International Journal Of Colorectal Disease[JOURNAL]
Sun
200 papers
Comments on "Arterial flow in healthy individuals and patients with hemorrhoidal disease: a Doppler ultrasound-based pathophysiological analysis".
Iftikhar K, Abdullah MF, Saeed MR … +1 more , Awan MA
Int J Colorectal Dis · 2026 Jun · PMID 42283787 · Full text
Abstract loading — click title to view on PubMed.
Focused analysis of the surgical management for recurrence of internal rectal prolapse and obstructed defecation syndrome after stapled rectal resection procedures: a long-term single-center experience.
Marra AA, Varrella C, Caruso C … +6 more , Simonelli I, Parello A, Litta F, Campennì P, Pagano M, Ratto C
Int J Colorectal Dis · 2026 Jun · PMID 42274779 · Publisher ↗
BACKGROUND: Stapled rectal resection procedures have been adopted for the treatment of internal rectal prolapse (IRP) and obstructed defecation syndrome (ODS). However, concerns remain in case of surgery for recurrence....
BACKGROUND: Stapled rectal resection procedures have been adopted for the treatment of internal rectal prolapse (IRP) and obstructed defecation syndrome (ODS). However, concerns remain in case of surgery for recurrence. This study aimed to analyze the impact of a staple-line scar in patients undergoing surgery for IRP and ODS recurrence. METHODS: A prospective maintained database of patients who underwent abdominal or perineal surgery for IRP and ODS between November 1998 and January 2025 was retrospectively analyzed. Patients with a history of stapled rectal resection procedures were specifically evaluated. Baseline clinical and radiological characteristics, surgical complexity related to stapled suture, postoperative complications, recurrence, and ODS and fecal incontinence scores were collected. RESULTS: Of 376 female patients, 50 (13.3%) with prior stapled rectal resection procedures underwent surgery for IRP and ODS recurrence. In three cases, the staple-line scar could not be safely overcome. At last follow-up, recurrence and complication rates were comparable between patients with and without previous stapled procedures (4.8% vs. 6.1% and 19.0% vs. 18.4%, respectively). One patient in the stapled group experienced persistent pelvic pain despite anatomical correction. Although ODS and fecal incontinence scores improved overall, patients with prior stapled rectal resection reported higher ODS scores. However, linear mixed-effects analysis did not demonstrate statistically significant differences between groups. CONCLUSIONS: Surgery for IRP and ODS recurrence after stapled rectal resection procedures is challenging. Although previous stapled rectal resection procedures may be associated with higher ODS scores, further studies are needed to clarify these findings.
The burden and histopathological characteristics of early-onset colorectal cancer: a retrospective cross-sectional study at Ethiopia's largest tertiary hospital (2019-2024).
Abdela A, Genet S, Bedada AT … +2 more , Bekele D, Labisso WL
Int J Colorectal Dis · 2026 Jun · PMID 42260223 · Publisher ↗
PURPOSE: The global rise in early-onset colorectal cancer (EOCRC) is a growing concern, particularly in low-resource settings. However, comprehensive data from Ethiopia are limited. AIM: This study aimed to describe the...
PURPOSE: The global rise in early-onset colorectal cancer (EOCRC) is a growing concern, particularly in low-resource settings. However, comprehensive data from Ethiopia are limited. AIM: This study aimed to describe the clinicopathological profile and proportional hospital-based representation of EOCRC at Ethiopia's largest tertiary referral center. METHODS: We conducted a retrospective cross-sectional analysis of 630 histologically confirmed colorectal cancer (CRC) cases diagnosed at Tikur Anbessa Specialized Hospital between January 2019 and September 2024. EOCRC was defined as a diagnosis before the age of 50 years and late-onset CRC (LOCRC) as a diagnosis at the age of 50 years or older. Data on demographics, tumor location, histology, differentiation grade, and TNM stage were also extracted. Descriptive statistics, chi-square tests, and binary logistic regression were used for the analysis. RESULTS: Of the 630 CRC cases, 292 (46.3%) were EOCRC (mean age 36.1 years, SD 7.9). Rectal tumors were significantly more common in EOCRC (31.2% vs. 22.5%, p = 0.012), as were poorly differentiated/undifferentiated tumors (21.9% vs. 13.0%, p = 0.003). Metastasis at diagnosis was less frequent in the EOCRC group (27.4% vs. 66.3%, p < 0.001). Multivariable analysis identified rectal location (adjusted odds ratio (AOR) = 1.60, 95% confidence interval (CI) 1.11-2.30) and poor differentiation (AOR = 1.94, 95% CI 1.25-3.00) as independent predictors of EOCRC, while metastasis was inversely associated (AOR = 0.20, 95% CI 0.14-0.29). CONCLUSION: In this hospital-based sample, EOCRC constitutes a substantial proportion of CRC cases, with distinct clinicopathological features, including rectal predilection and aggressive histology. These findings highlight the need for heightened clinical suspicion in younger adults while acknowledging the influence of Ethiopia's young population structure on the observed proportions.
