International Journal of Colorectal Disease最新文献

{"title":"Preoperative CT-derived sarcopenia as a predictor of postoperative complications in patients undergoing laparoscopic radical resection for non-metastatic colorectal cancer: a retrospective study.","authors":"Shuyan Su, Zejia Lin, Zelong Cai, Lipeng Huang, Yubin Xiao, Fangjie Yang, Xiujie Huang, Yikai Chen, Zhuoqun Zheng, Xinxin Li, Ruibin Huang","doi":"10.1007/s00384-025-04932-8","DOIUrl":"10.1007/s00384-025-04932-8","url":null,"abstract":"<p><strong>Purpose: </strong>Sarcopenia is increasingly recognized as a risk factor for postoperative complications in gastrointestinal cancer surgery. This study aimed to assess the association between sarcopenia and postoperative complications following laparoscopic radical resection of non-metastatic colorectal cancer (CRC).</p><p><strong>Methods: </strong>In this retrospective study, 387 non-metastatic CRC patients undergoing laparoscopic radical resection were categorized into a sarcopenic group and a non-sarcopenic group based on preoperative skeletal muscle index (SMI, cm²/m²). Logistic regression analysis was performed to identify independent predictors for postoperative complications.</p><p><strong>Results: </strong>Sarcopenia was present in 156 (40.31%) patients. The incidence of postoperative complications was 32.3%, with a serious complication (Clavien-Dindo III-V) rate of 12.1%. Compared with non-sarcopenic patients, sarcopenic patients had significantly higher incidences of total complications (P < 0.001) and severe complications (P = 0.026). Multivariable analysis identified sarcopenia as an independent risk factor for total postoperative complications (OR = 3.42, 95%CI 1.85-6.31). Further analysis of specific types of postoperative complications revealed that anastomotic leakage (P = 0.001), surgical site infection (P = 0.002), and surgical site adverse events (P = 0.001) rates were higher in sarcopenic patients. In multivariable analysis, sarcopenia was independently associated with anastomotic leakage (OR = 3.36, 95%CI = 1.12-10.12) and surgical site adverse events (OR = 3.02, 95%CI = 1.55-5.90).</p><p><strong>Conclusions: </strong>Preoperative CT-derived sarcopenia can predict postoperative complications in patients with non-metastatic CRC undergoing laparoscopic radical resection, particularly anastomotic leakage and surgical site adverse events.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"140"},"PeriodicalIF":2.5,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293734","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":"Effect of hyperthermic intraperitoneal chemotherapy on thrombin generation and fibrinolysis.","authors":"Mikkel Lundbech, Andreas Engel Krag, Lene Hjerrild Iversen, Birgitte Brandsborg, Anne-Mette Hvas","doi":"10.1007/s00384-025-04922-w","DOIUrl":"10.1007/s00384-025-04922-w","url":null,"abstract":"","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"139"},"PeriodicalIF":2.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266164","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":"Transperineal ultrasound in hemorrhoidal disease: pioneering the unseen.","authors":"Gianpiero Gravante, Veronica De Simone, Roberto Sorge, Marco La Torre, Vito D'Andrea, Stefania Romano, Gaetano Gallo","doi":"10.1007/s00384-025-04934-6","DOIUrl":"10.1007/s00384-025-04934-6","url":null,"abstract":"","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"138"},"PeriodicalIF":2.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247753","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":"Intraoperative oxygen concentration and postoperative delirium in elderly patients undergoing major abdominal surgery: a prospective randomized controlled clinical trial.","authors":"Shunpan Ji, Yue Shi, Xiaojing Fan, Bo Ye, Tianzhu Tao","doi":"10.1007/s00384-025-04929-3","DOIUrl":"10.1007/s00384-025-04929-3","url":null,"abstract":"<p><strong>Objective: </strong>Cerebral hypoxia and hypoperfusion are key pathophysiological contributors to postoperative delirium (POD). This study evaluated the impact of 40% versus 100% inspired oxygen (FiO₂) on POD incidence, neuroinflammation, and clinical outcomes in elderly patients undergoing major abdominal surgery.