Diseases of the Colon & Rectum最新文献

{"title":"Efficacy of Preoperative Colonoscopy Following Self-Expandable Metallic Stent Placement in Patients with Obstructive Colorectal Cancer.","authors":"Kojiro Inoue, Noboru Misawa, Hitomi Suzuki, Shigeki Tamura, Shungo Goto, Takamitsu Sato, Hitoshi Kuriyama, Takuma Higurashi","doi":"10.1097/DCR.0000000000004421","DOIUrl":"https://doi.org/10.1097/DCR.0000000000004421","url":null,"abstract":"<p><strong>Background: </strong>Obstructive colorectal cancer occurs in 8 to 13% of cases at diagnosis. Self-expandable metallic stents are increasingly used as a bridge to surgery to avoid emergency colostomy or ileostomy. However, whether preoperative total colonoscopy through a stent safely and effectively detect synchronous colorectal cancer remains unclear.</p><p><strong>Objective: </strong>To evaluate the safety and efficacy of preoperative total colonoscopy following self-expandable metallic stents placement for detecting synchronous colorectal cancer in patients with malignant colonic obstruction.</p><p><strong>Design: </strong>Single-center, retrospective study.</p><p><strong>Settings: </strong>Chigasaki Municipal Hospital, Japan (ethics approval obtained from Yokohama City University Hospital).</p><p><strong>Patients: </strong>Sixty-three consecutive patients (35 men, 28 women; median age: 75 years (range: 46-92years) who underwent self-expandable metallic stents placement as a bridge to surgery for obstructive colorectal cancer between April 2018 and November 2025.</p><p><strong>Interventions: </strong>Self-expandable metallic stents placement under fluoroscopic and endoscopic guidance, followed by preoperative total colonoscopy attempted 48 to 72h after self-expandable metallic stents placement once bowel obstruction resolved.</p><p><strong>Main outcome measures: </strong>Primary - detection rate of synchronous colorectal cancer. Secondary - technical and clinical success of self-expandable metallic stents, total colonoscopy completion rate, and procedure-related complications.</p><p><strong>Results: </strong>Self-expandable metallic stents placement was technically successful in 62 of 63 patients (98.4%), with clinical resolution of obstruction in 60 of 63 (95.2%). Preoperative total colonoscopy was attempted in 53 of 60 patients (88.3%) and completed in 43 of 53 (81.1%), yielding an overall completion rate of 68.3% (43 of 63). Synchronous colorectal cancer was detected preoperatively in 8 of 43 patients (18.6%), altering surgical strategy. No complications related to preoperative total colonoscopy occurred. Limitations: Retrospective, single-center design with a small sample size; only uncovered self-expandable metallic stents types were used, limiting generalizability.</p><p><strong>Conclusions: </strong>Preoperative total colonoscopy after self-expandable metallic stents placement is a safe and effective method for detecting synchronous colorectal cancer and optimizing surgical planning in obstructive colorectal cancer. Whenever feasible, total colonoscopy should be considered for patients undergoing self-expandable metallic stents as a bridge to surgery. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024229","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":"Understanding the Discordance between Low Anterior Resection Syndrome Scores and Bowel-Related Quality of Life: a Secondary Analysis of a Multicenter Trial.","authors":"Roseanna Presutti, Marie Demian, Sarah Sabboobeh, Sahir Bhatnagar, Julie Savard, Sebastien Drolet, A Sender Liberman, Carl J Brown, Jason Park, Carmen G Loiselle, Steven D Wexner, Liliana Bordeianou, Gabriela Ghitulescu, Julio Faria, Nancy Morin, Carol-Ann Vasilevsky, Marylise Boutros, Richard Garfinkle","doi":"10.1097/DCR.0000000000004445","DOIUrl":"https://doi.org/10.1097/DCR.0000000000004445","url":null,"abstract":"<p><strong>Background: </strong>Low anterior resection syndrome affects most individuals following rectal cancer surgery; however, symptom severity does not always correlate with bowel-related quality of life impairment.</p><p><strong>Objective: </strong>To characterize the discordance between low anterior resection syndrome and bowel-related quality of life scores and to identify clinical factors and low anterior resection syndrome symptoms most strongly correlated with bowel-related quality of life impairment.</p><p><strong>Design: </strong>Secondary analysis of a completed multicenter, pan-Canadian randomized controlled trial.</p><p><strong>Settings: </strong>Five Canadian hospitals.</p><p><strong>Patients: </strong>Adults who had undergone a restorative proctectomy for rectal cancer with ileostomy closure.</p><p><strong>Main outcome measures: </strong>Patient-reported outcomes were measured at 6months after ileostomy closure, including the low anterior resection syndrome score, bowel-related quality of life, general quality of life, and depression/anxiety.