Early hemodynamic changes following endoscopic sclerotherapy for hemorrhoidal disease assessed by transperineal ultrasound and their relationship with clinical outcomes.
Gravante G, De Simone V, Picciariello A … +6 more , Palmieri F, Missaglia C, Sorge R, Sorrenti S, Sileri P, Gallo G
Int J Colorectal Dis · 2026 Jun · PMID 42257743 · Publisher ↗
BACKGROUND: Polidocanol foam (PF) sclerotherapy has regained interest as a minimally invasive treatment for hemorrhoidal disease (HD). However, the early hemodynamic effects of sclerotherapy and their relationship with c...
BACKGROUND: Polidocanol foam (PF) sclerotherapy has regained interest as a minimally invasive treatment for hemorrhoidal disease (HD). However, the early hemodynamic effects of sclerotherapy and their relationship with clinical outcomes remain poorly defined. This study aimed to evaluate early local hemodynamic changes following endoscopic PF sclerotherapy using transperineal ultrasound (TPUS) and to explore their association with patient-reported outcome measures (PROMs). METHODS: This prospective observational study included patients with Goligher grade I-IV HD treated with endoscopic PF sclerotherapy. TPUS Doppler assessment of peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI) was performed at baseline, 7 days, and 30 days post-treatment. Symptoms were evaluated using the PROM-HISS score. Hemodynamic and clinical outcomes were compared over time and stratified by HD severity (Goligher I-II vs III-IV). RESULTS: Thirty-seven patients completed follow-up. No significant differences in preoperative PSV were observed between lower- (Goligher I/II) and higher-grade HD (Goligher III/IV). After treatment, patients with lower-grade HD showed a significant reduction in PSV and RI at both 7 and 30 days (p < 0.01), indicating effective modulation of arterial inflow. In contrast, no significant changes in PSV or RI were observed in higher-grade HD, while EDV increased at 30 days (p = 0.012). PROM-HISS scores significantly improved in all patients at 7 days; however, symptom scores increased between 7 and 30 days in higher-grade HD. CONCLUSIONS: PF sclerotherapy induces early short-term hemodynamic changes detectable by TPUS in lower-grade HD, paralleling consistent short-term symptom improvement. In advanced HD, clinical benefit appears transient and not supported by objective vascular remodeling. TPUS emerges as a valuable non-invasive tool for functional assessment, follow-up, and treatment stratification after sclerotherapy.
Extraperitoneal colostomy reduces parastomal hernia after laparoscopic abdominoperineal resection: a propensity score-matched study.
Li J, Quan J, Zhu Z … +12 more , Jiang D, Zhao Z, Zhang M, Zhou H, Pei W, Bi J, Feng Q, Wang Z, Liu Q, Zheng Z, Liang J, Shang L
Int J Colorectal Dis · 2026 Jun · PMID 42257707 · Publisher ↗
PURPOSE: Parastomal hernia (PSH) is one of the most frequent long-term complications following abdominoperineal resection (APR) for rectal cancer. The optimal colostomy route to minimize PSH remains controversial. This s...
PURPOSE: Parastomal hernia (PSH) is one of the most frequent long-term complications following abdominoperineal resection (APR) for rectal cancer. The optimal colostomy route to minimize PSH remains controversial. This study aimed to compare PSH risk between extraperitoneal colostomy (EPC) and transperitoneal colostomy (TPC) after laparoscopic APR. METHODS: A retrospective cohort study was conducted including patients who underwent laparoscopic APR for rectal cancer between 2014 and 2017. Patients were categorized according to colostomy route (EPC vs. TPC). The primary endpoint was PSH, and secondary endpoints included other short- and long-term stoma-related complications and perioperative outcomes. Propensity score matching (1:3) was applied to balance baseline characteristics. Risk factors for PSH were further analyzed using logistic regression. RESULTS: A total of 464 patients were included. After matching, 102 patients in the EPC group and 243 in the TPC group were analyzed. Perioperative outcomes and overall stoma-related complication rates were comparable between groups. However, PSH occurred less frequently in the EPC group than in the TPC group (10/102 [9.8%] vs. 79/243 [32.5%], P < 0.001). Multivariate logistic regression demonstrated that EPC was an independent protective factor against PSH (OR 0.190, 95% CI 0.089-0.406, P < 0.001), whereas increasing age and female sex were significant risk factors. CONCLUSION: Extraperitoneal colostomy was associated with a lower risk of PSH after laparoscopic APR for rectal cancer without increasing perioperative morbidity. These findings support consideration of the extraperitoneal route in experienced centers to improve long-term stoma outcomes, while prospective multicenter studies are needed for further validation.
A prospective randomized comparative trial of da Vinci SP versus da Vinci Xi in colon and rectosigmoid cancer surgery: a single-center, open-label study protocol.
Ishiyama Y, Hirano Y, Akuta S … +7 more , Minagawa Y, Nakanishi A, Nishi Y, Hayashi H, Fujii T, Sugita H, Hiranuma C
Int J Colorectal Dis · 2026 Jun · PMID 42249120 · Publisher ↗
BACKGROUND: Colorectal cancer surgery increasingly emphasizes not only oncological outcomes but also postoperative recovery and patient-centered outcomes. Robotic-assisted surgery has gained widespread acceptance, and th...
