Effect of self-expandable metal stent on morbidity and mortality and oncological prognosis in malignant colonic obstruction: retrospective analysis of its use as curative and palliative treatment
This study aimed to evaluate its impact on these variables and compare it with that of emergency surgery (ES).MethodsDescriptive, retrospective and single-centre study, performed between 2008 and 2015, with follow-up until 2017. One hundred eleven patients with diagnosis of left malignant colonic obstruction were included and divided according to the treatment received: stent as bridge to surgery (SBTS group: 39), palliative stent (PS group: 30) and emergency surgery with curative (ECS group: 34) or palliative intent (EPS group: 8). Treatment was decided by the attending surgeon in charge.ResultsTechnical and clinical gene...
Source: International Journal of Colorectal Disease - January 23, 2022 Category: Gastroenterology Source Type: research

Impact of the viability assessment of lateral lymph node metastasis in rectal cancer after neoadjuvant chemoradiotherapy
ConclusionThe majority of the residual cancer tissue in LNs observed by HE staining was found to be non-apoptotic. If LLN metastasis is suspected on pretreatment imaging, performing LLN dissection together with TME should be considered. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - January 22, 2022 Category: Gastroenterology Source Type: research

Oxaliplatin-based adjuvant chemotherapy rather than fluorouracil-based chemotherapy in rectal cancer is more efficient to decrease distant metastasis and increase survival after preoperative chemoradiotherapy and surgery: a meta-analysis
ConclusionThe addition of oxaliplatin to adjuvant therapy for stage II –III rectal cancer following preoperative CRT and TME may increase disease-free survival without significant increases in toxicity, but not overall survival. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - January 20, 2022 Category: Gastroenterology Source Type: research

Prostate radiotherapy and the risk of secondary rectal cancer —a meta-analysis
ConclusionThese findings confirm that prostate radiotherapy significantly increases the risk of subsequent rectal cancer. This risk has implications for treatment selection, surveillance and patient counselling. However, it is crucial that this information is presented in a rational and comprehensible manner that does not disproportionately frighten or deter patients from what might be their most suitable treatment modality. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - January 17, 2022 Category: Gastroenterology Source Type: research

Risk factors for the development of a parastomal hernia in patients with enterostomy: a systematic review and meta-analysis
ConclusionsThe current available evidence showed that higher BMI, older age, female, larger aperture size, the creation of a transperitoneal stoma, and a larger waist circumference were independent risk factors for PSH. For factors without exact cutoff value, further explorations are needed in the future. In addition, reference to the limited number of studies in the pooled analysis, these factors still need to be interpreted carefully. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - January 14, 2022 Category: Gastroenterology Source Type: research

Cecorectal (CRA) versus ileorectal (IRA) anastomosis after colectomy for slow transit constipation (STC): a meta-analysis
This study followed the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA guidelines. To identify all eligible records, a systematic literature search in the electronic scholar databases (Medline, Scopus, Web of Science) was performed.ResultsOverall, 5 trials and 291 patients were included in this meta-analysis. Pooled comparisons confirmed the comparability of the two techniques regarding perioperative complications (p = 0.55). CRA was associated with a shorter operation (p  = 0.0004) and hospitalization duration (p = 0.001). Although there was no difference...
Source: International Journal of Colorectal Disease - January 12, 2022 Category: Gastroenterology Source Type: research

Effect of antinuclear antibodies on pharmacokinetics of anti-TNF therapy in patients with inflammatory bowel disease
ConclusionsIn  IBD patients under maintenance therapy with anti-TNF ANA positivity is associated with lower TLs. The clinical significance of this finding remains to be defined in future larger prospective studies. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - January 11, 2022 Category: Gastroenterology Source Type: research

