International Journal of Colorectal Disease最新文献

{"title":"Association of lysyl oxidase expression with clinicopathological features in colorectal adenocarcinomas.","authors":"Ayça Dilşad Çağlayan, Seda Kahraman, Doğukan Çanakçı, Mustafa Tahtacı, Ayşegül Aksoy Altınboğa, Hayriye Tatlı Doğan","doi":"10.1007/s00384-025-04852-7","DOIUrl":"10.1007/s00384-025-04852-7","url":null,"abstract":"<p><strong>Purpose: </strong>Colorectal adenocarcinoma (CRC) is one of the leading causes of cancer-related mortality worldwide. Within the tumor microenvironment, neoplastic cells, along with tumor-promoting fibroblasts, contribute to the progression of CRC. Lysyl oxidase (LOX), an enzyme involved in this process facilitates collagen cross-linking within the extracellular matrix and plays a crucial role in remodeling the tumor microenvironment (TME) and promoting metastasis through epithelial-mesenchymal transition (EMT). This study investigates LOX expression in both tumor cells and the tumor stroma in relation with clinicopathological features in CRC patients.</p><p><strong>Method: </strong>Immunohistochemical staining of LOX proteins was performed on tissue microarrays from colorectal tumor samples taken from resection specimens. LOX expression was quantified in tumor cells and stroma. The correlation between the expression of LOX and clinicopathological parameters was analyzed.</p><p><strong>Results: </strong>A positive correlation was observed between peritumoral stromal LOX expression and LOX expression in the tumor epithelium. High expression of LOX in tumor cells was significantly associated with poorer progression-free survival (PFS) among patients. Low tumor budding was observed in tumors with low stromal LOX expression.</p><p><strong>Conclusion: </strong>The current study indicates that LOX may be an important contributor to CRC progression. The findings of this series, in which LOX expression correlated with tumor budding and survival, support a contribution for LOX to EMT and metastasis. Furthermore, LOX expression in both the tumor cell and stromal compartment may add information to improve prognosis in CRC management. These findings, however, have to be validated in further studies, as does also the investigation of LOX as a potential therapeutic target in CRC.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"75"},"PeriodicalIF":2.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700214","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":"Survival analysis and prediction of early-onset colorectal cancer patients post-chemotherapy: an analysis based on the SEER database.","authors":"Zhiguo Tang, Guojia Zhou, Yu Xu, Yinxu Zhang","doi":"10.1007/s00384-025-04853-6","DOIUrl":"10.1007/s00384-025-04853-6","url":null,"abstract":"<p><strong>Background: </strong>The incidence of Early-Onset Colorectal Cancer (EOCRC) has risen markedly in recent years, garnering widespread attention due to its distinctive clinical and biological features. However, systematic research on prognostic risk factors and long-term survival prediction for EOCRC patients undergoing postoperative chemotherapy remains scarce. This study seeks to pinpoint critical prognostic factors for EOCRC patients receiving postoperative chemotherapy and to devise a survival prediction tool employing a Nomogram model.</p><p><strong>Methods: </strong>Patients diagnosed with EOCRC between 2010 and 2015, who underwent postoperative chemotherapy, were extracted from the SEER (Surveillance, Epidemiology, and End Results) database. Only those meeting the inclusion criteria were included. Univariate and multivariate Cox regression analyses were performed to determine independent risk factors influencing overall survival (OS). A Nomogram model was then developed using significant variables. The model's predictive accuracy and clinical utility were assessed through the concordance index (C-index), calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA).</p><p><strong>Results: </strong>A cohort of 9,205 patients was analyzed, with 6,445 randomly allocated to the training group and 2,760 to the validation group from the SEER database. Independent prognostic factors, including gender, race, marital status, primary tumor location, histological type, TNM stage, CEA levels, bone metastasis, liver metastasis, and lung metastasis, were identified through univariate and multivariate Cox regression analyses. A Nomogram model constructed from these factors yielded a C-index of 0.76 (0.75, 0.77) in the training group and 0.76 (0.75, 0.78) in the validation group, reflecting robust discriminative ability and consistency. The area under the curve (AUC) for predicting 1-year OS was calculated as 0.84 (0.81, 0.86) in the training group and 0.82 (0.78, 0.85) in the validation group. For 3-year OS, AUCs were recorded at 0.83 (0.82, 0.84) and 0.82 (0.80, 0.84), respectively, while for 5-year OS, AUCs reached 0.81 (0.80, 0.82) and 0.82 (0.80, 0.84). Calibration curves demonstrated close alignment between predicted and observed survival rates. Additionally, DCA affirmed the model's clinical decision-making value.