Diseases of the Colon & Rectum最新文献

{"title":"Watch-and-Wait Policy to Defer Defunctioning Stoma After Low Anterior Resection: Preliminary Results From the Safe Anastomosis Project (KNUCRC-25CP02).","authors":"Hye Jin Kim, Gyu-Seog Choi, Jun Seok Park, Soo Yeun Park, Seung Ho Song, Sung Min Lee, Su Jin Kang","doi":"10.1097/DCR.0000000000004107","DOIUrl":"10.1097/DCR.0000000000004107","url":null,"abstract":"<p><strong>Background: </strong>Anastomotic leakage remains a severe complication after low anterior resection for rectal cancer, often leading to the routine use of protective stomas, which can cause additional complications. Inspired by the watch-and-wait approach in rectal cancer treatment, we hypothesized that deferring stoma creation could be feasible through the Safe Anastomosis Project, which includes minimizing technical risk factors, enabling early detection of preclinical leakage, and intervening only when necessary.</p><p><strong>Objective: </strong>This study aimed to evaluate whether technical modifications, comprehensive surveillance, and selective stoma creation could reduce the rate of protective stoma use while maintaining acceptable anastomotic leakage rates.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Setting: </strong>The study was conducted at a single-center, tertiary referral hospital.</p><p><strong>Patients: </strong>Between January and December 2024, 184 patients underwent curative resection for rectal cancer.</p><p><strong>Interventions: </strong>A standardized protocol was applied, including perfusion assessment with indocyanine green, single-stapled anastomosis creation using purse-string sutures, reinforcement in a continuous or intermittent manner, extraperitoneal pelvic drain placement, and assessment of anastomotic integrity. Patients were grouped by anastomotic technique: single-stapled with reinforcement, single-stapled alone, or double-stapled with reinforcement.</p><p><strong>Main outcome measures: </strong>The main outcome measures were the rates of protective stoma creation and anastomotic leakage.</p><p><strong>Results: </strong>A total of 99 patients completed the study protocol. Of these, 27 (27.3%) received a protective stoma and 11 (11.1%) developed anastomotic leakage. Patients who underwent a single-stapled technique with reinforcement had the lowest rates of both protective stoma use (18.8%) and anastomotic leakage (6.3%). Robotic surgery was more frequently used in this group (78.1%). Most leakages occurred within 8 days postoperatively and were managed with transanal repair, with or without stoma.</p><p><strong>Limitations: </strong>This study is limited by its single-center design and modest sample size.</p><p><strong>Conclusions: </strong>Deferral of protective stoma creation after low anterior resection appears feasible. Technical refinement, particularly single-stapled anastomosis with reinforcement and robotic assistance, may optimize outcomes. Further study based on a larger cohort is warranted. See Video Abstract .</p><p><strong>Poltica de observacin y espera para aplazar la desfuncionalizacin del estoma tras una reseccin anterior baja resultados preliminares del proyecto safe anastomosis knucrccp: </strong>ANTECEDENTES:La fuga anastomótica sigue siendo una complicación grave tras la resección anterior baja por cáncer rectal, lo que a menudo conduce al uso rutinario","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"642-650"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911057","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":"Exploring Self-Management Strategies: A Qualitative Analysis of Lives Affected by Low Anterior Resection Syndrome Through an Online Peer Support Forum in a Multicenter Randomized Controlled Trial.","authors":"Jeongyoon Moon, Haroon Munir, Sarah Sabboobeh, Marie Demian, Olivia Monton, Allister Smith, Carl J Brown, Sami A Chadi, Erin D Kennedy, Sender Liberman, Carol-Ann Vasilevsky, Fateme Rajabiyazdi, Marylise Boutros","doi":"10.1097/DCR.0000000000004088","DOIUrl":"10.1097/DCR.0000000000004088","url":null,"abstract":"<p><strong>Background: </strong>Low anterior resection syndrome describes chronic debilitating bowel dysfunction after rectal cancer surgery and is associated with poor quality of life. Conservative self-management strategies are the first-line treatment for low anterior resection syndrome.</p><p><strong>Objective: </strong>To explore the lived experience of using self-management for low anterior resection syndrome among rectal cancer survivors who have actively participated in the app.</p><p><strong>Design: </strong>Qualitative analysis of text data generated by participants through an online informational and peer support app, which was successfully tested through a multicenter randomized controlled trial.</p><p><strong>Patients: </strong>Forum posts were generated by study participants, peer mentors, and health care providers.</p><p><strong>Setting: </strong>Data analyzed from the app included forum posts, chat night transcripts, and video comments.</p><p><strong>Main outcome measures: </strong>Using an affinity diagram approach, 2 reviewers independently identified and organized themes from the compiled texts.