International Journal of Colorectal Disease最新文献

{"title":"Correction to: Long-term outcomes of transanal irrigation in patients with low anterior resection syndrome: what happens after more than five years?","authors":"Jacopo Martellucci, Maximilian Scheiterle, Gherardo Maltinti, Carlo Bergamini, Fabio Cianchi, Paolo Prosperi","doi":"10.1007/s00384-025-05012-7","DOIUrl":"10.1007/s00384-025-05012-7","url":null,"abstract":"","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"205"},"PeriodicalIF":2.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing pediatric loop colostomy closure: a comparative study of linear stapler and hand-sewn anastomosis.","authors":"Raashid Hamid, Ubayer Nabi, Akshat Sudhanshu, Vivek Sharma, Sabina Nisar, Nisar A Bhat, Ajaz A Baba, Gowhar N Mufti, Waseem Jan Shah, Mir Faheem Ul Hassan","doi":"10.1007/s00384-025-04973-z","DOIUrl":"10.1007/s00384-025-04973-z","url":null,"abstract":"<p><strong>Background: </strong>Conventional hand suture techniques for intestinal anastomosis have been standard practice for decades, but the development of staplers has significantly impacted surgical procedures. Staplers, designed to simplify surgery, have been increasingly used in various gastrointestinal surgeries, including pediatric procedures. Colostomy takedown in infants is a commonly performed surgical procedure in pediatric surgery, yet the optimal technique remains debated. This study aims to compare the outcomes of linear stapler anastomosis and hand-sewn anastomosis for elective closure of loop colostomies in children. The hypothesis is that linear stapler anastomosis offers advantages over hand-sewn anastomosis in terms of operative time, recovery, and hospital stay.</p><p><strong>Aim: </strong>To compare the outcomes of linear stapler and hand-sewn anastomosis in the elective closure of pediatric loop colostomies.</p><p><strong>Methods: </strong>This prospective, randomized controlled study was conducted at Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura, J&K, India, between 2021 and 2023. A total of 70 infants were enrolled, randomly assigned to two groups: Group A (35 infants) underwent SA (Stapled Anastomosis), and Group B (35 infants) underwent HS (Hand-Sewn Anastomosis). Both groups were matched for clinical characteristics. The primary outcomes included operative time and time to return of bowel movements. Secondary outcomes included anastomotic leaks, wound infections, and length of hospital stay. Data analysis was performed using appropriate statistical methods including t-tests and chi-square tests.</p><p><strong>Results: </strong>The mean age of patients was 5.79 ± 3.23 months in Group A and 4.21 ± 3.13 months in Group B. The mean time to return of bowel movements was significantly shorter in Group A (24.82 ± 6.34 h) compared to Group B (47.56 ± 5.65 h, p = 0.05). Oral feeding was commenced earlier in Group A (2.18 ± 0.39 days) than in Group B (3.16 ± 0.37 days, p < 0.001). Both groups had a follow-up of 1.81 ± 0.98 years, with no cases of anastomotic leakage or small bowel obstruction in either group. Hospital stay was shorter in Group A (53.82 ± 6.34 h) compared to Group B (79.56 ± 15.65 h, p < 0.0003).</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"207"},"PeriodicalIF":2.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Missed colorectal cancer diagnosis by screening colonoscopy based on the PLCO cancer screening trial.","authors":"Ying Li, Huan Xiong, Tongzhou Liang, Yuying Liu, Longjun He, Wencheng Tan, Yuhong Wang, Xiaofang Qiu, Bilv Zhong, Chuanbo Xie, Jianjun Li","doi":"10.1007/s00384-025-04952-4","DOIUrl":"10.1007/s00384-025-04952-4","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the proportion of colorectal cancer (CRC) missed by colonoscopy and the characteristics of the patients with missed diagnosis using data from the prostate, lung, colorectal, and ovarian (PLCO) cancer screening trial, and to analyze and compare patient survival between detection and missed diagnosis groups for an evidence-based basis for improving the effectiveness of colorectal cancer screening.</p><p><strong>Patients and methods: </strong>Patients with CRC identified by baseline or follow-up colonoscopy and those identified by annual study update questionnaires or National Death Index search, without any positive findings by colonoscopy in the screening arm of the PLCO study, were included in this study. We calculated the rate of missed CRC diagnosis by colonoscopy using the definition of missed cases as the numerator and the sum of patients with CRC as the denominator.