Techniques in Coloproctology最新文献

{"title":"Proposal of a new visual analogue scale to describe the extent of lymphadenectomy in right-sided colectomy for cancer-a prospective observational study.","authors":"F Pfeffer, P Kalgraff, K B Lygre, B S Nedrebø, H M Forsmo","doi":"10.1007/s10151-025-03182-8","DOIUrl":"10.1007/s10151-025-03182-8","url":null,"abstract":"<p><strong>Background: </strong>Lymphadenectomy in right-sided colon cancer lacks standardized reporting. The aim was to develop a visual analogue scale (VAS) based on mesenteric vessels to describe the extent of lymphadenectomy.</p><p><strong>Methods: </strong>We included patients undergoing surgery for right-sided colon cancer from January 2021 to September 2024. Data were collected via a web-based database. Immediately after surgery, surgeons recorded the VAS score, vascular visualization, and specimen quality.</p><p><strong>Results: </strong>Data from 155 patients were analyzed. Median age was 74 (IQR: 68-80), with 53% female. The median VAS score was 8.2 (IQR: 7.8-8.9). The superior mesenteric vein (SMV) was visualized in 84% of cases, with a median VAS score of 8.4 (IQR: 8.0-9.2) for visualized and 7.0 (IQR: 6.8-7.5) for non-visualized (p < 0.001). The gastrocolic trunk of Henle (GTH) was visualized in 51%, with a median VAS score of 8.7 (IQR: 8.3-9.7) for visualized and 7.9 (IQR: 7.3-8.0) for non-visualized (p < 0.001). Specimen quality was Type 0 (best) in 54% (VAS score 8.6, IQR: 8.2-9.5), Type I in 37% (VAS score 7.9, IQR: 7.3-8.0), and Type II in 6% (VAS score 6.9, IQR: 6.5-7.9; p < 0.001). A positive correlation between VAS score and lymph node count was found (r = 0.43, p < 0.001).</p><p><strong>Conclusions: </strong>The VAS score is a reliable and feasible method to describe lymphadenectomy in right-sided colon cancer. Unlike categorical classifications, the VAS score is based on anatomical landmarks and does not depend on consensus definitions. It reflects the visualization of vascular structures and correlates with specimen quality and lymph node yield.</p><p><strong>Clinical trial: </strong>ClinicalTrials.gov Identifier NCT06329102 (registered on March 24, 2024).</p><p><strong>Article type: </strong>Prospective observational study.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"166"},"PeriodicalIF":2.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977755","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":"Clinical value of fluorescence laparoscopic surgery on anastomotic leakage prevention in ultra-low rectal cancer: real-world multicenter retrospective evidence with neoadjuvant chemoradiotherapy stratification.","authors":"W Qiu, G Hu, K He, S Mei, Z Xing, Y Li, J Tang","doi":"10.1007/s10151-025-03203-6","DOIUrl":"https://doi.org/10.1007/s10151-025-03203-6","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemoradiotherapy (nCRT) is key for low rectal cancer but raises the risk of anastomotic leakage (AL). This study examines how fluorescence laparoscopic (FL) surgery reduces AL after intersphincteric resection (ISR), especially in nCRT patients.</p><p><strong>Methods: </strong>This real-world multicenter cohort study included 533 patients undergoing laparoscopic ISR for ultra-low rectal adenocarcinoma from January 2012 to July 2023. Patients were categorized into FL and non-FL groups. Propensity score matching (PSM) was used at a 1:2 ratio to adjust for baseline differences. The primary endpoint was the incidence of AL within 6 months postoperatively. Secondary endpoints included anastomotic site perfusion, intraoperative blood loss, lymph node retrieval, perioperative complications, and postoperative recovery metrics. Subgroup analyses were conducted on the basis of nCRT status.</p><p><strong>Results: </strong>After PSM, 393 patients were analyzed (131 FL versus 262 non-FL). The FL group showed a significantly lower AL incidence (3.1% versus 11.5%, P = 0.005), with fewer severe symptomatic AL cases (0.8% versus 6.1%, P = 0.014). Intraoperative blood loss was reduced (45.2 ± 58.9 mL versus 65.3 ± 73.1 mL, P = 0.004), and lymph node yield was higher (21.2 ± 11.4 versus 16.6 ± 7.3, P < 0.001) in the FL group. Postoperative recovery was accelerated, with earlier return of bowel function and shorter hospital stays (9.5 ± 3.1 versus 10.7 ± 3.8 days, P = 0.012). In subgroup analyses, FL significantly reduced AL rates in patients without nCRT (1.9% versus 7.2%, P = 0.045) and demonstrated a strong trend toward reduction in AL for patients receiving nCRT (13.0% versus 35.9%, P = 0.051). FL also increased the proportion of patients achieving benchmark lymph node retrieval, including those post-nCRT.</p><p><strong>Conclusions: </strong>Fluorescence-guided laparoscopic surgery reduces anastomotic leakage and improves outcomes in low rectal cancer, especially after chemoradiotherapy, by enhancing surgical precision and recovery.