Diseases of the Colon & Rectum最新文献

{"title":"To Pimp or Not to Pimp: That Is the Question.","authors":"Lester Gottesman","doi":"10.1097/DCR.0000000000003546","DOIUrl":"10.1097/DCR.0000000000003546","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"385-387"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913905","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":"Deloyers Technique for Restoration of Bowel Continuity Following Extended Left Hemicolectomy: A Comprehensive Analysis of 97 Cases and Literature Review.","authors":"Lucas F Sobrado, Lukas Schabl, Niamh M Foley, Christopher Prien, Sergio C Nahas, David Liska, Hermann Kessler, Michael A Valente, Scott R Steele, Tracy L Hull","doi":"10.1097/DCR.0000000000003597","DOIUrl":"10.1097/DCR.0000000000003597","url":null,"abstract":"<p><strong>Background: </strong>Deloyers technique addresses challenges in restoring bowel continuity after extended left hemicolectomies. Despite being first described in 1958, the technique remains underused, with limited data on long-term outcomes.</p><p><strong>Objective: </strong>To evaluate the indications of surgical and functional outcomes of the Deloyers technique and review existing literature.</p><p><strong>Design: </strong>Using a prospectively maintained database, patient demographics and perioperative data were collected. A telephone interview was conducted to assess bowel function, and statistical analysis identified factors affecting bowel function.</p><p><strong>Settings: </strong>Single tertiary care center.</p><p><strong>Patients: </strong>Patients who underwent the Deloyers technique from January 1995 to February 2023.</p><p><strong>Results: </strong>A total of 97 patients were included. The most common indications were colorectal cancer (50.5%) and diverticular disease (21.6%). In 53.6% of cases, Deloyers technique was performed at reoperations, and in 70.1% of cases, a diverting loop ileostomy was created. Early surgical complications occurred in 7.2% of patients, including 5 anastomotic leaks, 1 colonic conduit ischemia, and 1 small-bowel obstruction. Late complications occurred in 8.2% of cases, including 6 anastomotic strictures and 2 chronic leaks. There was no perioperative mortality. A total of 40 patients were interviewed and reported an average of 3.5 bowel movements per day and 0.5 at night; 17.5% of patients used bowel stoppers and 52.5% of patients reported that their bowel function did not impact their quality of life. Previous radiotherapy and anastomosis <8 cm from the anal verge were associated with having 4 or more bowel movements per day ( p < 0.01).</p><p><strong>Main outcome measures: </strong>Postoperative morbidity and bowel function.</p><p><strong>Limitations: </strong>Retrospective analysis of a heterogeneous group of patients with different pathologies and indications for surgery.</p><p><strong>Conclusions: </strong>Deloyers technique is a safe and effective alternative for restoring bowel continuity after extended left hemicolectomy. Postoperative functional results are generally satisfactory, with more favorable outcomes noted in patients with higher anastomoses and those who have not undergone prior pelvic radiotherapy. See Video Abstract .</p><p><strong>Tcnica de deloyers para la reconstruccin de la continuidad intestinal tras hemicolectoma izquierda ampliada anlisis exhaustivo de casos y revisin bibliogrfica: </strong>ANTECEDENTES:La técnica de Deloyers aborda los retos que plantea la reconstrucción de la continuidad intestinal tras hemicolectomías izquierdas ampliadas. A pesar de haber sido descrita inicialmente en 1958, la técnica sigue siendo poco utilizada, con datos limitados sobre sus resultados a largo plazo.OBJETIVO:Evaluar las indicaciones y los resultados tanto quirúrgicos como funciona","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"466-474"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946487","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 Early Detection and Active Management of Anastomotic Leaks Improve Outcomes.","authors":"Roel Hompes","doi":"10.1097/DCR.0000000000003626","DOIUrl":"10.1097/DCR.0000000000003626","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"397-398"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946489","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":"Robotic Complete Mesocolic Excision With Central Vascular Ligation: Bottom-to-up Approach.","authors":"Nishtha Midha, Syed Althaf, Pavan Sugoor","doi":"10.1097/DCR.0000000000003539","DOIUrl":"10.1097/DCR.0000000000003539","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e151-e152"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946491","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":"Complete Mobilization of the Splenic Flexure of the Colon: Five Laparoscopic Approaches and Standardization of the Technique.","authors":"David Moro-Valdezate, Stephanie García-Botello, José Martín-Arévalo","doi":"10.1097/DCR.0000000000003726","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003726","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729312","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":"Difference in the Prognostic Benefit Between Extended and Segmental Colectomy for Patients With Neoplasia Associated With Ulcerative Colitis: A Nationwide Multicenter Study.","authors":"Ryo Seishima, Koji Okabayashi, Jun Okui, Yasunori Sato, Tatsuki Noguchi, Kenichi Sugihara, Yoichi Ajioka, Soichiro Ishihara","doi":"10.1097/DCR.0000000000003662","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003662","url":null,"abstract":"<p><strong>Background: </strong>Extended colectomy is considered standard treatment for neoplasia associated with ulcerative colitis, but there is limited supporting evidence, particularly from large-scale studies.