Diseases of the Colon & Rectum最新文献

{"title":"The Impact of Follow-up Colonoscopy on Survival in a Fecal Immunochemical Test-Based Colorectal Cancer Screening Program: A Nationwide Study.","authors":"Matas Jakubauskas, Eugenijus Jasiunas, Kestutis Strupas, Tomas Poskus","doi":"10.1097/DCR.0000000000003771","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003771","url":null,"abstract":"<p><strong>Background: </strong>Various colorectal cancer screening programs are thought to be responsible for the decline in colorectal cancer incidence and mortality in developed countries. Few recently published studies indicate that a lot of patients do not fully complete the pre-planned colorectal cancer screening. Currently, there is a lack of high-volume data examining patient compliance and its impact on the screening program results.</p><p><strong>Objective: </strong>To assess the relationship between participation and compliance within the program and mortality of patients that participate in the screening program.</p><p><strong>Design: </strong>Large database cohort study.</p><p><strong>Settings: </strong>Nationwide colorectal cancer screening program of a European Union country (Lithuania).</p><p><strong>Patients: </strong>Data of patients aged 50-74, who participated in the colorectal cancer screening program from January 2013 to December 2019, were extracted from a national database.</p><p><strong>Main outcome measures: </strong>Mortality data was extracted on all persons, who died from 2013 to December 2020. Patients were divided into four groups according to their adherence to the colonoscopy screening program.</p><p><strong>Results: </strong>A total of 1,521,394 patients participated in the screening program. Positive fecal immunochemical test was detected for 127,503 (8.3%) patients, 55,202 (43.3%) of them proceeded with further colonoscopy. Patients with a negative fecal immunochemical test had the lowest mortality rates and the ones with a positive fecal immunochemical test but without undergoing a follow up colonoscopy had the worst ones with 4.9% and 8.6% respectively, p < 0.001. Logistic regression model indicated that patients with a positive fecal immunochemical test and without a subsequent colonoscopy had a significantly increased mortality risk (OR 2.18; 95% CI: 2.12-2.24; p < 0.001).</p><p><strong>Limitations: </strong>Lack of data on timing of colonoscopy, comorbidities, lifestyle factors, or previous medical history.</p><p><strong>Conclusions: </strong>Our study indicates that non-compliers with colonoscopy, especially women, after a positive fecal immunochemical test are at a significantly increased all-cause mortality risk. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810729","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 Microbiome in Colorectal Anastomotic Healing: The Cart or the Horse?","authors":"Emily Rivet, David B Stewart","doi":"10.1097/DCR.0000000000003784","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003784","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810731","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 Emperor's New Virtual Clothes: Conducting Colon & Rectal Surgery Residency Interviews in the Post-COVID Era.","authors":"Martin Uwah, Konstantin Umanskiy, Virginia Shaffer, Kinga S Olortegui","doi":"10.1097/DCR.0000000000003702","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003702","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810727","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":"Declining Colorectal Cancer Operations After Neoadjuvant Therapy: Having the Difficult Conversations.","authors":"Bailey K Hilty Chu, Fergal J Fleming","doi":"10.1097/DCR.0000000000003783","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003783","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802734","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 Declining Colorectal Cancer Operations After Neoadjuvant Therapy: Having the Difficult Conversations.","authors":"Ana C De Roo","doi":"10.1097/DCR.0000000000003782","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003782","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802737","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":"Controlling Oligopolyposis With Colonoscopy: A Cohort Study.","authors":"James Church","doi":"10.1097/DCR.0000000000003763","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003763","url":null,"abstract":"<p><strong>Background: </strong>Oligopolyposis is defined as between 10 and 100 polyps in the large intestine. If these are adenomas, at least 15% of affected patients will have a syndrome of hereditary colorectal cancer predisposition. Management is aimed at preventing the development of cancer and options include chemoprevention, colectomy, and colonoscopy, with colectomy generally favored. The role of colonoscopy is relatively unexplored.</p><p><strong>Objective: </strong>To present the results of colonoscopic control of patients with oligopolyposis.</p><p><strong>Design: </strong>Retrospective study of a cohort of patients with oligopolyposis separated by genotype and histology.</p><p><strong>Settings: </strong>Hereditary colorectal cancer center.</p><p><strong>Patients: </strong>Those with oligopolyposis preferring management with sequential colonoscopy to colectomy, who underwent at least three years of follow-up.</p><p><strong>Interventions: </strong>Colonoscopy and polypectomy, surgical resection.</p><p><strong>Main outcome measures: </strong>number of colonoscopies, complications of colonoscopies, length of follow-up, number of polyps at first and last colonoscopy, size of the largest polyp at first and last colonoscopy, incidence and stage of cancer, and timing of the cancer diagnosis.</p><p><strong>Results: </strong>There were 59 patients; 29 with sessile serrated polyposis, 13 with MUTYH-associated polyposis, 8 with attenuated FAP and 9 with oligopolyposis not otherwise specified. FAP patients were 20 years younger than the other groups. Patients averaged one colonoscopy per year for a mean follow-up between 5 and 11 years. One patient suffered a post polypectomy hemorrhage, but there was no perforation, and no admission. No patient needed surgery to control benign polyposis. Nine patients had cancer, 6 diagnosed and resected prior to the start of the colonoscopic surveillance. Three patients with sessile serrated polyposis developed interval cancers while on surveillance, all stage 1. These were the only patients to need colectomy.