Diseases of the Colon & Rectum最新文献

{"title":"Emergency Laparoscopic Right Hemicolectomy With Intracorporeal Anastomosis.","authors":"Chloe McDonald, Zi Qin Ng","doi":"10.1097/DCR.0000000000003650","DOIUrl":"10.1097/DCR.0000000000003650","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332636","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 Left Lateral Pelvic Lymph Node Dissection in Female.","authors":"Subhathira Manohkaran, Akash Mor, Avanish Saklani","doi":"10.1097/DCR.0000000000003745","DOIUrl":"10.1097/DCR.0000000000003745","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332637","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 Dissection of the Left Retrocolic Fascial Plane.","authors":"José Azevedo, Elisa Paoluzzi Tomada, Amjad Parvaiz","doi":"10.1097/DCR.0000000000003674","DOIUrl":"10.1097/DCR.0000000000003674","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332638","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 Endoscopic Submucosal Dissection for Large Rectal Lesions.","authors":"Matheus Meyer, Peterson M Neves, Henrique A Lima","doi":"10.1097/DCR.0000000000003682","DOIUrl":"10.1097/DCR.0000000000003682","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332640","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 Tumor Deposits in Colon Cancer.","authors":"Sandy H Fang","doi":"10.1097/DCR.0000000000003865","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003865","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324754","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":"Tumor Deposits in Colon Cancer.","authors":"Richard Sassun, Nicholas P McKenna","doi":"10.1097/DCR.0000000000003864","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003864","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324755","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":"Partial Responders to Neoadjuvant Therapy and the Risk of Distant Metastases: Longer Intervals to Definitive Resection Is Not a Risk Factor.","authors":"Laura M Fernandez, Bruna Borba Vailati, Guilherme Pagin São Julião, Leonardo Ervolino Corbi, Fernanda Elias, Angelita Habr-Gama, Jose Azevedo, Inês Santiago, Oriol Parés, Amjad Parvaiz, Véronique Vendrely, Anne Rullier, Eric Rullier, Quentin Denost, Rodrigo Perez","doi":"10.1097/DCR.0000000000003834","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003834","url":null,"abstract":"<p><strong>Background: </strong>The timing of resection after neoadjuvant therapy for rectal cancer remains a debated topic. Longer intervals from radiation completion have been associated with increased rates of clinical and pathological complete response, but concerns remain regarding partial responders and the risk of distant metastasis.</p><p><strong>Objective: </strong>To evaluate whether the interval between the end of neoadjuvant chemoradiation therapy and surgical resection affects the development of distant metastases in patients with an excellent partial response.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>Multicenter analysis from three institutions: Angelita & Joaquim Gama Institute, Champalimaud Foundation, and University Hospital Bordeaux.</p><p><strong>Patients: </strong>165 patients with rectal cancer who achieved either a near-complete pathological response or a clinical complete response followed by local regrowth.</p><p><strong>Interventions: </strong>Patients underwent total mesorectal excision or were managed by watch-and-wait with salvage surgery for local regrowth. The timing of surgery post- neoadjuvant chemoradiation therapy was analyzed.</p><p><strong>Main outcome measures: </strong>The primary outcome was the development of distant metastases.</p><p><strong>Results: </strong>34 patients developed distant metastases. There was no significant difference in the time to resection between those who developed metastases and those who did not (9.2 months vs. 10.6 months, p = 0.55). A secondary analysis of patients with local regrowth also showed no significant difference in metastasis development based on resection timing (14.4 months vs. 17.9 months, p = 0.26).</p><p><strong>Limitations: </strong>The study is limited by its retrospective nature and the subjective definition of excellent response in clinical settings.</p><p><strong>Conclusions: </strong>In patients with an excellent partial response to neoadjuvant chemoradiation therapy, the interval between radiation completion and surgical resection does not appear to influence the risk of distant metastases. This suggests that factors other than time may play a role in the development of distant metastases in this population. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316171","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":"Association of Cumulative Social Risk and Cancer-Specific Survival Among Patients With Advanced Colorectal Cancer.","authors":"Kirbi Yelorda, Heather Day, M Katherine Arnow, Sue Fu, Sanghyun A Kim, Arden M Morris","doi":"10.1097/DCR.0000000000003851","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003851","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic disadvantage is widely associated with poor clinical outcomes among patients with colorectal cancer. Interventions to address these pervasive public health problems have had mixed success, potentially related to their development based on aggregated data (e.g., average zip code income) and short-term outcomes, rather than individual level data and meaningful long-term cancer outcomes.</p><p><strong>Objective: </strong>To examine associations of individual and cumulative multiple, co-occurring individual-level social risk factors with long-term cancer-specific survival among patients with advanced colorectal cancer.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Setting: </strong>Between 2011-2014, we collaborated with Surveillance, Epidemiology and End Result in Georgia and Detroit to survey patients with Stage III colorectal cancer in the prior year. Cumulative social risk was calculated by summing significant factors associated with colorectal cancer-specific mortality: employment, insurance, health literacy, income, and marital status.</p><p><strong>Patients: </strong>Patients with stage III colorectal cancer.</p><p><strong>Main outcome measures: </strong>Time from diagnosis to cancer-specific mortality, adjusted for age, race, sex, and chemotherapy receipt, with comparisons provided in hazard ratios with 95% confidence intervals.