Colorectal ESD training with a focus on strategic preoperative techniques, including gravity traction, led to favorable outcomes with high en bloc and curative resection rates. Proficiency growth was evident after about 50 cases, with challenges varying across early and late phases. Traction-assisted ESD, particularly planned traction, proved beneficial in lesion management. “Strategy-focused” training consistently adapted […]
Category: Intestine and Lower Gastrointestinal Tract
Factors Predicting Readmission and Mortality in Patients Admitted for Malignant Bowel Obstruction
Non-English speaking patients had a higher risk of readmission for malignant bowel obstruction, with patient age, primary language, and palliative care consultation serving as predictors for readmission and potentially impacting 90-day mortality. Modifiable factors such as palliative care consultation and multidisciplinary goals of care discussions should be emphasized to reduce readmissions and improve quality of […]
Enhanced Lymph Node Retrieval in Left-Sided Colorectal Cancer with Indocyanine Green Fluorescence Imaging
This preliminary study showed that indocyanine green (ICG) fluorescence imaging-guided laparoscopic para-aortic lymphadenectomy in left-sided colorectal cancer patients resulted in increased retrieval of total lymph nodes, including inferior mesenteric artery and para-aortic lymph nodes. ICG imaging may improve the completeness of lymph node dissection without significantly affecting complications. Journal Article by Sun Y, Tang Z […]
Robotic D3-D4 Lymphadenectomy Improves Survival in Upper Rectum and Sigmoid Colon Cancer Patients
Standardized robotic D3-D4 lymphadenectomy improves survival in upper rectum and sigmoid colon cancer patients with more than N2 lymph node metastasis. Specific nodal stations contribute differently to overall survival, with common iliac vessels and infra-renal vein being significant predictors. Results suggest optimized surgical techniques and potential updates to treatment guidelines. Journal Article by Chen TC, […]
Machine Learning Models to Predict Laparoscopic Surgery Difficulty in Rectal Cancer
Researchers developed and validated machine learning (ML) models to predict the difficulty of laparoscopic total mesorectal excision (LaTME) in rectal cancer. In a study with 186 patients, four ML models—logistic regression (LR), support vector machine (SVM), random forest (RF), and decision tree (DT)—were developed using preoperative and intraoperative factors. All models showed strong performance in […]
Preoperative Checklist for Clinical Risk Assessment in Ileoanal Pouch Surgery
Clinicians developed a preoperative checklist to support clinical risk assessment and patient selection for patients with ulcerative colitis considering ileoanal pouch surgery (IPAA). The checklist includes risk factors such as gender, advanced age, obesity, comorbidities, sphincteric impairment, Crohn’s disease, and pelvic radiation therapy. It also incorporates crucial steps in the decision-making process, like pouch nurse […]
Effective Maintenance Therapies for Crohn’s Disease Post-Surgery
Effective maintenance therapies for Crohn’s disease post-surgery include 5-aminosalicylic acid, adalimumab, and thiopurine analogues. Cochrane reviews show these agents have varying levels of efficacy in preventing recurrence after surgery, with 5-ASA being probably more effective than placebo and adalimumab showing promise in network meta-analysis. Clinicians should consider these findings when discussing treatment options with patients, […]
Machine Learning for Predicting Future Surgery in Ileal Crohn’s Disease Using CT-Enterography
Researchers used machine learning (ML) to quantify cumulative ileal injury on CT-enterography (CTE) scans for patients with ileal Crohn’s disease (CD) to predict future bowel surgery. Analysis of 229 CTE scans with 8,424 mini-segments revealed strong agreement between ML and radiologists in grading bowel injury (κ=0.80), similar to inter-radiologist agreement (κ=0.87). Cumulative injury scores were […]
Effectiveness of Endoscopic Ultrasound in Predicting Colorectal Invasion of Pelvic Masses
The study evaluated the effectiveness of endoscopic ultrasound (EUS) in predicting colorectal invasion in patients with pelvic masses. EUS showed high diagnostic accuracy with sensitivity of 83.3% and specificity of 97.8%. It is recommended for preoperative diagnosis by gynecologists to determine suitable surgical methods and avoid unexpected situations during surgery. Journal Article by She Y, […]
Remote Programming for Sacral Neuromodulation: Feasibility and Patient Satisfaction
Researchers conducted a multicenter prospective study to assess remote programming’s effectiveness and patient satisfaction in stage I sacral neuromodulation (SNM). A total of 63 participants from 6 centers were divided into remote programming (RP) and outpatient control (OC) groups. The RP group showed high usability (98%) and satisfaction (96.83%). It significantly improved patient scores on […]