Diseases of the Colon & Rectum最新文献

{"title":"Mastering the Planes: Laparoscopic Left Hemicolectomy With Complete Mesocolic Excision.","authors":"Florentina Dermuth, Metincan Erkaya, Hermann P Kessler","doi":"10.1097/DCR.0000000000004244","DOIUrl":"10.1097/DCR.0000000000004244","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2538-2539"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560949","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":"Management and Survivorship Considerations in Early-Onset Rectal Cancer.","authors":"Megan E Boyer, Fergal J Fleming","doi":"10.1097/DCR.0000000000004398","DOIUrl":"10.1097/DCR.0000000000004398","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2425-2428"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577299","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":"Patterns and Outcomes of Elective Versus Nonelective Rectal Prolapse Repair: An American College of Surgeons National Quality Surgical Improvement Program Analysis.","authors":"Rehab Alsayari, Ying Cui, Allison J Pang, Gabriela A Ghitulescu, Julio Faria, Nancy A Morin, Carol-Ann Vasilevsky, Richard Garfinkle","doi":"10.1097/DCR.0000000000004365","DOIUrl":"10.1097/DCR.0000000000004365","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of knowledge regarding the presentation, surgical management, and short-term outcomes of rectal prolapse in the nonelective setting.</p><p><strong>Objective: </strong>The objectives of this study were to evaluate short-term postoperative outcomes after nonelective surgery for rectal prolapse and to compare those outcomes with those of patients who underwent elective repair.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>Multicenter North American database.</p><p><strong>Patients: </strong>Adults (aged 18 years or older) who underwent surgery for rectal prolapse.</p><p><strong>Interventions: </strong>Nonelective surgery (vs elective surgery).</p><p><strong>Main outcome measures: </strong>Coprimary outcomes included 30-day postoperative morbidity, mortality, reoperation, and unplanned hospital readmission.</p><p><strong>Results: </strong>In total, 17,836 patients underwent surgery for rectal prolapse and were followed for 30 days postoperatively; 1636 (9.2%) underwent nonelective and 16,200 (90.8%) underwent elective surgery. Patients who underwent nonelective surgery were older (age 85 years and older: 29.5% vs 13.9%, p < 0.001), more likely to be functionally dependent (16.8% vs 6.3%, p < 0.001), and were more likely to undergo a perineal approach (59.7% vs 40.7%, p < 0.001) than those who underwent elective surgery. On multiple logistic regression, nonelective surgery was independently associated with 30-day postoperative morbidity (adjusted OR 2.16; 95% CI, 1.87-2.48), mortality (adjusted OR 2.97; 95% CI, 2.10-4.14), reoperation (adjusted OR 1.89; 95% CI, 1.49-2.39), and unplanned hospital readmission (adjusted OR 1.87; 95% CI, 1.57-2.20). Furthermore, when stratified by surgical approach (perineal vs abdominal), nonelective surgery remained associated with a similar increase in postoperative risk across all outcomes. Among 1636 nonelective cases, 237 (14.5%) underwent emergent surgery and 1399 (85.5%) underwent nonemergent (or urgent) surgery. Compared with nonemergent surgery, emergent surgery for rectal prolapse was associated with an incrementally higher risk of 30-day postoperative morbidity (25.7% vs 19.6%, p = 0.030) and mortality (6.3% vs 3.3%, p = 0.022).</p><p><strong>Limitations: </strong>No data are available on previous repairs and/or hospital visits related to rectal prolapse.</p><p><strong>Conclusions: </strong>Nonelective rectal prolapse surgery was associated with significantly worse 30-day postoperative outcomes compared with elective repair. See Video Abstract .