Researchers conducted a randomized trial comparing stapled hemorrhoidopexy alone to stapled hemorrhoidopexy plus ligation anopexy for grade III-IV hemorrhoids. Although short-term outcomes were similar, the combined approach showed significantly better long-term results. After 36 months, the stapled-only group had a 16% recurrence rate, requiring redo surgery, while the combined group had only 5% recurrence with […]
Category: Intestine and Lower Gastrointestinal Tract
Elevated Fibrinogen-to-Prealbumin Ratio and Glasgow Prognostic Score Predict Poor Survival in Colorectal Cancer Patients Post Laparoscopic Surgery
High preoperative Fibrinogen-to-Prealbumin Ratio (FPR) and Glasgow Prognostic Score (GPS) are independently associated with worse overall survival in colorectal cancer patients after laparoscopic surgery. Combining FPR and GPS provides more accurate prognostic assessment, outperforming single indicators. Patients with elevated FPR and GPS values have a significantly poorer prognosis. Journal Article by Liu B, Qian J […]
Variability in Treatment Strategies for Upfront Resectable Colorectal Liver Metastases
European hepato-pancreato-biliary surgeons generally agree on the definition of upfront resectable colorectal liver metastases based on future liver remnant volume and tumor biology. However, there is significant variability in the use of thermal ablation as an adjunct to surgery and perioperative systemic therapy. The survey highlights the need for further evidence and consensus in treatment […]
Similar Pain and Opioid Use in Benign and Malignant Colorectal Resections
Comparing 641 benign and 276 malignant colorectal resection patients, initial unadjusted analysis showed higher pain scores and more opioids for benign cases. Yet, in an enhanced recovery pathway emphasizing non-opioid strategies, regression analysis nullified the differences. Notably, both groups exhibited comparable pain levels and opioid prescriptions postoperatively. This challenges previous inconclusive findings, suggesting that pain […]
Implication of Geriatric Assessment in Colorectal Surgery
Colorectal surgery among older adults is increasing, with geriatric conditions posing risks for poor outcomes. A systematic review found 25 cohort studies but no randomized trials on geriatric assessment in this context. Few studies focused on the domain of what matters most to geriatric patients, revealing a gap in evidence for tailored management strategies. Evidence […]
Impact of KRAS and Histopathological Growth Patterns on Resection Margins in Colorectal Liver Metastases
In colorectal liver metastases (CRLM), the review investigates the association between KRAS status, histopathological growth patterns (HGPs), and their impact on resection margins around major vasculature and bile ducts. The study emphasizes the importance of balancing negative margins and preserving vascular and biliary structures during surgery. While parenchymal sparing is crucial, the review explores how […]
Biologic Therapies Effective in Chronic Antibiotic Refractory Pouchitis
Studies on chronic antibiotic refractory pouchitis highlight limited evidence for non-pharmacologic therapies while demonstrating efficacy of biologic therapies such as mesalamine, budesonide, anti-tumor necrosis factor alpha therapies, ustekinumab, and vedolizumab in managing the condition. Biologic therapies offer a steroid-sparing option, with vedolizumab showing favorable results in randomized controlled trials. Non-medication therapies like hyperbaric oxygen and […]
Adjuvant Chemotherapy Improves 5-Year Survival in Near-Pathological Complete Response Patients with Locally Advanced Rectal Cancer
Patients achieving near-pathological complete response in locally advanced rectal cancer benefited from adjuvant chemotherapy, particularly those with ypt1-t2 stage tumors and positive lymph nodes. Act was associated with improved 5-year disease-free survival rates in downstage patients, emphasizing its significance in post-surgery outcomes. Additionally, serum carcinoembryonic antigen levels before treatment and ypT stage were identified as […]
Identification of low-risk surgical candidates for small intestinal neuroendocrine tumors through combined imaging
A tailored diagnostic protocol using contrast-enhanced computed tomography enterography and 68 Ga dotatate PET/CT showed high sensitivity and specificity in detecting primary small intestinal neuroendocrine tumors (SI-NETs) and distal lymph node disease. The combined imaging allowed for the identification of low-risk surgical candidates with single SI-NET lesions and distal lymph node disease preoperatively, enabling potential implementation […]
Acceptable outcomes and increased incontinence in Redo-Redo ileal pouch anal anastomosis procedures
Redo-Redo ileal pouch anal anastomosis procedures have an acceptable pouch survival rate of 76% at 3 years, mainly due to septic complications. Quality of life and functional outcomes are comparable between first and second redos, except for increased incontinence in second redos. A second pouch salvage procedure may be offered to selected patients with high […]