Rediversion with an ileostomy was a safe, important first step in pouch salvage, with subsequent surgery for noninflammatory indications showing significantly higher pouch salvage rates than for inflammatory complications. Overall, 52% of patients underwent successful pouch salvage after rediversion, with a 5-year pouch survival rate of 94.5% for noninflammatory indications. Rediversion can be a helpful […]
Category: Intestine and Lower Gastrointestinal Tract
Key correlations between step times and console time in robotic proctectomy
Quantification of surgical workflow in robotic proctectomy revealed strong correlations between step times and console time (ct). Steps such as inferior mesenteric vein dissection, lateral-to-medial splenic flexure mobilisation, and rectal dissection showed significant associations with ct. Total operative time (tot) was also strongly correlated with certain steps, indicating the importance of specific surgical tasks in […]
Improved quality of life and successful outcomes in surgical management of right-sided colonic diverticulitis
Patients with right-sided colonic diverticulitis who underwent surgery showed satisfactory short and long-term outcomes, with no disease recurrence or colorectal cancer detected on colonoscopy. A significant improvement in quality of life (QOL) was observed at 24 months post-surgery. The study highlights the effectiveness of surgical management in improving QOL and achieving successful outcomes in patients […]
Using Risk-Adjusted Cumulative Sum to Monitor Surgeon, Divisional, and Institutional Outcomes after Colorectal Operations
Researchers demonstrated the feasibility of using risk-adjusted cumulative sum to monitor outcomes after colorectal operations and identify performance variations. This method accurately tracked surgeon-specific outcomes, adjusting for patient-level risk factors. Outliers in performance were promptly identified at the surgeon, divisional, and institutional levels, contributing to quality assurance, root-cause analysis, and incentivization. Journal Article by Blackburn […]
Impact of KRAS status on surgical margins in liver resection for colorectal liver metastases
Patients with KRAS-mutated colorectal liver metastases had shorter overall and disease-free survival after liver resection. In these cases, the resection margin did not affect oncologic outcomes. However, for KRAS wild-type tumors, achieving an R0 resection was crucial for prolonged overall and disease-free survival. Primary tumor location was the only predictor of survival in multivariable analysis. […]
High Endoscopic Cuffitis Rates Post-Ileal Pouch-Anal Anastomosis: Association with Extensive Disease and Biologic Exposure
Endoscopic cuffitis occurred in approximately 60% of patients who underwent restorative proctocolectomy with stapled ileal pouch–anal anastomosis, and was significantly associated with extensive disease and exposure to multiple biologics before colectomy. Older age, extensive disease, exposure to biologics before colectomy, and exposure to at least 2 or more biologics before colectomy were all significantly associated […]
Pelvimetry Measurements Predict Total Mesorectal Excision Quality in Rectal Cancer Surgery
Pelvimetry measurements using CT scans can predict the quality of total mesorectal excision in rectal cancer surgery. Factors like a deeper sacral curve and greater transverse distance of pelvic outlet were associated with incomplete excision. An increased area of pelvic inlet was linked to a higher rate of complete excision. Visceral obesity did not impact […]
Optimizing Neoadjuvant Chemotherapy for Initially Resectable Colorectal Cancer Liver Metastasis
Neoadjuvant chemotherapy for initially resectable colorectal cancer liver metastasis aims at tumor downsizing, evaluating biological behavior, and reducing postoperative recurrence risk. Balancing tumor reduction benefits with hepatic injury risks and the need for timely surgery is crucial. Precision medicine’s role in tailoring neoadjuvant regimens, such as gene testing, and a multidisciplinary approach are emphasized. Tailored […]
High Success Rate of Colonic-Enteric Lumen-Apposing Metal Stents for Small-Bowel Obstruction
Colonic-enteric lumen-apposing metal stents (LAMS) showed high technical success (100%) and clinical success (92.3%) in managing small-bowel obstruction (SBO) in patients who are not surgical candidates due to malignancy. Adverse events occurred in 15.4% of patients, including bleeding, diarrhea, and postprocedure sepsis. Patients were able to resume enteral nutrition in 84.6% of cases. Further research […]
Stenting as a bridge to surgery increases peritoneal recurrence risk in non-metastatic obstructing left-sided colorectal cancer.
Stenting as a bridge to surgery for non-metastatic obstructing left-sided colorectal cancer increases the risk of peritoneal recurrence, especially in cases of T4 tumors, diabetes, and nodal positivity. However, no significant differences were found in overall survival, cancer-specific survival, or recurrence-free survival between stenting and upfront emergency surgery. Journal Article by Lin W, Chok AY, […]