Diseases of the Colon & Rectum最新文献

{"title":"Comparing the Management Recommendations of Large Language Model and Colorectal Cancer Multidisciplinary Team: A Pilot Study.","authors":"Nir Horesh, Sameh Hany Emile, Shashank Gupta, Zoe Garoufalia, Rachel Gefen, Peige Zhou, Giovanna da Silva, Steven D Wexner","doi":"10.1097/DCR.0000000000003504","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003504","url":null,"abstract":"<p><strong>Background: </strong>Management of anorectal cancers requires a multidisciplinary team approach. Recently, large language models have been suggested as potential tools for various applications in health care.</p><p><strong>Objective: </strong>Assess suggested management recommendations provided by a generative artificial intelligence chatbot with those of a colorectal cancer multidisciplinary team to evaluate applicability in clinical settings.</p><p><strong>Design: </strong>Comparative pilot study where management recommendations from a generative artificial intelligence chatbot for patients with anal or colorectal cancers were compared against historical consensus decisions from multidisciplinary team meetings.</p><p><strong>Setting: </strong>Single referral tertiary center.</p><p><strong>Patients: </strong>Fifteen patients (mean age of 66.5 years; 53.5% woman) were included; 80% were primarily diagnosed with rectal cancer, predominantly stage II and III disease (46.6%). The mean tumor height from the anal verge was 4 cm.</p><p><strong>Interventions: </strong>From a generative artificial intelligence chatbot, we generated management recommendations for each patient, which were subsequently compared to historical decisions from a multidisciplinary team to gauge concordance.</p><p><strong>Main outcome measures: </strong>Primary outcomes included a degree of concordance between generative artificial intelligence chatbot recommendations and the multidisciplinary team decisions, assessed on a scale from 1 (complete disagreement) to 5 (complete agreement), and justification was evaluated by 3 experienced colorectal surgeons.</p><p><strong>Results: </strong>A generative artificial intelligence chatbot achieved a high concordance rate with multidisciplinary team decisions, with an average concordance rating of 4.08. Multidisciplinary team treatment strategies included neoadjuvant therapy for 33.3% of patients, upfront surgery for 26.6%, and further diagnostic assessment for 20%. Interrater agreement on concordance was found to be moderate (κ coefficient range, 0.333-0.577), whereas agreement on decision justification was slight (κ coefficient range, 0.047-0.094).</p><p><strong>Limitations: </strong>Retrospective study with small sample size.</p><p><strong>Conclusions: </strong>The findings indicate a high level of concordance between generative artificial intelligence chatbot recommendations and the decisions from a colorectal cancer multidisciplinary team, suggesting the potential of large language models to support clinical decision-making in the management of anal and colorectal cancers. See Video Abstract.</p><p><strong>Comparacin entre recomendaciones de manejo del modelo extenso de lenguaje y el equipo multidisciplinario de cncer colorrectal un estudio piloto: </strong>ANTECEDENTES:El manejo de los cánceres anorrectales requiere un enfoque de equipo multidisciplinario. Recientemente, se han sugerido modelos extensos de lenguaje como he","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 1","pages":"41-47"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827842","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":"Impact of Surgeon Specialization on Outcomes in Emergency Colorectal Surgery: A Systematic Review and Meta-analysis.","authors":"Zachary Bunjo, Luke Traeger, Ishraq Murshed, Sergei Bedrikovetski, Nagendra N Dudi-Venkata, Christopher Dobbins, Tarik Sammour","doi":"10.1097/DCR.0000000000003418","DOIUrl":"10.1097/DCR.0000000000003418","url":null,"abstract":"<p><strong>Background: </strong>Colorectal emergencies represent a large proportion of acute general surgical workload and carry significant mortality.</p><p><strong>Objective: </strong>Identify the influence of surgeon specialization on mortality and other outcomes in emergency colorectal surgery.</p><p><strong>Data sources: </strong>Systematic searches of Ovid MEDLINE, Ovid Embase, and Cochrane electronic databases were performed for studies published from January 1, 1990, to August 27, 2023.