Diseases of the Colon & Rectum最新文献

{"title":"Time to Reconsider the Mechanism of Hemorrhoidectomy Pain.","authors":"Mina Sarofim","doi":"10.1097/DCR.0000000000003931","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003931","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793714","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":"Anterior Quadrant Extended Total Mesorectal Excision: Indications and Technique for Seminal Vesicle Excision.","authors":"Akash Mor, Avanish Saklani","doi":"10.1097/DCR.0000000000003761","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003761","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793713","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":"Evaluation of Anal Cancer Screening Practices Among a National Cohort of Veterans with HIV.","authors":"Austin J Hewitt, Matthew J Freeman, Dana M Hayden, Evie H Carchman, Marin L Schweizer, Cristina B Sanger","doi":"10.1097/DCR.0000000000003928","DOIUrl":"10.1097/DCR.0000000000003928","url":null,"abstract":"<p><strong>Background: </strong>When available, anal cytology is used for initial anal cancer screening, whereas diagnostic histology is typically performed after abnormal cytology or in symptomatic individuals.</p><p><strong>Objective: </strong>Analyze index anal evaluations (cytology vs. histology) in veterans with HIV.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>One hundred thirty Department of Veterans Affairs medical centers.</p><p><strong>Patients: </strong>Veterans with HIV who received care from 1999-2023.</p><p><strong>Main outcomes and measures: </strong>Distribution of index anal evaluations as cytology or histology, annual incidence rates of index evaluations, and regional anal cancer prevalence and screening rates.</p><p><strong>Results: </strong>Among 48,368 veterans with HIV, 7,127 (15%) had at least one anal evaluation. Index evaluations were cytology in 4,477 (63%) and histology in 2,650 (37%). The mean annual rate of index anal evaluations was 1.04%, with a relative decrease in 2020 and beyond. Among patients with anal evaluations, the Pacific region had the highest proportion of index cytology (77%), comprising 77% of evaluations, and the Continental region had the lowest (37%,p<0.001). Conversely, the lowest and highest rates of anal cancer were observed in the Pacific and Continental regions, respectively (4.7% vs. 9.4%, p < 0.001). However, this trend did not translate into differences in anal cancer rates between the two regions when comparing all veterans with HIV (1.01% vs. 0.90%, p = 0.52).</p><p><strong>Limitations: </strong>Retrospective data.</p><p><strong>Conclusions: </strong>In this national analysis of veterans with HIV, 15% had an anal evaluation, despite recommendations for annual screening. The majority of index evaluations were screening assessments with cytology (63%). There was a relative decrease in index evaluations after 2020. Regional screening differences were observed among patients with anal evaluations. Higher anal cancer detection was seen in the region with the lowest screening and lower detection in the region with the highest screening. Interestingly, this correlation did not persist when examining the overall regional populations of veterans with HIV, including those never evaluated. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788482","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":"Geographic Disparities by Income in Pelvic Floor Physical Therapy Locations in Philadelphia, Pennsylvania.","authors":"Stephanie Regis, Takshaka Patel, Emily Rockenbach, Edward Brown, Matthew Philp, Juan L Poggio, Joceline Vu","doi":"10.1097/DCR.0000000000003929","DOIUrl":"10.1097/DCR.0000000000003929","url":null,"abstract":"<p><strong>Background: </strong>Pelvic floor dysfunction impacts 1 in 4 women and can be disabling. Colorectal surgeons treat many of these conditions, including fecal incontinence, pelvic constipation, and rectal prolapse. Pelvic floor physical therapy can be an effective nonsurgical treatment for pelvic floor dysfunction. However, utilization remains limited, with insurance noncoverage, geographic constraints, and lack of availability cited as barriers to care.</p><p><strong>Objective: </strong>Evaluate the relationship between income and geographic distance to pelvic floor physical therapy locations in Philadelphia, Pennsylvania, a socioeconomically diverse city.</p><p><strong>Design: </strong>Pelvic floor physical therapy locations within Philadelphia were identified and contacted by telephone. A semi-structured script was used to interview staff and obtain characteristics of each site and its treated patients. We used census tracts as a geographic unit and calculated the distance of each tract to the nearest pelvic floor physical therapy location. We used linear regression to identify the association of median income with distance to the nearest physical therapy location, adjusting for population size of each tract.