Post-operative morbidity in Crohn ’s disease: what is the impact of patient-, disease- and surgery-related factors?
AbstractPurposeOver 50% of patients suffering from Crohn ’s disease (CD) require surgery in their lifetime. Predictors/risk factors of post-operative morbidity and mortality in CD are poorly investigated. We aimed to assess the risk factors of post-operative morbidity/mortality in CD.MethodsWe performed a retrospective cohort study in which all CD patients operated and followed up at our tertiary Inflammatory Bowel Disease Centre from 2014 to 2019 were enrolled. For each patient, we evaluated patient-dependent, disease-dependent and surgery-dependent variables. All patients underwent small bowel and/or colic resectio...
Source: International Journal of Colorectal Disease - January 11, 2022 Category: Gastroenterology Source Type: research

The influence of intraoperative rectal washout on local recurrence of colorectal cancer following curative resection: a systematic review and meta-analysis
ConclusionIt is safe to recommend the use of rectal washout for left sided and rectal tumour resections. It is a simple and safe step during colorectal surgery that appears to improve long-term oncological outcomes and was not reported to be associated with any complications. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - January 11, 2022 Category: Gastroenterology Source Type: research

Prehabilitation in rectal surgery: a narrative review
ConclusionCurrent evidence on prehabilitation in rectal surgery has considerable heterogenicity in both structure of programmes and outcome measures. Standardisation is required for future evaluation of the impact on outcomes. A trimodal approach of exercise, nutritional and psychological interventions has been employed in similar programmes, and should be used in rectal surgery. The intervention should be tailored to the patient and environment. This review highlights the benefits, safety and feasibility of prehabilitation and provides a platform for consensus-building for international trials. (Source: International Jour...
Source: International Journal of Colorectal Disease - January 10, 2022 Category: Gastroenterology Source Type: research

Malignant colon polyps: predicting lymph node metastasis following endoscopic excision
ConclusionEstimating LNM risk in MCPs by applying clinical characteristics along with limited histologic data can help inform decision-making when considering formal oncologic resection. The NSS and SSS demonstrated comparable predictability of LNM among pT1Nx MCPs. The models require external validation and may be strengthened by incorporating additional endoscopic and pathologic characteristics. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - January 10, 2022 Category: Gastroenterology Source Type: research

Risk factors for lymph node metastasis and prognosis in colorectal neuroendocrine tumours
AbstractPurposeThe detection rate of colorectal neuroendocrine tumours (CR-NETs) is increasing, but their treatment is still controversial. Lymph node metastasis is an important reference index for the selection of treatment. The aim of our study was to investigate the factors associated with lymph node metastasis and prognosis of CR-NETs.MethodsThe case characteristics of patients with colorectal neuroendocrine tumours from January 2011 to December 2020 were retrospectively analysed, including age, gender, tumour size, tumour location, lymph node metastasis, pathological grade and follow-up.ResultsA total of 195 cases of ...
Source: International Journal of Colorectal Disease - January 8, 2022 Category: Gastroenterology Source Type: research

Mesenteric occlusive disease of the inferior mesenteric artery is associated with anastomotic leak after left-sided colon and rectal cancer surgery: a retrospective cohort study
AbstractPurposeAnastomotic leak (AL) is a serious complication following colorectal surgery. Atherosclerosis causes inadequate anastomotic perfusion and is suggested to be a risk factor for AL. The aim of this study was to investigate the association of mesenteric occlusive disease on preoperative computed tomography (CT) scan with AL after left-sided colon or rectal cancer surgery.MethodsThis was a retrospective, multicenter cohort study including 1273 patients that underwent left-sided or rectal cancer resection between 2009 and 2018 from three hospitals in the Netherlands. AL patients were 1:1 matched with non-leak pati...
Source: International Journal of Colorectal Disease - January 7, 2022 Category: Gastroenterology Source Type: research

The effect of coffee/caffeine on postoperative ileus following elective colorectal surgery: a meta-analysis of randomized controlled trials
ConclusionPostoperative coffee or caffeine consumption improved bowel movement and decreased the duration of hospital stay in patients undergoing elective colorectal surgery. This method is safe and can prevent or treat POI. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - January 6, 2022 Category: Gastroenterology Source Type: research

