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Seminars in Colon and Rectal Surgery最新文献

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How can the surgeon reduce recurrence after surgery for ileocolic Crohn's disease? 外科医生如何减少回肠结肠性克罗恩病手术后的复发?
IF 0.3
Seminars in Colon and Rectal Surgery Pub Date : 2023-10-17 DOI: 10.1016/j.scrs.2023.100985
Steven R. Brown MD (Professor of Surgery)
{"title":"How can the surgeon reduce recurrence after surgery for ileocolic Crohn's disease?","authors":"Steven R. Brown MD (Professor of Surgery)","doi":"10.1016/j.scrs.2023.100985","DOIUrl":"10.1016/j.scrs.2023.100985","url":null,"abstract":"<div><p>Disease recurrence after surgery for ileocolic Crohn's is common, and repeat surgery is necessary for approximately one-third of patients within ten years. This recurrence rate is influenced by many factors, some of which relate to the disease phenotype. Others may be influenced by the patient (i.e., smoking) or the gastroenterologist with careful disease monitoring and the judicious use of adjuvant medication. The surgeon may also be able to reduce recurrence in the both preoperative preparation of the patient, the timing of surgery, and the intra-operative surgical technique. Evidence of how the surgeon can influence recurrence is discussed in this manuscript, considering current definitions, pathophysiology, and risk factors for recurrence.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"34 4","pages":"Article 100985"},"PeriodicalIF":0.3,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135811660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Local tumor complications in stage IV colorectal cancer 癌症IV期局部肿瘤并发症
IF 0.3
Seminars in Colon and Rectal Surgery Pub Date : 2023-09-01 DOI: 10.1016/j.scrs.2023.100973
Smadar R. Bogardus MD , Gregory K. Low MD
{"title":"Local tumor complications in stage IV colorectal cancer","authors":"Smadar R. Bogardus MD ,&nbsp;Gregory K. Low MD","doi":"10.1016/j.scrs.2023.100973","DOIUrl":"10.1016/j.scrs.2023.100973","url":null,"abstract":"<div><p>Colorectal cancer is associated with distant metastases<span> in 19–26% of patients at initial presentation. Local tumor complications such as obstruction, perforation, and hemorrhage may be identified at initial presentation or may develop during treatment<span> for those that were initially asymptomatic. Optimal management in these situations is dependent on rapid recognition and assessment of the patient's clinical condition, a thorough understanding of oncologic principles, and a multidisciplinary approach to treatment. Given the the reliance on systemic therapy for the management of metastatic disease, it is essential to minimize potential morbidity and mortality to avoid unnecessary treatment delays in this subset of patients. This review highlights the most common local tumor complications seen in the setting of stage IV colorectal cancer and approaches to each.</span></span></p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"34 3","pages":"Article 100973"},"PeriodicalIF":0.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46820784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sequence of colorectal and liver resection in patients with surgically-treatable stage IV colorectal cancer 可手术治疗的IV期结直肠癌患者的结肠和肝脏切除顺序
IF 0.3
Seminars in Colon and Rectal Surgery Pub Date : 2023-09-01 DOI: 10.1016/j.scrs.2023.100969
Calista Harbaugh MD, MSc , Aneel Damle MD, MBA
{"title":"Sequence of colorectal and liver resection in patients with surgically-treatable stage IV colorectal cancer","authors":"Calista Harbaugh MD, MSc ,&nbsp;Aneel Damle MD, MBA","doi":"10.1016/j.scrs.2023.100969","DOIUrl":"10.1016/j.scrs.2023.100969","url":null,"abstract":"<div><p>Approximately 25-30% of patients with colorectal cancer develop hepatic metastases<span><span><span>. For patients diagnosed with resectable colorectal hepatic metastases, variation exists regarding the timing of resection of the colorectal primary and the hepatic metastases including three approaches: (1) the “classical” colorectal-first staged approach, (2) the “combined” or simultaneous/synchronous approach, and (3) the “reverse” or liver-first staged approach. The purpose of this chapter is to review the current literature regarding the timing of colorectal and hepatic resection </span>in patients with surgically treatable </span>colorectal adenocarcinoma<span> hepatic metastases. There are inadequate data at the current time to provide definitive recommendations as to the optimal timing and sequence of surgery. Our recommendations based on existing data favor delivery of neoadjuvant therapy<span> followed by either: (1) the combined approach for low-risk resections, (2) the liver-first staged strategy for high-risk hepatic resections or mid- to distal rectal tumors<span> that may benefit from total neoadjuvant therapy, or (3) the colorectal-first approach for symptomatic primary colon tumors.</span></span></span></span></p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"34 3","pages":"Article 100969"},"PeriodicalIF":0.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41828736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advances in systemic chemotherapy and immunotherapy for metastatic colorectal cancer 转移性癌症的全身化疗和免疫治疗进展