</p><p><strong>Patrones y resultados de la reparacin electiva frente a la no electiva del prolapso rectal un anlisis del acsnsqip: </strong>ANTECEDENTES:Existe escasa información sobre la presentación clínica, el tratamiento quirúrgico y los resultados a corto plazo del prolapso rectal en casos no electivos.OBJETIVO:Los objetivos de este estudio fueron evaluar los resultados","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2492-2499"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469414","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":"Short- and Long-term Outcomes of 3-Row Vs 2-Row Circular Staplers for Low Colorectal Anastomosis After Total Mesorectal Excision: A Single-Center, Randomized, Single-Blind, Phase III Trial (THREESTAPLER Study).","authors":"Inna Tulina, Petr B Tsugulya, Valeriia Kim, Mingze He, Vladimir Balaban, Petr Tsarkov","doi":"10.1097/DCR.0000000000004381","DOIUrl":"10.1097/DCR.0000000000004381","url":null,"abstract":"<p><strong>Background: </strong>Anastomotic leakage remains a critical complication in colorectal surgery.</p><p><strong>Objective: </strong>This study compared the efficacy of 3-row versus 2-row circular staplers in reducing anastomotic leakage rates.</p><p><strong>Design: </strong>Prospective, randomized, single-center, noninferiority trial.</p><p><strong>Settings: </strong>Clinic of Colorectal and Minimally Invasive Surgery, University Hospital No. 2, Sechenov University.</p><p><strong>Patients: </strong>The trial included patients who underwent low anterior resection with total mesorectal excision.</p><p><strong>Interventions: </strong>Patients were randomly assigned in a 1:1 ratio to the 2-row or 3-row stapler group using centralized, computer-generated randomization. Outcome adjudicators, data collectors, and data analysts were blinded.</p><p><strong>Main outcome measures: </strong>Anastomotic leakage incidence, intra- and postoperative anastomotic bleeding, 30-day complications, low anterior resection syndrome, anastomotic stenosis, adverse events, time to and permanence of stoma, and 5-year overall survival are the main outcome measures.</p><p><strong>Results: </strong>Among 154 patients included in the study, the anastomotic leakage rate was 16.9% (13/77) in the 3-row group compared to 15.6% (12/77) in the 2-row group ( p = 0.8). The observed difference between groups was 1.3%, with a 1-sided 95% CI bounded below by -8.47%. The rates of anastomotic stricture were 1.4% (n = 2) in the 2-row group and 0.7% (n = 1) in the 3-row group ( p = 1). No patients experienced anastomotic hemorrhage. Stoma closure was successfully performed in 147 patients (95.5%). The 5-year overall survival was 80.2% (95% CI, 69.4%-92.8%) in the 3-row group versus 83.8% (95% CI, 75.6%-92.3%) in the 2-row group ( p = 0.80).</p><p><strong>Limitations: </strong>Routine postoperative proctography was not performed, so clinically silent (grade A) leaks may have been missed; the study was underpowered because the assumed 12% anastomotic leakage difference used for sample-size estimation was optimistic; neoadjuvant regimen heterogeneity may have influenced outcomes; and the single-center design may limit generalizability.</p><p><strong>Conclusions: </strong>The 3-row stapler was not noninferior to the 2-row stapler in preventing anastomotic leakage. See Video Abstract .</p><p><strong>Clinical trial registration number: </strong>NCT03910699.</p><p><strong>Resultados a corto y largo plazo de las grapadoras circulares de tres filas frente a las de dos filas para la anastomosis colorrectal baja tras la escisin total del mesorrecto un ensayo clnico de fase iii, aleatorizado, simple ciego y de un solo centro estudio threestapler: </strong>ANTECEDENTES:La fuga anastomótica sigue siendo una complicación crítica en la cirugía colorrectal.OBJETIVO:Este estudio comparó la eficacia de las grapadoras circulares de tres filas frente a las de dos filas para reducir las tasas de fuga anas","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2500-2510"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700991","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":"Ventral Mesh Rectopexy and Rectal Cancer: An Underrecognized Concern.","authors":"Carlo Ratto, Nurhilal Kiziltoprak, Angelo Alessandro Marra","doi":"10.1097/DCR.0000000000004388","DOIUrl":"10.1097/DCR.0000000000004388","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2402-2403"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561022","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":"Three-Year Follow-up of the Randomized Trial Comparing Open Versus Laparoscopic