</p><p><strong>Study selection: </strong>Studies investigating outcomes in emergency colorectal surgery for adults, comparing colorectal against noncolorectal surgeon specialization, were included. Exclusion criteria were: 1) publications studying primarily pediatric populations; 2) studies incorporating patients who had undergone surgery before 1990; and 3) studies only published in abstract form or non-English language.</p><p><strong>Main outcome measures: </strong>Primary outcomes were 30-day mortality and in-hospital mortality. Secondary outcomes were rates of anastomotic leak, reintervention, primary anastomosis, and laparoscopic approach.</p><p><strong>Results: </strong>Of 7676 studies identified, 155 were selected for full-text review and 21 were included for quantitative analysis. Eleven studies showed improved 30-day (OR 0.64; 95% CI, 0.60-0.68; p < 0.0001) and in-hospital mortality (OR 0.66; 95% CI, 0.49-0.89; p = 0.007) with colorectal specialization. There was a significantly higher rate of primary anastomosis (OR 2.95; 95% CI, 2.02-4.31; p < 0.0001) and use of laparoscopic surgery (OR 2.38; 95% CI, 1.42-4.00; p = 0.001) among specialized colorectal surgeons. Specialization was also associated with a significant reduction in any stoma formation (OR 0.52; 95% CI, 0.28-0.98; p = 0.04). No significant difference was observed for anastomotic leak (OR 0.70; 95% CI, 0.45-1.07; p = 0.10) or reintervention rates (OR 0.78; 95% CI, 0.55-1.10; p = 0.16).</p><p><strong>Limitations: </strong>Heterogeneity exists within the included patient populations and definitions of colorectal specialization observed in different countries.</p><p><strong>Conclusions: </strong>Emergency colorectal surgery undertaken by specialized colorectal surgeons is associated with significantly improved postoperative mortality, lower rates of stoma formation, and increased rates of primary anastomosis and minimally invasive surgery.</p><p><strong>Prospero registration: </strong>CRD42022300541.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"14-30"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460452","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":"Research Perspective on \"Impact of Surgeon Specialization on Outcomes in Emergency Colorectal Surgery: A Systematic Review and Meta-analysis\".","authors":"Vlad V Simianu","doi":"10.1097/DCR.0000000000003557","DOIUrl":"10.1097/DCR.0000000000003557","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"31"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460465","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":"Is Dilip's Transmucosal Internal Sphincterotomy a Modification of Closed Lateral Internal Sphincterotomy?","authors":"Vipul D Yagnik, Kaushik Bhattacharya, Pankaj Garg","doi":"10.1097/DCR.0000000000003567","DOIUrl":"10.1097/DCR.0000000000003567","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e7"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497002","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":"Known Knowns and Unknown Unknowns.","authors":"Lester Gottesman","doi":"10.1097/DCR.0000000000003376","DOIUrl":"10.1097/DCR.0000000000003376","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"6-8"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460453","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":"Socioecological Determinants of Health and the Quality of Colonoscopy in Rural Alabama.","authors":"Nathan C English, Burkely P Smith, Abiha Abdullah, Princy Gupta, Wendelyn M Oslock, Bayley A Jones, Lauren N Wood, Manu Kaushik, Quince-Xhosa D Gibson, Lacey Swenson, Rebecca A Young, Drew J Gunnells, Gregory D Kennedy, Daniel I Chu, Robert H Hollis","doi":"10.1097/DCR.0000000000003543","DOIUrl":"10.1097/DCR.0000000000003543","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Rural patients experience a higher incidence of and mortality from colorectal cancer. Ensuring high-quality screening is essential to address these disparities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate whether socioecological determinants of health are associated with colonoscopy quality in rural Alabama.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Retrospective review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Data across 3 rural hospitals in Alabama from August 2021 to July 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients: &lt;/strong&gt;We included adults (aged 18 years or older) who underwent screening or diagnostic colonoscopy and completed a validated survey that measures socioecological determinants of health.