International Journal of Colorectal Disease最新文献

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

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

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

{"title":"Effectiveness of Laser-Based Fistula Therapies with and without Adjunctive Measures in Anal Fistulas Management: A Systematic Review and Single-Arm Meta-Analysis.","authors":"Joao Ricardo Duda, Luiz Gustavo Albuquerque Mello de Oliveira, Luiza Fenelon Ferreira, Beanie Conceição Medeiros Nunes, Murilo Cavalcante Netto do Carmo, Diogo Bergesch Diedrich, Matheus Cavalcante Franco, Marcelo Cristalli Pacheco da Costa, Stefano Baraldo","doi":"10.1007/s00384-025-04995-7","DOIUrl":"10.1007/s00384-025-04995-7","url":null,"abstract":"<p><strong>Purpose: </strong>Fistula Laser Closure (FiLaC®) is a sphincter-preserving technique for anal fistulas, but its efficacy and safety remain under discussion. Therefore, we aim to evaluate the efficacy and safety of FiLaC® in the management of patients with cryptoglandular fistulas.</p><p><strong>Methods: </strong>A systematic review was performed in MEDLINE, Embase, and Cochrane databases in January 2025, following PRISMA guidelines. We included randomized controlled trials (RCTs) and observational studies assessing FiLaC® for cryptoglandular fistulas, with or without surgical adjunctive measures. The main outcome was the primary healing rate. Secondary outcomes included fistula recurrence, incontinence, reoperation rates, and postoperative complications. Subgroup analyses explored variables related to the primary healing rate. Data are presented as percentages (95% confidence interval). Statistical analyses were performed using R (version 4.4.1 (2024-06-14 (ucrt)).</p><p><strong>Results: </strong>We included 24 studies with 1,503 patients. The pooled primary healing rate was 57.46% (49.40-65.33). Recurrence occurred in 18.48% of patients (10.14-28.47), while new-onset incontinence was rare (0.57%; 0.00-2.15). The reoperation rate was 36.49% (28.95-44.36), and anal abscesses or infections affected 6.54% (1.93-13.09) of patients. Subgroup analysis showed no statistically significant differences in the primary healing rate based on fistula type, adjunctive measures, or sex. Sensitivity analysis confirmed the robustness of our findings.</p><p><strong>Conclusions: </strong>FiLaC® seems to be a safe option with an intermediate healing rate in patients with cryptoglandular fistulas, although it is associated with a considerable recurrence rate. While its sphincter preservation advantage is evident, further RCTs standardizing the technique and adjunctive approaches are needed to optimize outcomes and refine its application in fistula management.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"196"},"PeriodicalIF":2.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040052","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":"Standard of practice imaging vs. PET/MR: a comparative prospective study in rectal cancer staging.","authors":"Rafał Maksim, Angelika Buczyńska, Iwona Sidorkiewicz, Małgorzata Mojsak, Justyna Śliwowska-Burzyńska, Konrad Zuzda, Patryk Gugnacki, Adam Krętowski, Ewa Sierko","doi":"10.1007/s00384-025-04998-4","DOIUrl":"10.1007/s00384-025-04998-4","url":null,"abstract":"<p><strong>Background: </strong>Rectal cancer (RC) remains a significant global health concern, with increasing incidence rates and associated mortality. Early detection of metastases plays a crucial role in the effective management of rectal cancer and predicting patient outcomes. Imaging modalities are vital in diagnosing and evaluating the extent of metastases. The integration of novel hybrid positron emission tomography utilizing fluorodeoxyglucose (18F-FDG) fused with magnetic resonance (PET/MR) has emerged as an innovative diagnostic tool. By combining both technologies' strengths, PET/MR imaging provides precise metabolic information from PET alongside detailed anatomical data from MR. This prospective study aimed to assess the clinical utility of PET/MR imaging with the 18F-FDG tracer compared to standard imaging modalities for detecting the extent of RC.</p><p><strong>Methods: </strong>We enrolled 42 patients who underwent both standard imaging (CT and/or MRI) and whole-body PET/MR with 18F-FDG before preoperative therapy.</p><p><strong>Results: </strong>Our results indicated that PET/MR with 18F-FDG provides superior detection of lymph nodes and tumor deposits in the mesorectum, with the highest diagnostic accuracy for tumor length measurement (area under the ROC curve (AUC) = 0.730; p < 0.05) and a combined model of SUVmax and CEA (AUC = 0.921; p < 0.001). Furthermore, PET/MR changed the clinical stage in 64% of patients and altered clinical management in 26% of cases.  