Diseases of the Colon & Rectum最新文献

{"title":"Artificial Intelligence Recognition System of Pelvic Autonomic Nerve During Total Mesorectal Excision.","authors":"Fanghai Han, Guangyu Zhong, Shilin Zhi, Naiqian Han, Yongjun Jiang, Jia'nan Tan, Lin Zhong, Shengning Zhou","doi":"10.1097/DCR.0000000000003547","DOIUrl":"10.1097/DCR.0000000000003547","url":null,"abstract":"<p><strong>Background: </strong>The preservation of the pelvic autonomic nervous system in total mesorectal excision remains challenging to date. The application of laparoscopy has enabled visualization of fine anatomical structures; however, the rate of urogenital dysfunction remains high.</p><p><strong>Objective: </strong>To establish an artificial intelligence neurorecognition system to perform neurorecognition during total mesorectal excision.</p><p><strong>Design: </strong>This is a retrospective study.</p><p><strong>Setting: </strong>The study was conducted at a single hospital.</p><p><strong>Patients: </strong>Intraoperative images or video screenshots of patients with rectal cancer admitted to the Department of Gastrointestinal Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, between January 2016 and December 2023, were retrospectively collected.</p><p><strong>Main outcome measure: </strong>Mean intersection over union, precision, recall, and F1 of the model.</p><p><strong>Results: </strong>A total of 1424 high-quality intraoperative images were included in the training group. The proposed model was obtained after 700 iterations. The mean intersection over union was 0.75, and it slowly increased with an increase in training time. The precision and recall of the nerve category were 0.7494 and 0.6587, respectively, and the F1 was 0.7011. The video prediction shows that the model achieves a high accuracy rate, which could facilitate effective neurorecognition.</p><p><strong>Limitation: </strong>This was a single-center study.</p><p><strong>Conclusions: </strong>The artificial intelligence model for real-time visual neurorecognition in total mesorectal excision was successfully established for the first time in China. Better identification of these autonomic nerves should allow for better preservation of urogenital function, but further research is needed to validate this claim. See Video Abstract .</p><p><strong>Sistema de reconocimiento con inteligencia artificial del nervio autnomo plvico durante la escisin total del mesorrectal: </strong>ANTECEDENTES:La preservación del sistema nervioso autónomo pélvico en la escisión mesorrectal total sigue siendo un desafío hasta la fecha. La aplicación de la laparoscopia ha permitido la visualización de estructuras anatómicas finas; sin embargo, la tasa de disfunción urogenital sigue siendo alta.OBJETIVO:Establecer un sistema de reconocimiento neurológico con inteligencia artificial para realizar el reconocimiento neurológico durante la escisión mesorrectal total.DISEÑO Y ESCENARIO:Este estudio retrospectivo se realizó en un solo hospital.PACIENTES:Se recopilaron retrospectivamente imágenes intraoperatorias o capturas de pantalla de video de pacientes con cáncer de recto ingresados en el Departamento de Cirugía Gastrointestinal, del Hospital Memorial Sun Yat-sen, de la Universidad Sun Yat-sen, entre enero de 2016 y diciembre de 2023.PRINCIPALES MEDIDAS DE VALORACIÓN:Intersección media so","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"308-315"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic Low Anterior Resection With En Bloc Total Abdominal Hysterectomy With Bilateral Salpingo-oophorectomy.","authors":"Ankit Sharma, Yogesh Bansod, Avanish Saklani","doi":"10.1097/DCR.0000000000003396","DOIUrl":"10.1097/DCR.0000000000003396","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e103"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual Dysfunction After Pelvic Radiotherapy.","authors":"Alexandra N Jones, Hillary L Simon","doi":"10.1097/DCR.0000000000003618","DOIUrl":"10.1097/DCR.0000000000003618","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"267-270"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert Commentary on Sexual Function Following Radiation for Rectal Cancer.","authors":"Larissa K F Temple","doi":"10.1097/DCR.0000000000003622","DOIUrl":"10.1097/DCR.0000000000003622","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"270-271"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salvage Laparoscopic Left Lateral Lymph Node Dissection for Regrowth