</p><p><strong>Results: </strong>Among 1173 patients, pre-operative unemployment (1.76 [1.30-2.39]), uninsured or Medicaid insurance (1.54 [1.12-2.11]), low health literacy (1.40 [1.00-1.95]), annual income < $50,000 (1.34 [1.01-1.77]) and being unpartnered (1.34 [1.02-1.77]) were associated with higher likelihood of cancer-specific mortality. In cumulative risk analyses, each added social risk was associated with 24% higher adjusted likelihood of cancer-specific mortality (1.24 [1.12-1.37]).</p><p><strong>Limitations: </strong>This study has limitations inherent to survey research including the potential lack of generalizability and responses subject to recall bias. Additionally, the cross-sectional survey and linked longitudinal clinical data do not allow for determination of causality.</p><p><strong>Conclusion: </strong>Cumulative social risk was associated with long-term cancer-specific survival after treatment for Stage III colorectal cancer. Assessing social risk may help identify patients with colorectal cancer who are at higher risk of mortality to receive support programs designed to mitigate social disadvantage. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301361","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":"Risk Factors for Stricture After Endoscopic Submucosal Dissection of Large Rectal Neoplasms.","authors":"Daniel T Rezende, Fabio S Kawaguti, Cintia M S Kimura, Caio S R Nahas, Rodrigo A Pinto, Adriana V Safatle-Ribeiro, Fauze Maluf-Filho, Ulysses Ribeiro-Junior, Sergio C Nahas, Carlos F S Marques","doi":"10.1097/DCR.0000000000003827","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003827","url":null,"abstract":"<p><strong>Background: </strong>While acute adverse events after endoscopic submucosal dissection, such as perforation and bleeding, are well-documented, studies on stricture are scarce.</p><p><strong>Objective: </strong>This study aims to identify risk factors for rectal stricture and symptomatic stricture after endoscopic submucosal dissection, and to evaluate patient outcomes in a Western tertiary cancer center.</p><p><strong>Design: </strong>Single-center retrospective study from a prospectively collected database of rectal endoscopic submucosal dissections.</p><p><strong>Settings: </strong>Reference cancer center.</p><p><strong>Patients: </strong>Patients undergoing endoscopic submucosal dissection for rectal neoplasms from July 2010 to January 2020. Exclusion criteria were incomplete resections, referral for low anterior resection, proximal diversions (symptomatic group), and loss to follow-up. A specific follow-up protocol was established for patients with lesions occupying more than 90% of the rectal circumference.</p><p><strong>Interventions: </strong>Rectal strictures were classified as complete or partial.</p><p><strong>Main outcomes measures: </strong>Assessment of risk factors for stricture after rectal endoscopic submucosal dissection.</p><p><strong>Results: </strong>Of 109 rectal lesions resected, 94 cases were included. Twenty patients (21,3%) developed stricture (thirteen complete and seven partial stricture). Univariate analysis identified distance from the anal verge< 5 cm, larger size and circumferential mucosal defect >90% as significantly associated with stricture (p < 0.05). On multivariable analysis showed that only circumferential mucosal defect ≥90% was significantly associated with stricture (p < 0.001). None of the patients with partial stricture were symptomatic, while eleven out of thirteen with complete stricture were symptomatic. All symptomatic patients underwent serial dilations, with balloon or digitally, with symptom resolution within 1 to 8 months (mean of 7.8 sessions of dilation procedures).</p><p><strong>Limitations: </strong>Single-center retrospective study.</p><p><strong>Conclusions: </strong>Circumferential mucosal defect ≥90% was the only significant risk factor for stricture after extensive rectal endoscopic submucosal dissection procedures on multivariable analysis. All patients with symptomatic stricture were successfully treated with dilation sessions. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283033","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":"Textbook Outcomes of Minimally Invasive Total Mesorectal Excision: A Composite Tool to Assess and Compare Outcomes or Benchmarking.","authors":"Vipul Gupta, Akash Mor, Rohit Mundhada, Mufaddal Kazi, Anjali Daphal, Ankit Sharma, Ashwin Desouza, Avanish P Saklani","doi":"10.1097/DCR.0000000000003837","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003837","url":null,"abstract":"<p><strong>Background: </strong>Textbook outcome is an integrated measure including both clinical as well as oncological outcomes. Within minimally invasive rectal cancer surgery, if achievement of textbook outcome translates into improved oncological outcomes is not studied.</p><p><strong>Objective: </strong>To evaluate textbook outcome and its associated factors for patients undergoing minimally invasive total mesorectal excision.</p><p><strong>Design: </strong>Single center retrospective study.</p><p><strong>Settings: </strong>The study was conducted at a high-volume tertiary referral cancer center in India.</p><p><strong>Patients: </strong>All patients receiving elective laparoscopic or robotic total mesorectal excision from 2013- 2023 were included.</p><p><strong>Main outcome measures: </strong>The number of patients achieving textbook outcome, institute's time trend, factors affecting textbook outcome and intermediate oncological outcomes were evaluated.</p><p><strong>Results: </strong>Of the 1394 patients who underwent minimally invasive total mesorectal excision, 831 patients (60%) achieved textbook outcome. The conversion rate to open surgery is 0.2% with complications ≥ Clavien-Dindo 3 in 1.6% of patients. Twenty-seven percent patients had prolonged hospital stay with 30-day readmission rate being 3%. Four percent patients had a poor lymph node yield, R0 resection rate is 98% and adjuvant therapy delay is observed in 6% patients. The achievement of textbook outcome resulted in improved 3- year overall survival (92.1% vs 83.7%, p <0.001) and disease-free survival (81.5% vs 75.7%, p = 0.007).</p><p><strong>Limitation: </strong>The results of our study cannot be generalized to open total mesorectal excision, beyond total mesorectal excision and extended total mesorectal excision, where benchmark criteria definitions vary.</p><p><strong>Conclusion: </strong>Textbook outcomes for minimally invasive total mesorectal excision was achieved in 60% rectal cancer patients at a high-volume tertiary cancer institute. It could be used for benchmarking, thus improving results of minimally invasive total mesorectal excision and also as a quality indicator in nationwide surgical audits. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283034","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}