Diseases of the Colon & Rectum最新文献

{"title":"Selected Abstracts for August 2026 issue.","authors":"","doi":"10.1097/DCR.0000000000004280","DOIUrl":"https://doi.org/10.1097/DCR.0000000000004280","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835002","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":"Glycated Hemoglobin as a Predictor of Postoperative Outcomes after Elective Colorectal Surgery.","authors":"Nicholas Gagnon-Choy, Laurence Robert, Allison Pang, Gabriela Ghitulescu, Julio Faria, Nancy Morin, Carol-Ann Vasilevsky, Richard Garfinkle","doi":"10.1097/DCR.0000000000004271","DOIUrl":"https://doi.org/10.1097/DCR.0000000000004271","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus has been associated with poor outcomes following elective colorectal surgery. The use of preoperative glycated hemoglobin may provide a more precise estimate of glycemic control.</p><p><strong>Objective: </strong>To determine whether glycemic control, using preoperative glycated hemoglobin values, could risk-stratify postoperative outcomes.</p><p><strong>Design: </strong>Observational retrospective cohort study.</p><p><strong>Settings: </strong>Multicenter study including North American centers that contribute towards the National Surgical Quality Improvement Program of the American College of Surgeons dataset.</p><p><strong>Patients: </strong>Adult patients who underwent an elective colectomy or proctectomy for neoplasia or diverticular disease between 2021 and 2023.</p><p><strong>Interventions: </strong>The primary exposure was glycemic control, categorized according to diabetes mellitus status and glycated hemoglobin as \"no diabetes mellitus,\" \"well-controlled diabetes mellitus,\" and \"poorly controlled diabetes mellitus.\"</p><p><strong>Main outcome measures: </strong>Ten 30-day postoperative outcomes were evaluated and were defined according to the online National Surgical Quality Improvement Program surgical risk calculator. The co-primary outcomes included serious complications, any complication, cardiac complications, and surgical site infection.</p><p><strong>Results: </strong>In total, 32,578 patients were retained for analysis: 19,261 (59.1%) had no diabetes mellitus, 8,999 (27.6%) had well-controlled diabetes mellitus, and 4,318 (13.3%) had poorly controlled diabetes mellitus. On multivariable logistic regression, compared to those with no diabetes mellitus, those with well-controlled diabetes mellitus had a similar risk of any complication (OR 1.04; 95% CI: 0.96-1.12), serious complications (OR 1.03; 95% CI: 0.95-1.12), cardiac complications (OR 1.22; 95% CI: 0.93-1.59), and surgical site infection (OR 0.97; 95% CI: 0.87-1.07). In contrast, compared to patients with no diabetes mellitus, those with poorly-controlled diabetes mellitus had a higher odds of any complication (OR 1.23; 95% CI: 1.12-1.35), serious complications (OR 1.20; 95% CI: 1.08-1.33), and surgical site infection (OR 1.21; 95% CI: 1.06-1.37), but not cardiac complications (OR 1.27; 95% CI: 0.90-1.76).</p><p><strong>Limitations: </strong>Observational study design, limited to covariates within the National Surgical Quality Improvement Program dataset.</p><p><strong>Conclusions: </strong>In patients who underwent elective colorectal surgery, glycemic control based on preoperative glycated hemoglobin levels improved postoperative risk stratification compared to diabetes mellitus status alone. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834997","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":"Laparoscopic Sacrectomy as Part of En Bloc Resection for Locally Recurrent Rectal Cancer.","authors":"Mamoru Uemura, Chikako Kusunoki, Masakatsu Paku, Nobuo Takiguchi, Mao Osaki, Hiroshi Kusafuka, Shoichiro Nakajo, Yuki Sekido, Mitsunobu Takeda, Tsuyoshi Hata, Atsushi Hamabe, Takayuki Ogino, Norikatsu Miyoshi, Yoshinori Kagawa, Mitsuyoshi Tei, Takeshi Kato, Masataka Ikeda, Mitsugu Sekimoto, Yuichiro Doki, Hidetoshi Eguchi","doi":"10.1097/DCR.0000000000004059","DOIUrl":"10.1097/DCR.0000000000004059","url":null,"abstract":"<p><strong>Introduction: </strong>Achieving margin-negative complete resection in locally recurrent rectal cancer often requires en bloc resection involving adjacent structures such as the sacrum. However, sacrectomy is technically demanding and poses a high risk of significant intraoperative bleeding and postoperative pelvic sepsis due to the dead space created after resection. We developed a minimally invasive surgical technique to address these challenges.</p><p><strong>Technique: </strong>We used a laparoscopic approach to sacrectomy as part of en bloc resection for posterior locally recurrent rectal cancer. In this technique, the anterior and lateral dissection of the sacrum was performed laparoscopically, whereas the final sacral transection was performed under direct vision in the prone position. Preoperative imaging was used to identify the planned sacral transection line, which was reproduced intraoperatively using a premeasured vascular tape. Anterior and lateral dissection of the sacrum was performed laparoscopically to allow secure vascular control. Final sacral transection was performed under direct vision in the prone position. A pedicled omental flap and a dead-space-filling nonfunctional anastomosis were used to fill the pelvic cavity and prevent postoperative sepsis. A double-barreled stoma was created to facilitate fecal diversion.</p><p><strong>Results: </strong>Laparoscopic sacrectomy was successfully performed in 43 patients with locally recurrent rectal cancer. The margin-negative complete resection rate was 86%, which is notably high for this challenging population. The 5-year overall survival rate was approximately 59%. No cases of major intraoperative bleeding or early complications related to the dead-space-filling nonfunctional anastomosis were observed.</p><p><strong>Conclusions: </strong>This laparoscopic technique offers a safe and feasible option for selected patients with posterior locally recurrent rectal cancer. Combined dead-space management may further help reduce postoperative complications while preserving oncological validity.