International Journal of Colorectal Disease最新文献

{"title":"Perioperative and oncological outcomes of extended surgery for colorectal cancer in younger patients: a propensity score-matched study.","authors":"Katsuhiro Ogawa, Yuji Miyamoto, Ayane Kawata, Takahiko Akiyama, Kota Arima, Keisuke Kosumi, Kojiro Eto, Kazuto Hadara, Yukiharu Hiyoshi, Masaaki Iwatsuki","doi":"10.1007/s00384-026-05140-8","DOIUrl":"https://doi.org/10.1007/s00384-026-05140-8","url":null,"abstract":"<p><strong>Background: </strong>Extended surgery, including multivisceral resection, synchronous metastasectomy, and concomitant procedures for coexisting diseases, is occasionally required to achieve oncological clearance in patients with colorectal cancer. However, the perioperative and oncological impact of extended surgery in younger patients remains unclear. This study aimed to evaluate short- and long-term outcomes of extended surgery in younger patients with colorectal cancer.</p><p><strong>Methods: </strong>We conducted a single-center retrospective study of patients aged ≤ 65 years who underwent colorectal cancer surgery between 2014 and 2023. Extended surgery was defined as multivisceral resection for locally advanced tumors, resection of synchronous metastatic lesions, or concomitant surgery for coexisting diseases. Propensity score matching was performed to compare short-term postoperative outcomes and overall survival between extended and standard surgery. A secondary analysis compared younger and elderly patients who underwent extended surgery. The primary endpoint was overall survival.</p><p><strong>Results: </strong>After matching, 41 patients who underwent extended surgery were compared with 42 who underwent standard surgery. Extended surgery was associated with longer operative time and greater blood loss. However, rates of anastomotic leakage, major postoperative complications, and mortality were comparable between groups. Overall survival did not differ significantly between extended and standard surgery in younger patients. In addition, postoperative outcomes and overall survival were similar between younger and elderly patients undergoing extended surgery.</p><p><strong>Conclusions: </strong>Extended surgery was associated with increased operative invasiveness but did not adversely affect perioperative outcomes or overall survival in appropriately selected younger patients with colorectal cancer. These findings suggest that extended surgery may be considered when indicated by oncological factors, irrespective of chronological age.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trans-Pfannenstiel sigmoidectomy for sigmoid volvulus: description of a novel surgical technique and initial experience from a retrospective case series.","authors":"Valentina Murzi, Mauro Podda, Francesco Balestra, Marcello Pisano, Alessandra Saba, Alessia Dessì, Raimondo Sanna, Eleonora Silanos, Marco Puledda, Adolfo Pisanu","doi":"10.1007/s00384-026-05143-5","DOIUrl":"https://doi.org/10.1007/s00384-026-05143-5","url":null,"abstract":"<p><strong>Purpose: </strong>Sigmoid volvulus is a recurrent cause of large bowel obstruction that predominantly affects elderly and frail patients. After successful endoscopic detorsion, elective sigmoid resection is recommended to prevent recurrence. This study describes a new, trans-Pfannenstiel approach for sigmoidectomy and reports the initial clinical experience with this technique.</p><p><strong>Methods: </strong>This study was designed as a single-center retrospective case series. Adult patients surgically treated for sigmoid volvulus between 2024 and 2025 were included. All patients underwent successful endoscopic detorsion and decompression followed by planned surgical resection. The primary outcome was postoperative complications within 30 days. Surgical technique, perioperative outcomes and short-term follow-up were analyzed.</p><p><strong>Results: </strong>Eleven patients were included, with a median age of 71 years (IQR 51-79); five patients (45.4%) were classified as ASA III, and nine patients (63.6%) had experienced two or more previous episodes of volvulus. Median operative time was 105 min (IQR 90-125). No patient required postoperative intensive care or reoperation. Postoperative complications occurred in four patients (36.4%), with one Clavien-Dindo grade IIIa complication managed non-operatively with CT-guided percutaneous drainage. Median length of hospital stay was 6 days (IQR 5-6). Three patients (27.3%) required early readmission for medical complications (one Clavien-Dindo IIIa and two Clavien-Dindo II complications). No postoperative mortality or recurrence of sigmoid volvulus was observed during a median follow-up of 394 days (IQR 246-434).