</p><p><strong>Limitations: </strong>Relatively low numbers of FAP and oligopolyposis patients. Lack of specific data on variants.</p><p><strong>Conclusions: </strong>In compliant patients and experienced hands, endoscopic control of oligopolyposis can be safe and effective. See Video.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794373","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":"Short- and Long-term Outcomes After Continent Ileostomy, an Often Forgotten Option for Patients After Proctocolectomy.","authors":"Ravi P Kiran, Beatrix H Choi, Koby Herman, Bo Shen, James M Church","doi":"10.1097/DCR.0000000000003720","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003720","url":null,"abstract":"<p><strong>Background: </strong>The continent ileostomy is an alternative for reconstruction after proctocolectomy when the ileal pouch-anal anastomosis is not feasible. Due to technical difficulty and patient preference, few centers still perform these operations. Recent literature focuses on ileostomies that are as old as 40 years with a dearth of information on newly constructed continent ileostomies.</p><p><strong>Objective: </strong>To evaluate outcomes and patient satisfaction in a group of new continent ileostomy patients.</p><p><strong>Design: </strong>Retrospective case series.</p><p><strong>Setting: </strong>Urban academic center.</p><p><strong>Patients: </strong>All patients undergoing continent ileostomy creation, revision, or excision between 2013 and 2022.</p><p><strong>Intervention: </strong>Continent ileostomy.</p><p><strong>Main outcome measures: </strong>Short-term outcomes (length of stay, complications, reoperation, and readmission within 30 days); long-term outcomes (pouch revision, retention, quality of life, and functional outcome).</p><p><strong>Results: </strong>Eighty patients underwent 95 procedures. 38 patients (63% female, mean age 45) had their ileostomies created at our center. Mean hospitalization was 8.4 days. Readmission was 29%, reoperation 5% and mortality 0%. Major complications (leak or pelvic abscess) occurred in 11% and minor complications (ileus, transfusions) in 58%. Pouch revision was 34% (major 24%, minor 11%) and pouch retention was 87% after 37 months. 42 patients with prior ileostomies(75% female, mean age 55) underwent 57 revisions/excisions. Mean hospitalization was 5.1 days; readmission was 7%. Major complications occurred in 6% and minor complications in 14%. There was one reoperation and no deaths. Repeat pouch revision was 21% (major 9%, minor 12%) and pouch retention 88% after 42 months. Functional outcomes and quality of life on follow-up were excellent, with 92% of the creation group reporting improvement in function and quality of life, and 93% of the revision group reporting improvement.</p><p><strong>Limitations: </strong>Retrospective design, case series.</p><p><strong>Conclusions and relevance: </strong>A continent ileostomy program is feasible in the contemporary era, with good short- and long-term outcomes and excellent patient satisfaction. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794562","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":"Exploring the Somatic Mutation Landscape of T4N0: A Comparative Perspective on Late Stage 2 and Stage 3 Colon Cancer.","authors":"David Otohinoyi, Katherine Pavleszek, Danielle Dooley, Brian Carr, Triston Mabry, Chindo Hicks, Valentine Nfonsam","doi":"10.1097/DCR.0000000000003721","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003721","url":null,"abstract":"<p><strong>Background: </strong>Among the facets of colon cancer pathogenesis is the survival paradox between T4N0 (stage II) colon cancer and anyTN1 (stage III) colon cancer. There are limited genomic studies investigating why a T4N0 disease is deemed worse than stage III colon cancer.</p><p><strong>Objective: </strong>We demonstrate a multifaceted approach in unraveling the genomic intricacies of T4N0 colon cancer and how it differs from T123N0 and anyTN1 colon cancer using somatic mutation information.</p><p><strong>Design: </strong>Retrospective study of somatic mutations and their prognostic impact on survival.</p><p><strong>Settings: </strong>Conducted using The Cancer Genome Atlas and National cBioPortal for Cancer Genomics.</p><p><strong>Patients: </strong>We stratified our samples based on TNM staging: T4N0, T123N0 and anyTN1.</p><p><strong>Main outcome measures: </strong>We compared mutation frequency between groups using fishers exact test at P ≤ 0.05. We performed pathway analysis to map biological networks enriched with somatic mutations. We investigated somatic mutation interaction and validated our results with Kaplan-Meier survival analysis on independent datasets.</p><p><strong>Results: </strong>We observed 30 significantly differentially mutated genes that are unique to T4N0 colon cancer after T123N0 and anyTN1 comparisons. Among these genes, DIDO1, CACNA1B and ALMS1 showed somatic mutation interaction in a co-occurring pattern with other mutated genes. Pathway analysis revealed Ephrin B signaling, Nitric oxide signaling, and calcium signaling to be enriched with mutations and contributory to T4N0 pathogenesis. Survival analysis further substantiated our findings.</p><p><strong>Limitations: </strong>Retrospective study and patient numbers.</p><p><strong>Conclusions: </strong>There are patterns of somatic mutation in T4N0 colon cancer tumors that are significantly absent in T123N0 and anyTN1 colon tumors. Somatic mutation interaction highlighted the role of DIDO1, CACNA1B and ALMS1 in T4N0 pathogenesis which contained appreciable mutations that were predicted to be severe. Among these genes, DIDO1 was associated with a decrease in survival. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794550","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":"Artificial Intelligence in Clinical Decision-Making: Is It Problem Free?","authors":"Mesut Tez","doi":"10.1097/DCR.0000000000003636","DOIUrl":"10.1097/DCR.0000000000003636","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e161"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913566","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":"Corrigendum.","authors":"Donald B Colvin, Kelly M Tyler","doi":"10.1097/DCR.0000000000003640","DOIUrl":"10.1097/DCR.0000000000003640","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e162"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946496","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}