strategy to improve anastomotic healing. This scoping review aimed to map available evidence on microbiome-targeted interventions, synthesise mechanistic insights, and identify translation gaps in relation to anastomotic outcomes.</p><p><strong>Methods: </strong>A systematic scoping review was performed. MEDLINE, Embase and Cochrane Central Registry of Controlled Trials databases were searched from database inception to 5th August 2025. Studies were eligible if they investigated perioperative interventions that modulated the gut microbiome and evaluated anastomotic healing or leak rates. Both clinical and preclinical studies were included. A narrative synthesis was performed by charting key findings.</p><p><strong>Results: </strong>Of 4209 records screened, 27 studies met the inclusion criteria: 9 clinical and 18 preclinical. Interventions included bowel preparation, probiotics, synbiotics, arginine/omega-3 supplementation, dietary modification, faecal microbiota transplantation (FMT), phosphate, tranexamic acid, morphine and infliximab. Among clinical studies, only oral antibiotics combined with mechanical bowel preparation were associated with a significant reduction in leak rates. Preclinical studies showed interventions such as high-fibre diets, FMT, rectal tranexamic acid and phosphate supplementation improved anastomotic healing via enhanced microbial diversity, suppression of pathogenic organisms, or inhibition of collagenolytic activity.</p><p><strong>Conclusion: </strong>This review highlights a range of microbiome-targeted interventions with potential to reduce AL. While clinical evidence remains limited, several preclinical strategies demonstrate promise and warrant evaluation in early-phase human trials.</p>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 5","pages":"e70472"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834595","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":"Technical video: Transperineal anterior levatorplasty for symptomatic rectocele with perineal descent: A video vignette.","authors":"Ufuk Tali, Fatma Ayca Gultekin","doi":"10.1111/codi.70473","DOIUrl":"https://doi.org/10.1111/codi.70473","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 5","pages":"e70473"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811723","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":"Anal sphincter function in conservatively managed rectal intussusception at long-term follow-up: A prospective anal acoustic reflectometry study with comparison to healthy volunteer data.","authors":"Alexander O'Connor, Matthew Davenport, Niels Klarskov, Abhiram Sharma, Dipesh H Vasant, John McLaughlin, Edward Kiff, Karen Telford","doi":"10.1111/codi.70455","DOIUrl":"10.1111/codi.70455","url":null,"abstract":"<p><strong>Aim: </strong>Rectal intussusception (RI), proposed to be a progressive condition, is associated with internal sphincter dysfunction. This study examines sphincter function using anal acoustic reflectometry (AAR) at long-term follow-up.</p><p><strong>Methods: </strong>A prospective study of conservatively managed patients attending a tertiary pelvic floor unit. Clinical, AAR and symptom severity data were analysed at baseline and follow-up (>5 years). Patients were grouped into intra-rectal (Oxford I-II) or intra-anal RI (III-IV). Data from asymptomatic volunteers were used to estimate the effect of ageing on AAR parameters.</p><p><strong>Results: </strong>Twenty-nine patients (27 female; median age: 66 years) were recruited, with follow-up at a median of 66 (IQR: 64-67) months. Twelve were diagnosed with intra-rectal RI and 17 with intra-anal RI at baseline. No patient developed an external rectal prolapse. There were no differences in quality of life, faecal incontinence or constipation symptoms in either group at follow-up (p > 0.05). A non-significant decrease in opening pressure, a measure of internal sphincter function, was seen in both intra-rectal (-4.0 cmH₂O; p = 0.530) and intra-anal RI (-3.7 cmH₂O; p = 0.287). In healthy volunteers, opening pressure was associated with age (r = -0.402; p < 0.001) and a decline of 2.90 cmH₂O (95% CI: -4.35 to -1.50) would be expected after 5 years. Incremental squeeze opening pressure showed a non-significant increase in intra-rectal RI (8.4 cmH₂O; p = 0.099) and no change in intra-anal RI (-1.7 cmH₂O; p = 0.532).</p><p><strong>Conclusion: </strong>There were no significant changes in patient-reported symptoms or anal sphincter function in conservatively managed RI at follow-up, challenging the concept of a progressive condition with a detrimental impact on sphincter function.</p>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 5","pages":"e70455"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764025","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":"Management of rectal anastomotic leaks using modified endoluminal vacuum therapy.","authors":"Bülent Cavit Yüksel, Özgür Harmancı","doi":"10.1111/codi.70463","DOIUrl":"10.1111/codi.70463","url":null,"abstract":"<p><strong>Background: </strong>Anastomotic leak (AL) remains one of the most feared complications following rectal surgery in stable patients with localized abscesses or contained leaks, nonoperative approaches may be considered, including broad-spectrum antibiotics, image-guided percutaneous drainage, transanal lavage and endoluminal vacuum therapy (EVT).</p><p><strong>Method: </strong>The procedure is performed under sedation with the patient in the left lateral Sims position. After assessing the defect location and size, a standard endoscope is introduced, and a guidewire is used to measure the cavity length, the distal end of the cavity. A sponge is prepared to cover the distal portion of the defect. The catheter tip remains sponge-free but is perforated and positioned at the apex of the cavity using the over-the-guidewire technique or by direct placement with endoscopic large grasping forceps.