Clinics in Colon and Rectal Surgery最新文献_第3页

Barriers to Screening for Anal Dysplasia and Strategies to Overcome Them. 肛门发育不良筛查的障碍及克服策略。

IF 1.6 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-06-26 eCollection Date: 2026-03-01 DOI: 10.1055/s-0045-1809893

Elliot G Arsoniadis, Sarah Bennis, Christopher W Wheldon

{"title":"Barriers to Screening for Anal Dysplasia and Strategies to Overcome Them.","authors":"Elliot G Arsoniadis, Sarah Bennis, Christopher W Wheldon","doi":"10.1055/s-0045-1809893","DOIUrl":"10.1055/s-0045-1809893","url":null,"abstract":"Barriers to anal dyplasia screening are numerous and multifactorial. It is a rare disease, comprising only 2.5% of all gastrointestinal malignancies. Of the populations at high risk, men who have sex with other men (MSM), especially those living with HIV, represent the most studied high-risk population. Although knowledge of human papillomavirus (HPV) is relatively high in this population, its link to anal cancer and self-perception of risk of anal cancer in this population remains low. There are little, if any, data on provider knowledge or awareness of anal dysplasia or the high-risk populations that would benefit from screening. Given the recent advent of comprehensive anal cancer screening guidelines by the International Anal Neoplasia Society, this gap in knowledge is not suprising. Even among providers aware of these guidelines, other barriers exist, including possible discomfort discussing anal health, sexual practices, or discomfort in the performance of the screening test. Providers may also face challenges interpreting results of screening tests or finding specialists in high-resolution anoscopy for referral in the instance of a positive screening test. Finally, MSM and persons living with HIV have historically experienced stigmatization within the health care system. These historical underpinnings further complicate efforts to implement screening programs in these populations.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"39 2","pages":"151-157"},"PeriodicalIF":1.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12872290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127215","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

Anal Dysplasia: Epidemiology, Risk Factors, and Progression to Malignancy. 肛门发育不良：流行病学、危险因素和恶性进展。

IF 1.6 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-06-23 eCollection Date: 2026-03-01 DOI: 10.1055/s-0045-1809708

Megan Boyer, Zhaomin Xu

引用次数: 0

Evolving Options and Views on Anal Dysplasia. 肛门发育不良的发展选择和观点。

IF 1.6 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-06-23 eCollection Date: 2026-03-01 DOI: 10.1055/s-0045-1809904

Marianna J Steele, Scott R Steele

引用次数: 0

Anal Dysplasia: A Review of Pathology with Focus on Current Terminology, Pathologic Diagnosis, and Diagnostic Challenges. 肛门发育不良：病理学综述，重点关注当前术语、病理诊断和诊断挑战。

IF 1.6 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-06-17 eCollection Date: 2026-03-01 DOI: 10.1055/s-0045-1809709

Buket Bagci, Huina Zhang, Dan Lu, Yansheng Hao

{"title":"Anal Dysplasia: A Review of Pathology with Focus on Current Terminology, Pathologic Diagnosis, and Diagnostic Challenges.","authors":"Buket Bagci, Huina Zhang, Dan Lu, Yansheng Hao","doi":"10.1055/s-0045-1809709","DOIUrl":"10.1055/s-0045-1809709","url":null,"abstract":"Anal cancer, although rare, has been increasing in incidence, particularly among high-risk groups such as individuals with human immunodeficiency virus (HIV) and men who have sex with men. The majority of anal cancers are squamous cell carcinomas, most of which are associated with high-risk human papillomavirus (HPV), particularly HPV16. The diagnosis of anal dysplasia requires a multifaceted approach involving clinical evaluation, cytology, high-resolution anoscopy, and histopathologic examination. This review highlights the current understanding of the pathogenesis, diagnostic challenges, and management of HPV-related anal dysplasia and cancer. The evolution of diagnostic terminology, notably the adoption of the two-tiered classification system for HPV-related anal squamous lesions, has improved the consistency of diagnosis. Early detection of anal dysplasia is crucial for effective treatment, particularly in high-risk populations. While anal cytology is a key screening tool, its low specificity necessitates confirmatory diagnosis through anal biopsy with the aid of ancillary tests, including p16 and K i -67 staining, and HPV DNA/RNA testing. However, challenges still remain, such as interobserver variability and the potential for false positives or false negatives, highlighting the need for standardized reporting and multidisciplinary collaboration.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"39 2","pages":"122-130"},"PeriodicalIF":1.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12872294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127224","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

Zhaomin Xu, MD, MPH. 徐兆敏，医学博士，公共汽车时速。

IF 1.6 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2025-06-17 eCollection Date: 2026-03-01 DOI: 10.1055/s-0045-1809872

Scott R Steele

引用次数: 0

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

IF 1.6 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 1.6 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":1.6,"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 1.6 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 1.6 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":1.6,"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 1.6 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