Techniques in Coloproctology最新文献

{"title":"Neoadjuvant therapy for lateral pelvic lymph nodes: choosing between long course chemoradiation or short course radiotherapy with consolidation chemotherapy.","authors":"Subhathira Manohkaran, T Vispute, A Mor, K Prakash, M Kazi, A Sharma, S K Ankathi, A Desouza, A Saklani","doi":"10.1007/s10151-025-03177-5","DOIUrl":"https://doi.org/10.1007/s10151-025-03177-5","url":null,"abstract":"<p><strong>Background: </strong>The response of lateral pelvic lymph nodes (LPLNs) to various neoadjuvant treatments has not been thoroughly investigated. This study aims to compare the effects of long-course chemoradiotherapy (LCCRT) and total neoadjuvant therapy (TNT), i.e., short-course radiotherapy (SCRT) with consolidation chemotherapy, on LPLNs size reduction. The secondary objective is to compare the pathological positivity rates of LPLNs dissection (LPLND) postneoadjuvant treatment.</p><p><strong>Methods: </strong>This is a retrospective analysis based on a prospectively maintained database. Patients with rectal cancer registered between January 2020 and December 2021 with radiologically positive LPLNs who underwent neoadjuvant radiation therapy were included. Patients were divided into two groups: LCCRT and TNT.</p><p><strong>Results: </strong>Among 1200 registered rectal cancer cases, 160 had positive LPLNs, with 142 included in the analysis. A total of 61 patients received LCCRT, and 81 patients received TNT. No significant differences were found in tumor (T) and node (N) staging between the groups. However, the TNT cohort had a significantly higher proportion of patients with metastases (p < 0.001), poorly differentiated tumors (p = 0.021), and extramural venous invasion (p = 0.002). Baseline mean nodal sizes were similar between groups. Postneoadjuvant nodal sizes were 5.3 mm for LCCRT and 6.2 mm for TNT, with mean reductions of 5.7 mm and 4.6 mm, respectively (p = 0.136 and 0.54). Surgery was conducted in 77% of the LCCRT group and 59% of the TNT group, with 22 (46.8%) and 26 (54.1%) undergoing LPLND in their respective groups. The pathological positivity rates for LPLNs were similar (27.3% versus 23.1%, p = 0.731).</p><p><strong>Conclusions: </strong>SCRT with consolidation chemotherapy does not provide a significant advantage over LCCRT in reducing LPLNs size or reducing the need for LPLND.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"151"},"PeriodicalIF":2.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rerouting of the tract in the treatment of high anal fistula: a single-center experience.","authors":"Mahmoud Refaat Shehata, Mahmoud Mohamed Mohamed Abdelghany, Gamal Abdel-Hamid Ahmed Eid, Ragai Sobhi Hanna","doi":"10.1007/s10151-025-03179-3","DOIUrl":"https://doi.org/10.1007/s10151-025-03179-3","url":null,"abstract":"<p><strong>Background: </strong>High anal fistulae require more complicated treatment than low anal fistulae. Because of their complexity, this study aimed to assess the rerouting role in high anal fistulae treatment, as well as to assess recurrence and incontinence, and determine whether rerouting of the tract is a good option for treating high anal fistulae.</p><p><strong>Methods: </strong>This is a prospective interventional study that was conducted on 83 patients with high perianal fistula, ranging in age from 18 to 72 years old, of both genders. All cases were assigned to history taking, laboratory investigations, clinical examination (general examination and local examination), and magnetic resonance imaging (MRI) for objective delineation of the fistulous tract and its association to the anal sphincters.</p><p><strong>Results: </strong>After a minimum follow-up period of 9 months, five cases (6.02%) experienced recurrence. Mild incontinence was reported in four patients (4.8%), while four patients (4.8%) developed infection. In addition, tract gangrene was observed in two patients (2.41%). In multivariate regression analysis, suprasphincteric fistulae and infection were independent predictors for recurrence.</p><p><strong>Conclusions: </strong>The rerouting procedure is a feasible and safe surgical option for managing high transsphincteric perianal fistulae. It is associated with low postoperative complication rates, including short-term recurrence. It combines the advantages of fistulotomy and sphincter-preserving fistula surgery. However, further studies involving a large number of suprasphincteric fistula cases are needed to evaluate the efficacy of the rerouting technique in treating such fistulae.