International Journal of Colorectal Disease最新文献

{"title":"Neural influences in colorectal cancer progression and therapeutic strategies.","authors":"Zhibin Zeng, Shirong Cai, Chenle Ye, Tongduan Li, Yan Tian, Enyuan Liu, Junbin Cai, Xiaojun Yuan, Heng Yang, Quanqi Liang, Kaishu Li, Cui Peng","doi":"10.1007/s00384-025-04887-w","DOIUrl":"10.1007/s00384-025-04887-w","url":null,"abstract":"<p><strong>Purpose: </strong>This review aims to elucidate the neural mechanisms driving colorectal cancer (CRC) growth, metastasis, and therapeutic resistance, summarizing the roles of neurotransmitters, neurotrophic factors, and neural signaling in carcinogenesis. It further explores therapeutic strategies targeting neural dependencies in CRC.</p><p><strong>Methods: </strong>A comprehensive PubMed search was conducted using the keywords colorectal cancer and tumor innervation, focusing on studies published between 2000 and 2024. The review synthesizes evidence across four domains: neurotransmitter-receptor interactions, gut-brain-microbiota axis dynamics, neuroimmune modulation, and neural regulation of cancer stem cells, discussing their collective impact on CRC pathophysiology.</p><p><strong>Results: </strong>Neural innervation significantly influences CRC progression. For instance, the neurotransmitter serotonin promotes tumor growth and metastasis via paracrine and autocrine stimulation, while neurotrophic mediators like nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) activate oncogenic signaling through receptor tyrosine kinases (RTKs). Downstream pathways, such as Wnt/β-catenin signaling, are modulated by neural inputs, underscoring CRC's neurodevelopmental dependency and highlighting their potential as therapeutic targets.</p><p><strong>Conclusion: </strong>Neural mechanisms are pivotal in CRC progression, revealing novel therapeutic avenues. Strategies targeting neurotransmitter synthesis, neurotrophic signaling, or neuroimmune crosstalk may disrupt tumorigenic loops while preserving systemic nervous system integrity. Future research must prioritize translating these insights into clinical interventions to improve patient outcomes. Elucidating the intricate interplay between neural mediators and cancer pathogenesis, coupled with developing therapies specifically targeting the neurogenic basis of CRC aggressiveness, represents a critical frontier in oncology.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"120"},"PeriodicalIF":2.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086201","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":"Prevalence and pooled risk factors of stoma outlet obstruction after colorectal surgery with diverting ileostomy: a systematic review and meta-analysis.","authors":"Jian-Xin Gan, Hai-Peng Liu, Kang Chen","doi":"10.1007/s00384-025-04862-5","DOIUrl":"10.1007/s00384-025-04862-5","url":null,"abstract":"<p><strong>Background: </strong>Stoma outlet obstruction (SOO) is a significant complication following colorectal surgery with diverting ileostomy, but its prevalence and associated risk factors are not fully understood. This meta-analysis aimed to quantify the prevalence of SOO and identify key risk factors influencing its occurrence.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of 19 studies comprising 3287 patients were conducted. Pooled prevalence and odds ratios (ORs) for risk factors were calculated using a random-effects model. Subgroup and sensitivity analyses were performed to explore heterogeneity, and publication bias was assessed using funnel plots and Egger's regression test.</p><p><strong>Results: </strong>The pooled prevalence of SOO was 14% (95% CI = 11-18%, I² = 84.9%). Subgroup analysis revealed higher prevalence in studies focusing on benign conditions (20%) and smaller sample sizes (< 100 patients, 16%). Key risk factors included high-output syndrome (OR = 4.23, 95% CI = 2.28-7.85), increased rectus abdominis thickness (OR = 3.51, 95% CI = 2.27-5.41), and laparoscopic surgery (OR = 4.04, 95% CI = 1.62-10.04). While publication bias was detected, but the trim-and-fill method indicated that the adjusted prevalence remained basically consistent with the overall pooled estimate.</p><p><strong>Conclusions: </strong>SOO occurs in approximately 14% of patients undergoing colorectal surgery with diverting ileostomy. Key modifiable factors included high-output syndrome, rectus abdominis thickness, and laparoscopic surgery.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"119"},"PeriodicalIF":2.