Surgery for Primary Tumor Resection in Patients With Noncurable Stage IV Colon Cancer (JCOG1107).","authors":"Akio Shiomi, Tomonori Akagi, Riku Kajikawa, Hiroshi Katayama, Junki Mizusawa, Takumi Hasegawa, Masaaki Ito, Jun Watanabe, Toshifumi Yamaguchi, Masazumi Okajima, Satoshi Ikeda, Shunsuke Tsukamoto, Atsuo Takashima, Yukihide Kanemitsu, Masafumi Inomata","doi":"10.1097/DCR.0000000000004373","DOIUrl":"10.1097/DCR.0000000000004373","url":null,"abstract":"<p><strong>Background: </strong>JCOG1107 (University Hospital Medical Information Network Clinical Trials Registry, No. UMIN000009715) was a noninferiority phase III trial comparing laparoscopic and open surgery for symptomatic, noncurable stage IV colon cancer. The primary analysis confirmed the noninferiority of laparoscopic surgery in terms of progression-free survival.</p><p><strong>Objective: </strong>This study aimed to compare long-term outcomes of laparoscopic and open surgery for stage IV colon cancer.</p><p><strong>Design: </strong>Multicenter, open-label, randomized controlled phase III trial.</p><p><strong>Setting: </strong>Forty-two Japanese institutions.</p><p><strong>Patients: </strong>Participants were considered eligible if they had pathologically confirmed adenocarcinoma or adenosquamous carcinoma with a primary tumor between the cecum and rectosigmoid, presented with stenosis and/or bleeding, and 1 to 3 noncurable factors. The required sample size was 194 to ensure 70% power, a 1-sided alpha of 5%, and a noninferiority HR margin of 1.38.</p><p><strong>Interventions: </strong>Patients were randomly assigned to receive either open or laparoscopic primary tumor resection, followed by modified oxaliplatin, 5-FU, and folinic acid plus bevacizumab or capecitabine plus oxaliplatin with bevacizumab.</p><p><strong>Main outcome measures: </strong>The primary end point was progression-free survival.</p><p><strong>Results: </strong>A total of 195 patients were randomly assigned, including 95 open and 100 laparoscopic surgeries. Postoperative chemotherapy was given to 82 and 86 patients, respectively. The median follow-up period for all randomly assigned patients was 24.4 months. Grade 3 or higher late complications occurred in 1 open (1.1%) and 2 laparoscopic (2.0%) patients. Three-year progression-free survival rates were 5.3% (95% CI, 2.0-11.0) for open surgery and 3.0% (0.8-7.8) for laparoscopic surgery (HR 1.028; 95% CI, 0.772-1.370; p value for noninferiority = 0.02). The 3-year overall survival rates were 31.5% (22.5-41.0) and 28.5% (20.0-37.6; HR 1.048; 95% CI, 0.780-1.410), respectively.</p><p><strong>Limitations: </strong>Chemotherapy was administered without knowledge of microsatellite instability or RAS / BRAF mutation status.</p><p><strong>Conclusions: </strong>Laparoscopic surgery is noninferior to open surgery for noncurable stage IV colon cancer in terms of progression-free survival and should be considered an acceptable surgical option. See Video Abstract .</p><p><strong>Seguimiento a tres aos del ensayo aleatorizado que compara la ciruga abierta con la laparoscpica para la reseccin del tumor primario en pacientes con cncer de colon en estadio iv no curable jcog: </strong>ANTECEDENTES:JCOG1107 (UMIN-CTR, número UMIN000009715) fue un ensayo de fase III de no inferioridad que comparó la cirugía laparoscópica y la cirugía abierta para el cáncer de colon en estadio IV sintomático e incurable. El análisis primario confirmó la no","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2473-2483"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469600","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 Incision Plus One Robot-Assisted Surgery for Right-Sided Colon Cancer.","authors":"Takehito Yamamoto, Yoshiro Itatani, Ryuhei Aoyama, Yu Yoshida, Masahiro Maeda, Ryosuke Okamura, Koya Hida, Kazutaka Obama","doi":"10.1097/DCR.0000000000004160","DOIUrl":"10.1097/DCR.0000000000004160","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2535"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147527737","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":"Alexander R P K M van Renterghem, Adrianus M van der Holst, Sander M J van Kuijk, Eric Belgers, Mariëlle J