A study involving 191 patients undergoing minimally invasive colorectal resection found a stark contrast in incisional hernia rates based on extraction site. Incisional hernias occurred in 30.9% of midline extractions compared to 0% in off-midline procedures. Multivariate analysis identified midline extraction as a major risk factor, with a relative risk of 29.1. These findings underscore […]
Category: Intestine and Lower Gastrointestinal Tract
Histopathological features predict pouch failure in ulcerative colitis patients
A study evaluating 417 patients who underwent ileal pouch-anal anastomosis found a 23% risk of pouch failure over 18 years. Key predictors included post-procedure Crohn’s disease and specific histologic features such as deep chronic inflammation and severe disease activity. Single-cell spatial transcriptomics identified immune cell infiltration and disrupted signaling pathways associated with pouch failure. These […]
Endoscopic intermuscular dissection shows promise for rectal cancer
A study on endoscopic intermuscular dissection (EID) for deep submucosal invasive rectal cancer (d-smic) reports encouraging three-year outcomes. The procedure achieved a 94.1% en bloc resection and 82.5% R0 resection rates. In low-risk patients under active surveillance, locoregional recurrence rates were low (7%), while intermediate-risk had a 13% rate, all salvageable. Notably, there were no […]
Continuous glucose monitoring improves recovery in diabetic colorectal cancer patients
Enhanced recovery outcomes for colorectal cancer patients with type 2 diabetes markedly improved through continuous glucose monitoring (CGM). A study involving 181 patients revealed that those under CGM showed lower mean daily glucose levels (9.52 mmol/L) compared to conventional glucose monitoring (10.37 mmol/L) on postoperative day one. The technology significantly enhanced glycemic control and facilitated […]
Indocyanine green fluorescence angiography improves colorectal surgery outcomes
A meta-analysis of 25 studies involving 6,877 patients showed that indocyanine green (ICG) fluorescence angiography significantly reduced the rates of anastomotic leakage, symptomatic leakage, total postoperative complications, and the need for reoperation. Additionally, ICG use led to shorter postoperative hospital stays compared to traditional methods, with notable odds ratios indicating improved patient outcomes. These findings […]
Elevated homocysteine levels predict small bowel necrosis.
Findings indicate that serum homocysteine levels serve as reliable predictors of irreversible transmural intestinal necrosis in patients with adhesive small bowel obstruction. Among 221 patients studied, those requiring surgical intervention exhibited markedly higher homocysteine, endotoxin, IL-5, IL-6, hs-CRP, IL-1β, and PCT levels. Notably, homocysteine demonstrated a sensitivity of 89.71% and specificity of 83.03%, outpacing other […]
Deep learning model shows promise in assessing lymph node metastasis
A deep learning model utilizing multi-parametric MRI sequences effectively identifies lymph node metastasis in rectal cancer preoperatively. In trials involving 613 patients, this model, incorporating T2-weighted imaging, diffusion-weighted imaging, and dynamic contrast-enhanced sequence, achieved an area under the curve (AUC) of 0.808 in internal tests and 0.782 in external tests, outperforming traditional imaging and radiologists. […]
Biomarker strategies enhance detection of anastomotic leakage.
Early detection of anastomotic leakage (AL) post-low anterior resection for rectal cancer can significantly improve outcomes. Biomarkers such as CRP and PCT demonstrate high negative predictive values, facilitating timely interventions. Additionally, drainage fluid biomarkers like IL-6 and MMP9 showed enhanced site-specificity for leak detection. Novel strategies, including ischemia markers and microbiota profiling, require further validation, […]
Cytoreductive surgery improves survival in metastatic colorectal cancer.
National trends indicate that the utilization of cytoreductive surgery (CRS) for metastatic colorectal cancer (mCRC) increased from 33.1% in 2004 to 38.3% in 2015. In a cohort of 88,593 patients, those undergoing CRS exhibited significantly better overall survival (OS) compared to non-surgical patients, with median OS at 34.4 months, versus 13.2 months for no surgery. […]
Positive lymph node ratio enhances prognosis in colorectal cancer
A prognostic model incorporating positive lymph node ratio (LNR) significantly improves disease-free survival (DFS) predictions in yp stage III colorectal cancer patients post-neoadjuvant therapy. An optimal LNR threshold of 0.29 highlighted its role as an independent prognostic factor, with high LNR correlating to shorter DFS rates (HR=2.103). Furthermore, a nomogram integrating LNR demonstrated superior predictive […]