</p><p><strong>Methods: </strong>In this trial, 160 elderly patients scheduled for major abdominal surgery under general anesthesia from 2022 to September 2023 were randomly assigned to receive 40% FiO₂ (n = 80) or 100% FiO₂ (n = 80). The primary outcome was POD incidence within 3 postoperative days. Secondary outcomes included perioperative oxygenation parameters, plasma neuroinflammatory markers, pulmonary infections, pain scores, and hospitalization duration. Blood samples were collected preoperatively and postoperatively for biomarker analysis.</p><p><strong>Results: </strong>Among 154 analyzed patients, POD incidence was 5.2% (8/154), with no significant difference between 40% FiO₂ (6.4%, 5/78) and 100% FiO₂ (3.9%, 3/76) groups (P = 0.72). The 40% FiO₂ group exhibited lower saturation of pulse oxygen, regional cerebral oxygen saturation, and arterial partial pressure of oxygen from 1 h post-anesthesia (T2) to anesthesia end (T5) (P < 0.05). No intergroup differences in interleukin-6, tumor necrosis factor alpha, neuron-specific enolase, or neurofilament light chain levels were observed postoperatively (P > 0.05). FiO₂ levels did not influence pulmonary infection rates, postoperative VAS scores, or hospital stay (P > 0.05).</p><p><strong>Conclusions: </strong>While 100% FiO₂ enhances cerebral oxygenation, it does not reduce POD incidence or neuroinflammatory markers compared to 40% FiO₂. High-concentration oxygen did not increase pulmonary complications but offered no clinical benefits in this cohort. Intraoperative FiO₂ should be titrated based on individualized patient needs.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"137"},"PeriodicalIF":2.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234013","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":"Preoperative immunosuppressive therapy might not affect the length of resected bowel in patients receiving ileocolic resection for Crohn's disease.","authors":"Matthias Kelm, Michaela Bredl, Anna Widder, Katrin Schoettker, Markus Brand, Alexander Meining, Regina Pistorius, Joachim Reibetanz, Nicolas Schlegel, Christoph-Thomas Germer, Sven Flemming","doi":"10.1007/s00384-025-04927-5","DOIUrl":"10.1007/s00384-025-04927-5","url":null,"abstract":"<p><strong>Purpose: </strong>Rates of surgery remain relevant for localized Crohn's disease despite the evolution of novel therapies. However, the effect of immunosuppressive medication on the perioperative outcome including the extent of the resection is still inconclusive and needs to be evaluated.</p><p><strong>Methods: </strong>In a single-center study, all patients who received ileocolic resection due to localized Crohn's disease were retrospectively assessed and divided into two groups depending on previous treatment (preoperative medication versus therapy-naïve). Outcome parameters included patient characteristics, surgical and histopathological aspects.</p><p><strong>Results: </strong>Two hundred thirty-seven patients were analyzed of whom 192 patients received medical treatment prior to surgery. Preoperative treatment had neither an effect on the length of the resected specimen (29.4 cm versus 27.1 cm, p = 0.27) nor on the postoperative outcome. Only rates of conversion were significantly increased for therapy-naïve patients compared to patients receiving preoperative treatment (15.6% versus 5.7%, p = 0.025).</p><p><strong>Conclusion: </strong>Preoperative medical treatment does not have an effect on the extent of the resected bowel segment in patients suffering from localized Crohn's disease.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"136"},"PeriodicalIF":2.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225389","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":"Correspondence for the article titled \"Predictive value of rectal MRI variables for pathological complete response in locally advanced rectal cancer following neoadjuvant chemoradiotherapy\".","authors":"Mohit Bhatia, Danko Kostadinov, Georgi Gelov","doi":"10.1007/s00384-025-04925-7","DOIUrl":"10.1007/s00384-025-04925-7","url":null,"abstract":"","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"135"},"PeriodicalIF":2.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215742","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 the gracilis flap in colorectal surgery: surgical technique, results, and review of the literature.","authors":"Muharrem Oner, Anna T Tsay, Maher A Abbas","doi":"10.1007/s00384-025-04928-4","DOIUrl":"10.1007/s00384-025-04928-4","url":null,"abstract":"<p><strong>Background: </strong>The gracilis flap is rarely used in colorectal surgery and requires a multidisciplinary surgical team including plastic surgeons. There is a paucity of data on the outcome of the gracilis flap when performed by colorectal surgeons.</p><p><strong>Methods: </strong>A retrospective review was performed of all consecutive patients who underwent the gracilis flap at a single institution. Data collected included patient-related characteristics, indications for surgery, postoperative outcomes, and healing rates.</p><p><strong>Results: </strong>Eighteen patients underwent a total of 19 flaps. The median age was 60 years. Thirteen patients (72.2%) had prior radiation therapy. The most common indication for radiation was prostate carcinoma (38.9%) and rectal or anal carcinoma (33.3%). Indications for operation were complex fistulas in 14 patients (77.8%) or wound defect closure in four patients (22.2%). Six out of 14 patients (42.9%) had failed prior fistula repair. All patients had existing stoma or underwent stoma placement at the time of the gracilis flap. Median length of stay was 5 days. Post-operative complications occurred in three patients (16.7%), and the readmission rate was 11%. Flap failure was noted in three patients (16.6%). Both patients with rectourethral fistulas healed after additional intervention. During a median follow-up time of 24 months, 11 out of the 12 temporary stomas were closed, and one was converted to a permanent colostomy.</p><p><strong>Conclusions: </strong>The gracilis flap can be successfully used for complex pelvic fistulas and perineal wounds. This study demonstrates that a colorectal surgeon with interest and expertise in this technique can perform this operation with excellent outcomes.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"133"},"PeriodicalIF":2.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208506","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":"Right extended hemicolectomy with ileo-descending anastomosis is associated with prolonged postoperative ileus and longer hospital stay compared to right or left hemicolectomy.","authors":"Shani Y Parnasa, Amir Shweiki, Diana Pinhasov, Samer Abu Salem, Rachel Gefen, Ido Mizrahi, Mahmoud Abu-Gazala, Alon J Pikarsky, Noam Shussman","doi":"10.1007/s00384-025-04926-6","DOIUrl":"10.1007/s00384-025-04926-6","url":null,"abstract":"<p><strong>Purpose: </strong>Prolonged postoperative ileus (PPOI) is associated with a lengthy hospital stay, risk of additional complications and substantial costs. Data regarding the incidence of PPOI following right extended colectomy (REC) with ileo-descending anastomosis is limited. This study aimed to compare the incidence of PPOI and evaluate risk factors for this condition among patients undergoing REC, left hemicolectomy (LC), and right hemicolectomy (RC) for colon carcinoma.</p><p><strong>Methods: </strong>This retrospective, single-center cohort study included patients who underwent colectomy for cancer at our institution between January 2014 and January 2022. Outcome measures were postoperative time to first bowel movement and flatus, postoperative time to tolerate a solid low-residue diet, the need for nasogastric tube (NGT) decompression or total parenteral nutrition (TPN), and length of hospital stay (LOS).</p><p><strong>Results: </strong>A total of 534 patients were included: 242 (45.3%) underwent LC, 207 (38.8%) RC, and 85 (15.9%) REC. There were no significant differences in surgical approach (laparoscopic vs. open), operative time, percentage of urgent surgeries, postoperative complication rates, or advanced T stages among the groups. Compared with LC and RC, REC was associated with a longer time to first flatus (p = 0.04), delayed tolerance of a solid diet (p < 0.001), and increased LOS (p < 0.001). Patients following REC were at a higher risk for the need of NGT decompression (p = 0.003). Analysis of covariance controlling for potential confounding variables identified REC as an independent risk factor for PPOI following surgery.</p><p><strong>Conclusion: </strong>This study revealed a higher incidence of PPOI following REC for cancer compared to RC and LC.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"134"},"PeriodicalIF":2.