BACKGROUND: Colorectal cancer surgery increasingly emphasizes not only oncological outcomes but also postoperative recovery and patient-centered outcomes. Robotic-assisted surgery has gained widespread acceptance, and the da Vinci Single-Port (SP) system has emerged as a novel platform that may further reduce surgical invasiveness compared with the conventional multi-port da Vinci Xi system. However, current evidence comparing these platforms in colon cancer surgery remains limited to retrospective studies. METHODS: This study is a single-center, open-label, prospective randomized controlled trial designed to compare the da Vinci SP and Xi systems inpatients undergoing curative robot-assisted surgery for clinical stage 0-III colon or rectosigmoid adenocarcinoma. A total of 200 patients will be randomly assigned in a 1:1 ratio to the SP or Xi group. The primary endpoint is postoperative pain assessed using the Numerical Rating Scale on postoperative days 1 and 3. Secondary endpoints include operative variables, postoperative complications, inflammatory markers, pathological outcomes, and patient satisfaction. CONCLUSIONS: This trial is expected to provide prospective evidence on the clinical value of the SP platform and to support evidence-based decision-making in robotic colon cancer surgery. The trial has been registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR: R000065814). TRIAL REGISTRATION: UMIN-CTR R000065814 (2025/4/13) Saitama Medical University International Medical Center.
The effectiveness and safety of isoperistaltic versus antiperistaltic side-to-side ileocolic anastomosis in minimally invasive radical right hemicolectomy: a systematic review and meta-analysis.
Ren H, Lu S, Sun Y … +2 more , Zhang Q, Shen Y
Int J Colorectal Dis · 2026 Jun · PMID 42234166 · Publisher ↗
BACKGROUND AND PURPOSE: Two main side-to-side anastomosis techniques are used in minimally invasive radical right hemicolectomy: the traditional antiperistaltic (ANTI) and the more recently adopted isoperistaltic (ISO) o...
BACKGROUND AND PURPOSE: Two main side-to-side anastomosis techniques are used in minimally invasive radical right hemicolectomy: the traditional antiperistaltic (ANTI) and the more recently adopted isoperistaltic (ISO) overlap method. Their comparative clinical efficacy remains controversial. This study aimed to evaluate the effectiveness and safety of ISO versus ANTI for ileocolic anastomosis, providing evidence-based guidance for surgical technique selection. METHODS: We systematically searched CNKI, Wanfang, VIP, Sinomed, PubMed, Embase, Web of Science, and Cochrane Library from database inception to January 2026 for studies comparing ANTI and ISO. Cohort study quality was assessed using the Newcastle-Ottawa Scale, and randomized controlled trials (RCTs) were assessed using the Cochrane tools. Meta-analysis, sensitivity analysis, and publication bias evaluation were performed using RevMan 5.3 and STATA 17. RESULTS: Six studies (5 cohorts, 1 RCTs) comprising 931 patients were included. The meta-analysis indicated that the incidence of bowel obstruction was higher in the ANTI group than in the ISO group, with a borderline significant difference [RR = 1.75, 95% CI (1.01, 3.05), P = 0.05], and the ANTI group required a longer anastomosis time [MD = 1.03, 95% CI (0.35, 1.71), P = 0.003]. No significant differences were found between the two techniques regarding anastomotic leakage, anastomotic bleeding, time to first flatus, time to first defecation, readmission rate, surgery-related mortality, intra-abdominal infection, wound infection, chronic diarrhea, operative time, hospital stay, intraoperative blood loss, or time to first oral intake (all P > 0.05). Sensitivity analysis revealed significantly longer total operative time for ANTI [MD = 8.75, 95% CI (6.11, 11.39), P < 0.00001]. No reversal occurred in the results for other outcomes, indicating robust findings in this study. Publication bias risk analysis showed that publication bias was unlikely in this study. CONCLUSIONS: Both anastomotic methods are effective and safe in minimally invasive radical right hemicolectomy. The ISO may offer modest technical advantages, but current evidence does not justify a strong preferential recommendation.
Management of bowel dysfunction after pelvic surgery for endometriosis.
Martellucci J, Orlandi S
Int J Colorectal Dis · 2026 Jun · PMID 42234025 · Publisher ↗
INTRODUCTION: Bowel dysfunction is a common and debilitating condition affecting patients with endometriosis. Despite the extent of surgery, symptoms may persist or arise, often overlapping with low anterior resection sy...
