A systematic review and network meta-analysis involving 13 studies and 6,582 patients examined the effectiveness of open, laparoscopic, and robotic liver resections for colorectal liver metastases. Findings indicated no significant differences in R0 resection rates, disease-free survival, or overall survival among the methods. However, laparoscopic and robotic techniques displayed reduced postoperative complications, with robotic procedures […]
Category: Intestine and Lower Gastrointestinal Tract
Intracorporeal anastomosis offers benefits over extracorporeal method
A systematic review of seven randomized controlled trials involving 720 patients indicates that intracorporeal anastomosis in laparoscopic right hemicolectomy does not significantly increase the risk of anastomotic leakage compared to the extracorporeal technique. However, it is associated with lower rates of postoperative ileus and surgical site infections, along with quicker recovery of bowel function and […]
Robotic surgery enhances early discharge and reduces complications.
In a study of 282,490 patients undergoing elective colectomy, robotic surgery emerged as the strongest predictor of early discharge (15.3%), surpassing both laparoscopic and open techniques. Patients discharged early exhibited significantly lower rates of 30-day readmissions (5.84% vs. 10.37%), bounceback readmissions (3.56% vs. 5.75%), and overall complications (5.65% vs. 18.63%). These findings underscore the advantages […]
Most prescribed opioids for surgery are unused by patients
A significant portion of opioids prescribed post-elective colorectal surgery remains unused, with 63% of pills going unconsumed. In a study of 344 patients, the median prescribed amount was 13 pills, yet many reported using none. Factors like younger age, higher preoperative anxiety, and the number of pills prescribed correlated with increased consumption. These findings suggest […]
Short-Course TNT Outperforms Long-Course Treatment in Rectal Cancer
A multi-institutional review of 857 patients demonstrated that short-course total neoadjuvant therapy (sc TNT) significantly increases complete response (CR) rates in rectal cancer compared to long-course chemoradiation (lCRT). Specifically, CR rates were 34.1% for sc TNT versus 20.3% for lCRT. Notably, patients completing 5-6 months of consolidation chemotherapy had a CR rate of 42.9%. Despite […]
New machine learning model accurately predicts cancer treatment response
A novel machine learning model, utilizing systemic inflammation-nutritional index (SINI), successfully predicts pathological complete response (PCR) in patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiotherapy (NCRT). The model achieved a mean area under the curve (AUC) of 0.877 during training and demonstrated consistent performance in both internal (AUC 0.86) and external validation sets (AUC […]
Adjuvant chemotherapy improves outcomes in rectal cancer patients.
In patients with locally advanced rectal cancer, adjuvant chemotherapy significantly reduces the risk of mortality and locoregional recurrence after neoadjuvant treatment and proctectomy. Among 746 patients studied, those with a complete total mesorectal excision (TME) showed a 73% lower risk of mortality and an 88% reduction in locoregional recurrence when receiving adjuvant chemotherapy. Noncomplete TME […]
Laparoscopic techniques improve outcomes in ulcerative colitis surgery
A multicenter study with 379 ulcerative colitis patients reveals that laparoscopic colectomy and restorative procedures significantly enhance pouch function. Key findings indicate that mesocolic dissection and the transanal-transection single-stapling anastomosis are associated with reduced complications like pouchitis and cuffitis. Moreover, approaches such as mesentery lengthening increase failure risk while hand-sewn anastomoses correlate with stenosis. Findings […]
Colon cancer metastasis distribution shifts significantly over five years
A dramatic near 70% decline in resectable or borderline metastatic colorectal cancer cases was observed over the past five years. Researchers noted significant changes in metastasis distribution; specifically, m1a pathological cases decreased while m1c cases rose from 26.6% to 32.4%. Notably, stage 4b emerged as a strong predictor for hepatic metastasis. These findings underscore the […]
Lymph node retrieval impacts survival in rectal cancer patients.
Analysis of the STELLAR trial revealed that among patients with locally advanced rectal cancer treated with total neoadjuvant therapy (TNT), those undergoing limited lymphadenectomy had worse overall survival compared to those with extended lymphadenectomy (HR 2.95). A median of 11 lymph nodes were retrieved, and while adjuvant chemotherapy significantly improved outcomes in the limited group, […]