Journal of the Anus Rectum and Colon最新文献

{"title":"Prognostic Factors in Colorectal Cancer Patients with Synchronous Peritoneal Metastasis Undergoing Macroscopic Complete Resection: A Multicenter Prospective Observational Study.","authors":"Takatoshi Matsuyama, Hideyuki Ishida, Hirotoshi Kobayashi, Kenjiro Kotake, Masayasu Kawasaki, Yukihide Kanemitsu, Yusuke Kinugasa, Hideki Ueno, Kotaro Maeda, Takeshi Suto, Kenichi Sugihara","doi":"10.23922/jarc.2026-008","DOIUrl":"10.23922/jarc.2026-008","url":null,"abstract":"<p><strong>Objectives: </strong>Colorectal cancer (CRC) with synchronous peritoneal metastasis is considered to have a worse prognosis. Although macroscopic complete resection is associated with a favorable prognosis, the prognostic determinants in this population remain poorly characterized. Therefore, it is crucial to identify prognostic factors following macroscopic complete resection to determine optimal care strategies that improve patient outcomes and to predict prognosis.</p><p><strong>Methods: </strong>In a multi-institute cohort study, we prospectively assessed clinicopathological factors that affect prognosis in 36 patients with CRC and synchronous peritoneal metastasis who underwent macroscopic complete resection.</p><p><strong>Results: </strong>26 of 36 patients (72%) developed recurrence during follow-up, with a median of 34 months. Peritoneum was the most common site of recurrence. In survival analysis, patients with low preoperative serum CA19-9 levels had a favorable overall survival compared with those with high preoperative serum CA19-9 levels (HR: 0.42, 95% CI: 0.15-1.21, <i>P</i>=0.044). Also, patients with right-sided CRC had more favorable overall survival than those with left-sided CRC (HR: 0.44, 95% CI: 0.18-1.06, <i>P</i>=0.047). Furthermore, right-sided CRC with low preoperative serum CA19-9 levels was associated with significantly better overall survival than those with high preoperative serum CA19-9 levels or left-sided CRC (HR: 0.17, 95% CI: 0.07-0.41, <i>P</i><0.001).</p><p><strong>Conclusions: </strong>In this prospective multi-institutional cohort of CRC patients with synchronous peritoneal metastasis undergoing macroscopic complete resection, recurrence was frequent, predominantly involving the peritoneum. Integrating tumor biology (sidedness) and serum biomarkers (CA19-9) may enhance prognostic stratification and guide individualized management strategies in this high-risk population.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 3","pages":"343-350"},"PeriodicalIF":1.5,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654520","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 and Validation of a Computer-Aided Diagnostic System for Colorectal Lesions Based on the JNET Classification: Supporting the \"Resect and Discard\" Strategy.","authors":"Shin Morimoto, Shigeto Yoshida, Yongfei Wu, Tetsushi Koide, Toru Tamaki, Yudai Takehara, Yuki Kamigaichi, Hidenori Tanaka, Ken Yamashita, Yoshihiro Kishida, Toshio Kuwai, Shiro Oka","doi":"10.23922/jarc.2025-109","DOIUrl":"10.23922/jarc.2025-109","url":null,"abstract":"<p><strong>Objectives: </strong>Although the Japan NBI Expert Team (JNET) classification for colorectal lesions is clinically useful, standardization remains challenging owing to endoscopist variabilities. Therefore, we developed a computer-aided diagnosis (CADx) system to support JNET diagnoses, potentially facilitating a \"Resect and Discard\" strategy. The CADx system's diagnostic performance and its potential to support the \"Resect and Discard\" strategy were compared with those of endoscopists of varying experience.</p><p><strong>Methods: </strong>Forty-three patients (60 lesions) who underwent CADx system colonoscopies at Hiroshima University Hospital between September 2022 and July 2024 were evaluated. Endoscopists were grouped by experience: beginners (100-500 cases, n=4), intermediates (1,000-2,000 cases, n=5), and experts (>2,000 cases, n=3). In Study 1, JNET classification concordance between the CADx system and beginner/intermediate endoscopists was compared, using expert diagnosis as the gold standard. Study 2 included 38 <10 mm lesions, with histopathology as the gold standard. Lesions excluding advanced neoplasia were classified as \"Resect and Discard\". The CADx system and endoscopists were evaluated for identifying JNET Type 1 and 2A lesions as non-advanced neoplasia.