INTRODUCTION: Bowel dysfunction is a common and debilitating condition affecting patients with endometriosis. Despite the extent of surgery, symptoms may persist or arise, often overlapping with low anterior resection syndrome (LARS) or irritable bowel syndrome (IBS) typical features. This review aims to summarize the multifactorial pathophysiology and current therapeutic options for postoperative bowel dysfunction after endometriosis surgery. METHODS: A structured narrative review was conducted through a comprehensive search for studies published between 2000 and 2025. Inclusion criteria focused on postoperative functional outcomes and treatments (medical, rehabilitative and interventional) effectiveness. The available evidence is limited and largely extrapolated from related conditions such as LARS and neurogenic bowel dysfunction. RESULTS: The complex pathophysiology of postoperative dysfunction involves preoperative visceral hypersensitivity, surgical disruption of pelvic autonomic nerves, reduced rectal compliance, and pelvic floor dyssynergia. While dietary interventions (e.g., low-FODMAP diet) and pharmacological treatments (laxatives, antidiarrheals, or neuromodulators) serve as first-line therapies, they are often insufficient for severe symptoms. Emerging evidence supports the use of transanal irrigation (TAI) for mechanical emptying and sacral neuromodulation (SNM) for refractory sensorimotor disorders. Functional rehabilitation, including pelvic floor physiotherapy and manual therapy, represents a further opportunity to influence specific symptoms. CONCLUSIONS: Postoperative bowel dysfunction in endometriosis management requires a transition from rigid treatment protocols to a multidisciplinary, symptom-oriented approach. The support of specialized nursing, physiotherapy, and advanced interventions like TAI and SNM is essential. Future prospective studies using standardized outcome measures are needed to better define these therapeutic pathways and improve patient quality of life.
Prognostic divergence of hematogenous and lymphatic metastases in surgically treated patients with stage IV colorectal cancer.
Ma H, Wang L, Song B … +2 more , Chen Y, Hirano Y
Int J Colorectal Dis · 2026 Jun · PMID 42233994 · Publisher ↗
BACKGROUND: In patients with stage IV colorectal cancer (CRC), the prognostic impact of lymph node metastasis (LNM) remains controversial. A qualifying cohort served to explore its importance. METHODS: A total of 493 eli...
BACKGROUND: In patients with stage IV colorectal cancer (CRC), the prognostic impact of lymph node metastasis (LNM) remains controversial. A qualifying cohort served to explore its importance. METHODS: A total of 493 eligible patients with stage IV CRC were included in this retrospective cohort study. All were surgically treated between April 2007 and December 2020 at a high-volume cancer center in Japan. Subjects were stratified by presence/absence of LNM (N+M1 vs N0M1), and propensity score matching (PSM) was done at 1:1 ratio. We then compared cancer-specific (CSS) and overall (OS) survival rates before and after PSM, using Cox regression to identify pertinent independent risk factors. RESULTS: Patients assigned to N+M1 and N0M1 groups totaled 384 (77.9%) and 109 (22.1%), respectively. Five-year OS proved superior for the N0M1 (vs N+M1) group, both before (41.7% vs 30.8%; p = 0.020) and after (43.7% vs 26.5%; p = 0.042) PSM. LNM also emerged as an independent prognosticator of OS in multivariate analyses conducted before (hazard ratio [HR] = 1.5, 95% confidence interval [CI]: 1.09-2.08; p = 0.014) and after (HR = 1.72, 95% CI: 1.121-2.64; p = 0.013) matching. The same was true of 5-year CSS, both before (N0M1, 46.1%; N+M1, 32.4%; p = 0.009) and after (N0M1, 48.8%; N+M1, 28.0%; p = 0.027) matching, again verifying LNM as an independent prognostic factor before (HR = 1.6, 95% CI: 1.13-2.25; p = 0.007) and after (HR = 1.86, 95% CI: 1.185-2.90; p = 0.007) PSM. CONCLUSIONS: In patients with stage IV colorectal cancer (M1), those with distant hematogenous metastasis without regional lymph node involvement (N0M1) have a better prognosis than those with concurrent regional lymph node metastasis (N+M1). This apparent prognostic divergence must be reflected in refined tumor classification subsets.
Safety and feasibility of early discharge (≤ 23 h) following loop ileostomy reversal: a systematic review and meta-analysis.
Mulhall CB, O'Kelly R, Temperley HC … +3 more , Mac Curtain BM, Dunne M, Ng ZQ
Int J Colorectal Dis · 2026 May · PMID 42217048 · Publisher ↗
BACKGROUND: The standard practice for postoperative management of loop ileostomy reversal has been standard admission with several days of inpatient observation, largely to monitor for postoperative complications. These...
