Diseases of the Colon & Rectum最新文献

{"title":"Hypnosis for Postoperative Pain Management Following Colectomies: A Single-Center Randomized Controlled Feasibility Trial.","authors":"Ana-Maria Toth, Paul Mackey, Stefano Di Donato, Begonya Alcacer-Pitarch","doi":"10.1097/DCR.0000000000004384","DOIUrl":"10.1097/DCR.0000000000004384","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pain management after colectomy remains challenging, with opioid-related complications impacting recovery. This study evaluates the feasibility of implementing clinical hypnosis as an adjunctive intervention.</p><p><strong>Objective: </strong>To determine the feasibility of conducting a full-scale randomized controlled trial investigating hypnosis for postcolectomy pain management.</p><p><strong>Methods: </strong>Single-center randomized controlled feasibility trial.</p><p><strong>Setting: </strong>District general hospital in South-West England (July 2023 - February 2024).</p><p><strong>Patients: </strong>Forty-one adults undergoing elective colectomy.</p><p><strong>Interventions: </strong>Participants were randomized to standard care or standard care plus 3 perioperative hypnosis sessions (preoperatively, first- and third-day postsurgery).</p><p><strong>Main outcome measures: </strong>Primary: recruitment rates, retention, and intervention adherence. secondary: pain scores (numeric pain scale), analgesic requirements, and complications.</p><p><strong>Results: </strong>Recruitment achieved 58% (41/71 eligible patients), with 90% retention and 92.5% intervention adherence. The hypnosis group demonstrated pain reductions approximating the minimum clinically important difference, providing signals of potential clinical benefit following sessions: at 24-hour postsurgery, median pain decreased from 5.0 to 2.5 (median difference -2.0, 95% confidence interval -2.5 to -1.0), and at day 3, from 4.0 to 1.5 (median difference -2.5, 95% confidence interval -3.0 to -1.5). Between-group comparisons showed lower pain in the hypnosis group at 24 hours (median 5.0 vs 6.0, median difference -1.2, 95% confidence interval -2.3 to -0.1).</p><p><strong>Limitations: </strong>Single-center design limits generalizability; participant and staff blinding was unfeasible; hypnotizability was not assessed.</p><p><strong>Conclusions: </strong>Hypnosis is feasible in acute surgical settings, with trends supporting pain reduction and positive patient experiences. A definitive trial is warranted to determine efficacy for postcolectomy pain management. See Video Abstract.Registration number : ClinicalTrials.gov: NCT06499909.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7619523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826307","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}

{"title":"Robotic Transperineal Lateral Lymph Node Dissection for Rectal Cancer Through a Single-Port System: the World's First Clinical Experience.","authors":"Atsushi Ogura, Yuki Murata, Norifumi Hattori, Yusuke Sato, Shinichi Umeda, Chie Tanaka, Tomoki Ebata, Mitsuro Kanda","doi":"10.1097/DCR.0000000000004356","DOIUrl":"https://doi.org/10.1097/DCR.0000000000004356","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886727","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":"Selected Abstracts.","authors":"","doi":"10.1097/DCR.0000000000004464","DOIUrl":"https://doi.org/10.1097/DCR.0000000000004464","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886760","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 for Colorectal Surgeons-Part I: Foundations and Clinical and Educational Applications.","authors":"Ankit Sarin, Christopher M Seffren, Hussam A Shwaib, Monique Couto Matos, Samuel Eisenstein, Marco Ferrara, Nell Maloney Patel, Sean J Langenfeld","doi":"10.1097/DCR.0000000000004138","DOIUrl":"10.1097/DCR.0000000000004138","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence is rapidly transforming colorectal surgery through applications spanning screening to postoperative care. This 2-part review provides a comprehensive framework for understanding and implementing artificial intelligence technologies in surgical practice.</p><p><strong>Objective: </strong>Part I analyzes fundamental artificial intelligence concepts, clinical applications across the surgical continuum, and educational considerations for colorectal surgeons.</p><p><strong>Methods: </strong>Comprehensive literature review focusing on artificial intelligence applications in colorectal surgery, evaluating current evidence for clinical implementation and training approaches.</p><p><strong>Results: </strong>Artificial intelligence demonstrates measurable clinical impact across multiple domains. In screening, artificial intelligence-enhanced colonoscopy increases adenoma detection rates from 40.4% to 54.8% ( p < 0.001) in multicenter trials, with cross-validation on colonoscopy images demonstrating 96.4% polyp detection accuracy. Diagnostic applications include microsatellite instability prediction from histology and automated MRI tumor segmentation. Preoperatively, machine learning models predict mortality and morbidity, outperforming traditional risk measures such as the American Society of Anesthesiologists classification and the American College of Surgeon-National Surgical Quality Improvement Program. Intraoperatively, artificial intelligence has demonstrated early feasibility for real-time tissue plane, artificial intelligence-based automated perfusion assessment can predict anastomotic viability, and artificial intelligence can enable identification of critical structures such as pelvic nerves. Postoperatively, artificial intelligence is starting to detect complications hours before clinical diagnosis, reducing documentation time. Educational applications include artificial intelligence-enhanced simulation platforms, objective video-based performance assessment, and integration with virtual/augmented reality for immersive training experiences.