International Journal of Colorectal Disease最新文献

{"title":"Postoperative complications and hospital costs following elective and emergency colon cancer surgery: a Clavien-Dindo grade-specific cost analysis.","authors":"Sandra Bech-Larsen, Tomas Vedin, Jenny Engdahl, Astrid Öberg, Stefan Öberg","doi":"10.1007/s00384-026-05252-1","DOIUrl":"10.1007/s00384-026-05252-1","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative complications are drivers of healthcare costs following colon cancer surgery. We compared hospital costs between elective and emergency colon cancer resections according to complication severity.</p><p><strong>Methods: </strong>This retrospective cohort study included 520 patients undergoing colon cancer resection, of whom 431 underwent elective and 89 emergency surgery. Postoperative complications were graded according to the Clavien-Dindo classification. Hospital costs were analysed using a micro-costing approach. Adjusted costs were estimated using generalized linear models with gamma distribution and log link, adjusting for tumour stage, ASA classification, age and sex, with surgical technique in elective surgery.</p><p><strong>Results: </strong>CD II-V occurred in 35% of elective and 56% of emergency patients. Emergency patients had higher ASA class, more advanced tumour stage and lower BMI (p < 0.05). Among patients with no or minor complications (CD 0-I), median costs were €9809 following elective surgery and €12,079 following emergency surgery. Among patients with complications, costs were higher in emergency versus elective surgery (€19,655 vs. €14,820; p = 0.004). Adjusted excess costs increased from CD 0-I to CD IV, whereas CD V did not follow this pattern. In adjusted analyses, complication severity remained associated with increased costs, with cost ratios of 3.21 in elective and 4.86 in emergency surgery for grade IV vs no or minor complications; however, the emergency estimate was based on six patients with CD IV complications and should be interpreted cautiously.</p><p><strong>Conclusions: </strong>Complication severity was independently associated with substantial cost increases after colon resection. Observed costs were generally higher and more variable following emergency surgery.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181679","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":"Comment on: Optimizing surveillance in Lynch syndrome: lesion detection and comparative performance of different colonoscopy modalities, a systematic review and network meta-analysis.","authors":"Mohammad Al Hayek, Bisher Sawaf, Muhammed Elhadi","doi":"10.1007/s00384-026-05253-0","DOIUrl":"10.1007/s00384-026-05253-0","url":null,"abstract":"","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167459","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":"Clinicopathological characteristics and outcomes of rectal neuroendocrine tumors according to resection modality.","authors":"Wanrong Zhou, Qi Cheng, Xiaolin Lin, Xialu Hong, Ziyu Tai, Wan Du, Xiuying Xiao, Hua Xiong","doi":"10.1007/s00384-026-05247-y","DOIUrl":"https://doi.org/10.1007/s00384-026-05247-y","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the effects of different treatment methods on the postoperative results and long-term prognosis of patients with 1-2 cm rectal neuroendocrine tumors (R-NETs), and provide evidence-based guidance for the treatment decision-making of this specific tumor size.</p><p><strong>Methods: </strong>The retrospective cohort study of this single-center included 736 patients with pathologically diagnosed R-NETs who were treated from January 2013 to August 2024. According to the treatment received, the patients were divided into endoscopic resection group (ER), local surgery group (LS) and radical surgery group (RS). The primary endpoint was recurrence free survival (RFS).</p><p><strong>Results: </strong>A total of 736 R-NETs patients were enrolled. For the controversial 1-2 cm tumor, there was no significant difference in the long-term RFS between the LS group and the ER group (P = 0.280), and the postoperative hospitalization days of the LS group was relatively short (median 2 days vs. 3 days, P < 0.001). Sensitivity analysis using propensity score matching (PSM) further confirmed these outcomes in postoperative hospitalization days (P < 0.001).</p><p><strong>Conclusion: </strong>For 1-2 cm R-NETs, recurrence events were rare in both treatment groups, and local surgery was associated with a shorter postoperative hospital stay.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224017","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":"Long-term outcomes in recurrent diverticulitis: a systematic review of treatment strategies and recurrence rates.","authors":"Kaiser O'Sahil Sadiq, Rishab Belavadi, Swetha Lakshminarayanan, Andres Fontaine-Nicola, Robert D Bennett","doi":"10.1007/s00384-026-05196-6","DOIUrl":"10.1007/s00384-026-05196-6","url":null,"abstract":"<p><strong>Background: </strong>Diverticulitis prevalence is on the rise, with recurrences occurring in up to one-third following an uncomplicated initial episode. While sigmoid resection was historically routine after a second episode, current guidelines recommend individualization. This review evaluates long-term outcomes for recurrent diverticulitis, comparing different treatment approaches.</p><p><strong>Methods: </strong>A systematic review (PROSPERO ID CRD42024600674) adhering to PRISMA guidelines searched several electronic databases. Clinical trials and observational studies published in English over the past decade that reported outcomes for persistent or recurrent diverticulitis were sought.