Without Total Mesorectal Excision 30 Months After Completion of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer.","authors":"Ryutaro Kobayashi, Atsushi Ogura, Yuki Murata, Takanori Jinno, Konosuke Yogo, Koji Fukata, Takashi Mizuno, Tomoki Ebata","doi":"10.1097/DCR.0000000000003584","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003584","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 3","pages":"e102"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation Between Grade of Clinical Response to Neoadjuvant Therapy for Rectal Cancer and Oncologic Outcomes in the Era of Watch-and-Wait.","authors":"Roni Y Rosen, Aron P Bercz, Dana M Omer, Floris S Verheij, Hannah Williams, Parisa Malekzadeh, Danielle L Kong, Felipe F Quezada-Diaz, Iris H Wei, Maria Widmar, Georgios Karagkounis, Diana Roth O'Brien, Carla Hajj, Christopher H Crane, Ping Gu, Neil H Segal, Marina Shcherba, Karuna Ganesh, Rona Yaeger, Emmanouil Pappou, Paul B Romesser, Garrett M Nash, Leonard B Saltz, Andrea Cercek, Martin R Weiser, Mithat Gönen, Philip B Paty, Julio Garcia-Aguilar, J Joshua Smith","doi":"10.1097/DCR.0000000000003538","DOIUrl":"10.1097/DCR.0000000000003538","url":null,"abstract":"<p><strong>Background: </strong>The watch-and-wait strategy provides an opportunity to pursue nonoperative management in rectal cancer patients with clinical complete response after neoadjuvant therapy. The management of those with near-complete response remains controversial.</p><p><strong>Objective: </strong>We assessed the oncologic outcomes of patients managed by watch-and-wait versus total mesorectal excision according to clinical response to neoadjuvant therapy.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>Comprehensive cancer center in New York.</p><p><strong>Patients: </strong>Patients with rectal adenocarcinoma diagnosed between January 2006 and December 2020.</p><p><strong>Interventions: </strong>A watch-and-wait strategy of active surveillance was offered to patients if they achieved clinical complete response. Salvage surgery was used for watch-and-wait patients with local regrowth. Patients with an incomplete response underwent total mesorectal excision.</p><p><strong>Main outcome measures: </strong>Local regrowth rate, organ preservation rate, disease-free survival, and overall survival.</p><p><strong>Results: </strong>Patients with rectal adenocarcinoma (n = 1230) were divided into 3 response cohorts-incomplete (n = 646), near-complete (n = 189), and complete (n = 395). Eighty-one patients (43%) in the near-complete group and 351 patients (89%) in the complete group entered watch-and-wait. Three-year local regrowth rates were 40% and 24% in the near-complete and complete response cohorts, respectively. The 5-year organ preservation rate was 53% in near-complete responders and 73% in complete responders. Five-year disease-free survival increased with greater clinical response to neoadjuvant therapy, with intermediate outcomes noted for patients with a near-complete (73%) compared to complete (82%) or incomplete (68%) response. Overall survival at 5 years was similar between the 3 cohorts (complete 90%, near-complete 86%, and incomplete 85%).</p><p><strong>Limitations: </strong>Retrospective nature.</p><p><strong>Conclusions: </strong>Greater clinical response to neoadjuvant therapy is associated with improved oncologic outcomes. Near-complete responders may avoid surgery and still achieve high organ preservation rates yet experience greater local regrowth rates than clinical complete response patients. Ongoing prospective trials integrating watch-and-wait after complete response as determined by uniform criteria will bolster the work to help treating physicians better select patients who qualify for active surveillance. See Video Abstract .</p><p><strong>Correlacin entre el grado de respuesta clnica a la terapia neoadyuvante contra el cncer del recto y los resultados oncolgicos en la era de observar y esperar: </strong>ANTECEDENTES:La estrategia de observar y esperar brinda la oportunidad de buscar un tratamiento no quirúrgico en pacientes con cáncer del recto con respuesta clínica comp","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"300-307"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Anal Dysplasia: A Pragmatic Summary of the Current Evidence and Definition of Clinical Practices for Prevention, Diagnosis, and Treatment.","authors":"Marco Bertucci Zoccali, Cintia Mayumi Sakurai Kimura, Brandon