</p><p><strong>Results: </strong>In total, there were 45 participants and 2,363 app logins for 6 months. Of the 786 posts exchanged through the app, 112 (14.2%) were made by health care providers, and the rest by participants and peer mentors. Thematic analysis revealed 7 themes and 27 subthemes, which included 1) diet: use and benefit of food diaries, trigger foods and probiotics, fiber supplements, and personalized dietary guide with the help of a nutritionist; 2) coping strategies: sense of humor, finding peace with acceptance of \"new normal\" and managing expectations and recognition of the toll low anterior resection syndrome can have on mental health; 3) transanal irrigation: initial reluctance to try it, learning to perform transanal irrigation from peers online, leading to significant improvement in bowel function; and 4) benefits of peer support: sharing of knowledge and sense of community found through peer support are empowering and provide hope.</p><p><strong>Limitations: </strong>Small sample size and selection bias are limitations of this study.</p><p><strong>Conclusions: </strong>This qualitative analysis highlighted the lived experiences and unmet needs of rectal cancer survivors pursuing self-management strategies for low anterior resection syndrome. See Video Abstract .</p><p><strong>Exploracin de estrategias de autocontrol anlisis cualitativo de las vidas afectadas por el sndrome de reseccin anterior baja a travs de un foro de apoyo entre pares en lnea en un ensayo controlado aleatorio multicntrico: </strong>ANTECEDENTES:El síndrome de resección anterior baja describe una disfunción intestinal crónica debilitante tras una cirugía de cáncer rectal y se asocia con una mala calidad de vida. Las estrategias conservadoras de autocontrol son el tratamiento de primera línea para el síndrome de resección anterior baja.DISEÑO:An","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"617-631"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899585","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":"Preoperative Identification of Lymph Node Metastasis in Colorectal Cancer Using Noninvasive Circulating Tumor DNA Methylation Signatures: Results From a Prospective Study.","authors":"Hongli Ji, Mimi Xu, Yaowen Hu, Botao Yan, Wei Wu, Jixiang Zheng, Jun Yan","doi":"10.1097/DCR.0000000000004089","DOIUrl":"10.1097/DCR.0000000000004089","url":null,"abstract":"<p><strong>Background: </strong>Lymph node metastasis is important for the management and surgical procedures of patients with colorectal cancer. Preoperative identification of D3 metastasis could help evaluate the necessity of D3 lymphadenectomy. No adequate noninvasive method has been developed to detect the status of lymph nodes.</p><p><strong>Objective: </strong>To establish a circulating tumor DNA methylation-based method to preoperatively identify lymph node metastasis and D3 metastasis in colorectal cancer.</p><p><strong>Design: </strong>This is a prospective and paired diagnostic study. After an analysis of the genome-wide DNA methylation landscape, differential biomarkers were selected. A circulating tumor DNA methylation-based model for identifying lymph node metastasis was constructed with a machine learning algorithm. Its performance was compared with that of traditional methods. A nomogram was constructed by incorporating the circulating tumor DNA methylation-based model and clinicopathological predictors to identify D3 metastasis. In addition, a traditional clinicopathological method was constructed with the same method but without the circulating tumor DNA methylation-based model for identifying D3 metastasis. A comparison of the performance of the 2 models was performed.</p><p><strong>Settings: </strong>A single cancer center in China.</p><p><strong>Patients: </strong>A total of 206 patients with stage I to III colorectal cancer were recruited between June 2022 and September 2023. All patients underwent radical surgical resection and D3 lymphadenectomy without neoadjuvant treatment.</p><p><strong>Main outcome measures: </strong>The performance of identifying lymph node metastasis and D3 metastasis.</p><p><strong>Results: </strong>After selecting 27 differential biomarkers, a circulating tumor DNA methylation-based model for identifying lymph node metastasis was constructed, yielding a sensitivity of 82.6% and a specificity of 73.3%. The accuracy was superior to that of CT (77.2% vs 66.5%, p = 0.019). Afterward, a nomogram was constructed by incorporating the circulating tumor DNA methylation-based model and clinicopathological predictors to predict D3 metastasis, which had an accuracy that was also superior to that of the traditional method (82.6% vs 67.4%, p < 0.001).</p><p><strong>Limitation: </strong>This study included a small number of patients.</p><p><strong>Conclusions: </strong>The proposed novel approach based on circulating tumor DNA methylation could accurately identify lymph node metastasis and D3 metastasis in colorectal cancer preoperatively and inform tailored treatment. See Video Abstract .</p><p><strong>Clinical trial registration number: </strong>NCT05558436.