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"150"},"PeriodicalIF":2.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical distribution of hemorrhoidal piles in advanced disease: clinical insights and correlations.","authors":"I Osmanov, E Ergüder, J Ahmadov, C Ersak, S Leventoğlu, B B Menteş","doi":"10.1007/s10151-025-03184-6","DOIUrl":"https://doi.org/10.1007/s10151-025-03184-6","url":null,"abstract":"<p><strong>Background: </strong>A precise evaluation of the positional distribution of hemorrhoidal piles has not been distinctly conducted. We hypothesized that the distribution of hemorrhoidal piles follows a predictable anatomical pattern influenced by disease duration and recurrence.</p><p><strong>Methods: </strong>Our retrospective study analyzed the demographic data, surgical records, operative photographs, previous treatments, and associated colorectal symptoms of patients who underwent invasive procedures for advanced hemorrhoidal disease (2020-2024).</p><p><strong>Results: </strong>Of the 171 patients (123 male; 71.9%; median age 41 ± 12.04 years, range 18-88), 35 had prior interventions (recurrent cases). The largest pile was most commonly in the left lateral quadrant (40.14%), followed by right posterior (31.97%), right anterior (23.47%), and atypical locations (4.42%). Left lateral predominance was significantly higher in primary cases than in recurrent cases (p = 0.031). Most patients had more than one pile (87.7%). Symptom duration positively correlated with pile number (Spearman's rho = 0.229, p = 0.013), but not with hemoroid grade (p = 0.977). No significant differences in pile distribution were observed in patients with defecation disorders, labor history, or concomitant anal fissure (p > 0.05). Of the 48 patients with anal fissure had significantly shorter symptom duration compared to those without fissure (p = 0.011).</p><p><strong>Conclusion: </strong>The classical three-quadrant distribution is confirmed, with the left lateral pile being predominant in primary cases. The association between prolonged symptom duration and increased pile number offers novel insights, highlighting left lateral predominance in primary cases and its reduction in recurrence, enhancing clinical understanding and management.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"147"},"PeriodicalIF":2.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term incontinence rates after traditional lateral internal sphincterotomy: a 5-year retrospective analysis from a high-volume tertiary referral center for proctologic disorders.","authors":"A Realis Luc, A Di Vittori, A Salvatore, G Gravante, V De Simone, A Micarelli, G Clerico, M Trompetto, G Gallo","doi":"10.1007/s10151-025-03189-1","DOIUrl":"https://doi.org/10.1007/s10151-025-03189-1","url":null,"abstract":"<p><strong>Background: </strong>Chronic anal fissures (CAF) are a common proctological condition that significantly impacts patients' quality of life. Lateral internal sphincterotomy (LIS) is widely considered the gold-standard treatment for CAF; however, postoperative fecal incontinence remains a potential risk. The aim of this study is to evaluate long-term incontinence rates following traditional LIS for CAF.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients with CAF who underwent traditional LIS. Patients with any degree of continence impairment prior to surgery, as well as those who experienced events potentially affecting continence function after surgery, were excluded from the analysis. Incontinence was assessed using the Vaizey score both preoperatively and at follow-up.</p><p><strong>Results: </strong>Between January 2014 and May 2019, 98 patients met the inclusion criteria. The mean follow-up duration was 7 years (range 5-10 years). At follow-up, the Vaizey score ranged from 1 to 4 in 19 patients (19.4%) and from 5 to 9 in 5 patients (5.1%). Incontinence primarily involved gas or liquid stool; no patients reported solid stool incontinence. A total of four patients (4.1%) experienced defecatory urgency. No patients required constipating medications or reported lifestyle changes; only one patient (1.0%) required the use of pads. No correlation was found with age, sex, BMI, or smoking status.</p><p><strong>Conclusions: </strong>When present, incontinence following traditional LIS is generally mild, does not require constipating medications, and does not interfere with patients' lifestyle.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"149"},"PeriodicalIF":2.