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076964","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":"Quality of life in diverticular disease: translation and validation of the Danish version of the diverticulitis quality of life instrument (DV‑QOL).","authors":"Helene R Dalby, Katrine J Emmertsen","doi":"10.1007/s00384-025-04911-z","DOIUrl":"https://doi.org/10.1007/s00384-025-04911-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to translate and validate the Danish version of the DV-QOL questionnaire, originally developed in 2015, to assess the impact of diverticular disease on quality of life (QOL) in Danish-speaking patients with diverticulosis.</p><p><strong>Methods: </strong>Following international standards, the DV-QOL was translated. A cross-sectional survey was conducted in 2023 with Danish-speaking subjects. The survey included the Danish DV-QOL, an anchor QOL question, and the EuroQol visual analogue scale. Psychometric properties were evaluated for validity, internal consistency, and the ability to identify significant impacts on QOL.</p><p><strong>Results: </strong>The validation cohort included 16,766 subjects. The DV-QOL score showed a strong correlation with overall QOL (p < 0.001) and high discriminative validity (p < 0.001). Reliability was confirmed with an inter-item correlation of 0.41 and a Cronbach's α of 0.92. The score accurately identified patients with a significant impact of bowel function on QOL, achieving 82% sensitivity and 79% specificity.</p><p><strong>Conclusion: </strong>The Danish DV-QOL is a valid and reliable tool for measuring diverticular disease-specific QOL, beneficial for both clinical and research applications in understanding the impact of the disease and patient outcomes.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"117"},"PeriodicalIF":2.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077059","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":"Score assessment and treatment in patients presenting with low anterior resection syndrome after sphincter-sparing rectal cancer surgery.","authors":"R Sguinzi, J Fiechter, L Bafumi, B Gremaud, B Geng, P Janiak, L Bühler, B Egger","doi":"10.1007/s00384-025-04906-w","DOIUrl":"10.1007/s00384-025-04906-w","url":null,"abstract":"<p><strong>Background: </strong>Sphincter-sparing low anterior resection (SSLAR) with neoadjuvant radio-chemotherapy has been developed to avoid abdomino-perineal amputation and permanent colostomy in patients with low rectal cancer. However, many patients develop symptoms known as low anterior resection syndrome (LARS), including fecal urgency, incontinence, and a sensation of incomplete evacuation. The Low Anterior Resection Syndrome Score (LARS Score), a validated tool developed by Emmertsen and Laurberg, is used to assess symptom severity and guide treatment.</p><p><strong>Materials and methods: </strong>We present a single-center cohort study including patients having undergone SSLAR for rectal cancer between 2014 and 2021 at Fribourg Cantonal Hospital. Initial LARS-scores were obtained by completion of the QoL questionnaire. Patients with minor LARS (scores 21-29) were treated with electrostimulation and bio-feedback physiotherapy. Those with major LARS (scores > 29) were first investigated by anal manometry followed by physiotherapy. All treatments took place in 2022/2023. After treatment, LARS-scores were calculated again.</p><p><strong>Results: </strong>Of 54 patients included in the study, 18.5% had minor LARS, 40.8% major LARS, and 40.8% had no LARS. Of all patients with LARS, 18 (56%) completed pelvic physiotherapy, whereas 14 (44%) refused the treatment. Before and after pelvic physiotherapy, the median LARS score was 32 [interquartile range 29.50-38.50] and 22.5 [18.5-28], respectively (p < 0.001 according to Wilcoxon signed-rank test). Analysis of risk factors did not reveal any significant difference in age, gender, diabetes, nicotine or alcohol use, previous abdominal surgery, tumor stage, chemo/radiotherapy, type of operation and anastomosis, or anastomotic leakage.</p><p><strong>Conclusions: </strong>Approximately half of patients undergoing SSLAR experience LARS, and approximately one-third develop the major form. LARS scores may significantly improve with specific physiotherapeutic measures that have therefore been introduced as a standard procedure for all SSLAR patients at our institution.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"115"},"PeriodicalIF":2.