Satoshi Narihiro, Daichi Kitaguchi, Hiro Hasegawa, Nobuyoshi Takeshita, Masaaki Ito
{"title":"Deep Learning-Based Real-Time Ureter Identification in Laparoscopic Colorectal Surgery.","authors":"Satoshi Narihiro, Daichi Kitaguchi, Hiro Hasegawa, Nobuyoshi Takeshita, Masaaki Ito","doi":"10.1097/DCR.0000000000003335","DOIUrl":"10.1097/DCR.0000000000003335","url":null,"abstract":"<p><strong>Background: </strong>Iatrogenic ureteral injury is a serious complication of abdominopelvic surgery. Identifying the ureters intraoperatively is essential to avoid iatrogenic ureteral injury. We developed a model that may minimize this complication.</p><p><strong>Impact of innovation: </strong>We applied a deep learning-based semantic segmentation algorithm to the ureter recognition task and developed a deep learning model called UreterNet. This study aimed to verify whether the ureters could be identified in videos of laparoscopic colorectal surgery.</p><p><strong>Technology, materials, and methods: </strong>Semantic segmentation of the ureter area was performed using a convolutional neural network-based approach. Feature Pyramid Networks were used as the convolutional neural network architecture for semantic segmentation. Precision, recall, and the Dice coefficient were used as the evaluation metrics in this study.</p><p><strong>Preliminary results: </strong>We created 14,069 annotated images from 304 videos, with 9537, 2266, and 2266 images in the training, validation, and test data sets, respectively. Concerning ureter recognition performance, the precision, recall, and Dice coefficient for the test data were 0.712, 0.722, and 0.716, respectively. Regarding the real-time performance on recorded videos, it took 71 milliseconds for UreterNet to infer all pixels corresponding to the ureter from a single still image and 143 milliseconds to output and display the inferred results as a segmentation mask on the laparoscopic monitor.</p><p><strong>Conclusions: </strong>UreterNet is a noninvasive method for identifying the ureter in videos of laparoscopic colorectal surgery and can potentially improve surgical safety.</p><p><strong>Future directions: </strong>Although this deep learning model could lead to the development of an image-navigated surgical system, it is necessary to verify whether UreterNet reduces the occurrence of iatrogenic ureteral injury.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497390","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 \"Prehabilitation for Colorectal Cancer Surgery\".","authors":"Marylise Boutros","doi":"10.1097/DCR.0000000000003471","DOIUrl":"10.1097/DCR.0000000000003471","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626290","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: Association Between Cross-Stapling Technique in Mechanical Colorectal Anastomosis and Short-term Outcomes.","authors":"Jonathan S Abelson","doi":"10.1097/DCR.0000000000003420","DOIUrl":"10.1097/DCR.0000000000003420","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141455905","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}
Amr Aref, Ahmed Abdalla, Jasneet S Bhullar, Elon Knoll
{"title":"Perspective on the PROSPECT: The Conundrum of Managing T3n0-N1 Mid and Upper Rectal Cancer.","authors":"Amr Aref, Ahmed Abdalla, Jasneet S Bhullar, Elon Knoll","doi":"10.1097/DCR.0000000000003291","DOIUrl":"10.1097/DCR.0000000000003291","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dimitra Theodoropoulos, Shankar Raman, Donald B Colvin
{"title":"What Every Colorectal Surgeon Should Know About the Updated Medicare Access and Children's Healthcare Insurance Program Reauthorization Act and the Merit-Based Incentive Program System Legislation.","authors":"Dimitra Theodoropoulos, Shankar Raman, Donald B Colvin","doi":"10.1097/DCR.0000000000003448","DOIUrl":"10.1097/DCR.0000000000003448","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497395","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":"Indocyanine Green Fluorescence Imaging-Guided Laparoscopic Right Hemicolectomy With Complete Mesocolic Excision and Central Vascular Ligation and Transvaginal Specimen Extraction.","authors":"Hongming Li, Xiaochuang Feng, Dechang Diao","doi":"10.1097/DCR.0000000000003349","DOIUrl":"10.1097/DCR.0000000000003349","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537698","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}
Corey Chang, John E Lee, Kevin M Waters, Brent K Larson