</p><p><strong>Results: </strong>In Study 1, CADx-expert concordance was 83.3% (Kappa=0.75)-significantly higher than beginners (66.7%) and outperforming intermediates (78.0%). In Study 2, the CADx system's accuracy was 92.1%-significantly higher than beginners (70.4%) and outperforming intermediates (82.6%) and experts (78.9%). The CADx system's advanced neoplasia negative predictive value was 100%.</p><p><strong>Conclusions: </strong>The CADx system showed high concordance with expert diagnoses. For lesions <10 mm, its high advanced neoplasia diagnostic accuracy indicates its potential utility in supporting the \"Resect and Discard\" strategy.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 3","pages":"446-453"},"PeriodicalIF":1.5,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655115","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":"Safety and Efficacy of Nasogastric Tube Placement Prior to Long Tube Placement for the Conservative Management of Adhesive Small Bowel Obstruction: A Retrospective Analysis.","authors":"Sakuya Katakai, Kengo Kasuga, Tatsuya Kouga, Ayaki Isshiki, Ayako Matsui, Keisuke Iizuka, Shingo Ishihara, Takashi Ueno, Xing Hua Ma, Takashige Masuo, Yoji Takeuchi, Toshio Uraoka","doi":"10.23922/jarc.2026-013","DOIUrl":"10.23922/jarc.2026-013","url":null,"abstract":"<p><strong>Objective: </strong>Adhesive small bowel obstruction (ASBO) without strangulation or ischemia is typically treated conservatively. Compared to nasogastric tube (NGT) placement, long tube (LT) placement has shown lower surgery rates, but it is more invasive and may be poorly tolerated in frail patients. This study evaluated the safety and efficacy of initial NGT placement followed by LT placement in ASBO.</p><p><strong>Methods: </strong>We retrospectively analyzed 337 ASBO-related admissions between 2019 and 2023. Analyses were performed on an admission-level basis. After exclusions, admissions were categorized into the NGT group (initial NGT placement, n=135), and the LT group (initial LT placement, n=60). Admissions requiring LT placement after NGT placement were defined as the NGT+LT group (n=63). Clinical characteristics, treatment outcomes, and adverse events were compared between groups.</p><p><strong>Results: </strong>Admissions in the NGT group involved older patients and a poorer performance status than the LT group; similar differences were observed between the NGT+LT and LT groups. LT placement time was significantly shorter in the NGT+LT group compared with the LT group (18 vs. 24 minutes, p < 0.001). No statistically significant differences were observed between the NGT+LT and LT groups in surgery rates (13% vs. 12%), hospital stay, mortality, or adverse events. In admissions treated with NGT alone, the surgery rate was 4%, and clinical outcomes were favorable.</p><p><strong>Conclusions: </strong>Initial NGT placement followed by selective LT insertion appears to be a reasonable stepwise treatment strategy in real-world clinical practice, associated with a lower proportion of admissions requiring LT placement and shorter LT insertion time.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 3","pages":"437-445"},"PeriodicalIF":1.5,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632632","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":"Comparative Outcomes of Hemorrhoidectomy under Spinal Anesthesia between Older and Super-old Patients.","authors":"Uido Yeo, Jong Kyun Lee, Do Yeon Hwang, Woo Jung Nam, Dong Ho Cho, Keehoon Hyun, JaeIl Lee","doi":"10.23922/jarc.2025-126","DOIUrl":"10.23922/jarc.2025-126","url":null,"abstract":"<p><strong>Objectives: </strong>With increasing life expectancy, the number of older and very old patients undergoing anorectal surgery is rising. However, concerns remain regarding the safety of hemorrhoidectomy among those aged ≥80 years. In this study, we compared postoperative outcomes between older (age 65-79 years) and very old (age ≥80 years) patients undergoing open hemorrhoidectomy under spinal anesthesia.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included consecutive adult patients who underwent excisional hemorrhoidectomy between April 2024 and May 2025. Patients were stratified into older (65-79 years) and very old (≥80 years) groups. Baseline characteristics, perioperative factors, and postoperative outcomes, including 6-month complications, and predictors of Foley catheter insertion or additional analgesic injections were assessed.