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"165"},"PeriodicalIF":2.9,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977793","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":"Comparison of short- and long-term outcomes among laparoscopic, robotic-assisted, and transanal total mesorectal excision procedures in patients with rectal cancer: a propensity score-matching analysis.","authors":"G-Y Chen, C-K Liao, J-F You, C-C Lai, S-H Huang","doi":"10.1007/s10151-025-03204-5","DOIUrl":"10.1007/s10151-025-03204-5","url":null,"abstract":"<p><strong>Background: </strong>Total mesorectal excision (TME) remains the oncologic standard for rectal cancer surgery; however, technical challenges persist in the minimally invasive treatment of low rectal cancer. Transanal TME (TaTME) and robotic TME were developed to overcome the limitations of laparoscopic TME in confined pelvic spaces. Despite promising results, comparative evidence among these approaches remains limited and heterogeneous. To address this gap, we conducted a propensity score-matched analysis to evaluate and compare the clinical and oncologic outcomes of TaTME, robotic TME, and laparoscopic TME in patients with rectal cancer treated at a high-volume tertiary center.</p><p><strong>Methods: </strong>This retrospective study included patients with rectal cancer who underwent restorative proctectomy between 2015 and 2021. Propensity score matching was used to balance demographic, clinical, and treatment variables across the three groups. Outcomes were analyzed using standard statistical methods.</p><p><strong>Results: </strong>After matching, 240 patients were included (40 TaTME, 40 robotic TME, and 160 laparoscopic TME). TaTME and robotic TME demonstrated significantly lower overall complication rates than laparoscopic TME (27.5% versus 20.0% versus 39.4%, p = 0.033). The circumferential resection margin positivity rate was highest in the laparoscopic group (10.6% versus 0% versus 2.5%, p = 0.031). However, 5-year overall survival (82.5% versus 85.0% versus 88.1%, p = 0.251), disease-free survival (75.0% versus 72.5% versus 73.8%, p = 0.772), local recurrence (17.5% versus 12.5% versus 24.7%, p = 0.488), and distal metastasis (17.5% versus 22.5% versus 25.2%, p = 0.694) did not significantly differ among groups.</p><p><strong>Conclusions: </strong>All three minimally invasive TME techniques achieved comparable long-term oncologic outcomes. Surgical approach should be tailored on the basis of surgeon expertise and patient-specific factors.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"163"},"PeriodicalIF":2.9,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876613","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":"Abdominoperineal pull-through with delayed coloanal anastomosis for pelvic anastomotic failure-a systematic review.","authors":"T J K Tan, S-M Ng, T S Q Lee, E K-W Tan, I Seow-En","doi":"10.1007/s10151-025-03206-3","DOIUrl":"10.1007/s10151-025-03206-3","url":null,"abstract":"<p><strong>Aim: </strong>Despite the potential benefits of abdominoperineal pull-through with delayed coloanal anastomosis (DCAA), it is still infrequently performed as a salvage procedure for pelvic anastomotic failure. We aimed to perform a systematic review on the subject to guide practice.</p><p><strong>Method: </strong>PubMed, Embase and Cochrane were used to identify studies evaluating DCAA for salvage after pelvic surgery from inception to August 2024. Risk of bias assessment was performed using the Newcastle-Ottawa scale. The primary outcome was overall stoma-free survival. Secondary outcomes included hospital length of stay, high-grade postoperative complication rates, 30-day postoperative mortality rates, incidence of redo surgical intervention after DCAA, and postoperative anorectal function.</p><p><strong>Results: </strong>Five retrospective cohort studies evaluating a total of 97 patients who underwent salvage abdominoperineal pull-through and DCAA were included in this review. All patients had previous pelvic surgery, predominantly proctectomy (n = 84, 86.6%). The most common indication for redo surgery was chronic fistula (n = 62, 63.9%) followed by anastomotic leak or chronic pelvic sepsis (n = 34, 35.1%). The pooled overall stoma-free survival rate across all five studies was 81.4% over a mean 24-month postoperative follow-up duration. The overall incidence of high-grade complications after DCAA was 39.1% (n = 38). Pooled mean length of stay was 17 days. There were no cases of early postoperative death. Pooled rate of repeat surgery across four studies was 11.6% (n = 8). Pooled mean functional scores across three studies indicated minor low anterior resection syndrome at 26 months.</p><p><strong>Conclusion: </strong>Abdominoperineal pull-through with delayed coloanal anastomosis is a viable option for salvage surgery following pelvic anastomotic complications, with low rates of permanent stoma and acceptable long-term anorectal function.