Journal of the Anus Rectum and Colon最新文献

{"title":"Subcutaneous Pedicle Advancement Flap Anoplasty with Pivot Point Medialization for Anal Stenosis: A Single-center Retrospective Study.","authors":"Naoki Yago, Masami Saito, Hiroki Yago","doi":"10.23922/jarc.2026-035","DOIUrl":"10.23922/jarc.2026-035","url":null,"abstract":"<p><strong>Objectives: </strong>Severe anal stenosis, particularly Whitehead deformity, presents a significant reconstructive challenge. This study reports the clinical outcomes of a modified subcutaneous pedicle advancement flap anoplasty emphasizing pivot point medialization, developed in collaboration with plastic surgeons.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 52 consecutive patients (aged 32-97 years; median, 67) treated between April 2021 and June 2025. The etiologies included postsurgical cicatricial stenosis (65.4%) and chronic anal fissure (34.6%). The technique involves establishing the pivot point-defined in this study as the biomechanical anchoring point at the deep subcutaneous fat layer-allowing tension-free advancement of the flap medially without rotation while preserving blood flow through the subcutaneous pedicle. Forty-nine patients completed the 6-month follow-up. Bougie examination at 6 months was performed without anesthesia during outpatient visits.</p><p><strong>Results: </strong>Surgical success, defined as bougie passage of ≥22 mm (#9), was achieved in 48 of 49 patients (98.0%), with a median operative time of 24 min (range, 14-35 min). No flap necrosis occurred (0%). Complications included wound dehiscence in nine patients (17.3%), which healed conservatively within a median of 4 weeks, and rectal prolapse in one patient (1.9%). One patient (2.0%) showed insufficient dilation at 6 months and required reoperation at 12 months. No fecal incontinence was observed. Patient satisfaction at 3 months was high (very satisfied 63.5%, satisfied 21.2%, unchanged 15.4%, dissatisfied 0%).</p><p><strong>Conclusion: </strong>This technique, utilizing pivot point medialization and straight advancement without rotation, may offer a safe and effective option for severe anal stenosis.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 3","pages":"487-494"},"PeriodicalIF":1.5,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Consensus Molecular Subtype Classification of Colorectal Cancer Using Preoperative Biopsy Specimens: A Prospective Pilot Study (COLLAB Study).","authors":"Shunsuke Kasai, Keiichi Hatakeyama, Akio Shiomi, Kinichi Hotta, Shoichi Manabe, Kenichiro Imai, Yusuke Tanaka, Tadahiro Kojima, Keiichi Ohshima, Kenichi Urakami, Yasuto Akiyama, Yusuke Kinugasa","doi":"10.23922/jarc.2026-004","DOIUrl":"10.23922/jarc.2026-004","url":null,"abstract":"<p><strong>Background: </strong>The consensus molecular subtype (CMS) classification stratifies colorectal cancer (CRC) into four groups based on gene expression, offering potential for tailored therapy. This study evaluated the feasibility of CMS classification using preoperative biopsy specimens.</p><p><strong>Methods: </strong>This prospective pilot study enrolled eight patients with primary CRC (cT2 or deeper). In all cases, two biopsy specimens were obtained from different tumor regions during preoperative colonoscopy, using two forceps: forceps A (standard) and forceps B (jumbo). RNA yield and quality were measured, and CMS classification was conducted based on the microarray data. Concordance between a CMS classification of specimens obtained with the two forceps and the safety of the procedure were also examined.</p><p><strong>Results: </strong>Median patient age was 59 years; five were male. Tumor sites included two right-sided colon, two left-sided colon, and four rectal cancers. All biopsy procedures were performed safely without adverse events. Median RNA yield with forceps A was 210.20 (105.76-589.87) ng/μl, with an RNA integrity number (RIN) of 9.2 (7.8-9.9). For forceps B, median RNA yield was 295.99 (162.23-642.17) ng/μl, with a RIN of 9.1 (8.6-9.6). CMS classification was successfully achieved in all samples. Notably, in three of the eight patients, the CMS classifications differed between specimens collected using the two forceps.</p><p><strong>Conclusions: </strong>Preoperative biopsy specimens provided RNA of sufficient quality for CMS classification. However, intratumoral heterogeneity may lead to discordant classifications, and the results should therefore be interpreted cautiously. Further validation in larger cohorts is warranted.