Prophylactic use of tamsulosin significantly decreased urinary retention rates (4.7% vs. 9.2%) and reduced hospital stays (4.2 days vs. 5 days) in colorectal surgery patients. The study, which involved 2,072 patients, demonstrated that incorporating tamsulosin into the enhanced recovery after surgery (ERAS) protocol can enhance recovery outcomes. Propensity score matching ensured robust comparisons between the […]
Category: Intestine and Lower Gastrointestinal Tract
Hybrid ESD proves efficient for specific colorectal tumors
A multicenter study involving 890 patients evaluated hybrid endoscopic submucosal dissection (ESD) against conventional ESD for treating laterally spreading tumors (LSTs). Hybrid ESD demonstrated significantly reduced procedure times and hospitalization costs, particularly for lesions sized 10-30 mm. However, it yielded lower R0 resection rates and lifting sign positivity. For larger lesions, conventional ESD maintained better […]
Primary anastomosis shows better outcomes in sigmoid volvulus surgery
In a comprehensive analysis of 1,083 sigmoid volvulus cases treated over 58 years, primary anastomosis emerged as the superior technique compared to stoma creation following urgent sigmoidectomy. Key findings include significantly lower complication rates, shorter hospitalization durations, and reduced costs associated with primary anastomosis. Notably, patients undergoing primary anastomosis experienced fewer incidents of shock, bowel […]
Mature tertiary lymphoid structures indicate better prognosis in colorectal cancer.
Colorectal cancer patients with mature tertiary lymphoid structures (TLS) demonstrated notably improved outcomes, including reduced rates of vascular tumor thrombus, lymph node, and liver metastasis. An analysis of 230 specimens revealed that mature TLS correlated with lower Ki-67 expression and higher levels of deficient mismatch repair and PD-L1 positivity. These findings suggest that TLS maturation […]
Deep learning model effectively predicts mismatch repair deficiency in colorectal cancer
A new deep learning model demonstrated strong predictive capabilities for mismatch repair deficiency in colorectal cancer. An area under the receiver operating characteristic (AUROC) score of 0.948 was achieved during testing, while independent validation yielded an AUROC of 0.807. Notably, the model achieved a negative predictive value of 94.2%. In a prospective trial, it accurately […]
Enhanced recovery after colorectal surgery significantly improves patient outcomes
A study on enhanced recovery after surgery (ERAS®) revealed notable improvements in patient recovery post-elective colorectal surgery. Patients in cohorts following ERAS® implementation experienced significantly higher rates of bowel movement and solid food intake, with 98% achieving bowel movements by discharge compared to only 66% prior. Additionally, opioid use decreased significantly, and cohort C reported […]
Early discharge after ostomy construction does not increase readmission rates.
A study analyzed 13,628 patients undergoing ostomy construction, revealing that early discharge within 1-2 days did not significantly increase 30-day readmission rates compared to discharges of 3-5 days. Readmission rates were 13.6% for expedited discharges versus 14.2% for nonexpedited, with no significant difference found after adjusting for various factors. These findings provide support for expedited […]
Trained medical students can effectively assess surgical quality
Trained medical students demonstrated excellent reliability in evaluating minimally invasive right hemicolectomy videos, achieving an intraclass correlation coefficient of 0.885. When combined with expert colorectal surgeons’ scores, the inter-rater reliability increased to 0.945. These trained students accurately identified lower quality surgeries, while untrained students assigned higher scores to poorer quality surgeries. The findings suggest that […]
Indocyanine green significantly lowers anastomotic leak risk.
A systematic review and meta-analysis examining randomized controlled trials reveals that indocyanine green fluorescence angiography (ICG-FA) leads to a 45% reduction in overall anastomotic leaks during colorectal surgery. Specific findings indicate a 47% reduction for low anastomoses and a 69% reduction in grade A leaks. However, no significant differences were noted in secondary outcomes such […]
Mechanical bowel preparation reduces anastomotic leaks in surgery
A systematic review and meta-analysis of 11 studies revealed that pre-operative mechanical bowel preparation significantly reduces the rate of anastomotic leaks in adult patients undergoing elective restorative colorectal surgery. The analysis included a diverse participant pool with a mean age of 62.98 years, primarily featuring individuals with colorectal carcinoma. While it effectively shortened hospital stays, […]