Diseases of the Colon & Rectum最新文献

{"title":"A Multi-institutional Study From the US Resident Operative Experience Consortium Examining Factors Associated With Exposure and Pursuit of Colorectal Fellowship After General Surgery Residency.","authors":"Adam D Price, Bilal W Nasim, Kelsey B Montgomery, Desmond L Layne, Alexander R Cortez, Jonathan S Abelson, Jitesh A Patel","doi":"10.1097/DCR.0000000000003671","DOIUrl":"10.1097/DCR.0000000000003671","url":null,"abstract":"<p><strong>Background: </strong>Colon and rectal surgery is a popular fellowship after general surgery residency. The impact of a resident's colon and rectal surgery experience during residency may impact their career trajectory and pursuit of colon and rectal surgery.</p><p><strong>Objective: </strong>This study aims to identify individual and program factors associated with matriculation into a colon and rectal surgery fellowship compared to other career trajectories.</p><p><strong>Design: </strong>An analysis of case logs and demographic data from graduates of 19 accredited general surgery residency programs from the Accreditation Council for Graduate Medical Education between 2010 and 2020 was completed using the US Resident Operative Experience Consortium. The demographics and operative experience of residents who pursued colon and rectal surgery fellowship were compared to those who did not.</p><p><strong>Settings: </strong>This study is a retrospective review of resident specialty selection, demographic information, and operative case logs.</p><p><strong>Patients: </strong>Graduates of 19 accredited general surgery residency programs from the Accreditation Council for Graduate Medical Education between 2010 and 2020 participated in the study.</p><p><strong>Main outcome measures: </strong>Resident demographics, general surgery and colon and rectal surgery program-specific characteristics, and resident operative case logs associated with entrance into colon and rectal surgery fellowship served as the primary outcome measures.</p><p><strong>Results: </strong>Those in the colon and rectal surgery cohort were more likely to be female sex and have completed a dedicated research experience. No association was noted with the colocation of a colon and rectal surgery fellowship and general surgery residency. Multivariable analysis demonstrated a higher likelihood of colon and rectal surgery fellowship matriculation for female sex residents and residents who completed a clinical fourth-year colon and rectal surgery rotation. Higher logged colon and rectal surgery-specific case volume was associated with those matriculating into colon and rectal surgery.</p><p><strong>Limitations: </strong>Self-reported case log data, differences in residency structures in offering colon and rectal surgery rotations to clinical fourth-year residents, and academic bias of participating residency programs.</p><p><strong>Conclusions: </strong>This study identified individual and program-specific factors associated with matriculating into colon and rectal surgery fellowship, such as female sex, colon and rectal surgery-specific rotation in the fourth clinical year, and higher volume of colon and rectal surgery-specific cases. These data may optimize resident colon and rectal surgery experience and strengthen the colon and rectal surgery fellowship pipeline. See Video Abstract .</p><p><strong>Un estudio multiinstitucional del consorcio rope de ee uu que examina los factore","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"637-646"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364077","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":"Enhanced Recovery Independently Lowers Failure to Rescue After Colorectal Surgery.","authors":"Marco Catarci, Giacomo Ruffo, Massimo Giuseppe Viola, Gianluca Garulli, Maurizio Pavanello, Marco Scatizzi, Vincenzo Bottino, Stefano Guadagni","doi":"10.1097/DCR.0000000000003655","DOIUrl":"10.1097/DCR.0000000000003655","url":null,"abstract":"<p><strong>Background: </strong>High adherence to the enhanced recovery after surgery pathway reduces morbidity and mortality rates after elective colorectal surgery.</p><p><strong>Objective: </strong>To evaluate the effect of adherence to the enhanced recovery after surgery pathway on the failure to rescue rates after elective colorectal surgery.</p><p><strong>Design: </strong>Retrospective analysis of a prospective database.</p><p><strong>Patients: </strong>Adults (18 years or older) who underwent elective colorectal resection with anastomosis for benign and malignant disease.</p><p><strong>Settings: </strong>Prospective enrollment in 78 centers in Italy from 2019 to 2021.</p><p><strong>Interventions: </strong>All outcomes were measured 60 days after surgery. Several patient-, disease-, treatment-, hospital-, and complication-related variables were analyzed. After univariate analyses, independent predictors of the end points were identified through logistic regression analyses, presenting ORs and 95% CIs.</p><p><strong>Main outcome measures: </strong>Failure to rescue after any adverse event, defined as the ratio between the number of deaths and the number of patients showing any adverse event; failure to rescue after any major adverse event, with the denominator represented by the number of patients showing any major adverse event.