BACKGROUND: The standard practice for postoperative management of loop ileostomy reversal has been standard admission with several days of inpatient observation, largely to monitor for postoperative complications. These primarily include anastomotic leak, postoperative ileus, and surgical site infection. In recent years, several studies have piloted ambulatory or short-stay pathways; however, the safety and impact of these pathways on complications remains unclear. METHODS: This systematic review and meta-analysis was conducted in accordance with PRISMA. It was also conducted in accordance with a prospectively registered protocol (PROSPERO CRD420251252408). Adults undergoing loop ileostomy reversal discharged within 23 h of surgery (including same-day discharge (SDD), short-stay protocols (LOS 1)) were compared with patients managed with standard admission. Primary outcomes were anastomotic leak, postoperative ileus, and surgical site infection at 30 postoperative days; secondary outcomes included readmission, overall complications including Clavien-Dindo-graded events, and mortality. Random-effects models were used to pool odds ratios with 95% confidence intervals. RESULTS: Twelve studies (11 retrospective cohort studies, 1 RCT), comprising 30,040 patients were included. Of these, 2611 (8.7%) patients underwent ambulatory or short-stay reversal. There was no significant difference between early discharge and standard cohorts in anastomotic leak (pooled OR 1.31, 95% CI 0.24-7.32), postoperative ileus (pooled OR 0.49, 95% CI 0.16-1.55), or surgical site infection (pooled OR 0.76, 95% CI 0.38-1.51). However, the low event rates and wide Cis likely preclude confident exclusion of a clinically meaningful effect. Similarly, readmission rates showed no difference between groups (pooled OR 0.97, 95% CI 0.78-1.19). Early discharge following reversal was, however, associated with a modest but statistically significant reduction in overall postoperative complications (pooled OR 0.70, 95% CI 0.50-0.98), with comparable rates of major (Clavien-Dindo III-IV) complications and very low mortality in both groups. CONCLUSIONS: This study suggests that early discharge following loop ileostomy reversal, if carried out as part of a structured perioperative pathway, appears to be safe, with no apparent increase in risk of any additional postoperative complications. However, the data available at present is dominated by largely retrospective cohort studies, with heterogenous discharge criteria, and inconsistency in intervention (SDD vs 23 h stay vs short-stay protocol), precluding any firm conclusions regarding equivalence with standard admission. Rather than advocating for its widespread adoption, these findings support the cautious implementation of early discharge pathways in select cohorts with prospectively collected outcomes. Adequately powered multicentre RCTs with standardisation of intervention and outcome measures are required before broader dissemination can be recommended. CLINICAL TRIAL REGISTRATION: Not applicable. This study is not a clinical trial.
The predictive value of contrast-enhanced CT characteristics combined with composite inflammatory markers for lymph node metastasis in T1 colorectal cancer.
Li X, Fu X, Zhang C … +4 more , Li M, Han D, Fu G, Zhou Y
Int J Colorectal Dis · 2026 May · PMID 42215802 · Publisher ↗
OBJECTIVES: This study aimed to investigate the predictive value of contrast-enhanced computed tomography (CECT) characteristics of peritumoral lymph node (LN) combined with composite inflammatory markers in lymph node m...
OBJECTIVES: This study aimed to investigate the predictive value of contrast-enhanced computed tomography (CECT) characteristics of peritumoral lymph node (LN) combined with composite inflammatory markers in lymph node metastasis (LNM) for patients with T1 colorectal cancer (CRC), and evaluated their diagnostic efficacy. METHODS: This retrospective study included 212 patients with T1 CRC (non-LNM: n = 185; LNM: n = 27). The CECT characteristics of the peritumoral LN and inflammatory markers were analyzed. Variables with statistical significance were included in penalized logistic regression (the least absolute shrinkage and selection operator, LASSO) for further feature selection and coefficient shrinkage. The diagnostic performance of the prediction models was evaluated using the receiver operating characteristic curve. The net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were calculated to quantify the incremental predictive value between the models, and the decision curve analysis was plotted to evaluate the clinical practicability. RESULTS: 27/212 (12.74%) patients had LNM. Six CECT characteristics, three inflammatory markers and six clinical pathological parameters differed significantly between the two groups (all p < 0.05). Eight non-zero coefficient variables were retained. The preoperative prediction model based on CECT characteristics and inflammatory markers had the highest AUC (AUC = 0.830), with NRI and IDI both greater than 0, and had the optimal clinical decision-making value. CONCLUSIONS: Preoperative CECT characteristics of LN and composite inflammatory markers were significantly correlated with the occurrence of LNM in T1 CRC patients. The combined model may be useful for the early identification of LNM.
Turnbull procedure-analysis of a cohort in the salvage setting.
Arlt G, Doyon F, Magdeburg R … +1 more , Kienle P
Int J Colorectal Dis · 2026 May · PMID 42207292 · Full text
PURPOSE: The Turnbull procedure (coloanal pull-through with delayed coloanal anastomosis, DCAA) serves as a salvage option for complex, therapy-refractory pelvic floor disorders to avoid permanent colostomy. This study e...
PURPOSE: The Turnbull procedure (coloanal pull-through with delayed coloanal anastomosis, DCAA) serves as a salvage option for complex, therapy-refractory pelvic floor disorders to avoid permanent colostomy. This study evaluated the perioperative outcomes, stoma avoidance, and functional results of 16 patients treated between 2018 and 2024. METHODS: A retrospective analysis of 16 consecutive patients with hostile pelvis (e.g., post-surgical fistulas, chronic pelvic sepsis, and Crohn's disease). The key outcomes were time to anastomosis, Clavien-Dindo complications, stoma reversal rate, SF-12 quality of life, LARS, and Wexner continence score. Follow-up = 19-80 months. RESULTS: Anastomosis occurred after a mean of 11 days (range, 6-19 days). Permanent stoma was avoided in 13/16 (81%) patients. Perioperative morbidity was low, and the SF-12 scores (14/16) ranged from 29 to 86%, correlating with the LARS (p = 0.016). In 12 patients, minor LARS was observed in 3/12, major LARS in 7/12, the Wexner incontinence score showed good continence in 4/12, moderate incontinence in 5/12, and severe incontinence in 3/12. The fistula subgroup showed the best functional results. CONCLUSIONS: The Turnbull/DCAA procedure enables sphincter preservation in complex pelvic disorders, particularly postoperative fistulas. Despite frequent major LARS and incontinence, 81% of the patients avoided permanent stoma. Meticulous selection and informed consent are essential because of the functional limitations.