C Chapman, Tamzin Cuming, Carmen F Fong, Naomi Jay, Jennifer A Kaplan, Michelle J Khan, Craig A Messick, Vlad V Simianu, Jeremy J Sugrue, Luis F Barroso","doi":"10.1097/DCR.0000000000003444","DOIUrl":"10.1097/DCR.0000000000003444","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"272-286"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"If Nothing Goes Wrong, Is Everything All Right? The Rule of 3.","authors":"Richard L Nelson","doi":"10.1097/DCR.0000000000003604","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003604","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 3","pages":"264-266"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deciphering Early-Onset Colorectal Cancer: Molecular Profiling of the Tumor Microenvironment.","authors":"Munir H Buhaya, Emina H Huang","doi":"10.1097/DCR.0000000000003447","DOIUrl":"10.1097/DCR.0000000000003447","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"257-260"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Value of Infrapyloric Lymph Nodes Dissection in Right Hemicolectomy for Hepatic Flexure Colon Cancer: A Multicenter Analysis Based on Propensity Score Matching.","authors":"Tao Pan, Xian-Wen Liang, Jing Wen, Hui Yang, Yang-Chun Zheng, Jin Yan, Chao Liu, Hai Hu","doi":"10.1097/DCR.0000000000003356","DOIUrl":"10.1097/DCR.0000000000003356","url":null,"abstract":"<p><strong>Background: </strong>There is a dispute regarding the necessity of infrapyloric lymph node dissection in right hemicolectomy for hepatic flexure colon cancer.</p><p><strong>Objective: </strong>To evaluate the risk factors for infrapyloric lymph node metastasis and the prognostic role of infrapyloric lymph node dissection in patients with hepatic flexure colon cancer and identify the population of patients who would benefit from infrapyloric lymph node dissection.</p><p><strong>Design: </strong>Retrospective multicenter propensity score matching study to minimize heterogeneity between 2 groups.</p><p><strong>Settings: </strong>This study was conducted at 3 medical centers.</p><p><strong>Patients: </strong>A total of 531 patients who underwent curative resection for hepatic flexure colon cancer were included.</p><p><strong>Main outcome measures: </strong>The primary outcome measure was the metastasis rate of infrapyloric lymph nodes, whereas secondary outcome measure included overall survival. Logistic regression analysis was used to identify risk factors, and Kaplan-Meier analysis was used to evaluate survival outcomes.</p><p><strong>Results: </strong>The metastasis rate of infrapyloric lymph nodes among patients undergoing infrapyloric lymph node dissection was 11.8% (26/221). Cox multivariate analysis confirmed that infrapyloric lymph node dissection was an independent prognostic factor after propensity score matching (HR 0.60; 95% CI, 0.38-0.84; p = 0.007). A proposed flowchart for infrapyloric lymph node dissection based on preoperative factors was created. Based on the proposed flowchart, patients with preoperative serum CEA level ≤5.0 ng/mL, cN + , and tumor size ≥5 cm and patients with preoperative serum CEA level >5.0 ng/mL were identified as the high-priority infrapyloric lymph node dissection group. The metastasis rate of infrapyloric lymph nodes in the high-priority group was 16.0% (20/125). In the high-priority group, patients undergoing infrapyloric lymph node dissection had better survival outcomes than those not undergoing infrapyloric lymph node dissection ( p = 0.005).</p><p><strong>Limitations: </strong>This study is limited by its retrospective nature.</p><p><strong>Conclusions: </strong>This study suggests that infrapyloric lymph node dissection should be performed in specific patients with hepatic flexure colon cancer. See Video Abstract .</p><p><strong>El valor de la diseccin de los ganglios linfticos infra pilricos en la hemicolectoma derecha para el cncer de colon del angulo heptico un anlisis multicntrico basado en el emparejamiento por puntaje de propensin: </strong>ANTECEDENTES:Existe controversia sobre la necesidad de la disección de los ganglios linfáticos infra pilóricos en la hemicolectomía derecha por cáncer de colon del ángulo hepático.OBJETIVO:Evaluar los factores de riesgo de metástasis de los ganglios linfáticos infra pilóricos y el papel pronóstico de la disección de los ganglios linfáticos infra pil","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"338-350"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}