Diseases of the Colon & Rectum最新文献

{"title":"Simultaneous Application of Robotic Surgery and Transanal Minimally Invasive Surgery Platform in the Context of Sphincter Preservation, Stepwise Description.","authors":"Ali Toffaha, Mahmood Al-Dhaheri, Mohamed Kurer","doi":"10.1097/DCR.0000000000004133","DOIUrl":"10.1097/DCR.0000000000004133","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2339"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289696","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":"Residual Disease at the Margin: More Than an Incidental Finding.","authors":"Alexander R P K M van Renterghem, Adrianus M van der Holst, Sander van Kuijk, Eric H J Belgers, Mariëlle Romberg-Camps, Marieke Pierik, Laurents P S Stassen","doi":"10.1097/DCR.0000000000004295","DOIUrl":"10.1097/DCR.0000000000004295","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2348-2349"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981080","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":"Herrmann and Desfosses, the 2 Men \"Behind the Anal Glands\": A Brief Account of a Notable Page in the History of Proctology.","authors":"Paul-Antoine Lehur, Emilie Duchalais","doi":"10.1097/DCR.0000000000004200","DOIUrl":"10.1097/DCR.0000000000004200","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2241-2247"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148028319","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":"Quadratus Lumborum Block During Minimally Invasive Colorectal Surgery: A Tool for Enhanced Recovery.","authors":"Leonardo E Garcia, Luisa J Maldonado, Rebekah J Bihun, Jennifer L Irani, Nelya Melnitchouk, Joel E Goldberg, Ronald Bleday","doi":"10.1097/DCR.0000000000004308","DOIUrl":"10.1097/DCR.0000000000004308","url":null,"abstract":"<p><strong>Background: </strong>Multimodal opioid-sparing analgesia has been well established as a component of enhanced recovery after surgery protocols for colorectal surgery patients. Commonly used regional anesthesia techniques include transversus abdominis plane blocks, rectus sheath blocks, or continuous wound infiltration/catheters. Another proposed technique is the quadratus lumborum block, which has been suggested to provide better visceral analgesia. It resembles a posterior approach to the transversus abdominis plane block, and its target is the ventral rami of the spinal nerve roots (including the subcostal and ilio-hypogastric nerves), which pass between the quadratus lumborum and its anterior fascia.</p><p><strong>Objective: </strong>We aimed to evaluate the efficacy of an intraoperative quadratus lumborum block and compare it with other regional anesthetic techniques used in colorectal surgery patients at the same institution.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Settings: </strong>Tertiary care academic medical center.</p><p><strong>Patients: </strong>Adult patients who underwent minimally invasive (laparoscopic or robotic) colectomy or low anterior resection between September 2022 and September 2024.</p><p><strong>Interventions: </strong>Intraoperative transversus abdominis plane versus transversus abdominis plane + quadratus lumborum block versus no regional block. The anesthetic agent used was 0.25% bupivacaine without epinephrine (1 mg/kg). When performing a quadratus lumborum block, approximately two-thirds of the total dose was administered in the quadratus lumborum spaces.</p><p><strong>Main outcome measures: </strong>Cumulative opioid dose, quantified in morphine milligram equivalents, subjective pain scores, and need for intravenous hydromorphone were evaluated in the postanesthesia care unit on postoperative day 1 and postoperative day 2 and compared between patients getting a transversus abdominis plane + quadratus lumborum block, transversus abdominis plane block alone, and no regional block. Length of stay, early mobilization, and return of bowel function were also evaluated and compared between groups.</p><p><strong>Results: </strong>A total of 224 patients were included (mean age 60.1 ± 13 years; 46.8% men); 82.1% underwent laparoscopic surgery, and 93.7% were opioid-naive. Forty-three patients (19.2%) received no regional block, 69 (30.8%) received transversus abdominis plane block alone, and 112 (50.0%) received transversus abdominis plane + quadratus lumborum block. Postoperative opioid use did not differ in the postanesthesia care unit or postoperative day 1. On postoperative day 2, opioid requirements were lower in the transversus abdominis plane + quadratus lumborum block group compared with transversus abdominis plane block alone (median 7.5 vs 18.8 mg; p = 0.030), and pain scores were lower (median 4 vs 5; p = 0.014). The median length of stay was shorter with the t","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2291-2300"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149088","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":"Managing Reach Limitations in Left-Sided Colectomy.","authors":"Lucas Faraco