This systematic review reveals significant inconsistencies in cost reporting for robot-assisted colorectal surgery trials compared to laparoscopic approaches, with substantial implications for decision-making. Only 46.7% of the trials reported any cost data, and just 13.3% conducted formal economic evaluations. Robot-assisted surgery was consistently more expensive, but the evidence quality varied, with formal evaluations leading to […]
Category: Intestine and Lower Gastrointestinal Tract
Complete Resection of Hepatic and Pulmonary Metastases Boosts Survival
Complete resection of simultaneous hepatic and pulmonary metastases from metastatic colorectal cancer shows significant survival benefits and should be a key treatment goal for selected patients. The 5-year overall survival rate post-metastasectomy is 53.6%, with a 3-year rate of 70.9%. Patients undergoing complete metastasectomy had a hazard ratio of 0.30 for overall survival compared to […]
Biological Mesh for Pelvic Reconstruction Not Cost-Effective
Using biological mesh for pelvic floor reconstruction after extralevator abdominoperineal resection in low rectal cancer patients does not provide a cost-effective solution despite slightly reducing perineal complications. Pelvic reconstruction with biological mesh increased costs (€57,991) versus primary closure (€56,232) without significant improvement in long-term patient outcomes or quality of life. The study’s conclusions suggest routine […]
Prophylactic HIPEC Improves Survival in Advanced Colorectal Cancer
Prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) significantly enhances peritoneal metastasis-free survival and disease-free survival in patients with locally advanced colorectal cancer, though overall survival rates and complication rates remain unchanged. One-year peritoneal metastasis-free survival improved by 48% (HR 0.521), 3-year disease-free survival improved by 67% (HR 0.333), and 5-year disease-free survival improved by 29% (HR 0.714) […]
Improved Outcomes for Locally Recurrent Rectal Cancer Surgery
Curative surgery for locally recurrent rectal cancer (LRRC) is yielding better long-term outcomes, with a significant increase in the R0 resection rate and overall survival. The R0 resection rate increased from 59% to 78% from 2000 to 2023 (p < 0.001). Overall survival significantly improved in the recent cohort (2018-2023) with a hazard ratio of […]
Predictors of DVT After Gastric or Colorectal Surgery Identified
A nomogram can help predict early postoperative deep vein thrombosis (DVT) in gastric and colorectal cancer patients despite routine anticoagulant prophylaxis. In this study of 388 patients, 32% had DVT detected by screening, predominantly asymptomatic distal DVT. Key predictors for DVT included age, activated partial thromboplastin time, prothrombin time, and postoperative day 1 d-dimer. The […]
Sexual Distress Common After Pelvic Pouch Surgery in Women
Sexual distress affects 39% of patients following pelvic pouch surgery for ulcerative colitis, significantly more in women (57.8% vs. 26.5% in men). Female gender is the only strong preoperative predictor of sexual distress (OR 4.796; p < 0.001). Poor bowel function, anxiety, and depression significantly correlate with sexual distress (all p < 0.001). Surgeons should […]
Standardizing Day 1 Discharge After Minimally Invasive Colon Surgery
Implementing a day-1 discharge pathway for minimally invasive colon surgery is safe and effective. Discharge rates jumped from 4.6% to 65.0% after pathway adoption (p < 0.001). Median hospital stay shrank from 3.0 to 1.0 days (p < 0.001), with no increase in readmissions (p = 0.43) or severe complications (p = 0.91). Tailor discharge […]
Radiotherapy Duration in Total Neoadjuvant Therapy for Rectal Cancer
Short versus long course radiation in total neoadjuvant therapy for locally advanced rectal cancer yields similar overall survival outcomes. Overall survival at 48 months is comparable between long course (86.2%) and short course (13.8%) radiation (p = 0.397). Long course radiotherapy shows higher nodal downstaging rates (66.5% vs 62.7%, p = 0.023). Consider both regimens […]
Increase Colorectal Cancer Screening During Anorectal Visits
Missed opportunities exist during benign anorectal visits to boost colorectal cancer screening for patients under 50. Only 60.5% of adults aged 45-49 had a colonoscopy in the last decade. 69% completed the colonoscopy when recommended, versus 0% without a recommendation. Surgeons should leverage these visits to encourage screening, significantly impacting early detection and patient outcomes. […]