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 3","pages":"368-374"},"PeriodicalIF":1.5,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of Pathological Complete Response after Chemoradiation for Locally Advanced Rectal Cancer Using Machine Learning with Clinical Features, the INTERCEPTOR Study Preliminary Model.","authors":"David Mens, Soogyeong Shin, Farhan Akram, Andrew Stubbs, Michail Doukas, Cornelis Verhoef, Denise Hilling, Jan von der Thüsen","doi":"10.23922/jarc.2025-106","DOIUrl":"10.23922/jarc.2025-106","url":null,"abstract":"<p><strong>Background: </strong>Organ-preserving strategies are increasingly used in rectal cancer for those achieving a pathological complete response (pCR) following chemoradiotherapy (CRT). In locally advanced rectal cancer (LARC), CRT may not significantly impact local recurrence or overall survival when an R0 resection is feasible. Accurate pretreatment prediction of pCR is critical to assist patients in deciding on CRT when it may not be oncologically required. The initial phase of the ongoing INTERCEPTOR study evaluated whether machine learning (ML) models using pretreatment clinical variables could improve pCR prediction beyond the baseline probability of 15-20%.</p><p><strong>Methods: </strong>Patients with LARC who received CRT followed by total mesorectal excision between 2004 and 2018 at a tertiary referral center were analyzed. Eligible patients received ≥25 fractions of CRT (50.0-50.4 Gy with concomitant capecitabine) and surgery ≥6 weeks after CRT. Extreme gradient boosting (XGBoost) models were trained with 5-fold cross-validation. Model performance was assessed using AUROC, sensitivity, and specificity. Feature importance was assessed with Shapley additive explanations (SHAP) and XGBoost feature importance.</p><p><strong>Results: </strong>Among 238 included patients, 30 (12.6%) achieved pCR. The number of radiologically positive lymph nodes was the strongest single predictor, but with limited discriminative power (AUROC 0.65 ± 0.04, sensitivity 0.83 ± 0.15 and specificity 0.45 ± 0.1). Combining positive node count with additional clinical variables led to a modest improvement in performance. SHAP analysis confirmed positive lymph node count was the most influential predictor.</p><p><strong>Conclusion: </strong>Pretreatment clinical variables alone provide poor-to-fair accuracy for predicting pCR after CRT in LARC.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 3","pages":"384-391"},"PeriodicalIF":1.5,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Significance of Lymph Node Count in Colon Cancer Surgery: A Tumour Location-stratified Prognostic Analysis Based on an Integrated Phase-III Randomized Controlled Trial (JCOG2310AS3).","authors":"Kenta Iguchi, Kozo Kataoka, Junki Mizusawa, Akira Ouchi, Yusuke Sano, Fumihiko Fujita, Satoshi Maruyama, Kohei Murata, Yusuke Suwa, Kazuma Ito, Takeshi Suto, Shin Fujita, Ryo Inada, Yasuhiro Shimada, Masafumi Inomata, Tetsuya Hamaguchi, Yasumasa Takii, Atsuo Takashima, Shunsuke Tsukamoto, Yukihide Kanemitsu","doi":"10.23922/jarc.2026-032","DOIUrl":"10.23922/jarc.2026-032","url":null,"abstract":"<p><strong>Objectives: </strong>The prognostic significance of lymph node (LN) count in colon cancer (CC) remains controversial. Current guidelines recommend retrieval of ≥12 LNs for accurate staging; however, tumour sidedness may influence its prognostic relevance. This study evaluated the impact of LN count on survival according to tumour sidedness and pathological stage (pStage).</p><p><strong>Methods: </strong>This integrated analysis used data from randomised trials conducted by the Japan Clinical Oncology Group. Data from patients with pStage II/III CC who underwent curative resection were analysed. The prognostic significance of LN count was evaluated using Cox proportional hazards models for each subgroup consisting of a combination of tumour sidedness (right-sided CC [RSCC] vs. left-sided CC [LSCC]) and pStage.</p><p><strong>Results: </strong>A total of 2,849 patients (1,034 RSCC, 1,815 LSCC) were included. LN counts were higher in RSCC than in LSCC (median: 30 vs. 21). LN count was not independently associated with overall survival (OS) in pStage II. In contrast, in pStage III, lower LN counts were associated with worse OS on both tumour sides. In RSCC, thresholds of 9-14 (hazard ratio range: 0.17-0.50) and 26-41 (0.50-0.65) were associated with improved OS, whereas in LSCC, thresholds of 8-12 (0.34-0.61) were significant.</p><p><strong>Conclusion: </strong>Tumour sidedness and stage were associated with the prognostic impact of LN count in patients with pStage II/III CC. LN count showed limited prognostic impact in pStage II but was associated with survival in pStage III.