Diseases of the Colon & Rectum最新文献

{"title":"Minimal Invasive Robotic Surgery in Lateral Lymph Node Dissection by Pelvic Floor First Approach.","authors":"Mitsuru Yokota, Akitaka Morikawa, Hiroya Matsuoka, Yoshio Nagahisa, Kenji Kawata, Michio Okabe, Toshihiko Masui, Kazuyuki Kawamoto","doi":"10.1097/DCR.0000000000003507","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003507","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188448","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":"Transanal Minimally Invasive Surgery for a Large Rectal Polyp.","authors":"Hani Bendib, Khaled Khansal, Razika Hachlaf","doi":"10.1097/DCR.0000000000003551","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003551","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188487","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":"National Trends in Hospital Admissions, Interventions and Outcomes for Early-Onset (Age <50) Diverticulitis From 2005-2020.","authors":"Shineui Kim, Bill Kwon, Nikhil Chervu, Saad Mallick, Konmal Ali, Peyman Benharash, Alexander T Hawkins, Hanjoo Lee, Aimal Khan","doi":"10.1097/DCR.0000000000003668","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003668","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the burden and outcomes of diverticulitis in patients under the age of 50. This knowledge gap hinders the development of effective management strategies and preventive measures for this population.</p><p><strong>Objective: </strong>This study aimed to analyze national trends in hospitalizations, interventions, and outcomes for early-onset (age <50) diverticulitis in comparison to standard-onset (age ≥50) cohorts.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>A survey-weighted, national sample extracted from the National Inpatient Sample.</p><p><strong>Patients: </strong>All adults (≥ 18 years) hospitalized for diverticulitis between 2005 and 2020.</p><p><strong>Main outcome measures: </strong>National trends in the proportions of early-onset vs. standard-onset diverticulitis related, along with the rates of colectomy.</p><p><strong>Results: </strong>From 2005-2020, 5,239,735 patients were electively hospitalized for diverticulitis. 837,195 (16.0%) were early onset. During the study period, the proportion of Early-onset cohort admitted for complicated-diverticulitis significantly increased from 18.5% to 28.2% (nptrend < 0.001) Additionally, there was a decline in the proportion of early-onset diverticulitis patients needing a colectomy (34.7% to 20.3%, nptrend < 0.001), with a corresponding increase in the proportion of patients needing Interventional Radiology intervention (12.7% to 28.6%, nptrend < 0.001). Compared to standard-onset diverticulitis, early-onset diverticulitis was associated with decreased odds of mortality (Adjusted Odds Ratio [AOR] 0.18, 95% Confidence Interval (95% CI) 0.16-0.20, p < 0.001) as well as decreased length of stay (β -0.28 days, 95% CI [-0.32,-0.24], p < 0.001) and hospitalization costs (β -$1,900, 95%CI [-$2,100,-$1,800], p < 0.001). Additionally, early-onset diverticulitis was associated with increased odds of colectomy (AOR 1.29, 95%CI 1.26-1.31) and percutaneous drainage (AOR 1.58, 95% CI 1.53-1.62).</p><p><strong>Limitations: </strong>Retrospective data collection. Lack of granular clinical data.</p><p><strong>Conclusion: </strong>There has been a significant increase in the proportion of complicated-diverticulitis related admissions among patients under 50. Patients with early-onset diverticulitis were more likely to undergo colectomy or percutaneous drainage than those with standard-onset (≥50 years) diverticulitis. Future work is needed to determine the cause for these trends and identify public health policies aimed at potential preventing the increasing burden of diverticulitis among younger populations. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188451","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":"Research Perspective on: \"Impact of Anastomotic Leakage After Colorectal Cancer Surgery on Quality of Life: A Systematic Review\".","authors":"Tara A Russell","doi":"10.1097/DCR.0000000000003558","DOIUrl":"10.1097/DCR.0000000000003558","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"171"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460464","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":"Access to High-Resolution Anoscopy and Colorectal Surgery Support Identified as Important Facilitators to Successful Veterans Affairs Anal Cancer Screening Programs.","authors":"Austin J Hewitt, Linda Cherney Stafford, Esra Alagoz, Cristina B Sanger","doi":"10.1097/DCR.0000000000003512","DOIUrl":"10.1097/DCR.0000000000003512","url":null,"abstract":"<p><strong>Background: </strong>Anal cancer disproportionately affects people living with HIV. The Department of Veterans Affairs is the largest single provider of health care to people living with HIV in the United States and recommends all veterans living with HIV be screened for anal cancer annually. There are barriers to developing successful anal cancer screening programs, and screenings within Veterans Affairs have been underused.</p><p><strong>Objective: </strong>This study aims to identify facilitators to anal cancer screening programs in Veterans Affairs.</p><p><strong>Design: </strong>This is a qualitative study involving semistructured virtual interviews. Thematic analysis was used to identify themes in the interview data.