Colorectal Disease最新文献

{"title":"Does timing of ileostomy closure impact postoperative morbidity?","authors":"Maxwell D. Mirande,&nbsp;Katherine A. Bews,&nbsp;Justin T. Brady,&nbsp;Dorin T. Colibaseanu,&nbsp;Sherief F. Shawki,&nbsp;William R. Perry,&nbsp;Kevin T. Behm,&nbsp;Kellie L. Mathis,&nbsp;Nicholas P. McKenna","doi":"10.1111/codi.70088","DOIUrl":"https://doi.org/10.1111/codi.70088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Reversal of diverting loop ileostomy (DLI) traditionally occurs at ≥12 weeks after formation. Early closure has been performed in attempts to reduce DLI-associated morbidity. Therefore, the aim of this study was to determine whether time to stoma reversal impacts postoperative morbidity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A retrospective review was conducted using institutional-level American College of Surgeons National Surgical Quality Improvement Program data for adult patients who underwent DLI closure between January 2012 and December 2021 across a multistate health system. Time to DLI closure was stratified into three groups: ≤12, 12–24 or 24–36 weeks. Additional data were obtained from the electronic medical record. The primary outcome was major morbidity after DLI closure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 482 patients underwent DLI closure. Eighty four patients underwent closure at ≤12 weeks (17.4%), 300 at 12–24 weeks (62.2%) and 98 at 24–36 weeks (20.3%). The most common diagnosis at DLI formation was cancer (<i>n</i> = 211, 43.8%). Patients in the ≤12 weeks closure group more commonly had ulcerative colitis or diverticular disease and a lower American Society of Anesthesiologists class than patients with closure at 24–36 weeks (<i>p</i> &lt; 0.05). There were no significant differences in complication severity, overall major morbidity or its individual components amongst the time to DLI closure groups. There were no differences in anastomotic leaks or need for laparotomy. On multivariable analysis, immunosuppressive therapy and preoperative haematocrit &lt;30% were significant risk factors for major morbidity after DLI closure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Major morbidity did not differ by time to DLI closure group, indicating that closure at ≤12 weeks is safe in selected patients.</p>\u0000 </section>\u0000 </div>","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":"143793412","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":"Ventral mesh rectopexy: Variations in technique and care process. A multicentre study","authors":"Ellen Coeckelberghs,&nbsp;Ahmed M. Chaoui,&nbsp;Mohamed Abasbassi,&nbsp;Gabriele Bislenghi,&nbsp;Katrien Boon,&nbsp;Michel Goethals,&nbsp;Tom Hendrickx,&nbsp;Bert Houben,&nbsp;Marc Krick,&nbsp;Frederic Meekers,&nbsp;Paul Pattyn,&nbsp;Pieter Pletinckx,&nbsp;Deborah Seys,&nbsp;Jasper Stijns,&nbsp;Sylvie Van den Broeck,&nbsp;Bart Van Geluwe,&nbsp;Yves Pirenne,&nbsp;Albert M. Wolthuis,&nbsp;Kris Vanhaecht,&nbsp;André D'Hoore","doi":"10.1111/codi.70084","DOIUrl":"https://doi.org/10.1111/codi.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this improvement collaborative is to explore the variation in care within and between Flemish hospitals in preoperative assessment, surgical indications, perioperative management and surgical technique for ventral mesh rectopexy (VMR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This observational, cross-sectional multicentre study was performed in 14 Flemish hospitals. Twenty consecutive patients per hospital undergoing primary VMR in 2022 were included. Quality of care was assessed via predefined perioperative disease-specific quality indicators (QIs) by means of structured questionnaires. Data were collected from electronic patient files.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 280 patients were included. All patients were female and their mean age was 62 ± 14 years. Significant intra- and interhospital variation was observed in preoperative work-up, indications, operative technique and postoperative management. Total rectal prolapse was the indication for VMR in only 17.5% of the patients. The surgical approach was minimally invasive in all cases, with 40% via a robotic and 60% a laparoscopic approach. Fifteen per cent of patients had mechanical bowel preparation. All centres used a synthetic polypropylene mesh to perform a VMR, and in 85.6% (<i>n</i> = 238) of all patients a lightweight mesh was used. Diverging practices were noted as to type of mesh fixation to the rectum. In one third of patients a nonresorbable suture was combined with biological glue (<i>n</i> = 89, 31.8%). The overall mean length of stay was 2.1 (± 2.7) days. Only 3% of the procedures were performed as same day discharge, 47% of the patients remained for 1 day and 50% for ≥2 days. Only four patients were readmitted within 30 days after surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study shows a significant variation in the perioperative management and surgical technique for VMR between hospitals, ongoing controversies and a lack of standardization. This collaborative can serve as a structured feedback tool to define minimum QIs and minimum outcome reporting parameters. Consensus building and adherence to evidence-based guidelines should reduce variation in care processes and lead to improved patient outcomes.