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"164"},"PeriodicalIF":2.9,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876712","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":"What do colorectal specialists think about female participation in anal intercourse? An online survey of UK coloproctologists.","authors":"Tabitha Gana, Lesley Hunt","doi":"10.1007/s10151-025-03202-7","DOIUrl":"10.1007/s10151-025-03202-7","url":null,"abstract":"<p><strong>Background: </strong>Increasing participation in anal intercourse (AI) raises questions about its effects on the female anus. Societal change has moved faster than published literature.</p><p><strong>Method: </strong>Online survey of Association of Coloproctology of Great Britian & Ireland (ACPGBI) and Association of Surgeons of Great Britain & Ireland (ASGBI) members to document clinical practice regarding female AI; opinion on female AI in causation of anal pathology; barriers to discussing AI; possible harms and harm reduction and public information.</p><p><strong>Results: </strong>91% of consultant colorectal surgeons (CCS) agree female AI causes anal fissures. Only 25% usually or always ask young women with fissures about AI and 31% never ask. Enquiry increases with refractory fissures (34%) and vulnerable patients (57%); 48% of CCS cite fear of patient discomfort, and 40% fear what the patient thinks of them as barriers to enquiry. Eighty per cent of CCS and 85% of pelvic floor specialists (PFS) agree AI can cause internal anal sphincter (IAS) damage and 72% and 78% faecal incontinence (FI) in women. Eleven per cent of CCS and no PFS agreed relaxation techniques, and 17% and 14% lubrication, protect the IAS; 97% of CCS think there should be increased public health awareness about female AI.</p><p><strong>Conclusions: </strong>Experts think participation in AI can cause fissures, IAS damage and FI in women. They are sceptical about the protective value of lubrication and relaxation. Clinical conversations lag behind experts' opinions on the importance and possible consequences of female AI. Concern over patients' feelings are barriers to enquiry. Colorectal specialists think there should be more public health information about female AI.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"162"},"PeriodicalIF":2.9,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859904","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":"Transanal irrigation is effective for low anterior resection syndrome: a systematic review and meta-analysis of randomized controlled trials.","authors":"S Hou, S Zhang, X Zheng, X Wu, H Zhu, K Shen, Z Gao, C Zhong, Y Ye","doi":"10.1007/s10151-025-03201-8","DOIUrl":"10.1007/s10151-025-03201-8","url":null,"abstract":"<p><strong>Background: </strong>The therapeutic value of transanal irrigation (TAI) for low anterior resection syndrome (LARS) has not been fully confirmed. This study aims to evaluate the efficiency of TAI in improving bowel function and quality of life (QoL) following sphincter-preserving resections (SPRs) for rectal cancer through a systematic review and meta-analysis of randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>The protocol was registered in PROSPERO (CRD42024598219). PubMed, Embase, Web of Science, Cochrane Library, CNKI, and WanFang databases were systematically searched for RCTs comparing TAI with conservative treatments for LARS published before December 2024. Outcomes included pooled risk ratios (RRs) for dichotomous variables and weighted mean differences (WMDs) for continuous variables, calculated using Review Manager 5.4.1 with 95% confidence intervals (CIs). P < 0.05 was considered statistically significant. The I² test was used to assess heterogeneity.</p><p><strong>Results: </strong>Among 123 initially identified studies, six RCTs involving 317 patients were included. Meta-analysis demonstrated that the TAI group exhibited significantly lower LARS scores (WMD = -10.35, 95% CI [-15.92, -4.78], P < 0.01). The TAI group demonstrated significantly better outcomes across all five LARS subscales compared to controls, including flatus incontinence (WMD = -0.92; 95% CI [-1.30, -0.54]; P < 0.01), liquid stool incontinence (WMD = -0.83; 95% CI [-1.07, -0.59]), frequency (WMD = -1.33; 95% CI [-1.95, -0.72]; P < 0.01), stool clustering (WMD = -4.89; 95% CI [-5.90, -3.88]), and urgency (WMD = -5.35; 95% CI [-7.12, -3.58]). There was also a significant difference in Wexner score (WMD = -2.78, 95% CI [-4.13, -1.42], P < 0.01). However, no significant differences were observed in SF-36 mental (WMD = 7.27, 95% CI [-1.61,16.15], P = 0.11) or physical component scores (WMD = 6.97, 95% CI [-1.26,15.19], P = 0.10). Heterogeneity was substantial for LARS score analysis (I² = 86%) but resolved in subgroup analyses.