{"title":"GI Polyps and Polyposis in Individuals Harboring Germline CHEK2 Mutations.","authors":"Corey Chang, John E Lee, Kevin M Waters, Brent K Larson","doi":"10.1097/DCR.0000000000003365","DOIUrl":"10.1097/DCR.0000000000003365","url":null,"abstract":"<p><strong>Background: </strong>Checkpoint kinase 2 is a tumor suppressor gene in the DNA damage checkpoint system that may be mutated in several cancers. Patients with germline checkpoint kinase 2 mutations and multiple colon polyps were noted during routine care, and genetic testing is recommended for patients with as few as 10 lifetime polyps.</p><p><strong>Objective: </strong>This study assessed whether checkpoint kinase 2 is associated with attenuated or oligopolyposis and characterized the GI clinicopathologic profile.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Settings: </strong>Records from patients harboring germline checkpoint kinase 2 mutations from 1999 to 2020 were reviewed.</p><p><strong>Patients: </strong>A total of 45 patients with germline checkpoint kinase 2 mutations with endoscopic examinations.</p><p><strong>Main outcome measures: </strong>Description of clinicopathologic variables.</p><p><strong>Results: </strong>Twenty-five of 45 patients had polyps: 3 with only upper GI polyps, 17 with only lower GI polyps, and 5 with both upper and lower GI polyps. The most common germline checkpoint kinase 2 mutations in patients with polyps were p.S428F (n = 10), p.I157T (n = 4), and p.T476M (n = 2), with other mutations present in 1 patient each. Among patients with lower GI polyps, 9 had adenomas, 6 had serrated polyps, 1 had an inflammatory polyp, and 6 had both adenomatous and serrated polyps. Three patients (p.I157T, n = 2; p.R117G, n = 1) had more than 10 adenomas and 1 (p.G259fs) had 18 serrated polyps. Five patients (11.1%) developed colorectal adenocarcinoma, including 2 with more than 10 adenomas. Five patients with p.S428F (50%) exclusively had right-sided adenomas.</p><p><strong>Limitations: </strong>Single-center descriptive study.</p><p><strong>Conclusions: </strong>Germline checkpoint kinase 2 mutations should be considered in patients with polyposis. The preponderance of right-sided adenomas in patients with p.S428F mutations suggests the importance of right-sided colonoscopy in these patients. See Video Abstract .</p><p><strong>Plipos y poliposis gastrointestinales en individuos que albergan mutaciones en la lnea germinal del gen chek: </strong>ANTECEDENTES:El punto de control quinasa 2 (CHEK2) es un gen supresor de tumores en el sistema de puntos de control de daño del ácido desoxirribonucleico (ADN) que puede mutar en varios cánceres. Durante la atención de rutina se observaron pacientes con mutaciones de la línea germinal CHEK2 y múltiples pólipos en el colon, y se recomiendan pruebas genéticas para pacientes con al menos 10 pólipos en su vida.OBJETIVO:Este estudio evaluó si CHEK2 está asociado con poliposis atenuada u oligopoliposis y caracterizó el perfil clínico-patológico gastrointestinal (GI).DISEÑO:Estudio observacional retrospectivo.ESCENARIO:Se revisaron los registros de pacientes que albergaban mutaciones de la línea germinal CHEK2 de 1999 a 2020.PACIENTES:45 pacientes co","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497393","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}
Fatemeh Chinisaz, Seyed Amir Miratashi Yazdi, Hadi Ahmadi Amoli, Leyla Sahebi
{"title":"Evaluating the Application of Nail Polish as an Ostomy Baseplate: A Comparative Analysis With Conventional Ostomy Pastes in the Market and a Clinical Trial.","authors":"Fatemeh Chinisaz, Seyed Amir Miratashi Yazdi, Hadi Ahmadi Amoli, Leyla Sahebi","doi":"10.1097/DCR.0000000000003446","DOIUrl":"10.1097/DCR.0000000000003446","url":null,"abstract":"<p><strong>Background: </strong>Peristomal skin complications are prevalent among patients with ostomies and significantly impact their quality of life. Ostomy care is crucial for patients with ostomies because it ensures proper adhesion and protects and reduces the peristomal skin complications.</p><p><strong>Objectives: </strong>To assess the effectiveness of nail polish as a novel skin barrier and compare its performance with the commonly available ostomy barriers in the market.</p><p><strong>Design: </strong>Phase I randomized controlled trial.</p><p><strong>Settings: </strong>A single trauma and surgery center.</p><p><strong>Patients: </strong>Forty patients who were hospitalized for ostomy implantation were enrolled. Twenty cases were included in each group.