Annals of Coloproctology最新文献

{"title":"Surgical and oncologic outcomes of cT4b rectal cancer: a propensity score-matched comparison between a university center and regional hospitals.","authors":"Takashi Nonaka, Keisuke Noda, Tetsuro Tominaga, Hiroki Katayama, Shintaro Hashimoto, Makoto Hisanaga, Hiroaki Takeshita, Kazuo To, Hidetoshi Fukuoka, Keitaro Matsumoto","doi":"10.3393/ac.2025.01585.0226","DOIUrl":"10.3393/ac.2025.01585.0226","url":null,"abstract":"<p><strong>Purpose: </strong>Surgery for cT4b rectal cancer remains technically demanding, and outcomes may vary substantially across institutions. This study evaluated perioperative and oncologic outcomes of cT4b rectal cancer surgery performed at a university center compared with those at regional hospitals within a collaborative network.</p><p><strong>Methods: </strong>A total of 103 patients who underwent curative-intent surgery for cT4b rectal cancer between 2016 and 2024 were retrospectively reviewed. After 1:1 propensity score matching based on baseline characteristics and treatment factors, 54 patients were included in the analysis. Perioperative outcomes, pathological findings, and long-term oncologic outcomes were compared between the university hospital and affiliated regional institutions. Overall survival, relapse-free survival, and local control rate were additionally evaluated in patients with pathological stage II-III disease.</p><p><strong>Results: </strong>Postoperative hospital stay was significantly shorter at the university center (18 days vs. 25 days, P=0.022). Local control was higher in the university hospital group (3-year local control rate: 95.2% vs. 71.5%, P=0.025). Among patients with pathological stage II-III disease, 3-year relapse-free survival was comparable between groups (51.8% vs. 49.0%, P=0.434), whereas local control demonstrated a favorable trend in the university hospital group (91.7% vs. 65.4%, P=0.063).</p><p><strong>Conclusion: </strong>Perioperative safety in cT4b rectal cancer surgery was comparable across institutions; however, higher local control at the university center suggests that technically complex cases may benefit from selective centralization in specialized centers. These findings support a hybrid model in which regional collaboration ensures safety while advanced procedures are concentrated in specialized centers.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 4","pages":"407-414"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879124","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":"Splenic flexure mobilization using a fusion surgery technique in robotic left hemicolectomy for colon cancer: a video vignette.","authors":"Masahiro Hashimoto, Yujiro Nishizawa, Shinya Kato, Yoshihiro Morimoto, Masaaki Motoori, Taishi Hata, Kazumasa Fujitani","doi":"10.3393/ac.2026.00346.0049","DOIUrl":"10.3393/ac.2026.00346.0049","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 4","pages":"484-485"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879102","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 neutrophil to lymphocyte ratio as a survival predictor in nonmetastatic colon cancer in a Latin America-based population.","authors":"Horacio N López-Basave, Germán Calderillo-Ruíz, Flavia Morales-Vásquez, Gerardo Miranda-Dévora, David Tlelo-Amastal, Luis M Alavez-Ortega, Wendy R Muñoz-Montaño","doi":"10.3393/ac.2025.01347.0192","DOIUrl":"10.3393/ac.2025.01347.0192","url":null,"abstract":"<p><strong>Purpose: </strong>Colon cancer represents a major global health challenge, with a steadily increasing incidence. Therefore, the identification of novel and easily accessible biomarkers in colon cancer is essential. Although the neutrophil to lymphocyte ratio (NLR) has emerged as a potential prognostic indicator in various malignancies, its applicability in colon cancer within Latin America remains unexplored. This study evaluated the association between preoperative NLR and overall survival (OS) and disease-free survival (DFS).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study at the gastroenterology department of Mexico's National Cancer Institute between 2008 and 2022. All patients with nonmetastatic colon cancer who underwent upfront surgery were screened for inclusion. The optimal NLR cutoff value was determined using X-tile software and receiver operating characteristic curve analysis. Prognostic factors were assessed using Cox proportional hazards regression models.