Association between circulating metabolic biomarkers and the risk of inflammatory bowel disease: a prospective cohort study.
Fan M, Wang M, Chen H … +4 more , Lin S, Bai H, Han H, Chen L
Int J Colorectal Dis · 2026 May · PMID 42203976 · Full text
Abstract loading — click title to view on PubMed.
Pulmonary metastasectomy in colorectal cancer: the importance of interpreting neoadjuvant strategies in the era of modern systemic therapy.
Ilhan Y, Guzel HG
Int J Colorectal Dis · 2026 May · PMID 42189289 · Full text
Abstract loading — click title to view on PubMed.
Gut microbiota profiles in reactive and metastatic lymphadenopathy in colorectal cancer: a tumor location-stratified analysis.
Miyake T, Kojima M, Tani S … +5 more , Muramoto K, Maehira H, Kaida S, Shimizu T, Tani M
Int J Colorectal Dis · 2026 May · PMID 42185684 · Publisher ↗
PURPOSE: Preoperative lymphadenopathy in colorectal cancer may represent nodal metastasis or reactive change. We aimed to compare gut microbiota profiles between reactive and metastatic lymphadenopathy and to explore mic...
PURPOSE: Preoperative lymphadenopathy in colorectal cancer may represent nodal metastasis or reactive change. We aimed to compare gut microbiota profiles between reactive and metastatic lymphadenopathy and to explore microbial features associated with nonmetastatic lymph node enlargement. METHODS: We conducted a retrospective observational study of colorectal cancer patients with radiological lymphadenopathy who underwent resection at Shiga University of Medical Science Hospital between 2018 and 2021. For the primary analysis, we included patients with radiological lymphadenopathy on preoperative CT. An additional analysis restricted to right-sided colon cancer compared no lymphadenopathy without pathological lymph node metastasis (NN), lymphadenopathy without pathological lymph node metastasis (PN), and lymphadenopathy with pathological lymph node metastasis (PP). RESULTS: Pathological nodal metastasis was identified in 34 patients, whereas 29 had reactive lymphadenopathy. Fecal samples showed higher alpha diversity than tumor tissues. In left-sided colorectal cancer, no notable bacterial taxa exceeded the predefined LDA threshold. In right-sided colon cancer, Proteobacteria were enriched in metastatic cases, whereas Firmicutes were more abundant in reactive lymphadenopathy. Predicted pathway analysis suggested distinct metabolic profiles between the two groups. In the additional right-sided analysis, alpha and beta diversity did not significantly differ among NN, PN, and PP, although taxon-level differences were observed between NN and PN. CONCLUSION: Gut microbiota profiles differed between reactive and metastatic lymphadenopathy in colorectal cancer, with more distinct findings in right-sided tumors. These findings suggest an association between microbial patterns and reactive lymphadenopathy.
Impact of socioeconomic status on patient characteristics and postoperative outcomes in colorectal cancer surgery: A retrospective cohort study.
Schraps N, Nassar A, Zhang S … +9 more , Zgurskyi P, Kemper M, Papazoglou ED, Wolters-Eisfeld G, Giannou AD, Izbicki JR, Hackert T, Melling N, Mercanoglu B
Int J Colorectal Dis · 2026 May · PMID 42185678 · Full text
BACKGROUND: Colorectal cancer remains among the most common malignancies worldwide and the second leading cause of cancer-related death. Prior studies suggest that socioeconomic deprivation is associated with higher inci...
BACKGROUND: Colorectal cancer remains among the most common malignancies worldwide and the second leading cause of cancer-related death. Prior studies suggest that socioeconomic deprivation is associated with higher incidence and poorer outcomes in colorectal cancer patients. METHODS: We conducted a retrospective study of 476 patients who underwent colorectal cancer resection at a high-volume center in Germany between 2016 and 2023. Area-level socioeconomic status (SES) was estimated using a region-specific purchasing power index (PPI) derived from patients' residential postal codes. We retrospectively examined whether SES was associated with mode of presentation, perioperative course, postoperative complications, and oncologic outcomes. In addition, a prespecified exploratory subgroup analysis was performed by comparing patients in the highest 20% (top) and lowest 20% (bottom) of the cohort according to PPI distribution. RESULTS: In the overall cohort, higher area-level SES was associated with emergency surgery. In the subgroup analysis, the top SES subgroup was also associated with older age and postoperative complications. We further observed significant associations between the bottom SES subgroup and both younger age at diagnosis and higher body mass index (BMI). No statistically significant association between SES and overall or disease-free survival was observed in our patient cohort. CONCLUSIONS: In this single-center study, area-level SES was associated with distinct patient and perioperative profiles, but not with long-term oncologic outcomes. These findings suggest potentially actionable differences in risk profiles across SES strata, particularly regarding age at diagnosis, obesity, and complication burden.
