Diseases of the Colon & Rectum最新文献

{"title":"Selected Abstracts.","authors":"Maria Abou Khalil, Carla F Justiniano, Samuel Eisenstein, Michelle F DeLeon, Shannon L McChesney, Mayin Lin","doi":"10.1097/DCR.0000000000003850","DOIUrl":"10.1097/DCR.0000000000003850","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 9","pages":"1120-1125"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871963","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":"Conservative Management of Perianal Fistulas Described By İbn Al-Quff Al Karaki (1232-1286 CE): Old Contributions to Modern Practice.","authors":"Ali Ibrahim Bekraki","doi":"10.1097/DCR.0000000000003634","DOIUrl":"10.1097/DCR.0000000000003634","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"1031-1036"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274421","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":"Reevaluating Preoperative Type and Screen: Identifying When It Is Necessary for Elective Colorectal Surgery.","authors":"Sidrah Khan, Amy Glasgow, Roy Hajjar, Ian S Reynolds, Lauren T Gleason, Emilo Sanchez, William R G Perry, Kellie L Mathis, Nicholas P McKenna","doi":"10.1097/DCR.0000000000003844","DOIUrl":"10.1097/DCR.0000000000003844","url":null,"abstract":"<p><strong>Background: </strong>Rising health care costs necessitate a reassessment of routine preoperative practices. Despite low transfusion rates in elective colorectal operations, many hospitals continue to perform routine preoperative type and screen testing.</p><p><strong>Objective: </strong>To assess perioperative blood transfusion rates and determine preoperative and surgical factors associated with transfusions to determine whether the routine preoperative type and screen testing are necessary for elective abdominal colorectal surgeries, particularly in the setting of minimally invasive surgery.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>Mayo Clinic, 2019-2023.</p><p><strong>Patients: </strong>Adult patients undergoing elective abdominal colorectal operations. Exclusion criteria included emergent operations and nonabdominal procedures.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main outcome measures: </strong>The primary outcome was the incidence of intraoperative and immediate postoperative (≤72 hours) blood product transfusion. Secondary outcomes assessed associations between transfusion rates, surgical approach, and preoperative variables.</p><p><strong>Results: </strong>Among 4652 patients, 2770 underwent minimally invasive surgery and 1882 underwent open procedures. Perioperative red blood cell transfusion rates were lower in minimally invasive procedures (3.0% colectomy, 4.5% proctectomy) compared to open procedures (8.7% colectomy, 21.5% proctectomy). Open proctectomy was the strongest predictor of transfusion (OR 12.05; 95% CI, 8.94-16.26; p < 0.0001) followed by open colectomy (OR 2.59; 95% CI, 2.04-3.30; p < 0.0001). Preoperative factors including ASA class IV (OR 5.21; 95% CI, 1.09-24.82; p < 0.0382) and anemia (OR 4.14; 95% CI, 3.09-5.55; p < 0.0001) were also significantly associated with red blood cell transfusion.</p><p><strong>Limitations: </strong>The retrospective nature of the study may introduce selection bias. In addition, institutional practice patterns may limit the generalizability of findings.</p><p><strong>Conclusions: </strong>Patients undergoing elective minimally invasive colorectal surgery have very low rates of perioperative blood transfusions; thus, routine preoperative type and screen testing is likely unnecessary for this patient cohort. However, patients undergoing planned open operations, likely due to procedural complexity, and those who are ASA class IV, have preoperative anemia, or have anal cancer have higher transfusion risks and may benefit from selective testing. Implementing a risk-stratified approach based on surgical technique and patient comorbidities could potentially reduce unnecessary testing and associated health care costs. See Video Abstract .</p><p><strong>Retipificacin y evaluacin preoperatorias cmo identificar cundo es necesaria una ciruga colorrectal electiva: </strong>ANTECEDENTES:El aumento en los costos de la atenci","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"1093-1099"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257611","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":"Association of Cumulative Social Risk and Cancer-Specific Survival Among Patients With Advanced Colorectal Cancer.","authors":"Kirbi L Yelorda, Heather S Day, Katherine D Arnow, Sue J Fu, Sanghyun A Kim, Arden M Morris","doi":"10.1097/DCR.0000000000003851","DOIUrl":"10.1097/DCR.0000000000003851","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic disadvantage is widely associated with poor clinical outcomes among patients with colorectal cancer. Interventions to address these pervasive public health problems have had mixed success, potentially related to their development based on aggregated data (eg, average zip code income) and short-term outcomes, rather than individual-level data and meaningful long-term cancer outcomes.</p><p><strong>Objective: </strong>To analyze associations of individual and cumulative multiple, co-occurring individual-level social risk factors with long-term cancer-specific survival among patients with advanced colorectal cancer.