</p><p><strong>Conclusion: </strong>Prognostic risk factors for EOCRC patients receiving postoperative chemotherapy were systematically evaluated in this study, leading to the development of a Nomogram-based survival prediction model. This tool offers a robust scientific foundation for tailoring individualized treatment and guiding follow-up strategies.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"74"},"PeriodicalIF":2.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676629","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":"The use of negative pressure wound therapy following stoma reversal: a systematic review and meta-analysis of randomized controlled trials.","authors":"Caroline Drumm, Ben Creavin, Iva Pranjic Previsic, Maeve O'Neill, John Larkin, Brian J Mehigan, Dara Kavanagh, Paul McCormick, Michael Eamon Kelly","doi":"10.1007/s00384-025-04865-2","DOIUrl":"10.1007/s00384-025-04865-2","url":null,"abstract":"<p><strong>Introduction: </strong>Stoma reversal is a contaminated surgery with many patients experiencing significant wound complications that contribute to patient morbidity. It is believed that the use of prophylactic negative pressure wound therapy (NPWT) may enhance wound healing and help reduce the risk of developing surgical site infections (SSI). However, there is conflicting research regarding its effectiveness following stoma reversal. Our systematic review aims to evaluate the available randomized data to determine if the use of prophylactic NPWT after stoma reversal improves the duration of wound healing and reduces rates of postoperative complications.</p><p><strong>Methods: </strong>A comprehensive search of literature published up to January 2025 was conducted using the following databases: PubMed, Embase, Medline, and Cochrane Library. The included trials were randomized controlled trials that investigated the effect of NPWT following stoma reversal. The primary outcome was the time to complete wound healing. Secondary outcomes included the incidence of wound complications, SSI, hematomas, and the length of hospital stay.</p><p><strong>Results: </strong>Six randomised control trials were included, with 332 patients, of which 171 of these underwent NPWT. There was a significant reduction in time to complete wound healing (OR - 2.53, 95% CI - 3.82 to - 1.24, p = 0.0001, I² = 45%) and wound healing at 42 days (OR 0.36, 95% CI 0.14 - 0.88, p = 0.03, I² = 0%) in the NPWT group. There was no significant difference in any wound complications (OR 0.72, 95% CI 0.23-2.28, p = 0.58, I² = 42%), SSI rates (OR 0.95, 95% CI 0.27-3.29, p = 0.94, I² = 38%) or haematoma rates (OR 0.21, 95% CI 0.03-1.27, p = 0.09, I² = 0%) between the groups. There was no significant difference in length of stay (OR - 0.02, 95% CI - 1.21-1.18, p = 0.98, I² = 66%).</p><p><strong>Conclusion: </strong>The use of NPWT after stoma reversal significantly reduces the time needed for complete wound healing while maintaining a comparable rate of wound complications and length of hospital stay. Therefore, NPWT may be valuable in optimizing postoperative recovery and enhancing patient outcomes.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"73"},"PeriodicalIF":2.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669832","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":"No operation after short-course radiotherapy followed by consolidation chemotherapy in locally advanced rectal cancer (NOAHS-ARC): study protocol for a prospective, phase II trial.","authors":"Felipe F Quezada-Díaz, Aron Bercz, Jose L Escobar, Nicole Caire, Lucia E Díaz-Feldman, Erik Manriquez, Gonzalo Carvajal","doi":"10.1007/s00384-025-04850-9","DOIUrl":"10.1007/s00384-025-04850-9","url":null,"abstract":"<p><strong>Purpose: </strong>Organ preservation through a watch-and-wait (W&W) strategy has become a viable option for select rectal cancer patients with clinical complete responses (cCR) to total neoadjuvant therapy (TNT). This approach limits the morbidity associated with multimodal treatment. However, the optimal treatment strategy and predictors of treatment response are still unresolved. Rectal cancer incidence is rising, particularly in developing countries, and the disease is a major public health concern in Chile. Prior to the no operation after short-course radiotherapy followed by consolidation chemotherapy in locally advanced rectal cancer (NOAHS-ARC) trial, TNT-based treatments and W&W programs had not been implemented in Chile.