Diseases of the Colon & Rectum最新文献

{"title":"Appraising a CREATEive Surgeon-Scientist Initiative: Impact and Future Directions.","authors":"Christopher J Neylan, Aron Bercz, Scott E Regenbogen, Emina H Huang, J Joshua Smith, Lillias H Maguire, Jonathan B Mitchem","doi":"10.1097/DCR.0000000000003614","DOIUrl":"10.1097/DCR.0000000000003614","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"656-657"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540359","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 Anal Canal Mucosectomy: An Essential Step in Ileal Pouch Anastomosis.","authors":"Antonio Manenti, Stefania Caramaschi, Luca Reggiani Bonetti, Gianrocco Manco","doi":"10.1097/DCR.0000000000003713","DOIUrl":"10.1097/DCR.0000000000003713","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e1038"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540545","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":"Avoiding Exenteration in Anterior Margin-Positive Rectal Cancer After Total Neoadjuvant Therapy With Immunotherapy.","authors":"Yogesh Bansod, Ashwin L Desouza, Avanish Saklani","doi":"10.1097/DCR.0000000000003564","DOIUrl":"10.1097/DCR.0000000000003564","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e1036-e1037"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566324","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":"Diagnosis and Management of Common Stomal Complications.","authors":"Diego Schaps, Susanna S Hill","doi":"10.1097/DCR.0000000000003716","DOIUrl":"10.1097/DCR.0000000000003716","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"682-685"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566425","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":"Surgeons: Heroes of Our Own Lives?","authors":"Lester Gottesman","doi":"10.1097/DCR.0000000000003670","DOIUrl":"10.1097/DCR.0000000000003670","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"658-660"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566484","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":"Reply.","authors":"Serena Perotti, Michela Mineccia, Paolo Massucco, Federica Gonella, Alessandro Ferrero","doi":"10.1097/DCR.0000000000003714","DOIUrl":"10.1097/DCR.0000000000003714","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e1039"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540544","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":"What Every Colorectal Surgeon Should Know About Physician Unions.","authors":"Samantha M Linhares, Kurt S Schultz, Anne K Mongiu","doi":"10.1097/DCR.0000000000003734","DOIUrl":"10.1097/DCR.0000000000003734","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"661-664"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596569","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":"Outcomes After Elective Versus Emergency Resection for Right-Sided Colon Cancer: A Propensity Score-Matched Analysis.","authors":"Bas A J Kertzman, Femke J Amelung, Thijs A Burghgraef, Esther C J Consten, Werner A Draaisma","doi":"10.1097/DCR.0000000000003680","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003680","url":null,"abstract":"<p><strong>Background: </strong>Previous studies reported similar complication rates, including anastomotic leakage, after elective and emergency surgery for right-sided colon cancer. This led to the consensus that emergency resection with primary anastomosis is safe. However, recent evidence suggests higher complication rates after emergency surgery, indicating that alternative strategies, such as a bridge to surgery, may be more suitable.</p><p><strong>Objective: </strong>To assess whether complication rates, particularly anastomotic leakage, are higher after emergency resections compared to elective resections in patients with right-sided colon cancer.</p><p><strong>Design: </strong>A retrospective cohort study using data from the Dutch ColoRectal Audit from 2010 to 2019.</p><p><strong>Settings: </strong>Nationwide data from hospitals across the Netherlands.</p><p><strong>Patients: </strong>Patients who underwent resection for right-sided colon cancer (n = 5056 emergency resections matched 1:1 to elective resections using propensity score matching).</p><p><strong>Main outcome measures: </strong>Incidence of anastomotic leakage, 90-day complication rates, and mortality rates after elective versus emergency surgery for right-sided colon cancer.</p><p><strong>Results: </strong>After matching, no significant baseline differences remained. There was no significant difference in anastomotic leakage rates. However, the mortality rate was twice as high in the emergency group (9.4% vs 4.2%, p < 0.001), and the 90-day complication rate was also higher (41.7% vs 33.0%, p < 0.001).</p><p><strong>Limitations: </strong>Minimal missing data were handled with multiple imputation. Although propensity score matching was used, bias from unknown confounders may persist. The emergency group included more high-risk patients, potentially influencing outcomes.</p><p><strong>Conclusions: </strong>Emergency resections for right-sided colon cancer are associated with higher complication and mortality rates compared to elective surgery. A bridge-to-surgery approach could reduce these risks by converting emergency cases to elective procedures. Further research is needed to validate these findings. See Video Abstract.</p><p><strong>Resultados tras la reseccin electiva frente a la reseccin de emergencia para cncer de colon del lado derecho un anlisis de puntuacin de propensin coincidente: </strong>ANTECEDENTES:Estudios previos informaron tasas de complicaciones similares, incluida la fuga anastomótica, después de una cirugía electiva y de emergencia para el cáncer de colon del lado derecho. Esto llevó al consenso de que la resección de emergencia con anastomosis primaria es segura. Sin embargo, evidencia reciente sugiere tasas de complicaciones más altas después de la cirugía de emergencia, lo que indica que las estrategias alternativas, como un puente a la cirugía, pueden ser más adecuadas.OBJETIVO:Evaluar si las tasas de complicaciones, en particular la fuga anastomótica,","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 6","pages":"753-763"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149734","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":"Evaluating the Impact of Induction and Consolidation Total Neoadjuvant Therapies Compared to Conventional Chemoradiotherapy for Locally Advanced Rectal Cancer: A Systematic Review and Network Meta-analysis.","authors":"Chinock Cheong, Na Won Kim, Sung Ryul Shim, Jeonghyun Kang","doi":"10.1097/DCR.0000000000003687","DOIUrl":"10.1097/DCR.0000000000003687","url":null,"abstract":"<p><strong>Background: </strong>Total neoadjuvant therapy has been introduced to enhance oncological outcomes and minimize toxicity in locally advanced rectal cancer, but the superiority between the induction and consolidation of therapy remain unclear.