Neoplasia in the ileal pouch of patients with inflammatory bowel diseases or familial adenomatous polyposis is rare but poses a significant risk. Annual endoscopic surveillance is crucial for detecting dysplasia in high-risk patients. While dysplastic polyps in familial adenomatous polyposis are easily identifiable and removable, glandular dysplasia in ulcerative colitis may be challenging to detect. […]
Category: Intestine and Lower Gastrointestinal Tract
Development of Prediction Models for Mortality Risk After Colorectal Cancer Surgery
Researchers developed prediction models using preoperative data to assess short-term mortality risk following colorectal cancer surgery. The models showed good discrimination and calibration, with an area under the receiver operating characteristic curve of 0.88, 0.878, and 0.861 for 30-day, 90-day, and 1-year mortality, respectively. Subgroup analysis did not improve discrimination or calibration. Combining all operated […]
Low Colorectal Cancer Risk After Resection of High-Risk Pedunculated Polyps
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 […]
What are the distinct quality-of-life trajectories after pelvic exenteration?
Quality of life trajectories after pelvic exenteration diverge into distinct classes, with most patients experiencing optimal outcomes. Two classes were identified for physical scores and three for mental and functional scores, with higher overall survival probabilities in the optimal trajectory class. Age, repeat surgery, neoadjuvant therapy, surgical margin, operation duration, and hospital stay were significant […]
Reduced Postoperative Laboratory Testing Improves Outcome After Colorectal Surgery
After implementing a reduction in postoperative laboratory testing following colorectal surgery, the intervention group experienced a 33% decrease in tests per hospital stay, a 26% decrease per day, and a 49% increase in test-free days, with no impact on length of stay or readmissions. The nonintervention group did not show significant changes in laboratory work. […]
Enhancing Anastomotic Leak Prediction in Colorectal Surgery: A Call for Improved Scoring Models
Existing scores for predicting anastomotic leak in colorectal surgery are varied in pre-operative and peri-operative variables. Studies recommend future prediction scores to be based on larger patient cohorts, include a validation set, and report the area under the curve. This systematic review highlights the importance of refining prediction models for anastomotic leak in colorectal surgery. […]
Identification of a Pathomics Signature for Chemotherapy Benefits in Stage III Colon Cancer
Researchers developed and validated a pathomics signature based on 4 features to estimate prognosis and chemotherapy benefits in stage III colon cancer. The signature was found to be significantly associated with disease-free survival (DFS) and overall survival (OS) in training and validation cohorts. Patients with a low pathomics signature were more likely to benefit from […]
Specimen Extraction Site Affects Postoperative Incisional Hernia Risk After Minimally Invasive Right Colectomy
Minimally invasive right colectomy patients with midline specimen extraction have a higher risk of developing postoperative incisional hernia (ih) compared to those with pfannenstiel extraction. The study of 341 patients found that midline extraction was associated with a 25% ih rate, while pfannenstiel extraction had a 0% rate. Midline extraction was also linked to longer […]
Age and Grade III hemorrhoids are associated with a higher likelihood of choosing hemorrhoidectomy as the initial treatment
Patients with grade III hemorrhoids were more likely to choose hemorrhoidectomy as the initial treatment compared to grade II. Additionally, younger patients (18-30 and 31-50 age groups) were more likely to opt for hemorrhoidectomy as the initial treatment compared to older patients. However, there were no significant differences in the time to hemorrhoidectomy based on […]
Similar Oncological and Quality of Life Outcomes Following Pelvic Exenteration for Recurrent Rectal Cancer With and Without En Bloc Sacrectomy
Patients undergoing pelvic exenteration for locally recurrent rectal cancer, with or without en bloc sacrectomy, had similar rates of r0 resection, survival, and quality of life outcomes. Although sacrectomy patients experienced more postoperative complications, mortality rates were not increased. The median overall survival was slightly higher without sacrectomy. The study suggests that referral to specialized […]