</p><p><strong>Methods/design: </strong>This single-arm, multicenter, phase II prospective trial, conducted in Santiago, Chile, will enroll patients with stage II/III rectal adenocarcinoma. Treatment involves induction short-course radiotherapy (25 Gy in 5 fractions) followed by consolidation chemotherapy (FOLFOX × 9 or CAPOX × 6 cycles). The response will be assessed 4-8 weeks after chemotherapy completion. Patients achieving cCR will be offered W&W, while those with incomplete responses will undergo total mesorectal excision. The primary endpoint is the rate of complete tumor response, combining pathologic complete responses (pCR) and sustained cCR (> 1 year), compared to a matched cohort treated with neoadjuvant chemoradiation alone. The trial aims to recruit 48 patients, assuming a combined pCR/sustained cCR rate of 12%. Quality of life measures will be assessed, and a biorepository of tissue and plasma samples will be established for future research, alongside serial endoscopic and MRI images.</p><p><strong>Discussion: </strong>NOAHS-ARC seeks to advance organ preservation strategies in rectal cancer while pioneering TNT and W&W protocols in Chile. The study will also focus on functional outcomes and provide valuable data for improving patient care both locally and globally.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier NCT04864067. Registered on April 28, 2021.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"69"},"PeriodicalIF":2.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656628","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":"Risk factors for postoperative acute kidney injury in colorectal cancer: a systematic review and meta-analysis.","authors":"Lumei Huang, Aifang Xiao, Yufeng Li","doi":"10.1007/s00384-025-04860-7","DOIUrl":"10.1007/s00384-025-04860-7","url":null,"abstract":"<p><strong>Purpose: </strong>To thoroughly examine the risk factors that may predispose patients with colorectal cancer to postoperative acute kidney injury (AKI).</p><p><strong>Methods: </strong>To find relevant studies (from the beginning up to May 2024), two researchers searched PubMed, Web of Science, the Cochrane Library, and Embase databases. Two researchers evaluated the quality of the literature using the Newcastle-Ottawa Scale (NOS) and extracted data individually. Data analysis was performed using the Review Manager 5.4.</p><p><strong>Results: </strong>Our meta-analysis included 23 studies, encompassing a total of 167,904 patients. The identified risk factors for postoperative AKI in colorectal cancer patients were male sex, older age, body mass index (BMI) ≥ 25 kg/m², hypertension, diabetes mellitus (DM), chronic kidney disease (CKD), hypoalbuminemia, emergency surgery, open surgery, prolonged operation time, American Society of Anesthesiologists (ASA) score ≥ 3, and intraoperative transfusion. In contrast, anemia and elevated creatinine levels did not emerge as significant risk factors for AKI in this population.</p><p><strong>Conclusion: </strong>To mitigate the incidence of postoperative AKI among these patients, healthcare professionals must proactively identify these risk factors and implement appropriate preventive measures.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"70"},"PeriodicalIF":2.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656632","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 cancer-specific survival prediction nomogram for patients with T4 stage colon cancer after surgical resection: a population-based study.","authors":"Yuncan Xing, Sirui Zhu, Liang Zhou, Jiawei Tu, Zheng Wang","doi":"10.1007/s00384-025-04856-3","DOIUrl":"10.1007/s00384-025-04856-3","url":null,"abstract":"<p><strong>Purpose: </strong>The increasing incidence of colorectal cancer has coincided with a rise in T4 stage colon cancer (CC), yet research on its prognosis remains limited. This study aimed to identify risk factors and develop a nomogram to predict cancer-specific survival (CSS), optimizing treatment strategies for different subgroups.</p><p><strong>Methods: </strong>Using data from the from the Surveillance, Epidemiology, and End Results (SEER) database, we identified risk factors in T4 stage CC patients and created a nomogram to predict CSS. Patients were divided into low- and high-risk groups, and the nomogram was validated. Propensity score matching was used to evaluate the benefits of various therapies across subgroups.</p><p><strong>Results: </strong>Independent risk factors, including T stage, N stage, tumor grade, age, and therapy sequence, were identified through Cox regression analyses and incorporated into the nomogram. The nomogram outperformed the American Joint Committee on Cancer (AJCC) 7th staging system, with a Concordance-index of 0.77 in both training and validation sets. The receiver operating characteristic curves showed area under the curve values of 0.81, 0.77, and 0.75 for 1-, 3-, and 5-year CSS, respectively. Calibration plots confirmed strong alignment between predicted and actual outcomes, and decision curve analysis highlighted the nomogram's superior clinical utility. Chemotherapy significantly improved CSS, while radiation did not. Adjuvant therapy was particularly beneficial in high-risk groups.