</p><p><strong>Results: </strong>Three hundred sixty patients with CRC were included in the final analysis (detection group, n = 298; missed diagnosis group, n = 62). The overall rate of missed CRC diagnosis by colonoscopy was 17.22%. Patients with a history of colorectal polyps had a higher rate of missed diagnoses (33.3%). The missed diagnosis rate was higher in patients with proximal CRC (31.3%). CRC occurring in the transverse colon (29.6%), hepatic flexure of the colon (40.0%), ascending colon (27.0%), and cecum (36.6%) were more likely to be missed by colonoscopy. The later the stage, the higher the missed CRC diagnosis rate (10.5, 20.0, 30.8, and 30.8% for stages I-IV, respectively).</p><p><strong>Conclusion: </strong>Colonoscopy missed a relatively high proportion of CRC, mainly in the proximal colon (especially in the hepatic flexure and cecum of the colon). Recent developments in non-invasive screening technologies, such as stool DNA testing and liquid biopsy, may help address the limitations of colonoscopy. Combining these approaches with traditional endoscopy could enhance overall detection accuracy and reduce the rate of missed colorectal cancer.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"206"},"PeriodicalIF":2.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of machine-learning model based on dynamic tumor markers in predicting pathological complete response after neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer: a multicenter cohort study.","authors":"Bin Chen, Tengyi Peng, Zhen Pan, Shoufeng Li, Ye Wang, Shaoqing Zheng, Jinfu Zhuang, Xing Liu, Xingrong Lu, Changqing Zeng, Guoxian Guan","doi":"10.1007/s00384-025-04993-9","DOIUrl":"10.1007/s00384-025-04993-9","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we constructed a new pCR predictor based on dynamic tumor marker changes before and after NCRT, the dynamic tumor marker score (DTMS), and combined it with other clinicopathological features to build a machine-learning model.</p><p><strong>Methods: </strong>In this retrospective study of patients with LARC between September 2010 and October 2017 at The First Affiliated Hospital of Fujian Medical University (FJMUFAH), Fujian Medical University Union Hospital (FJMUUH), and Fujian Provincial Hospital (FJPH), the DTMS predictor was constructed using logistic regression. Factors associated with pCR were screened using single-factor and multifactorial logistic regression, and 10 machine-learning algorithms were used to construct a pCR prediction model. Additionally, various metrics, including the area under the receiver operating characteristic curve (AUC), area under the precision-recall curve (AUPRC), decision curve analysis, and calibration curves, were obtained to validate the model performance and verified using an external validation set. Finally, SHapley Additive exPlanations (SHAP) values were used to interpret the predictive model. Moreover, we developed a website to facilitate the use of prediction modeling.</p><p><strong>Results: </strong>After analyzing the data of 892 patients with LARC from FJMUFAH, DTMS, tumor size, N stage, and tumor distance from the anal verge were identified as independent predictive factors for pCR using univariate and multivariate regression analyses. The \"extreme gradient boosting\" (XGB) model displayed the best performance in the training set, with a mean AUC value of 0.86, an AUPRC value of 0.732, and SHAP values utilized in the analysis. In the two external validation sets, the model yielded AUC values of 0.80 and 0.82, along with corresponding AUPRC values of 0.519 and 0.593, respectively, which were the highest among all ten evaluated models, incorporating the use of SHAP values in the analysis. The model maintained superior predictive efficacy in the external validation cohorts (FJMUUH and FJPH).</p><p><strong>Conclusions: </strong>As a novel marker based on dynamic changes in CEA and CA19-9 levels, DTMS effectively predicted pCR within the XGB model, providing clinicians with a practical tool for treatment decision-making regarding LARC.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"204"},"PeriodicalIF":2.