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 3","pages":"463-473"},"PeriodicalIF":1.5,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Perianal Inflammatory Lesions in Crohn's Disease Patients with Anorectal Cancer.","authors":"Nobuaki Hoshino, Koya Hida, Kazutaka Obama, Yusuke Fujii, Takuya Takami, Tatsuki Noguchi, Kenichi Sugihara, Yoichi Ajioka, Soichiro Ishihara","doi":"10.23922/jarc.2025-130","DOIUrl":"10.23922/jarc.2025-130","url":null,"abstract":"<p><strong>Objectives: </strong>Perianal inflammatory lesions (PILs), such as anal fistulas and perianal abscesses, are major complications of perianal Crohn's disease (CD). These lesions reflect inflammation status of CD and pose a risk of carcinogenesis. Their presence may be a risk factor for surgical complications and poor prognosis; however, their impact on CD patients with anorectal cancer is not well understood.</p><p><strong>Methods: </strong>This nationwide multicenter observational study included patients with CD who underwent abdominoperineal resection or total pelvic exenteration for anorectal cancer. Patients with distant metastases were excluded. Data collected by the Japanese Society for Cancer of the Colon and Rectum from 43 participating hospitals between January 1983 and December 2020 were analyzed according to the presence or absence of PILs. Postoperative complications, overall survival, and relapse-free survival rates were compared between groups.</p><p><strong>Results: </strong>A total of 173 patients (135 with and 38 without PIL) were included. Postoperative complications were not significantly different between the patients with and without PILs (46.2% vs 45.9%, P=1.000). Five-year overall survival was 73.3% (95% confidence interval (CI) 48.8-87.4%) in patients without PILs, which was significantly higher than the 46.8% (95%CI 36.4-56.6%) in those with PILs (P=0.027). Five-year relapse-free survival was 52.5% (95% CI 30.8-70.3%) in patients without PILs, which was higher than the 40.2% (95%CI 30.6-49.5%) in those with PILs, without statistical significance (P=0.065).</p><p><strong>Conclusion: </strong>In patients with CD and anorectal cancer, the presence of PILs did not increase the incidence of postoperative complications; however, it worsened prognosis.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 3","pages":"317-324"},"PeriodicalIF":1.5,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaginal Estriol Tablet Therapy for Rectovaginal Fistula after Low Rectal Surgery: Endoscopic Evaluation of Efficacy and Healing Mechanism.","authors":"Takashi Tamura, Fumikazu Koyama, Yosuke Iwasa, Tadataka Takagi, Kosuke Fujimoto, Goki Ejiri, Chihiro Yoshikawa, Takashi Inoue, Masayuki Sho","doi":"10.23922/jarc.2026-007","DOIUrl":"10.23922/jarc.2026-007","url":null,"abstract":"<p><strong>Background and study aim: </strong>Rectovaginal fistula (RVF) remains a challenging complication after low rectal surgery, lacking a standardized, effective, and less-invasive treatment. Current strategies often require multiple invasive procedures following stoma creation. This study aimed to evaluate the outcomes and potential healing mechanisms of vaginal estriol tablet (VET) therapy for RVF following low rectal surgery.</p><p><strong>Patients and methods: </strong>A retrospective analysis was performed on the medical records and serial endoscopic images of five patients with RVF after rectal tumor surgery who received VET treatment (0.5 mg daily) between 2008 and 2024. We assessed the fistula closure rate, recurrence rate, and endoscopic findings, with a focus on mucosal changes.</p><p><strong>Results: </strong>All five patients had a diverting stoma. The fistula closure rate was 100% (5/5). The median time to closure was 125 days (range, 7-168). Endoscopic examination revealed vaginal mucosal neovascularization in three patients, all of whom exhibited vaginal-side primary healing. The recurrence rate was 20% (1/5), and this patient achieved successful closure after stoma reconstruction and VET readministration. No adverse events were observed.</p><p><strong>Conclusion: </strong>VET therapy following stoma creation may be an effective, non-invasive treatment option for small to moderate-sized RVF after low rectal surgery. It potentially promotes vaginal tissue regeneration and neovascularization, suggesting a novel, targeted approach to RVF healing.