CONCLUSIONS: The presented findings demonstrate the effectiveness of this advanced imaging technique and its potential to enhance treatment planning. By providing more accurate staging information, this method could significantly improve diagnosis, treatment customization, and overall outcomes for patients with rectal cancer, particularly in cases where lymph node involvement and tumor deposits impact therapeutic decisions.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"198"},"PeriodicalIF":2.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040069","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":"Outcomes of the management of synchronous rectal and prostate cancer: a systematic review.","authors":"Ahmed Nassar, Noha E Aly, Mootaz Elhusseini, Craig Parnaby, Emad Aly","doi":"10.1007/s00384-025-04992-w","DOIUrl":"10.1007/s00384-025-04992-w","url":null,"abstract":"<p><strong>Background: </strong>The optimal management of synchronous rectal cancer (RC) and prostate cancer (PC) remains unclear. This systematic review evaluates treatment strategies and reports postoperative, oncological, and quality-of-life outcomes in patients treated with curative intent.</p><p><strong>Methods: </strong>Following PRISMA guidelines, this systematic review was registered in PROSPERO (CRD42024598049). A search of Ovid MEDLINE, Embase, CENTRAL, and CDSR (inception to February 2025) identified randomised controlled trials and observational studies on synchronous RC and PC. Synchronous disease was defined as diagnosis or treatment initiation within 12 months. Patients with incurable RC were excluded. Treatment strategies and surgical approaches were analysed, with postoperative, oncological, and survival outcomes assessed.</p><p><strong>Results: </strong>Eight retrospective studies (124 patients) were included. Common treatments included pelvic chemoradiotherapy (CRT) followed by surgery (29%), prostate booster radiotherapy with CRT (24.2%), prostate brachytherapy (8%), and no prostate-directed treatment (11.3%). Surgical approaches included total mesorectal excision (TME) (74.4%), TME with prostatectomy (10.8%), and en-bloc pelvic exenteration (8%). Primary anastomosis was achieved in 61.8%, with 70% requiring a diverting stoma. Anastomotic leaks occurred in 10.8%, and severe complications (grades 3b-5) affected 15.4%, with fewer in robotic-assisted surgery (8.3%). R0 resection was achieved in 92.8%, with no difference between robotic and non-robotic groups. Local recurrence and distant metastasis occurred in 5.9% and 27%, respectively.</p><p><strong>Conclusion: </strong>There is no consistent approach for managing synchronous RC and PC. High-dose prostate radiotherapy may not improve survival and may increase postoperative complications. Robotic-assisted resections may reduce major complications without compromising oncological outcomes.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"195"},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033349","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":"Investigating recurrence in pilonidal sinus disease: results of a nationwide, multicenter study in Turkey (PISI TURKEY).","authors":"Ali Yalcinkaya, Ahmet Yalcinkaya, Can Sahin, Bengi Balci, Elif Ozeller, Ece Ozturk, Gulsum Sueda Kayacan, Berkay Enes Karaca, Ahmet Faruk Oyanik, Aydin Yavuz, Erdinc Kamer, Sezai Leventoglu","doi":"10.1007/s00384-025-04921-x","DOIUrl":"10.1007/s00384-025-04921-x","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to investigate the recurrence rates for the treatment of pilonidal sinus disease (PSD) in Turkey and the factors associated with recurrence of PSD after surgery on a nationwide scale.</p><p><strong>Methods: </strong>This national, multicenter, database review was conducted in Turkey by the PISI TURKEY Research Group, and included recipients of PSD surgery in 41 select hospitals in Turkey, between January 2019 and January 2020. Data were collected by completion of standardized data forms. Sociodemographic and anthropometric data, comorbidities, PSD type, previous PSD interventions, index PSD intervention, recurrence, and complications were collected from baseline to postoperative 12 months.