</p><p><strong>Results: </strong>From 189 references, three retrospective cohort studies and one randomized control trial (RCT) were included, totaling 446 patients (42.1% male). Recurrence rates were 5.6-21.1% over follow-up durations ranging between 17 and 190 months. Definitions for recurrent diverticulitis varied across studies, with employed treatments including elective resection and nonoperative management. Outcomes evaluated included quality of life (QoL) assessments, reintervention rates, and recurrence risk. QoL showed greater improvement with surgery, but reintervention was more common after surgery (21%) than with nonoperative management. Recurrent or persistent diverticulitis demonstrated a higher recurrence risk, with increased incidence of surgery and comparable incidence of ostomy.</p><p><strong>Conclusions: </strong>Persistent or recurrent diverticulitis appears to be associated with higher rates of recurrence and surgery. However, contemporary literature detailing long-term outcomes is limited. Although surgical intervention may enhance QoL, it may also necessitate more reinterventions. Standardizing recurrent diverticulitis definitions would enable comparative analyses and inform guideline updates, facilitating evidence-based clinical decision-making.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929908","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":"Early versus late closure of protective ileostomy after rectal cancer surgery.","authors":"Elias Khajeh, Andrea Sosková, Johanna Fellhofer-Hofer, Nastaran Sabetkish, Rajan Nikbakhsh, Mohammadamin Shahrbaf, Arianeb Mehrabi, Fee Klupp","doi":"10.1007/s00384-026-05239-y","DOIUrl":"10.1007/s00384-026-05239-y","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal timing of protective ileostomy closure after rectal cancer surgery remains uncertain. This systematic review and meta-analysis compares early (EC) versus late closure (LC) and evaluates the associated risks and benefits.</p><p><strong>Methods: </strong>Medline, Web of Science, and CENTRAL were searched for RCTs published up to May 2025 that compared EC (≤ 30 days after creation) with LC (≥ 12 weeks after creation) following rectal cancer surgery.</p><p><strong>Results: </strong>Nine RCTs including 387 patients (EC: 195, LC: 192) were analyzed. We found no significant difference between the two groups regarding intraoperative blood loss, operation time, length of hospital stay, overall postoperative morbidity, major complications, anastomotic leakage, readmission, perioperative mortality, administration of adjuvant chemotherapy, occurrence of LARS, and quality of life. However, the EC group showed a tendency toward better functional outcomes in terms of shorter time to first passage of flatus (p < 0.001). Additionally, one RCTs reported a significant, yet clinically irrelevant delay in initiation of adjuvant chemotherapy in the EC group (p < 0.001). Two RCTs demonstrated a significant cost reduction in the EC group - lower costs of stoma bags over the treatment period (p < 0.001) and lower total cost at 12 months following the initial rectal resection (p < 0.001).</p><p><strong>Conclusion: </strong>EC can be considered a safe and feasible alternative to LC in carefully selected patients. However, caution is required in treating high-risk patients, and further research is necessary in order to identify potential risk factors that may predict unfavorable outcomes.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929911","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":"Association of objectively assessed physical activity with immune cell infiltration of the tumor microenvironment in non-metastatic colon cancer.","authors":"David Renman, Sofia Edin, Ulf Gunnarsson, Niillas Blind, Karin Strigård, Richard Palmqvist","doi":"10.1007/s00384-026-05232-5","DOIUrl":"10.1007/s00384-026-05232-5","url":null,"abstract":"<p><strong>Purpose: </strong>Physical activity and immune cell infiltration of the tumor microenvironment are associated with improved prognosis in colon cancer. There is also evidence that physical activity may mobilize immune cells against colon tumors. One possible mechanism behind the positive effect of physical activity on colon cancer prognosis could thus be increased immune cell infiltration of the tumor microenvironment. There are few previous studies examining this association, and none has included an objective assessment of physical activity.</p><p><strong>Methods: </strong>This was a study on 69 patients enrolled in the Physical Activity and its impact on COlon cancer Surgery (PACOS) prospective cohort, all diagnosed with colon cancer stages I-III, all eligible for curative surgery, and with no previous treatment. Prior to surgery, the participants underwent physical tests, dual-energy X-ray absorptiometry, and wore an accelerometer to quantify their physical activity and physical fitness. Tumor infiltration by cytotoxic T cells, T-helper 1 cells, regulatory T cells, B cells, and macrophages was objectively assessed with multispectral quantitative automated pathology imaging. Odds ratios for associations between physical activity and immune cell infiltration were estimated.</p><p><strong>Results: </strong>A higher number of repetitions in the 30-s sit-to-stand test was associated with a lower density of T-helper 1 cells in the stromal compartment of the tumor, in the model adjusted for age and sex. When correcting for multiple testing, the association was considered non-significant. No other significant association was seen for any of the physical tests or immune cell types.</p><p><strong>Conclusions: </strong>No consistent evidence was found to support the hypothesis of an association between physical activity or fitness and increased immune cell tumor infiltration in colon cancer.</p><p><strong>Trial registration: </strong>This study was registered at clinicaltrials.gov (ID NCT03947840), registration date 2019-05-19.