Increased utilization of induction chemotherapy in total neoadjuvant therapy for locally advanced rectal cancer led to higher pathologic downstaging rates compared to consolidation chemotherapy. From 2006 to 2017, 46.7% of patients experienced downstaging, with induction chemotherapy resulting in a higher rate of pathologic downstaging (58% vs. 44.7%). These findings suggest that induction chemotherapy may be […]
Category: Intestine and Lower Gastrointestinal Tract
Standardized Perioperative Fluid Management in Colorectal Surgery
Perioperative fluid management in colorectal surgery is discussed within enhanced recovery after surgery (ERAS) pathways. The review highlights the lack of standardized definitions for restrictive or liberal fluid regimens, with challenges related to patient selection. Goal-directed fluid therapy is suggested for more complex cases. Critical thresholds for total intravenous fluids and weight gain are identified, […]
Low Adherence to Guidelines for Extended Thromboprophylaxis in Colorectal and Anal Cancer Patients Undergoing Surgery
Researchers found that despite recommendations for extended thromboprophylaxis, only 63% of patients received appropriate treatment in the inpatient setting. Additionally, only 2% of patients received recommended prophylaxis post-discharge, resulting in no thromboembolic events. Adherence to risk-guided prophylaxis led to decreased rates of venous thromboembolism without increasing bleeding complications, highlighting the need for improved guideline adherence […]
Low-risk pedunculated polyps do not increase colorectal cancer risk compared to fit+/colonoscopy negative group
Colorectal cancer (CRC) risk after resection of low- and high-risk adenomas was investigated in a fit-based CRC screening program. The study included 87,248 post-fit+ colonoscopies and found that patients with low-risk adenomas did not have an increased CRC incidence compared to the fit+/colonoscopy negative group. However, patients with high-risk adenomas had a significantly higher CRC […]
Robotic Surgery Reduces the Incidence and Severity of Low Anterior Resection Syndrome in Patients with Lower Rectal Cancer
Robotic surgery has been shown to significantly reduce the occurrence and severity of low anterior resection syndrome (LARS) in patients with lower rectal cancer. In a study involving 342 patients, the incidence of major LARS was significantly lower in the robotic surgery group compared to the laparoscopic surgery group at 6, 12, and 18 months […]
Prone Jack-Knife Transanal Minimally Invasive Surgery: A Safe and Effective Approach for Anterior Low Rectal Gastrointestinal Stromal Tumors
Prone Jack-Knife Transanal Minimally Invasive Surgery (tamis) is a feasible and safe approach for managing subepithelial rectal lesions, specifically anterior low rectal gastrointestinal stromal tumors (gist). This surgical technique, performed with the patient in the prone jack-knife position and using transanal access, provides excellent surgical ergonomics and avoids the need for radical resection. The study […]
Postoperative Adjuvant Chemotherapy Improves Overall Survival in Colorectal Cancer Liver Metastases Patients
A retrospective study investigated the impact of postoperative adjuvant chemotherapy (POAC) on outcomes in patients with colorectal cancer liver metastases (CRLM) undergoing simultaneous resection. After propensity score matching analysis, 478 patients were enrolled and assigned to POAC or non-POAC groups. The study found that POAC significantly improved overall survival (OS) but not progression-free survival (PFS) […]
Evaluating Rectal Intussusception Grades: Impact of Pelvic Floor Decline and Dyssynergic Defecation Association
Researchers conducted a retrospective analysis of 238 women with defecatory disorders and found that age, vaginal delivery, and prior pelvic surgery were associated with increased grades of rectal intussusception. The study also revealed that obstructive defecation symptoms and dyssynergic defecation were common across the groups. The findings suggest that abnormal levator ani laxity, independent of […]
Positive Outcomes of Kono-S Anastomosis in Crohn’s Disease: Low Complications and Recurrence Rates
In a large series of Crohn’s disease patients, the Kono-S anastomosis demonstrated very low postoperative complication rates (1.5% anastomotic failure, 6.1% infection). Surgical recurrence occurred in 7.6% of cases, with perianal disease, urgent/emergent surgery, and postoperative steroid use associated with increased risk. The anastomosis showed promising short- and long-term outcomes, suggesting it as a safe […]
Long-term Locoregional Control and Survival in Low Rectal Cancer: Transanal Radical Proctosigmoidectomy Outcomes
A retrospective cohort study was conducted to assess the local recurrence and survival rates after transanal abdominal transanal radical proctosigmoidectomy for low rectal cancer treated with neoadjuvant chemoradiation therapy. The study included 255 patients and found that the procedure demonstrated excellent long-term locoregional control and a 5-year overall survival rate of 84.1%. The results suggest […]