IF 0.3
Seminars in Colon and Rectal Surgery Pub Date : 2023-09-01 DOI: 10.1016/j.scrs.2023.100972
Nikhil Grandhi MD , Bindiya Patel MD , Olivia Aranha MD, PhD
{"title":"Advances in systemic chemotherapy and immunotherapy for metastatic colorectal cancer","authors":"Nikhil Grandhi MD ,&nbsp;Bindiya Patel MD ,&nbsp;Olivia Aranha MD, PhD","doi":"10.1016/j.scrs.2023.100972","DOIUrl":"10.1016/j.scrs.2023.100972","url":null,"abstract":"<div><p><span>Colorectal cancer is the second leading cause of cancer related death in the United States. Approximately 25% of patients are diagnosed with metastatic colorectal cancer<span><span> (mCRC) and the 5-year survival rate in mCRC is low at 14%. Primary treatment for mCRC is systemic therapy, which includes chemotherapy, </span>immunotherapy, and targeted agents. With advances in genomic profiling, we can now tailor treatment to unique patient populations and improve overall survival. In this review, we discuss treatment strategies for mCRC patients based on tumor sidedness, KRAS/BRAF wild-type versus mutant tumors, and review the benefit of immunotherapy in microsatellite unstable and </span></span>mismatch repair deficient tumors.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"34 3","pages":"Article 100972"},"PeriodicalIF":0.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46258258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epidemiological trends in stage IV colorectal cancer 结直肠癌IV期流行病学趋势
IF 0.3
Seminars in Colon and Rectal Surgery Pub Date : 2023-09-01 DOI: 10.1016/j.scrs.2023.100967
Jeffrey Roberson MD, Lillias Maguire MD
{"title":"Epidemiological trends in stage IV colorectal cancer","authors":"Jeffrey Roberson MD,&nbsp;Lillias Maguire MD","doi":"10.1016/j.scrs.2023.100967","DOIUrl":"10.1016/j.scrs.2023.100967","url":null,"abstract":"<div><p><span><span><span><span>Epidemiological trends in stage IV colorectal cancer are concerning. As older adults in highly developed countries enjoy decreasing colorectal cancer incidence and mortality, younger patients are developing metastatic disease with increasing frequency, and profound systemic </span>disparities<span><span> persist in screening, treatment, and survival. Globally, the young populations of low- and middle-income countries are exposed to ever higher levels of colorectal </span>cancer risk factors without </span></span>colorectal cancer screening systems in place or ability to provide care, leading to an impending crisis. Scientific discoveries reveal the complex interplay between inherent, tumor-specific, and environmental risks, but the most profound factor underlying the </span>epidemiology of </span>metastatic colorectal cancer is inequality, globally and within the United States.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"34 3","pages":"Article 100967"},"PeriodicalIF":0.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46257243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Resecting the asymptomatic colon cancer primary in stage IV disease with unresectable metastases 切除无症状结肠癌原发于IV期疾病并有不可切除的转移
IF 0.3
Seminars in Colon and Rectal Surgery Pub Date : 2023-09-01 DOI: 10.1016/j.scrs.2023.100971
Kristen A. Ban MD, MS
{"title":"Resecting the asymptomatic colon cancer primary in stage IV disease with unresectable metastases","authors":"Kristen A. Ban MD, MS","doi":"10.1016/j.scrs.2023.100971","DOIUrl":"10.1016/j.scrs.2023.100971","url":null,"abstract":"<div><p>Many patients with synchronous metastatic colorectal cancer<span> (CRC) are asymptomatic from the primary tumor. While primary tumor resection is indicated for symptoms including bleeding, obstruction, and perforation, the role for asymptomatic primary tumor resection has been debated. Studies in favor of and against primary tumor resection are reviewed. Unlike previously published non-randomized studies, whose results may have been strongly influenced by selection bias, recently published randomized controlled trials<span> suggest that primary tumor resection in Stage IV CRC with an asymptomatic primary and unresectable metastatic disease does not provide a survival benefit to the patient.</span></span></p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"34 3","pages":"Article 100971"},"PeriodicalIF":0.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41344677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Colorectal liver metastases: Resect, ablate, or embolize 结直肠癌肝转移：切除、消融或栓塞
IF 0.3
Seminars in Colon and Rectal Surgery Pub Date : 2023-09-01 DOI: 10.1016/j.scrs.2023.100968
Natasha Leigh MD, Dominic E. Sanford MD