External validation of predictive models for prolonged postoperative ileus following colorectal resection.
Ramírez-Giraldo C, Cirillo B, Lucietto M … +4 more , Fabbri N, Biondi A, Feo C, Pesce A
Int J Colorectal Dis · 2026 May · PMID 42171774 · Publisher ↗
INTRODUCTION: Prolonged postoperative ileus (PPOI) is a frequent complication after colorectal surgery. Several prediction models have been proposed to estimate PPOI risk, but few have undergone external validation, limi...
INTRODUCTION: Prolonged postoperative ileus (PPOI) is a frequent complication after colorectal surgery. Several prediction models have been proposed to estimate PPOI risk, but few have undergone external validation, limiting their generalizability and clinical usefulness. The primary aim of this study was to externally validate two predictive models for PPOI after colorectal resection; a secondary aim was to explore factors associated with PPOI in our cohort. METHODS: Data from all consecutive patients who underwent elective colorectal resection in our department between 2019 and 2022 were retrospectively analyzed from a prospective database. Eligible criteria were age ≥ 18 years, elective colorectal resection, and ASA score I-III. Based on a recent systematic review, we selected the models by Hain et al. and Wolthuis et al. for external validation, as all required variables were available in our dataset. Model performance was assessed in terms of discrimination, calibration, and overall accuracy. An exploratory multivariable regression analysis was also performed to assess factors associated with PPOI. RESULTS: Among 200 patients undergoing colorectal resection, 43 (21.5%) developed PPOI. Both prediction models showed poor external performance. The Hain model had a C-statistic of 0.597 (95% CI 0.514-0.681) and the Wolthuis model a C-statistic of 0.589 (95% CI 0.501-0.677), with suboptimal calibration and limited overall accuracy. In secondary exploratory multivariable analyses, postoperative opioid use was associated with PPOI in both models. In the model excluding postoperative oral intake initiation and autonomous postoperative mobilization, splenic flexure mobilization was associated with lower odds of PPOI; in the fully adjusted model, delayed postoperative oral intake initiation was associated with PPOI. These exploratory local findings should be interpreted as hypothesis-generating. CONCLUSIONS: External validation of two previously published PPOI prediction models demonstrated poor performance in this cohort, limiting their transportability to our setting. The secondary exploratory analysis identified potentially relevant postoperative factors, but these findings should be considered hypothesis-generating. Further research should prioritize harmonized PPOI definitions and robust multicentre validation of prediction models.
Automated deep learning model for predicting pathological complete response in rectal cancer: A tool to organ-preserving strategies.
J MA, F LM, D MV … +9 more , L PS, I PL, A GS, N TL, B CP, M RC, G LA, M M, V PM
Int J Colorectal Dis · 2026 May · PMID 42171757 · Publisher ↗
BACKGROUND: Accurate identification of pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC) remains a key clinical challenge. Clinical complete response...
BACKGROUND: Accurate identification of pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC) remains a key clinical challenge. Clinical complete response is an imperfect surrogate, and pCR can only be definitively established after surgery. We developed a fully automated, segmentation-free deep learning model to support post-treatment response assessment using routine T2-weighted MRI. METHODS: A longitudinal three-dimensional (3D) siamese convolutional neural network was trained using paired pre- and post-nCRT axial T2-weighted MRI volumes and a normalized signed voxel-wise difference map. The multitask framework simultaneously predicted rectal wall response (good response: modified Ryan score 0-1 vs poor response ≥ 2) and nodal status (ypN0 vs ypN +), from which pCR probability (ypT0N0) was derived. A retrospective single-center cohort of 195 patients was divided into training and independent test sets stratified by pCR status. Performance was evaluated using AUC-ROC and standard classification metrics with bootstrap-derived 95% confidence intervals. RESULTS: In the independent test set (n = 49; pCR prevalence 18.5%), the model achieved an AUC-ROC of 0.71 (95% CI: 0.55-0.85) for pCR prediction. At the selected operating threshold, sensitivity was 100% (95% CI: 70.1-100) and negative predictive value (NPV) was 100% (95% CI: 81.6-100), with a specificity of 42.5% (95% CI: 28.5-57.8). The high NPV reflects the low prevalence of pCR in the study cohort and may vary across external populations. CONCLUSIONS: This fully automated longitudinal deep learning model demonstrated moderate discrimination and a high-sensitivity profile for pCR detection. Its performance suggests potential utility as a screening or triage tool to support multidisciplinary assessment, rather than to directly guide organ-preserving strategies. External multicenter validation is required before clinical implementation.
Microsatellite instability and mismatch repair deficiency prevalence among Hispanic/Latino individuals with colorectal cancer: a systematic review and meta-analysis.
