Annals of Coloproctology最新文献

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Extracellular vesicles in colorectal cancer. 结直肠癌的细胞外囊泡。
IF 2.1
Annals of Coloproctology Pub Date : 2025-10-01 Epub Date: 2025-10-16 DOI: 10.3393/ac.2025.00745.0106
Young Il Kim, Chungyeop Lee, Hakho Lee, In Ja Park
{"title":"Extracellular vesicles in colorectal cancer.","authors":"Young Il Kim, Chungyeop Lee, Hakho Lee, In Ja Park","doi":"10.3393/ac.2025.00745.0106","DOIUrl":"10.3393/ac.2025.00745.0106","url":null,"abstract":"<p><p>Colorectal cancer (CRC) remains a major global health issue, with challenges including early detection and recurrence monitoring. While colonoscopy and fecal-based tests are standard screening tools, their limitations have driven interest in less invasive alternatives. Extracellular vesicles (EVs) present in patient liquid biopsy samples have emerged as potential biomarkers and therapeutic tools in CRC. EVs carry molecular cargo, including nucleic acids and proteins, that reflect the status of their cells of origin and can be readily accessed through minimally invasive liquid biopsy. This review outlines the role of EVs in the initiation and progression of CRC, summarizes recent advances in EV isolation techniques, and highlights candidate EV-derived biomarkers for diagnosis, prognosis, and treatment monitoring. By providing an updated synthesis of current research, this review aims to inform future studies and support clinical translation of EV-based approaches in CRC.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 5","pages":"379-392"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12569783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145386325","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}
引用次数: 0
Prognostic significance of carbohydrate antigen 19-9 (CA19-9) change during immediate postoperative periods in patients with stage I-III colorectal cancer. I-III期结直肠癌患者术后即刻碳水化合物抗原19-9 (CA19-9)变化的预后意义
IF 2.1
Annals of Coloproctology Pub Date : 2025-10-01 Epub Date: 2025-10-23 DOI: 10.3393/ac.2025.00528.0075
Wooram Choi, Yongjung Park, Jeonghyun Kang
{"title":"Prognostic significance of carbohydrate antigen 19-9 (CA19-9) change during immediate postoperative periods in patients with stage I-III colorectal cancer.","authors":"Wooram Choi, Yongjung Park, Jeonghyun Kang","doi":"10.3393/ac.2025.00528.0075","DOIUrl":"10.3393/ac.2025.00528.0075","url":null,"abstract":"<p><strong>Purpose: </strong>Although carbohydrate antigen 19-9 (CA19-9) may exhibit low sensitivity in tumor screening, its prognostic significance has been highlighted. This study assessed the significance of preoperative CA19-9 and early postoperative CA19-9 levels in patients with nonmetastatic colorectal cancer (CRC).</p><p><strong>Methods: </strong>Patients diagnosed with stage I-III CRC between January 2004 and April 2014 were included. Preoperative CA19-9 was assessed within 2 months of operation, whereas postoperative CA19-9 was measured 4 to 7 days after operation. The optimal cutoff values for preoperative and postoperative CA19-9 were established to maximize the differences in overall survival. Patients were categorized into 3 groups based on the CA19-9 change (CA19-9 trend): group 1, low preoperative CA19-9; group 2, high preoperative and low postoperative CA19-9; and group 3, high preoperative and postoperative CA19-9. The discriminatory powers of all variables were compared using the concordance index.</p><p><strong>Results: </strong>A total of 816 patients were included. The determined cutoff values for preoperative and postoperative CA19-9 were 18.9 and 21.4 U/mL, respectively. Subgroup dichotomization revealed associations of preoperative CA19-9, postoperative CA19-9, and CA19-9 trend with overall survival in univariable analysis. The CA19-9 trend emerged as an independent prognostic factor in the multivariable analysis (group 1 vs. group 2: hazard ratio, 1.682 [95% confidence interval (CI), 1.043-2.710], P=0.032; group 1 vs. group 3: hazard ratio, 2.882 [95% CI, 1.899-4.371], P<0.001). The concordance index value of the CA19-9 trend (0.636; 95% CI, 0.509-0.682) surpassed those of preoperative and postoperative CA19-9.</p><p><strong>Conclusion: </strong>The amalgamation of preoperative and postoperative CA19-9 levels demonstrated enhanced prognostic stratification, allowing for a more detailed classification of patients with nonmetastatic CRC.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":" ","pages":"400-408"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12569770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342999","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}
