Diseases of the Colon & Rectum最新文献

{"title":"Long-term Outcomes After Minimally Invasive Ventral Rectopexy for Rectal Prolapse Using Biologic Graft Prosthesis: A 15-Year Retrospective Cohort Study.","authors":"Michael L R Lonne, Amy M Y Cao, Ashley Jenkin, Liam J Convie, Grant E Stevenson, Jayson M Moloney, Andrew R L Stevenson","doi":"10.1097/DCR.0000000000003661","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003661","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive ventral rectopexy has widely become the preferred prolapse procedure. However there have been recent concerns regarding the safety of permanent synthetic mesh in the pelvis. Biologic grafts have also been commonly used as an alternative prosthesis, but data on their safety and the longevity of the prolapse repair have been lacking.</p><p><strong>Objective: </strong>To assess the short and long-term safety and efficacy of biologic grafts in minimally invasive ventral rectopexy.</p><p><strong>Design: </strong>Retrospective cohort study using data from a prospectively collected database.</p><p><strong>Settings: </strong>Single surgeon at a single tertiary hospital in Australia.</p><p><strong>Patients: </strong>There were 366 patients with minimum 6 months follow-up undergoing minimally invasive ventral rectopexy using a biologic graft between January 1, 2008, and October 5, 2023.</p><p><strong>Main outcome measures: </strong>Overall recurrence, complications and functional outcomes.</p><p><strong>Results: </strong>A total of 57 patients (15.6%, n = 57) experienced a recurrence during the study period, with a median follow up time of 35.5 months (range, 6-183 months). Of these, 17 (4.6%) were full thickness recurrence. The Kaplan-Meier estimates of the overall 1-, 3-, and 5-year recurrence rates were 2.0%, 6.0% and 16.0% respectively. There was no statistically significant difference in recurrence for patients who presented with a full thickness prolapse compared to those with other indications (16.8% vs 14.2%, p=0.29). Overall, there were a total of 34 complications which occurred in 29 (7.9%) patients. 19 patients (5.2%) required a return to theatre. There were no graft related complications or long-term pelvic pain. 98% of patients had symptomatic improvement and were satisfied with their outcome.</p><p><strong>Limitations: </strong>Retrospective study and generalizability of the results from single surgeon experience. Late recurrences may have been missed.</p><p><strong>Conclusions: </strong>Minimally invasive ventral rectopexy using a biological graft is both safe and effective, offering acceptable short- and long-term recurrence rates and overall complications with no graft related morbidity. See Video.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064164","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":"Ventral Rectopexy: An International Expert Panel Consensus and Review of Contemporary Literature.","authors":"William R G Perry, Peter Christensen, Rowan J Collinson, Julie A Cornish, Andre D'Hoore, Brooke Gurland, Anders Mellgren, Carlo Ratto, Frederic Ris, Andrew R L Stevenson, Liliana Bordeianou","doi":"10.1097/DCR.0000000000003656","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003656","url":null,"abstract":"<p><strong>Background: </strong>Ventral rectopexy has become increasingly utilized in the surgical management of rectal prolapse. There is a need for a contemporary evaluation of the role of the procedure and description of its use in clinical practice.</p><p><strong>Objective: </strong>To create an international consensus on ventral rectopexy.</p><p><strong>Design: </strong>An expert panel undertook a scoping review of the literature to identify subject domains of interest. Literature reviews were completed for each domain with subsequent development of evidence-based and practice-based statements. These were compiled and reviewed by the group over a total of nine meetings. Once statements were confirmed, supportive text was finalized, and an anonymous vote was completed using REDCap to record consensus.</p><p><strong>Setting: </strong>An international expert panel comprising colorectal surgeons who perform ventral rectopexy in a high-volume center.</p><p><strong>Main outcome measures: </strong>Statements and associated expert consensus.</p><p><strong>Results: </strong>Eleven experts identified ten domains for review: indications, contraindications, assessment and planning, consent, operative details, prostheses, complications, follow-up, recurrence and reoperative surgery and specific considerations. After round-table review, there were 17 resultant statements for consideration. Experts agreed unanimously with the thirteen of the statements and their accompanying text, with different experts disagreeing each with four statements (91% consensus each).</p><p><strong>Limitations: </strong>Paucity of high-quality data.</p><p><strong>Conclusion: </strong>This international group developed 17 statements with high consensus. These statements provide an up-to-date summary of the literature, identify key areas for research development and a reference point for colon and rectal surgeons who undertake ventral rectopexy as part of their practice. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064181","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.0000000000003640","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003640","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946496","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":"Rectal Cancer Surgery Can Be Tailored To Reduce Morbidity.","authors":"Martin Rutegård, Josefin Segelman, Peter Matthiessen, Marie-Louise Lydrup, Jennifer Park","doi":"10.1097/DCR.0000000000003638","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003638","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946498","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":"A Summer Research Experience for First-Year Medical Students: The Research Foundation of the American Society of Colon and Rectal Surgeons Diversity and Inclusion in Surgery - Colorectal Opportunity in Research (DISCOveR) Program.","authors":"Samantha Cooley, Brandon Rosamond, Tiffany Wong, Gifty Kwayke, Calista Harbaugh, Aaron J Dawes, Arden M Morris, Ann Lowry, Krista Baran, Elizabeth C Wick","doi":"10.1097/DCR.0000000000003516","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003516","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946493","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":"Rectum, Mesorectum, and Inframesorectum Radical Excision in Low Rectal Cancer.","authors":"Antonio Manenti, Stefania Caramaschi, Gianrocco Manco, Luca Reggiani Bonetti","doi":"10.1097/DCR.0000000000003637","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003637","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946500","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":"https://doi.org/10.1097/DCR.0000000000003639","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-07","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.","authors":"Yuesheng Yang, Zifeng Yang, Yong Li","doi":"10.1097/DCR.0000000000003641","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003641","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-07","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":"Artificial Intelligence in Clinical Decision Making: Is It Problem-Free?","authors":"Mesut Tez","doi":"10.1097/DCR.0000000000003636","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003636","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913566","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":"Rise in Minimally Invasive Surgery for Colorectal Cancer Is Associated With Adoption of Robotic Surgery.","authors":"Naveen Manisundaram, Christopher P Childers, Chung-Yuan Hu, Abhineet Uppal, Tsuyoshi Konishi, Brian Bednarski, Michael G White, Oliver Peacock, Y Nancy You, George J Chang","doi":"10.1097/DCR.0000000000003617","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003617","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgery is associated with improved short-term outcomes and similar long-term oncologic outcomes for colorectal cancer patients compared with open surgery. Although the robotic approach has ergonomic and technical benefits, how it has impacted utilization of traditional laparoscopic surgery and minimally invasive surgery overall is unclear.</p><p><strong>Objective: </strong>Describe trends in open, robotic, and laparoscopic approaches for colorectal cancer resections and examine factors associated with minimally invasive surgery.</p><p><strong>Design: </strong>Retrospective cohort study using data from the National Cancer Database from 2010 through 2020.</p><p><strong>Setting: </strong>Commission on Cancer-accredited U.S. facilities.</p><p><strong>Patients: </strong>Patients diagnosed with nonmetastatic colon or rectal adenocarcinoma.</p><p><strong>Main outcomes measures: </strong>Surgical approach rates (open, robotic, laparoscopic).</p><p><strong>Results: </strong>We identified 475,001 patients diagnosed with nonmetastatic colorectal adenocarcinoma, of whom 192,237 (40.5%) underwent open surgery, 64,945 (13.7%) underwent robotic surgery, and 217,819 (45.9%) underwent laparoscopic surgery. For colon cancer, laparoscopic minimally invasive surgery use steadily increased, with a peak prevalence of 54.0% in 2016, and total minimally invasive surgery (robotic + laparoscopic) was performed more often than open surgery from 2013 through 2020. For rectal cancer, laparoscopic minimally invasive surgery had a peak prevalence of 37.2% in 2014 and declined from 2014 through 2020; robotic surgery prevalence increased throughout the study period (5.5% in 2010, 24.7% in 2015, 48.8% in 2020). Minimally invasive surgery use increased in facilities performing robotic surgery every year during the study period. For both colon and rectal cancer, use of open surgery decreased across all facilities throughout the study period.</p><p><strong>Limitations: </strong>Utilized National Cancer Database which may not be generalizable to non-Commission on Cancer institutions.</p><p><strong>Conclusions: </strong>Minimally invasive surgery steadily increased across all facilities from 2010 through 2020. Open resections declined, laparoscopic resections plateaued, and robotic resections increased for colon and rectal cancer. Minimally invasive surgery increases may be driven by increases in robot-assisted surgery. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913656","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}