</p>\u0000 </section>\u0000 </div>","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":"143793411","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":"Early detection and immediate repair of iatrogenic ureteral injury in laparoscopic anterior resection for recurrent rectal cancer—A video vignette","authors":"Carlo Alberto Manzo,&nbsp;Caterina Baldi,&nbsp;Leonardo Lorusso,&nbsp;Ai Ling Romanò,&nbsp;Gianluca Matteo Sampietro","doi":"10.1111/codi.70096","DOIUrl":"https://doi.org/10.1111/codi.70096","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":"143793414","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":"Oncological and functional outcomes after sacrectomy for colorectal cancer: A systematic review","authors":"Nathalie Braeckman,&nbsp;Eva Kerckhove,&nbsp;Andreas Denys,&nbsp;Gwen Sys,&nbsp;Gabriëlle H. van Ramshorst","doi":"10.1111/codi.70083","DOIUrl":"https://doi.org/10.1111/codi.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Worldwide, of all cancers, colorectal cancer has the fourth highest rate of mortality. Curative treatment for locally advanced or recurrent rectal cancer can require extended resections with sacrectomy, but this sugery can have major consequences for patients. The aim of this study was to investigate the oncological and functional outcomes after sacrectomy in patients with colorectal cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The protocol was registered in (PROSPERO), the international prospective register of systematic reviews. PubMed, Embase, The Cochrane Library, Scopus and Google Scholar were searched using a predetermined search strategy. Article selection, quality of evidence [Grading of Recommendation, Assessment, Development and Evaluation (GRADE)] and risk of bias [The Risk Of Bias In Non-randomized Studies—of Interventions (ROBINS-I)] were assessed by two independent reviewers. Studies reporting on sacrectomy for colorectal cancer were included. Oncological and functional outcomes after sacrectomy for colorectal cancer were the primary outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-six articles with 1687 patients (1115 men; 506 women) were included. Median follow-up was 31.4 months. Mean 30-day mortality was 1.1%. After R0 resection, overall survival was achieved in 86.2%, 68.0% and 42.1% patients, and disease-free survival was achieved in 75.0%, 51.0% and 43.0% patients, respectively, after 1, 3 and 5 years. Survival rates were lower after R1 or R2 resection. Most patients reported elimination of or significantly reduced pain after surgery, and 82.2% were able to walk independently, without the use of assistive devices. More patients were dependent on walking-assist devices after high sacrectomy than after low sacrectomy. The most commonly reported bowel dysfunctions were bowel obstruction (22.3%) and fistula (4.6%). Bladder dysfunction was mainly reported as incontinence (8.3%) and neurogenic bladder (23.3%). No study included quality of life as an outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The mortality was limited, and the morbidity rates were in concordance with published literature. The results suggest that R0 resection has higher survival rates than R1/R2 resections. Both short- and long-term functional outcomes could have major impact on a patient's quality of life. Heterogeneity was high, and neither comparative analyses nor meta-analysis could be performed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778119","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 excision of a rare retrorectal cyst: Demonstration of operative strategy—A video vignette","authors":"Mahmood Al-Dhaheri,&nbsp;Ali Toffaha,&nbsp;Ibrahim Amer,&nbsp;Mahwish Khawar,&nbsp;Mohamed AbuNada,&nbsp;Amjad Parvaiz","doi":"10.1111/codi.70080","DOIUrl":"https://doi.org/10.1111/codi.70080","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762119","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 left-sided intracorporeal anastomosis with indocyanine green – A video vignette","authors":"Da Wei Thong,&nbsp;Abraham Jacob,&nbsp;Ruben Rajan","doi":"10.1111/codi.70082","DOIUrl":"https://doi.org/10.1111/codi.70082","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741039","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 right hemicolectomy with D3 lymphadenectomy—A video vignette","authors":"Celia Martinez Alvez,&nbsp;Javier Corral Rubio,&nbsp;Clara Gené Skrabec,&nbsp;Anna Vidal Carné,&nbsp;Ingrid Tapiolas Gracia,&nbsp;David Parés Martinez","doi":"10.1111/codi.70079","DOIUrl":"https://doi.org/10.1111/codi.70079","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741044","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 multicentre prospective single-arm clinical trial to evaluate the treatment outcomes of prophylactic laparoscopic lateral pelvic lymph node dissection for advanced lower rectal cancer","authors":"Atsushi Hamabe,&nbsp;Junichi Nishimura,&nbsp;Yozo Suzuki,&nbsp;Masayoshi Yasui,&nbsp;Masakazu Ikenaga,&nbsp;Tsukasa Tanida,&nbsp;Shinichi Yoshioka,&nbsp;Yoshihito Ide,&nbsp;Yusuke Takahashi,&nbsp;Hiroshi Takeyama,&nbsp;Takayuki Ogino,&nbsp;Hidekazu Takahashi,&nbsp;Norikatsu Miyoshi,&nbsp;Makoto Fujii,&nbsp;Yuko Ohno,&nbsp;Hirofumi Yamamoto,&nbsp;Kohei Murata,&nbsp;Mamoru Uemura,&nbsp;Yuichiro Doki,&nbsp;Hidetoshi Eguchi","doi":"10.1111/codi.70078","DOIUrl":"https://doi.org/10.1111/codi.