</p><p><strong>Conclusions: </strong>Artificial intelligence technologies have achieved clinical validation for specific colorectal surgery applications, with several technologies receiving regulatory approval. Successful integration requires understanding fundamental concepts, appropriate clinical application, and structured training approaches. Part II of this series analyzes research applications, implementation resources, challenges, and future directions that will further transform surgical practice.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2230-2240"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147527764","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 Lateral-to-Medial Left Colon Dissection: A Technical Approach for Total Mesorectal Excision.","authors":"Fabio Lopes de Queiroz, Marina Barbabela Grisolia de Oliveira, Daniel Mauricio Londoño Estrada","doi":"10.1097/DCR.0000000000004247","DOIUrl":"10.1097/DCR.0000000000004247","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2340-2342"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257572","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-Assisted Anatomical Recognition System-Guided Robotic Total Mesorectal Excision and Autonomic Nerve Preservation for Rectal Neuroendocrine Tumor.","authors":"Yudai Fukui, Sung Uk Bae","doi":"10.1097/DCR.0000000000004183","DOIUrl":"10.1097/DCR.0000000000004183","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2338"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282787","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":"Yihu Mao, Lie Yang","doi":"10.1097/DCR.0000000000004299","DOIUrl":"10.1097/DCR.0000000000004299","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2354"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013706","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":"Considerations on Upfront Surgery for Stage II/III Rectal Cancer.","authors":"Kun Xu, Haode Shen, Weidong Tong, Fan Li","doi":"10.1097/DCR.0000000000004314","DOIUrl":"10.1097/DCR.0000000000004314","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2355"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149086","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 Managing Reach in Colectomy: Achieving a Tension-Free Anastomosis.","authors":"H David Vargas","doi":"10.1097/DCR.0000000000004318","DOIUrl":"10.1097/DCR.0000000000004318","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2252-2253"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162143","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":"Sexual Distress Is Common in Long-term Follow-up After Pelvic Pouch for Ulcerative Colitis: A Cross-Sectional Study.","authors":"Garrett Johnson, Tae L Hart, Mantaj S Brar, Selina Schmocker, Amandeep Pooni, Jordyn Vernon, Erin Kennedy","doi":"10.1097/DCR.0000000000004352","DOIUrl":"10.1097/DCR.0000000000004352","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sexual dysfunction is common after pelvic pouch surgery for ulcerative colitis. Despite this, little work has been done to explore the degree of sexual distress this causes in patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To determine the proportion of patients with ulcerative colitis who experience sexual distress after pelvic pouch surgery and to explore the effects of social demographics, age, bowel function, anxiety, and depression on sexual distress.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A cross-sectional survey that was emailed to patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Settings: &lt;/strong&gt;A large tertiary care teaching hospital.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients: &lt;/strong&gt;Patients who underwent pelvic pouch surgery for ulcerative colitis from 1980 to 2022.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interventions: &lt;/strong&gt;Validated questionnaires included the 13-item Sexual Distress Scale, Hospital Anxiety and Depression Scale, and Colorectal Functional Outcome questionnaire.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;The primary outcome was the proportion of patients meeting established thresholds for sexual distress. Multivariable regression was used to evaluate associations between sexual distress and operative factors, age, sex, income, education, ethnicity, sexual orientation, and relationship status.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 1830 eligible patients, 497 responded and were included in the analysis. Overall, 194 patients (39%) screened positive for sexual distress. Women were disproportionately affected, with more than half reporting clinically significant distress (141/243; 57.8%). Female gender was the only independent preoperative predictor of sexual distress on multivariable analysis (OR 4.796; 95% CI, 3.119-7.374; p &lt; 0.001). Poor bowel function, anxiety, and depression were all significantly more prevalent among patients with sexual distress (all p &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Cross-sectional design limits causal inference. Selection and response bias are possible.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Sexual distress is common after pelvic pouch surgery for ulcerative colitis, particularly among women, and is strongly associated with bowel dysfunction, anxiety, and depression. These findings highlight the importance of holistic preoperative and postoperative counseling and the consideration of psychological screening in follow-up care. Further research is needed to elucidate underlying mechanisms and develop targeted interventions. See Video Abstract.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;La disfuncin sexual es frecuente en el seguimiento a largo plazo tras la creacin de una bolsa plvica para la colitis ulcerosa un estudio transversal: &lt;/strong&gt;ANTECEDENTES:La disfunción sexual es frecuente tras la cirugía de reservorio pélvico para la colitis ulcerosa. A pesar de ello, se ha investigado poco sobre el grado de malestar sexual que esto provoca en los pacientes.OBJETIVO:Determinar la proporción de pacientes con colitis ulcerosa que experimentan malestar sexual ","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"2273-2282"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276567","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}