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017658","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":"Short-course versus long-course neoadjuvant chemoradiotherapy in patients with rectal cancer: long-term results of a randomized controlled trial.","authors":"Mahdi Aghili, Mohammad-Mahdi Aghaei, Romina Abyaneh, Mohammad Babaei, Farshid Farhan, Marzieh Lashkari, Borna Farazmand, Kasra Kolahdouzan, Guglielmo Niccolò Piozzi, Felipe Counago, Reza Ghalehtaki","doi":"10.1007/s00384-025-04901-1","DOIUrl":"10.1007/s00384-025-04901-1","url":null,"abstract":"<p><strong>Background and purpose: </strong>Short-course radiotherapy (SCRT) and long-course radiotherapy (LCRT) are the primary neoadjuvant radiotherapy schedules for locally advanced rectal cancer. Recent research has questioned the efficacy of SCRT. This study presents an updated analysis of our previous research, extending the follow-up to evaluate 5-year outcomes by comparing the long-term results of these two strategies.</p><p><strong>Materials and methods: </strong>This randomized controlled trial compared SCRT and LCRT in locally advanced middle or high rectal adenocarcinoma. The SCRT group received 25 Gy/5 fractions over 1 week plus CAPOX, while the LCRT group received 50-50.4 Gy/25-28 fractions over 5-5.5 weeks plus capecitabine. All patients received consolidation chemotherapy and then underwent delayed surgery after 8 weeks or more post-radiotherapy. The endpoints of this updated analysis include overall survival (OS),disease-free survival (DFS), locoregional recurrence (LR) and distant metastasis (DM).</p><p><strong>Results: </strong>Ninety-nine cases (45 LCRT, 54 SCRT) were followed for a median of 4.7 years. Five-year OS rates were 77.3% for LCRT vs. 65.6% for SCRT group (P = 0.4). The 5-year DFS rates were 69.6% for LCRT vs. 54.9% for SCRT (P = 0.07). Cox regression indicated no prominent difference between the two groups regarding OS, LR, or DM. Subgroup analysis demonstrated a significantly better DFS with LCRT compared to SCRT in male patients ([HR] = 2.48, 95%CI: 1.04-5.93, P = 0.03), patients under the age of 60 (HR = 3.19, 95%CI: 1.03-9.92, P = 0.04), and cT4 patients (HR not calculated: no events in LCRT group, P = 0.004).</p><p><strong>Conclusion: </strong>DFS showed a trend in favor of the LCRT group, with LCRT being significantly superior among men, patients under 60, and cT4 stage. Despite being intensified, SCRT failed to achieve long-term outcomes comparable to LCRT. Further research is needed to compare these two approaches in the context of total neoadjuvant treatment.</p><p><strong>Trial registration data: </strong>IRCT2017110424266N3 (Registration date: 2017-11-12).  https://irct.behdasht.gov.ir/trial/20526 .</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"118"},"PeriodicalIF":2.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077712","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":"Efficacy of a novel one-step knife compared to conventional knife for colorectal endoscopic submucosal dissection: a prospective multicenter randomized controlled trial.","authors":"Hong Jun Park, Su Young Kim, Gwang Ho Baik, Myeongsook Seo, Hyun Il Seo, Sung Chul Park, Hyunil Kim, Hyun-Soo Kim","doi":"10.1007/s00384-025-04910-0","DOIUrl":"10.1007/s00384-025-04910-0","url":null,"abstract":"<p><strong>Purpose: </strong>For the treatment of advanced colorectal neoplasms, colon endoscopic submucosal dissection (ESD) is a crucial technique, although it is time-consuming. The purpose of this study was to evaluate the efficacy of a recently developed one-step knife (OSK) in colon ESD and compare its performance with that of a conventional knife (CK).</p><p><strong>Methods: </strong>Between July 2020 and November 2021, patients scheduled to undergo colorectal ESD were randomly assigned to either the OSK group or the CK group. The primary outcome was the total submucosal injection time. Additionally, total procedure time, treatment outcomes, adverse events, and operator convenience were analyzed.</p><p><strong>Results: </strong>Data from 53 patients (28 in the OSK group and 25 in the CK group) were analyzed. The mean total injection time was lower in the OSK group than in the CK group (186 s [IQR, 116.8-249.5] vs. 265 s [IQR, 130.5-553.0]), but the difference was not statistically significant (P = 0.082). The total procedure time tended to be shorter in the OSK group than in the CK group (15.5 min [IQR, 11.3-22.8] vs. 20 min [IQR, 13.5-42.5], P = 0.110). Resection rates and adverse events did not differ between the two groups. A greater proportion of endoscopists expressed high satisfaction with the OSK, particularly regarding submucosal injection.</p><p><strong>Conclusion: </strong>Compared to the CK, OSK use led to shorter injection and procedure times, though not statistically significant. The use of this newly developed endoscopic knife can potentially enhance the effectiveness and efficiency of colorectal ESD (Clinical Research Information Service: KCT0005123).