A meta-analysis of 154 studies involving 358,257 participants identified 48 unique risk factors for inadequate bowel preparation (IBP) before colonoscopy. Key sociodemographic predictors included Medicaid insurance, obesity, and male sex, while comorbidities such as psychiatric disease and diabetes also played significant roles. Medication use, particularly tricyclic antidepressants and opioids, exacerbated risk. These findings aim to […]
Category: Intestine and Lower Gastrointestinal Tract
Concomitant hernia and colorectal surgery increases complication risks
Analysis of 7,783 patients revealed that simultaneous incisional hernia repair and colorectal surgery significantly increases surgical site infections (55.4%) compared to isolated hernia repairs (30.7%). Multivariate assessments identified key risk factors, including BMI, smoking, and surgery type. Higher overall complication rates, including increased mortality and Clavien-Dindo grades, were observed in patients undergoing combined procedures, particularly […]
Single-port laparoscopic method proves effective for Hartmann’s reversal
A single-port laparoscopic technique for Hartmann’s reversal was successfully implemented in 85.1% of patients, significantly enhancing postoperative recovery. The procedure showed a median operation time of 92 minutes and limited blood loss of 100 ml. Postoperative complications were noted in 21.7% of cases, with the most severe classified as grade 3a. Notably, no anastomotic leaks […]
Predictive tool for early detection of anastomotic leakage
A novel predictive tool combining early warning scores and C-reactive protein levels has been developed to detect anastomotic leakage after colon cancer surgery. Analysis of 1,855 patient records revealed that mean CRP levels exceeded 200 mg/l and early warning scores above 2 indicated leakage. Specifically, postoperative day 3 emerged as critical for detection, with cutoffs […]
Machine learning enhances assessment of colorectal liver metastases response
A machine learning model utilizing CT-based radiomics significantly surpassed traditional radiologist assessments in estimating pathologic response of colorectal liver metastases after neoadjuvant therapy. In a study involving 85 patients, the model achieved an area under the curve (AUC) of 0.87, contrasting sharply with the AUCs of 0.53 for RECIST assessments and 0.56 for morphologic evaluation. […]
Patients with isolated lateral lymph node metastasis show better outcomes
A significant proportion of rectal cancer patients exhibit isolated lateral lymph node (LLN) metastases without mesenteric involvement. Results indicate these patients have a markedly better prognosis, with three-year overall survival rates of 85% compared to 51% for those with both LLN and mesenteric metastases. Furthermore, findings revealed that characteristics such as poor histological types and […]
NOSES technique shows advantages over conventional surgeries for colorectal cancer
A comparative analysis involving 540 patients indicates that the NOSES technique for colorectal cancer surgeries is effective and safe, with notable advantages over laparoscopic-assisted resection. Patients undergoing NOSES experienced fewer postoperative complications, shorter hospital stays, and quicker recovery of gastrointestinal function. The duration of surgery was similar in both groups, reinforcing NOSES as a promising […]
Diversion stoma is unnecessary for rectovaginal fistula closure
A multicentric retrospective study of 82 patients with postoperative rectovaginal fistulas revealed an 85.4% treatment success rate. Notably, the creation of a diversion stoma did not enhance management outcomes. While interventions averaged 3.04 per patient, neither the number of interventions nor the stoma correlated with success rates. Instead, direct coloanal anastomosis significantly improved success compared […]
Robotic-assisted surgery shows improved lymph node retrieval in colorectal cancer treatment
In a cohort study involving 100 colorectal cancer patients, researchers observed that robotic-assisted surgery (RAS) resulted in a significant increase in lymph node retrieval, with 95% achieving a minimum of 12 nodes compared to 88% in laparoscopic surgery. Key performance indicators were maintained or improved through RAS, suggesting advantages in theater utilization and potential cost […]
Outpatient management is effective for acute uncomplicated diverticulitis
In a study involving 688 patients with acute uncomplicated diverticulitis, outpatient management proved to be effective, showing no significant differences in treatment failure, pain recurrence, or elective surgery needs compared to inpatient care. Inpatients had higher rates of severe symptoms such as elevated CRP levels and systemic inflammatory responses. Notably, previous episodes of diverticulitis significantly […]