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 […]
Category: Intestine and Lower Gastrointestinal Tract
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 […]
Minimally Invasive Surgery vs. Laparotomy for Nonmetastatic pT4a Colorectal Cancer: Propensity Score Analysis
Analyzing 634 nonmetastatic pT4a colorectal cancer patients (2015–2021), researchers compared minimally invasive surgery (MIS) and laparotomy outcomes. MIS exhibited lower blood loss, quicker recovery parameters, and a 3.5% conversion rate. After 5 years, MIS showed comparable overall survival (72.7%) and disease-free survival (72.2%) to laparotomy. Multivariate analysis identified age, lymph node metastasis, and carcinoembryonic antigen […]
Feasibility and Safety of Single-Incision Robotic Assisted Colorectal Surgery
In a nonrandomized cohort pilot study, researchers explored the feasibility and safety of single-incision robotic-assisted surgery (SIRAS) using the Shurui Endoscopic Surgical Robotic System (SR-ENS-600). Seven patients underwent successful SIRAS for colorectal malignancy. The SR-ENS-600 platform exhibited preferable maneuverability/stability in confined fields. Although one case encountered intraoperative hemorrhage, overall outcomes were satisfactory, with no short-term […]
Appendectomy vs. Hemicolectomy for 1- to 2-cm Appendix Neuroendocrine Tumors: A Survival Analysis
Examining 3,189 patients with 1- to 2-cm neuroendocrine tumors of the appendix, researchers found that while the appendectomy rate increased over the years, it wasn’t linked to improved survival compared to right hemicolectomy. Grade 2 and 3 tumors were associated with a lower likelihood of appendectomy. Despite differences in tumor grades and patient travel distance, […]