</p><p><strong>Settings: </strong>Philadelphia, Pennsylvania.</p><p><strong>Main outcome measures: </strong>Distance of each census tract to the nearest pelvic floor physical therapy location.</p><p><strong>Results: </strong>Nineteen sites offered pelvic floor physical therapy, primarily located in areas of high median income. Distance to a pelvic floor physical therapist decreased as median income increased. People from the lowest quartile of income lived farthest from a physical therapy location (2.1 miles), compared to people from the highest quartile (1.0 miles, p<0.001). Urogynecologic or postpartum conditions were treated most often, with only 3 sites reporting expertise in anorectal disease.</p><p><strong>Limitations: </strong>Generalizability given focus on one city.</p><p><strong>Conclusions: </strong>Pelvic floor physical therapy remains underutilized and primarily focused on urogynecologic and postpartum conditions. In Philadelphia, we found that pelvic floor physical therapy was primarily located in areas of high median income, suggesting geographic access barriers for poorer patients. See Abstract Video .</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788483","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":"Eyal Aviran","doi":"10.1097/DCR.0000000000003786","DOIUrl":"10.1097/DCR.0000000000003786","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e1165"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991678","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 Small Bowel Adenocarcinoma.","authors":"Floriano Marchetti","doi":"10.1097/DCR.0000000000003831","DOIUrl":"10.1097/DCR.0000000000003831","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"939-940"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092025","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":"Selected Abstracts.","authors":"Matthew Fuglestad, Carla F Justiniano, Warqaa Akram, Mayin Lin, Scott Dolejs, Jeffrey S Barton","doi":"10.1097/DCR.0000000000003817","DOIUrl":"10.1097/DCR.0000000000003817","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 8","pages":"1017-1021"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658696","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":"Examining the Correlation Between Robotic System Deployment Numbers and Minimally Invasive Surgery Trends.","authors":"Wenhan Wu","doi":"10.1097/DCR.0000000000003787","DOIUrl":"10.1097/DCR.0000000000003787","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e1166"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958571","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 to Open.","authors":"Robert J Kucejko, Don Colvin","doi":"10.1097/DCR.0000000000003818","DOIUrl":"10.1097/DCR.0000000000003818","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"935"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","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 Intrapouch Bypass in IPAA.","authors":"Wei Liu, Weilin Qi, Xiaolong Ge, Yi Dai, Yifan Tong, Xiujun Cai, Wei Zhou","doi":"10.1097/DCR.0000000000003805","DOIUrl":"10.1097/DCR.0000000000003805","url":null,"abstract":"<p><strong>Background: </strong>IPAA is the standard surgical treatment for ulcerative colitis. However, IPAA has a risk of anastomotic leakage after pouch reconstruction, which may lead to significant morbidity, additional surgeries, and, in many cases, a dysfunctional pouch. This study introduces a technique that enhances the safety of IPAA.</p><p><strong>Impact of innovation: </strong>We present a novel degradable stent-secured intrapouch 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 intrapouch bypass system consists of a biofragmentable stent and a protective sleeve. A total of 18 patients with ulcerative colitis who underwent IPAA with degradable stent-secured intrapouch bypass were identified from a prospectively collected case series conducted over 3 years (2022-2024).</p><p><strong>Preliminary results: </strong>The mean 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: </strong>The degradable stent-secured intrapouch bypass technique appears to be a promising adjunct for pouch protection in ulcerative colitis surgery, demonstrating both safety and efficacy in this initial series.</p><p><strong>Future directions: </strong>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":"e1159-e1163"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","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}