Clinics in Colon and Rectal Surgery最新文献_第2页

General Principles of Risk Mitigation before Colorectal Surgery. 结直肠手术前降低风险的一般原则。

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-0045-1807736

Sarah Atoui, A Sender Liberman

{"title":"General Principles of Risk Mitigation before Colorectal Surgery.","authors":"Sarah Atoui, A Sender Liberman","doi":"10.1055/s-0045-1807736","DOIUrl":"10.1055/s-0045-1807736","url":null,"abstract":"Preoperative risk mitigation is vital for improving surgical outcomes and patient safety, particularly in colorectal cancer (CRC) surgeries. While traditional approaches have primarily focused on postoperative care, the preoperative period is a unique opportunity for intervention to enhance patients' physiological readiness for surgery and minimize complications. This narrative review examines the general principles of preoperative risk mitigation, identifies common complications in colorectal surgery, and explores the impact of patient comorbidities on surgical outcomes. Additionally, the review discusses the strategic management of modifiable risk factors. The integration and impact of prehabilitation protocols in colorectal surgery are also evaluated. Evidence indicates that addressing modifiable preoperative risk factors can significantly improve surgical outcomes. Obesity management, nutritional optimization, and enhancing functional capacity through prehabilitation have been shown to reduce postoperative complications. Multimodal prehabilitation benefits high-risk and frail patients, improving their postoperative recovery and reducing complication rates. The preoperative period is crucial for implementing risk mitigation strategies to enhance surgical outcomes in CRC patients. Interventions targeting modifiable risk factors and integrating prehabilitation protocols can complement traditional postoperative care, improving recovery and reducing complications. Despite promising findings, further research is necessary to fully understand the long-term benefits and optimize preoperative interventions to mitigate postoperative morbidities effectively.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"39 1","pages":"15-23"},"PeriodicalIF":1.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12716932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806013","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

Sexual Dysfunction after Colorectal Surgery. 结直肠手术后性功能障碍。

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-0045-1807737

Sophia Zigouras, James P Taylor

引用次数: 0

Things that go Bump in the Night: Rare, Severe, and Long-term Complications after Colorectal Surgery. 夜间发生的事情：结直肠手术后罕见、严重和长期的并发症。

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-04-09 eCollection Date: 2026-01-01 DOI: 10.1055/s-0045-1807278

Ira L Leeds

引用次数: 0

Preoperative Risk Stratification for Major Events. 术前重大事件的风险分层。

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-04-07 eCollection Date: 2026-01-01 DOI: 10.1055/s-0045-1807280

Trevor Wood, Jonathan M Stem

{"title":"Preoperative Risk Stratification for Major Events.","authors":"Trevor Wood, Jonathan M Stem","doi":"10.1055/s-0045-1807280","DOIUrl":"10.1055/s-0045-1807280","url":null,"abstract":"The preoperative assessment of surgical patients, including colorectal patients, has undergone significant changes over the last 20 years. The rationale for such changes is based on evidence-based guidelines that showed a minimal clinical impact from broad base testing in healthy patients. Additionally, nonselective testing has been shown to be a large economic burden to the American health care system. As such, a tailored approach based on risk stratification is recommended rather than a \"standard, one-size-fits-all\" approach. This article will review current risk stratification and preoperative evaluation strategies for patients undergoing elective colorectal surgery. Emphasis will be given to areas in which preoperative optimization strategies may be employed to minimize operative risks. We will review the role and need of preoperative testing in specific patient populations and highlight situations where preoperative evaluation impacts operative timing and planning. Specifically, emphasis will be placed on strategies for mitigation of major adverse cardiac events. The aim is to provide a framework that allows for safe and responsible preoperative assessment.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"39 1","pages":"9-14"},"PeriodicalIF":1.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12716923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806054","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

Ira L. Leeds, MD, MBA, ScM, FACS, FASCRS. Ira L. Leeds， MD， MBA, ScM， FACS， FASCRS。

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-04-03 eCollection Date: 2026-01-01 DOI: 10.1055/s-0045-1807276

Scott R Steele

引用次数: 0

Optimizing Colorectal Surgery Outcomes: The Role of the Advanced Practice Provider (APP) in Developing a Center for Pelvic Floor Disorders and Maximizing Scope of Practice for APPs. 优化结直肠手术结果：高级实践提供者（APP）在建立盆底疾病中心和最大化APP实践范围中的作用。

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-03-12 eCollection Date: 2025-11-01 DOI: 10.1055/s-0045-1804515