</p><p><strong>Results: </strong>A total of 522 patients were included in the analysis and categorized into high NLR (>3.0, n=230) and low NLR (≤3.0, n=292). High NLR was associated with worse 3- and 5-year OS compared with low NLR (89.9% vs. 97.5% and 84.8% vs. 94.8%, respectively) in both univariate (P<0.001) and multivariate analyses (hazard ratio [HR], 3.020; 95% confidence interval [CI], 1.638-5.570; P<0.001). High NLR was also associated with worse 3- and 5-year DFS compared with low NLR (74.2% vs. 86.5% and 72.4% vs. 82.9%, respectively) in univariate (P=0.002) and multivariate analyses (HR, 1.627; 95% CI, 1.106-2.392; P=0.013).</p><p><strong>Conclusion: </strong>This exploratory study highlights the prognostic relevance of NLR in nonmetastatic colon cancer and supports its utility for predicting OS and DFS in a Latin American population. As a readily available biomarker, NLR may be particularly useful in low-income settings. Further prospective studies are required to validate its clinical applicability.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 4","pages":"396-406"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879089","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":"A systematic literature review of colorectal robotic surgery with the Hugo robotic-assisted surgery (RAS) system: feasibility, safety, and clinical applications.","authors":"Filippo Carannante, Kiara Sejfullai, Valentina Miacci, Guglielmo Niccolò Piozzi, Gianluca Costa, Jim S Khan, Marco Caricato, Gabriella Teresa Capolupo","doi":"10.3393/ac.2025.01431.0204","DOIUrl":"10.3393/ac.2025.01431.0204","url":null,"abstract":"<p><strong>Purpose: </strong>The Hugo robotic-assisted surgery (RAS) system is a novel modular robotic platform that has recently been introduced in colorectal surgery. Although robotic approaches have improved surgical ergonomics and precision, evidence specific to the Hugo RAS system remains limited. This systematic review synthesizes the current literature on colorectal procedures performed with the Hugo RAS system and evaluates feasibility, safety, and early oncologic outcomes.</p><p><strong>Methods: </strong>A systematic literature search of PubMed, Scopus, Embase, and Ovid was conducted through September 2025 in accordance with the PRISMA 2020 guidelines. Eligible studies included case series, cohort studies, and comparative analyses that reported perioperative or oncologic outcomes of colorectal procedures performed using the Hugo RAS system.</p><p><strong>Results: </strong>Thirteen studies were included and encompassed right and left hemicolectomies, rectal resections, and total colectomies. The median docking time was 7.5 minutes (range, 5-18 minutes), the median operative time was 225 minutes (range, 163-632 minutes), the conversion rate was 3.6%, and the mean hospital stay was 5.6 days. The overall complication rate was 11%, and most complications were Clavien-Dindo grade I-II. Perioperative and oncologic outcomes, including lymph node yield, total mesorectal excision quality, and circumferential resection margin status, were comparable to those reported for laparoscopy. Reported advantages included modular arm flexibility, an ergonomic open-console design, and stable visualization, whereas reported limitations included setup time and arm bulkiness.</p><p><strong>Conclusion: </strong>The available evidence supports the feasibility and safety of the Hugo RAS system in colorectal surgery, with outcomes broadly comparable to those of laparoscopy; however, the evidence remains limited by study heterogeneity, the absence of randomized trials, and reliance mainly on small retrospective series. The platform offers potentially useful ergonomic and technical features, but multicenter prospective studies with larger cohorts, long-term follow-up, and cost-effectiveness analyses are needed to define its role in oncologic colorectal surgery. Trial registration: The protocol was registered in PROSPERO (No. CRD420251028698).