Diseases of the Colon & Rectum最新文献

{"title":"Comparative Study of Diluted Hydrogen Peroxide and Sulfur Hexafluoride in the Contrast-Enhanced Ultrasound Assessment of Anal Fistulas.","authors":"Fernando de la Portilla de Juan, Anabel García-León, Carlos Javier García-Sánchez, Gabriel Marín, María L Reyes-Díaz, Jorge Vázquez-Monchul, Francisco J Padillo Ruiz","doi":"10.1097/DCR.0000000000003445","DOIUrl":"10.1097/DCR.0000000000003445","url":null,"abstract":"<p><strong>Background: </strong>Endoanal ultrasound for the diagnosis of anal fistulas requires the injection of hydrogen peroxide, but it is often uncomfortable for the patient and has the potential to cause complications. Novel ultrasound contrast is currently available.</p><p><strong>Objective: </strong>To assess the efficacy and safety of sulfur hexafluoride as an ultrasound contrast agent for the diagnosis of a perianal fistula by comparing it with those of 50% diluted hydrogen peroxide.</p><p><strong>Design: </strong>Double-blinded superiority study with 4 consecutive visits to perform an ultrasound without contrast, a hydrogen peroxide-enhanced ultrasound, a sulfur hexafluoride-enhanced ultrasound, and a rectal exploration in the operating room (the criterion standard). The 3 expert surgeon sonographers independently reviewed the ultrasound images.</p><p><strong>Setting: </strong>This study was conducted at a single university hospital.</p><p><strong>Patients: </strong>Data from 176 patients were evaluated.</p><p><strong>Main outcome measures: </strong>Demographic and exploratory data and the ultrasound findings related to the location of the internal fistula orifice, description of the primary and secondary tracts, and presence of cavities and sphincter defects were analyzed. Complications occurring before and after the contrast agent administration and pain score measured using a visual analog scale were considered.</p><p><strong>Results: </strong>Eighty-eight patients were included (men: 71.5%; mean age: 48.3 years), with 62.5% having a complex type fistula and 83.7% having a transsphincteric type fistula. Sulfur hexafluoride-enhanced ultrasounds demonstrated a higher interobserver agreement in determining the secondary tracts (κ = 0.604) and anal fistula height (κ = 0.604) compared with other methods. Both hydrogen peroxide-enhanced ultrasound (90.91%) and sulfur hexafluoride-enhanced ultrasound (89.77%) detected the internal orifice more frequently than ultrasounds without contrast (62.5%; p < 0.001), with no differences between contrast agents ( p = 0.810). Sulfur hexafluoride-enhanced ultrasound was less painful than peroxide-enhanced ultrasound ( p < 0.001).</p><p><strong>Limitations: </strong>Most of the patients had transsphincteric anal fistulas.</p><p><strong>Conclusions: </strong>Sulfur hexafluoride proved comparable to hydrogen peroxide in evaluating fistulous tracts and identifying the internal orifice, and it significantly reduced pain and discomfort. Furthermore, it demonstrated a higher interobserver agreement in determining the secondary tracts and anal fistula height compared with other methods. See Video Abstract .</p><p><strong>Estudio comparativo de perxido de hidrgeno diluido y hexafluoruro de azufre en la evaluacin ecogrfica con contraste de fstulas anales: </strong>ANTECEDENTES:La ecografía endoanal para el diagnóstico de fístulas anales requiere la inyección de peróxido de hidrógeno, pero generalmente resulta inc","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859323","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 ctDNA Testing for Minimal Residual Disease Assessment and Surveillance.","authors":"Smitha S Krishnamurthi","doi":"10.1097/DCR.0000000000003491","DOIUrl":"10.1097/DCR.0000000000003491","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893147","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":"Laparoscopic Hartmann's Reversal After Perforated Sigmoid Diverticulitis in a Woman.","authors":"Lukas Schabl, William C Chapman, Hermann P Kessler","doi":"10.1097/DCR.0000000000003044","DOIUrl":"10.1097/DCR.0000000000003044","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003879","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":"Is Dilip's Transmucosal Internal Sphincterotomy a Modification of Closed Lateral Internal Sphincterotomy?","authors":"Vipul D Yagnik, Kaushik Bhattacharya, Pankaj Garg","doi":"10.1097/DCR.0000000000003567","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003567","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497002","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":"Tryptophan Metabolites Improve Intestinal Mucosal Barrier via the Aryl Hydrocarbon Receptor-Interleukin-22 Pathway in Murine Dextran Sulfate Sodium-Induced Pouchitis.","authors":"Tenghui Zhang, Zeqian Yu, Yi Xu, Lei Zhao, Feng Zhu, Yan Zhou, Lili Gu, Jianfeng Gong","doi":"10.1097/DCR.0000000000003549","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003549","url":null,"abstract":"<p><strong>Background: </strong>Pouchitis is the commonest complication after ileal pouch-anal anastomosis for ulcerative colitis. The protective effect of tryptophan metabolites on the mucosal barrier may be an effective method for treating pouchitis. The role of tryptophan metabolites on pouchitis remained unclear.</p><p><strong>Objective: </strong>We aimed to establish a murine model of dextran sulfate sodium-induced pouchitis to examine the roles of tryptophan metabolites in its pathogenesis.</p><p><strong>Design: </strong>This is a study combined clinical patient data and animal research. A total of 22 patients were enrolled: 5 with familial adenomatous polyposis after ileal pouch-anal anastomosis, eight ulcerative colitis patients after ileal pouch-anal anastomosis patients with pouchitis, and 9 ulcerative colitis patients after ileal pouch-anal anastomosis with normal pouch. The demographic data and fecal samples of patients were collected. Male C57BL/6 mice were purchased from a licensed breeder and underwent ileal pouch-anal anastomosis to establish murine model of pouch. The bloods, feces, tissues of mice were collected.