</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"116"},"PeriodicalIF":2.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007079","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":"Peritoneal reflection involvement as a prognostic factor in rectal cancer. Long-term oncological outcomes from a prospective study.","authors":"Eduardo Alvarez-Sarrado, Matteo Frasson, Jorge Sancho-Muriel, Maria Jose Gomez-Jurado, Hanna Cholewa, Vicent Primo-Romaguera, Monica Millan, Adela Batista, Polina Rudenko, Blas Flor-Lorente, Eduardo Garcia-Granero, Francisco Giner","doi":"10.1007/s00384-025-04909-7","DOIUrl":"10.1007/s00384-025-04909-7","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the relevance of peritoneal reflection involvement in long-term oncological outcomes in patients with rectal cancer.</p><p><strong>Methods: </strong>Prospective observational study from a specialized colorectal unit that included a consecutive series of patients undergoing mesorectal excision for rectal cancer. Peritoneal reflection (PR) involvement was evaluated on pathological examination using Shepherd's classification. Overall survival (OS), disease-free survival (DFS), and local recurrence (LR) were assessed.</p><p><strong>Results: </strong>One hundred sixty patients were included in the present analysis. Peritoneal involvement was present in 28.2% of the 85 tumors above or at the level of PR. There were no differences in OS, DFS, or LR according to tumor's height location. The 5-year OS, DFS, and LR for tumors involving PR were 58.3%, 61.7%, and 30.3%, respectively. Patients with peritoneal involvement had a higher LR rate (p = 0.02) and shorter OS (p = 0.04). Shepherd's grade 4 peritoneal involvement was an independent risk factor for OS (HR 2.9; 95% CI 1.1-9.5, p = 0.04) and LR (HR 4.2; 95% CI 1.2-16.9, p = 0.04).</p><p><strong>Conclusion: </strong>After rectal cancer resection, peritoneal involvement is an independent risk factor for local recurrence and poor survival.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"114"},"PeriodicalIF":2.5,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998966","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":"Drug dissolution problems in ostomy patients: a chart review and patient interview analysis.","authors":"Yvonne Remane, Maria Astrid Stolz, Katrin Heinitz, Albrecht Hoffmeister, Matthias Mehdorn, Stefan Niebisch, Kirsten Lincke, Annett Huke, Daniel Seehofer, Thilo Bertsche","doi":"10.1007/s00384-025-04907-9","DOIUrl":"https://doi.org/10.1007/s00384-025-04907-9","url":null,"abstract":"<p><strong>Purpose: </strong>The pharmacokinetic properties of peroral drugs, e.g. considering dissolution, release and absorption, can be influenced by a shortened transit time after ostomy placement. Its aim was to find unexpected undissolved drugs in stoma bags and establish a correlation with formulations using patient interviews and chart review analysis.</p><p><strong>Methods: </strong>(i) A patient chart review was performed to assess prescribed drugs on the basis of their formulation and potential influence on pharmacokinetics. (ii) Subsequent to the chart review, the patient was interviewed to ascertain (ii.a) the appearance of indigested drugs in the stoma bag, (ii.b) observed changes in drug efficacy and therapy, and (ii.c) information status regarding indigestible and undissolved formulations.</p><p><strong>Results: </strong>(i) 22.4% (134/598) of the prescribed formulations were assessed as critical concerning their pharmacokinetic release characteristics. (ii.a) A total of 22.0% (11/50) of the interviewed patients indicated that they had experienced this at least once. (ii.b) Of the patients, 14.0% (7/50) observed changes in drug efficacy, and 12% (6/50) experienced changes in their therapy regimens. (ii.c) More than 60% of the patients lacked information that indigestible and undissolved formulations could be found in their stoma bag.</p><p><strong>Conclusions: </strong>A considerable proportion of formulations investigated caused problems for patients with ostomy. Additional patient education and resources are needed to support ostomy patients by managing drug release-related problems.