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stapled versus handsewn closure of enterotomy for intracorporeal overlap anastomosis in laparoscopic colectomy: in vitro study.","authors":"Tetsuo Ishizaki, Junichi Mazaki, Kenta Kasahara, Ryutaro Udo, Tomoya Tago, Yuichi Nagakawa","doi":"10.1007/s10151-025-03190-8","DOIUrl":"https://doi.org/10.1007/s10151-025-03190-8","url":null,"abstract":"<p><strong>Background: </strong>In laparoscopic colectomy, overlap anastomosis (OA) is the most standard method of intracorporeal anastomosis. To avoid narrowing the anastomotic area, the closure of the enterotomy is often performed with handsewn running sutures of the monofilament. The purpose of this study was to compare two porcine in vitro colon models of stapled versus handsewn closure of enterotomy in intracorporeal OA.</p><p><strong>Methods: </strong>In total, 40 porcine in vitro colon OA models (20 cases in the stapled closure, SC group, in which the enterotomy was closed with a stapler, and 20 cases in the handsewn closure with monofilament, HC group) were created, and anastomotic area with maximum intensity projection-computed tomography, anastomotic time, and leakage pressure were measured.</p><p><strong>Results: </strong>In the anastomotic area, there was no significant difference between in the SC group and HC group (474.0 ± 105.0 mm² versus 502.6 ± 155.6 mm², p = 0.552). The anastomotic time was significantly shorter in the SC group than in the HC group (185.9 ± 38.3 s versus 292.4 ± 67.8 s, p < 0.001). The leakage pressure was significantly higher in the SC group than in the HC group (30.1 ± 3.8 mmHg versus 21.6 ± 5.3 mmHg, p < 0.001).</p><p><strong>Conclusions: </strong>The findings of this study using porcine in vitro colon model showed that, in OA, the anastomotic area was similar, anastomotic time was significantly shorter, and leakage pressure was significantly higher in SC compared with HC. The results suggest that SC may be superior to HC when performing intracorporeal OA in laparoscopic surgery for colon cancer.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"148"},"PeriodicalIF":2.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of anastomotic technique and norepinephrine on microcirculation in colorectal surgery: findings from a porcine model using laser speckle contrast imaging.","authors":"R Paramasivam, R Ambrus, N M Kristensen, M Stavsetra, C Jaensch, M W Ørntoft, A H Madsen","doi":"10.1007/s10151-025-03195-3","DOIUrl":"10.1007/s10151-025-03195-3","url":null,"abstract":"<p><strong>Background: </strong>Proper intestinal anastomosis healing in colorectal surgery relies on optimal microcirculation, with surgeons choosing between the hand-sewn and stapled techniques. However, the impact of these methods on the microcirculation remains unclear. This study used laser speckle contrast imaging (LSCI) to objectively assess the impact of hand-sewn and stapled techniques on microcirculation in a porcine model during open surgery and examined microcirculatory changes during hypotension and norepinephrine (NE) correction.</p><p><strong>Methods: </strong>Ten healthy female pigs underwent midline laparotomy, with one hand-sewn and one stapled anastomosis in both the small intestine and colon. LSCI measurements were obtained before creation (baseline), immediately after anastomosis (T₀), after 1 h of rest (T₆₀), during induced hypotension, and after NE infusion. Measurements were performed directly on the anastomosis, adjacent tissue, and an untouched area of the intestine.</p><p><strong>Results: </strong>At T₀, microcirculation significantly decreased across all anastomosis types, with hand-sewn anastomoses experiencing a greater decline than stapled anastomoses. An improvement was noted at T₆₀ for all anastomoses. Hypotension worsened microcirculation in all anastomosis types, and NE infusion did not improve microcirculation despite increased and stabilized mean arterial pressure (MAP).</p><p><strong>Conclusions: </strong>Stapled anastomoses initially exhibited superior microcirculation compared with hand-sewn anastomoses, but the disparity disappeared after 1 h. Hypotension significantly impairs simple anastomotic microcirculation. Moreover, while NE is effective in stabilizing the general blood pressure, it contributed to further diminishment in intestinal microcirculation, especially around anastomoses. Thus, the use of NE postoperatively may be considered a risk factor for anastomotic leakage.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"144"},"PeriodicalIF":2.