Techniques in Coloproctology最新文献

{"title":"Prospective analysis of factors influencing the change of the section line based on fluorescence angiography with ICG for colorectal anastomosis.","authors":"J R Gómez-López, A Balla, E Licardie, S Morales-Conde","doi":"10.1007/s10151-025-03173-9","DOIUrl":"10.1007/s10151-025-03173-9","url":null,"abstract":"<p><strong>Background: </strong>Indocyanine green fluorescence angiography (ICG-FA) in colorectal surgery allows changing the section line (CSL) based on objective evaluation of the vascular supply. The aim of this prospective study is to report our experience with CSL based on ICG-FA during colorectal surgery and to report risk factors influencing it.</p><p><strong>Methods: </strong>From 2014 to 2023, all patients who underwent any colorectal surgical procedure with anastomosis and ICG-FA were enrolled. Patients for whom changing the section line based on ICG-FA was not necessary were included in group A, and patients for whom ICG-FA determined a CSL were included in group B.</p><p><strong>Results: </strong>Four hundred consecutive patients underwent laparoscopic surgery, except for two. In 334 patients (group A, 83.5%), CSL based on ICG-FA did not occur, while CSL occurred in 66 patients (group B, 16.5%). In group B, median time from ICG injection and fluorescence visualization (TIFV) was statistically significantly longer than in group A (28.5 s versus 23 s, p = 0.003). Anastomotic leakage rate was 1.8% and 4.5% in group A and B, respectively, without a statistically significant difference. The multivariate logistic regression analysis identified age > 60 years and TIFV ≥ 20 s as independent risk factors for CSL.</p><p><strong>Conclusions: </strong>Factors influencing the CSL are identified, which could be useful to determine the cases in which this technology should be mandatory and to consider when ICG is not available. These factors could also influence the decision-making process during surgery, such as using protective ileostomy.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"136"},"PeriodicalIF":2.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295353","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":"Prospective nationwide audit of short-term outcomes after surgery for chronic pilonidal sinus disease in the Netherlands.","authors":"E A Huurman, C A L de Raaff, R van den Berg, S J Baart, B P L Wijnhoven, R Schouten, E J B Furnée, B R Toorenvliet, R M Smeenk","doi":"10.1007/s10151-025-03159-7","DOIUrl":"10.1007/s10151-025-03159-7","url":null,"abstract":"<p><strong>Background: </strong>The optimal surgical approach for chronic pilonidal sinus disease (PSD) remains unclear, resulting in variation in surgical practice. This study aimed to provide an overview of PSD subtypes and assess practice variation and short-term outcomes.</p><p><strong>Methods: </strong>A nationwide prospective observational cohort study was conducted. All patients with PSD and who underwent surgery were included during a 3-month inclusion period between March 1, 2020 and March 1, 2021. Primary endpoints were PSD classification and type and frequency of surgical approach. Secondary endpoints included symptoms, complications, recurrent open wounds, wound healing rate, time to wound healing, time to resume daily activities, reasons for selecting therapy, antibiotic prophylaxis, type of anesthesia, and hospital admission.</p><p><strong>Results: </strong>A total of 36 hospitals participated in the study, and 405 patients had chronic disease. The median follow-up period was 42 days. Mean age was 28 years and 335 (82.7%) patients were male. Simple (n = 213) and complex PSD (n = 192) was equally common. Twelve different treatment modalities were performed. Minimally invasive techniques were used the most (61.2%) and off-midline closure in only a small proportion of patients (5.7%). Minimally invasive techniques showed a significantly higher wound healing rate (41.1% vs 28.6%) and a shorter median time to closure (41 vs 78 days) compared to excision with secondary healing. They also had the shortest median time to resume daily activities (14 days).</p><p><strong>Conclusions: </strong>Simple and complex PSD were equally common. Practice variation in surgery is substantial. Minimally invasive techniques were most frequently performed and showed good short-term outcomes.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"134"},"PeriodicalIF":2.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267862","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":"Deep learning neural network prediction of postoperative complications in patients undergoing laparoscopic right hemicolectomy with or without CME and CVL for colon cancer: insights from SICE (Società Italiana di Chirurgia Endoscopica) CoDIG data.","authors":"G Anania, P Mascagni, M Chiozza, G Resta, A Campagnaro, S Pedon, G Silecchia, D Cuccurullo, C Bergamini, G Sica, V Nicola, M Alberti, M Ortenzi, R Reddavid, D Azzolina","doi":"10.1007/s10151-025-03165-9","DOIUrl":"10.1007/s10151-025-03165-9","url":null,"abstract":"<p><strong>Background: </strong>Postoperative complications in colorectal surgery can significantly impact patient outcomes and healthcare costs. Accurate prediction of these complications enables targeted perioperative management, improving patient safety and optimizing resource allocation. This study evaluates the application of machine learning (ML) models, particularly deep learning neural networks (DLNN), in predicting postoperative complications following laparoscopic right hemicolectomy for colon cancer.