</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 4","pages":"386-395"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879162","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":"Comments on \"Palliative resection versus palliative stenting for intestinal obstruction in patients with metastatic left-sided colonic cancer: a propensity score-matched analysis\".","authors":"Rıza Deryol","doi":"10.3393/ac.2026.00570.0081","DOIUrl":"10.3393/ac.2026.00570.0081","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 4","pages":"486-487"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879081","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":"Defining \"optimal recovery\" in colorectal surgery: a path to precision prehabilitation.","authors":"Chun Gao, Li Zhu, Cheng Cheng Jin, Sheng Zhang","doi":"10.3393/ac.2026.00080.0011","DOIUrl":"10.3393/ac.2026.00080.0011","url":null,"abstract":"<p><strong>Purpose: </strong>This study defined \"optimal recovery\" as a multidimensional composite endpoint for colorectal cancer surgery and investigated whether its predictors were specific to tumor location.</p><p><strong>Methods: </strong>In this retrospective cohort of 396 patients undergoing curative-intent resection, optimal recovery required achievement of 5 criteria: no major complications, timely gastrointestinal recovery, ambulation by postoperative day (POD) 2, oral intake by POD 4, and discharge by POD 7. Multivariable logistic regression was used to identify predictors in the overall cohort and site-specific subgroups. The endpoint was then evaluated against 30-day patient-reported outcomes using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30).</p><p><strong>Results: </strong>The optimal recovery rate was 44.4%. Four independent predictors emerged: age <60 years (odds ratio [OR], 2.35; P<0.001), prognostic nutritional index (PNI) ≥46 (OR, 2.70; P<0.001), operation time ≤180 minutes (OR, 2.94; P<0.001), and blood loss ≤30 mL (OR, 2.17; P=0.005). Subgroup analysis revealed marked divergence between cancer sites: blood loss was the dominant predictor in colon cancer (OR, 6.67; P<0.001), whereas PNI predominated in rectal cancer (OR, 2.56; P=0.005). Patients achieving optimal recovery reported significantly better global health status (72.4 vs. 63.8; P<0.001) and physical functioning (83.5 vs. 74.2; P<0.001) at 30 days.</p><p><strong>Conclusion: </strong>Optimal recovery provides a stringent quality benchmark, with findings highlighting site-specific determinants of recovery. Recovery after colon surgery was associated primarily with technical factors, particularly lower blood loss, whereas recovery after rectal surgery was strongly linked to nutritional status. These results support precision prehabilitation strategies tailored to site-specific pathophysiology. Trial registration: Registered in the Chinese Clinical Trial Registry (No. ChiCTR2300075424) on September 9, 2023.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 4","pages":"425-435"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879113","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":"Advancing as an international journal: a new chapter for Annals of Coloproctology.","authors":"Gyung Mo Son","doi":"10.3393/ac.2026.01256.0179","DOIUrl":"10.3393/ac.2026.01256.0179","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 4","pages":"383-385"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879167","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":"Linear versus circular stapler for colorectal anastomosis in laparoscopic sigmoidectomy: a retrospective comparative study.","authors":"Hiep Van Pham, Thang Manh Tran, Phuong Nguyen Nhu Pham","doi":"10.3393/ac.2025.01242.0177","DOIUrl":"10.3393/ac.2025.01242.0177","url":null,"abstract":"<p><strong>Purpose: </strong>The choice between linear side-to-side and circular end-to-end staplers for colorectal anastomosis after laparoscopic sigmoidectomy remains a topic of debate. This study compared intraoperative efficiency, postoperative recovery, complications, and quality of life (QoL) between the 2 techniques.</p><p><strong>Methods: </strong>This retrospective cohort study included 83 patients who underwent elective laparoscopic sigmoidectomy for sigmoid cancer at a single center between January 2023 and August 2024. Patients were grouped according to the stapling technique used for anastomosis (linear stapler, n=23; circular stapler, n=60). Intraoperative characteristics, including operative time and stapler use; postoperative outcomes, including length of hospital stay and complications; and longitudinal QoL, assessed using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Colorectal Cancer (QLQ-CR29) questionnaire at 1, 3, 6, 9, and 12 months, were analyzed.