</p><p><strong>Objective: </strong>To evaluate oncological and postoperative outcomes by comparing induction chemotherapy and consolidation chemotherapy with conventional chemoradiotherapy in patients with locally advanced rectal cancer.</p><p><strong>Data sources: </strong>Systematic searches of PubMed, Embase, and Cochrane databases wereperformed for studies published from the database's inception until June 2023.</p><p><strong>Study selection: </strong>The inclusion criteria were patients diagnosed with rectal cancer. Interventions included induction chemotherapy and consolidation chemotherapy, and comparisons were specified as conventional neoadjuvant chemoradiotherapy.</p><p><strong>Main outcome measures: </strong>Primary outcomes were the rates of pathologic or clinical complete response, postoperative results, chemoradiotherapy-related toxicity, and survival outcomes.</p><p><strong>Results: </strong>Thirty-three studies, encompassing patients from 1991 to 2021, were eligible for analysis. In network meta-analysis, a significantly increased OR for a pathologic complete response was observed in both the induction therapy group at 1.65 (95% credible interval, 1.18-2.30) and the consolidation therapy group at 1.87 (95% credible interval, 1.40-2.47) compared to conventional chemoradiotherapy. However, no difference was observed in complete response rates, postoperative results, or chemoradiotherapy-related toxicity grade 3 or higher between the groups. There were no differences among the groups in local recurrence, distant metastasis, or disease-free survival, whereas the induction group showed a nonsignificant improvement in overall survival.</p><p><strong>Limitations: </strong>There was significant heterogeneity among the studies, and the short follow-up period in most studies limited the assessment of long-term survival outcomes.</p><p><strong>Conclusions: </strong>Both induction and consolidation total neoadjuvant therapy increase the pathologic complete response rate in locally advanced rectal cancer without compromising safety or postoperative outcomes. However, total neoadjuvant therapy was not associated with a significant improvement in survival outcomes. Although total neoadjuvant therapy strategies for locally advanced rectal cancer are considered safe, additional long-term studies are needed.</p><p><strong>Trial registration no: </strong>CRD42023445348.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"687-701"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596566","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":"Optimal Pouch Training: Investigating Operative and Nonoperative Needs Study.","authors":"Emily Steinhagen, Sharon L Stein, Asya Ofshteyn, Karen L Sherman, Jennifer L Miller-Ocuin, Erin B Fennern, Liliana G Bordeianou","doi":"10.1097/DCR.0000000000003685","DOIUrl":"10.1097/DCR.0000000000003685","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Ileal pouch anal anastomosis is an important part of colorectal surgery training. However, decreasing case numbers create fewer chances to teach the knowledge and skills to trainees.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The purpose of this study is to define the components and format of an adjunctive curriculum for teaching colon and rectal surgery residents ileal pouch anal anastomosis. More specifically, it aims to create expert consensus on the essential and unique elements of a curriculum, determine which alternative strategies will be acceptable, and identify methods of assessment to evaluate the effectiveness of the curriculum.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This was a modified Delphi Consensus study. Semistructured interviews with thematic analysis were used to develop the initial round of the survey.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Interviews, surveys, and online consensus conference.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Faculty who were at North American Accreditation Council for Graduate Medical Education colorectal residencies, and participants from each round were invited to subsequent rounds.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;Three rounds of surveys were used to select high-priority items for inclusion in the curriculum, educational strategies, and assessments. This was followed by a consensus conference to clarify prioritization and acceptable options for teaching and assessment. Participants from the third round of surveys, as well as Program Directors from colorectal residencies, were invited to the consensus conference.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twelve semistructured interviews defined the educational needs of colorectal residents, the appropriateness of alternative educational strategies, and concerns about case minimums as an assessment of readiness for practice for this procedure. The needs were divided into preoperative, intraoperative, and postoperative phases, with knowledge and skills in each phase. The resulting survey was completed by 85 colorectal surgeons in round 1, 43 in round 2, and 38 in round 3. These results were subsequently summarized by a team of 9 participants in a final consensus conference, where the participants made suggestions on the recommended educational strategies for each educational need.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Inclusion of colorectal surgeons involved in training programs only, bias in respondents, and participation rate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This shared understanding of educational needs for colorectal residents that includes knowledge, judgment, and technical skills is the first step toward developing a curriculum to teach ileal pouch anal anastomosis. A collaborative effort to create the necessary curriculum is underway. See Video Abstract .&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Entrenamiento ptimo en reservorio ileal investigacin sobre las necesidades quirrgicas y no quirrgicas: &lt;/strong&gt;ANTECEDENTES:La anastomosis ileoanal con reservorio (IPA","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"764-775"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566437","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}