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 3","pages":"480-486"},"PeriodicalIF":1.5,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes and Recurrence Prevention in Laparoscopic Wells Rectopexy for Rectal Prolapse through Mesh Trimming and Fixation Techniques.","authors":"Takashi Ueno, Keita Ishido, Tomotaka Kuraya, Tomoko Mizota, Kunishige Okamura, Yoshihiro Murakami, Yuji Sasamura, Satoshi Hirano","doi":"10.23922/jarc.2026-034","DOIUrl":"10.23922/jarc.2026-034","url":null,"abstract":"<p><strong>Objectives: </strong>Laparoscopic Wells rectopexy (LWR) is a standard procedure for rectal prolapse; however, recurrence and mesh-related complications remain clinical challenges, particularly in elderly patients with small pelvic anatomy. This study aimed to evaluate the clinical outcomes of a modified LWR technique featuring intraoperative mesh tailoring and a hybrid fixation method.</p><p><strong>Methods: </strong>We retrospectively analyzed 29 patients who underwent modified LWR between October 2014 and June 2025. Technical modifications included intraoperative trimming of the polypropylene mesh to fit each patient's pelvic dimensions and a hybrid fixation technique using both sacral tacks and continuous barbed sutures. Patient demographics, operative outcomes, and recurrence rates were evaluated.</p><p><strong>Results: </strong>The study cohort consisted of 29 patients (median age, 78 years; median body mass index, 20.3 kg/m²). All procedures were completed laparoscopically, with a median operative time of 171 min and minimal blood loss (median, 0 mL). The mesh was tailored to a median size of 12 × 8 cm, and fixation was performed using a median of eight tacks combined with barbed sutures. The median postoperative hospital stay was 4 days. One patient (3.4%) experienced a minor complication (Clavien-Dindo Grade II). During a median follow-up of 190 days, recurrence occurred in only one patient (3.4%) at 30 months postoperatively.</p><p><strong>Conclusions: </strong>Our modified LWR technique, featuring individualized mesh tailoring and robust hybrid fixation, is safe and effective for high-risk, elderly Asian patients with small pelvic frames.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 3","pages":"474-479"},"PeriodicalIF":1.5,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Verification of the Storage Stability of Fecal Hemoglobin in Stool Sampling Bottle Using Improved Buffer - A Pilot Study.","authors":"Masakatsu Fukuzawa, Sakiko Naito, Shin Kono, Yoshiya Yamauchi, Takashi Morise, Kumiko Uchida, Yasuyuki Kagawa, Takahiro Muramatsu, Shiori Enomoto, Shizuka Takehara, Norimitsu Hosaka, Takao Itoi","doi":"10.23922/jarc.2025-124","DOIUrl":"10.23922/jarc.2025-124","url":null,"abstract":"<p><strong>Objective: </strong>The temperature and duration of sample storage is known to affect the accuracy of the fecal immunochemical test (FIT). This study compared an improved stool collection buffer with the conventional buffer on the fecal hemoglobin (Hb) correlation and high-temperature stability and simultaneously evaluated the stability of fecal transferrin (Tf) and fecal calprotectin (FC).</p><p><strong>Methods: </strong>From June 2021 to December 2024, 130 stool samples collected from patients with informed consent were analyzed. Fecal Hb, Tf, and FC were measured in samples stored in both buffers, followed by correlation and stability assessments. High-temperature stability was evaluated at 37°C for 1 week.</p><p><strong>Results: </strong>The improved buffer showed strong correlations with the conventional buffer for three markers (r ≥ 0.95; slope 1.00 ± 0.10). In the high-temperature stability test, residual reactivities were assessed for Hb ≥10 μg/g, Tf ≥10 μg/g, and FC ≥50 μg/g. Hb residual reactivity was significantly higher with the improved buffer (<i>p</i> < 0.01), while Tf maintained high stability (> 90%) in both buffers. FC showed reduced stability in the conventional buffer under prolonged high-temperature exposure, whereas the improved buffer demonstrated better preservation. The improved buffer also maintained higher Hb stability at elevated concentrations (≥30 μg/g).</p><p><strong>Conclusions: </strong>The improved stool collection buffer effectively addressed the limitations of the conventional buffer by providing better Hb stability under high-temperature and high-concentration conditions, while preserving excellent stability for Tf and FC. These findings support its potential utility for postal stool collection in FIT-based colorectal cancer screening.