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"113"},"PeriodicalIF":2.5,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999136","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":"Minimizing incisional hernia: intracorporeal anastomosis makes the difference after laparoscopic right colectomy.","authors":"Ernesto De Giulio, Giulia Turri, Ruben Sciortino, Matteo Rivelli, Gabriele Gecchele, Alessandro Valdegamberi, Tommaso Campagnaro, Andrea Ruzzenente, Corrado Pedrazzani","doi":"10.1007/s00384-025-04903-z","DOIUrl":"https://doi.org/10.1007/s00384-025-04903-z","url":null,"abstract":"<p><strong>Purpose: </strong>The anastomosis technique following laparoscopic right colectomy remains a subject of ongoing debate. One of the potential advantages of intracorporeal anastomosis is the flexibility it offers in selecting the location of the minilaparotomy. This study aimed to evaluate the differences in the rate of incisional hernia between intracorporeal and extracorporeal anastomosis after laparoscopic right colectomy.</p><p><strong>Methods: </strong>We retrospectively analysed patients undergoing laparoscopic right colectomy for colon neoplasia between April 2013 and January 2024, retrieved from a prospectively maintained database. The occurrence of incisional hernia was assessed according to the anastomosis technique. Univariate and multivariate analyses were performed to investigate the relationship between incisional hernia and anastomosis technique, while controlling for other risk factors.</p><p><strong>Results: </strong>Among 192 patients, 94 underwent intracorporeal anastomosis and 98 underwent extracorporeal anastomosis. The groups were comparable in terms of clinical, pathological, and surgical data. The intracorporeal group showed a lower incidence, although not statistically significant, of postoperative ileus (p = 0.052), and a shorter hospital stay (p = 0.003). No incisional hernias were observed at the minilaparotomy site in the intracorporeal anastomosis group, while 13.3% of patients in the extracorporeal anastomosis group developed an incisional hernia (p < 0.001). One incisional hernia at the umbilical trocar site occurred after intracorporeal anastomosis. Multivariate analysis identified postoperative general complications (OR [95% CI]: 4.1 [1.0-16.5], p = 0.049) and extracorporeal anastomosis (OR [95% CI]: 15.4 [1.0-126.9], p = 0.011) as independent risk factors for incisional hernia.</p><p><strong>Conclusions: </strong>Intracorporeal anastomosis significantly reduces the incidence of incisional hernia at the minilaparotomy site. This finding is further supported by logistic regression analysis, which identified intracorporeal anastomosis as a significant and independent protective factor against incisional hernia.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"112"},"PeriodicalIF":2.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978195","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":"Prospective and multicenter study on clinical-biological factors predictive of chronic colon diverticulitis: DICRO Trial.","authors":"Marta Climent, Lucia Sobrino, Jordi Guardiola, Esther Kreisler, Sebastiano Biondo","doi":"10.1007/s00384-025-04902-0","DOIUrl":"10.1007/s00384-025-04902-0","url":null,"abstract":"<p><strong>Purpose: </strong>This manuscript presents the protocol for a prospective, multicenter study aimed at identifying prognostic factors for the recurrence of diverticulitis. The design, methodology, and analysis plan are detailed, providing a comprehensive framework for evaluating clinical endpoints and intervention outcomes in patients with diverticulitis.</p><p><strong>Methods: </strong>Clinical, observational, prospective, and multicenter study of patients diagnosed with acute diverticulitis in the Emergency Department (ED) of 5 Spanish hospitals. The inclusion criteria were patients with acute diverticulitis who did not require emergency surgery. A 2-year follow-up will be carried out. The main objective is the description of prognostic factors of new episodes of acute diverticulitis and the creation of a therapeutic algorithm to select patients who could benefit from early elective surgery. Secondary endpoints are descriptive analyses of quality of life at different periods to establish the evolution of the disease and to correlate symptoms with systemic and local inflammatory markers; and sub-analysis of immunosuppressed patients to assess disease virulence.</p><p><strong>Conclusion: </strong>Determination of a marker predictive of recurrent disease or chronic inflammation would be of benefit in developing a good treatment strategy. One group that would particularly benefit is immunosuppressed patients.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04407793.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"111"},"PeriodicalIF":2.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022173","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}