A study involving 256 patients undergoing left-sided colorectal surgery assessed the effectiveness of a three-day versus a seven-day selective digestive decontamination (SDD) regimen. Results indicated anastomotic leakage rates of 1.2% for the three-day group compared to 5.2% for the seven-day group, and surgical site infections were 3.6% and 5.8%, respectively. The shortened three-day regimen was […]
Category: Intestine and Lower Gastrointestinal Tract
Indicators for Predicting Pathological Complete Response in Rectal Cancer
Key findings indicate that flattening of marginal tumor swelling is a strong independent predictor of pathological complete response (PCR) in rectal cancer patients post-neoadjuvant therapy (p < 0.001, odds ratio = 100.605). Additionally, lower preoperative carcinoembryonic antigen and erythrocyte sedimentation rates also correlate with PCR, with cutoffs established at 2.15 ng/ml and 19.0 mm/h, respectively. […]
KRAS and RYR2 mutations significantly predict unresectable recurrence
The study identified several key prognostic factors impacting unresectable recurrence-free survival (urfs) in colorectal liver-only metastasis patients. Significant predictors included KRAS G12D mutation positivity (HR: 7.69), RYR2 mutation positivity (HR: 4.03), KRAS G12S mutation positivity (HR: 3.96), CA19-9 > 37 U/ml prior to hepatectomy (HR: 3.62), and primary tumor PN2 stage (HR: 3.22). These findings […]
Cap-assisted polidocanol foam sclerobanding outperforms ERBL
A study involving 195 patients revealed that cap-assisted endoscopic polidocanol foam sclerobanding (EFSB) significantly reduced hemorrhoid severity scores (HSS) compared to endoscopic rubber band ligation (ERBL) at eight weeks. While post-procedural pain was notably lower in the EFSB group, long-term satisfaction and effective relief from recurrence of prolapse and pain were also achieved 24 hours […]
Higher surgical volume significantly reduces postoperative morbidity in Crohn’s surgery
Analysis of 4,205 patients revealed that postoperative morbidity (POM) following ileocolic resection (ICR) for Crohn’s disease is significantly lower in high-surgical-volume centers (6.2%) compared to low-surgical-volume centers (9.1%) with a p-value of 0.0004. Independent factors influencing major POM include surgical hospital volume, male sex, Elixhauser Comorbidity Index ≥ 1, and minor POM. Findings advocate for […]
Small bowel resection has higher wound complications in surgery.
Outcomes from a review of 2,578 patients show that while various surgical approaches for Crohn’s disease offer comparable 30-day readmission and reoperation rates, small bowel resection is linked to the longest hospital stays and the highest rates of superficial/deep wound infections (44%) and sepsis (3.5%). This method also presents significantly higher odds of wound complications […]
Perineal block significantly improves postoperative outcomes after haemorrhoidectomy
Adding a perineal block during haemorrhoidectomy markedly reduces postoperative pain intensity and opioid consumption. Patients receiving the block reported less pain (p < 0.0001), needed fewer opioids (p = 0.03), and experienced longer pain-free periods (p = 0.0002) than controls. Furthermore, only 58% of the experimental group required additional NSAIDs for pain relief, compared to […]
Robotic-assisted surgery shows improved outcomes for ulcerative colitis patients
Robotic-assisted stapled ileal pouch-anal anastomosis (ro stapled-ipaa) yielded significant advantages over conventional laparoscopic surgery in ulcerative colitis patients. Key findings include a lower anastomosis height (0.5 vs. 3.0 cm, p
Early detection of anastomotic leaks enhances patient outcomes.
A comprehensive analysis determined that C-reactive protein (CRP) and procalcitonin (PCT) are effective in early detection of anastomotic leaks (AL) after colorectal surgery. Additionally, computed tomography (CT) imaging proves valuable in identifying various signs of leaks, such as fluid collection and abscess formation. By integrating CRP and PCT assessments with CT diagnostics, clinicians can implement […]
Robotic surgery reduces risk of positive circumferential resection margins.
This systematic review and meta-analysis of 18 studies shows that robotic surgery (rs) significantly decreases the risk of circumferential resection margin (crm) positivity in rectal cancer patients undergoing mesorectal excision, with a relative risk of 0.82 (95% CI, 0.73-0.92; p=0.001). The combined data from 4 randomized controlled trials and 14 propensity score matching studies, encompassing […]