</p><p><strong>Conclusions: </strong>Trans-Pfannenstiel sigmoidectomy is a feasible, safe, and reproducible technique for the surgical management of sigmoid volvulus in selected patients. When performed after endoscopic decompression in a planned setting, it allows definitive treatment while limiting abdominal wall trauma in a fragile population.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of web-based prediction models for major low anterior resection syndrome at 3 and 6 months after sphincter-preserving surgery in patients with rectal cancer.","authors":"Lin Sun, Xiaoshuang Zhang, Qiang Zhou, Jiacheng Wang, Minjing Shen, Yuzhen Ding, Zhiqiang Zhu, Jianbo Yang, Xi Wang, Juju Huang, Haonan Fang","doi":"10.1007/s00384-026-05133-7","DOIUrl":"https://doi.org/10.1007/s00384-026-05133-7","url":null,"abstract":"<p><strong>Objective: </strong>To analyse the factors influencing major low anterior resection syndrome (LARS) at 3 months and 6 months after surgery in rectal cancer patients undergoing sphincter-preserving procedures, and separately develop and validate risk prediction models for the 3-month and 6-month postoperative periods.</p><p><strong>Methods: </strong>This study enrolled patients who underwent radical sphincter-preserving surgery for rectal cancer at the First Affiliated Hospital of the University of Science and Technology of China between August 2017 and September 2024. The LARS scale was used to assess bowel function at 3 months and 6 months postoperatively. In total, 794 patients at 3 months postoperatively and 749 patients at 6 months postoperatively were included and randomly allocated to a training set and a validation set in a 7:3 ratio. Least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression were used to identify factors influencing major LARS at 3 months and 6 months postoperatively, and to separately develop risk prediction models for the two time points. Receiver operating characteristic (ROC) curves, calibration curves, and clinical decision curve analysis were applied to evaluate the discrimination, calibration, and clinical applicability of the two models.</p><p><strong>Results: </strong>Multivariable logistic regression demonstrated that preoperative chemotherapy, preoperative radiotherapy, and tumour distance from the anal verge were common risk factors associated with major LARS at 3 months and 6 months postoperatively in rectal cancer patients undergoing sphincter-preserving surgery. Anastomotic leakage was identified as a risk factor specific to 3 months postoperatively, whereas prophylactic stoma was a risk factor specific to 6 months postoperatively. Based on these findings, risk prediction models for major LARS at 3 months and 6 months postoperatively were developed, and interactive web-based calculators were developed using the RShiny platform, accessible at https://zhang13579.shinyapps.io/Postoperative_3-Month/ and https://zhang13579.shinyapps.io/Postoperative_6-Month/, respectively. Both models demonstrated good predictive performance in the training cohort and the validation cohort, as assessed by discrimination, calibration, and clinical applicability.</p><p><strong>Conclusion: </strong>The risk prediction models for major LARS at 3 months and 6 months postoperatively in rectal cancer patients undergoing sphincter-preserving procedures developed in this study demonstrated good predictive performance and can assist clinical healthcare professionals in identifying patients at high risk of major LARS.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete pathologic response surrogacy for survival and its predictors in locally advanced rectal cancer: a retrospective cohort study.","authors":"Reza Ghalehtaki, Romina Abyaneh, Samaneh Salarvand, Saeid Rezaei, Azadeh Sharifian, Farzaneh Bagheri, Reza Nazari, Naeim Nabian, Sara Naseri, Setayesh Mostakhdemin Hoseini, Ali Nouranifar, Hamid Reza Javid, Negin Mohammadi, Nima Mousavi Darzikolaee, Behnam Behboudi, Mohsen Ahmadi Tafti, Mohammadsadegh Fazeli, Amir Keshvari, Alireza Kazemeini, Mohammadreza Keramati, Haleh Pak, Mohammad Babaei, Farshid Farhan, Ehsan Saraee, Mahdi Aghili, Kasra Kolahdouzan","doi":"10.1007/s00384-026-05142-6","DOIUrl":"https://doi.org/10.1007/s00384-026-05142-6","url":null,"abstract":"<p><strong>Background: </strong>Improved treatment techniques in locally advanced rectal cancer (LARC) with neoadjuvant chemoradiation and total mesorectal excision have resulted in higher rates of tumor downstaging and complete pathologic response (pCR). We aimed to explore the association of pCR with survival outcomes and its predictors.</p><p><strong>Methods: </strong>We retrospectively enrolled 478 LARC patients referred to a tertiary cancer center from July 2008 to October 2023 who had received neoadjuvant long-course chemoradiation followed by definitive surgery. The patients were followed up, and the association of pCR with disease-free survival (DFS) and overall survival (OS), as well as its predictors, was analyzed.