</p><p><strong>Results: </strong>Overall, 693 older patients and 68 very old patients were included. The incidence of early (≤6 months) postoperative complications, including constipation, bleeding, and recurrence, did not differ significantly between the two groups. Foley catheter insertion occurred more frequently in the very old group than in the older group (45.6% vs 31.0%, <i>p</i> = 0.021). No Clavien-Dindo grade III or higher complications occurred in the very old group. In the multivariable analysis, intravenous patient-controlled analgesia was associated with a reduced likelihood of needing additional analgesic injections (odds ratio, 0.39; 95% confidence interval, 0.22-0.69).</p><p><strong>Conclusions: </strong>Hemorrhoidectomy under spinal anesthesia led to comparable short-term postoperative outcomes in older and very old patients without severe systemic disease.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 3","pages":"361-367"},"PeriodicalIF":1.5,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633181","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":"Validation of Magnetic Resonance Imaging-Based Diagnostic Criteria for Lateral Lymph Node Dissection in Rectal Cancer: A Multicenter Prospective Study.","authors":"Kosuke Ozaki, Kazushige Kawai, Kay Uehara, Takuya Miura, Soichiro Ishihara, Yoshiki Kajiwara, Mayumi Ozawa, Riki Ohno, Yosuke Iwasa, Kiichi Sugimoto, Nobuaki Hoshino, Yoichi Ajioka","doi":"10.23922/jarc.2025-100","DOIUrl":"10.23922/jarc.2025-100","url":null,"abstract":"<p><strong>Objectives: </strong>Optimal indications for lateral lymph node dissection in patients with rectal cancer have not yet been established. To address this, we previously proposed magnetic resonance imaging-based size criteria that combine long- and short-axis measurements. However, the initial study derived criteria based on an analysis with knowledge of histopathological outcomes. Therefore, this study aimed to prospectively validate the clinical utility of these magnetic resonance imaging-based criteria.</p><p><strong>Methods: </strong>We conducted a prospective multicenter validation study including 125 patients with rectal cancer who underwent radical surgery with lateral lymph node dissection. Two independent reviewers who were blinded to the clinical and pathological data evaluated 250 lateral pelvic regions using pretreatment magnetic resonance imaging. Interobserver agreement was assessed using weighted kappa statistics. The need for lateral lymph node dissection was evaluated using predefined size-based criteria and compared with the histopathological outcomes.</p><p><strong>Results: </strong>Among the 250 lateral regions evaluated, 206 were dissected, and 29 were histopathologically positive for lateral lymph node metastases. Two reviewers independently assessed whether lateral lymph node dissection was required or could be omitted in 250 regions based on the criteria, and the interobserver agreement was good (weighted kappa = 0.671). The proposed criteria achieved sensitivities of 86.2% and 82.8% and specificities of 57.1% and 52.0% for reviewers 1 and 2, respectively.</p><p><strong>Conclusion: </strong>This validation study demonstrated that our magnetic resonance imaging-based size criteria are clinically applicable and effective for the preoperative diagnosis of lateral lymph node metastases.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 2","pages":"264-269"},"PeriodicalIF":1.5,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935784","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":"Preoperative and Pathological Discrepancies in Colorectal Cancer: A Single-Institution Retrospective Analysis Based on Mismatch Repair/<i>BRAF</i> V600E Status.","authors":"Yoshinori Iwata, Chihiro Tanaka, Shinya Ohno, Shunya Kiriyama, Kakeru Tawada, Tomonari Suetsugu, Shuji Komori, Narutoshi Nagao, Masaki Katayama, Masahiko Kawai","doi":"10.23922/jarc.2025-118","DOIUrl":"10.23922/jarc.2025-118","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the concordance between preoperative clinical and postoperative pathological staging in stage II-III colorectal cancer (CRC), stratified by <i>BRAF</i> V600E mutation and mismatch repair (MMR) status.