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668988","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 feasibility of D3 lymph node dissection in oldest-old patients undergoing colorectal cancer surgery: a multi-institutional, retrospective analysis.","authors":"R Inada, F Teraishi, T Mitsuhashi, S Takanaga, T Toshima, T Ohtani, R Yoshida, N Hori, K Shigemitsu, S Yamamoto, T Kubota, Y Okano, T Nobuhisa, F Taniguchi, W Ishikawa, R Shoji, T Matsuda, T Umeoka, T Fujiwara","doi":"10.1007/s10151-025-03187-3","DOIUrl":"10.1007/s10151-025-03187-3","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is a significant health burden, with lymph node dissection (LND) playing a critical role in staging and guiding treatment. However, the optimal extent of LND for the oldest-old population (aged ≥ 90 years) remains undefined because of insufficient targeted clinical data. This study aimed to compare the short-term outcomes of D3 versus non-D3 LND in Stage II-III CRC in oldest-old patients.</p><p><strong>Methods: </strong>This retrospective cohort study utilized data from the Setouchi Colorectal Neoplasm Registration database, including 282 oldest-old patients with CRC treated between 2011 and 2022. Patients were stratified into D3 and non-D3 LND groups, with inverse-probability-weighted regression adjustment implemented to address potential confounding factors. Postoperative complications and hospital stays were analyzed using regression models and descriptive statistics.</p><p><strong>Results: </strong>D3 LND resulted in significantly higher lymph node harvests in both Stage II and Stage III patients (p < 0.01). There were no significant differences in overall or major postoperative complications between D3 and non-D3 groups. Hospital stays were comparable for Stage II patients but shorter for Stage III patients in the D3 group (p < 0.01). Complication rates ranged from 28% to 47.7%, with surgical site infections and pneumonia being the most common.</p><p><strong>Conclusions: </strong>D3 LND can be safely performed in oldest-old patients with CRC without increasing postoperative complications or extending hospital stays. These findings support the feasibility of extensive LND in this age group, but further studies are needed to evaluate its oncological benefits.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"146"},"PeriodicalIF":2.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668960","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":"A simple and effective evaluation method to determine the difficulty of total mesorectal excision for male patients with mid and lower rectal cancer.","authors":"X Huang, Z Xiao, Z Huang","doi":"10.1007/s10151-025-03181-9","DOIUrl":"10.1007/s10151-025-03181-9","url":null,"abstract":"<p><strong>Background: </strong>Radical resection for mid and low rectal cancer is probably the most challenging type of surgery in colorectal surgery, especially in a narrow male pelvis. In this study, we aimed to define a simple and effective evaluation method based on magnetic resonance imaging (MRI) and body mass index (BMI) to predict the operation difficulty of radical resection for mid and low rectal cancer in male patients.</p><p><strong>Methods: </strong>A total of 264 male patients who underwent total mesorectal excision (TME) due to primary rectal cancer located in the mid and low rectum (distal tumor margin distance from the anal verge ≤ 7 cm) were retrospectively included in the study. An angle SAU° [formed by two lines: line 1 (connecting the anteroinferior border of the fifth sacral vertebra and center point of anus) and line 2 (connecting internal urethral orifice and center point of anus)] was measured using the built-in software of MRI for every patient. The patients were categorized into four groups according to the angle SAU° and BMI. The operative time, estimated blood loss, TME quality, and anastomotic leakage (AL) were compared between group 1 and group 2 as well as between group 3 and group 4.</p><p><strong>Results: </strong>Group 1 included 111 patients with angle SAU° > 60 and BMI < 25 kg/m²; group 2 included 51 patients with angle SAU° ≤ 60 and BMI < 25 kg/m²; group 3 included 74 patients with angle SAU° > 60 and BMI ≥ 25 kg/m²; group 4 included 28 patients with angle SAU° ≤ 60 and BMI ≥ 25 kg/m². The operative time, estimated blood loss, and the rate of AL in group 1 and group 3 were significantly less than those in group 2 and group 4, respectively (P < 0.05). Similarly, the TME quality in group 1 and group 3 was significantly better than that in group 2 and group 4, respectively (P < 0.05).