</p><p><strong>Main outcome measures: </strong>The use of nail polish as a baseplate was tested against the common ostomy pastes. Over 6 months, the study enrolled 40 patients who required loop ileostomy and were followed up for 8 weeks. Postoperative evaluation was performed using the City of Hope-Quality of Life ostomy and 36-Item Short Form questionnaires, as well as physical examinations conducted 1 day after surgery and at 4 and 8 weeks after surgical treatment.</p><p><strong>Results: </strong>Forty patients were included in the study. At all 3 time points, significant differences were observed in 36-Item Short Form scores, time, and costs spent on ostomy care. The intervention group experienced fewer peristomal skin complications (skin itching, redness, inflammation, and burning) and skin allergies at the first and second time points (p < 0.05). Furthermore, none of the patients in the intervention or control group experienced rare complications such as folliculitis, candidiasis, contact dermatitis, or pyoderma gangrenosum.</p><p><strong>Limitations: </strong>Single institution.</p><p><strong>Conclusions: </strong>The utilization of nail polish as a baseplate reduces skin allergies, peristomal skin complications, and the time and financial resources spent on ostomy care. Furthermore, using nail polish has demonstrated promising results in patients' quality of life. Consequently, using nail polish emerged as the preferred choice among study participants. See the Video Abstract .</p><p><strong>Evaluando la aplicacin de esmalte de uas como placa base de ostoma un anlisis comparativo con pastas de ostoma convencionales en el mercado en un ensayo clnico: </strong>ANTECEDENTES:Las complicaciones de la piel periestomal son frecuentes entre los pacientes con ostomías y afectan significativamente su calidad de vida. Los cuidados de la ostomía son cruciales para los pacientes ostomizados, ya que garantizan una adhesión adecuada y protegen y reducen las complicaciones de la piel periestomal.OBJETIVOS:Evaluar la eficacia del esmalte de uñas como nueva barrera cutánea y comparar su rendimiento con las barreras de ostomía comúnmente disponibles en el mercado.DISEÑO:Ensayo clínico aleatorizado de","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558311","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}
Sofia J Sandberg, Jennifer M Park, Viktor A Tasselius, Eva Angenete
{"title":"Bowel Dysfunction After Colon Cancer Surgery: A Prospective, Longitudinal, Multicenter Study.","authors":"Sofia J Sandberg, Jennifer M Park, Viktor A Tasselius, Eva Angenete","doi":"10.1097/DCR.0000000000003358","DOIUrl":"10.1097/DCR.0000000000003358","url":null,"abstract":"<p><strong>Background: </strong>Longitudinal studies on functional outcomes after colon resection are limited.</p><p><strong>Objective: </strong>To evaluate bowel dysfunction and related distress 1 and 3 years after colon resection using the low anterior resection syndrome score as well as specific validated items.</p><p><strong>Design: </strong>This study presents the long-term results of bowel dysfunction and related distress based on the Quality of Life in Colon Cancer study, an observational, prospective multicenter study of patients with newly diagnosed colon cancer.</p><p><strong>Settings: </strong>The study was conducted at 21 Swedish and Danish surgical centers between 2015 and 2019.</p><p><strong>Patients: </strong>All patients who underwent right-sided or left-sided colon resection were considered eligible. Exclusion criteria were age younger than 18 years, cognitive impairment, or inability to understand Swedish/Danish. Patients completed extensive questionnaires at diagnosis and after 1 and 3 years. Clinical data were supplemented by national quality registries.</p><p><strong>Main outcome measures: </strong>The low anterior resection syndrome score, specific bowel symptoms, and patient-reported distress were assessed.</p><p><strong>Results: </strong>Of 1221 patients (83% response rate), 17% reported major low anterior resection syndrome 1 year after either type of resection; this finding was consistent at 3 years (17% right, 16% left). In the long-term, the only significant difference between types of resections was a high occurrence of loose stools after right-sided resections. Overall, less than one-fifth of patients experienced distress, with women reporting more frequent symptoms and greater distress. In particular, incontinence and loose stools correlated strongly with distress.</p><p><strong>Limitations: </strong>Absence of prediagnosis bowel function data.