Diseases of the Colon & Rectum最新文献

{"title":"Endoscopic and Transanal Management of Anastomotic Leak.","authors":"Grace M Crouch, Amanda M McClure","doi":"10.1097/DCR.0000000000003635","DOIUrl":"10.1097/DCR.0000000000003635","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"394-397"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913571","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":"Audit of a Novel Nurse-Led Program for Nonantibiotic Management of Acute Uncomplicated Diverticulitis.","authors":"Huseen Alibrahim, Jessica Pinto, Sarah Sabboobeh, Neyla Boukhili, Marie Demian, Carol-Ann Vasilevsky, Marylise Boutros","doi":"10.1097/DCR.0000000000003612","DOIUrl":"10.1097/DCR.0000000000003612","url":null,"abstract":"<p><strong>Background: </strong>Nonantibiotic outpatient treatment of acute uncomplicated diverticulitis is safe; however, uptake remains low.</p><p><strong>Objective: </strong>To assess the success of nonantibiotic management of uncomplicated diverticulitis through a nurse-led outpatient program.</p><p><strong>Design: </strong>Retrospective audit from June 2022 to March 2024.</p><p><strong>Settings: </strong>Nurse-led outpatient program for nonantibiotic management of acute uncomplicated diverticulitis at a university-affiliated hospital.</p><p><strong>Patients: </strong>Immunocompetent adults with CT-proven acute uncomplicated diverticulitis and C-reactive protein <150 mg/L. Eligible patients not referred to the program but treated in the emergency department during the same period were also reviewed.</p><p><strong>Interventions: </strong>This program included education, diet modification, analgesia, clinic visit, and telephone follow-ups by a nurse.</p><p><strong>Main outcome measures: </strong>The primary outcome was the success of the program, defined as the proportion not requiring an emergency department visit, admissions within 60 days of diagnosis, or need for antibiotics.</p><p><strong>Results: </strong>Of 236 patients referred to the program, 84 met inclusion criteria, of whom 43 patients (51.2%) were started on antibiotics before referral but were treated by the program. Forty-one patients (48.8%) completed the nonantibiotic protocol (48.8%; n = 41), which had a 97.6% success rate. Concurrently, 219 eligible patients were treated in the emergency department but not referred to the program. There was no difference in the number of emergency department visits between the 2 groups (program: n = 7 [8.3%] vs emergency department: n = 27 [12.3%]) within 60 days of diagnosis. Two patients (2.3%) treated in the program required admission, whereas 7 patients (3.2%) in the emergency department group were admitted. Overall, antibiotics were started before referral in 51.2% of patients in the program compared to 92.2% in the emergency department ( p < 0.005).</p><p><strong>Limitations: </strong>Modest sample size, single institutional data, and retrospective design.</p><p><strong>Conclusions: </strong>Implementation of nonantibiotic treatment for mild acute uncomplicated diverticulitis can be successful using an outpatient nurse-led program with referrals from the emergency department and community. See Video Abstract .</p><p><strong>Auditora de un nuevo programa dirigido por enfermeras para el tratamiento sin antibiticos de la diverticulitis aguda no complicada: </strong>ANTECEDENTES:El tratamiento ambulatorio sin antibióticos de la diverticulitis aguda no complicada es seguro; sin embargo, la aceptación sigue siendo baja.OBJETIVO:Evaluar el éxito del manejo sin antibióticos de la diverticulitis no complicada a través de un programa ambulatorio dirigido por enfermeras clínicas.DISEÑO:Auditoría retrospectiva de junio 2022 a marzo 2024.AJUSTE:Prog","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"437-446"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892968","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":"Comment on \"Risk of Postoperative Venous Thromboembolism After Benign Colorectal Surgery: Systematic Review and Meta-analysis\".","authors":"Syed Mohammad Nabeel Aamir, Umer Zada, Fatima Sohail, Saima Syed","doi":"10.1097/DCR.0000000000003639","DOIUrl":"10.1097/DCR.0000000000003639","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e156"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946495","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: TNMF Vs. TNM in Staging of Colorectal Cancer.","authors":"Yuesheng Yang, Yong Li, Zifeng Yang","doi":"10.1097/DCR.0000000000003641","DOIUrl":"10.1097/DCR.0000000000003641","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e158"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946502","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":"EndoRobotic Submucosal Dissection After Total Neoadjuvant Treatment in Rectal Cancer.","authors":"Kamil Erozkan, Metincan Erkaya, Mehmet Ayhan Kuzu, Emre Gorgun","doi":"10.1097/DCR.0000000000003591","DOIUrl":"10.1097/DCR.0000000000003591","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e150"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913569","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":"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":"TEMPOUR: A Randomized Controlled Trial Assessing Perioperative Use of an Alpha-1 Blocker to Reduce Postoperative Urinary Retention After Transanal Endoscopic Microsurgery Procedures.","authors":"Thomas Couture, Claudya Morin, Janyssa Charbonneau, Émilie Papillon-Dion, Alexandre Bouchard, François Rouleau-Fournier, Philippe Bouchard, François Letarte, Alexis F Turgeon, Sebastien Drolet","doi":"10.1097/DCR.0000000000003623","DOIUrl":"10.1097/DCR.0000000000003623","url":null,"abstract":"<p><strong>Background: </strong>Transanal endoscopic microsurgery is a treatment option for a wide range of rectal lesions. Postoperative urinary retention is a frequently associated complication. Some studies have suggested that the use of alpha-1 blockers may reduce the risk of postoperative urinary retention after hernia and colorectal surgery, but evidence is lacking.</p><p><strong>Objective: </strong>This trial aims to evaluate whether prophylactic use of an alpha-1 blocker reduces the rate of postoperative urinary retention after transanal endoscopic microsurgery.