Colorectal Disease最新文献

{"title":"Drain fluid iodine as a biomarker of anastomotic leak after low anterior resection in patients undergoing Gastrografin rectal tube flushes and omission of a diverting ileostomy: The GUSH study","authors":"David A. Clark,&nbsp;Karen Dobeli,&nbsp;Darren Allen,&nbsp;Brett McWhinney,&nbsp;Michael Lonne,&nbsp;GUSH Study Collaborators,&nbsp;Aleksandra Edmundson","doi":"10.1111/codi.70031","DOIUrl":"https://doi.org/10.1111/codi.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Anastomotic leak (AL) is the anathema of colorectal surgery and its occurrence constitutes a serious risk to patients and places a substantial burden on the health system. The analysis of extravasated intraluminal substances in drain fluid has shown promise for the early detection of AL. The aim of this study is to assess the measurement of drain fluid iodine as a biomarker of AL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This prospective, observational, 2b exploration cohort study measured the iodine in drain fluid of patients undergoing a low colorectal anastomosis and without a diverting ileostomy (DI) when the rectal tube was flushed with Gastrografin®. Iodine was measured by dual-energy computed tomography (DECT) and inductively coupled plasma mass spectroscopy (ICPMS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-six patients underwent a rectal resection and low colorectal anastomosis. Five patients experienced an AL. Four had grade C AL and returned to the operating theatre for peritoneal lavage and DI. The fifth was diagnosed at 30 days postoperatively and underwent image-guided drainage (grade B). The mean drain fluid iodine was significantly elevated in patients who experienced an AL compared with those who did not, as measured by DECT and ICPMS. The mean iodine value was 6.05 mg/mL vs. 0.088 mg/mL (<i>p</i> &lt; 0.0001) for DECT and 41 437 μmol/L vs. 3.81 μmol/L (<i>p</i> &lt; 0.0001) for ICPMS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study showed that drain iodine can be used as a sensitive indicator of early AL in patients undergoing a rectal resection with an extraperitoneal colorectal anastomosis and omission of a DI and when the rectal tube is flushed with Gastrografin following surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143446951","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":"Total proctocolectomy with ileal pouch anal anastomosis using the Versius robotic surgical system—A video vignette","authors":"Raj Nagarkar,&nbsp;Vikas Jain,&nbsp;Kalyan Kumar Kunda,&nbsp;Yasam Venkata Ramesh","doi":"10.1111/codi.70040","DOIUrl":"https://doi.org/10.1111/codi.70040","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143446952","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":"Management of colorectal anastomotic stricture post-low anterior resection—A video vignette","authors":"Pinak Dasgupta,&nbsp;Tarun Sai,&nbsp;Ajay Pai,&nbsp;Niranjan Ravuri","doi":"10.1111/codi.70034","DOIUrl":"https://doi.org/10.1111/codi.70034","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439133","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":"Colovesical fistula: When the treatment of choice does not work—a video vignette","authors":"Paolo Fabiano,&nbsp;Francisco Reyes Martinez,&nbsp;Marlo Saenz Gallo","doi":"10.1111/codi.70030","DOIUrl":"https://doi.org/10.1111/codi.70030","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439132","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":"Editorial February 2025: Robotics and sustainability in instrument design and manufacturing","authors":"Carlos Pastor,&nbsp;Patricia Tejedor","doi":"10.1111/codi.70033","DOIUrl":"https://doi.org/10.1111/codi.70033","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424079","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":"Faecal calprotectin as a non-invasive marker of Crohn's disease in anal fistulas","authors":"Helene Perregaard,&nbsp;Freja Pust,&nbsp;Andreas Nordholm-Carstensen","doi":"10.1111/codi.70026","DOIUrl":"https://doi.org/10.1111/codi.