</p><p><strong>Results: </strong>Ninety-one (22.5%) patients achieved a pCR and 167 (39.9%) patients were downstaged to ypT_0-2ypN₀. The 5-year OS and DFS rates were 64.1% and 56% in patients without a pCR and 90.3% and 91.8% in patients with a pCR, respectively (p-value < 0.001). Receipt of adjuvant chemotherapy in patients who did not achieve a pCR did not improve either DFS or OS (p-value 0.44 and 0.73, respectively). Clinical N2 and preoperative carcinoembryonic antigen (CEA) > 5ng/mL independently predicted for pCR.</p><p><strong>Conclusions: </strong>Our study underscores the importance of pCR as an independent predictor of survival in LARC. Patients with higher nodal burden as well as an abnormal preoperative CEA are less likely to achieve a pCR.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous sedation combined with local anesthesia versus spinal anesthesia for hemorrhoidectomy with rubber band ligation: A retrospective cohort study.","authors":"Limian Ling, Can Lu, Federico Maria Mongardini, Zhaohui Liu, Lei Bao, Xiaowen Ji, Ying Luo, Qun Deng, Feng Yu, Ludovico Docimo, Massimo Mongardini, Shaojun Yu, Wenwen Zheng","doi":"10.1007/s00384-026-05139-1","DOIUrl":"https://doi.org/10.1007/s00384-026-05139-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Evidence comparing intravenous sedation combined with local anesthesia (IV + LA) versus spinal anesthesia (SA) for hemorrhoidectomy with concomitant rubber band ligation (RBL) is limited, particularly in the context of ambulatory-oriented pathways.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a single-center retrospective cohort study including consecutive adults undergoing hemorrhoidectomy with RBL between January 2024 and January 2026. Patients were grouped by anesthetic technique (IV + LA vs SA). The primary outcome was postoperative pain at 24 h measured by the numerical rating scale (NRS). Secondary outcomes included early pain at 6 h, rescue analgesia within 24 h, recovery metrics (time to meet discharge criteria), and anesthesia-related adverse events. Multivariable regression adjusted for prespecified confounders (age, sex, body mass index, American Society of Anesthesiologists class, operative time, extent of hemorrhoidectomy, number of bands, and year of surgery). Propensity-score inverse probability of treatment weighting (IPTW) and an additional sensitivity analysis stratified by calendar period were performed to assess the robustness of the findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 220 screened patients, 146 were included (IV + LA, n = 72; SA, n = 74). NRS at 24 h was lower with IV + LA than with SA (1.2 ± 1.1 vs 2.1 ± 1.2; mean difference - 0.9, 95% CI - 1.27 to - 0.53; P &lt; 0.001), although the magnitude of this difference was modest. Patients receiving SA required 5.5 ± 1.3 h to meet discharge criteria, compared with 2.8 ± 0.9 h in the IV + LA group (P &lt; 0.001). Urinary retention requiring catheterization within 6 h occurred in 17 of 74 patients (23.0%) in the SA group and in none of the 72 patients in the IV + LA group (absolute risk difference, - 23.0 percentage points; P &lt; 0.001). Because no urinary retention events occurred in the IV + LA group, the corresponding adjusted odds ratio should be interpreted cautiously owing to model instability from complete separation. In multivariable analysis, SA remained independently associated with higher NRS at 24 h (β = 0.92, 95% CI 0.56-1.26; P &lt; 0.001), whereas higher odds of hypoxemia/oxygen supplementation were observed in the IV + LA group (adjusted OR 3.89, 95% CI 1.13-13.37; P = 0.014). IPTW diagnostics suggested improved covariate balance and adequate propensity-score overlap, and the direction of the association for the primary outcome was unchanged in sensitivity analyses stratified by calendar period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;For hemorrhoidectomy with RBL, IV + LA and SA were associated with different perioperative trade-offs. Compared with SA, IV + LA was associated with modestly lower 24-h pain scores, faster discharge readiness, and fewer early urinary retention events requiring catheterization, but more frequent hypoxemia/oxygen supplementation. Given the retrospective design, temporal practice change, potential residual confo","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and external validation of an interpretable multimodal deep learning model for 5-year mortality in high-risk stage ii colorectal cancer.","authors":"Xin Li, Lei Liang, Zhong-Hua Liu, Chun Wang, Tawfik Ali Hamood Alburiahi, Zhen-Ya Yang, Ning Xu, Jun Yang","doi":"10.1007/s00384-026-05132-8","DOIUrl":"https://doi.org/10.1007/s00384-026-05132-8","url":null,"abstract":"<p><strong>Purpose: </strong>High-risk stage II colorectal cancer (CRC) shows heterogeneous outcomes despite adjuvant chemotherapy. We developed and validated an interpretable multimodal deep learning model integrating clinical data, serum biomarkers, and venous-phase CT to predict 5-year CRC-specific mortality in high-risk stage II CRC.