</p><p><strong>Conclusion: </strong>This study offered a thorough prognostic analysis of T4 stage colon cancer patients and developed nomograms for predicting CSS. Subgroup analyses highlight the potential benefits of various treatment options.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"72"},"PeriodicalIF":2.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657329","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":"Evaluation of anastomotic blood supply during digestive tract reconstruction with the use of the oxygen saturation index: A pooling up analysis.","authors":"Xiao-Qiang Zhang, Chao-Fu Zhang, Xiang-Jun Zhou, Lei-Yuan Shuai, Dong Peng, Guang-Yan Ji","doi":"10.1007/s00384-025-04864-3","DOIUrl":"10.1007/s00384-025-04864-3","url":null,"abstract":"<p><strong>Purpose: </strong>Anastomotic leakage (AL) is one of the most serious clinical complications in digestive tract reconstruction (DTR) surgery, and it is currently hypothesized that this may be related to insufficient anastomotic blood supply. Thus, Therefore, we aimed to assess the ability of tissue oxygen saturation(StO₂) as a measure to evaluate anastomotic blood supply.</p><p><strong>Methods: </strong>A comprehensive literature search was performed using Embase, PubMed and Cochrane Library. StO₂ was used as an evaluation index of anastomotic blood supply after DTR to analyze the potential association between this index and the occurrence of AL in the postoperative period.</p><p><strong>Results: </strong>A total of eleven articles involving 867 participants were included in this systematic review and meta-analysis. After pooling the standardized mean difference (SMD) and 95% confidence intervals (Cls), low StO₂ was found to be an independent risk factor for AL (P < 0.00001; 95%CI: 1.02 [0.53-1.51]). The mean StO₂ in the AL group (62.3%) was significantly lower than that in the non-AL group (74.3%); AL incidence increased with the reduction of StO₂ to a certain value to 201.8% and 338.1% respectively.</p><p><strong>Conclusion: </strong>Oxygen saturation index can be utilized in DTR to accurately and quantitatively evaluate the anastomotic blood supply to reduce the probability of postoperative AL.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"71"},"PeriodicalIF":2.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656583","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":"DIVERT-Ca: unveiling the hidden link between acute diverticulitis and colorectal cancer risk-multicentre retrospective study.","authors":"Mohamed Talaat Issa, Emiko Sultana, Mohammed Hamid, Ali Yasen Mohamedahmed, Mohamed Albendary, Shafquat Zaman, Santosh Bhandari, William Ball, Sangara Narayanasamy, Pradeep Thomas, Najam Husain, Rajeev Peravali, Diwakar Sarma","doi":"10.1007/s00384-025-04858-1","DOIUrl":"10.1007/s00384-025-04858-1","url":null,"abstract":"<p><strong>Introduction: </strong>Colorectal cancer (CRC) is the third most common cancer worldwide, accounting for approximately 10% of all malignancies. Emerging trends of association with risk factors such as diverticulitis highlight the need for updated screening and follow-up protocols. We aimed to examine risk factors associated with the development of CRC within 12 months following an episode of acute diverticulitis, and identify areas to streamline follow-up.</p><p><strong>Methods: </strong>We performed a retrospective multicentre study of adult patients admitted in 2022 with computed tomography (CT) confirmed acute diverticulitis across four large NHS Trusts in the UK. Patient demographics, comorbidities, clinical presentation, vital signs, laboratory results, details of in-patient stay, and follow-up investigations were collected and analysed. Our primary outcome was the incidence of CRC within 12 months of index presentation with acute diverticulitis. Analysed secondary outcomes were potential patient risk factors associated with a diagnosis of CRC and follow-up protocols. All statistical analysis was performed using R (version 4.4) and P-values of < 0.05 were considered statistically significant.</p><p><strong>Results: </strong>A total of 542 patients with acute diverticulitis over the study period were included. The median age of our cohort was 62 (51-73) years, and 204 (37.6%) were male. Ten (1.8%) patients were diagnosed with CRC within the 12-month period. Hinchey grade Ib was significantly associated with CRC (OR 4.51, P = 0.028). Colonoscopic follow-up requests were associated with age between 40 and 60 years, mild white cell count (WCC) elevation, and a hospital stay of 3-7 days. Male gender, age between 18 and 40 years, and elevated C-reactive protein (CRP) were all strongly associated with CRC but not statistically significant. Follow-up was inconsistent with 53.7% of the cohort having luminal investigations.</p><p><strong>Conclusion: </strong>The incidence of CRC was in-keeping with published literature. Hinchey grade 1b was significantly associated with a subsequent CRC diagnosis. These findings emphasise the need for specialised radiological review of CT scans to detect underlying malignancy. Moreover, standardised follow-up protocols following an episode of acute diverticulitis are needed to avoid missing malignant lesions.