Holly Bonnette, Lieba R Savitt

{"title":"Optimizing Colorectal Surgery Outcomes: The Role of the Advanced Practice Provider (APP) in Developing a Center for Pelvic Floor Disorders and Maximizing Scope of Practice for APPs.","authors":"Holly Bonnette, Lieba R Savitt","doi":"10.1055/s-0045-1804515","DOIUrl":"10.1055/s-0045-1804515","url":null,"abstract":"Many patients with pelvic floor disorders who are referred to colorectal surgery do not actually need surgery. The Massachusetts General Hospital (MGH) Center for Pelvic Floor Disorders (PFDC) was established in 2008 out of a recognition of the need for a specialized comprehensive treatment for patients living with a pelvic floor disorder. To describe the model that we have created utilizing advanced practice providers (APPs) within the PFDC at the MGH as an example of a model of care for patients who historically may have been managed by colorectal surgeons. The utilization of APPs in surgery has increased, which in turn has had positive effects on patient care and can help reduce the demands put on surgeons to see patients who ultimately do not end up having surgery. There is also a potential for both direct and indirect revenue production through the utilization of APPs at the top of their scope of practice as well as increased access to care for these patients. Training APPs to work at the top of their scope within a surgical practice increases patient's access to care, allows surgeons to focus on those who ultimately require surgery, and can lead to better patient outcomes at a reduced healthcare cost. In order for this symbiotic relationship between APPs and surgeons to be successful, it is essential that there is mutual collaboration and trust between providers. It requires commitment from surgeons to appropriately train their APPs.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"38 6","pages":"411-416"},"PeriodicalIF":1.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214179","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

How to Best Measure and Characterize Symptoms of Patients with Pelvic Floor Disorders. 如何最好地测量和表征盆底疾病患者的症状。

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-03-05 eCollection Date: 2025-11-01 DOI: 10.1055/s-0045-1804513

Goda Savulionyte, Liliana Bordeianou

{"title":"How to Best Measure and Characterize Symptoms of Patients with Pelvic Floor Disorders.","authors":"Goda Savulionyte, Liliana Bordeianou","doi":"10.1055/s-0045-1804513","DOIUrl":"10.1055/s-0045-1804513","url":null,"abstract":"Pelvic floor disorders (PFDs) are common and can be associated with various symptoms, including fecal incontinence, constipation, urinary incontinence, lower urinary tract symptoms, sexual dysfunction, and pelvic pain. Characterizing symptoms can be challenging due to limitations in patient reporting, provider ability to collect data, and the instruments used to collect the data. Symptoms are assessed using patient-reported outcome measures (PROMs), instruments that can be generic or disease-specific. Here, we describe the frequently used and recommended instruments for assessing symptoms of PFDs. We review the Pelvic Floor Disorders Consortium (PFCD) consensus document called IMPACT (Initial Measurement of Patient-reported Pelvic Floor Complaints Tool), a collection of recommended instruments in their unaltered form as well as within a consolidated short form. A multidisciplinary approach to patient care and interpretation of data is important to best characterize symptoms of PFDs. Future steps should include further collaborating across specialties and with patients to develop more condition-specific and patient-centered PROMs.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"38 6","pages":"369-374"},"PeriodicalIF":1.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214176","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

Fistula to the Neovagina After Gender-Affirming Surgery: Understanding, Management, and Postoperative Care. 性别确认手术后阴道瘘：理解，管理和术后护理。

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-03-05 eCollection Date: 2025-11-01 DOI: 10.1055/s-0045-1804521

Arielle E Kanters

引用次数: 0

Recurrent Rectal Prolapse. 复发性直肠脱垂。

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-02-28 eCollection Date: 2025-11-01 DOI: 10.1055/s-0045-1804524

Leon Naar, Vipul Sheth, Brooke Gurland

引用次数: 0

History of the Treatment of Rectal Prolapse. 直肠脱垂的治疗史。

IF 1.1 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-02-25 eCollection Date: 2025-11-01 DOI: 10.1055/s-0045-1804512

Rebecca Spivak, Katherine Hu

{"title":"History of the Treatment of Rectal Prolapse.","authors":"Rebecca Spivak, Katherine Hu","doi":"10.1055/s-0045-1804512","DOIUrl":"10.1055/s-0045-1804512","url":null,"abstract":"Rectal prolapse is the intussusception of the rectum, resulting in its full-thickness protrusion out of the anus. Approximately 0.5% of the general population is affected by this condition, with a higher occurrence in women and the elderly. While benign, rectal prolapse can be debilitating, as it can cause pain, bleeding, mucus discharge, and fecal incontinence. The earliest documented records of rectal prolapse date back to Ancient Egypt (1500-1200 BC), describing laxatives and topical therapeutics for the treatment of an anus turned inside out. Many techniques were devised to hold the reduced prolapsed rectum in place, ranging from cords to the use of bandages. Surgical cauterization of the anal sphincter to prevent recurrent prolapse began as early as 6 BC in India, a practice that continued into the 1800s. Advances in fundamental understanding of the anatomy of the colon, rectum, and anus in the 19th and early 20th centuries paved the way for modern surgical approaches. The 20th century saw the development of procedures proposed by surgeons such as Delorme, Moschowitz, Ripstein, and Altemeier. The emergence of the laparoscopic rectopexy in 1992 and subsequent use of robotic-assisted techniques in the early 2000s marked the transition to modern rectal prolapse surgeries, improving both precision and outcomes. The overall management of rectal prolapse has evolved significantly from ancient remedies to the surgeries known today, yet some fundamental similarities remain consistent between today's outlook and what was documented centuries ago. Understanding the historical evolution of the diagnosis and treatment of rectal prolapse provides insight into the contemporary management of the disorder.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"38 6","pages":"363-368"},"PeriodicalIF":1.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214234","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