Letter to the editor: Not inferior but rather superior long-term disease-free survival after laparoscopic versus open total mesorectal excision for low and mid rectal cancer!
(Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - January 6, 2022 Category: Gastroenterology Source Type: research

The impact of COVID-19 pandemic on the treatment of acute appendicitis in China
AbstractObjectiveThis research aims to analyze the impact of the novel coronavirus pandemic on the hospital visits of patients with acute appendicitis.MethodsThe retrospective analysis was designed to look at the treatment of acute appendicitis in the Department of General Surgery in Beijing Jishuitan Hospital before and during the COVID-19 pandemic (2019 –2020). Data was analyzed by the numbers of patients, sex, age, onset time, fever or not, laboratory examination, imaging test, and treatment. And we analyzed the differences between the “pre-COVID group” and “during-COVID group”.ResultsCompa...
Source: International Journal of Colorectal Disease - January 1, 2022 Category: Gastroenterology Source Type: research

Racial differences in the outcomes of IBD hospitalizations: a national population-based study
ConclusionWhite patients hospitalized with a principal diagnosis of IBD had no difference in inpatient mortality or septic shock but had worse outcomes such as increased odds of bowel perforation compared to black patients. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - January 1, 2022 Category: Gastroenterology Source Type: research

Value of high-field magnetic resonance imaging for diagnosis and classification of acute colonic diverticulitis
ConclusionModern high-field MRI is fully comparable to MDCT in the assessment of ACD and has the potential to serve as a first-line imaging tool. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - January 1, 2022 Category: Gastroenterology Source Type: research

Reply to the Letter to the Editor: Surgery, selection, or biology in lung metastasectomy for colorectal lung metastasectomy? PulMiCC may not provide all the answers but it does narrow down the question
(Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - January 1, 2022 Category: Gastroenterology Source Type: research

Correction to: Robotic versus conventional laparoscopic technique for the treatment of left ‑sided colonic diverticular disease: a systematic review with meta‑analysis
(Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - January 1, 2022 Category: Gastroenterology Source Type: research

Combining the quantitative faecal immunochemical test and full blood count reliably rules out colorectal cancer in a symptomatic patient referral pathway
AbstractPurposeFaecal Immunochemical Test (FIT) has proven utility for Colorectal Cancer (CRC) detection in symptomatic patients. Most studies have examined FIT in symptomatic patients subsequently referred from primary care. We investigated associations between CRC and FIT in both referred and non-referred symptomatic patients.MethodsA retrospective, observational study of all patients with a FIT submitted Aug 2018 to Jan 2019 in NHS GG&C was performed. Referral to colorectal/gastroenterology and decision to perform colonoscopy were recorded. FIT results were grouped as f-Hb  
Source: International Journal of Colorectal Disease - December 21, 2021 Category: Gastroenterology Source Type: research

Preoperative intravenous iron treatment reduces postoperative complications and postoperative anemia in preoperatively anemic patients with colon carcinoma
AbstractPurposeAnemia is common among patients with colorectal cancer and is associated with an increased risk of complications and poorer survival rate. The main objective of our study was to determine the effect of preoperative intravenous iron supplementation therapy on the need for red blood cell transfusions, other postoperative complications, and length of hospital stay in colon cancer patients undergoing colon resection.MethodsIn this retrospective cohort study, data were collected from medical records of all 549 colon carcinoma patients who underwent a colon resection in Helsinki University Hospital during the year...
Source: International Journal of Colorectal Disease - December 20, 2021 Category: Gastroenterology Source Type: research

Completion surgery vs. primary TME for early rectal cancer: a national study
ConclusionsOncological results were similar in the two groups. However, there may be an increased risk for a permanent stoma in the CS group. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - December 16, 2021 Category: Gastroenterology Source Type: research