引用次数: 0
Prevalence and clinical significance of evacuation disorders in patients with low anterior resection syndrome. 下前切除术综合征患者排空障碍的患病率及临床意义。
IF 2.1
Annals of Coloproctology Pub Date : 2025-08-01 Epub Date: 2025-08-25 DOI: 10.3393/ac.2024.00934.0133
Yuko Homma, Toshiki Mimura, Koji Koinuma, Hisanaga Horie, Naohiro Sata
{"title":"Prevalence and clinical significance of evacuation disorders in patients with low anterior resection syndrome.","authors":"Yuko Homma, Toshiki Mimura, Koji Koinuma, Hisanaga Horie, Naohiro Sata","doi":"10.3393/ac.2024.00934.0133","DOIUrl":"10.3393/ac.2024.00934.0133","url":null,"abstract":"<p><strong>Purpose: </strong>Low anterior resection syndrome (LARS) manifests with evacuation disorder symptoms and continence problems. However, no prior study has focused on evacuation disorders in patients with LARS. This study investigated the prevalence of evacuation disorders and their association with the LARS score.</p><p><strong>Methods: </strong>This study included patients with defecation per anus at the time of the survey, which was conducted between November 2020 and April 2021. These patients had undergone anus-preserving surgery for rectal tumors between 2014 and 2019 at a tertiary university hospital. The severity of evacuation disorders and LARS was evaluated using the Constipation Scoring System and the LARS score, respectively. The primary endpoint was the prevalence of evacuation disorders, defined as evacuation difficulty, feeling of incomplete evacuation, and abnormally long time on the toilet. The secondary endpoints were the associations between these symptoms and the LARS score.</p><p><strong>Results: </strong>Of 332 eligible patients, 238 (71.7%) completed the questionnaire. The overall prevalence of evacuation disorders was 48.3%. The rates of feeling incomplete evacuation, evacuation difficulty, and prolonged time on the toilet were 45.6%, 15.5%, and 8.4%, respectively. Patients with minor or major LARS had a significantly higher prevalence of evacuation disorders than those with no LARS, particularly regarding feeling incomplete evacuation.</p><p><strong>Conclusions: </strong>Evacuation disorders were present in 48.3% of patients following anus-preserving surgery. Greater severity of LARS was associated with a higher prevalence of evacuation disorders, especially a feeling of incomplete evacuation. Patients should be informed about the potential for both evacuation disorders and continence-related symptoms following anus-preserving surgery.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 4","pages":"271-278"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940192","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}
引用次数: 0
Improved outcomes with cyanoacrylate glue for ileocolic anastomosis in right colectomy: a multicenter study. 一项多中心研究:氰基丙烯酸酯胶改善右结肠切除术回肠结肠吻合效果。
IF 2.1
Annals of Coloproctology Pub Date : 2025-08-01 Epub Date: 2025-06-04 DOI: 10.3393/ac.2024.00899.0128
Daniela Rega, Ernesto De Giulio, Raffaele De Luca, Andrea Muratore, Marco Milone, Giuseppe Sica, Paolo Millo, Carmela Cervone, Nicola Cillara, Patrizia Marsanic, Brunella Maria Pirozzi, Valeria Grazia Malagnino, Pietro Anoldo, Marcello Calabrò, Giovanni De Palma, Michele Simone, Paolo Delrio