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Faecal calprotectin (FC) is a noninvasive marker that reflects intestinal inflammation with good sensitivity. A prior study indicated that FC values above 150 μg/g could distinguish between anal fistulas (AF) of cryptoglandular or Crohn's disease (CD) origin. It is hypothesized as a useful triage test to rule out CD in newly referred AF patients, thus reducing the number of ileocolonoscopies performed and optimizing treatment regimens in AF while minimizing patient discomfort as well as healthcare costs. The aim of the study was to determine the accuracy of FC in distinguishing between anal fistulas of cryptoglandular and CD origin, as well as compare characteristics in fistulas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Patients referred with anal fistula who had an FC measurement and either ileocolonoscopy or colonoscopy within 12 weeks were included. Demographic and clinical characteristics were registered. Area under the curve (AUC) was calculated as well as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 63 patients were included (CD <i>n</i> = 31, 49%). FC was significantly higher in CD compared to cryptoglandular fistulas, even when CD was medically treated or had no luminal activity on endoscopy. FC ≥110 μg/g was significantly associated with CD (OR 12.5; 95% CI: 3.77–41.4) <i>p</i> &lt; 0.0001. This was found by plotting a receiver operating characteristic (ROC) curve, with AUC 80.8 (95% CI: 0.6952–0.9217). Sensitivity and specificity were 0.76 and 0.80, respectively (PPV 76%, NPV 80% and accuracy 78%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>FC discriminates CD from cryptoglandular fistulas, even in medically treated CD with normal endoscopic findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423794","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":"Can we use integrated total pelvic floor ultrasound as a screening tool in defaecatory pelvic floor dysfunction? A prospective evaluation of the accuracy of integrated total pelvic floor ultrasound compared with defaecation proctography","authors":"Charlotte Ralston,&nbsp;Max Reena,&nbsp;Deepa Solanki,&nbsp;Samantha Morris,&nbsp;Alexis M. P. Schizas,&nbsp;Andrew B. Williams,&nbsp;Alison J. Hainsworth","doi":"10.1111/codi.17274","DOIUrl":"https://doi.org/10.1111/codi.17274","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Pelvic floor dysfunction is common and includes symptoms such as urinary incontinence, pelvic pain, faecal incontinence, obstructive defaecation syndrome symptoms and pelvic organ prolapse. It is investigated with defaecation proctography (DP) and integrated total pelvic floor ultrasound (TPFUS). Whilst DP is currently the gold standard, TPFUS is efficient and less invasive, offering additional sphincter function assessment. This study aimed to compare TPFUS accuracy to DP in the evaluation of pelvic floor dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From 2015 to 2016, a prospective observational study was conducted at Guy's and St Thomas's Foundation Trust. Symptomatic women with incomplete evacuation were consecutively invited to participate. Patients underwent three scans using both TPFUS and DP. Reports were independently verified by a blinded consultant. Sensitivity, specificity and agreement were calculated for anatomical (rectocele, intussusception, enterocele, cystocele) and functional (coordination, evacuation) features.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 216 patients were included. Moderate agreement was seen between DP and TPFUS in prediction of rectoceles (positive predictive value 85%, negative predictive value 67%, Cohen's kappa 0.46) and on the evaluation of dimensions of rectoceles (<i>R</i> coefficient 0.55) (<i>P</i> &lt; 0.0001). Fair agreement was seen in the assessment of propulsion (positive predictive value 76%, negative predictive value 50%, Cohen's kappa 0.25). Poor agreement was observed on other anatomical and functional objectives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the most extensive prospective comparison of these imaging modalities. While there is limited correlation between DP and TPFUS in exploring anatomical and functional aspects of pelvic floor disorders, TPFUS proves to be an effective screening tool. With enhanced expertise and confidence in its use, TPFUS could potentially guide surgical planning rather than solely identifying those needing DP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404456","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 impact of surgeon speciality on surgical outcomes following colorectal resection for endometriosis","authors":"Yosef Nasseri,&nbsp;Rachel Ma,&nbsp;Negin Fani,&nbsp;Kristina La,&nbsp;Paola Solis-Pazmino,&nbsp;Vincent Xu,&nbsp;Matthew T. Siedhoff,&nbsp;Kelly N. Wright,&nbsp;Rebecca Schneyer,&nbsp;Kacey M. Hamilton,&nbsp;Moshe Barnajian,&nbsp;Raanan Meyer","doi":"10.1111/codi.70028","DOIUrl":"https://doi.org/10.1111/codi.70028","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>An estimated 5%–25% of women with endometriosis have colorectal involvement. Colorectal resection is the most suitable surgical management for cases with large bowel infiltration. However, this method is also associated with the highest rate of postoperative complications. Data focusing