</p><p><strong>Methods: </strong>Data were drawn from the CoDIG (ColonDx Italian Group) multicenter database, which includes information on patients undergoing laparoscopic right hemicolectomy with complete mesocolic excision (CME) and central vascular ligation (CVL). The dataset included demographic, clinical, and surgical factors as predictors. Models such as decision trees (DT), random forest (RF), and DLNN were trained, with DLNN evaluated using cross-validation metrics. To address class imbalance, the synthetic minority over-sampling technique (SMOTE) was employed. The primary outcome was the prediction of postoperative complications within 1 month of surgery.</p><p><strong>Results: </strong>The DLNN model outperformed other models, achieving an accuracy of 0.86, precision of 0.84, recall of 0.90, and an F1 score of 0.87. Relevant predictors identified included intraoperative minimal bleeding, blood transfusion, and adherence to the fast-track recovery protocol. The absence of intraoperative bleeding, intracorporeal anastomosis, and fast-track protocol adherence were associated with a reduced risk of complications.</p><p><strong>Conclusion: </strong>The DLNN model demonstrated superior predictive performance for postoperative complications compared to other ML models. The findings highlight the potential of integrating ML models into clinical practice to identify high-risk patients and enable tailored perioperative care. Future research should focus on external validation and implementation of these models in diverse clinical settings to further optimize surgical outcomes.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"135"},"PeriodicalIF":2.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267861","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":"Artificial intelligence and endoanal ultrasound: pioneering automated differentiation of benign anal and sphincter lesions.","authors":"M Mascarenhas, M J Almeida, M Martins, F Mendes, J Mota, P Cardoso, B Mendes, J Ferreira, G Macedo, C Poças","doi":"10.1007/s10151-025-03160-0","DOIUrl":"10.1007/s10151-025-03160-0","url":null,"abstract":"<p><strong>Background: </strong>Anal injuries, such as lacerations and fissures, are challenging to diagnose because of their anatomical complexity. Endoanal ultrasound (EAUS) has proven to be a reliable tool for detailed visualization of anal structures but relies on expert interpretation. Artificial intelligence (AI) may offer a solution for more accurate and consistent diagnoses. This study aims to develop and test a convolutional neural network (CNN)-based algorithm for automatic classification of fissures and anal lacerations (internal and external) on EUAS.</p><p><strong>Methods: </strong>A single-center retrospective study analyzed 238 EUAS radial probe exams (April 2022-January 2024), categorizing 4528 frames into fissures (516), external lacerations (2174), and internal lacerations (1838), following validation by three experts. Data was split 80% for training and 20% for testing. Performance metrics included sensitivity, specificity, and accuracy.</p><p><strong>Results: </strong>For external lacerations, the CNN achieved 82.5% sensitivity, 93.5% specificity, and 88.2% accuracy. For internal lacerations, achieved 91.7% sensitivity, 85.9% specificity, and 88.2% accuracy. For anal fissures, achieved 100% sensitivity, specificity, and accuracy.</p><p><strong>Conclusion: </strong>This first EUAS AI-assisted model for differentiating benign anal injuries demonstrates excellent diagnostic performance. It highlights AI's potential to improve accuracy, reduce reliance on expertise, and support broader clinical adoption. While currently limited by small dataset and single-center scope, this work represents a significant step towards integrating AI in proctology.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"132"},"PeriodicalIF":2.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259348","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":"Limitations of the Goligher classification in randomized trials for hemorrhoidal disease: a qualitative systematic review of selection criteria.","authors":"J Y van Oostendorp, U Grossi, I Hoxhaj, M L Kimman, S Z Kuiper, S O Breukink, I J M Han-Geurts, G Gallo","doi":"10.1007/s10151-025-03170-y","DOIUrl":"10.1007/s10151-025-03170-y","url":null,"abstract":"<p><strong>Background: </strong>The diverse range of therapeutic options for hemorrhoidal disease (HD) highlights the need for precise classification systems to guide treatment. Although the Goligher classification remains the most widely used, it has been criticized for its simplicity and limited ability to capture symptom severity or guide treatment decisions. This study aims to evaluate the patient selection criteria and classification systems employed in randomized controlled trials (RCTs) for HD.</p><p><strong>Methods: </strong>A systematic review was conducted following the 2020 PRISMA guidelines. A comprehensive search of databases identified randomized controlled trials (RCTs) comparing treatments for HD, focusing on classification systems used for patient enrollment. Eligible studies included adult patients and at least one arm involving surgical treatment.