</p><p><strong>Settings: </strong>Study participants included Veterans Affairs infectious disease providers and colorectal surgeons who care for veterans living with HIV. Participants were asked to discuss factors that influence anal cancer screenings in Veterans Affairs.</p><p><strong>Main outcome measures: </strong>Themes were mapped to theoretical constructs and domains related to behavioral change using the Theoretical Domains Framework.</p><p><strong>Results: </strong>A total of 23 Veterans Affairs providers from all major United States geographical regions were interviewed. Important facilitators identified included access to high-resolution anoscopy and colorectal surgery support. The themes for successful anal cancer screening programs were mapped to 15 behavior-influencing constructs and categorized into 6 domains: 1) knowledge, 2) skills, 3) professional role and identity, 4) goals, 5) environmental context and resources, and 6) social influences.</p><p><strong>Limitations: </strong>This study involves health care providers who are invested in caring for veterans living with HIV, and their perspectives might not be representative of all Veterans Affairs providers.</p><p><strong>Conclusions: </strong>Access to a clinician with high-resolution anoscopy training and colorectal surgery support were identified as integral components of a successful anal cancer screening program. This study provides a framework for improving anal cancer screenings in veterans living with HIV by use of evidence-based interventions that incorporate the identified facilitators. See Video Abstract .</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"172-179"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946483","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":"Do We Really Know That a \"Substantial\" Proportion of Near-Complete Pathological Responses Become Complete Over Time?","authors":"Guilherme P São Julião, Laura M Fernandez, Bruna B Vailati, Leonardo Ervolino Corbi, Quentin Denost, Rodrigo O Perez","doi":"10.1097/DCR.0000000000003608","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003608","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 2","pages":"e54"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028163","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":"Corrigendum.","authors":"","doi":"10.1097/DCR.0000000000003600","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003600","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 2","pages":"e55"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028159","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":"Colonoscopy-Assisted Laparoscopic Wedge Resection for Colonic Lesions and Its Impact on Quality of Life: Results From the LIMERIC Study.","authors":"Amber G Brink, Julia Hanevelt, Laura W Leicher, Leon M G Moons, Frank P Vleggaar, Jelle Frank Huisman, Wouter H de Vos Tot Nederveen Cappel, Henderik L van Westreenen","doi":"10.1097/DCR.0000000000003531","DOIUrl":"10.1097/DCR.0000000000003531","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The LIMERIC study has proven that colonoscopy-assisted laparoscopic wedge resection effectively and safely removes benign colonic lesions unsuitable for endoscopic removal, thereby avoiding the need for major surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the impact of colonoscopy-assisted laparoscopic wedge on health-related quality of life of patients who participated in the LIMERIC study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Prospective multicenter study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Settings: &lt;/strong&gt;The LIMERIC study was performed between 2016 and 2020 in 13 Dutch hospitals. Five-level EuroQoL 5-dimension questionnaires were administered at baseline and 3 months after the procedure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients: &lt;/strong&gt;Patients with incomplete pre- or postoperative questionnaires or those undergoing combined interventions were excluded from the intention-to-treat analysis. Those for whom CAL-WR was not feasible or who underwent completion surgery were excluded from the per-protocol analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;Colonoscopy-assisted laparoscopic wedge for either 1) colon polyp unsuitable for endoscopic resection; 2) nonlifting residual or recurrent polyp within scar tissue after previous polypectomy; or (3) Rx/R1 endoscopic removal of a low-risk pT1 colon carcinoma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;Three-month health-related quality of life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Colonoscopy-assisted laparoscopic wedge did not affect health-related quality of life in the per-protocol analysis (n = 56) or in the intention-to-treat analysis (n = 67). The majority of patients reported no change in health status (57%). No significant differences were observed in the distribution of responses across all 5 dimensions before and after colonoscopy-assisted laparoscopic wedge. Patients'EuroQoL self-rated visual analog scale scores were also unaffected by a colonoscopy-assisted laparoscopic wedge, with a median score of 82.5 at baseline and 80 after surgery in the per-protocol analysis ( p = 0.63).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Solely a patient-reported outcome measure evaluating global health-related quality of life was used, rather than one specifically assessing disease-related quality of life, such as the quality of life questionnaire colorectal cancer module 29.