</p><p><strong>Results: </strong>The data of 1662 patients from 41 centers were analyzed. The median age was 25 (21-32) years, and 80.26% of the cases were male. The recurrence rate following index operations was 6.26% in the 12-month period. Age (p = 0.594) and sex distribution (p = 0.441) were similar in patients with and without recurrence. The recurrent group had significantly higher frequencies of type V PSD (p < 0.001), wound site infection (p < 0.001), and wound separation (p < 0.001), whereas the non-recurrent group had a significantly higher frequency of type III PSD (p < 0.001). Multivariable logistic regression revealed that prior recurrence, postoperative wound site infection, and postoperative wound separation were independently associated with recurrence.</p><p><strong>Conclusions: </strong>The recurrence rate after PSD surgery in Turkey was close to the lower ranges reported in prior literature. Turkish patients with a history of prior recurrence, postoperative wound site infection, or postoperative wound separation should be considered to have higher risks for recurrence.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"194"},"PeriodicalIF":2.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033359","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":"Less combination therapy and more fistulotomy in perianal fistulizing Crohn's disease in the elderly.","authors":"Oumniya Arjafallah Goulet, Charlène Brochard, Laurent Siproudhis, Isabelle Etienney","doi":"10.1007/s00384-025-04991-x","DOIUrl":"10.1007/s00384-025-04991-x","url":null,"abstract":"<p><strong>Background and aims: </strong>This study aimed to describe Crohn's disease perianal fistulizing lesions in patients undergoing surgery over 60 years to compare clinical presentation, management and outcomes with those observed in younger patients.</p><p><strong>Methods: </strong>Between January 2012 and December 2022, all patients over 60 years old who underwent a first surgical intervention for anal fistula at two medical centers were included. For each patient included, two younger patients who underwent the same surgical procedure during the same period in the same centers were matched for comparison.</p><p><strong>Results: </strong>Among 536 patients who underwent surgery, 6% (n = 30) aged over 60 years at first surgery were included. Compared with their younger counterparts, older patients had: i) a diagnosis of Crohn's disease and fistula more often in the same year: 63% vs 26%, p = 0.001; ii) combined therapy and anti-TNF alpha optimization less often (p = 0.0002 and p = 0.0001); iii) fewer surgical interventions: 3 vs 4.5, p = 0.008; iv) sparing surgery less frequently: 30% vs 58%, p = 0.01; v) fistulotomy more often: 27% vs 5%, p = 0.003. The rates of anal fistula closure were comparable between the two groups: 60% vs 62%, p = 0.93.</p><p><strong>Conclusion: </strong>Synchronous diagnosis of anal fistula and Crohn's disease within the first year of care is not uncommon after 60 years of age, suggesting that Crohn's disease should not be overlooked in older individuals developing an anal fistula. Despite receiving less aggressive medical management due to age-related factors, elderly patients achieved similar fistula closure rates, through a more pragmatic surgical approach, including more fistulotomies in selected patients.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"192"},"PeriodicalIF":2.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029634","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 and safety of indocyanine green fluorescence imaging in colorectal cancer: a systematic review and meta-analysis of randomized controlled trials.","authors":"Abdullah Afridi, Ayesha Zulfiqar, Fatima Sajjad, Iqra Shahid, Hira Habib, Yasir Saleem, Zain Afridi, Asad Iqbal, Fazia Khattak, Farwa Nisa, Hanifullah Khan, Zaryab Bacha, Muhammad Abdullah Ali, Muhammad Hamza Khan, Rizwan Afridi, Kamil Ahmad Kamil","doi":"10.1007/s00384-025-04941-7","DOIUrl":"10.1007/s00384-025-04941-7","url":null,"abstract":"<p><strong>Background: </strong>The primary treatment for colorectal cancer, which is very prevalent, is surgery. Anastomotic leaking poses a significant risk following surgery. Intestinal perfusion can be objectively and instantly assessed with indocyanine green fluorescence imaging, which may lower leakage rates and enhance surgical results.</p><p><strong>Methods: </strong>PubMed, Embase, and Web of Science databases were systematically searched using relevant keywords from inception until 5th of March 2025. Eight studies were included after final screening. Outcomes were reported as overall anastomotic leakage, wound infection, paralytic ileus, mechanical ileus, and post-operative hospital stay. Interstudy heterogeneity was assessed using I² and X² statistics (I² > 50% = significant heterogeneity). Statistical calculations were performed using Review Manager 5.4.1 (The Cochrane Collaboration, Copenhagen, Denmark), with a p-value of < 0.05 indicating statistical significance.