</p><p><strong>Results: </strong>An adverse event was recorded in 2321 of 8359 patients (27.8%), a major adverse event in 523 patients (6.3%), and death in 88 patients (1.0%). The failure to rescue rates were 3.8% after any adverse event and 16.8% after any major adverse event. Independent predictors of primary end points were identified among patient- (age, ASA class, and nutritional status), treatment- (type of resection), and complication-related (anastomotic leakage and reoperation) variables. Enhanced recovery pathway adherence of more than 70% independently reduced failure to rescue rates.</p><p><strong>Limitations: </strong>Clustering from multicenter data and unmeasured confounding from observational data.</p><p><strong>Conclusions: </strong>After elective colorectal resection, adherence of more than 70% to the enhanced recovery pathway independently decreased failure to rescue rates, along with other patient- or treatment-related factors. See Video Abstract .</p><p><strong>La recuperacin mejorada reduce de forma independiente la posibilidad de fracaso en el rescate despus de una ciruga colorrectal: </strong>ANTECEDENTES:La alta adherencia a la vía de recuperación mejorada después de la cirugía reduce las tasas de morbilidad y mortalidad después de la cirugía colorrectal electiva.OBJETIVO:Evaluar el efecto de la adherencia a la vía ERAS en las tasas de fracaso en el rescate después de la cirugía colorrectal electiva.DISEÑO:Análisis retrospectivo de una base de datos prospectiva.PACIENTES:Adultos (≥ 18 años) que se sometieron a una resección colorrectal electiva con anastomosis por enfermedad benigna y maligna","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"616-626"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390504","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":"Clip-and-Lift Retraction Technique During Endoscopic Submucosal Dissection.","authors":"Kamil Erozkan, Attila Ulkucu, Lucas F Sobrado, Emre Gorgun","doi":"10.1097/DCR.0000000000003593","DOIUrl":"10.1097/DCR.0000000000003593","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e202"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398578","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":"Minimally Invasive Robotic Surgery in Lateral Lymph Node Dissection by Pelvic Floor First Approach.","authors":"Mitsuru Yokota, Akitaka Morikawa, Hiroya Matsuoka, Yoshio Nagahisa, Kenji Kawata, Michio Okabe, Toshihiko Masui, Kazuyuki Kawamoto","doi":"10.1097/DCR.0000000000003507","DOIUrl":"10.1097/DCR.0000000000003507","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e200-e201"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188448","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":"Cancer Incidence and Mortality in Familial Adenomatous Polyposis Syndrome.","authors":"Dan Feldman, Linda H Rodgers-Fouche, Chinedu Ukaegbu, Matthew B Yurgelun, Sapna Syngal, Daniel C Chung","doi":"10.1097/DCR.0000000000003645","DOIUrl":"10.1097/DCR.0000000000003645","url":null,"abstract":"<p><strong>Background: </strong>Risk-reducing colectomy in familial adenomatous polyposis syndrome is the standard of care. This has increased the importance of surveillance for extracolonic malignancies in postcolectomy individuals.</p><p><strong>Objective: </strong>We sought to define the present-day incidence of all cancers and mortality in familial adenomatous polyposis.</p><p><strong>Design: </strong>Retrospective longitudinal cohort study.</p><p><strong>Settings: </strong>Two large academic hospitals.</p><p><strong>Patients: </strong>Eligible patients carried an APC pathogenic variant or met clinical criteria for familial adenomatous polyposis.</p><p><strong>Main outcome measures: </strong>Cancer diagnosis, mortality, and associated risk factors.</p><p><strong>Results: </strong>A total of 358 patients were identified. The percentage who exhibited a classic familial adenomatous polyposis phenotype was 63.7%; 21.2% were de novo, and 82.7% had a colectomy. Colorectal cancer was the most common cancer (n = 59; 16.5%). Colorectal cancer diagnoses were associated with de novo familial adenomatous polyposis (OR 7.8 [95% CI, 3.51-17.35]; p < 0.001). Thyroid, duodenal/small bowel, gastric, and neuroendocrine tumors were reported in 7.5%, 3.1%, 2.8%, and 2.5% of patients, respectively. Rates of cancer were similar in classic and attenuated familial adenomatous polyposis. Thirty-nine patients (10.9%) died at a mean age of 49.6 ± 17.1 years. Twenty-six deaths were malignancy-related, and colorectal cancer was the leading cause (n = 10). All colorectal cancer-related deaths occurred in individuals with classic familial adenomatous polyposis, and 9 of 10 individuals were not previously diagnosed with the syndrome. Gastric and duodenal/small bowel cancers were the second leading causes (4 deaths each), and all occurred after colectomy. Fifty-nine percent of all deaths were attributable to a familial adenomatous polyposis-related malignancy or morbidity.</p><p><strong>Limitations: </strong>Retrospective clinical data.</p><p><strong>Conclusions: </strong>Colorectal cancer remains the most common malignancy and cause of death in familial adenomatous polyposis. However, nearly all colorectal cancer-related deaths occurred in individuals unaware of their familial adenomatous polyposis diagnosis, and none occurred in the attenuated syndrome. In patients who had a colectomy, gastric and duodenal/small bowel cancers are now the leading causes of death. See Video Abstract .