{"title":"Colorectal liver metastases: Resect, ablate, or embolize","authors":"Natasha Leigh MD,&nbsp;Dominic E. Sanford MD","doi":"10.1016/j.scrs.2023.100968","DOIUrl":"10.1016/j.scrs.2023.100968","url":null,"abstract":"<div><p>The management of colorectal liver metastases<span> (CRLM) is complex and should be individualized to each patient. Resectable CRLM benefit from surgical resection, preferably minimally invasive and parenchymal sparing, when feasible. Ablation is a viable alternative. Chemotherapy in this setting is potentially indicated in select patients, however, it has a clear role in unresectable CRLM. Newer locoregional therapies<span> may benefit some unresectable CRLM with resistance to chemotherapy. Liver transplantation, a new therapy on the horizon for unresectable disease, has encouraging preliminary long-term survival outcomes for carefully selected patients.</span></span></p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"34 3","pages":"Article 100968"},"PeriodicalIF":0.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46040066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evolving role of cytoreduction and HIPEC for colorectal cancer 细胞减少和HIPEC在结直肠癌中的作用
IF 0.3
Seminars in Colon and Rectal Surgery Pub Date : 2023-09-01 DOI: 10.1016/j.scrs.2023.100970
Alexander Loftus MD , Richard Hoehn MD , Timothy Nywening MD, MS, MPHS
{"title":"Evolving role of cytoreduction and HIPEC for colorectal cancer","authors":"Alexander Loftus MD ,&nbsp;Richard Hoehn MD ,&nbsp;Timothy Nywening MD, MS, MPHS","doi":"10.1016/j.scrs.2023.100970","DOIUrl":"10.1016/j.scrs.2023.100970","url":null,"abstract":"<div><p><span>Peritoneal metastases<span> from colorectal cancer have a dismal natural history and poor response to systemic chemotherapy. Cytoreductive surgery<span>, the mainstay of locoregional control of peritoneal carcinomatosis<span>, with hyperthermic intraperitoneal chemotherapy (HIPEC) has shown survival benefit in selected patients. While recent studies such as the PRODIGE 7 trial have not demonstrated added benefit of HIPEC, these trials have limitations (i.e. choice of HIPEC agent, patient population), and more studies are needed. The efficacy of prophylactic HIPEC </span></span></span></span>in patients at high risk for peritoneal recurrence remains controversial. Ongoing trials, including intraperitoneal delivery of novel anti-cancer agents, may yield significant new therapeutic options.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"34 3","pages":"Article 100970"},"PeriodicalIF":0.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45898038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Stoma prolapse 气孔脱垂
IF 0.3
Seminars in Colon and Rectal Surgery Pub Date : 2023-06-01 DOI: 10.1016/j.scrs.2023.100958
Saher-Zahra Khan MD, Emily Steinhagen MD
{"title":"Stoma prolapse","authors":"Saher-Zahra Khan MD,&nbsp;Emily Steinhagen MD","doi":"10.1016/j.scrs.2023.100958","DOIUrl":"https://doi.org/10.1016/j.scrs.2023.100958","url":null,"abstract":"<div><p>Stoma prolapse is a common late complication that approximately 30% of ostomates experience. Interventions vary from simple local revisions to trans-abdominal approaches for resection and re-siting of the prolapsed stoma. Definitively addressing stoma prolapse frequently requires surgical treatment of an associated parastomal hernia. Stoma prolapse infrequently leads to incarceration or strangulation requiring emergent surgical intervention. The decisions regarding intervention depend on acuity of patient presentation, the severity of the prolapse, and patient fitness for operative intervention.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"34 2","pages":"Article 100958"},"PeriodicalIF":0.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49724501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
High ileostomy output: A practical review of pathophysiology, causes, and management✰ 高回肠造口输出:病理生理、原因和处理的实用回顾
IF 0.3
Seminars in Colon and Rectal Surgery Pub Date : 2023-06-01 DOI: 10.1016/j.scrs.2023.100955
Harold J. Boutté Jr. MD , Vitaliy Poylin MD, MBA
{"title":"High ileostomy output: A practical review of pathophysiology, causes, and management✰","authors":"Harold J. Boutté Jr. MD ,&nbsp;Vitaliy Poylin MD, MBA","doi":"10.1016/j.scrs.2023.100955","DOIUrl":"10.1016/j.scrs.2023.100955","url":null,"abstract":"<div><p><span>Ileostomies are commonly created for a variety of </span>gastrointestinal disease<span><span>; however, anatomic and physiologic alterations often render ileostomy patients vulnerable to high outputs, dehydration, and electrolyte derangements. Proactive dietary, medical, and behavioral strategies can decrease ileostomy outputs and minimize complications related to high outputs. This article discusses physiology and pathophysiology relating to ileostomies and high-output ileostomies. Diagnostic assessments, work-up, and </span>treatment options for patients with high output ileostomies are thoroughly reviewed through the lens of a healthcare provider.</span></p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"34 2","pages":"Article 100955"},"PeriodicalIF":0.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42729060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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