Correction to: The treatment of acute appendicitis in two age ‑based groups during COVID‑19 pandemic: a retrospective experience in a COVID‑19 referral hospital
(Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - December 15, 2021 Category: Gastroenterology Source Type: research

Mortality following elective and emergency colectomy in patients with cirrhosis: a population-based cohort study from England
ConclusionPatients with cirrhosis undergoing emergency colectomy have a higher mortality risk than those undergoing elective colectomy both at 90  days and 1 year. The greatest mortality risk at 90 days was in those with decompensation undergoing emergency surgery. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - December 11, 2021 Category: Gastroenterology Source Type: research

Evaluation of diagnostic factors used to refer children with constipation for rectal biopsies
ConclusionIn children referred for rectal biopsy, the factors most indicative of Hirschsprung ’s disease were “male sex”, “failure to thrive”, “gross abdominal distention plus vomiting” and “fulfils the Rome 4 criteria for functional constipation”. Notably, the prevalence of Hirschsprung’s disease decreased with the increasing age of the children. Girls referred for a bio psy rarely had Hirschsprung’s disease, especially those older than 1 month. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - December 9, 2021 Category: Gastroenterology Source Type: research

The outcome of patients with inflammatory bowel disease –associated colorectal cancer is not worse than that of patients with sporadic colorectal cancer–a matched-pair analysis of survival
ConclusionIBD-CRC patients were younger and more frequently had right-sided carcinomas compared to sporadic CRC. CRC in IBD patients did not show survival difference compared to matched-pair sporadic CRC patients without distant metastases after curative resection. Surveillance might be important for early detection of CRC in IBD patients. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - December 4, 2021 Category: Gastroenterology Source Type: research

Oncologic colorectal surgical site infection: oral or not oral antibiotic preparation, that is the question
AbstractPurposeSurgical wound infection is the most frequent postoperative complication in abdominal surgery, especially at the colorectal level. The aim of this study is analysing the results of mechanical colon preparation combined with oral antibiotic versus mechanical colon preparation without antibiotic therapy in patients with colorectal cancer undergoing elective surgery.MethodsThis retrospective cohort study had been developed from November 2017 to February 2020. We have included a total of 281 consecutive patients undergoing elective colon and rectal oncological surgeries by the same surgical group using laparosco...
Source: International Journal of Colorectal Disease - December 2, 2021 Category: Gastroenterology Source Type: research

Colon ischemia in patients with severe COVID-19: a single-center retrospective cohort study of 20 patients
ConclusionIn this cohort study of patients with severe COVID-19 and colonic ischemia, clinical presentation and laboratory findings varied. However, the majority of patients required (sub)total colectomy. Despite a lower threshold to surgery in the second wave, mortality remained high. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - November 14, 2021 Category: Gastroenterology Source Type: research

Study protocol: a multicenter randomized controlled trial of the multifaceted workload reduction of the anti-adhesion barrier for diverting ileostomy in laparoscopic rectal surgery, YCOG 2005 (ADOBARRIER study)
ConclusionsThis RCT will evaluate the efficacy and safety of spray-type anti-adhesion material for diverting ileostomy construction. The results of this study are expected to facilitate decision-making regarding the use of anti-adhesion material.Trial registrationThis trial was registered with the Japan Registry of Clinical Trials (jRCT) in October 2020 as jRCTs032200155. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - November 14, 2021 Category: Gastroenterology Source Type: research

Post-hemorrhoidectomy pain: can surgeons reduce it? A systematic review and network meta-analysis of randomized trials
ConclusionHemorrhoidal surgery is feasible in day surgery units and post-operative pain can be adequately managed in an outpatient setting. Hemorrhoidopexy was the least painful; however, data should be carefully evaluated by the high rate of long-term recurrence described in literature. Closed hemorrhoidectomy, performed with bipolar or ultrasonic sealing, avoiding transfixive ligation of the hemorrhoidal pedicle, may improve post-operative pain control.Trial registrationCRD42020185160 (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - November 14, 2021 Category: Gastroenterology Source Type: research