{"title":"Improved outcomes with cyanoacrylate glue for ileocolic anastomosis in right colectomy: a multicenter study.","authors":"Daniela Rega, Ernesto De Giulio, Raffaele De Luca, Andrea Muratore, Marco Milone, Giuseppe Sica, Paolo Millo, Carmela Cervone, Nicola Cillara, Patrizia Marsanic, Brunella Maria Pirozzi, Valeria Grazia Malagnino, Pietro Anoldo, Marcello Calabrò, Giovanni De Palma, Michele Simone, Paolo Delrio","doi":"10.3393/ac.2024.00899.0128","DOIUrl":"10.3393/ac.2024.00899.0128","url":null,"abstract":"<p><strong>Purpose: </strong>Anastomotic leaks (AL) remain a major complication following right colectomy for colon cancer. This multicenter, prospective, observational study evaluated the efficacy of Glubran 2, a cyanoacrylate-based sealant, in reducing the incidence of AL by reinforcing ileocolic anastomoses.</p><p><strong>Methods: </strong>The study enrolled 380 patients undergoing right colectomy for colon cancer across 7 Italian hospitals. Glubran 2 was applied to reinforce ileocolic anastomoses. The primary endpoint was a 50% reduction in AL incidence from a baseline of 6.18% within 10 days after surgery. Secondary endpoints included examining the correlation between AL and preexisting risk factors and determining the rate of anastomotic bleeding. Statistical analyses employed binomial tests and logistic regression.</p><p><strong>Results: </strong>The AL rate was reduced to 1.85% compared to the reference rate of 6.18% (P<0.01). Glubran 2 exhibited a protective effect even in patients with preexisting risk factors such as smoking, diabetes, or prior surgeries; none of these factors was significantly associated with AL (P>0.05). Surgical technique (P=0.687), anastomosis technique (P=0.998), and anastomosis type (P=0.998) did not influence AL rates. Operation time was similar across groups (P=0.613), and anastomotic bleeding occurred in 1.3% of cases, with no association with AL (P=0.989).</p><p><strong>Conclusions: </strong>Glubran 2 was safely applied to ileocolic anastomoses, significantly reducing AL rates and potentially providing a protective effect even in patients with known risk factors. Its hemostatic and bacteriostatic properties support improved postoperative outcomes, highlighting its potential as an effective adjunct in colorectal surgery. Further studies are warranted to confirm these findings and explore broader applications.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":" ","pages":"293-302"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214771","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}
引用次数: 0
Expanding the boundaries of minimally invasive surgery: the feasibility of robotic natural orifice transluminal extraction colectomy and robotic no-incision colectomy in colorectal practice. 拓展微创手术的边界:机器人自然孔腔内抽提结肠切除术和机器人无切口结肠切除术在结直肠实践中的可行性。
IF 2.1
Annals of Coloproctology Pub Date : 2025-08-01 Epub Date: 2025-08-28 DOI: 10.3393/ac.2025.00647.0092
Thalia Petropoulou, Kyriacos Evangelou, Andreas Polydorou
{"title":"Expanding the boundaries of minimally invasive surgery: the feasibility of robotic natural orifice transluminal extraction colectomy and robotic no-incision colectomy in colorectal practice.","authors":"Thalia Petropoulou, Kyriacos Evangelou, Andreas Polydorou","doi":"10.3393/ac.2025.00647.0092","DOIUrl":"10.3393/ac.2025.00647.0092","url":null,"abstract":"<p><strong>Purpose: </strong>Minimally invasive surgery offers reduced trauma, accelerated recovery, and shorter hospital stays. Robotic technology further enhances laparoscopic precision, particularly in colorectal procedures. This study investigated the safety and effectiveness of robotic natural orifice transluminal extraction colectomy (R-NOTEC) and robotic no-incision colectomy (R-NIC), comparing these techniques to the conventional robotic colectomy.</p><p><strong>Methods: </strong>Outcomes of patients undergoing robotic-assisted colorectal resection-either conventional robotic colectomy or R-NOTEC/R-NIC-using a single docking technique at a tertiary hospital over 3 years were analyzed. All patients were managed according to established Enhanced Recovery After Surgery protocols.</p><p><strong>Results: </strong>In total, 100 patients were included, with 25 receiving R-NOTEC or R-NIC. The median age was 65 years (range, 30-82 years), and the median body mass index was 31.0 kg/m2 (range, 20.1-43.0 kg/m2). The median length of stay was significantly shorter in the R-NOTEC/R-NIC group than in the conventional robotic group (2.0 days vs. 3.4 days, P=0.021). Other outcomes, such as circumferential resection margin status, lymph node yield, and mortality, were similar between groups. The R-NOTEC/R-NIC group exhibited a slightly lower complication rate, as well as less opioid use. No conversions to open surgery occurred in either group.