</p><p><strong>Methods: </strong>We retrospectively analyzed 754 patients who underwent curative resection for stage II-III CRC between 2015 and 2023. Molecular subtypes were defined as proficient MMR with <i>BRAF</i> mutation (pMMR/<i>BRAF</i>-MT), proficient MMR without mutation (pMMR/<i>BRAF</i>-WT), or deficient MMR (dMMR). Concordance of T factor, N factor, and overall stage was classified as underdiagnosis, match, or overdiagnosis.</p><p><strong>Results: </strong>The cohort included 29 (3.8%) pMMR/<i>BRAF</i>-MT, 646 (85.7%) pMMR/<i>BRAF</i>-WT, and 79 (10.5%) dMMR cases. The overall concordance rates between clinical and pathological staging were 55.2% for the T factor, 39.9% for the N factor, and 50.4% for stage. N-factor concordance was lowest (39.9%), with pMMR/<i>BRAF</i>-MT showing the highest underdiagnosis (44.8%) and dMMR the highest overdiagnosis (50.6%). Multivariable analysis identified pMMR/<i>BRAF</i>-MT as an independent predictor of N-factor underestimation (OR 2.76, 95% CI 1.24-6.12, p=0.013). Survival analyses were exploratory and potentially underpowered because of the limited number of events.</p><p><strong>Conclusions: </strong>Molecular subtype significantly affects staging accuracy in stage II-III CRC. <i>BRAF</i>-mutated and dMMR tumors are prone to under- and overstaging, respectively. These findings highlight the potential value of incorporating molecular subtype information into preoperative assessment to improve staging accuracy and guide optimal treatment planning.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 2","pages":"278-288"},"PeriodicalIF":1.5,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935808","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":"Short-term Outcomes of Sacral Neuromodulation for Fecal Incontinence and the Predictive Role of Test Stimulation.","authors":"Hidetoshi Katsuno, Tomoyoshi Endo, Koji Morohara, Kenichi Nakamura, Kazuhiro Matsuo, Kazuki Tsujimura, Tetsuya Koide, Takashi Imanaka, Tomohiro Kubo, Zenichi Morise","doi":"10.23922/jarc.2025-080","DOIUrl":"10.23922/jarc.2025-080","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate short-term outcomes of sacral neuromodulation (SNM) for fecal incontinence (FI) in a Japanese clinical setting, and to assess the predictive value of response during the test stimulation phase.</p><p><strong>Methods: </strong>We retrospectively evaluated patients with FI who underwent SNM between 2014 and 2024. Patients proceeded to permanent implantation following a 2-week test stimulation. Primary outcomes included changes in weekly FI episodes, Cleveland Clinic Florida Fecal Incontinence Score (CCFIS), Fecal Incontinence Severity Index (FISI), and Japanese Fecal Incontinence Quality of Life Scale (JFIQL). Anorectal manometry data were also assessed. A receiver operating characteristic (ROC) curve was constructed to investigate the predictive utility of test-phase response.</p><p><strong>Results: </strong>Of 34 patients, 32 (94.1%) proceeded to implantation. Two subsequently required explantation, and 30 completed the 12-month follow-up. At 12 months, median weekly FI episodes decreased from 7.5 to 3.0, CCFIS from 15.0 to 9.0, and FISI from 36.5 to 22.5; JFIQL improved from 2.02 to 2.53 (all p < 0.05). A ≥50% reduction in FI episodes was achieved in 20 of 30 patients (66.7%). Maximum squeezing pressure significantly increased from 90.0 to 107.0 mmHg (p = 0.013), while maximum resting pressure did not change significantly. ROC analysis yielded an area under the curve (AUC) of 0.663, identifying a 36.4% reduction in FI episodes during the test phase.</p><p><strong>Conclusions: </strong>SNM demonstrated favorable short-term outcomes in Japanese patients with FI, including improved continence, quality of life, and anal sphincter function. Early partial response during the test phase may serve as a useful predictor of sustained benefit.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 2","pages":"199-205"},"PeriodicalIF":1.5,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935855","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":"Clinicopathologic Features of Self-expandable-metallic Stent for Left-sided Obstructive Colorectal Cancer.","authors":"Kimihiko Yoshida, Satoru Kagami, Kimihiko Funahashi, Satoshi Sonobe, Tetsuo Mikami, Shuichiro Matoba, Yuichiro Otsuka","doi":"10.23922/jarc.2025-068","DOIUrl":"10.23922/jarc.2025-068","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to clarify the differences in clinical and histological characteristics between two decompression techniques for obstructive colorectal cancer (OCRC): trans-anal decompression tube (TADT) and self-expandable metallic stent (SEMS).