</p><p><strong>Conclusion: </strong>Angle SAU° based on MRI combined with BMI is a simple and effective evaluation method to predict the difficulty in TME for male patients with mid and low rectal cancer. It may also have value in predicting AL.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"145"},"PeriodicalIF":2.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668986","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":"Removal of the \"dog-ear\" during laparoscopic anterior resection with double stapling technique reduces the anastomotic leakage: a prospective cohort study.","authors":"S Liu, J Guo, Z Cheng, M Wei, Z Dong, Z Nie, K Zhou, W Yu, Y Wang, Z Yan","doi":"10.1007/s10151-025-03178-4","DOIUrl":"10.1007/s10151-025-03178-4","url":null,"abstract":"<p><strong>Background: </strong>In laparoscopic preresection, the use of double anastomosis techniques creates a potential anastomotic angle (called a \"dog-ear\"), which represents an area with a high incidence of anastomotic leakage.</p><p><strong>Methods: </strong>This prospective study, conducted from July 2022 to July 2023, ultimately included 471 patients undergoing laparoscopic colorectal cancer surgery using dual anastomosis techniques. Among them, 179 patients had one or two stapled corners removed during the surgery using a modified double stapling technique (MDST), while 292 patients did not have stapled corners removed during surgery using the traditional double stapler technique (DST). The incidence of anastomotic fistula and the probability of anastomotic bleeding within 30 days after operation were analyzed.</p><p><strong>Results: </strong>In the surgery, 179 patients had one or two dog-ears removed, constituting the MDST group (n = 179). The remaining 292 patients did not have a dog-ear removed, constituting the no dog-ear removal group (DST group, n = 292). Statistical analysis revealed a significant difference between the two groups in terms of anastomotic leakage (6 [3.4%] vs 23 [7.9%]; relative risk 0.426; 95% CI 0.177-1.025; p = 0.047). Additionally, a significant difference was observed in preventing anastomotic bleeding by removing one or both dog-ears (7 [3.9%] vs 30 [10.3%], relative risk 0.381; 95% CI 0.171-0.848; p = 0.013).</p><p><strong>Conclusions: </strong>This prospective study indicates that removing one or both dog-ears during surgery is beneficial in preventing anastomotic leakage and anastomotic bleeding.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"143"},"PeriodicalIF":2.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668989","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":"First-in-human robot-assisted laparoscopic sigmoid resection using ANSUR surgical unit^®.","authors":"H Hasegawa, N Takeshita, D Kitaguchi, K Ikeda, Y Nishizawa, Y Tsukada, M Ito","doi":"10.1007/s10151-025-03183-7","DOIUrl":"10.1007/s10151-025-03183-7","url":null,"abstract":"<p><strong>Background: </strong>The ANSUR surgical unit^® is a newly formulated robot that plays the roles of both the first assistant and scopist. This surgical unit was approved as a medical device in Japan in 2023. We report the first case of robot-assisted laparoscopic sigmoid resection for sigmoid colon cancer using the ANSUR surgical unit.</p><p><strong>Methods: </strong>Robot-assisted laparoscopic sigmoid resection using the ANSUR surgical unit was planned for a 69-year-old woman with advanced sigmoid colon cancer.</p><p><strong>Results: </strong>Tumor resection was successfully completed without conversion to open surgery. The operative time was 147 min, and the estimated blood loss was 36 mL. The roll-in, roll-out, docking, and undocking times were 182, 36, 387, and 41 s, respectively. No mechanical failure or malfunction of the surgical unit was observed. Moreover, no adverse events related to the surgical unit were observed. The patient was discharged 5 days postoperatively without complications. The histopathological diagnosis was T3N1aM0, stage IIIB, with clear proximal and distal resection margins. During follow-up 30 days later, an uneventful patient recovery was noted.</p><p><strong>Conclusions: </strong>This is the first case of robot-assisted laparoscopic sigmoid resection for sigmoid colon cancer using the ANSUR surgical unit. The procedure was performed with technical and oncological safety.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"142"},"PeriodicalIF":2.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668987","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}