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-operative ultrasound in the surgical treatment of complex and recurrent pilonidal disease: a retrospective, observational, single-center study.","authors":"Gaetano Gallo, Marta Goglia, Veronica De Simone, Gianpiero Gravante, Pierpaolo Sileri, Antonio Crucitti, Marco La Torre","doi":"10.1007/s00384-025-04961-3","DOIUrl":"10.1007/s00384-025-04961-3","url":null,"abstract":"<p><strong>Background: </strong>Pilonidal disease (PD) is frequently associated with high recurrence rates and delayed healing, particularly in complex or recurrent cases. While Endoscopic Pilonidal Sinus Treatment (EPSiT) has improved postoperative recovery and patient satisfaction, its effectiveness can be limited by incomplete identification of fistulous tracts. Intraoperative ultrasound (IUS) offers real-time visualization of subcutaneous structures and may aid in detecting hidden tracts during surgery. This study evaluates the clinical outcomes of combining IUS with EPSiT in the treatment of complex and recurrent PD.</p><p><strong>Materials and methods: </strong>A retrospective cohort, single-center study was conducted on patients with recurrent and complex PD treated between 2018 and 2021 using IUS in conjunction with EPSiT. All patients had a minimum follow-up of 36 months. The study recorded the number of cases in which IUS identified additional fistulous tracts and led to a modification of the surgical strategy, as well as clinical outcomes including recurrence rate, time to wound healing, and incidence of incomplete wound healing.</p><p><strong>Results: </strong>Nineteen patients were included (14 males, 73.7%; mean age of 35.4 ± 6.4 years). The mean operative time was 42 min, with IUS requiring an additional 6 min. IUS identified previously undetected fistulous tracts in 6 patients (31.5%), leading to modifications in the surgical strategy. At 36-month follow-up, disease persistence (recurrence or incomplete healing) was observed in 5 patients (26.3%). Recurrent cases were successfully managed with additional procedures, achieving 100% healing after reintervention.</p><p><strong>Conclusions: </strong>Intraoperative IUS identified previously undetected secondary tracts in 31.5% of patients, leading to a modification of the surgical approach. Further comparative studies are needed to validate its effectiveness and assess its potential role as a standard adjunct in the surgical management of pilonidal disease.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"203"},"PeriodicalIF":2.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arterial flow in healthy individuals and patients with hemorrhoidal disease: a Doppler ultrasound-based pathophysiological analysis.","authors":"Gianpiero Gravante, Veronica De Simone, Roberto Sorge, Arcangelo Picciariello, Pierpaolo Sileri, Gaetano Gallo","doi":"10.1007/s00384-025-04951-5","DOIUrl":"10.1007/s00384-025-04951-5","url":null,"abstract":"<p><strong>Background: </strong>To evaluate arterial flow patterns in healthy individuals and patients with hemorrhoidal disease (HD) using Doppler transperineal ultrasound (TPUS), aiming to clarify the vascular contribution to HD pathophysiology.</p><p><strong>Methods: </strong>A prospective observational study was conducted on 50 healthy controls (HC) and 94 HD patients classified by Goligher grade. All underwent TPUS with Doppler assessment to record vascular patterns and quantify peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI).</p><p><strong>Results: </strong>A vascular Doppler pattern was observed in 92.6% of HD patients vs. 50% of HCs (p < 0.001). HD patients showed significantly higher PSV (11.1 ± 3.6 cm/s vs. 8.3 ± 2.9 cm/s, p < 0.001) and RI (0.8 ± 0.1 vs. 0.7 ± 0.1, p = 0.015), with no significant difference in EDV. Among Goligher groups, grades III and IV showed significantly elevated PSV compared to HCs. No differences were observed in EDV or RI among subgroups.</p><p><strong>Conclusion: </strong>Doppler TPUS can identify distinct hemodynamic profiles in HD patients, supporting a vascular component in HD pathogenesis. Its ability to detect subclinical alterations and distinguish severity grades may enhance diagnostic accuracy and guide tailored treatment strategies.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"202"},"PeriodicalIF":2.