Diseases of the Colon & Rectum最新文献

{"title":"Evaluation and Management of Small Bowel Adenocarcinoma.","authors":"Rita Pedroso de Lima, Artur C Silva","doi":"10.1097/DCR.0000000000003830","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003830","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076579","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":"Integrity: Let Us Rise to the Highest Standards.","authors":"Susan Galandiuk","doi":"10.1097/DCR.0000000000003822","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003822","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958599","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-term Outcomes of Primary Fistula Closure with Platelet-Rich Plasma: A Prospective Study.","authors":"María Luisa Reyes Díaz, Fátima Hinojosa Ramírez, Rocio Olmo Santiago, Irene M Ramallo-Solís, Rosa M Jiménez Rodríguez, José Pintor Tortolero, Jorge M Vázquez-Monchul, Ana M García Cabrera, Fernando de la Portilla de Juan","doi":"10.1097/DCR.0000000000003820","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003820","url":null,"abstract":"<p><strong>Background: </strong>Treating complex perianal fistula remains a challenge and finding surgical techniques that guarantee high cure rates without compromising continence is necessary. Plateled rich plasma has been studied in different disciplines, with treatment being successful due to its properties as a tissue regenerator.</p><p><strong>Objective: </strong>To assess the 5-year cure rate and complications among patients with complex perianal fistula treated with plasma therapy.</p><p><strong>Design: </strong>A prospective, observational study conducted from 2011 to 2022. Patients with complex perianal fistula who met the inclusion criteria were treated with plasma rich in growth factors. Follow-up and assessment were performed for 5 years after treatment, with visits at 1, 3, 6, 12, 36, and 60 months.</p><p><strong>Setting: </strong>This study was conducted at a single tertiary referral centre.</p><p><strong>Patients: </strong>Data from 166 patients were assessed.</p><p><strong>Main outcome measures: </strong>The primary outcome measure was the rate of fistula healing and the secondary outcome measures assessed recurrence, continence status, and complications.</p><p><strong>Results: </strong>A total of 166 patients with cryptoglandular complex perianal fistula (68.7% male, mean age 51.4 ± 13.2 years) were included. The majority of the fistulas (88.5%) were trans-sphincteric; 87.8% were relapsed fistulas, with a mean of 3.3 ± 3.1 previous procedures. The median time to recurrence-free healing was 26 ± 5 months (95% CI: 16-36). The 1-year follow-up was completed by 154 patients, 3-years by 140 patients, and at 5-years by 91 patients. The estimated healing rate decreased over time reaching 70.9% at 1 year, 42.8% at 3 years, and 24.3% at 5 years. Complications were absent in 92.7% of the cases. No changes in continence were observed in any patients.</p><p><strong>Limitations: </strong>Most patients presented with trans-sphincteric anal fistulas.</p><p><strong>Conclusions: </strong>Treatment of complex cryptoglandular anal fistula with platelet rich plasma is safe and feasible in the long term. See Video Abstract .</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984677","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":"Ira J. Kodner, MD: ASCRS President and Creator of the Washington University Colorectal Surgery Residency.","authors":"","doi":"10.1097/DCR.0000000000003643","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003643","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968858","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":"International Consensus on Reporting Anastomotic Leaks After Colorectal Cancer Surgery: The CoReAL Reporting Framework.","authors":"Danique J I Heuvelings, Nicole D Bouvy, Nader Francis, Sander M J van Kuijk, Merel L Kimman, Marylise Boutros, Patricia Sylla","doi":"10.1097/DCR.0000000000003790","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003790","url":null,"abstract":"<p><strong>Background: </strong>Anastomotic leak frequently complicates colorectal anastomoses with high morbidity and mortality. The substantial variability in published leak rates reflects the lack of consistency in reporting variables that may impact the occurrence, management, short and long-term outcomes of patients.</p><p><strong>Objective: </strong>The Consensus for Reporting of colorectal Anastomotic Leaks is an international collaborative that developed a standardized evidence-based framework for reporting key variables related to the entire episode of colorectal anastomotic leak in cancer patients.</p><p><strong>Design: </strong>Along the preoperative, intraoperative, short- and long-term postoperative phases of a left-sided colorectal anastomotic leak, key questions regarding all potentially relevant variables were formulated. A literature review was conducted to generate evidence-based statements in response to these questions. Statements that reached consensus, together with input from patients' experience and experts' opinion, were incorporated into the framework as reporting elements.</p><p><strong>Setting: </strong>Modified Delphi methodology, including online voting and an in-person consensus meeting, was used to generate consensus statements based on the literature review, and to develop the reporting framework.</p><p><strong>Participants: </strong>An international panel of 32 colorectal surgeons with expertise in the field of colorectal anastomotic leaks, representing 6 surgical societies, along with radiologists, research collaborators, patients, healthcare economists and surgical trial methodologists.</p><p><strong>Main outcome measures: </strong>Evidence-based statements and reporting elements with >70% agreement were included.</p><p><strong>Results: </strong>Consensus among experts was achieved on 33 evidence-based statements and 43 reporting elements for the CoReAL framework. The reporting elements encompassed evidence-based statements (27), patient perspectives (7), as well as expert opinion (9).</p><p><strong>Limitations: </strong>Sampling did not represent all regions in the world. Because of the paucity of evidence for some topics, evidence-based statements were primarily based on moderate to low level of evidence.</p><p><strong>Conclusions: </strong>This international consensus provides an evidence-based standardized framework for reporting of key variables related to a colorectal anastomotic leak following oncologic resection. See Video Abstract .