</p><p><strong>Methods: </strong>This retrospective, multicenter cohort included 778 high-risk stage II CRC patients from three centers, all treated with adjuvant chemotherapy and with complete preoperative clinical, biomarker, and venous-phase CT data. Patients were split into a development cohort (Centers A + B, n = 720) and an external testing cohort (Center C, n = 58). A multimodal model combining numerical (clinical + biomarker) and imaging (CT) inputs was developed and internally validated using tenfold cross-validation in the development cohort and evaluated in the external cohort. Interpretability was assessed using SHAP and Grad-CAM.</p><p><strong>Results: </strong>In the development cohort, the multimodal model showed superior discrimination (AUC 0.89; 95% CI, 0.87-0.91) versus numerical-only (AUC 0.76) and imaging-only (AUC 0.69). In the external testing cohort (9/58 CRC-specific deaths), the multimodal model achieved an AUC of 0.88 (95% CI, 0.76-0.96). SHAP and Grad-CAM consistently highlighted age, CA125, and tumor regions on CT as key contributors.</p><p><strong>Conclusion: </strong>This interpretable multimodal approach, using routine clinical, biomarker, and CT data, improves 5-year mortality risk stratification in high-risk stage II CRC and may inform risk-adapted surveillance and clinical decision support; prospective validation is warranted before treatment modification.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a predictive scoring model for post-ESD coagulation syndrome in elderly with colorectal LSTs.","authors":"Qian Zhang, Fengcheng Zang, Bin He, Yunfu Feng, Zhibing Wang, Xiaodan Xu, Jian Chen, Luojie Liu, Wenwen Diao","doi":"10.1007/s00384-026-05141-7","DOIUrl":"https://doi.org/10.1007/s00384-026-05141-7","url":null,"abstract":"<p><strong>Background: </strong>Post-endoscopic submucosal dissection (ESD) electrocoagulation syndrome (PEECS) is a known complication in colorectal laterally spreading tumors (LSTs), but its risk factors in elderly patients remain unclear. This study aimed to develop and validate a risk-stratification scoring system for PEECS in elderly ESD patients.</p><p><strong>Methods: </strong>A multicenter retrospective study (2020-2025) enrolled 506 elderly patients with colorectal LSTs undergoing ESD, randomly allocated to training (TC, n = 354) and validation (VC, n = 152) cohorts (7:3). Synthetic minority over-sampling technique (SMOTE) was used in the TC to identify risk factors and construct a predictive model, which was validated in the VC.</p><p><strong>Results: </strong>The incidence of post-ESD PEECS was 8.1% (41 cases). After applying the SMOTE, multivariate analysis identified sex, lesion with fibrosis, and intraoperative bleeding as independent risk factors. The scoring system assigned: 1 point for female sex, 3 points for lesion with fibrosis, and 2 points for intraoperative bleeding. In the VC, the model demonstrated an area under the curve (AUC) of 0.921, with a specificity of 0.949 and an accuracy of 0.908. Following risk stratification, the low-risk group (0-4 points) showed a PEECS incidence of 10.1% in the TC and 5.1% in the VC, while the high-risk group (5-6 points) exhibited 94.5% in the TC and 53.3% in the VC.</p><p><strong>Conclusion: </strong>In elderly patients with colorectal LSTs undergoing ESD, female sex, fibrotic lesions, and intraoperative bleeding were identified as independent predictors of PEECS. The proposed scoring system demonstrated good discriminatory ability in both cohorts and may be useful for risk stratification in this population.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic direct-vision therapy vs. antibiotics for acute uncomplicated appendicitis: a retrospective cohort study.","authors":"Li-Peng Chen, Feng Zhou, Qirun Cheng, Yu-Liang Feng","doi":"10.1007/s00384-026-05136-4","DOIUrl":"https://doi.org/10.1007/s00384-026-05136-4","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic direct-vision appendicitis therapy (EDAT) is an emerging ultra-minimally invasive technique for acute uncomplicated appendicitis (AUA). Its comparative effectiveness against antibiotic therapy remains unclear.</p><p><strong>Purpose: </strong>To compare short-term outcomes and recurrence rates of EDAT versus antibiotic therapy in AUA.