CRC incidence is significantly higher in patients with high-risk adenomas (HRAs) diagnosed at colonoscopy, with a 1.53-fold increase in risk. However, patients with only distal pedunculated polyps without high-grade dysplasia do not have an increased CRC risk. The presence of certain risk factors explains most of the excess CRC risk in the HRA group, indicating […]
Category: Intestine and Lower Gastrointestinal Tract
Prognostic Factors in Solitary Colorectal Liver Metastasis: N2 Stage, Hypoalbuminemia, and Neutrophil-Lymphocyte Ratio
Researchers analyzed data from 230 patients with solitary liver metastases from colorectal cancer undergoing liver resection. They found that initial N2 stage, hypoalbuminemia before surgery, and high neutrophil-to-lymphocyte ratio after surgery were independent prognostic factors for recurrence-free and overall survival. Patients with these factors should receive upfront chemotherapy, prompt postoperative chemotherapy, and intensive postoperative surveillance. […]
High Social Vulnerability Index is Associated with Poorer Prognosis in Colorectal Cancer Patients
Results show that patients in neighborhoods with a high Social Vulnerability Index (SVI) have a higher risk of all-cause and cancer-specific mortality after colorectal cancer resection, regardless of other demographic or clinical factors. This suggests that focusing on neighborhood-level vulnerability may help target interventions to improve outcomes in colorectal cancer care. Journal Article by Masoud […]
Pouch Surgery in the 21st Century: Evolving Techniques and Considerations
An ileoanal pouch with ileal pouch-anal anastomosis is the preferred method for restoring intestinal continuity after total proctocolectomy. Changes in medical management and technological advancements have improved pouch surgery. The number of stages, minimally invasive approaches, pouch design, and anastomotic configuration are key considerations. The laparoscopic j pouch with double-stapled anastomosis is the current standard, […]
Robotic-assisted transabdominal plus transanal approach shortens operation time and reduces bleeding in lateral lymph node dissection for low rectal cancer
Comparison of robotic-assisted lateral lymph node dissection for low rectal cancer with or without transanal approach revealed that the 2team group had significantly shorter operation times (366 minutes vs. 513 minutes), reduced intraoperative bleeding (30 ml vs. 80 ml), and comparable postoperative complication rates (5% urinary disturbance in both groups). The combined approach was deemed […]
Identification of Fatigue and Pain as Key Predictors of Health-Related Quality of Life in Patients Treated for Rectal Cancer
Rectal cancer treatment negatively impacts health-related quality of life (HRQOL). A multivariable prediction model developed in this study found that patient-reported outcomes from EORTC QLQ-C30, particularly fatigue and pain, were significant predictors of global HRQOL at all time points. These factors explained 55-65% of the variation in HRQOL, compared to patient characteristics and clinical factors […]
Opportunities for Improving Care in Managing Acute Colonic Pseudo-Obstruction
Researchers examined outcomes of patients with acute colonic pseudo-obstruction (ACPO) and adherence to treatment guidelines. A total of 45 patients were identified, with 13 admitted under general surgery. Despite all patients receiving admission bloods, ACPO management, often overseen by general surgeons, may impact conservative treatment quality and intervention timeliness. Further optimization is necessary to improve […]
Hand-sewn ileal pouch-anal anastomosis improves survival in familial adenomatous polyposis patients
Comparison between stapled and hand-sewn ileal pouch-anal anastomosis in familial adenomatous polyposis patients showed that hand-sewn anastomosis was associated with better overall survival. The stapled group had higher rates of adenoma in the remnant rectum or anal transitional zone, metachronous rectal cancer, and mortality. Cox regression analysis confirmed the negative impact of stapled anastomosis on […]
Majority of Rectal Cancer Survivors Show Continued Improvement in Low Anterior Resection Syndrome Beyond 3 Years Post-Surgery
Rectal cancer survivors with low anterior resection syndrome showed improvement beyond 3 years post-proctectomy, with a decrease in mean syndrome score from 29.5 to 18.6. 31.5% experienced a shift from major to no/minor severity, while 3.4% required a new stoma. Long-term improvement was negatively associated with neoadjuvant radiation. This study emphasizes the importance of long-term […]
Modified 2-stage IPAA shows similar outcomes to 3-stage IPAA in patients with ulcerative colitis
The study compared perioperative complications, quality of life, and functional outcomes in patients with ulcerative colitis undergoing either 3-stage or modified 2-stage IPAA. Results showed similar rates of anastomotic leak, surgical site infection, ileus, quality of life, and pouch function between the two approaches. However, modified 2-stage IPAA had significantly lower postoperative bowel obstruction rates […]