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups. Operative time did not differ significantly between the linear and circular stapler groups (90.73±14.02 minutes vs. 94.63±13.65 minutes, P=0.25). The linear stapler group required more staplers overall (3.04±0.82 vs. 1.53±0.72, P<0.001) but had a shorter hospital stay (10.09±1.83 days vs. 11.70±3.62 days, P=0.04). Oncologic outcomes and complication rates were low and comparable (anastomotic leakage: 4.3% vs. 0%, P=0.277). At 12 months, QoL scores did not differ significantly between groups, although descriptive trends suggested faster recovery of bowel function and abdominal pain in the linear stapler group during the first 6 months.</p><p><strong>Conclusion: </strong>In this single-center retrospective series, both linear side-to-side and circular end-to-end stapling techniques appeared safe, feasible, and clinically acceptable. Circular stapling required fewer stapling devices intraoperatively, whereas linear stapling was associated with modestly shorter hospitalization and descriptively faster early functional recovery. These findings are hypothesis-generating and warrant prospective validation in larger, balanced cohorts to guide patient- and technique-specific surgical decision-making.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 4","pages":"468-477"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879134","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":"Sushruta and Maimonides-two civilizations, one ailment: a comparative view of hemorrhoid care.","authors":"Kaushik Bhattacharya","doi":"10.3393/ac.2025.01410.0201","DOIUrl":"10.3393/ac.2025.01410.0201","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 4","pages":"481-483"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879149","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":"Endoscopists' attitudes toward and experiences with artificial intelligence-assisted colonoscopy: a 3-year follow-up survey after the implementation of GI Genius.","authors":"Ronja M B Lagström, Mustafa Bulut, Ismail Gögenur, Frederick H Koh","doi":"10.3393/ac.2026.00178.0025","DOIUrl":"10.3393/ac.2026.00178.0025","url":null,"abstract":"<p><strong>Purpose: </strong>Artificial intelligence (AI) can improve colonoscopy quality by increasing adenoma detection rates. At Sengkang General Hospital (SKH), Singapore, AI-assisted colonoscopy was introduced in July 2021. An initial survey suggested that attitudes toward AI were shaped more by hands-on experience than by general knowledge of AI. This follow-up survey assessed how these attitudes evolved over time and compared responses from SKH with those from endoscopists at institutions without routine AI use.</p><p><strong>Methods: </strong>An online survey was conducted 3 years after implementation of routine AI-assisted colonoscopy at SKH to evaluate endoscopists' knowledge, perceptions, and behaviors regarding AI. Endoscopists from 7 tertiary institutions in Singapore were invited to participate. The 44-item questionnaire covered 4 thematic domains. Responses were compared with those from SKH's initial survey and across institutions.</p><p><strong>Results: </strong>A total of 57 endoscopists, including 46 consultants and 11 residents, completed the survey. Most respondents were familiar with AI, but only approximately half understood its underlying mechanisms. Most endoscopists supported early AI training, although agreement was significantly lower at SKH than at other hospitals (62.0% vs. 88.9%, P=0.02). Overall, 91.2% agreed that AI should be used as an adjunct to colonoscopy, and 80.7% agreed that AI can improve the quality of a performed colonoscopy. Enjoyment of AI-assisted colonoscopy was higher at SKH than at other hospitals (85.7% vs. 58.3%, P=0.04).</p><p><strong>Conclusion: </strong>Endoscopists generally perceived AI as improving colonoscopy quality. Greater colonoscopy experience and more extensive exposure to AI-assisted colonoscopy appeared to be associated with more positive attitudes toward AI and greater acceptance of its potential benefits.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 4","pages":"436-445"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879086","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}