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Colonoscopy-assisted laparoscopic wedge has no significant impact on the health-related quality of life in patients with benign colonic lesions and should therefore be considered before major surgery is performed. See Video Abstract.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Reseccin laparoscpica en cua asistida por colonoscopia para lesiones colnicas impacto en la calidad de vida resultados del estudio limeric: &lt;/strong&gt;ANTECEDENTES:El estudio LIMERIC ha demostrado que la resección laparoscópica en cuña asistida por colonoscopia elimina de forma eficaz y segura las lesiones colónicas benignas inadecuadas para la extirpación endoscópica,","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"242-251"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603566","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 Remembered.","authors":"James M Church","doi":"10.1097/DCR.0000000000003560","DOIUrl":"10.1097/DCR.0000000000003560","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"128-130"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616338","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":"Final Results of the GRECCAR-6 Trial on Waiting Period Following Neoadjuvant Radiochemotherapy for Locally Advanced Rectal Cancer: 5 Years of Follow-up.","authors":"Maxime K Collard, Laurent Mineur, Célia Nekrouf, Quentin Denost, Philippe Rouanet, Cécile de Chaisemartin, Aude Merdrignac, Mehrdad Jafari, Eddy Cotte, Jérôme Desrame, Gilles Manceau, Stéphane Benoist, Etienne Buscail, Mehdi Karoui, Yves Panis, Guillaume Piessen, Alain Saudemont, Michel Prudhomme, Frédérique Peschaud, Anne Dubois, Jérôme Loriau, Jean-Jacques Tuech, Emilie Duchalais, Renato M Lupinacci, Nicolas Goasguen, Tabassome Simon, Yann Parc, Jérémie H Lefevre","doi":"10.1097/DCR.0000000000003477","DOIUrl":"10.1097/DCR.0000000000003477","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The potential oncological benefit of extending the waiting period between neoadjuvant radiochemotherapy and surgical resection for rectal cancer is debated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the impact of prolonging this waiting period on the 5-year oncological prognosis and 2-year functional result of locally advanced rectal adenocarcinoma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Phase III, multicenter, randomized, open-label, parallel-group, controlled trial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Settings: &lt;/strong&gt;Patients were enrolled from 24 colorectal centers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients: &lt;/strong&gt;Patients with nonmetastatic mid or lower cT3/T4Nx or cTxN+ rectal adenocarcinoma who had received radiochemotherapy (45-50 Gy radiation dose with fluorouracil or capecitabine).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;Patients were randomly assigned to undergo total mesorectal excision either 7 weeks or 11 weeks after radiochemotherapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes measures: &lt;/strong&gt;Overall survival and disease-free survival at 5-year follow-up and low anterior resection syndrome score assessed after 2 years of follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 265 patients enrolled, 133 were randomized in the 7-week group and 132 in the 11-week group. Twelve patients were excluded because they did not undergo resection. Among 253 patients analyzed, 5-year overall survival was not different between the 2 groups (81.6% in the 7-week group vs 82.6% in the 11-week group, p = 0.827), and neither was the 5-year disease-free survival (70.4% in the 7-week group vs 69.5% in the 11-week group, p = 0.856). No difference was observed between the 2 groups for distant recurrence (27.4% in the 7-week group vs 25.7% in the 11-week group, p = 0.777) or local recurrence (8.4% in the 7-week group vs 10.2% in the 11-week group, p = 0.543). The low anterior resection syndrome score was similar between the 7-week (25.0; interquartile range, 15.0-34.0) and 11-week groups (23.0; interquartile range, 14.2-32.0; p = 0.743).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;The response rate to the low anterior resection syndrome questionnaire was only 52%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Extending the waiting period between radiochemotherapy and resection from 7 to 11 weeks does not change the 5-year oncological prognosis in rectal cancer or the 2-year low anterior resection occurrence. See Video Abstract.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Resultados finales del ensayo greccar sobre el perodo de espera tras la radioquimioterapia neoadyuvante para el cncer de recto localmente avanzado aos de seguimiento: &lt;/strong&gt;ANTECEDENTES:Se debate el posible beneficio oncológico de prolongar el periodo de espera entre la radioquimioterapia neoadyuvante y la resección quirúrgica del cáncer de recto.OBJETIVO:Evaluar el impacto de la prolongación de este periodo de espera sobre el pronóstico oncológico a 5 años y el resultado funcional a 2 años del adenocarcinoma rectal localmente avanzado.DISEÑO:Ensayo controlado d","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"199-208"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603568","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}