on surgeon speciality and surgical outcomes are currently limited. The aim of this work was to evaluate the surgical characteristics and short-term postoperative outcomes following colorectal resection for endometriosis according to surgeon speciality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Using the National Surgical Quality Improvement Program (NSQIP) database, we included women who underwent colorectal resection for endometriosis between 2012 and 2020. Surgeries by general/colorectal surgeons were compared with those by gynaecological surgeons. The primary outcome was major complications according to the Clavien–Dindo classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 745 colorectal resections, 82.3% were performed by general/colorectal surgeons and 17.7% by gynaecologists. Racial and ethnic characteristics differed between groups, but other baseline characteristics were comparable. General/colorectal surgeons performed fewer minimally invasive surgeries (29.9% vs. 58.3%, <i>p</i> &lt; 0.001). General/colorectal surgery cases had lower rates of any postoperative complications and minor complications (14.8% vs. 29.5%, <i>p</i> &lt; 0.001; 10.1% vs. 23.5%, <i>p</i> &lt; 0.001), while major complication rates were similar. Multivariable regression showed no association between major complications and surgical speciality. In a propensity score-matched analysis, no significant differences were found between the two cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Most colorectal resections are performed by general/colorectal surgeons while a minimally invasive approach is more common among gynaecologists. There were no significant differences in outcomes between the two groups after adjusting for confounding variables. This suggests considering a multidisciplinary or dual surgery team approach to deep infiltrative endometriosis requiring bowel resection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404402","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":"Efficacy of inferior vesical vessels preservation in lateral lymph node dissection for rectal cancer: Short- and long-term outcomes","authors":"Sodai Arai,&nbsp;Hiroyasu Kagawa,&nbsp;Akio Shiomi,&nbsp;Shoichi Manabe,&nbsp;Yusuke Yamaoka,&nbsp;Chikara Maeda,&nbsp;Yusuke Tanaka,&nbsp;Shunsuke Kasai,&nbsp;Akifumi Notsu,&nbsp;Yusuke Kinugasa","doi":"10.1111/codi.70029","DOIUrl":"https://doi.org/10.1111/codi.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Lateral lymph node dissection (LLD) is performed for rectal cancer, with some cases requiring resection of the inferior vesical vessels (IVV). However, whether preservation or resection of the IVV affects urinary dysfunction (UD) as a major complication or local recurrence (LR) is unclear. Thus, we assessed the effect of IVV resection on the short- and long-term outcomes of rectal cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This retrospective cohort study included patients who underwent robotic mesorectal excision with LLD between December 2011 and April 2021. The patients were divided into two groups based on preserved and resected IVV. Postoperative complications, including UD, and long-term outcomes, including cumulative LR and cumulative lateral local recurrence (LLR), were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 340 patients, 298 (87.6%) and 42 (12.4%) were included in the IVV preservation and resection groups, respectively. UD was more frequent (50% vs. 16.8%) in the IVV resection group than in the IVV preservation group (<i>p</i> &lt; 0.01). In the multivariate analysis, IVV and autonomic nervous system resections were significantly associated with UD. The 3-year LR was 4.0% and 5.7% in the IVV preservation and resection groups, respectively (<i>p</i> = 0.99). The 3-year LLR was 2.1% and 0% in the IVV preservation and resection groups, respectively (<i>p</i> = 0.27).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>IVV resection and autonomic nervous system resection were independent risk factors for UD in robotic LLD. IVV preservation, except in cases of necessity, improves patients’ quality of life and has favourable oncological outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404704","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":"Sphincteroplasty and levator imbrication for faecal incontinence—A video vignette","authors":"Justin Dourado,&nbsp;Victoria Rose DeTrolio,&nbsp;Rachel Gefen,&nbsp;David Meyer,&nbsp;Anjelli Wignakumar,&nbsp;Steven D. Wexner","doi":"10.1111/codi.70032","DOIUrl":"https://doi.org/10.1111/codi.70032","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397106","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}