</p><p><strong>Conclusions: </strong>R-NOTEC/R-NIC offer significant promise in colorectal surgery by minimizing trauma, expediting recovery, and maintaining oncologic safety. Nevertheless, these procedures require specialized surgical expertise and careful patient selection. Further research should focus on long-term outcomes and standardization of these techniques. .</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 4","pages":"346-353"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940202","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}
引用次数: 0
Comparison of chyle leakage between laparoscopic and open colectomy in patients with colon cancer: a systematic review and meta-analysis. 腹腔镜和开放式结肠切除术对结肠癌患者乳糜漏的比较:一项系统回顾和荟萃分析。
IF 2.1
Annals of Coloproctology Pub Date : 2025-08-01 Epub Date: 2025-08-27 DOI: 10.3393/ac.2025.00045.0006
Tharin Thampongsa, Sitanun Saengsri, Pichet Wattanapreechanoni, Chairat Supsamutchai, Chumpon Wilasrusmee, Napaphat Poprom
{"title":"Comparison of chyle leakage between laparoscopic and open colectomy in patients with colon cancer: a systematic review and meta-analysis.","authors":"Tharin Thampongsa, Sitanun Saengsri, Pichet Wattanapreechanoni, Chairat Supsamutchai, Chumpon Wilasrusmee, Napaphat Poprom","doi":"10.3393/ac.2025.00045.0006","DOIUrl":"10.3393/ac.2025.00045.0006","url":null,"abstract":"<p><strong>Purpose: </strong>Laparoscopic complete mesocolon excision (LCME) for right colonic cancer improves oncological outcomes. This meta-analysis aimed to compare the rate of chylous leakage between laparoscopic and open right colectomy with CME for right-sided colonic cancers.</p><p><strong>Methods: </strong>A literature search was performed up to February 2022. The primary outcome was the rate of chylous leakage. Secondary outcomes included related surgical and clinical parameters. A meta-analysis was performed to calculate risk ratios.</p><p><strong>Results: </strong>Eleven studies were included. The rate of postoperative chylous leakage was lower in laparoscopic surgery compared to open surgery (risk ratio, 0.63; 95% confidence interval, 0.33-1.20), although this difference was not statistically significant. LCME showed superior outcomes to open CME (OCME) in secondary outcomes, such as reduced blood loss, increased harvested lymph node count, and decreased overall morbidity.</p><p><strong>Conclusions: </strong>There was no significant difference between LCME and OCME regarding the rates of chylous leakage, anastomosis leakage, or operative time. However, LCME demonstrated superiority in blood loss reduction, harvested lymph node number, and overall morbidity in patients undergoing surgery for right colon cancer.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 4","pages":"262-270"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940246","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}
引用次数: 0
Racing toward the future of robot-assisted rectal cancer surgery: a comparative study of hinotori and da Vinci. 奔向机器人辅助直肠癌手术的未来:hinotori和达芬奇的比较研究。
IF 2.1
Annals of Coloproctology Pub Date : 2025-08-01 Epub Date: 2025-08-29 DOI: 10.3393/ac.2025.00990.0141
Sung Uk Bae
{"title":"Racing toward the future of robot-assisted rectal cancer surgery: a comparative study of hinotori and da Vinci.","authors":"Sung Uk Bae","doi":"10.3393/ac.2025.00990.0141","DOIUrl":"10.3393/ac.2025.00990.0141","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 4","pages":"259-261"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940323","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}
引用次数: 0
Incisional hernia risk in intracorporeal anastomosis with Pfannenstiel incision versus extracorporeal anastomosis with midline incision for laparoscopic right hemicolectomy: a multicenter comparison. 腹腔镜右半结肠切除术中Pfannenstiel切口与中线切口体外吻合的切口疝风险的多中心比较
IF 2.1
Annals of Coloproctology Pub Date : 2025-08-01 Epub Date: 2025-06-18 DOI: 10.3393/ac.2024.00682.0097