</p><p><strong>Objective: </strong>This study aimed to assess the prognostic benefits of extended colectomy in patients with neoplasia associated with ulcerative colitis using a nationwide database.</p><p><strong>Design: </strong>Multicenter retrospective study.</p><p><strong>Settings: </strong>Forty-three institutions in Japan participated in this study.</p><p><strong>Patients: </strong>Patients with ulcerative colitis diagnosed with intestinal neoplasia between 1983 and 2020 at 43 institutions were analyzed.</p><p><strong>Main outcome measures: </strong>Five-year overall survival and disease-free survival were assessed based on different surgical procedures, with a subgroup analysis comparing neoplasia associated with ulcerative colitis to sporadic cancer.</p><p><strong>Results: </strong>Among 879 patients, 801 were diagnosed with neoplasia associated with ulcerative colitis and 78 with sporadic cancer. The 5-year disease-free survival for total proctocolectomy and subtotal colectomy were similar (87.8% and 83.9%), both superior to segmental colectomy (72.0%). When comparing neoplasia associated with ulcerative colitis to sporadic cancer, extended colectomy (total proctocolectomy and subtotal colectomy) showed significantly better outcomes for neoplasia associated with ulcerative colitis, while no significant difference was observed for sporadic cancer. Multivariable analysis revealed a significantly better prognosis for extended colectomy compared to segmental colectomy in neoplasia associated with ulcerative colitis patients, both in overall survival and disease-free survival (P < 0.001).</p><p><strong>Limitation: </strong>Nonrandomized retrospective study design.</p><p><strong>Conclusion: </strong>This nationwide cohort study supports extended colectomy as the gold standard for neoplasia associated with ulcerative colitis management and underscores the importance of accurate diagnosis to distinguish between neoplasia associated with ulcerative colitis and sporadic cancer for optimal treatment decisions. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729313","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":"Ice Packing Versus Warm Sitz Baths for Post-Hemorrhoidectomy Pain Management: A Randomized Controlled Trial.","authors":"Pin-Chun Chen, Yi-Kai Kao, Po-Wen Yang, Chia-Hung Chen, Chih-I Chen","doi":"10.1097/DCR.0000000000003707","DOIUrl":"10.1097/DCR.0000000000003707","url":null,"abstract":"<p><strong>Background: </strong>Post-hemorrhoidectomy pain management remains challenging, with warm sitz baths being a common yet debated intervention.</p><p><strong>Objective: </strong>To compare the efficacy of ice packing versus warm sitz baths in managing post-hemorrhoidectomy pain and wound healing.</p><p><strong>Design: </strong>Randomized controlled trial.</p><p><strong>Settings: </strong>Single-center study at E-DA Hospital, Taiwan.</p><p><strong>Patients: </strong>166 patients undergoing Ferguson hemorrhoidectomy.</p><p><strong>Interventions: </strong>Patients were randomized to receive either ice packing (n = 82) or warm sitz bath (n = 84) for initial post-operative care.</p><p><strong>Main outcome measures: </strong>Primary outcomes were pain (visual analog scale) and swelling. Secondary outcomes included wound healing (REEDA scale), analgesic consumption, and adverse events.</p><p><strong>Results: </strong>Ice packing group showed lower pain scores within 16h post-surgery ( p < 0.01), reduced swelling at 24h (76.8% vs. 56.0% with no/mild swelling, p = 0.03), superior wound healing at 7 days (REEDA score: 2.56±1.89 vs. 3.27±2.12, p = 0.02), and lower 24h morphine consumption (4.58±2.56 mg vs. 6.39±2.7 mg, p < 0.01).</p><p><strong>Limitations: </strong>Single-center design, short follow-up period, lack of validated hemorrhoid-specific wound assessment tools, and exclusion of ASA III patients limiting generalizability.</p><p><strong>Conclusions: </strong>Ice packing demonstrated superior efficacy in managing post-hemorrhoidectomy pain, reducing edema, and promoting wound healing, with comparable safety profile and lower opioid requirements. See Video Abstract .</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718335","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":"Time To Come Into the Cold: Rethinking The Sitz Bath After Anorectal Surgery.","authors":"William J Harb","doi":"10.1097/DCR.0000000000003752","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003752","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718338","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":"How to Write a Systematic Review and Meta-Analysis Response.","authors":"Richard L Nelson","doi":"10.1097/DCR.0000000000003767","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003767","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708985","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":"Striking A Balance: the Risks of Oversimplifying Systematic Review Methodology.","authors":"Diego Adão, Rafael L Pacheco, Rachel Riera","doi":"10.1097/DCR.0000000000003766","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003766","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708998","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}