</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976621","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":"Oncological Outcomes of Intersphincteric Resection Versus Abdominoperineal Resection for ypT3 Low Rectal Cancer Following Neoadjuvant Chemoradiotherapy: A Multicenter Retrospective Analysis.","authors":"Xiaojie Wang, Yingru Li, Wenchang Gan, Lishuo Shi, Shaoyong Peng, Ying Huang, Bing Zeng, Pan Chi","doi":"10.1097/DCR.0000000000003821","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003821","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sphincter preservation, crucial for patients traditionally facing abdominoperineal resection, was advanced by neoadjuvant chemoradiotherapy and intersphincteric resection. T4 lower rectal cancer with levator ani muscle infiltration was a contraindication for intersphincteric resection, with most debates on intersphincteric resection indications focusing on the T3 stage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the oncological outcomes in patients with locally advanced distal rectal cancer, located within 5 cm from the anal verge, who underwent preoperative chemoradiotherapy followed by intersphincteric resection or abdominoperineal resection, with a focus on ypT3 very low rectal cancers that were technically feasible for intersphincteric resection without evidence of levator ani or external sphincter muscle invasion intraoperatively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A retrospective analysis of prospectively collected data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Settings: &lt;/strong&gt;Conducted at two colorectal surgery referral centers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients: &lt;/strong&gt;The study included 381 patients with ypT3 low rectal cancer post- chemoradiotherapy, from 2010 to 2021.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;Five-year disease-free survival, 5-year overall survival, circumferential resection margin status, and complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The 5-year disease-free survival rates were 63.4% for intersphincteric resection and 63.8% for abdominoperineal resection ( p = 0.806), with 5-year overall survival rates at 78.8% for intersphincteric resection and 67.5% for abdominoperineal resection ( p = 0.103). There were no significant differences in 5-year local recurrence or metastasis rates. Circumferential resection margin involvement was low in both groups: 1.9% (5/258) for intersphincteric resection and 4.9% (6/123) for abdominoperineal resection ( p = 0.202). Distal margin involvement was minimal in intersphincteric resection at 0.8% (2/258). Abdominoperineal resection had higher wound infection rates at 15.4% compared to 0.7% in intersphincteric resection ( p &lt; 0.001), and a longer median postoperative hospital stay (10.0 days vs. 7.0 days for intersphincteric resection, p &lt; 0.001). In abdominoperineal resection cases, primary closure was used for reconstruction, with pelvic peritoneum closure in 4 instances. No significant difference in perineal wound infection rates was observed between those with and without pelvic peritoneum closure ( p = 0.495). Subgroup analysis of intersphincteric resection with handsewn anastomoses showed no significant differences in 5-year disease-free survival (53.8% vs. 63.8%, p = 0.068), overall survival (74.5% vs. 67.5%, p = 0.313), or local recurrence rates (20.2% vs. 21.7%, p = 0.877) compared to abdominoperineal resection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;The retrospective design introduced potential selection bias. Procedures were conducted by highly skilled surgeons, which may lim","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986336","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":"Right and Left Colectomies.","authors":"Kelly Tyler, Don Colvin","doi":"10.1097/DCR.0000000000003819","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003819","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990505","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":"Lap to Open.","authors":"Robert Kucejko, Don Colvin","doi":"10.1097/DCR.0000000000003818","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003818","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974105","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":"Clinical Application of the Degradable Stent-Secured Intra-Pouch Bypass in Ileal Pouch-anal Anastomosis.","authors":"Wei Liu, Weilin Qi, Xiaolong Ge, Yi Dai, Yifan Tong, Xiujun Cai, Wei Zhou","doi":"10.1097/DCR.0000000000003805","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003805","url":null,"abstract":"<p><strong>Background: </strong>Ileal pouch-anal anastomosis is the standard surgical treatment for ulcerative colitis. However, ileal pouch-anal anastomosis carries a risk of anastomotic leakage following pouch reconstruction, which may lead to significant morbidity, additional surgeries, and, in many cases, a dysfunctional pouch. This study aims to introduce a technique that enhances the safety of ileal pouch-anal anastomosis.</p><p><strong>Impact of innovation: </strong>We present a novel degradable stent-secured intra-pouch bypass designed to minimize the risk of pouch or anastomotic leakage. By preventing direct fecal contact with the anastomosis, this approach aims to improve surgical outcomes and reduce stoma-related morbidity.</p><p><strong>Technology, materials, and methods: </strong>The degradable stent-secured intra-pouch bypass system consists of a biofragmentable stent and a protective sleeve. A total of 18 ulcerative colitis patients who underwent ileal pouch-anal anastomosis with degradable stent-secured intra-pouch bypass were identified from a prospectively collected case series conducted over three years (2022-2024).</p><p><strong>Results: </strong>The average operative time was 303.9 ± 43.9 minutes, with pouch creation and stent placement taking 21.4 ± 3.2 minutes. No cases of anastomotic leakage or stent-related complications were observed. Seven patients experienced minor complications, all of which resolved with conservative management. The mean time to stent expulsion was 23.9 ± 2.5 days.</p><p><strong>Conclusions and future directions: </strong>The degradable stent-secured intra-pouch bypass technique appears to be a promising adjunct for pouch protection in ulcerative colitis surgery, demonstrating both safety and efficacy in this initial series. Future studies should further validate the benefits of this technique in larger clinical trials and investigate long-term patient outcomes.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997612","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":"Redo Robotic Low Anterior Resection by Natural Orifice Intracorporeal Anastomosis With Extraction.","authors":"Chang-Lin Lin, Shih-Wei Chiang, Shih-Feng Huang, Chun-Yen Hung, Feng-Fan Chiang","doi":"10.1097/DCR.0000000000003646","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003646","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994916","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}