</p><p><strong>Design: </strong>Double-blinded, placebo-controlled trial.</p><p><strong>Settings: </strong>Single high-volume Canadian colorectal center.</p><p><strong>Patients: </strong>Adult male patients awaiting transanal endoscopic microsurgery and not taking alpha-1 blockers were included.</p><p><strong>Intervention: </strong>Patients were allocated to either tamsulosin or placebo from 5 days before surgery to 2 days postoperatively.</p><p><strong>Main outcomes measures: </strong>The primary outcome was the incidence of postoperative urinary retention. Secondary outcomes were urinary retention-related hospitalization, time to removal of a bladder catheter, International Prostate Symptom Score (before and after treatment), and adverse events.</p><p><strong>Results: </strong>158 patients were randomly assigned between October 2017 and July 2022. There was no significant difference in postoperative urinary retention between groups (23% vs 14%; p = 0.16), respectively, in the tamsolusin and placebo groups. Time to removal of bladder catheter was not statistically different between groups (4.8 vs 8.6 days, p = 0.26). No failure of same-day discharge nor readmissions related to urinary retention occurred. International Prostate Symptom Scores were not significantly different at the time of surgery (3.8 vs 5.4; p = 0.11), and reported adverse events did not differ between groups.</p><p><strong>Limitations: </strong>We cannot exclude a potential type II error.</p><p><strong>Conclusions: </strong>Prophylactic use of an alpha-1 blocker for patients undergoing transanal endoscopic microsurgery was not associated with a reduction in postoperative urinary retention. See Video Abstract.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03314025.</p><p><strong>Tempour un ensayo controlado aleatorizado que evala el uso perioperatorio de un bloqueador alfa para reducir la retencin urinaria posoperatoria despus de microciruga endoscpica transanal: </strong>ANTECEDENTES:La microcirugía endoscópica transanal es una opción de tratamiento para una amplia gama de lesiones rectales. La retención urinaria posoperatoria es una complicación frecuentemente asociada. Algunos estudios han sugerido que el uso de bloqueadores alfa-1 puede reducir el riesgo de retención urinaria posoperatoria después de cirugía colorrectal o de hernia, pero falta evidencia al respecto.OBJETIVO:Este","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"475-482"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913902","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":"Guideline-Concordant Extended Pharmacologic Venous Thromboembolism Prophylaxis Utilization After Colorectal Cancer Resection Is Low Regardless of Patient Factors or Hospital Characteristics.","authors":"Colleen A Donahue, Daniel L Brinton, Alexander T Booth, Maggie L Westfal, Virgilio George, Pinckney Johnstone Maxwell, Kit N Simpson, Thomas Curran","doi":"10.1097/DCR.0000000000003616","DOIUrl":"10.1097/DCR.0000000000003616","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism after colorectal cancer resection is common and highly morbid. Extended pharmacologic venous thromboembolism prophylaxis after cancer surgery lowers venous thromboembolism risk and is recommended by major professional societies. Adherence is low in contemporary local and regional studies.</p><p><strong>Objective: </strong>Assess patient and hospital factors associated with receipt of prophylaxis after colorectal cancer surgery in a national data set.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>Surveillance, epidemiology, and end results in a Medicare data set.</p><p><strong>Patients: </strong>Patients older than 64 years undergoing resection for colorectal cancer between 2016 and 2017.</p><p><strong>Main outcome measures: </strong>The primary outcome was the receipt of prophylaxis within 7 days of discharge. Patient and hospital factors associated with receiving prophylaxis were identified using multivariable logistic regression. Secondary outcomes included 30- and 90-day venous thromboembolism.</p><p><strong>Results: </strong>Of 23,527 patients, 4.7% received prophylaxis. Utilization increased from 2016 to 2017 (3.9% vs 5.5%; p < 0.001). Patients treated at National Cancer Institute-designated hospitals received prophylaxis more frequently than teaching, non-National Cancer Institute hospitals and nonteaching, non-National Cancer Institute hospitals (10.2% vs 5.6% vs 1.7%; p < 0.001). Patients receiving care at larger hospitals by bed size quartile were more likely to receive prophylaxis compared to those at smaller hospitals (9.0% vs 4.0% vs 3.4% vs 2.2%; p < 0.01). On multivariable regression, National Cancer Institute status, larger bed size, White race (compared to others), rectal tumor location, and more recent year of treatment were independently associated with prophylaxis utilization. Venous thromboembolism events at 30 and 90 days were 1.87% and 2.63%, respectively. Prophylaxis was associated with decreased 30-day venous thromboembolism (1.26% vs 1.9%; p = 0.1211).</p><p><strong>Limitations: </strong>Retrospective, large database study.</p><p><strong>Conclusions: </strong>Utilization of prophylaxis after colorectal cancer surgery remains limited even in large, specialized hospitals. Further work is needed to understand this departure from guideline-concordant care. See Video Abstract .</p><p><strong>La directriz concordante extendida sobre la utilizacion de profilaxis para la tromboembolia venosa despus de la reseccin del cncer colorrectal es baja independientemente de los factores del paciente o las caractersticas del hospital: </strong>ANTECEDENTES:La tromboembolia venosa tras la resección del cáncer colorrectal es común y presenta una alta morbilidad. La profilaxis farmacológica prolongada indicada para la tromboembolia venosa después de la cirugía del cáncer reduce el riesgo de tromboembolia venosa y es recomendada por las principa","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"417-425"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892969","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}