International Journal of Colorectal Disease最新文献

{"title":"Outcomes of embolization therapy of superior rectal arteries for the management of grade 1 to 3 internal hemorrhoids: a systematic Review of clinical studies.","authors":"Mustafa Al Jnainati, Niharika Ikkurthy, Mohammad Ayoub, Areeba Shahid, Mirza Taha Baig, Muhammad Iltaf, Jana Al Jnainati","doi":"10.1007/s00384-025-04944-4","DOIUrl":"10.1007/s00384-025-04944-4","url":null,"abstract":"<p><strong>Background: </strong>Superior rectal artery embolization (\"Emborrhoid\") offers a catheter-based alternative for grade I-III internal hemorrhoids when office therapies fail or surgery is undesirable.</p><p><strong>Methods: </strong>Following PRISMA 2020, PubMed and Embase were searched (Jan 2014-Jan 2024). Two reviewers independently screened records, extracted data, and applied RoB 2, ROBINS-I, or an adapted Newcastle-Ottawa Scale. Prespecified outcomes were technical success, clinical success (≥ 2-point fall in bleeding score or equivalent), adverse events, and recurrence. Substantial heterogeneity blocked meta-analysis; results were narratively synthesized.</p><p><strong>Results: </strong>Twenty-two studies encompassing 810 procedures qualified. Technical success reached 93-100%. Clinical success ranged from 63 to 94%, yielding marked bleeding control and symptom relief. Reported complications were mild and self-limited (pelvic discomfort, nausea, and low-grade fever); no ischemic injury, continence disturbance, or mortality occurred. Recurrence necessitating repeat treatment affected 8-20% of patients, usually when collateral arterial supply persisted. Patient-reported satisfaction exceeded 80% in every series. Only two small, heterogeneous comparative studies versus rubber-band ligation or sclerotherapy were available, precluding a pooled analysis.</p><p><strong>Conclusions: </strong>Current evidence suggests Emborrhoid is a safe, effective bridge between office procedures and surgery-particularly valuable for frail or anticoagulated patients. Yet small single-center cohorts, disparate techniques, and scarce head-to-head trials limit external validity. Multicenter randomized studies with harmonized outcomes and ≥ 24-month follow-up are required to confirm long-term efficacy, cost-effectiveness, and optimal patient selection.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"190"},"PeriodicalIF":2.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953209","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":"Beyond recurrence detection: advancing TPUS applications in hemorrhoidal disease through context-specific protocols and AI integration.","authors":"Hengqing Gao, Lingyu Liu, Yuting Xi","doi":"10.1007/s00384-025-04988-6","DOIUrl":"https://doi.org/10.1007/s00384-025-04988-6","url":null,"abstract":"","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"189"},"PeriodicalIF":2.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953238","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":"Influence of seton configuration, thickness, and laxity on patient comfort in chronic perianal fistula: a prospective comparative study.","authors":"J Barambio, Ana Leon-Bretscher, María Ramírez Bescos, Paula Soto García, Paloma Gadea Uria, Teresa Laloumet Garcimartin, Elena Viejo Martinez, Felipe Acedo Fernandez de Pedro, Patricia Ortega Domene, Alicia Ruiz de la Hermosa, María Luisa De Fuenmayor-Valera, Gloria Paseiro-Crespo","doi":"10.1007/s00384-025-04985-9","DOIUrl":"https://doi.org/10.1007/s00384-025-04985-9","url":null,"abstract":"<p><strong>Purpose: </strong>To determine how seton configuration, thickness, and laxity influence patient comfort and clinical outcomes in the management of chronic perianal fistulas.</p><p><strong>Methods: </strong>A prospective single-center study was conducted involving 33 patients (53 setons). Both intraindividual paired (n = 20) and independent group analyses (n = 13) were performed. Setons were categorized by configuration (O-shaped vs. V-shaped), thickness (1.5 mm vs. 2.5 mm), and laxity (≤ 2 cm vs. > 2 cm from the anal verge). Patient-reported outcomes were assessed using structured questionnaires evaluating sitting discomfort, discharge, sexual impact, and fecal incontinence.</p><p><strong>Results: </strong>O-shaped setons caused significantly less sitting discomfort than V-shaped ones (50.0% vs. 80.0%, p = 0.021). Excess laxity (> 2 cm) was associated with increased discharge (86.4% vs. 51.6%, p = 0.008), sexual impact (42.1% vs. 10.3%, p = 0.016), and fecal incontinence (66.7% vs. 10.0%, p = 0.041). Thicker setons (2.5 mm) showed a non-significant trend toward more pain (42.9% vs. 17.9%, p = 0.080).</p><p><strong>Conclusion: </strong>Seton configuration and laxity significantly affect patient comfort. O-shaped setons and shorter laxity (≤ 2 cm) are preferable for reducing discomfort. These findings support evidence-based seton selection, although larger multicenter studies are needed to confirm these results.