Francesco Saverio Lucido, Giusiana Nesta, Luigi Brusciano, Claudio Gambardella, Francesco Pizza, Giuseppe Scognamiglio, Gianmattia Del Genio, Salvatore Tolone, Federico Maria Mongardini, Massimo Mongardini, Ludovico Docimo, Simona Parisi
{"title":"Incisional hernia risk in intracorporeal anastomosis with Pfannenstiel incision versus extracorporeal anastomosis with midline incision for laparoscopic right hemicolectomy: a multicenter comparison.","authors":"Francesco Saverio Lucido, Giusiana Nesta, Luigi Brusciano, Claudio Gambardella, Francesco Pizza, Giuseppe Scognamiglio, Gianmattia Del Genio, Salvatore Tolone, Federico Maria Mongardini, Massimo Mongardini, Ludovico Docimo, Simona Parisi","doi":"10.3393/ac.2024.00682.0097","DOIUrl":"10.3393/ac.2024.00682.0097","url":null,"abstract":"<p><strong>Purpose: </strong>Laparoscopic right hemicolectomy can be performed via intracorporeal ileocolic anastomosis (ICA) or extracorporeal ileocolic anastomosis (ECA). Prior studies have emphasized ICA's advantages in hospital stay and postoperative pain. This multicenter study aimed to compare the 2-year incidence of incisional hernia between ICA (using a suprapubic Pfannenstiel incision) and ECA (using a pararectal incision) and assess perioperative outcomes.</p><p><strong>Methods: </strong>We retrospectively analyzed patients undergoing laparoscopic right hemicolectomy between 2019 and 2020, divided into 2 groups: ICA with a Pfannenstiel incision and ECA with a pararectal incision.</p><p><strong>Results: </strong>The mean operative time was longer in the ICA group (190 minutes vs. 170 minutes, P=0.004). Despite requiring advanced surgical skills and prolonged operative time, ICA was associated with superior short-term outcomes and a significantly lower incisional hernia rate compared to ECA (1.2% vs. 14.7%, P=0.044) at 24-month follow-up.</p><p><strong>Conclusions: </strong>ICA is linked to longer operative times, but shorter hospital stays, fewer wound complications, and reduced incisional hernia rates compared to ECA.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 4","pages":"287-292"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940281","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}
引用次数: 0
Transverse perineal support improves long-term outcomes in patients undergoing stapled transanal rectal resection for obstructed defecation syndrome: a multicenter observational case-control study. 横向会阴支持改善经肛直肠吻合器切除术治疗排便障碍综合征患者的长期预后:一项多中心观察性病例对照研究。
IF 2.1
Annals of Coloproctology Pub Date : 2025-08-01 Epub Date: 2025-08-25 DOI: 10.3393/ac.2025.00073.0010
Adolfo Renzi, Luigi Marano, Pasquale Talento, Luigi Brusciano, Angela Pezzolla, Domenico Izzo, Carmine Antropoli, Francesco D'Aniello, Giandomenico Di Sarno, Gianluca Minieri, Grazia Cantore, Gianmattia Terracciano, Domenico Barbato, Ludovico Docimo, Massimo Antropoli, Alessio Palumbo, Michele Lanza, Emanuele Mario Caputi, Antonio Brillantino
{"title":"Transverse perineal support improves long-term outcomes in patients undergoing stapled transanal rectal resection for obstructed defecation syndrome: a multicenter observational case-control study.","authors":"Adolfo Renzi, Luigi Marano, Pasquale Talento, Luigi Brusciano, Angela Pezzolla, Domenico Izzo, Carmine Antropoli, Francesco D'Aniello, Giandomenico Di Sarno, Gianluca Minieri, Grazia Cantore, Gianmattia Terracciano, Domenico Barbato, Ludovico Docimo, Massimo Antropoli, Alessio Palumbo, Michele Lanza, Emanuele Mario Caputi, Antonio Brillantino","doi":"10.3393/ac.2025.00073.0010","DOIUrl":"10.3393/ac.2025.00073.0010","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety and long-term efficacy of stapled transanal rectal resection (STARR) combined with the transverse perineal support (TPS) procedure in the surgical treatment of obstructed defecation syndrome (ODS) associated with internal rectal prolapse and excessive perineal descent (PD).</p><p><strong>Methods: </strong>This multicenter observational case-control study involved 7 European centers. During the initial study period, patients underwent STARR alone (group 1), while in the subsequent period, patients received STARR combined with TPS (group 2). All patients were followed clinically at 6, 12, 36, and 60 months, and were offered radiological evaluation between 3 and 5 years postoperatively.