</p><p><strong>Results: </strong>In total, 135 patients were included. Among patients with major low anterior resection syndrome (n = 82), 61.0% had bowel-related quality of life impairment and 39.0% had no bowel-related quality of life impairment. Patients with both major low anterior resection syndrome and bowel-related quality of life impairment were more likely to still be working compared to those without bowel-related quality of life impairment (66.0 vs 43.8%, p = 0.044). Among those with minor/no low anterior resection syndrome (n = 53), 20.8% had major bowel-related quality of life impairment. In the major low anterior resection syndrome subgroup, patients with bowel-related quality of life impairment had significantly higher mean scores of stool incontinence (2.76 vs 1.88, p = 0.001), frequency (2.48 vs 1.63, p = 0.010), and urgency (15.6 vs 14.75, p = 0.035) than those without bowel-related quality of life impairment. In the minor/no low anterior resection syndrome subgroup, patients with major bowel-related quality of life impairment had significantly higher mean scores of frequency (1.73 vs 0.95, p = 0.047) than those without bowel-related quality of life impairment. The presence of major bowel-related quality of life impairment correlated well with decreased general quality of life and increased depression/anxiety, irrespective of low anterior resection syndrome severity.</p><p><strong>Limitations: </strong>Secondary analysis with modest sample size.</p><p><strong>Conclusions: </strong>Approximately 20 to 40% of patients had discordant low anterior resection syndrome severity and bowel-related quality of life scores, the latter of which correlated better with other patient-reported outcomes. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024192","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":"Early-Onset Colorectal Cancer: Contemporary Management, Immunotherapy, and Organ Preservation.","authors":"Maher Al Khaldi, Sameh Hany Emile","doi":"10.1097/DCR.0000000000004479","DOIUrl":"https://doi.org/10.1097/DCR.0000000000004479","url":null,"abstract":"<p><p>A 36-year-old man with no family history of colorectal cancer or inflammatory bowel disease presented with a 3-month history of bright red blood per rectum and constipation. Anoscopy demonstrated Grade II internal hemorrhoids, and he was initially treated conservatively with fiber and hydration. Despite compliance, bleeding persisted. Colonoscopy performed 6months later revealed a large, friable midrectal mass. Biopsies demonstrated poorly differentiated invasive adenocarcinoma with deficient mismatch repair (dMMR) protein expression on immunohistochemical staining. Staging CT of the chest, abdomen, and pelvis demonstrated no distant metastases, while pelvic MRI revealed a cT3N1 midrectal tumor. Given his young age and dMMR status, he was referred for genetic counseling and underwent germline multigene panel testing, which identified a pathogenic MLH1 variant consistent with Lynch syndrome. He received genetic counseling. Fertility preservation was discussed before treatment, and the patient elected to undergo sperm cryopreservation. After multidisciplinary review, neoadjuvant PD-1 blockade with dostarlimab was recommended. After 6 months of therapy, restaging with digital rectal examination, endoscopy, and pelvic MRI demonstrated a clinical complete response. After shared decision-making, the patient elected nonoperative management with intensive surveillance rather than total mesorectal excision. He remained without clinical evidence of disease at 12-month follow-up.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024232","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":"Know Your Worth: The American Society of Colon and Rectal Surgeons Advocacy for the Colorectal Surgeon.","authors":"Kirsten Bass Wilkins","doi":"10.1097/DCR.0000000000004476","DOIUrl":"https://doi.org/10.1097/DCR.0000000000004476","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024242","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":"The THOMAS Study: A Pilot Study for Patient-Administered Anal Cancer Screening.","authors":"Nanami L Miyazaki, M Ary Matecki, Sean Lee, Amy Van Tassel, Antonia Sepulveda, Elham Arbzadeh, Marian Khalili, Matthew Ng","doi":"10.1097/DCR.0000000000004452","DOIUrl":"10.1097/DCR.0000000000004452","url":null,"abstract":"<p><strong>Background: </strong>Screening for anal dysplasia and human papilloma virus allows for appropriate surveillance and treatment, but not all patients are willing or able to have this test performed in a physician's office. At-home testing may be a viable option to expand access to anal dysplasia screening, but its feasibility and reliability have not yet been tested.</p><p><strong>Objective: </strong>This is a pilot study to determine if patient-sampled screening is feasible and accurate compared to physician-sampled anal dysplasia screening.</p><p><strong>Design: </strong>Single-center prospective trial.</p><p><strong>Settings: </strong>A single tertiary care center.</p><p><strong>Patients: </strong>Fifty patients over 35 years old, who are HIV-positive, participated in anoreceptive intercourse, and without a previous diagnosis of anal cancer were recruited.