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"187"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953274","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":"Obesity Selectively Increases Intraoperative Risk in Left-Sided Colon Cancer Surgery: A Retrospective Cohort Study.","authors":"Simon Xu, Rathin Gosavi, Yat Cheung Chung, William Teoh, T C Nguyen, Geraldine Ooi, Vignesh Narasimhan","doi":"10.1007/s00384-025-04989-5","DOIUrl":"https://doi.org/10.1007/s00384-025-04989-5","url":null,"abstract":"<p><strong>Background: </strong>Obesity is traditionally viewed as a risk factor for adverse surgical outcomes. This study evaluated whether obesity (BMI ≥ 30 kg/m²) independently affected intraoperative and postoperative outcomes following colon cancer resection, and whether these effects varied by anatomical site.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted of consecutive patients who underwent colon cancer resection at a single institution from 2015 to 2022. Patients were stratified by BMI (≥ 30 kg/m² vs < 30 kg/m²) and further grouped by urgency (elective or emergency) and anatomical subsite (right- vs left-sided). Primary outcomes were intraoperative complications, severe postoperative morbidity (Clavien-Dindo ≥ III), conversion to open surgery, ICU admission, and 30-day mortality. Multivariate logistic regression was used to adjust for confounders.</p><p><strong>Results: </strong>Among the 737 patients, 33.5% were obese (BMI ≥ 30). Obese patients were younger and had higher rates of hypertension (55% vs 46%, p = 0.01), diabetes (25% vs 16%, p < 0.01), and respiratory disease (22% vs 11%, p < 0.01). In the overall cohort, obesity was not associated with increased rates of intraoperative complications, severe postoperative complications, conversion to open surgery, or 30-day mortality. In elective resections, obesity was independently associated with increased likelihood of ICU admission (aOR 1.82, 95% CI 1.08-3.09; p = 0.02), while in emergent resections obesity was independently associated with higher intra-operative complications (aOR 2.18, 95% CI 1.19-3.97; p = 0.01). Stratified analysis by resection site revealed that obesity was an independent risk factor associated with intraoperative complications (aOR 1.89, 95% CI 1.03-3.47; p = 0.04) and ICU admission (aOR 3.17, 95% CI 1.61-6.23; p < 0.01) following left-sided colectomy, but not right-sided surgery.</p><p><strong>Conclusions: </strong>Obesity was not associated with adverse outcomes following colon cancer surgery overall. However, when stratified by anatomical subsite, obesity was independently associated with increased perioperative risk in left-sided resections. These findings support a more nuanced approach to operative planning and perioperative risk stratification.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"188"},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953245","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":"Organ preservation in rectal cancer: opportunity within boundaries.","authors":"Michele Maria Cantagalli, Valentina Sani, Carlo Alberto Schena, Nicola de'Angelis","doi":"10.1007/s00384-025-04984-w","DOIUrl":"https://doi.org/10.1007/s00384-025-04984-w","url":null,"abstract":"<p><strong>Purpose: </strong>To highlight the opportunities and pitfalls of organ-preservation strategies for rectal cancer and to define the clinical circumstances in which radical total mesorectal excision (TME) remains imperative, particularly when treatment is delivered outside referral centres.</p><p><strong>Methods: </strong>Two illustrative patients initially managed in a tertiary hospital that is not a referral centre for rectal cancer and organ-preservation strategies are presented. Clinical records, imaging, histopathology, and follow-up were reviewed. Key management decisions were compared with current European Society for Medical Oncology (ESMO) and Italian Association of Medical Oncology (AIOM) guidelines, as well as recent evidence from systematic reviews.</p><p><strong>Results: </strong>Case 1 involved a bulky (10 cm), circumferential cT3N + mucinous adenocarcinoma. Despite apparent local control after transanal excision, the patient developed sphincter-destructive recurrence requiring abdominoperineal resection; final pathology was ypT3N2b KRAS-mutant. Case 2 concerned an initially pT1 rectal adenocarcinoma in a 6-cm laterally spreading tumour, but surveillance was non-standardized; the patient re-presented with metastatic (liver) mucinous adenocarcinoma 4 years later, misdiagnosed as liver abscesses. In both patients, deviation from guideline criteria (tumour size, nodal status, unfavourable histology, or inadequate follow-up) led to undertreatment and delayed radical therapy.</p><p><strong>Conclusion: </strong>Organ preservation offers functional benefits but must be confined to rigorously selected low-risk lesions within prospective protocols and high-volume centres. Radical TME remains the gold standard when guideline criteria are not fully met or staging is ambiguous.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"186"},"PeriodicalIF":2.3,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953254","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":"Unveiling the impact of body mass index on surgical difficulty and oncological prognosis in low rectal cancer: post-hoc analysis of the LASRE trial.","authors":"Yanwu Sun, Zhenyu Xu, Yongqin Tang, Yu Deng, Zihan Tang, Weizhong Jiang, Ying Huang, Pan Chi","doi":"10.1007/s00384-025-04979-7","DOIUrl":"https://doi.org/10.1007/s00384-025-04979-7","url":null,"abstract":"<p><strong>Purpose: </strong>This post-hoc analysis of the LASRE trial aims to evaluate the impact of body mass index (BMI) on surgical difficulty and oncological outcomes in patients undergoing laparoscopic or open resection for low rectal cancer.</p><p><strong>Methods: </strong>The LASRE trial was a multicenter, randomized controlled trial comparing laparoscopic and open surgery for low rectal cancer. Patients aged 18-75 years with rectal adenocarcinoma located within 5 cm of the dentate line were enrolled and stratified into four BMI groups: underweight (BMI < 18.5 kg/m²), normal weight (BMI 18.5-23.9 kg/m²), overweight (BMI 23.9-27.9 kg/m²), and obese (BMI ≥ 28.0 kg/m²). The primary endpoints were surgical difficulty, circumferential resection margin (CRM) positivity, and postoperative complications.</p><p><strong>Results: </strong>A total of 1,039 patients were included. Obese patients exhibited significantly longer operative times (P < 0.001) and higher intraoperative blood loss (P = 0.001). The 30-day complication rate (P = 0.030) and Clavien-Dindo classification (P = 0.040) differed significantly between groups. However, CRM positivity rates did not significantly differ between BMI groups (P = 0.42). During the median follow-up of 36 months, the 3-year OS rate was comparable across BMI groups (P = 0.709), and the 3-year DFS rate showed no significant differences among the BMI groups (P = 0.966).</p><p><strong>Conclusions: </strong>Higher BMI increases surgical difficulty and postoperative complications in low rectal cancer but does not significantly impact CRM positivity or DFS. These findings underscore the importance of considering BMI in surgical planning and patient counseling.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"185"},"PeriodicalIF":2.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952919","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":"Functional and multimodal approach to sarcopenia in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.","authors":"Semra Demirli Atici, Aras Emre Canda, Mustafa Cem Terzi","doi":"10.1007/s00384-025-04981-z","DOIUrl":"https://doi.org/10.1007/s00384-025-04981-z","url":null,"abstract":"","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"183"},"PeriodicalIF":2.3,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953263","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":"ERO1α regulates colon cancer progression and 5-FU resistance through the miR-451a/ARF1 axis.","authors":"Kun Yu, Ping Liu, Jianhua Dong, Xuan Zhang, Quan Yang, Ke Lian, Wenliang Li, Yunfeng Li","doi":"10.1007/s00384-025-04987-7","DOIUrl":"https://doi.org/10.1007/s00384-025-04987-7","url":null,"abstract":"<p><strong>Background: </strong>Colon cancer (CC) is one of the three most common cancers worldwide. In the treatment of CC, 5-fluorouracil (5-FU) is one of the main components of chemotherapeutic combinations, but severe chemical resistance still occurs. In addition, endoplasmic reticulum (ER) oxidoreductase-1α (ERO1α) has been shown to be highly expressed in CC, but its specific molecular mechanisms remain unclear.</p><p><strong>Methods: </strong>Via western blot, real-time quantitative polymerase chain reaction (RT‒qPCR), colony formation, Transwell, CCK-8, immunofluorescence, and immunohistochemistry experiments,we evaluated the expression of related genes and the progression of CC.  RESULTS: In this study, we found that ERO1α was highly expressed in CC and that miR-451a expression was low. Knocking down ERO1α can restrain the proliferation and invasion of CC cells; facilitate the expression of the ER stress-related proteins inositol-requiring enzyme (IRE), phosphorylated IRE (Pho-IRE), glucose-regulated protein 78 (GRP78), and activating transcription factor 4 (ATF4) and the proapoptotic proteins Bcl-2-associated X protein (Bax) and cleaved-caspase-3 in CC cells; and alleviate the progression of CC. The addition of the miR-451a inhibitor weakened the effect of sh-ERO1α. In terms of mechanism, we predicted that miR-451a targets ADP-ribosylation factor 1 (ARF1) through the StarBase website and confirmed the interaction between the two through a dual-luciferase gene reporter assay. Next, we verified that knocking down ERO1α promoted miR-451a and inhibited ARF1 expression, thus promoting ER stress and ultimately inhibiting the progression of CC. In addition, knocking down ERO1α promoted ER stress and weakened CC cell resistance to 5-FU.  CONCLUSION: Our studies revealed that ERO1α could mediate ER stress to regulate the progression of CC and 5-FU resistance through the miR-451a/ARF1 axis, which may provide new treatment directions and molecular targets for CC.