</p><p><strong>Results: </strong>Out of 6692 records, 162 studies met the inclusion criteria, with a median cohort size of 84 patients and 55.4% male. Most studies (86.4%) used the Goligher system, though the majority did not fully describe or cite the system. Only 13.6% of studies employed more recent alternative classification systems. The most common outcome measures across studies were postoperative pain (147 studies) and complications (133 studies). Recurrence rates were reported in 42% of studies, yet 70% of these did not provide adequate inclusion criteria or references to Goligher's classification.</p><p><strong>Conclusions: </strong>The inconsistent application of the Goligher classification and the variability in patient selection criteria across RCTs highlight the need for more nuanced and standardized systems. Future research should focus on refining classification methods and incorporating patient-reported outcomes to improve the reliability and relevance of HD trials.</p><p><strong>Prospero registration: </strong>CRD42023387339.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"133"},"PeriodicalIF":2.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259349","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":"Laser fistula treatment: beyond the controversial aspects: best clinical practice recommendations from an international group of surgeons with extensive experience in the procedure-the FiLaC recommendations.","authors":"P C Ambe, G P Martin-Martin, A A Alam, S Chaudhri, B Bogdanic, H Ma, B Bolik, I H Roman, J Wu, J D P Hernandez, N Vasas, Q Dong, P Istok, R Schouten, S Kalaskar, Y Yao, T Bruketa, E Koulouteri, V Dobricani, C Zhe, P Giamundo","doi":"10.1007/s10151-025-03164-w","DOIUrl":"10.1007/s10151-025-03164-w","url":null,"abstract":"<p><strong>Background: </strong>Fistula tract laser closure (FiLaC) represents a minimally invasive, sphincter-sparing technique for managing fistula in ano with increasing popularity among proctologists. Despite its increasing adoption, significant variations exist in the application of FiLaC in daily practice.</p><p><strong>Purpose: </strong>The aim of these recommendations was to define some basic principles and recommendations for performing a standard FiLaC procedure.</p><p><strong>Methods: </strong>The recommendation development group (RDG) consisting of surgeons with experience in the FiLaC were invited to formulate recommendations for the procedure. The recommendations were generated following systematic literature research and discussion amongst experts (expert opinion) where no substantial literature was available. The developed recommendations were voted upon by a panelist via the Delphi process. Consensus was a priori defined as agreement of 75% and above.</p><p><strong>Results: </strong>The RDG developed 25 recommendations that were voted upon by 21 panelists from 13 nations. Consensus was reached for all 25 recommendations after the first Delphi round.</p><p><strong>Conclusion: </strong>The FiLaC RDG offers a comprehensive suite of recommendations to enhance the safety and efficacy of standard FiLaC procedures. These 25 detailed recommendations collectively address the full spectrum of FiLaC procedures-from laser settings, preoperative preparations, and perioperative strategies to postoperative care. This coherent framework is anticipated not only to standardize but also to refine the FiLaC technique to ensure best possible surgical outcomes while preserving patient safety.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"131"},"PeriodicalIF":2.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250767","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":"Functional outcomes and quality of life after intersphincteric resection with transverse coloplasty pouch anastomosis for ultralow rectal cancer: a prospective cohort study.","authors":"Y Jia, B Zhang, Y Zhao, G Zhuo, X Song, J Xiang, J Ding","doi":"10.1007/s10151-025-03174-8","DOIUrl":"10.1007/s10151-025-03174-8","url":null,"abstract":"<p><strong>Background: </strong>Functional outcomes and quality of life (QoL) of transverse coloplasty pouch (TCP) in intersphincteric resection (ISR) for ultralow rectal cancer remain poorly understood.</p><p><strong>Methods: </strong>A prospective analysis was conducted on patients who received ISR treatment from January 2020 to May 2022. Patients were divided into TCP and straight coloanal anastomosis (SCAA) groups. Comparisons were made for low anterior resection syndrome (LARS) score, Wexner incontinence score (WIS), Kirwan's incontinence score, visual analog scale (VAS), and fecal incontinence quality of life (FIQL) questionnaire at 3, 6, and 12 months post ileostomy closure. Additionally, anorectal manometry outcomes were compared pre ileostomy closure.</p><p><strong>Results: </strong>A total of 75 patients were included, with 25 in the TCP group and 50 in the SCAA group. At 3, 6, 12 months post ileostomy closure, the TCP group showed significantly lower LARS (31, 30, 28; p = 0.033, 0.044, 0.019, respectively), WIS (11.04, 9.92, 7.32; p = 0.025, 0.043, 0.007, respectively), and Kirwan's incontinence scores (p = 0.044, 0.033, 0.022). Additionally, the TCP group showed higher VAS (5, 6, 7; p = 0.004, 0.006, 0.005, respectively) and FIQL summary scores (2.67, 2.79, 2.86; p = 0.001, 0.002, 0.004, respectively). Prior to ileostomy closure, the rectal first sensation and maximum tolerance volumes were significantly higher in the TCP group compared to the SCAA group (22 ml vs. 20 ml, 51.56 ml vs. 34.52 ml; p = 0.019, 0.038, respectively). There were no significant differences in postoperative complications or recurrence rates between the groups.