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 3","pages":"375-383"},"PeriodicalIF":1.5,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an Artificial Intelligence for Detecting False Positive Detection to Manage the Accuracy of Artificial Intelligence in Colonoscopy.","authors":"Naohisa Yoshida, Ruiyao Zhang, Yasutaka Morimoto, Takeshi Yasuda, Reo Kobayashi, Naoto Iwai, Ken Inoue, Osamu Dohi, Hardesh Dhillon, Ryohei Hirose, Tomohisa Takagi, Xin Zhu","doi":"10.23922/jarc.2025-112","DOIUrl":"10.23922/jarc.2025-112","url":null,"abstract":"<p><strong>Objectives: </strong>False positive detection (FPD) is a clinically relevant challenge that must be solved to ensure the safe and effective integration of artificial intelligence (AI) into colonoscopy. This study aimed to develop a novel AI system for quantifying FPD and to compare FPD rates between two commercially available AI platforms.</p><p><strong>Methods: </strong>From October 2022 to May 2025, a total of 436,637 images were collected from 78 patient colonoscopy videos: 38 videos (340,121 images) using CAD EYE (Fujifilm, Tokyo, Japan) and 40 videos (96,516 images) using EndoBRAIN (Olympus, Tokyo, Japan). Using these images, YOLOv8 convolutional neural networks were applied to construct original AI model for FPD analysis: ARBS-YOLOv8 (with active learning). The performance of the model was validated using the CAD EYE and EndoBRAIN clinical videos.</p><p><strong>Results: </strong>For CAD EYE validation, ARBS-YOLOv8 achieved an accuracy, sensitivity, specificity, precision, and F1 score of 99.22%, 99.51%, 99.97%, 99.96%, and 99.90%, respectively. For EndoBRAIN validation, the ARBS-YOLOv8 results were 99.97%, 99.84%, 99.97%, 99.97%, and 99.90%, respectively. The false-positive and false-negative rates of FPD detection were only 0.04% and 0.03% for CAD EYE and 0.03% and 0.03% for EndoBRAIN. In 13 collected clinical videos (7 CAD EYE, 6 EndoBRAIN), ARBS-YOLOv8 identified total FPD rates of 8.08% for CAD EYE and 2.47% for EndoBRAIN, showing a significant difference (p<0.001).</p><p><strong>Conclusion: </strong>We developed the first AI system capable of objectively measuring FPD during colonoscopy under two commercially available AI platforms. The model validated performance differences between CAD EYE and EndoBRAIN, providing a basis for FPD reduction and safe AI endoscopy.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 3","pages":"351-360"},"PeriodicalIF":1.5,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Blood Perfusion Assessment by Indocyanine Green Fluorescence Angiography in the Prevention of Anastomotic Leakage after Rectal Cancer Surgery in Japan: A Retrospective Study Using the Diagnosis Procedure Combination Database.","authors":"Takao Amaike, Makoto Okawara, Yasuki Akiyama, Jun Nagata, Kensuke Nitta, Masumi Yamauchi, Yoshihisa Fujino, Kazunori Shibao, Kiyohide Fushimi, Shinya Matsuda, Keiji Hirata","doi":"10.23922/jarc.2026-014","DOIUrl":"10.23922/jarc.2026-014","url":null,"abstract":"<p><strong>Background: </strong>Several studies have reported the potential effectiveness of indocyanine green fluorescence angiography (ICG-FA) for preventing anastomotic leakage (AL) in rectal cancer surgery; however, its clinical benefit remains uncertain. The purpose of this study was to investigate the effectiveness of ICG-FA in rectal cancer surgery in Japan using real-world data.</p><p><strong>Methods: </strong>We retrieved data from the Diagnosis Procedure Combination database in Japan for rectal cancer surgeries between April 2018 and March 2022. A total of 68,022 cases were registered, and 55,299 eligible patients were analyzed. Using a two-level structure of nested individuals from 1,057 hospitals, we applied multilevel logistic regression.</p><p><strong>Results: </strong>A total of 40,013 laparoscopic (72.4%), 7,464 robotic (13.5%), and 7,822 open (14.1%) operations were performed. The rate of AL was 4.3% in the ICG-FA group and 5.1% in the non-ICG-FA group. After adjustment for patient- and hospital-level factors, ICG-FA was associated with a lower risk of AL (OR 0.87, 95% CI 0.76-1.00, <i>p</i> = 0.043); however, after additional adjustment for fiscal year, the association was no longer statistically significant (OR 0.91, 95% CI 0.79-1.04, <i>p</i> = 0.167).</p><p><strong>Conclusions: </strong>ICG-FA may be associated with a lower risk of AL after rectal cancer surgery in real-world settings, although the benefit was not statistically significant after additional adjustment for fiscal year.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 3","pages":"454-462"},"PeriodicalIF":1.5,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}