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;Primary outcomes included bowel preparation quality, cecal intubation, and adenoma detection rate. We linked the survey responses to these quality metrics to identify factors associated with outcomes. Analyses included the χ 2 , Fisher exact, and Kruskal-Wallis rank-sum tests, with a p value of &lt; 0.05 considered statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The 84 patients surveyed were 66.7% men, 50.0% Black, and had a median age of 64 years. Optimal bowel preparation was present in 88.0%, successful cecal intubation was observed in 89.3%, and the overall adenoma detection rate was 45.8%. Patients with suboptimal bowel preparation described lower rates of internet access (60.0% vs 87.4%, p &lt; 0.05), more difficulty in understanding written information (30.0% vs 1.4%, p &lt; 0.05), and lacked a sense of responsibility for their health (30.0% vs 51.4%, p &lt; 0.05) compared to those having optimal bowel preparation. Those with unsuccessful cecal intubations had lower physician trust (55.6% vs 73.3%, p &lt; 0.05), whereas patients with successful cecal intubations were more confident in preventing health-related problems (53.3% vs 33.3%, p &lt; 0.05) and had a more supportive social environment (72.0% vs 66.7%, p &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Retrospective design and small sample size limiting multivariable analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In rural Alabama, lower health literacy, internet access, and physician trust were associated with low-quality colonoscopy, whereas a higher patient sense of responsibility and a supportive social environment were associated with higher-quality metrics. These findings identify potential targets for improving colonoscopy quality in rural settings. See Video Abstract.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Determinantes socioecolgicos de la salud y la calidad de la colonoscopia en las zonas rurales de alabama: &lt;/strong&gt;ANTECEDENTES:Los pacientes rurales sufren una mayor incidencia y mortalidad por cáncer colorrectal. Garantizar un cribado de alta calidad es esencial para abordar estas disparidades.OBJETIVO:Investigar si los determinantes socioecológicos de la salud están asociados con la calidad de la colonoscopia en las zonas rurales de Alabama.DISEÑO:Revisión re","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"107-118"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460467","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":"Tryptophan Metabolites Improve Intestinal Mucosal Barrier via the Aryl Hydrocarbon Receptor-Interleukin-22 Pathway in Murine Dextran Sulfate Sodium-Induced Pouchitis.","authors":"Tenghui Zhang, Zeqian Yu, Yi Xu, Lei Zhao, Feng Zhu, Yan Zhou, Lili Gu, Jianfeng Gong","doi":"10.1097/DCR.0000000000003549","DOIUrl":"10.1097/DCR.0000000000003549","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pouchitis is the most common complication after IPAA for ulcerative colitis. The protective effect of tryptophan metabolites on the mucosal barrier may be effective for treating pouchitis. The role of tryptophan metabolites on pouchitis remained unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to establish a murine model of dextran sulfate sodium-induced pouchitis to examine the roles of tryptophan metabolites in its pathogenesis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This is a study that combines clinical patient data and animal research. A total of 22 patients were enrolled: 5 patients with familial adenomatous polyposis after IPAA, 8 patients with ulcerative colitis after IPAA with pouchitis, and 9 patients with ulcerative colitis after IPAA with normal pouch. The demographic data and fecal samples of patients were collected. Male C57BL/6 mice were purchased from a licensed breeder and underwent IPAA to establish a murine model of the pouch. The blood, feces, and tissues of mice were collected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Settings: &lt;/strong&gt;This study was performed in an academic medical center in China.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interventions: &lt;/strong&gt;The demographic data of patients were observationally collected. The mice that underwent IPAA were divided into a control group that received a chow diet and 5 study groups: 1) dextran sulfate sodium, 2) 6-formylindolo[3,2-b] carbazole + dextran sulfate sodium, 3) high tryptophan diet + dextran sulfate sodium, 4) CH-223191 + dextran sulfate sodium, and 5) indole-3-carboxaldehyde + dextran sulfate sodium. Animals were euthanized after receiving dextran sulfate sodium for 7 days.