In the era of biological agents, Crohn’s disease patients show varying surgery rates based on Montreal classifications. Notably, type B3 patients have the highest likelihood of requiring surgery, while type A1 patients tend to undergo surgery earlier than A2 and A3. The use of biological agents within one month of diagnosis significantly decreases the chances […]
Category: Intestine and Lower Gastrointestinal Tract
Intraoperative factors improve prediction of hospital stay length
A new model predicting length of stay (LOS) after colorectal surgery demonstrates enhanced accuracy by including intraoperative risk factors. The intraoperative prediction model (IP model) achieved an area under the curve (AUC) of 0.84, outperforming the preoperative model (PP model) with an AUC of 0.75. This significant improvement, validated across 2,140 patients, supports better patient […]
Enhanced recovery protocols for colorectal surgery reduce complications and costs.
Implementation of an Enhanced Recovery After Surgery (ERAS) protocol significantly decreased infectious complications and postoperative hospital stays in colorectal cancer patients. In a matched study of 142 patients, ERAS yielded an 8.5% reduction in anastomotic dehiscence and surgical wound infections. Importantly, it was found to be more cost-effective, saving €37,673.44 compared to traditional methods. Thus, […]
Elevated postoperative CEA levels indicate poor prognosis in CRC patients
A meta-analysis of 20 studies involving 10,114 colorectal cancer patients found that elevated postoperative carcinoembryonic antigen (CEA) levels significantly correlate with poorer overall survival, disease-free survival, and recurrence-free survival. Specifically, increased CEA levels were associated with hazard ratios indicating a roughly threefold decrease in survival prospects. This analysis emphasizes the need for proactive interventions when […]
Preoperative multidisciplinary team meetings improve survival in rectal cancer.
A population-based study in Catalonia analyzed 5,249 rectal cancer patients, revealing that those whose cases were discussed in preoperative multidisciplinary team meetings (MTMs) exhibited better 2-year survival rates. Specifically, the MTM group had a 22% increase in survival compared to those not discussed in such meetings (hazard ratio 1.22), after adjusting for confounding factors. The […]
A new score predicts lymph node involvement in rectal cancer
A novel lateral pelvic lymph node positivity (LPLNP) score was developed to predict lymph node involvement in western rectal cancer patients. The score was validated on a cohort where 40 patients above a threshold of 0.23 underwent dissection, revealing a 55% positive confirmation rate. It exhibited a remarkable negative predictive value of 96%, with sensitivity […]
Kono-S anastomosis significantly reduces postoperative recurrence in Crohn’s disease.
Kono-S anastomosis shows promising results in lowering recurrence rates for Crohn’s disease patients undergoing surgery. In a systematic review and meta-analysis of 1,501 patients, endoscopic recurrence rates were 41% for Kono-S compared to 48% for conventional techniques, while surgical recurrence rates were remarkably lower at 2.7% versus 21.0%. Additionally, the anastomotic leak rate with Kono-S […]
Robotic colectomy leads to better short-term oncologic outcomes.
Analysis of over 44,000 minimally invasive colectomy cases indicates that robotic techniques significantly enhance short-term oncologic results for colon cancer patients. Robotic colectomy correlated with nearly double the likelihood of chemotherapy initiation within 90 days (RR 1.98), more lymph nodes harvested, a 36% reduction in blood transfusion rates (RR 0.64), and a 74% decrease in […]
Wide hot snare polypectomy outperforms other methods for small tumors
In a study assessing salvage treatments for rectal neuroendocrine tumors (RNETs) under 10 mm, wide hot snare polypectomy (WHSP) showed superior outcomes. Of 121 patients analyzed, WHSP achieved an impressive 72.7% R0 resection rate compared to other methods. With a focus on effectiveness and safety, WHSP emerged as a rapid and straightforward approach for these […]
PIPAC improves quality of life and survival in cancer treatment
The analysis demonstrated that patients receiving pressurized intraperitoneal aerosolized chemotherapy (PIPAC) experienced significantly more good days and reduced hospital stays compared to those treated with standard therapy (ST). Specifically, PIPAC patients had a median of 181 good days at six months versus 131 days for ST, and an overall survival median of 11.3 months compared […]