</p><p><strong>Intervention: </strong>Eligible participants were provided written instructions and self-collected a sample independently, followed by another anal swab performed by a physician. Both samples were submitted to pathology for human papilloma virus and anal dysplasia testing. Patients also completed a questionnaire on their perceptions of the self-collection and willingness to pursue this in the future.</p><p><strong>Main outcome measures: </strong>Accuracy, sensitivity, and specificity of pathology results.</p><p><strong>Results: </strong>For detecting the presence of atypical cells, patient-collected samples had 72.0% accuracy, 85.7% sensitivity, 72.0% specificity, 72.0% positive predictive value, and 85.7% negative predictive value. Cytology classification had moderate agreement between patient and physician-collected samples (Cohen's κ = 0.51, p < 0.01). For detecting the presence of high-risk human papilloma virus, patient-collected samples had 83.7% accuracy, 87.5% sensitivity, 81.8% specificity, 70.0% positive predictive value, and 93.1% negative predictive value. Human papilloma virus subtype classification had moderate agreement between patient and physician-collected samples (Cohen's κ = 0.63, p < 0.01).</p><p><strong>Limitations: </strong>This is a single-institution pilot study with a small sample size, limiting generalizability.</p><p><strong>Conclusions: </strong>Preliminary results show promising results for patient administered anal dysplasia sampling, and most patients have confidence in the results. At-home screening could be a feasible method for increasing anal dysplasia screening. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024216","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":"Measuring Symptom Severity and Health-Related Quality-of-Life with Hemorrhoid Treatments: Systematic Review.","authors":"Marquise Soto, Vamshek Srinivasan, William Perry, Eric D Shah","doi":"10.1097/DCR.0000000000004429","DOIUrl":"https://doi.org/10.1097/DCR.0000000000004429","url":null,"abstract":"<p><strong>Background: </strong>Hemorrhoids are common and relief anchors on symptom improvement. Despite several available treatment options, the optimal patient-reported outcome measure for contemporary clinical trials is not established.</p><p><strong>Objective: </strong>We aimed to systematically assess patient-reported outcome measures that measure hemorrhoid symptom severity and/or health-related quality of life.</p><p><strong>Data sources: </strong>A systematic review was performed using PubMed and Embase (1980-2025).</p><p><strong>Study selection: </strong>Prospective development/validation studies evaluating patient-reported outcome measures relevant to hemorrhoidal disease.</p><p><strong>Main outcome measures: </strong>Patient-reported outcome measures were evaluated on key measurement properties of reliability, internal consistency, construct validity, and responsiveness according to COSMIN v2.0 criteria.</p><p><strong>Results: </strong>Of the 1,266 total studies reviewed, nine patient-reported outcome measures were identified: seven measure symptom severity and six measure health-related quality-of-life. Three demonstrated reliability, internal consistency, construct validity, and responsiveness. The Patient Reported Outcome Measure-Haemorrhoidal Impact And Satisfaction Score comprehensively measures symptom severity, health-related quality-of-life, and treatment satisfaction. The Hemorrhoidal Disease Symptom Score classifies patients with high or low symptom load, and when used in combination with Short Health Scale-Hemorrhoidal Disease, also measures impact on health-related quality of life.</p><p><strong>Limitations: </strong>Preference toward specific measures may differ between clinical trials and clinical practice.</p><p><strong>Conclusions: </strong>We identify two viable patient-reported outcome measures for use in future clinical trials that evaluate hemorrhoid interventions.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024194","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":"Stefan D Holubar","doi":"10.1097/DCR.0000000000004472","DOIUrl":"https://doi.org/10.1097/DCR.0000000000004472","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988508","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":"On the Venous Thromboembolism Signal in the NSQIP-IBD Biologic Safety Analysis.","authors":"Alp Omer Canturk, Yasemin Yildirim","doi":"10.1097/DCR.0000000000004471","DOIUrl":"https://doi.org/10.1097/DCR.0000000000004471","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988554","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 in the Elderly: To Operate or Not to Operate? A Nationwide Retrospective Study of the Italian Society of Surgical Oncology-Colorectal Cancer Network Collaborative Group.","authors":"Uğur Sungurtekin","doi":"10.1097/DCR.0000000000004467","DOIUrl":"https://doi.org/10.1097/DCR.0000000000004467","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966830","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":"Rossella Reddavid, Danila Azzolina","doi":"10.1097/DCR.0000000000004468","DOIUrl":"https://doi.org/10.1097/DCR.0000000000004468","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148967187","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}