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;Fecal tryptophan metabolite level and microbiome composition, the severity of pouchitis, intestinal mucosal barrier function, and activation of the aryl hydrocarbon receptor-interleukin 22 pathway were assessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Patients with pouchitis had lower fecal microbial diversity and indole-3-acetic acid levels. In the murine pouchitis model, high tryptophan diet increased fecal levels of 3-indoleglyoxylic acid, indole-3-aldehyde, and indole. A high tryptophan diet and intraperitoneal aryl hydrocarbon receptor ligand 6-formylindolo[3,2-b] carbazole injection alleviated pouchitis. Tryptophan metabolites improved pouch mucosal barriers. Aryl hydrocarbon receptor inhibitors exacerbated experimental pouchitis and disrupted the mucosal barrier; however, the aryl hydrocarbon receptor ligand indole-3-carboxaldehyde reversed this effect.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;This study was limited by a small human sample size and lacked an aryl hydrocarbon receptor knockout mouse model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A high tryptophan diet and aryl hydrocarbon receptor ligand alleviated dextran sulfate sodium-induced pouchitis in a murine IPAA model, which might be achieved through regulating epithelial tight junctions and promoting goblet cell differentia","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"77-90"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497005","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":"Long Rectal Cuff and Remnant Mesorectum Are Major Preventable Causes of Ileal Pouch Failure.","authors":"Mehmet Gulmez, Pranav Hinduja, Eren Esen, Michael J Grieco, Arman Erkan, Andre da Luz Moreira, John Kirat, Feza H Remzi","doi":"10.1097/DCR.0000000000003530","DOIUrl":"10.1097/DCR.0000000000003530","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Long rectal cuff (&gt;2 cm) and remnant mesorectum are known causes of pouch dysfunction because of obstructive defecation as well as pelvic sepsis after prolonged obstruction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of this study was to report the rates and management of patients who underwent redo IPAA because of pouch failure associated with a retained mesorectum and long rectal cuff.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This is a retrospective study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Settings: &lt;/strong&gt;The investigation is based on data from a quaternary IBD center.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients: &lt;/strong&gt;Patients undergoing redo IPAA surgery with a long rectal cuff and/or remnant mesorectum between September 2016 and September 2023 were included in the study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;The main outcomes were functioning pouch rate and functional results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 245 patients who underwent redo IPAA surgery, 98 patients (40%) had long rectal cuff and/or remnant mesorectum. Redo IPAA in this patient group was successful (92%) at a median follow-up of 28 (18-52) months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;The retrospective nature of the study and inclusion of a single specialized center.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Long rectal cuff and remnant mesorectum are major causes of pouch failure, which can be successfully managed with redo IPAA surgery. Nearly half of pouch failure patients who had successful redo IPAA surgery initially received unnecessary biologic therapy before coming to our center. See Video Abstract .&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Muon rectal largo y mesorrecto remanente son las principales causas prevenibles de disfuncin de la bolsa ileal: &lt;/strong&gt;ANTECEDENTES:El muñon rectal largo (&gt;2 cm) y el mesorrecto remanente son causas conocidas de disfunción de la bolsa debido a defecación obstructiva, así como de sepsis pélvica tras obstrucción prolongada.OBJETIVO:El objetivo de este estudio es informar las tasas y el tratamiento de los pacientes que se sometieron a una nueva anastomosis anal con bolsa ileal debido al fracaso de la bolsa asociado a mesorrecto remanente y el muñon rectal largo.DISEÑO:Se trata de un estudio retrospectivo.LUGAR:La investigación se basa en un centro cuaternario de enfermedad inflamatoria intestinal.PACIENTES:Se incluyeron en el estudio los pacientes sometidos a una nueva cirugía de anastomosis anal con bolsa ileal y que tenían muñon rectal largo y/o mesorrecto remanente entre septiembre de 2016 y septiembre de 2023.PRINCIPALES MEDIDAS DE VALORACIÓN:Los principales resultados fueron la tasa de funcionamiento de la bolsa y los resultados