</p><p><strong>Methods: </strong>Overall, 96 of 175 patients with OCRC treated in our department between 2000 and 2020, were assigned into TADT (n = 44) and SEMS (n = 52) groups, and the success rate and complications of decompression, surgical outcomes, clinicopathological findings, and prognosis were compared.</p><p><strong>Results: </strong>The technical success rate was high in all patients. During surgery, the SEMS group showed significant differences in laparoscopy (<i>p</i> < 0.01), D3 dissection (<i>p</i> < 0.001), and the number of lymph nodes dissected (<i>p</i> < 0.01). In multivariate analysis, lymphatic invasion was associated with decompression (odds ratio [OR], 5.49; 95% confidence interval [CI], 2.12-14.20; <i>p</i> < 0.01) and lymph node metastasis (OR, 4.44; 95% CI, 1.69-11.70; <i>p</i> < 0.01), while SEMS was associated with venous invasion (OR, 0.40; 95% CI, 0.16-0.98; <i>p</i> = 0.04). The 5-year and recurrence-free survival rates for 70 patients with stage II and III OCRC were 76.7% and 73.2%, respectively. Although there was no significant difference in the overall survival, the recurrence-free survival was significantly better in the SEMS group (85.0% vs. 58.3%, <i>p</i> = 0.04).</p><p><strong>Conclusions: </strong>The results of this study suggest that SEMS may be preferable to TADT from a histological perspective.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 2","pages":"220-229"},"PeriodicalIF":1.5,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935831","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":"Comment on \"Is Injectable Sclerotherapy with Polidocanol Foam Effective for Treating Hemorrhoids in Patients with Severe Anemia?\"","authors":"Edoardo Segalini, Jessica Della Torre, Alberto Longo","doi":"10.23922/jarc.2025-077","DOIUrl":"10.23922/jarc.2025-077","url":null,"abstract":"","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 2","pages":"311-312"},"PeriodicalIF":1.5,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935772","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 Factors for Successful Total Colonoscopy after Self-Expandable Metallic Stent Placement as a Bridge-to-Surgery in Patients with Obstructive Colorectal Cancer.","authors":"Yoshifumi Fujii, Tsutomu Nishida, Dai Nakamatsu, Kengo Matsumoto, Shiro Hayashi, Koji Fukui, Masashi Yamamoto","doi":"10.23922/jarc.2025-047","DOIUrl":"10.23922/jarc.2025-047","url":null,"abstract":"<p><strong>Objectives: </strong>Colonic self-expandable metallic stents (SEMSs) are widely used for preoperative decompression in obstructive colorectal cancer (CRC) patients undergoing total colonoscopy (TCS). However, the factors influencing the success of TCS and the risk of perforation remain unclear. This study aimed to identify key determinants of successful TCS after SEMS placement.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical data of 48 patients who underwent placement of an 18 mm diameter colorectal SEMS as a bridge to surgery (BTS) at a single center between November 2017 and November 2023. Clinical success was defined as successful TCS regardless of endoscopist or scope change. Patients were divided into successful and unsuccessful TCS groups. The effects of tumor (location, stenosis, depth, and peritoneal dissemination) and procedural variables (timing of TCS, stent size, colonoscope type, and performing endoscopist) were analyzed.</p><p><strong>Results: </strong>The mean patient age was 72 years, and 71% were male. The clinical success rate of TCS was 77% (37/48). Univariate analysis revealed that tumor invasion depth (T4) was significantly associated with TCS failure (odds ratio [OR]: 0.23, P=0.0427). Smaller-diameter colonoscopes were correlated with higher success rates. Synchronous cancers were detected in 10% of the cases.</p><p><strong>Conclusions: </strong>The tumor invasion depth impacts the success of TCS. Smaller-diameter scopes may improve outcomes, particularly with deeper tumor invasion.</p>","PeriodicalId":56349,"journal":{"name":"Journal of the Anus Rectum and Colon","volume":"10 2","pages":"289-297"},"PeriodicalIF":1.5,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935778","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}