</p><p><strong>Conclusions: </strong>Our study indicates that bowel function remains largely intact after colon resection, with only a minority reporting significant distress. Adverse outcomes were more common among women. The occurrence of loose stools after right-sided resection and the association between incontinence, loose stools, and distress highlights a need for postoperative evaluations and more thorough assessments beyond the low anterior resection syndrome score when evaluating patients with colon cancer. See the Video Abstract .</p><p><strong>Disfuncionamiento intestinal despus de la ciruga por cncer de colon estudio prospectivo, longitudinal y multicntrico: </strong>ANTECEDENTES:Los estudios longitudinales sobre el resultado funcional después de una resección cólica son limitados.OBJETIVO:Examinar la disfunción intestinal y el malestar relacionado uno y tres años después de la resección del colon utilizando la puntuación de referencia en el síndrome de resección anterior baja (LARS), así como otros ítems de validez específica.DISEÑO:Este estudio presenta los resul","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yujin Kato, Kohei Shigeta, Yuki Tajima, Jumpei Nakadai, Yuki Seo, Hiroto Kikuchi, Ryo Seishima, Koji Okabayashi, Yuko Kitagawa
{"title":"Combined Comprehensive Risk Score of the Estimation of Physiologic Ability and Surgical Stress and C-Reactive Protein-to-Albumin Ratio Is a Strong Prognostic Indicator of Long-term Outcomes in Colorectal Cancer.","authors":"Yujin Kato, Kohei Shigeta, Yuki Tajima, Jumpei Nakadai, Yuki Seo, Hiroto Kikuchi, Ryo Seishima, Koji Okabayashi, Yuko Kitagawa","doi":"10.1097/DCR.0000000000003348","DOIUrl":"10.1097/DCR.0000000000003348","url":null,"abstract":"<p><strong>Background: </strong>In patients with colorectal cancer, both the C-reactive protein-to-albumin ratio and comprehensive risk score of the estimation of physiologic ability and surgical stress have demonstrated prognostic significance.</p><p><strong>Objective: </strong>To assess the clinical value of the combined use of C-reactive protein-to-albumin ratio and comprehensive risk score for predicting prognosis in patients with colorectal cancer.</p><p><strong>Design: </strong>Multicenter retrospective study.</p><p><strong>Settings: </strong>The cohort was divided into 3 groups based on a combined score derived from the value of C-reactive protein-to-albumin ratio and comprehensive risk score (low/mid/high).</p><p><strong>Patients: </strong>Patients who underwent curative resection between 2010 and 2019 at multiple institutions were enrolled in this study.</p><p><strong>Main outcome measures: </strong>Overall and recurrence-free survival.</p><p><strong>Results: </strong>A total of 2207 patients (801 in the low cohort, 817 in the mid cohort, and 589 in the high cohort) were included in this study. Multivariate analysis revealed that combined score was an independent prognostic factor for both overall and recurrence-free survival, irrespective of disease stage ( p < 0.05). Furthermore, Harrell's C-index indicated that the predictive power of the combined score was significantly superior to that of the C-reactive protein-to-albumin ratio or comprehensive risk score ( p < 0.001).</p><p><strong>Limitations: </strong>This study had a retrospective design, and data on genetic markers were not included.</p><p><strong>Conclusions: </strong>The synergistic combination of C-reactive protein-to-albumin ratio and comprehensive risk score contributes to the robust definition of combined score, a potent prognostic factor, regardless of disease stage. This finding has the potential to provide novel insights into the management of patients with colorectal cancer who have undergone curative resection. See the Video Abstract .</p><p><strong>La puntuacin combinada de riesgo integral de la estimacin de la capacidad fisiolgica y el estrs quirrgico y la relacin protena c reactiva/albmina es un fuerte indicador pronstico de los resultados a largo plazo en el cncer colorrectal: </strong>ANTECEDENTES:En pacientes con cáncer colorrectal, tanto la relación proteína C reactiva/albúmina como la puntuación de riesgo integral de la Estimación de la capacidad fisiológica y el estrés quirúrgico han demostrado importancia pronóstica.OBJETIVO:Evaluar el valor clínico del uso combinado de la relación proteína C reactiva/albúmina y la puntuación de riesgo integral para predecir el pronóstico en pacientes con cáncer colorrectal.DISEÑO:Estudio retrospectivo multicéntrico.AJUSTES:La cohorte se dividió en tres grupos según una puntuación combinada derivada del valor de la relación proteína C reactiva/albúmina y la puntuación de riesgo integral (bajo/medio/alto).PACIENTES:En este e","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431592","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}