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>There has been no prospective multicentre validation of the treatment outcomes of minimally invasive lateral pelvic lymph node dissection for lower rectal cancer; hence, this prospective study aimed to evaluate the treatment outcomes of prophylactic laparoscopic lateral pelvic lymph node dissection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Between May 2018 and August 2021, 90 patients with Stage II–III rectal cancer were registered. The clearance range for lateral pelvic lymph node dissection included the lymph nodes around the internal iliac artery and the obturator lymph nodes, while the autonomic nerves were generally preserved. The primary outcome was the incidence of Grade III–IV postoperative complications at discharge. The secondary outcomes were surgical and pathological outcomes, urinary function, sexual function, disease-free survival and overall survival. The experience of each facility and surgeon requirements were set to maintain quality control of lateral pelvic lymph node dissection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 90 patients, 87 were analysed after exclusion of ineligible patients. There were 30 and 57 cases, respectively, of Stage II and III rectal cancer, among which 17 patients underwent neoadjuvant chemotherapy. The median operating time and blood loss were 472 min and 55 mL, respectively. Postoperative complications were observed in 22 patients (25.3%), and the primary outcome of Grade III postoperative complication was observed in five patients (5.7%). Eight lateral lymph nodes were harvested bilaterally, and lateral lymph node metastasis was observed in 14 patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Prophylactic lateral pelvic lymph node dissection can be safely performed with adequately quality-controlled laparoscopic procedures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741043","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":"The use of preoperative enteral immunonutrition in patients undergoing elective colorectal cancer surgery: A systematic review and meta-analysis","authors":"Tyler McKechnie,&nbsp;Tania Kazi,&nbsp;Ghazal Jessani,&nbsp;Victoria Shi,&nbsp;Niv Sne,&nbsp;Aristithes Doumouras,&nbsp;Dennis Hong,&nbsp;Cagla Eskicioglu","doi":"10.1111/codi.70061","DOIUrl":"https://doi.org/10.1111/codi.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The present systematic review and meta-analysis aims to compare adult patients receiving enteral immunonutrition prior to elective colorectal surgery with those receiving conventional preoperative nutrition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>MEDLINE, Embase and the Cochrane Central Register of Controlled Trials were searched from database inception to March 2024. Articles were included if they were randomized controlled trials or cohort studies evaluating adult patients undergoing elective colorectal surgery comparing preoperative enteral immunonutrition with conventional preoperative nutrition protocols. Main outcomes of interest included surgical site infection, anastomotic leak, overall postoperative morbidity and postoperative length of stay. An inverse variance random effects meta-analysis was performed. Risk of bias was assessed with Cochrane risk of bias assessment tools. The GRADE approach was conducted to assess quality of evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After reviewing 2508 relevant citations, 10 studies met inclusion criteria. Overall, 1521 patients (mean age 64.9 ± 10.0 years, 49.4% women) received preoperative immunonutrition and 1816 patients (mean age 64.1 ± 11.0 years, 52.1% women) received conventional preoperative nutrition. Across seven studies, there was a non-significant 30% relative risk reduction of surgical site infection (risk ratio 0.70, 95% CI 0.44–1.11, <i>P</i> = 0.13, <i>I</i>² = 33%) and a non-significant 44% relative risk reduction of anastomotic leak (risk ratio 0.56, 95% CI 0.28–1.10, <i>P</i> = 0.09, <i>I</i>² = 0%) in the immunonutrition group. Across eight studies, postoperative length of stay was 0.48 days shorter in the immunonutrition group (mean difference −0.48, 95% CI −0.84 to −0.12, <i>P</i> = 0.01, <i>I</i>² = 53%). GRADE certainty of evidence was low or very low for all outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While point estimates suggest a likely benefit associated with preoperative enteral immunonutrition, wide corresponding 95% CIs suggest uncertainty remains. Further prospective study is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726847","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 colectomy for familial adenomatous polyposis and synchronous right colon cancer: a video vignette","authors":"Igor Monsellato,&nbsp;Teresa Gatto,&nbsp;Federico Sangiuolo,&nbsp;Marco Palucci,&nbsp;Celeste del Basso,&nbsp;Fabrizio Panaro","doi":"10.1111/codi.70076","DOIUrl":"https://doi.org/10.1111/codi.70076","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 4","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707243","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}