</p><p><strong>Results: </strong>The median postoperative ODS score was similar between groups at 6 months (6 [range, 2-15] vs. 5 [range, 2-13]; P=0.16, Mann-Whitney U-test), but at 36 months, it was significantly lower in group 2 compared to group 1 (11 [range, 5-16] vs. 5 [range, 2-15]; P<0.001, Mann-Whitney U-test), with stable results maintained through 5 years. The success rate followed a similar trend. Postoperative maximum PD during straining remained unchanged in group 1, whereas it significantly decreased compared to preoperative values in group 2.</p><p><strong>Conclusions: </strong>The addition of TPS to STARR in the surgical treatment of ODS associated with internal rectal prolapse and excessive PD appears to significantly improve long-term success rates and correct descending perineum.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 4","pages":"330-337"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940333","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}
引用次数: 0
Short-term surgical outcomes following neoadjuvant immunotherapy in mismatch repair-deficient colorectal cancer: initial experience from a tertiary referral center. 错配修复缺陷结直肠癌新辅助免疫治疗后的短期手术效果:来自三级转诊中心的初步经验。
IF 2.1
Annals of Coloproctology Pub Date : 2025-08-01 Epub Date: 2025-08-28 DOI: 10.3393/ac.2025.00381.0054
Ejaz Ahmed Latif, Ayman Abdelhafiz Ahmed, Mahmood Saad Al-Dhaheri, Ammar Aleter, Ali Toffaha, Mohamed Kurer, Tausief Fatima, Amjad Parvaiz, Mohmmad Hosni Abunada
{"title":"Short-term surgical outcomes following neoadjuvant immunotherapy in mismatch repair-deficient colorectal cancer: initial experience from a tertiary referral center.","authors":"Ejaz Ahmed Latif, Ayman Abdelhafiz Ahmed, Mahmood Saad Al-Dhaheri, Ammar Aleter, Ali Toffaha, Mohamed Kurer, Tausief Fatima, Amjad Parvaiz, Mohmmad Hosni Abunada","doi":"10.3393/ac.2025.00381.0054","DOIUrl":"10.3393/ac.2025.00381.0054","url":null,"abstract":"<p><strong>Purpose: </strong>Immunotherapy has demonstrated remarkable efficacy in mismatch repair-deficient (MMR-D) colorectal cancer (CRC). Due to their significant response rates, immune checkpoint inhibitors have emerged as a promising neoadjuvant therapy. However, data regarding short-term surgical outcomes following immunotherapy remain limited. The aim of this study is to evaluate the safety and feasibility of surgical resection after immunotherapy, as well as its short-term clinical outcomes.</p><p><strong>Methods: </strong>A retrospective review of prospectively collected data was performed at a tertiary referral center from January 2020 to July 2024. Fifteen consecutive patients with MMR-D CRC treated with pembrolizumab were analyzed. The patients' demographics, tumor characteristics, clinical outcomes, and histopathological responses were assessed.</p><p><strong>Results: </strong>In total, 15 patients diagnosed with MMR-D locally advanced or metastatic colorectal cancers received neoadjuvant immunotherapy followed by surgery. Of the 15 patients, 11 (73.3%) were male, 12 (80.0%) presented with T3/T4 tumors, and 3 (20.0%) had metastatic disease at diagnosis. The median number of immunotherapy cycles was 5 (range, 3-13). Surgery was performed without any anastomotic leaks or 30-day mortality. The median length of hospital stay was 5 days (range, 3-14 days). All surgical specimens had negative resection margins. Major pathological response was observed in 11 patients (73.3%), including complete response in 8 (53.3%) and near-complete response in 3 (20.0%). The median follow-up was 14 months (range, 1-56 months). One patient developed liver metastasis, which was successfully resected.</p><p><strong>Conclusions: </strong>Surgical resection of MMR-D CRC following neoadjuvant immunotherapy is safe and associated with low morbidity. Neoadjuvant immunotherapy in MMR-D CRC facilitates high rates of major pathological response.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 4","pages":"338-345"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940338","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}
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