Sobrado","doi":"10.1097/DCR.0000000000004315","DOIUrl":"10.1097/DCR.0000000000004315","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2248-2251"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155614","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":"CRC Screening, A Long Way Off.","authors":"Fei Chen, Cheng Luo, Song Zhao","doi":"10.1097/DCR.0000000000003570","DOIUrl":"10.1097/DCR.0000000000003570","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2356"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497000","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":"Jeongyoon Moon, Marylise Boutros","doi":"10.1097/DCR.0000000000004297","DOIUrl":"10.1097/DCR.0000000000004297","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2352"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013719","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":"Oncologic Outcomes of Robot-Assisted Upfront Surgery Using a Fascia-Guided Total Mesorectal Excision Strategy for T3 Rectal Cancer.","authors":"Shota Izukawa, Masakatsu Numata, Keisuke Kazama, Yosuke Atsumi, Suguru Nukada, Mayumi Ozawa, Tsutomu Sato, Takaki Yoshikawa","doi":"10.1097/DCR.0000000000004303","DOIUrl":"10.1097/DCR.0000000000004303","url":null,"abstract":"<p><strong>Background: </strong>Local recurrence remains a major challenge in rectal cancer. Total mesorectal excision is the surgical cornerstone; however, early outcomes after its adoption have not consistently achieved satisfactory local control, partially reflecting the difficulty of maintaining appropriate mesorectal dissection. Advances in the understanding of the perirectal fascia and dissection planes, together with robotic technology, have enabled high-quality, fascia-guided total mesorectal excision. Despite this progress, regional strategies differ, emphasizing either the optimization of upfront surgery or intensified preoperative systemic therapy. Long-term oncologic evidence for an upfront robotic strategy remains limited, and concerns, including signals of increased local recurrence after intensified preoperative approaches, have renewed the debate regarding optimal indications. Benchmark data are needed to clarify whether high-quality upfront robotic total mesorectal excision can achieve favorable local control.</p><p><strong>Objective: </strong>To evaluate oncologic outcomes after robot-assisted upfront surgery using a study-defined fascia-guided total mesorectal excision framework in a homogeneous cohort limited to pathological T3 rectal cancer.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>Two high-volume medical centers.</p><p><strong>Patients: </strong>Consecutive patients with pathological T3 rectal adenocarcinoma who underwent robot-assisted primary resection between June 2017 and August 2023 were included.</p><p><strong>Main outcome measures: </strong>The primary end point was the 3-year cumulative incidence of local recurrence. The secondary end points included overall survival and relapse-free survival.</p><p><strong>Results: </strong>The final cohort included 125 patients with a median follow-up of 43.4 months. The 3-year cumulative incidence of local recurrence was 2.04% (pathological stage II, 1.80%; pathological stage III, 2.36%). The 3-year overall survival rate was 93.9% and the 3-year relapse-free survival rate was 72.8%.</p><p><strong>Limitations: </strong>Retrospective design with few local recurrence events. Also, preoperative MRI was not uniformly available.</p><p><strong>Conclusions: </strong>In a homogeneous pathological T3 cohort, robot-assisted upfront surgery under a fascia-guided total mesorectal excision strategy achieved low 3-year local recurrence and favorable survival, providing stage-specific benchmark outcomes for evaluating upfront surgical approaches. See Video Abstract .</p><p><strong>Resultados oncolgicos de la ciruga robtica inicial mediante una estrategia de escisin mesorrectal total guiada por fascia para el cncer de recto t: </strong>ANTECEDENTES:La recidiva local sigue siendo un desafío importante en el cáncer de recto. La escisión total del mesorrecto es la piedra angular de la cirugía; sin embargo, los resultados iniciales tras su adopción no","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2254-2265"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148028292","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":"Single-Port Robotic Transstomal End Colostomy Resection and Closure.","authors":"Madeline L D'Aquila, Kurt S Schultz, Haddon J Pantel","doi":"10.1097/DCR.0000000000004233","DOIUrl":"10.1097/DCR.0000000000004233","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2343-2344"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149071","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":"Being Artificially Intelligent.","authors":"James Church","doi":"10.1097/DCR.0000000000004302","DOIUrl":"10.1097/DCR.0000000000004302","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2223-2225"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162209","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}