</p><p><strong>Methods: </strong>This retrospective cohort study included 92 AUA patients (41 EDAT, 51 antibiotics). Outcomes included symptom relief, hospital stay, inflammatory markers, treatment success, and recurrence. Subgroup analyses were performed based on fecalith presence and baseline inflammation severity.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups (all P > 0.05), except for a significantly higher prevalence of fecaliths in the EDAT group (43.9% vs. 21.6%, P = 0.022). EDAT was associated with significantly faster abdominal pain relief [median 12.0 (IQR 12.0-24.0) h vs. 24.0 (12.0-36.0) h, P = 0.008], shorter hospital stay [3.0 (2.0-3.5) days vs. 4.0 (3.0-5.0) days, P < 0.001], and lower postoperative inflammatory markers (WBC =6.83 ± 1.39 vs. 8.53 ± 1.87 × 10⁹/L, P < 0.001; CRP =7.89 ± 2.98 vs. 21.16 ± 12.21 mg/L, P < 0.001). Initial treatment success was 100% in both groups (EDAT = 41/41, antibiotics = 51/51; P = 1.000). At a mean follow-up of 7.88 ± 3.52 months (EDAT) and 14.92 ± 2.61 months (antibiotics), recurrence rates were 7.3% (3/41) vs. 27.5% (14/51), respectively (P = 0.014). Subgroup analyses confirmed that EDAT's advantages were consistent across patients with and without fecaliths, as well as across different levels of baseline inflammation severity.</p><p><strong>Conclusion: </strong>In selected patients with AUA, EDAT offers faster symptom resolution, better early inflammatory control, and significantly lower recurrence rates compared with antibiotic therapy. The presence of fecaliths and elevated baseline CRP predicts a higher risk of antibiotic failure, suggesting that EDAT may be particularly valuable in these subgroups. Further prospective studies are warranted to clarify the role of EDAT relative to surgical appendectomy.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary team-guided combined endoscopic laparoscopic surgery for complex colonic lesions: a single-center retrospective cohort study.","authors":"Mustafa Bulut, Svend Knuhtsen, Jens Ravn Eriksen, Lasse Bremholm, Ismail Gögenur","doi":"10.1007/s00384-026-05131-9","DOIUrl":"https://doi.org/10.1007/s00384-026-05131-9","url":null,"abstract":"<p><strong>Purpose: </strong>Combined endoscopic laparoscopic surgery (CELS) is a minimally invasive alternative treatment for complex colonic polyps that can reduce surgical overtreatment. We report implementing a standardized treatment strategy with patients selected for CELS procedures via multidisciplinary team (MDT) conferences.</p><p><strong>Methods: </strong>This observational cohort study included 97 consecutive patients treated with CELS between 2016 and 2022. All cases were discussed by either a benign or malignant MDT. Two CELS techniques were employed: endoscopically assisted wedge resection (EA-WR) and laparoscopically assisted endoscopic mucosal resection (LA-EMR). Patients with suspected malignancies underwent step-up segmental resection (SR) if necessary. Primary outcomes were morbidity and mortality; secondary outcomes included adherence to MDT decisions, procedure durations, length of stay (LOS), histopathology, recurrence, and follow-up.</p><p><strong>Results: </strong>The approach decided by the MDT was unchanged in 81% of cases (79/97). Median age was 70 years and 43% were female. Lesions had a mean size of 31 mm and were predominantly located in the right colon. Technical success for lesion removal during the index procedure was 98% (95/97), with 93% completed by CELS alone. Median operative durations were shorter for EA-WR (52 min) and LA-EMR (73 min) than for SR (163 min, p < 0.001). Median LOS was 1 day for CELS and 5 days for SR (p < 0.001). Eleven patients (11.3%) experienced complications; four required re-interventions. Adenocarcinomas were found in 15 patients (15/97, 12.6%), with treatment individualized based on intraoperative and histological findings. The recurrence rate for benign lesions was 4%; these recurrences were exclusively in the LA-EMR group.</p><p><strong>Conclusion: </strong>An MDT-guided strategy incorporating CELS, with optional intraoperative step-up, is an individualized and organ-preserving approach to managing complex colonic lesions that minimizes unnecessary surgical resections. This strategy has the potential to improve clinical decision-making and should be validated in multicenter settings.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disclosure of mesh origin in rectopexy: an under-recognized component of informed consent.","authors":"Eleftherios Gialamas, Frédéric Ris, Zoe Garoufalia, Guillaume Meurette","doi":"10.1007/s00384-026-05138-2","DOIUrl":"10.1007/s00384-026-05138-2","url":null,"abstract":"","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770778","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}