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Setting: </strong>Between 2011 and 2014, we collaborated with Surveillance, Epidemiology and End Result in Georgia and Detroit to survey patients with stage III colorectal cancer in the prior year. Cumulative social risk was calculated by summing significant factors associated with colorectal cancer-specific mortality: employment, insurance, health literacy, income, and marital status.</p><p><strong>Patients: </strong>Patients with stage III colorectal cancer were included.</p><p><strong>Main outcome measures: </strong>Time from diagnosis to cancer-specific mortality, adjusted for age, race, sex, and chemotherapy receipt, with comparisons provided in HRs with 95% CIs.</p><p><strong>Results: </strong>Among 1173 patients, preoperative unemployment (1.76 [1.30-2.39]), uninsured or Medicaid insurance (1.54 [1.12-2.11]), low health literacy (1.40 [1.00-1.95]), annual income below $50,000 (1.34 [1.01-1.77]), and being unpartnered (1.34 [1.02-1.77]) were associated with higher likelihood of cancer-specific mortality. In cumulative risk analyses, each added social risk was associated with a 24% higher adjusted likelihood of cancer-specific mortality (1.24 [1.12-1.37]).</p><p><strong>Limitations: </strong>This study has limitations inherent to survey research, including the potential lack of generalizability and the possibility of responses being subject to recall bias. In addition, the cross-sectional survey and linked longitudinal clinical data do not allow for the determination of causality.</p><p><strong>Conclusions: </strong>Cumulative social risk was associated with long-term cancer-specific survival after treatment for stage III colorectal cancer. Assessing social risk may help identify patients with colorectal cancer who are at higher risk of mortality to receive support programs designed to mitigate social disadvantage. See Video Abstract .</p><p><strong>Asociacin entre el riesgo social acumulado y la supervivencia especfica por cncer en pacientes con cncer colorrectal avanzado: </strong>ANTECEDENTES:Las desventajas socioeconómicas se asocian ampliamente con malos resultados clínicos en pacientes con cáncer colorrectal. Las intervenciones para abordar estos problemas de salud pública han tenido un éxito desigual, lo que po","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"1085-1092"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301361","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 Transanal Minimally Invasive Surgery With da Vinci Single-Port Platform and Single-Port Access Port.","authors":"Garrett Friedman, Katherine Specht","doi":"10.1097/DCR.0000000000003852","DOIUrl":"10.1097/DCR.0000000000003852","url":null,"abstract":"<p><strong>Background: </strong>The da Vinci single-port system has been used for transanal minimally invasive surgery, but there are limitations in accessing the distal rectum with the single-port system and traditional transanal access platforms. We present our case series using the single-port access port, which may provide more flexibility than traditional transanal access modalities.</p><p><strong>Impact of innovation: </strong>This is, to our knowledge, the largest series presented of single-port transanal minimally invasive surgery using the access port as the transanal access platform. The access port provided safe and effective access to the anal canal, the entirety of the rectum, and even the distal sigmoid colon.</p><p><strong>Technology, materials, and methods: </strong>We reviewed data for all patients who underwent transanal minimally invasive surgery using the da Vinci single-port system with the access port performed by a single surgeon. The primary outcomes analyzed included the success of the procedure without conversion to another method, intraoperative complications, and postoperative complications. We additionally analyzed tumor location from the verge, tumor pathology, and margin status.</p><p><strong>Preliminary results: </strong>Seventeen patients underwent single-port transanal minimally invasive surgery using the access port between March 2023 and May 2024. All procedures had technical success, defined as the completion of the transanal minimally invasive surgery using the da Vinci single-port system without conversion to another method. No patient experienced intraoperative complications. We found the access port allowed us to access a range of lesions in terms of location in the rectum from the anal verge up to 22 cm proximally.</p><p><strong>Conclusions and future directions: </strong>Robotic transanal minimally invasive surgery with the single-port system using the access port is safe, technically feasible, and allows a wide variety of lesions to be addressed both with full and partial-thickness resection. Further studies may additionally show improvements in patient comfort due to reduced trauma to the anus from the soft, flexible ringed access system.