A recent systematic review and meta-analysis examined alternative colorectal anastomotic devices, finding a pooled complication rate of 9.7% in human studies. Notably, the leak rate for compression anastomoses was only 3.3%, demonstrating no variation among studies. This review included 18 studies with a total of 955 anastomoses and highlighted significant advancements in new technologies, particularly […]
Category: Intestine and Lower Gastrointestinal Tract
Sacral neuromodulation emerges as the gold standard for fecal incontinence.
Fecal incontinence, a common yet often overlooked condition, can be managed surgically when conservative treatments fail. This review highlights that sacral neuromodulation (SNM) has established itself as the first-line treatment option due to its high success rates and minimal invasiveness. In contrast, sphincteroplasty is only advisable for specific patients with anal sphincter lesions and shows […]
Completion transanal total mesorectal excision is oncologically safe.
A study analyzed the oncological safety and technical feasibility of completion transanal total mesorectal excision (TaTME) following local excision in 189 rectal cancer patients. Results showed a low complication rate, with only 7% experiencing anastomotic leakage. The two-year local recurrence rate was 5%, while disease-free and overall survival rates were 85% and 95%, respectively. These […]
Nomogram predicts delayed bleeding risk after colorectal ESD
A nomogram has been developed to predict delayed bleeding risks following endoscopic submucosal dissection (ESD) for colorectal tumors. Analysis of 587 patients revealed an 8.98% incidence of delayed bleeding, influenced by lesion location in the rectum, size, and surgical duration. The model’s c-index was 0.89, indicating strong predictive accuracy. Implementing this nomogram can enhance surgical […]
Postoperative renal insufficiency affects 6.58% of colectomy patients.
A study of 7,477 patients undergoing colectomy for diverticulitis revealed a 6.58% incidence of postoperative renal insufficiency. Key comorbidities associated with increased kidney injury risk included diabetes, congestive heart failure, hypertension, and chronic obstructive pulmonary disease. Multivariate regression analysis identified that postoperative renal insufficiency is independently linked to a 3.8-fold increase in mortality risk. These […]
Bile acid levels predict anastomotic leakage and safe discharge
Bile acid levels in drainage fluid demonstrate high negative predictive value for early identification of anastomotic leakage post minimally invasive rectal cancer resection. In a study with 419 patients, those with leakage had significantly elevated bile acid levels compared to non-leakage cases on postoperative days 3 and 5. Furthermore, of the 384 who met discharge […]
Specialization in colorectal surgery improves patient outcomes
Emergency colorectal surgeries performed by specialized surgeons significantly lower 30-day and in-hospital mortality rates. Results from 21 studies indicate a marked increase in primary anastomosis and laparoscopic procedure rates among colorectal specialists, alongside a reduction in stoma formation. The findings, though subject to variability in patient demographics and definitions of specialization globally, emphasize the critical […]
Rectoprostatic fascia sparing is feasible and beneficial in surgery.
Feasibility of sparing the rectoprostatic fascia (rpf) during total mesorectal excision for rectal cancer is confirmed. Out of 785 patients, 63.4% successfully had the rpf preserved. Surgical specimen quality remained high. Urogenital function integrity at six months post-surgery was compromised in 27.9% of rpf-sparing cases compared to 41% in traditional surgeries. Notably, local and systemic […]
Intravenous iron enhances hemoglobin levels in colorectal cancer patients
In colorectal cancer patients with iron deficiency anemia, preoperative intravenous iron (IVI) significantly raised hemoglobin levels and reduced the need for red blood cell transfusions, complications, and wound dehiscence. An analysis of data from 11 studies involving 2024 patients demonstrated these benefits, highlighting the importance of IVI in managing anemia in this population. However, further […]
End ileostomy technique reduces stoma outlet obstruction risk
A novel end ileostomy surgical technique significantly decreased stoma outlet obstruction (SOO) rates in patients post-rectal resection. In a study of 78 patients, only 2.9% with end ileostomy experienced SOO compared to 25% with loop ileostomy, identifying the latter as an independent risk factor. This innovative approach presents a safer option for patients undergoing defunctioning […]