</p><p><strong>Conclusion: </strong>TAI significantly improves bowel function in patients with LARS, as evidenced by reduced LARS and Wexner scores. However, its impact on QoL remains inconclusive. Large-scale RCTs with extended follow-up periods are warranted to validate long-term clinical benefits.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"161"},"PeriodicalIF":2.9,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859903","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":"Low workload for pelvic neuromonitoring supported by teleconsulting: technical considerations and feasibility.","authors":"M Paschold, E Soufiah, L Zimniak, F Jäger, W Kneist","doi":"10.1007/s10151-025-03210-7","DOIUrl":"10.1007/s10151-025-03210-7","url":null,"abstract":"<p><strong>Background: </strong>Pelvic intraoperative neuromonitoring (pIONM) prevents functional disturbances after low anterior rectal resection. We investigated the workload of performing pIONM under telementoring conditions to catalyze translation into surgical practice.</p><p><strong>Methods: </strong>Six patients with rectal cancer underwent nerve-sparing total mesorectal excision (TME) with laparoscopic or robot-guided pIONM. A telementoring system enables cross-reality interaction, with online communication between a briefed on-site surgeon at the operating room and a remote mentor at an external hospital. The validated NASA Task Load Index (NASA-TLX) was used to measure the workload for standardized pIONM.</p><p><strong>Results: </strong>The pIONM was installed and performed without any problems. It required a median 7 min stimulation time (range 7-10 min) and confirmed nerve-sparing TME in all six patients. Remote and on-site telepresence required a median 31 min (range 24-44 min), enabling adequate application training for a first-time user. The overall NASA-TLX-based workload realizing pIONM was a median 8.7 (range 3.3-16.3) points. There was no significant difference in TLX between on-site and remote surgeons (p = 0.180). Overall workload was highest for the first-time user but decreased upon repetition. Significantly higher values were found in the following subscales for the surgeon performing pIONM: physical demand (p = 0.002) and temporal demand (p = 0.03).</p><p><strong>Conclusion: </strong>Initiation of pIONM supported by teleconsulting is feasible and requires a low workload.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"158"},"PeriodicalIF":2.9,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12354609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856996","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":"Does robotic circumferential oversewing reduce anastomotic leakage in stapled anastomosis for rectal cancer surgery?","authors":"J-M Jung, S Yang, Y S Yoon, Y I Kim, M H Kim, J L Lee, C W Kim, I J Park, S-B Lim, C S Yu","doi":"10.1007/s10151-025-03207-2","DOIUrl":"10.1007/s10151-025-03207-2","url":null,"abstract":"<p><strong>Background: </strong>Anastomotic leakage (AL) remains a challenging complication of rectal cancer surgery. In patients diagnosed with low risk of AL, low anterior resection (LAR) is often performed without creating a stoma. However, AL can still occur even in patients considered to be at low risk. This study assessed the effects of circumferential oversewing (CO) on AL in patients undergoing robotic LAR without fecal diversion.</p><p><strong>Methods: </strong>We retrospectively reviewed data from 225 patients with rectal cancer who underwent robotic LAR without fecal diversion. They were divided into CO and non-CO groups. The CO group received oversewing along the circular staple line. The AL rate was assessed after the inverse probability of treatment weighting (IPTW) adjustments.</p><p><strong>Results: </strong>After IPTW adjustment, no significant differences in baseline characteristics were observed between the two groups. Overall complication and AL rates were 12.0% and 4.5%, respectively. Although no difference in overall complications was observed between the two groups, patients in the CO group had a significantly lower AL rate than the non-CO group (1.7% vs. 10.3%, p = 0.010). Logistic regression analysis revealed that the CO procedure was a protective factor against AL (IPTW-adjusted OR 0.153, 95% CI 0.036-0.643, p = 0.010).</p><p><strong>Conclusions: </strong>The application of the CO procedure in patients with LAR who were not indicated for stoma creation may contribute to reducing the risk of AL.