</p><p><strong>Settings: </strong>This study was performed in an academic medical center in China.</p><p><strong>Interventions: </strong>The demographic data of patients were observational collected. The mice underwent ileal pouch-anal anastomosis were divided into six groups: control group with chow diet, dextran sulfate sodium, 6-formylindolo[3,2-b] carbazole + dextran sulfate sodium, high tryptophan diet + dextran sulfate sodium, CH-223191 + dextran sulfate sodium, indole-3-carboxaldehyde + dextran sulfate sodium. Animals were sacrificed after dextran sulfate sodium for 7 days.</p><p><strong>Main outcome measures: </strong>Fecal tryptophan metabolite level and microbiome composition, the severity of pouchitis, intestinal mucosal barrier function, and activation of the aryl hydrocarbon receptor-interleukin 22 pathway were assessed.</p><p><strong>Results: </strong>Patients with pouchitis had lower fecal microbial diversity and indole-3-acetic acid levels. In murine pouchitis model, high-tryptophan diet increased fecal levels of 3-indoleglyoxylic acid, indole-3-aldehyde, and indole. A high-tryptophan diet and intraperitoneal aryl hydrocarbon receptor ligand 6-formylindolo[3,2-b] carbazole injection alleviated pouchitis. Tryptophan metabolites improved pouch mucosal barriers. aryl hydrocarbon receptor inhibitors exacerbated experimental pouchitis and disrupted the mucosal barrier; however, the aryl hydrocarbon receptor ligand indole-3-carboxaldehyde reversed this effect.</p><p><strong>Limitations: </strong>This study was limited by small human sample size and lacking an Aryl hydrocarbon receptor knockout mouse model.</p><p><strong>Conclusions: </strong>A high-tryptophan diet and aryl hydrocarbon receptor ligand alleviated dextran sulfate sodium-induced pouchitis in murine ileal pouch-anal anastomosis model, which might be","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497005","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":"https://doi.org/10.1097/DCR.0000000000003570","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-23","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":"Impact of Anastomotic Leakage After Colorectal Cancer Surgery on Quality of Life: A Systematic Review.","authors":"Anke H C Gielen, Danique J I Heuvelings, Patricia Sylla, Yu-Ting van Loon, Jarno Melenhorst, Nicole D Bouvy, Merel L Kimman, Stephanie O Breukink","doi":"10.1097/DCR.0000000000003478","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003478","url":null,"abstract":"<p><strong>Background: </strong>Colorectal anastomotic leakage remains one of the most frequent and dreaded postoperative complications following colorectal resection. However, limited research has been conducted on the impact of this complication on quality of life of patients undergoing colorectal cancer surgery.</p><p><strong>Objective: </strong>The aim of this systematic review was to identify, appraise and synthesize the available evidence regarding quality of life in patients with anastomotic leakage following oncological colorectal resections in order to inform clinical decision-making.</p><p><strong>Data sources and study selection: </strong>PubMed, Embase, and the Cochrane library were searched for studies reporting on quality of life using validated questionnaires in patients with anastomotic leakage after oncological colorectal resections. The literature search was performed systematically and according to PRISMA guidelines.</p><p><strong>Outcomes: </strong>Outcomes of quality of life questionnaire scores of patients with and without anastomotic leakage were analyzed.</p><p><strong>Results: </strong>Thirteen articles reporting on 4618 individual patients were included, among which 527 patients developed anastomotic leakage. Quality of life was evaluated utilizing ten distinct questionnaires administered at various postoperative time points, ranging from 1 month to 14 years. Quality of life outcomes differed across studies and timepoints, but overall scores were most negatively affected by anastomotic leakage up to 12 months postoperatively.</p><p><strong>Limitations: </strong>There was a high heterogeneity between the included studies based on used questionnaires and time of assessment.</p><p><strong>Conclusion: </strong>The published evidence suggests that anastomotic leakage following oncologic colorectal resection is associated with impaired quality of life, especially within the first postoperative year. The impact of anastomotic leakage on quality of life warrants further evaluation and discussion with patients.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497001","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":"Response to: CRC Screening, A Long Way Off.","authors":"Anyelin Almanzar, Sophia L Dahmani, Sami Shoucair","doi":"10.1097/DCR.0000000000003569","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003569","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497003","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":"Author Reply.","authors":"Dilip Pathak","doi":"10.1097/DCR.0000000000003568","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003568","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496999","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":"Robot-Assisted Surgery for Colorectal Cancer in Adults ≥ 75 Years Old: Value for Money?","authors":"Yingnan Hu, Wei Zhang","doi":"10.1097/DCR.0000000000003571","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003571","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497004","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}