</p><p><strong>Results: </strong>We applied this method to a total of 3 patients. We applied it twice to the first two patients and three times to the third patient. In one patient, the abscess and sinus condition improved. In two patients, the sinus closed completely. In three patients, the opening at the anastomosis was almost completely repaired after 3 sessions. No complications occurred during the procedures.</p><p><strong>Conclusion: </strong>Modified EVT is a cost-effective, easy-to-assemble and patient-specific version of traditional vacuum therapy. Its ability to accommodate irregular leakage spaces allows for more efficient negative-pressure application, accelerates cavity collapse and granulation and improves patient comfort by allowing for longer change intervals. This technique can broaden access to EVT and improve outcomes in selected patients.</p>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 5","pages":"e70463"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764510","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":"Expert consensus on robotic colorectal surgery proctoring in the UK.","authors":"Matthew Harris, Taner Shakir, Frances Dixon, Anu Krishna, Charles Evans, Richard Justin Davies, Subash Vasudevan, Kenneth Campbell, Julian Hance, Douglas Speake, Philip Varghese, Oroog Ali, Kai Leong, Barrie Keeler, Jonathan Morton, Nuha Yassin, Shakil Ahmed, Irshad A Shaikh, Danilo Miskovic, Jim Khan, Deena Harji","doi":"10.1111/codi.70468","DOIUrl":"10.1111/codi.70468","url":null,"abstract":"<p><strong>Background: </strong>The adoption of robotic-assisted surgery (RAS) in colorectal practice is accelerating, supported by growing evidence of clinical benefit. Robotic proctors play a critical role in ensuring safe dissemination by guiding and supporting new users. However, national standards outlining their responsibilities, training and governance remain undefined.</p><p><strong>Methods: </strong>All UK-based colorectal robotic proctors within the Association of Coloproctology of Great Britain and Ireland (ACPGBI) were invited to participate in a consensus process structured around eight predefined domains. These were informed by a prior scoping meeting. Participants received a summary report and had the opportunity to propose additional themes. A modified nominal group technique was used to generate and vote on statements. Final statements were circulated for further input post-meeting.</p><p><strong>Results: </strong>Twelve of twenty invited proctors participated. A total of 32 statements were generated; 30 reached consensus and 21 were unanimously supported. Key recommendations include: (1) Robotic proctorship in the UK should encompass proctoring, preceptoring, coaching and mentoring tailored to individual surgeon needs. (2) Proctors should complete a robotic-specific 'Train the Trainers' course or equivalent. (3) Proctors must ensure the proctee can safely operate the system whilst maintaining patient safety and delivering structured feedback. (4) Industry should support communication, theatre team training and structured feedback mechanisms. (5) A distinction should be made between first- and second-generation proctors to support safe innovation in new robotic platforms.</p><p><strong>Conclusion: </strong>This expert consensus provides one of the first structured frameworks for robotic proctoring in colorectal surgery, aiming to improve training consistency, professional standards and patient safety.</p>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 5","pages":"e70468"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811769","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":"Optimisation before Crohn's surgery using Exclusive enteral Nutrition (OCEaN): A randomised controlled trial to determine whether preoperative exclusive enteral nutrition is more clinically and cost effective compared with standard care in patients undergoing surgery for Crohn's disease.","authors":"Pooja Badwal, Joshua Baxter, Fran Brown, Rachel Cooney, Caris Grimes, Jack Hall, Karl Hazel, Manjinder Kaur, Miranda Lomer, Thomas Pinkney, Natalie Rowland, Konstantinos Gerasimidis, Asif Iqbal, Laura Magill, Jonathan Mathers, Raymond Oopong","doi":"10.1111/codi.70435","DOIUrl":"10.1111/codi.70435","url":null,"abstract":"<p><strong>Background: </strong>Exclusive enteral nutrition (EEN) is commonly used in paediatric Crohn's disease patients as a first-line therapy for inducing remission. Despite advances in immunosuppressive and biologic treatments, 23%-47% of patients with Crohn's disease will require surgery, with approximately 22% needing repeat surgeries. Potential suggested benefits of EEN in the perioperative setting include reduced steroid usage, reduced operative complications, and reduced need for stoma formation.</p><p><strong>Methods: </strong>A multi-centre, two-arm, parallel group, open-label, pragmatic randomised controlled trial to assess the clinical and cost-effectiveness of preoperative EEN. The trial will be conducted in at least 40 UK-wide tertiary and district general NHS hospitals. Participants will be randomised to either six weeks of preoperative EEN or standard care as per local standard care. Primary outcomes will be quality of life and post-surgical complications at six weeks and 30 days post-surgery, respectively.</p><p><strong>Discussion: </strong>The optimisation before Crohn's surgery using exclusive enteral nutrition trial aimed to determine whether preoperative EEN is more clinically and cost effective compared with standard care in patients undergoing surgery for Crohn's disease.</p><p><strong>Trial registration: </strong>ISRCTN73953171.</p>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 5","pages":"e70435"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764499","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}