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"160"},"PeriodicalIF":2.9,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12354487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856995","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":"Surgical outcomes on health-related quality of life in rectal prolapse: A systematic review and meta-analysis.","authors":"Hannaneh Yousefi-Koma, Yassin Rahnama, Dorsa Najari, Fatemeh Fathabadi, Mojtaba Sedaghat, Alireza Kazemeini, Mohammad Reza Keramati, Amir Keshvari, Mohammad Sadegh Fazeli, Behnam Behboudi, Seyed Mohsen Ahmadi-Tafti","doi":"10.1007/s10151-025-03198-0","DOIUrl":"10.1007/s10151-025-03198-0","url":null,"abstract":"<p><strong>Objectives: </strong>Rectal prolapse is a serious but not life-threatening condition. It can involve many complications, including quality-of-life changes. Surgical intervention is the standard medical treatment for these patients. In this article, we aim to investigate the quality-of-life outcomes in patients undergoing rectal prolapse surgery, compare different surgical methods, and assess different quality-of-life questionnaires to study these patients.</p><p><strong>Data sources: </strong>We conducted a systematic literature search on PubMed, Scopus, ScienceDirect, and Embase.</p><p><strong>Study selection: </strong>A total of 4916 studies were screened, resulting in a final 34 included studies, and 20 were included in the meta-analysis.</p><p><strong>Interventions: </strong>Data were extracted from studies comparing the quality of life in rectal prolapse patients before and after surgery.</p><p><strong>Main outcome measures: </strong>Except for one, all included studies reported improved quality-of-life scores. Different instruments were used to examine these patients' quality of life, but SF-36 was implemented most frequently. It comprises eight different domains, and these domains were reported in six different studies.</p><p><strong>Results: </strong>All eight domains showed better outcomes after surgery. The final analysis was based on the surgical approach (perineal or abdominal) and showed no statistically significant superiority of any of the approaches.</p><p><strong>Limitations: </strong>The high heterogeneity of the included studies.</p><p><strong>Conclusion: </strong>Surgical intervention can improve the quality of life of rectal prolapse patients. However, there is no consensus on which surgical approach achieves the best outcomes. Different instruments are used to evaluate the quality of life in these patients, but there is no specific questionnaire to assess this.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"159"},"PeriodicalIF":2.9,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12354557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856997","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":"Hemoclip-suture-rubber band traction improves efficiency of colonic ESD: a randomized controlled trial.","authors":"X Leng, W Wang, F Wang, H Cang, Y Gao, H Liu, Y Sun","doi":"10.1007/s10151-025-03194-4","DOIUrl":"10.1007/s10151-025-03194-4","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate the efficacy and safety of a novel, simple internal traction method using a hemoclip, suture, and rubber band during endoscopic submucosal dissection (ESD) for colonic lesions.</p><p><strong>Methods: </strong>A total of 96 patients undergoing ESD at Jiangyin Hospital Affiliated with Nantong University between January 2021 and December 2024 were randomized into two groups: Group A (n = 48) underwent conventional ESD, while Group B (n = 48) underwent ESD with hemoclip-suture-rubber band traction. The study included patients with early stage colon cancer, precancerous lesions (e.g., adenomas with high-grade dysplasia), and neuroendocrine tumors. Outcome measures included total procedure time, mucosal dissection time, number of submucosal injections, en bloc resection rate, adverse events, and the size of lesion area.</p><p><strong>Results: </strong>The hemoclip-suture-rubber band traction group (Group B) demonstrated significantly shorter total procedure time (72.63 ± 34.14 min versus 85.13 ± 38.18 min, P < 0.05) and mucosal dissection time (53.56 ± 29.03 min versus 71.63 ± 39.18 min, P < 0.001) compared with the conventional ESD group (Group A). Group B also required significantly fewer submucosal injections (1.63 ± 1.23 versus 4.75 ± 1.62, P < 0.001). Lesions in Group B were significantly larger (7.650 [2.857, 10.386] cm² versus 4.895 [2.062, 6.774] cm², P < 0.05). There were no statistically significant differences in en bloc resection rate or adverse events between the two groups (P > 0.05). However, in Group B, two patients experienced intraoperative muscularis propria injury (2/48, 4.2%) and presented with postoperative abdominal pain.</p><p><strong>Conclusions: </strong>The hemoclip-suture-rubber band traction technique facilitates colonic ESD by reducing procedure time and the need for submucosal injections, especially in larger lesions.While overall safety is comparable to conventional ESD, the potential for muscularis propria injury warrants further study in larger, multicenter trials.This simple and effective method holds promise for improving the efficiency and potentially the safety of colonic ESD.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"156"},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755050","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}