Actual 5-year survival rates after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) for patients with peritoneal carcinomatosis (PC) of colorectal origin were reported in this study. A total of 103 patients were analyzed, with a median follow-up of survivors at 88 months. The 5-year overall survival (OS) was 36%, and the median OS was 42.5 […]
Category: Intestine and Lower Gastrointestinal Tract
Colorectal Surgery Postdischarge App: Enhancing Satisfaction, Impact on 30-Day Readmission Limited
A randomized controlled trial evaluated the effectiveness of a postdischarge mobile app in reducing 30-day readmissions and improving patient-reported outcomes after elective colorectal surgery. The app did not significantly reduce readmissions or emergency room visits, but it led to significant improvements in patient satisfaction, well-being, and reduced anxiety levels. While the app may not reduce […]
Total Neoadjuvant Therapy for Rectal Cancer: Impact on Surgical Outcomes and Pathology
In a meta-analysis of 11 randomized controlled trials involving 3,185 rectal cancer patients, researchers compared total neoadjuvant therapy (TNT) to standard long course chemoradiotherapy (LCRT). TNT did not significantly differ in mortality or major complications but increased the risk of breached total mesorectal excision (TME). However, TNT showed a lower risk of disease progression during […]
Perioperative Chemotherapy Improves Overall Survival in Synchronous Colorectal Liver Metastases
Analyzing 72,376 patients with colorectal liver metastases (CRLM) from the National Cancer Database, researchers found that liver-only CRLM patients undergoing perioperative chemotherapy had a superior median overall survival (OS) of 44.7 months. Resection of both primary and metastatic sites also correlated with better OS (38.9 months) compared to metastatic site alone (30.2 months) or primary […]
Pelvic Exenterations and Cytoreductions Safely Combined for T4 Rectal Cancers with Peritoneal Metastasis
Investigating the combination of pelvic exenterations and cytoreductions in T4 rectal cancers with peritoneal metastasis, a study on 39 patients (median age 35) revealed safety in terms of morbidity (18% major complications). Although achieving CC-0 in 97.4%, hyperthermic intraperitoneal chemotherapy was administered to 15 patients. Despite safety, overall and recurrence-free survival remained modest at 17 […]
Optimal Surgical Approach for Small Bowel Neuroendocrine Tumors
In addressing the surge in small bowel neuroendocrine tumors (SB-NETs), this study underscores surgery’s pivotal role. Emphasizing multifocal assessment and mesenteric-sparing strategies, it delineates eight systematic steps for surgical planning. While stressing the necessity of achieving oncological control, some controversies persist, notably regarding resection in the presence of liver metastasis. The study encourages SB-NET resection […]
Optimizing Surgical Approach in Synchronous Colorectal Liver Metastases
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 […]
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 […]