</p><p><strong>Identificacin preoperatoria de metstasis en ganglios linfticos en cncer colorrectal mediante firmas de metilacin no invasivas del adn libre en sangre resultados de un estudio prospectivo: </strong>ANTECEDENTES:La metástasis en los ganglios linf","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"586-597"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145721653","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":"Correction of a Prolapsed Stoma With the \"Phillips\" Ileostomy Technique.","authors":"Elizabeth A Clement, Michelle M Kwon, Ahmer A Karimuddin","doi":"10.1097/DCR.0000000000004017","DOIUrl":"10.1097/DCR.0000000000004017","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"668-669"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767569","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":"Single-Port Robotic Right Colectomy: A Technical Video Report.","authors":"Patricia Marcolin, Pia Canal Zarate, Daniel J Wong, Evangelos Messaris","doi":"10.1097/DCR.0000000000004008","DOIUrl":"10.1097/DCR.0000000000004008","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"676-677"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009215","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":"Old Dogs Can Learn New Tricks: Artificial Intelligence Improves Adenoma Detection Rates in Screening Colonoscopies in Experienced Endoscopists.","authors":"Renee M Cholyway, Alexander J Rossi, Koby A Herman, Brian R Kann, William C Kethman, Danielle I Kay, William F Johnston, Jennifer L Paruch","doi":"10.1097/DCR.0000000000004235","DOIUrl":"10.1097/DCR.0000000000004235","url":null,"abstract":"<p><strong>Background: </strong>A high adenoma detection rate in screening colonoscopy is associated with decreased rates of post-colonoscopy colorectal cancer. The use of artificial intelligence has emerged to assist with the identification of adenomas.</p><p><strong>Objective: </strong>Evaluating if adopting artificial intelligence-powered computer-aided detection systems in colonoscopy will increase the adenoma detection rate, with the greatest increase seen among low-volume and junior endoscopists.</p><p><strong>Design: </strong>A retrospective review compared the adenoma detection rate before and after computer-aided detection in a single-center high-volume endoscopy practice, including both colorectal surgeons and gastroenterologists with a wide variety of experience.</p><p><strong>Setting: </strong>Single tertiary referral institution between April 2023 and August 2023, and April 2024 and August 2024.</p><p><strong>Patients: </strong>Endoscopists board-certified in colorectal surgery or gastroenterology.</p><p><strong>Intervention: </strong>Incorporation of computer-aided detection software to colonoscopy equipment.</p><p><strong>Main outcome measure: </strong>Adenoma detection rate.</p><p><strong>Results: </strong>Data from 9 colorectal surgeons and 15 gastroenterologists were included. A total of 2,327 colonoscopies were performed over the 10 months - 1,285 pre-computer-aided detection and 1,042 post-computer-aided detection. The overall mean adenoma detection rate significantly increased from 53.9% to 61.3% ( p = 0.02). Colorectal surgeons had a statistically significant increase in adenoma detection rate from 49% to 62% ( p = 0.02), but gastroenterologists did not (56.9% to 60.8%, p = 0.15). Of 12 senior and 12 junior endoscopists, the seniors had a statistically significant increase ( p = 0.02) from 51.7% to 59.6%, while juniors did not (56.2% to 62.9%, p = 0.12). From 12 high-volume and 12 low-volume endoscopists, the high-volume group had a statistically significant increase (51.3% to 59.4%, p = 0.01), but the low-volume group did not (56.5% to 63.1%, p = 0.13).</p><p><strong>Limitations: </strong>Single institution, limited time of study to show if increased adenoma detection rate will impact overall colorectal cancer incidence.</p><p><strong>Conclusions: </strong>Computer-aided detection in colonoscopy correlated with increased adenoma detection rate for experienced endoscopists. See Video Abstract .</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590742","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 Intracorporeal Anastomosis for Anterior Resection.","authors":"Ashley Jenkin, Amirala Khalessi, Kim-Chi Phan-Thien","doi":"10.1097/DCR.0000000000003868","DOIUrl":"10.1097/DCR.0000000000003868","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"672-673"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145631305","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":"Se-Jin Baek, Hosub Lim, Yanghee Kim","doi":"10.1097/DCR.0000000000004099","DOIUrl":"10.1097/DCR.0000000000004099","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"679-680"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793477","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":"Methodological Reflections on the Development of Breath Volatile Organic Compounds Models in Colorectal Cancer Screening.","authors":"Zhihan Li, Yunshi Wu, Wenbo Niu","doi":"10.1097/DCR.0000000000004098","DOIUrl":"10.1097/DCR.0000000000004098","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"678"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793483","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":"Anterior Sagittal Anorectoplasty for Low-Type Anorectal Malformation in an Middle-Aged Woman.","authors":"Ebubekir Korucuk, Kamil Erozkan, Ulgen Celtik, Orkan Ergun, Osman Bozbiyik","doi":"10.1097/DCR.0000000000003998","DOIUrl":"10.1097/DCR.0000000000003998","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"667"},"PeriodicalIF":3.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767611","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}