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interobserver agreement of the Taulí-pT1 classification in rectal pT1 adenocarcinoma.","authors":"Cristina Gener-Jorge, Joan Carles Ferreres Piñas, Ana Belén Moreno Garcia, Doris Sofia Melgar Rivera, Alex Casalots, Anna Nonell, Beatriz Espina, Aleidis Caro-Tarragó, Xavier Serra-Aracil","doi":"10.1007/s00384-025-04996-6","DOIUrl":"10.1007/s00384-025-04996-6","url":null,"abstract":"<p><strong>Purpose: </strong>In pT1 rectal adenocarcinoma, adverse pathological features guide the indication for radical surgery; however, they are present in only 10-15% of cases. Therefore, in most patients, accurate en bloc local excision with clear margins and precise submucosal invasion assessment is essential for appropriate risk stratification. Beyond absolute depth, a major challenge is the wide interindividual variability in submucosal thickness. The Taulí-pT1 classification, based on the measurement of healthy residual submucosa (hrSB) from the muscularis propria, has been proposed as an objective and reproducible system. This study aimed to validate this classification.</p><p><strong>Method: </strong>An interobserver study was conducted on 30 patients with pT1 rectal adenocarcinoma treated by transanal endoscopic surgery. Four pathologists with varying experience levels independently evaluated digitized histological slides, measuring hrSB, total submucosal thickness, and invasion depth. They also classified specimens as sm1, sm2, or sm3. Interobserver agreement was assessed using intraclass correlation coefficients (ICC), and Fleiss' and Cohen's kappa indices.</p><p><strong>Results: </strong>Excellent interobserver agreement was observed for hrSB (ICC = 0.99; 95% CI: 0.98-0.99), total submucosal thickness (ICC = 0.96; 95% CI: 0.93-0.98), and depth of invasion (ICC = 0.94; 95% CI: 0.9-0.97). The Taulí-pT1 classification demonstrated good agreement (Fleiss' kappa = 0.71). Identification of the muscularis mucosae showed moderate agreement (kappa = 0.612).</p><p><strong>Conclusion: </strong>The Taulí-pT1 classification demonstrates high interobserver reproducibility, even among pathologists with varying levels of experience, supporting its utility as an objective and standardized tool for the assessment of pT1 rectal adenocarcinoma.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov Identifier: NCT06218108.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"201"},"PeriodicalIF":2.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to multi-target stool DNA colorectal cancer screening and clinical follow-up in the Hartford HealthCare system.","authors":"Shrey Gohil, Daniel D'Attilio, Ruchir Paladiya, Arup Ganguly, Cunegundo Manuel Vergara, Jordan J Karlitz, Mallik Greene","doi":"10.1007/s00384-025-04997-5","DOIUrl":"10.1007/s00384-025-04997-5","url":null,"abstract":"<p><strong>Background: </strong>The multi-target stool DNA (mt-sDNA) test is a growing and convenient option for colorectal cancer (CRC) screening. Adherence to screening is critical to optimize patient outcomes. This study aimed to evaluate real-world adherence to mt-sDNA testing and the rate of follow-up colonoscopy after positive results among average-risk patients within a large regional health system.</p><p><strong>Methods: </strong>This retrospective cohort study included patients aged 45-75 years in the Hartford HealthCare system whose provider ordered an mt-sDNA test between August 2014 and May 2023. Those at high risk of CRC were excluded. Adherence was defined as the return of a successfully completed test with valid results within 365 days of shipment. Rates of and time to follow-up colonoscopy were assessed in mt-sDNA-positive patients. Logistic regression assessed characteristics associated with adherence.</p><p><strong>Results: </strong>Of 24,945 included patients, 96.8% had never previously taken an mt-sDNA test and 60.5% were female. Overall, 17,240 patients (69.1%) adhered to the mt-sDNA test. Younger adults aged 45-49 years had high adherence (74.0%). Logistic regression found age 45-49 years, income > $75K, history of mt-sDNA adherence, and seeing a gastrointestinal specialist were predictors of greater adherence. Of 2,468 patients (14.3%) with positive test results, 1,686 (68.3%) had follow-up colonoscopies within a year, and 1,322 (53.6%) within 4 months, of the test result.</p><p><strong>Conclusions: </strong>In this regional health system, nearly 70% of patients adhered to mt-sDNA testing. Among those with positive results, 68.3% completed follow-up colonoscopies. These findings highlight the potential utility of mt-sDNA testing in supporting CRC screening and follow-up in certain clinical settings.