Analyzing data from 976 patients with synchronous colorectal liver metastases, researchers compared simultaneous and staged resections. Simultaneous resection, beneficial for low to moderate tumor burden and node-negative right-sided primary tumors, showed increased complications in high tumor burden cases. Staged resection demonstrated better outcomes for patients with node-positive left-sided primaries and higher tumor burden scores. Tailoring […]
Category: Intestine and Lower Gastrointestinal Tract
Surgery in Acute Lower Gastrointestinal Bleeding
In a cohort study of 10,342 acute lower gastrointestinal bleeding (ALGIB) cases, surgery was performed in 1.3%. Colonoscopy (87.7%) and endoscopic hemostasis (26.7%) were common. Surgery indications included diverticular bleeding (24%) and colorectal cancer (22%). Sixty-four percent were for severe refractory bleeding. Postoperative rebleeding rates were 22% (presumptive/obscure source) and 12% (definitive identification). Thirty-day mortality […]
Optimizing Rectal Cancer Surgery: Benefits of Transanal Total Mesorectal Excision
In a meta-analysis of four randomized controlled trials (1,339 patients), researchers compared laparoscopic total mesorectal excision (TME) with and without transanal dissection for lower rectal cancers. Those undergoing laparoscopic TME with transanal dissection exhibited lower conversion rates, a higher likelihood of achieving complete TME, and fewer harvested lymph nodes compared to the group without transanal […]
Innovative Closure Strategy for Rectal Defects Post-Endoscopic Submucosal Dissection
Researchers introduced an endoscopic hand-suturing with clips strategy (EHS-clips) for closing rectal defects after endoscopic submucosal dissection (ESD) or ESD with myectomy. All 49 defects achieved complete closure, with 71.4% through EHS alone and 28.6% with additional clips. Zero cases experienced delayed bleeding. Sustained closure reached 73.5% on postoperative days 3-5, with a stitch margin […]
Sacral Neuromodulation Triumphs Over Conservative Treatment for Refractory Slow-Transit Constipation
In the No.2-Trial, comparing sacral neuromodulation (SNM) to personalized conservative treatment (PCT) for refractory idiopathic slow-transit constipation, SNM demonstrated significant success (53.7%) compared to PCT (3.8%) after six months. SNM patients reported lower constipation severity and fatigue, along with improved quality of life. Serious adverse events were minimal (6 SNM, 2 PCT), supporting SNM as […]
Equivalency in Colorectal Metastases Management: Liver vs. Peritoneum
Examining outcomes in metastatic colorectal cancer treatment, researchers conducted a review, analyzing six selected studies. Comparing surgical interventions on the liver and peritoneum, cytoreductive surgery with heated intraperitoneal chemotherapy showed comparable safety and survival outcomes to hepatectomy. This suggests a need for early integration of cytoreduction in the management algorithm for colorectal cancer patients with […]
Virtual Reality for Colorectal Cancer Surgery Consent
In a pilot trial, colorectal cancer patients undergoing elective surgery were randomized to receive standard consent (CT images) or virtual reality (VR) consent (CT images and immersive VR models). While not statistically significant, VR showed a trend toward improved patient-reported understanding, with most patients preferring VR as an educational tool. Well-tolerated and enjoyable, VR’s feasibility […]
Unveiling Survival Insights: Radiotherapy Redundant for Stage III Mucinous Rectal Cancer
Contrary to the conventional recommendation, researchers analyzed SEER data (2004-2015) for stage III rectal mucinous adenocarcinoma (RMC) patients. RMC, distinct in T and N stage at diagnosis, emerged as an independent poor prognostic factor for overall and cancer-specific survival. Notably, adjuvant radiotherapy failed to confer survival benefits, with no significant difference found between chemotherapy alone […]
Tailoring Prophylaxis in Crohn’s Disease Surgery: Real-world Insights into Risk Factors and Recurrence
Examining 1404 Crohn’s disease patients post-ileocecal resection, researchers identified high-risk factors for surgical recurrence (multiple surgeries, active smoking, penetrating or perianal disease). Biologic prophylaxis post-surgery lowered surgical recurrence in high-risk patients. Additionally, prophylaxis reduced endoscopic recurrence regardless of risk, suggesting its potential benefits across risk profiles. These findings emphasize the relevance of individualized prophylactic approaches […]
ECCO Workshop Yields Postoperative Management Algorithm for Crohn’s Disease Patients
The 8th ECCO scientific workshop addressed postoperative recurrence (POR) in Crohn’s disease after ileocolonic resection. Despite modern therapies, POR remains a challenge, impacting patients’ lives. The workshop extensively reviewed data on preventive and treatment strategies, including medications, endoscopic procedures, and surgery. Synthesizing available knowledge, the workshop produced a practical algorithm for managing POR in daily […]