Romberg-Camps, Marieke Pierik, Laurents P S Stassen","doi":"10.1097/DCR.0000000000004317","DOIUrl":"10.1097/DCR.0000000000004317","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2549"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162230","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":"William R G Perry, Peter Christensen, Rowan J Collinson, Julie A Cornish, Andre D'Hoore, Brooke H Gurland, Anders Mellgren, Carlo Ratto, Frederic Ris, Andrew R L Stevenson, Liliana Bordeainou","doi":"10.1097/DCR.0000000000004338","DOIUrl":"10.1097/DCR.0000000000004338","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2551"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148224076","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 and Physiological Characterization of Neurogenic Bowel Dysfunction in Motor-Incomplete Spinal Cord Injury.","authors":"Margarita Vallès, Sergiu Albu, Fernando Martins Braga, Wendy-Johanna Domínguez","doi":"10.1097/DCR.0000000000004358","DOIUrl":"10.1097/DCR.0000000000004358","url":null,"abstract":"<p><strong>Background: </strong>Neurogenic bowel dysfunction is highly prevalent after spinal cord injury and significantly affects quality of life. The pathophysiology in motor-incomplete spinal cord injury remains poorly characterized despite the availability of physiological tests, such as high-resolution anorectal manometry and colonic transit time.</p><p><strong>Objective: </strong>This study aims to characterize clinical presentation, high-resolution anorectal manometry findings, and colonic transit time in motor-incomplete spinal cord injury and to compare patients with neurological level at or above T6 versus below T6.</p><p><strong>Design: </strong>Prospective cross-sectional study.</p><p><strong>Settings: </strong>Specialized Neurorehabilitation Center.</p><p><strong>Patients: </strong>Fifty-eight consecutively recruited patients with motor-incomplete spinal cord injury (72.4% men; mean age, 51.3 ± 16.3 years) were included. The cause of injury was traumatic in 39.7% of cases, with a mean time since injury of 3.9 ± 1.3 months. A neurological level at or above T6 was observed in 58.6%.</p><p><strong>Main outcome measures: </strong>Clinical bowel characteristics, colonic transit time measurement, and high-resolution anorectal manometry (International Anorectal Physiology Working Group protocol, London Classification) and their associations.</p><p><strong>Results: </strong>Eighty-one percent of patients had fecal incontinence, constipation, or both. Prolonged colonic transit time was observed in 50%, without clear correlation with symptoms. High-resolution anorectal manometry showed a preserved rectoanal inhibitory reflex in all cases. According to the London Classification, the most common abnormalities were anal hypocontractility, with or without anal hypotension (63.8%), rectoanal coordination disorders (56.9%), and rectal hyposensitivity (60.3%). No consistent associations were found between physiological findings, symptoms, and neurological characteristics.</p><p><strong>Limitations: </strong>Treatment during assessment, limited normative high-resolution anorectal manometry data, small subgroups, and lack of a control group.</p><p><strong>Conclusions: </strong>Neurogenic bowel dysfunction in motor-incomplete spinal cord injury shows substantial pathophysiological heterogeneity, frequently combining anorectal dysfunction and delayed colonic transit time. This may explain the limited ability of symptoms and neurological characteristics to identify underlying mechanisms and supports systematic physiological testing to guide mechanism-oriented management. See Video Abstract .</p><p><strong>Caracterizacin clnica y fisiolgica de la disfuncin intestinal neurognica en la lesin medular motora incompleta: </strong>Antecedentes:La Disfunción Intestinal Neurogénica Es Muy Frecuente Tras Una Lesión Medular Y Afecta Significativamente a La Calidad De Vida. La Fisiopatología De La Lesión Medular Motora Incompleta Sigue Estando Poco Caracterizada, a ","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2511-2520"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535461","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}