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929895","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":"Matters arising in IJCD beyond minimally invasive pelvic exenteration: can single-port robotics overcome deep pelvic constraints?","authors":"Christos Kontovounisios","doi":"10.1007/s00384-026-05224-5","DOIUrl":"https://doi.org/10.1007/s00384-026-05224-5","url":null,"abstract":"","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792759","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":"Distinct enteric nervous system pattern in obstructed defecation syndrome and slow-transit constipation: a controlled digital pathology study.","authors":"Tillmann Bedau, Aryan Mirzaie-Kuzehgarani, Joshy Madukkakzhy, Luisa Halbe, Alexander Quaas, Claudia Rudroff","doi":"10.1007/s00384-026-05209-4","DOIUrl":"10.1007/s00384-026-05209-4","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic constipation comprises heterogeneous clinical entities, including slow-transit constipation (STC) and functional defecation disorders such as obstructed defecation syndrome (ODS). Although neuroenteric mechanisms are implicated, reproducible histomorphological correlates remain incompletely defined, partly due to methodological heterogeneity and lack of standardized quantification. The study characterizes the myenteric plexus morphology and neuroimmune cell distribution across clinically defined subgroups of functional bowel disorders using a standardized digital pathology approach.</p><p><strong>Methods: </strong>Retrospective observational cohort study at a tertiary colorectal referral center. A total of 100 patients after bowel surgery were included: ODS (n = 17), STC (n = 24), combined ODS + STC (n = 28), and a control cohort without clinically evident bowel motility disorders (n = 31). Digital morphometric assessment of ganglionic density and morphology, neuronal content (immunohistochemistry against MAP2, HuC/D), and the distribution of CD3-positive T-lymphocytes within and around myenteric ganglia were performed.</p><p><strong>Results: </strong>Ganglionic density differed significantly between groups (p = 0.002), with increased density in ODS, whereas STC values were comparable to controls. Neuronal content per ganglion was preserved across all groups as demonstrated by MAP2 and HuC/D analyses. In contrast, the presence of CD3-positive lymphocytes was reduced in all constipation groups, most pronounced in STC, affecting both the intra- and periganglionic compartments.</p><p><strong>Conclusion: </strong>Functional bowel motility and defecation disorders appear to show distinct neuroarchitectural and neuroimmune patterns. Increased ganglionic density in ODS contrasts with preserved neuronal content and reduced presence of T-lymphocytes, particularly in STC. These findings represent associations rather than proven disease mechanisms, derived from comparison with a surgical rather than a healthy control cohort. Standardized digital morphometry nonetheless provides a reproducible framework for phenotypic characterization of chronic constipation and may support future studies linking enteric structure to function.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov (NCT05016700; 09/12/2020).</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669467","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":"Prehabilitation for colon cancer surgery: a systematic review of quality-of-life outcomes and a feasibility study.","authors":"Michelle V Stadelhofer, Helene R Dalby, Anne Thyø, Katrine J Emmertsen","doi":"10.1007/s00384-026-05203-w","DOIUrl":"https://doi.org/10.1007/s00384-026-05203-w","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the feasibility of short-term prehabilitation and its impact on quality of life in patients with colorectal cancer through a systematic review and a feasibility study.</p><p><strong>Methods: </strong>The systematic review was conducted in accordance with the PRISMA guidelines. PubMed, PubPsych, CINAHL, EMBASE, Web of Science and EBSCOhost were searched for studies evaluating quality of life in colorectal cancer patients undergoing prehabilitation. We conducted a prospective non-randomised interventional feasibility study, with a 2-week post-surgery follow-up, enrolling patients diagnosed with colon cancer.</p><p><strong>Results: </strong>The systematic review included six studies from 517 unique records for final analysis. Among six studies, evidence for quality-of-life benefits of prehabilitation was conflicting but predominantly favourable, with generally low-to-moderate study quality and substantial heterogeneity. In the feasibility study, 110 patients were eligible for inclusion; 70 (64%) were included, and 63 completed the entire study. Of the 32 patients in the intervention group, compliance > 80% was observed in 66% (nutrition) and 88% (physical activity) of patients, with a median compliance of 100% for both. Quality-of-life outcomes were explored as secondary measures and showed potential favourable trends following prehabilitation.</p><p><strong>Conclusion: </strong>Evidence on the effect of prehabilitation on quality of life in colorectal cancer remains inconsistent; our feasibility study shows that short-term multimodal prehabilitation is feasible and supports the need for adequately powered trials.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227868","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":"Correspondence for the article \"Histological architecture of the intersphincteric region of the anal canal: implications for the anatomical basis of anal fistula pathways\".","authors":"Nicola Clemente, James C W Khaw","doi":"10.1007/s00384-026-05212-9","DOIUrl":"10.1007/s00384-026-05212-9","url":null,"abstract":"","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591126","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}