</p><p><strong>Results: </strong>This meta-analysis includes 4047 patients from eight investigations (2026 indocyanine green (ICG) group, 2021 non-ICG group). Overall anastomotic leak risk was considerably decreased with ICG use (risk ratio (RR) = 0.66; 95% CI: 0.54-0.81; p < 0.0001) and showed no heterogeneity (I² = 0%). There was no heterogeneity (I² = 0%) in the Grade A leakage occurrence, which was considerably lower in the ICG group (RR = 0.34; 95% CI: 0.16-0.72; p = 0.005). With little heterogeneity (I² = 8.6%), combined leakage grades also supported ICG use (RR = 0.54; 95% CI: 0.35-0.84; p = 0.006). ICG was associated with a substantial decrease in Clavien-Dindo Grade I complications (RR = 0.67; 95% CI: 0.49-0.92; p = 0.01) without heterogeneity (I² = 0%). Initial postoperative hospital stays, mechanical ileus, paralytic ileus, and abdominal bleeding did not differ significantly. Although there was no heterogeneity (I² = 0%), sensitivity analysis showed that the ICG group had a substantially longer postoperative stay (MD = 0.27; 95% CI 0.05-0.49; p = 0.02) and significantly fewer wound infections (RR = 0.17; 95% CI 0.04-0.76; p = 0.02). With noteworthy heterogeneity (I² = 70%), the ICG group's operating time was significantly longer (MD = 8.26 min; 95% CI 0.52-16.00; p = 0.04).</p><p><strong>Conclusion: </strong>Although indocyanine green fluorescence imaging may marginally lengthen the recovery period and duration of operation, it dramatically lowers anastomotic leakage and wound infections following colorectal surgery, enhancing results.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"193"},"PeriodicalIF":2.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029608","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":"Neoadjuvant therapy for resectable colorectal cancer pulmonary oligometastases: a retrospective cohort study.","authors":"Yibo Cai, Guohui Xu, Yanxi Shao, Dening Ma, Yuping Zhu","doi":"10.1007/s00384-025-04986-8","DOIUrl":"https://doi.org/10.1007/s00384-025-04986-8","url":null,"abstract":"<p><strong>Purpose: </strong>Lung metastasectomy has been considered the cornerstone of treatment of resectable colorectal cancer pulmonary oligometastases (CRCPOM). However, the role of chemotherapy in the neoadjuvant setting remains unclear. This study aimed to determine whether neoadjuvant therapy (NAT) could further improve survival outcomes of patients with resectable CRCPOM.</p><p><strong>Methods: </strong>We included all 253 consecutive patients at our center between 2010 and 2022. Propensity score matching (PSM) was performed to balance the baseline characteristics. The efficacy of NAT was evaluated using the Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST v1.1). Disease-free survival (DFS) was the primary endpoint, which was estimated by the Kaplan-Meier method. Multivariate analyses were conducted using Cox proportional hazards regression to identify independent predictors.</p><p><strong>Results: </strong>The cumulative 5- and 10-year DFS rates following lung metastasectomy were 48.3% and 39.4%, respectively. After PSM, NAT was significantly associated with improved DFS (HR, 0.52; P = 0.009). A clinical risk score was constructed using four independent predictors of worse DFS (serum carcinoembryonic antigen > 5.0 ng/mL, disease-free interval after colorectal resection < 2 years, primary tumor with nodal involvement, extrapulmonary metastases) and enabled risk stratification. The administration of NAT could improve DFS in patients with ≥ 1 risk factor (HR, 0.60; P = 0.020), while such benefit was not observed in those with no risk factor. RECIST-defined response was noted in 34/74 (46.0%) patients who received NAT, which was correlated with improvement in DFS (HR, 0.31; P = 0.008).</p><p><strong>Conclusions: </strong>NAT may confer a survival benefit in patients with resectable CRCPOM. Using an easy-to-use clinical risk score, patients with ≥ 1 risk factor are good candidates for initial NAT. The RECIST criteria are deemed suitable for the assessment of efficacy of NAT before lung metastasectomy.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"191"},"PeriodicalIF":2.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953186","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}