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"68"},"PeriodicalIF":2.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634031","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":"Impact of leptin on postoperative peritoneal adhesion formations in colorectal resection.","authors":"Takeru Maekawa, Toru Miyake, Masatsugu Kojima, Soichiro Tani, Takashi Matsunaga, Yusuke Nishina, Sachiko Kaida, Hiromitsu Maehira, Tomoharu Shimizu, Masaji Tani","doi":"10.1007/s00384-025-04851-8","DOIUrl":"10.1007/s00384-025-04851-8","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative peritoneal adhesion formation (PAF) is a distressing complication. Leptin, secreted by fat tissues, may be associated with PAF. However, the relationships between PAF and leptin are unclear. This study investigated the impact of leptin on PAF after colorectal tumor resection.</p><p><strong>Methods: </strong>A cecum cauterization mouse model was used to investigate PAF and its association with leptin. Mice adhesion score (AS) was evaluated on day 7 after treatment. The clinical study included patients who underwent elective colorectal resection with temporary ileostomy between April 2021 and December 2024. The AS was evaluated at the time of ileostomy closure. Patients with the highest AS quartile were classified into the high-AS group; clinical factors associated with PAF were examined. An enzyme-linked immunosorbent assay was used to measure human and murine serum leptin concentrations.</p><p><strong>Results: </strong>The animal experiment revealed that serum leptin levels on postoperative day 7 were negatively correlated with mice ASs (P = 0.0043, r = -0.6241). In a clinical study, eight patients had a high AS (27.6%). Visceral fat mass and preoperative serum leptin levels were higher in the high-AS group than in the low-AS group. The serum leptin ratio (postoperative value to preoperative value) on postoperative day 7 was lower in the high-AS group. In multivariate analysis, the serum leptin ratio was an independent factor for classifying into the high-AS group.</p><p><strong>Conclusions: </strong>A decrease in postoperative serum leptin levels was associated with severe PAF. Leptin may be a novel key molecule in PAF.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"67"},"PeriodicalIF":2.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634032","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":"MRI navigation surgery for T4b rectal cancer using multiple minimally invasive surgical approaches.","authors":"Madoka Hamada, Yuki Matsumi, Ryo Inada, Tomoko Matsumoto, Masato Kita, Shogen Boku, Hiroaki Kurokawa, Koji Tsuta","doi":"10.1007/s00384-025-04838-5","DOIUrl":"10.1007/s00384-025-04838-5","url":null,"abstract":"<p><strong>Background: </strong>These days, various surgical techniques such as trans-anal, trans-perineal total mesorectal excision, and transvaginal natural orifice transluminal endoscopic surgery have been utilized with flexibility, which was not possible before the laparoscopic era.</p><p><strong>Methods: </strong>From January 2014 to January 2023, 40 cases of c(yc)T4b rectal cancer underwent local curative surgery laparoscopically at Kansai Medical University Hospital. In 25 consecutive cases, we adopted multiple approaches (trans-anal total mesorectal excision, transvaginal natural orifice transluminal endoscopic surgery, trans-perineal total mesorectal excision, or prone position first abdominoperineal excision) to remove the deepest part of the tumor indicated by MRI last as the specimen-oriented surgery. The remaining 15 patients underwent top-to-bottom surgery based on standard surgery. The primary endpoint was the local recurrence rate of the specimen-oriented surgery group compared to that of the standard surgery group.</p><p><strong>Results: </strong>The specimen-oriented surgery group had a median follow-up of 3.9 (0.4-7.4) years with no local recurrence, while the standard surgery group had a median follow-up of 1.5 (0.7-3.7) years with 5 of 15 patients (33%) experiencing more local recurrence than specimen-oriented surgery group (p = 0.005). Comparison of the local recurrence ( +) and ( -) groups showed significant differences in pCRM positive rate, neoadjuvant therapy, tumor size, and approach (specimen-oriented surgery vs. standard surgery) in univariate analysis (p < 0.05). Still, no significant differences were found in the multivariate analysis.</p><p><strong>Conclusions: </strong>In the laparoscopic setting, local cure of c(yc)T4b rectal cancer requires a different strategy than open surgery, and specimen-oriented surgery may be a promising procedure.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"66"},"PeriodicalIF":2.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630375","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}