funcionales.RESULTADOS:De los 245 pacientes que se sometieron a una nueva cirugía de anastomosis anal con bolsa ileal, 98 (40%) pacientes tenían un muñon rectal largo y/o mesorrecto remanente. La repetición de la anastomosis anal con bolsa ileal en este grupo de pacientes fue exitosa (92%) en una mediana de seguimiento de 28 (18-52) mes","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"69-76"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343665","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":"Quality of Life, Functional Outcomes, and Recurrence After Resection Rectopexy Versus Ventral Mesh Rectopexy for Rectal Prolapse Repair.","authors":"Anna R Spivak, Marianna Maspero, Rebecca Y Spivak, Jessica A Sankovic, Stephanie Norman, Caitlyn Deckard, Scott R Steele, Tracy L Hull","doi":"10.1097/DCR.0000000000003467","DOIUrl":"10.1097/DCR.0000000000003467","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Resection rectopexy and ventral mesh rectopexy are widely accepted surgical options for the treatment of rectal prolapse; however, reports on long-term recurrence rates and functional outcomes are lacking.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We compared quality of life, long-term functional outcomes, and prolapse recurrence after resection rectopexy versus ventral mesh rectopexy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;We retrospectively reviewed our prospectively collected rectal prolapse surgery database.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Settings: &lt;/strong&gt;Patients who underwent resection rectopexy or ventral mesh rectopexy at our center between 2009 and 2016 were included.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients: &lt;/strong&gt;Two hundred twenty patients were included, of whom 208 (94%) were women; 85 (39%) underwent resection rectopexy and 135 (61%) ventral mesh rectopexy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;Prolapse recurrence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The resection rectopexy group was younger (median 52 vs 60 years old, p = 0.02) and had more open procedures (20% vs 9%, p &lt; 0.001). After a median follow-up of 110 (interquartile range 94-146) months for resection rectopexy and 113 (87-137) months for ventral mesh rectopexy, recurrences occurred in 21 (26%) in the resection rectopexy and 50 (39%) in the ventral mesh rectopexy group ( p = 0.041). The median time to recurrence was 44 (18-80) months in the resection rectopexy group and 28.5 (11-52.5) months in the ventral mesh rectopexy group ( p = 0.14). There were no differences in the recurrence rate for primary prolapses in resection rectopexy versus ventral mesh rectopexy. The recurrence rate for redo prolapses was higher in the ventral mesh rectopexy group at 63% at 10 years versus 25% in the resection rectopexy group ( p = 0.006). Functional outcomes were similar between the 2 groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Retrospective review, recall bias.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Long-term quality of life and functional outcomes after resection rectopexy and ventral mesh rectopexy were comparable. Ventral mesh rectopexy was associated with a higher prolapse recurrence rate after recurrent rectal prolapse repair. See Video Abstract .&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Calidad de vida, resultados funcionales y recurrencia despus de la rectopexia por reseccin versus la rectopexia ventral con malla para la reparacin del prolapso rectal: &lt;/strong&gt;ANTECEDENTES:La rectopexia de resección y la rectopexia ventral con malla son opciones quirúrgicas ampliamente aceptadas para el tratamiento del prolapso rectal; sin embargo, faltan informes sobre las tasas de recurrencia a largo plazo y los resultados funcionales.OBJETIVO:Comparamos la calidad de vida, los resultados funcionales a largo plazo y la recurrencia del prolapso después de la rectopexia de resección versus la rectopexia ventral con malla.DISEÑO:Revisamos retrospectivamente nuestra base de datos de cirugía de prolapso rectal recopilada prospectivamente.EN","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"91-100"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343666","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":"January 2025 Translations.","authors":"","doi":"10.1097/DCR.0000000000003615","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003615","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 1","pages":"e10-e44"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827855","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}