Guerron-Gomez G, Mendivelso-González DF, Chaves-Cabezas V … +3 more , Chaves JJ, Riaño-Moreno JC, Parra-Medina R
Int J Colorectal Dis · 2026 May · PMID 42165902 · Publisher ↗
BACKGROUND: Colorectal cancer (CRC) is the third most common cancer globally, with rising cases in Latin America. MSI-H and MMRd play key roles in CRC, but data on their prevalence in Hispanic/Latino populations are limi...
BACKGROUND: Colorectal cancer (CRC) is the third most common cancer globally, with rising cases in Latin America. MSI-H and MMRd play key roles in CRC, but data on their prevalence in Hispanic/Latino populations are limited. This study evaluates these biomarkers in the region. METHODS: A systematic review and meta-analysis were conducted following PRISMA guidelinesin Medline, Virtual Health Library, Scopus, and Web of Science. Random-effects models were used to estimate pooled prevalence due to expected heterogeneity between studies. Studies (cohort and cross-sectional) that evaluated MMRd and/or MSI-H through IHC and PCR techniques in Hispanic/Latino individuals with colorectal cancer (whether sporadic, associated with Lynch Syndrome, or other forms), residing in Latin American countries or elsewhere, were included. RESULTS: A total of 52 studies including 10,596 patients were included. The pooled prevalence of mismatch repair deficiency (MMRd) and microsatellite instability-high (MSI-H) in Hispanic/Latino populations was 15% (95% CI: 10%-20%; I = 89.6%) and 18% (95% CI: 13%-24%; I = 84.0%), respectively. Costa Rica and Mexico had the highest MMRd prevalence (30% and 24%), while Uruguay showed the highest MSI-H prevalence (45%). MSI-H was significantly associated with female sex (OR: 1.83) and right-sided tumors (OR: 8.16). MMRd was associated with right-sided tumors compared with the rectum (OR: 1.73) and the left colon (OR: 5.65). CONCLUSIONS: This meta-analysis underscores the unique prevalence of MMRd and MSI-H in Hispanics, highlighting regional variations and the need for broader representation.
Defining proficiency in THD-Anolift: a CUSUM analysis of the learning curve in 51 consecutive cases.
Galli AC, Dionigi G, Lauricella S … +5 more , Agradi S, Sassun R, Leone AE, Cirocchi R, Brucchi F
Int J Colorectal Dis · 2026 May · PMID 42159773 · Publisher ↗
BACKGROUND: Transanal hemorrhoidal dearterialization (THD) with Anolift mucopexy is a validated non-excisional procedure for hemorrhoidal disease. Although surgeon experience is acknowledged as a determinant of THD outco...
BACKGROUND: Transanal hemorrhoidal dearterialization (THD) with Anolift mucopexy is a validated non-excisional procedure for hemorrhoidal disease. Although surgeon experience is acknowledged as a determinant of THD outcomes, no formal learning curve analysis exists. This study aimed to characterize the learning curve of a single surgeon adopting THD-Anolift. METHODS: Retrospective analysis of 60 consecutive THD-Anolift cases (May 2023-February 2026). Nine patients with incomplete outcome data were excluded, leaving 51 for analysis. Median follow-up was 12 months (range 3-33). Cumulative sum (CUSUM) charts were constructed for a composite failure endpoint (recurrence and/or any complication) and for operative time. The proficiency point was identified at the CUSUM inflection. Sensitivity analyses included CUSUM on recurrence alone, CUSUM restricted to recurrence and Clavien-Dindo ≥ II complications, best-case/worst-case imputation for excluded patients, and risk-adjusted CUSUM controlling for hemorrhoid grade and previous procedures. RESULTS: Median age was 53 years; 72.5% were male; 80.4% had grade III hemorrhoids. The overall composite failure rate was 37.3% (19/51) and the recurrence rate 15.7% (8/51). Mean operative time was 23.5 ± 7.4 min. The composite outcome CUSUM identified a proficiency point at case 23: the failure rate decreased from 52.2% in Phase 1 (cases 1-23) to 25.0% in Phase 2 (cases 24-51; p = 0.080, not statistically significant at the conventional threshold). Operative time decreased from 27.1 ± 7.4 to 20.4 ± 6.0 min (p < 0.001). On sensitivity analysis, both the recurrence-only CUSUM and the risk-adjusted CUSUM confirmed an identical proficiency point at case 23, and worst-case/best-case imputation for excluded patients moved the inflection only to cases 25 and 22 respectively, indicating that the finding was robust to endpoint definition and case-mix variation, as well as to plausible patterns of missing data. CONCLUSIONS: CUSUM analysis identified an inflection at approximately 23 cases, with a statistically significant reduction in operative time and a clinically relevant but underpowered reduction in composite failure that did not reach the conventional threshold for statistical significance. Rather than a fixed competency threshold, these findings provide an initial benchmark to help structure supervised adoption-suggesting that the 10 mentored cases conventionally proposed in industry-sponsored teaching may be insufficient- and to inform future multicenter validation.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe