Clinics in Colon and Rectal Surgery最新文献

Artificial Intelligence as the Ultimate Operative Assistant. 人工智能作为终极操作助手。

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2026-01-09 eCollection Date: 2026-05-01 DOI: 10.1055/a-2769-1318

Carl G Engelke, Rami J N Aoun, Emily Huang

{"title":"Artificial Intelligence as the Ultimate Operative Assistant.","authors":"Carl G Engelke, Rami J N Aoun, Emily Huang","doi":"10.1055/a-2769-1318","DOIUrl":"10.1055/a-2769-1318","url":null,"abstract":"Artificial intelligence (AI) is poised to become transformational in many aspects of modern society and has attracted significant interest within the field of medicine. This review outlines the foundational components of modern AI such as including machine learning, deep learning, natural language processing, computer vision, and generative modeling, and examines their emerging applications within surgery. In the preoperative domain, AI-driven risk stratification models inform patient selection and resource allocation, while parallel advances in deep learning-enabled anatomic segmentation and three-dimensional reconstruction have the potential to streamline surgical planning by automating labor-intensive imaging workflows. Intraoperatively, maturing capabilities in phase recognition, anatomic identification, augmented reality overlay, and real-time decision support demonstrate the possibility for improved safety, workflow efficiency, and early recognition of surgical and physiologic challenges. And although the first fully autonomous AI-driven surgical robot in humans is likely still far off, the recent advances in robotic surgery suggest this may no longer be the purview of science fiction. For all its promise, significant challenges still persist for the robust implementation of AI into surgical workflows regarding data governance, algorithmic transparency, regulatory oversight, model generalizability, and, especially, many philosophical and ethical questions that remain unanswered.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"39 3","pages":"219-226"},"PeriodicalIF":1.1,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unique Challenges of Shared Decision-Making in Colorectal Surgery for the Elderly Patient. 老年结直肠手术患者共同决策的独特挑战。

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-12-23 DOI: 10.1055/a-2760-7343

Madhuri V Nishtala, Julia R Berian

引用次数: 0

Anastomotic Leak Following Colorectal Surgery. 结直肠手术后吻合口漏。

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-04-29 eCollection Date: 2026-01-01 DOI: 10.1055/s-0045-1807727

Olivia Ziegler, Audrey S Kulaylat

引用次数: 0

The Impact of Social Determinants of Health on Severe Colorectal Complications. 健康的社会决定因素对严重结直肠并发症的影响

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-04-24 eCollection Date: 2026-01-01 DOI: 10.1055/s-0045-1807758

Wendelyn M Oslock, Leanne D Jeong, Mei Lin N Dye, Meet Patel, Daniel I Chu

{"title":"The Impact of Social Determinants of Health on Severe Colorectal Complications.","authors":"Wendelyn M Oslock, Leanne D Jeong, Mei Lin N Dye, Meet Patel, Daniel I Chu","doi":"10.1055/s-0045-1807758","DOIUrl":"10.1055/s-0045-1807758","url":null,"abstract":"Complications following colorectal surgery remain a persistent issue despite advances in surgical technique, development of enhanced recovery, and improvements in perioperative care. Social determinants of health (SDOHs) at the individual, interpersonal, institutional, community, and policy levels have been associated with the risk of patients experiencing a complication. At the individual level, race and ethnicity are associated with complications, with the Black race having the most robust data demonstrating increased risk for complication. Additional individual-level factors associated with complications include food insecurity, health literacy, or the presence of an SDOH diagnostic Z-ICD code. Institutionally, hospital size, case volume, and teaching status were characteristics associated with the risk of complications, while safety net status was not. Hospital and home rurality, as well as food deserts, are community-level characteristics associated with an increased likelihood of complication. For policy-level SDOH, insurance type was associated with complications. Specifically, patients with Medicare, Medicaid, uninsured, or a combination of the three were more likely to experience a complication than a patient with private insurance. Additionally, composite measures for SDOH, such as the social vulnerability index, are associated with postoperative complications. There are SDOH at each level that influence the risk of complications following colorectal surgery, highlighting the need to incorporate these factors into quality improvement efforts.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"39 1","pages":"102-111"},"PeriodicalIF":1.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12716933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Beyond Bleeding, Infection, Damage to Surrounding Structures: Challenges and Opportunities When Communicating about Surgical Risks. 超越出血、感染、周围结构损伤：沟通手术风险时的挑战与机遇。

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-04-24 eCollection Date: 2026-01-01 DOI: 10.1055/s-0045-1807757

Melanie L Fritz, Ana C De Roo

引用次数: 0

Prophylactic Operative Interventions for Preventing Parastomal Hernias after Colorectal Surgery. 预防结直肠术后造口旁疝的预防性手术干预。

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-04-22 eCollection Date: 2026-01-01 DOI: 10.1055/s-0045-1807749

Tyler McKechnie, Neil J Smart, Cagla Eskicioglu

{"title":"Prophylactic Operative Interventions for Preventing Parastomal Hernias after Colorectal Surgery.","authors":"Tyler McKechnie, Neil J Smart, Cagla Eskicioglu","doi":"10.1055/s-0045-1807749","DOIUrl":"10.1055/s-0045-1807749","url":null,"abstract":"The most common long-term stoma-related morbidity following colorectal surgery is parastomal hernia formation. Given the risk of developing parastomal hernias and the risk of postoperative complications following their repair, practices have evolved to incorporate prophylactic strategies to reduce the risk of parastomal hernia formation after colorectal surgery. The majority of the data forming the evidence base for parastomal hernia prophylaxis pertains to patients undergoing end colostomy formation in the setting of colorectal cancer. The only prophylactic intervention for prevention of parastomal hernia formation with substantial amounts of high-quality data is the insertion of prophylactic mesh at the index operation for patients undergoing formation of a permanent end colostomy. Other interventions that have been proposed but have less published data substantiating their use include lateral pararectus stoma placement, extraperitoneal stoma creation, circular stoma trephine, and small fascial defects. This chapter will review each of these interventions in detail, along with the associated literature supporting or refuting their use. Additionally, we will discuss other important issues regarding the evidence base for parastomal hernia prophylaxis, parastomal hernia classifications, and risk factors for developing parastomal hernias.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"39 1","pages":"51-61"},"PeriodicalIF":1.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12716925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Palliation for Inoperable Infectious and Neoplastic Long-Term Surgical Complications. 不能手术的感染性和肿瘤性长期手术并发症的缓解。

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-04-21 eCollection Date: 2026-01-01 DOI: 10.1055/s-0045-1807756

Peter A Bryant, Myrick C Shinall

引用次数: 0

Role of Post-discharge Venous Thromboembolism Prophylaxis after Colorectal Surgery. 结直肠手术后静脉血栓栓塞预防的作用。

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-04-17 eCollection Date: 2026-01-01 DOI: 10.1055/s-0045-1807287

Pavel Lenkov, Elissa Dabaghi, Stefan Holubar

{"title":"Role of Post-discharge Venous Thromboembolism Prophylaxis after Colorectal Surgery.","authors":"Pavel Lenkov, Elissa Dabaghi, Stefan Holubar","doi":"10.1055/s-0045-1807287","DOIUrl":"10.1055/s-0045-1807287","url":null,"abstract":"Despite significant advances in colorectal surgery (CRS), postoperative venous thromboembolism (VTE) remains a critical issue that contributes to substantial morbidity and mortality. The incidence of VTE, including deep vein thrombosis, pulmonary embolism, and portomesenteric vein thrombosis, in the colorectal surgical population varies from 2 to 15%, with elevated risks in patients with colorectal cancer and inflammatory bowel disease. This review article examines the effects of VTE on postoperative outcomes and explores the efficacy of extended chemoprophylaxis (ePPx) for mitigating these risks. We will review the rates of morbidity and mortality associated with VTE, as well as the role of postdischarge ePPx in VTE prevention, while exploring how other specialties utilize ePPx strategies to decrease their postdischarge VTE rates, some of which may be translatable to CRS patients. Our analysis highlights the role of various prophylactic measures, including low-molecular-weight heparin (LMWH), aspirin, and direct oral anticoagulants (DOACs), comparing their effectiveness and cost implications as well as the use of thromboelastography to help guide ePPx management. Overall, findings suggest that VTE ePPx with LMWH significantly reduces the incidence of postoperative VTE and related complications, although patient compliance remains a challenge. While aspirin is a cost-effective alternative, its efficacy in patients with CRS requires further investigation. Emerging data on DOACs indicate their potential as viable options for ePPx, although their safety profile requires careful consideration. Tailored ePPx strategies, particularly with LMWH, appear to be crucial for reducing VTE in CRS patients. Further research is needed to refine the prophylactic approaches and establish standardized guidelines that incorporate new insights into VTE prevention and management in CRS.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"39 1","pages":"37-50"},"PeriodicalIF":1.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12716937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgery-induced and Associated Long-term Strictures. 手术引起的和相关的长期狭窄。

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-04-17 eCollection Date: 2026-01-01 DOI: 10.1055/s-0045-1807728

Matthew J Freeman, Corinne E Praska, Cristina B Sanger

{"title":"Surgery-induced and Associated Long-term Strictures.","authors":"Matthew J Freeman, Corinne E Praska, Cristina B Sanger","doi":"10.1055/s-0045-1807728","DOIUrl":"10.1055/s-0045-1807728","url":null,"abstract":"Strictures, commonly referred to as stenoses, are a rare but significant complication for patients who have undergone colorectal surgery. Strictures are difficult to diagnose due to variable clinical presentations, diverse etiologies, and lack of formalized diagnostic criteria. The clinical impact of strictures can be quite variable, ranging from a benign course not requiring intervention to emergent complications (e.g., bowel obstruction, perforation). Importantly, strictures can also have a large impact on patient quality of life and long-term bowel function. Once a stricture is diagnosed or clinically suspected, it is critical to determine its etiology to help guide clinical management and prevent recurrence. Strictures can be categorized as partial or complete, intrinsic or extrinsic, benign or malignant. We propose the ARCTIC mnemonic (Anastomosis, Radiation/Chemotherapy, Technical, Inflammation, and Compression) as a useful tool for remembering common stricture causes in the postoperative environment. This review seeks to provide an overview of the etiologies, diagnosis, and management of strictures in the postoperative setting.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"39 1","pages":"83-88"},"PeriodicalIF":1.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12716921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Low Anterior Resection Syndrome Evaluation and Management. 前低位切除综合征的评估和处理。

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-04-16 eCollection Date: 2026-01-01 DOI: 10.1055/s-0045-1807741

Samantha M Linhares, Anne K Mongiu

{"title":"Low Anterior Resection Syndrome Evaluation and Management.","authors":"Samantha M Linhares, Anne K Mongiu","doi":"10.1055/s-0045-1807741","DOIUrl":"10.1055/s-0045-1807741","url":null,"abstract":"Low anterior resection syndrome (LARS) is a constellation of symptoms consisting of stool or flatus incontinence, urgency, and/or clustering of bowel movements. Up to 80% of patients experience these symptoms after sphincter-sparing surgery for rectal cancer with concomitant decrease in quality of life. Multiple measurement tools have been developed and different treatment options have been explored. The purpose of this review was to evaluate LARS assessment tools, treatment options, and the supporting evidence for these strategies. We performed a literature review related to the evaluation and treatment of LARS, and ongoing clinical trials up to 2024 were reviewed. We found the definition of LARS was recently revised, with current validated diagnostic tools lagging behind this update. First-line treatment includes optimizing bowel habits, dietary changes, and medications. Second-line treatment includes pelvic floor rehabilitation or transanal irrigation. Third-line treatment includes sacral nerve stimulation or posterior tibial nerve stimulation before the discussion of antegrade enemas or permanent stoma creation. In summary, LARS remains a challenging symptomatic disorder to capture and treat effectively. There are opportunities for better standardization of preoperative education, evaluation, and escalation of treatment strategies. Further investigation into psychosocial and patient support adjuncts need to be developed. Continued research will help to refine and develop a clear treatment algorithm.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"39 1","pages":"70-82"},"PeriodicalIF":1.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12716930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0