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"859-865"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009299","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":"What Every Colorectal Surgeon Should Know About the Centers for Medicare and Medicaid Services Age-Friendly Hospital Measure.","authors":"Jessica N Cohan, Julia R Berian","doi":"10.1097/DCR.0000000000004146","DOIUrl":"10.1097/DCR.0000000000004146","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"736-740"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017800","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":"Local Excision After Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer: More Questions Than Answers?","authors":"Zachary Bunjo, Tarik Sammour","doi":"10.1097/DCR.0000000000004114","DOIUrl":"10.1097/DCR.0000000000004114","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"866"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899011","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":"Integrating Core Descriptors With Core Outcomes in Rectal Prolapse: A Patient-Centered Framework for Trials and Registries.","authors":"Zubing Mei, De Zheng","doi":"10.1097/DCR.0000000000004116","DOIUrl":"10.1097/DCR.0000000000004116","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"868"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892295","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":"Remodified Hanley Technique for Horseshoe Abscess.","authors":"Francisco Castillejos-Ibáñez, Leticia Pérez-Santiago, Stephanie Anne García-Botello","doi":"10.1097/DCR.0000000000004021","DOIUrl":"10.1097/DCR.0000000000004021","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"858"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009281","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 Price of Free Advice.","authors":"Lester Gottesman","doi":"10.1097/DCR.0000000000004046","DOIUrl":"10.1097/DCR.0000000000004046","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"733-735"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146060861","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":"Comment on \"Long-Term Outcomes of Primary Fistula Closure With Platelet-Rich Plasma\".","authors":"Firdaus Hayati","doi":"10.1097/DCR.0000000000004119","DOIUrl":"10.1097/DCR.0000000000004119","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"870"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911077","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":"Biologics Before Surgery Are Not Associated With Complications After Surgery for IBD: A National Surgery Quality Improvement Program IBD Collaborative Causal Inference Analysis.","authors":"Stefan D Holubar, Tara A Russell, Nicholas C Neel, Tracy L Hull, Randolph M Steinhagen, Liliana Bordeianou, Neil H Hyman, Benjamin L Cohen, Samuel Eisenstein","doi":"10.1097/DCR.0000000000004077","DOIUrl":"10.1097/DCR.0000000000004077","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The association between preoperative exposure to biologics and postoperative outcomes after surgery for IBD remains controversial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We hypothesized biologic exposure within 60 days of surgery is safe and not associated with an increase in postoperative adverse events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Multicenter national cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Settings: &lt;/strong&gt;Twenty-four IBD centers, from 2020 to 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients: &lt;/strong&gt;Adult patients from the American College of Surgeons-National Quality Improvement Program IBD Collaborative were included.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;The primary outcome was adverse event rates within 30 days postoperatively; secondary outcomes included rates of infectious and overall complications. The primary predictor was exposure to biologics within 60 days of surgery. Propensity score-based causal inference modeling was performed. Point estimates were expressed as relative risks with 95% CIs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 2926 patients were included: 1427 (48.8%) were exposed to biologics and 1499 (51.2%) were not exposed. Preoperatively, the biologic cohort was more likely to have Crohn's disease, be younger, be from high-volume centers (all p  &lt; 0.0001), be anemic and malnourished (both p  = 0.02), and be exposed to corticosteroids and/or immunomodulators (both p  &lt; 0.0001). Intraoperatively, the biologic cohort had shorter operative times, more minimally invasive procedures and partial colectomies, and fewer ileoanal pouches and ileostomies (all p  &lt; 0.0001). Inverse probability treatment weighting revealed that biologics were not associated with postoperative infections (0.97; 95% CI, 0.72-1.05), complications (0.92; 95% CI, 0.81-1.04), or adverse events (0.92; 95% CI, 0.83-1.02). Similar results were observed in unadjusted, propensity score-adjusted, and propensity score-matched models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Generalizability, selection bias, unmeasured confounders, and a 60-day window for biologics were the limitations of this study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Preoperative biologic exposure within 60 days of surgery for IBD was not associated with any causal increase in postoperative adverse outcomes. These findings indicate that administration of biologics before IBD surgery is safe and does not increase short-term adverse outcomes. See Video Abstract .&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Los productos biolgicos administrados antes de la ciruga no se asocian con complicaciones posoperatorias tras la ciruga para la enfermedad inflamatoria intestinal anlisis de inferencia causal colaborativo sobre la enfermedad inflamatoria intestinal del programa nacional de mejora de la calidad quirrgica: &lt;/strong&gt;ANTECEDENTES:La relación entre la exposición preoperatoria a productos biológicos y los resultados posoperatorios tras una cirugía por enfermedad inflamatoria intestinal sigue siendo controvertida.Objetivo:Nuestra h","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"778-791"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911068","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}