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e1783-e1787"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274423","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":"Surgical Outcomes in Metastatic Mismatch Repair-Deficient/Microsatellite Instability-High Colorectal Cancer After Disease Control With Immune Checkpoint Inhibitors: A Retrospective Observational Study.","authors":"Qiaoqi Sui, Leen Liao, Jiehai Yu, Linjie Zhang, Binyi Xiao, Wu Jiang, Zhizhong Pan, Pei-Rong Ding","doi":"10.1097/DCR.0000000000003845","DOIUrl":"10.1097/DCR.0000000000003845","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Surgical intervention after systemic therapy improves prognosis in metastatic colorectal cancer. However, surgical outcomes after immune checkpoint inhibitor therapy remain controversial in patients with mismatch repair-deficient/microsatellite instability-high disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to demonstrate the outcomes of patients with metastatic mismatch repair-deficient/microsatellite instability-high colorectal cancer who underwent curative surgery after achieving disease control with immune checkpoint inhibitors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This is a single-center retrospective observational study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;This study was conducted in a tertiary referral center in China.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients: &lt;/strong&gt;The data of patients diagnosed with metastatic mismatch repair-deficient/microsatellite instability-high colorectal cancers between 2017 and 2023 were reviewed. Patients who achieved disease control after immune checkpoint inhibitors and underwent curative surgeries were enrolled.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;Pathological responses and survival outcomes were assessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 39 patients were enrolled. The median age was 41 years (range, 16-74). Pathological residuals were diagnosed in 38.5% of the patients (15/39), whereas 61.5% (24/39) achieved a pathological complete response. Mucinous adenocarcinoma (33.3% vs 4.2%; difference 29.1%; 95% CI, 3.9%-53.3%; p = 0.02) was associated with pathological residual, whereas extensive disease (residual lesions in 2 or more organs or 2 or more residual lesions in a single organ; 93.3% vs 62.5%; difference 30.8%; 95% CI, 7.7%-53.9%; p = 0.06) and liver/peritoneum residuals (93.3% vs 62.5%; difference 30.8%; 95% CI, 7.7%-53.9%; p = 0.06) suggested possible associations with pathological residual. Pathological complete response (HR 0.059; 95% CI, 0.007-0.500; p = 0.01), mucinous adenocarcinoma (HR 7.170; 95% CI, 1.438-35.759; p = 0.02), and a surgical interval of &gt;1 year (HR 4.673; 95% CI, 1.003-21.779; p = 0.02) were observed to be associated with relapse-free survival.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Limitations include potential selection bias and a small sample size.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Pathological residuals are relatively common and pose a threat for patients with metastatic mismatch repair-deficient/microsatellite instability-high colorectal cancers controlled via immune checkpoint inhibitors. Patients with mucinous adenocarcinoma, extensive disease, or liver/peritoneal involvement may benefit from surgical resection. See Video Abstract .&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Resultados quirrgicos en cncer colorrectal metastsico con deficiencia en la reparacin de desajustes y alta inestabilidad de microsatlites tras el control de la enfermedad con inhibicin de puntos de control inmunitario un estudio observacional retrospectivo: &lt;/strong&gt;ANTECEDENTES:La intervención ","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"1052-1061"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505097","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":"Intracorporeal Side-to-End Anastomosis During Robotic Stapled Circular Anastomosis: A Primer.","authors":"Ameer Farooq, Sunil V Patel, Peter Hugh MacDonald","doi":"10.1097/DCR.0000000000003663","DOIUrl":"10.1097/DCR.0000000000003663","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e1782"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224726","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 Cytoreductive Surgery and Heated Intraperitoneal Chemotherapy for Low-Grade Pseudomyxoma Peritonei and as a Risk Reduction Procedure.","authors":"Aseem Jindal, Chelliah R Selvasekar, Sarah J Madden","doi":"10.1097/DCR.0000000000003561","DOIUrl":"10.1097/DCR.0000000000003561","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e1778-e1779"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224727","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":"Extraperitoneal Colostomy Creation Technique.","authors":"Amanda Chiu, Charles A Ternent, Maniamparampil Shashidharan","doi":"10.1097/DCR.0000000000003631","DOIUrl":"10.1097/DCR.0000000000003631","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e1780-e1781"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224724","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":"Lina Björklund Sand, Charlotta Larsson, Rode Grönkvist, Eva Haglind, Eva Angenete","doi":"10.1097/DCR.0000000000003859","DOIUrl":"10.1097/DCR.0000000000003859","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e1789"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274426","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}