</p><p><strong>Conclusions: </strong>TCP is a safe technique, which may improve bowel function and QoL in ISR patients with low rectal cancer within 1 year.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"130"},"PeriodicalIF":2.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250766","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 the most effective treatment for major LARS.","authors":"A D Rink","doi":"10.1007/s10151-025-03171-x","DOIUrl":"10.1007/s10151-025-03171-x","url":null,"abstract":"","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"129"},"PeriodicalIF":2.7,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250768","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":"Development of a laparoscopic right hemicolectomy training simulator: COLOMASTER.","authors":"H Hasegawa, K Teramura, Y Park, M Ito","doi":"10.1007/s10151-025-03166-8","DOIUrl":"10.1007/s10151-025-03166-8","url":null,"abstract":"<p><strong>Background: </strong>Given that a surgeon's technical skills affect not only short- but also long-term outcomes, adequate surgical training is very important. We developed the world's first training simulator for laparoscopic right hemicolectomy that does not use animal tissue, called COLOMASTER, which was designed to accurately reproduce the anatomical and membrane structures of the human body. Here, we report the features of COLOMASTER.</p><p><strong>Methods: </strong>Dry polyester fibers were used to reproduce the multilayered membrane structure, and the adhesive strength of the layers was controlled using bonding technology, allowing realistic peeling techniques. Hydrogel was used to achieve electrical conductivity.</p><p><strong>Results: </strong>COLOMASTER allows surgeons to simulate the entire surgical step and practice complete mesocolic excision, central vascular ligation, and intracorporeal anastomosis, the importance of which has been reported in recent years.</p><p><strong>Conclusion: </strong>We present the world's first right hemicolectomy simulator that does not use animal tissue and believe that it will contribute to efficient off-the-job training.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"128"},"PeriodicalIF":2.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235910","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":"Carbon footprint of common procedures in inflammatory bowel disease.","authors":"L Munster, B van der Zwet, J de Groof, M Mundt, O van Ruler, G D'Haens, W Bemelman, C Buskens, M Duijvestein, T Stobernack, J van der Bilt","doi":"10.1007/s10151-025-03123-5","DOIUrl":"10.1007/s10151-025-03123-5","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to assess the environmental impact, primarily the carbon footprint of the most common procedures in inflammatory bowel disease (IBD).</p><p><strong>Methods: </strong>In this study, all processes and products used during a total of eight laparoscopic ileocecal resections (ICRs) in patients with Crohn's disease (CD), eight laparoscopic subtotal colectomies (STCs) for ulcerative colitis (UC), and eight ligation of the intersphincteric fistula tract (LIFT) procedures in patients with Crohn's perianal fistula (PAF) (all in adults ≥ 16 years) between March 2023 and May 2024 were collected. A life cycle assessment (LCA) was conducted, mean CO² emission rates were calculated, the major contributors (\"hotspots\") were determined, and midpoint/endpoint analysis was performed.</p><p><strong>Results: </strong>The mean total carbon footprints of laparoscopic ICR, STC, and LIFT were, respectively, 104 kg, 116 kg, and 43.6 kg CO²eq, equaling one-way trips by airplane from Amsterdam to Paris, to Manchester, and to Düsseldorf, respectively. The main contributors in laparoscopic ICR and STC were transport of employees and patients (48% and 49%, respectively), energy use in the theater (21% and 27%, respectively), and the use of surgical equipment (14% and 17%, respectively). In LIFT procedures, transport of employees/patients accounted for 47% of total emission rates, followed by the use of surgical equipment (28%), and electricity use in the theater (13%). Besides the impact on global warming, significant impact on fine particulate matter formation, land use, terrestrial acidification, and fossil resource scarcity was identified. Endpoint analysis showed an amount of disability-adjusted life years (DALYs) of approximately 2 h of health damage per laparoscopic ICR/STC and 47 min per LIFT.</p><p><strong>Conclusions: </strong>The carbon footprint of three commonly performed IBD surgeries is mainly determined by transportation of patients/healthcare personnel, followed by electricity and material use. The latter two vary with the complexity of the surgeries. IBD surgeons should focus on minimizing energy resources and using standard surgical materials. Also, employees should be encouraged to travel by foot/bicycle/public transport/carpooling/electric car.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"127"},"PeriodicalIF":2.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188513","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}