</p><p><strong>Incidencia y mortalidad por cncer en el sndrome de poliposis adenomatosa familiar: </strong>ANTECEDENTES:La colectomía para reducir el riesgo en el síndrome de poliposis adenomatosa familiar es el estándar de atención. Esto ha aumentado la importancia de la vigilancia de las neoplasias malignas extracolónicas en individuos post-colectomía.OBJETIVO:Buscamos definir la incidencia actual de todos los cánceres y la mortalidad en la poliposis adenomatosa familiar.DISEÑO:Estudio de coho","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"531-543"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390503","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":"Enhancing LARS Management: Learnings and Challenges From the SANLARS Study.","authors":"Michele Schiano di Visconte","doi":"10.1097/DCR.0000000000003694","DOIUrl":"10.1097/DCR.0000000000003694","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e211"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364105","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 Readability, Actionability, and Accessibility of Hemorrhoid-Focused Online Patient Education Materials: Are We Adequately Addressing Patient Concerns?","authors":"Isabel K Eng, Formosa C Chen, Marcia M Russell, Folasade P May, Amanda N Labora, Daniela A Salinas, Tara A Russell","doi":"10.1097/DCR.0000000000003691","DOIUrl":"10.1097/DCR.0000000000003691","url":null,"abstract":"<p><strong>Background: </strong>Hemorrhoidal disease is highly prevalent in the United States and frequently queried online. Unfortunately, health education web pages often lack reliable information.</p><p><strong>Objective: </strong>To evaluate whether online hemorrhoid education materials in English and Spanish meet national recommendations for readability, actionability, and accessibility and provide critical clinical guidance on when to seek medical care.</p><p><strong>Design: </strong>Using 3 search engines (Bing, Google, and Yahoo), we selected the top 30 results for formal medical and colloquial English and Spanish search terms regarding hemorrhoids. We assessed readability using validated scoring systems for readability in English and Spanish to report median reading levels and assessed health literacy performance on a 6-point checklist in 3 categories: accessibility, actionability, and critical clinical guidance.</p><p><strong>Settings: </strong>University of California Los Angeles.</p><p><strong>Main outcome measures: </strong>Readability and health literacy performance.</p><p><strong>Results: </strong>After removing duplicates, 90 to 95 web pages generated from formal English, Spanish, and colloquial English terms remained. There was minimal overlap of results from the formal and colloquial English searches. Median reading levels were first-year university for formal and colloquial English web pages and 11th grade for Spanish web pages. Regarding health literacy, 43.2%, 48.4%, and 18.2% of formal English, Spanish, and colloquial English websites, respectively, had minimal health literacy performance. Health literacy performance criteria that were met least often were printability and providing specific, actionable goals for patients to implement.</p><p><strong>Limitations: </strong>Our study represents searches completed at 1 point in time using specific terms. Colloquial search terms were generated via a survey with convenience sampling and may not be representative of all possible searches used by patients seeking information on hemorrhoidal disease.</p><p><strong>Conclusions: </strong>Most English and Spanish hemorrhoid-focused web pages failed to provide appropriate patient education, as they exceeded the recommended sixth-grade reading level, lacked actionable recommendations, were not accessible, and failed to provide critical clinical guidance. Online resources are essential for patients of all health literacy levels; improvement is critical to reducing health care disparities. See Video Abstract .</p><p><strong>La legibilidad, viabilidad y accesibilidad de los materiales educativos en lnea centrados en las hemorroides para pacientes estamos abordando adecuadamente las inquietudes de los pacientes: </strong>ANTECEDENTES:La enfermedad hemorroidal es muy prevalente en los Estados Unidos y se busca con frecuencia información en línea. Desafortunadamente, las páginas web de educación para la salud a menudo carecen de información con","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"584-592"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425110","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":"Transanal Minimally Invasive Surgery for a Large Rectal Polyp.","authors":"Hani Bendib, Khaled Khansal, Razika Hachlaf","doi":"10.1097/DCR.0000000000003551","DOIUrl":"10.1097/DCR.0000000000003551","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e204"},"PeriodicalIF":3.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188487","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":"When Minimally Invasive Surgery is NOT the Least Invasive Surgical Option.","authors":"William C Cirocco","doi":"10.1097/DCR.0000000000003813","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003813","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998764","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":"A Commentary on Persistent Sitting and Walking Difficulties After Abdominoperineal Excision and Anterior Resection.","authors":"Chang Mao, Qingming Wang","doi":"10.1097/DCR.0000000000003812","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003812","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982726","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}