</p><p><strong>Impact: </strong>mt-sDNA testing may support improved CRC screening adherence and timely follow-up in certain health care settings.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"200"},"PeriodicalIF":2.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colonic Volvulus Associated with Hirschsprung's Disease in the Pediatric Age.","authors":"Hazem Samir Amra, Mostafa M Elghandour, Mohammed Abdel-Latif","doi":"10.1007/s00384-025-04994-8","DOIUrl":"10.1007/s00384-025-04994-8","url":null,"abstract":"<p><strong>Purpose: </strong>Colonic volvulus (CV) is a twist of part of the colon over its mesentery. Although CV is rare in children, its incidence is unknown. Hirschsprung's disease (HD) represents a significant risk factor of CV in children, especially when diagnosed late.</p><p><strong>Aim: </strong>To review the clinical, radiological and management data of children with CV associated with HD.</p><p><strong>Methods: </strong>Medical records were reviewed from January 2000 to December 2022 looking for children had CV associated with HD.</p><p><strong>Results: </strong>21 cases (17 males and 4 females) were admitted with CV. Their ages ranged from 8 days to 14 years. Sigmoid volvulus was recorded in 17 (81%) cases, while 4 (19%) cases had cecal volvulus. CV was associated with HD in 9 (42.9%) cases. Their median age was 7 years. Eight cases had sigmoid volvulus associated with short segment HD, while one case had cecal volvulus with long segment HD. CV was the first presentation, before the diagnosis of HD, in 8 cases. The diagnosis of HD was overlooked in 3 cases; 2 cases had an anastomotic leakage after sigmoidectomy, while the third case had recurrence of volvulus after successful nonoperative management.</p><p><strong>Conclusion: </strong>The diagnosis of CV in children mandates a high index of suspicion. Moreover, HD should be suspected and excluded in every case of CV in children.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"199"},"PeriodicalIF":2.3,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visceral obesity as a predictor of ileal pouch reachability in ulcerative colitis: A prospective single-center study.","authors":"Yuki Horio, Motoi Uchino, Masato Kiriki, Yusuke Tomoo, Kazunori Nomura, Kentaro Nagano, Kurando Kusunoki, Ryuichi Kuwahara, Kei Kimura, Kozo Kataoka, Masataka Ikeda, Hiroki Ikeuchi","doi":"10.1007/s00384-025-04990-y","DOIUrl":"10.1007/s00384-025-04990-y","url":null,"abstract":"<p><strong>Aim: </strong>Obesity has been reported to increase the risk of technical inability in performing ileal pouch-anal anastomosis (IPAA) in patients with ulcerative colitis (UC). This study aimed to prospectively investigate the association between visceral fat and the feasibility of pouch reach in hand-sewn IPAA.</p><p><strong>Methods: </strong>We prospectively enrolled patients with UC scheduled for two-stage restorative proctocolectomy with a preoperative plan for hand-sewn IPAA. Patients were categorized into a conversion group that required conversion to stapled IPAA intraoperatively and a non-conversion group. Preoperative visceral fat area and anatomical indicators were measured using computed tomography (CT). Logistic regression analysis was performed to identify predictors of conversion surgery.</p><p><strong>Results: </strong>A total of 106 patients were included, with 12 (11.3%) in the conversion group. Compared with those in the non-conversion group, patients in the conversion group had significantly higher body mass index (BMI), greater visceral fat, and a longer distance between the ileal end and the anal verge (p < 0.01). Logistic regression identified visceral fat (per 10 cm² increase: odds ratio [OR] 1.19, 95% confidence interval [CI] 1.02-1.39, p = 0.01) as a significant predictor of conversion surgery, whereas BMI was not (OR 1.03, 95% CI 0.77-1.21, p = 0.72).</p><p><strong>Conclusions: </strong>Visceral fat is an independent risk factor for conversion surgery in patients undergoing hand-sewn IPAA. Preoperative CT-based measurement of visceral fat may provide a more accurate prediction of pouch reachability than BMI alone. These findings may help surgeons decide preoperatively whether a hand-sewn IPAA is feasible.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"197"},"PeriodicalIF":2.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}