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215743","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":"Geriatric 8 score as a prognostic factor of the efficacy and safety of oxaliplatin-based chemotherapy in elderly patients with metastatic colorectal cancer.","authors":"Koki Hara, Wakana Chikaishi, Yunami Yamada, Hironori Fujii, Jesse Yu Tajima, Hirotoshi Iihara, Akitaka Makiyama, Daichi Watanabe, Koichi Ohata, Chiemi Hirose, Ryo Kobayashi, Akio Suzuki, Nobuhisa Matsuhashi","doi":"10.1007/s00384-025-04923-9","DOIUrl":"10.1007/s00384-025-04923-9","url":null,"abstract":"<p><strong>Objective: </strong>Oxaliplatin (L-OHP) is effective in the treatment of metastatic colorectal cancer (mCRC). However, given concerns about the possible impact of L-OHP-based chemotherapy regimens in the face of physical functional decline, the question of whether they should be actively recommended for elderly patients remains unclear. This study evaluated the relationship between the Geriatric 8 (G8) score, which assesses overall function in the elderly, and the efficacy and safety of L-OHP-based chemotherapy regimens.</p><p><strong>Methods: </strong>This retrospective study included mCRC patients aged ≥ 70 years who received L-OHP as first-line therapy between January 2017 and December 2022. The primary endpoints were overall survival (OS) and progression-free survival (PFS), and the secondary endpoint was incidence of adverse events (Grade ≥ 2). Patients were classified into high (≥ 14 points) and low (< 14 points) G8 score groups for comparison.</p><p><strong>Results: </strong>A total of 55 patients were included. Median PFS was significantly longer in the high G8 score group compared to the low G8 score group (12.4 vs. 6.0 months, P = 0.034). No significant difference in OS was observed (27.9 vs. 29.8 months, P = 0.833). The overall incidence of adverse events was comparable, but nausea incidence tended to be higher in the low G8 score group (0% vs. 25.5%, P = 0.096).</p><p><strong>Conclusion: </strong>The G8 score may serve as a useful prognostic factor in elderly mCRC patients receiving L-OHP. Those with lower G8 scores may be at higher risk of L-OHP-induced nausea.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"132"},"PeriodicalIF":2.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186934","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":"Safety and efficacy of gastrointestinal motility agents following elective colorectal surgery: a systematic review and meta-analysis of randomised controlled trials.","authors":"Rathin Gosavi, Nagendra N Dudi-Venkata, Simon Xu, Mohammad Asghari-Jafarabadi, Simon Wilkins, T C Nguyen, William Teoh, Raymond Yap, Paul McMurrick, Vignesh Narasimhan","doi":"10.1007/s00384-025-04924-8","DOIUrl":"10.1007/s00384-025-04924-8","url":null,"abstract":"<p><strong>Background: </strong>Postoperative ileus (POI) is a frequent complication after elective colorectal surgery, delaying gastrointestinal (GI) recovery and discharge. While pharmacologic agents such as laxatives and prokinetics are often included in enhanced recovery after surgery (ERAS) protocols, their efficacy and safety remain uncertain.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted to evaluate the effect of Gastrointestinal (GI) motility agents on postoperative recovery in elective colorectal surgery. Primary outcomes included GI-2 recovery (tolerance of solid diet and stool passage), time to first defaecation, and safety endpoints. Data was pooled using random-effects models.</p><p><strong>Results: </strong>Seven RCTs involving 849 patients were included. GI motility agents significantly accelerated GI-2 recovery (mean difference -1.01 days; 95% CI -1.29 to -0.73; p < 0.001) and reduced time to first defaecation (mean difference -1.07 days; 95% CI -1.40 to -0.73; p < 0.001). No significant differences were observed in safety outcomes, including anastomotic leak (OR 0.97; 95% CI 0.53 to 1.77), nasogastric tube reinsertion (OR 0.86; 95% CI 0.49 to 1.51), or readmission rates (OR 1.03; 95% CI 0.62 to 1.72).</p><p><strong>Conclusion: </strong>Motility agents enhance postoperative GI recovery without compromising safety in patients undergoing elective colorectal surgery. Given their low cost, wide availability, and favourable safety profile, gastrointestinal motility agents may be considered for integration into ERAS protocols. However, further high-quality, standardised trials are needed to confirm their benefits across diverse surgical populations.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"131"},"PeriodicalIF":2.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173694","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}