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"184"},"PeriodicalIF":2.3,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953226","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":"Long-term outcomes of transanal irrigation in patients with low anterior resection syndrome: what happens after more than five years?","authors":"Jacopo Martellucci, Maximilian Scheiterle, Gherardo Maltinti, Carlo Bergamini, Fabio Cianchi, Paolo Prosperi","doi":"10.1007/s00384-025-04977-9","DOIUrl":"10.1007/s00384-025-04977-9","url":null,"abstract":"<p><strong>Background: </strong>Low anterior resection syndrome (LARS) significantly impacts quality of life after rectal cancer surgery. Transanal irrigation (TAI) is a potential treatment, but long-term outcome data are limited. This study aims to evaluate the efficacy and safety of TAI in LARS patients after more than 5 years of follow-up.</p><p><strong>Methods: </strong>From April 2015 to December 2019, consecutive patients with LARS following low anterior resection for rectal cancer, trained in TAI at Careggi University Hospital, were prospectively collected. Patients with LARS scores > 30 or those failing conservative management were included. TAI was performed using the Peristeen® device, with a standard protocol of 400-600 ml irrigation 3-4 times/week. Primary outcomes were maintenance of TAI benefits and patient satisfaction (VAS).</p><p><strong>Results: </strong>After an appropriate training and evaluation period, 35 patients were referred to TAI. While interruptions in the first year were mainly related to technical problems, ineffectiveness, or the onset of other clinical problems, afterward, patients tended to discontinue treatment only in the event of death (6 patients) or clinical well-being (5 patients). At the last follow-up control, with a median follow-up of 89 months, 15 patients (43%) still used TAI treatment. The median VAS satisfaction score for bowel control was 8.2.</p><p><strong>Conclusions: </strong>TAI demonstrates sustained benefits in LARS patients over 5 years, with significant symptom improvement and high patient satisfaction. Further studies are needed to identify predictors of long-term success.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"181"},"PeriodicalIF":2.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873075","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 impact of nano-carbon suspension lymph node tracing on rectal cancer surgery post-neoadjuvant therapy.","authors":"Shuai Shen, Hui Gao, Zhongzheng Cao, Wenlong Xia, Chengren Li","doi":"10.1007/s00384-025-04982-y","DOIUrl":"10.1007/s00384-025-04982-y","url":null,"abstract":"<p><strong>Background: </strong>To explore the impact of using nano-carbon suspension for lymph node tracing on the number of detected lymph nodes and short-term clinical outcomes in patients undergoing laparoscopic radical resection for rectal cancer following neoadjuvant therapy.</p><p><strong>Methods: </strong>This study retrospectively analyzed clinical data from 109 patients who underwent neoadjuvant therapy and laparoscopic radical resection for rectal cancer at Weifang People's Hospital from January 2020 to December 2022. Of these, 43 patients received an endoscopic submucosal injection of nano-carbon suspension (experimental group), with 22 patients receiving the injection before neoadjuvant therapy and 21 patients receiving it 24 h before surgery. The remaining 66 patients did not receive the nano-carbon injection (control group). All patients received neoadjuvant therapy according to guidelines and were operated on by the same surgical team. By comparing the number of detected lymph nodes and short-term clinical outcomes among the three groups, the study aimed to investigate the impact of the endoscopic submucosal injection of nano-carbon and the timing of injection on the surgical quality for patients with rectal cancer undergoing neoadjuvant therapy.</p><p><strong>Results: </strong>The number of detected lymph nodes in the groups injected with nano-carbon before neoadjuvant therapy and 24 h before surgery was significantly higher than that in the non-injected group (P = 0.000), with a significant increase in the proportion of detecting ≥ 12 lymph nodes (P = 0.016), showing statistical significance. There is no statistically significant difference in the number of detected lymph nodes between the group injected with nano-carbon before neoadjuvant therapy and the group injected 24 h before surgery (P = 0.141).</p><p><strong>Conclusions: </strong>Endoscopic submucosal injection of nano-carbon suspension for lymph node tracing can increase the number of detected lymph nodes in rectal cancer surgery following neoadjuvant therapy, enabling more precise postoperative tumor staging. Although pre-neoadjuvant nano-carbon injection yielded a numerically higher lymph-node detection rate, this trend was not statistically significant (P = 0.141). Consequently, the optimal injection timing remains unconfirmed and should be validated in larger prospective studies.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"182"},"PeriodicalIF":2.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12364729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882837","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}