Readmission, healthcare consumption, and mortality in Clostridioides difficile infection hospitalizations: a nationwide cohort study
We examined these outcomes in a US-based cohort of patients with CDI.MethodsWe queried the 2017 Nationwide Readmission Database using ICD-10-CM codes to identify all adult patients admitted with a principal diagnosis of CDI. Primary outcomes were 30- and 90-day readmission rates. Secondary outcomes included mortality rates and healthcare consumption.ResultsOf the 83,865 patients discharged from an index hospitalization for CDI, 22.37% were readmitted within 30  days, and an additional 15.01% were readmitted within 90 days. Recurrent CDI was responsible for more than 30% of readmissions at both 30 and 90 days...
Source: International Journal of Colorectal Disease - November 14, 2021 Category: Gastroenterology Source Type: research

Phosphodiesterase type 5 inhibitors use and risk of colorectal cancer: a systematic review and meta-analysis
AbstractBackgroundExperimental evidence has revealed that phosphodiesterase five inhibitors (PDE5is) increase epithelial barrier function and suppress intestinal carcinogenesis. Few epidemiological studies have investigated the role of PDE5i in increasing the risk of colorectal cancer (CRC); however, these studies have proffered varying conclusions. We therefore aimed to perform a comprehensive review and meta-analysis to investigate whether PDE5i use is associated with the incidence of CRC.MethodsDatabases, namely, PubMed, Scopus, Embase, and Web of Science, were used for literature search. Observational studies (publishe...
Source: International Journal of Colorectal Disease - November 14, 2021 Category: Gastroenterology Source Type: research

Re-evaluation of controversial issues in the treatment of cT3N0-2 rectal cancer: a 10-year cohort analysis using propensity-score matching
ConclusionsWe found any treatment modalities including competent TME and postoperative adjuvant CTX efficiently reducing LR generating robust survival outcome in the propensity-matched cohorts, demanding further randomized controlled trials by clinical sub-stages II –III. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - November 14, 2021 Category: Gastroenterology Source Type: research

A meta-analysis of low Hartmann ’s procedure versus abdominoperineal resection for non-restorative treatment of rectal cancer
ConclusionAn extrasphincteric APR is associated with higher overall and pelvic-perineal complications and may be reserved for tumours invading the anal sphincter complex. In the absence of sphincter involvement, both HP and intersphincteric APR are better alternatives with comparable morbidity. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - November 14, 2021 Category: Gastroenterology Source Type: research

Low anterior resection syndrome: can it be prevented?
AbstractSurgery remains the cardinal treatment in colorectal cancers but changes in bowel habits after rectal cancer surgery are common and disabling conditions that affect patients ’ quality of life. Low anterior resection syndrome is a disorder of bowel function after rectal resection resulting in a lowering of the QoL and recently has been defined by an international working group not only by specified symptoms but also by their consequences. This review aims to explore an extensive bibliographic research on preventive strategies for LARS. All “modifiable variables,” quantified by the LARS Score, such ...
Source: International Journal of Colorectal Disease - November 14, 2021 Category: Gastroenterology Source Type: research

Type of recurrence is associated with disease-free survival after salvage surgery for locally recurrent rectal cancer
AbstractPurposeTo compare the characteristics and outcomes of rectal cancer patients with local recurrence at a perianastomotic site (PA), a surgical field (SF) site, or in lateral lymph nodes (LLN).MethodsA total of 114 consecutive patients who underwent surgery for recurrent, non-metastatic rectal cancer at a single comprehensive cancer center between 1997 and 2012 were grouped on the basis of radiographic assessment of type of recurrence: PA, 76 (67%) patients; SF, 25 (22%) patients; LLN, 13 (11%) patients. Demographic, clinical, and pathological features were compared between the three groups, as were disease-free surv...
Source: International Journal of Colorectal Disease - November 14, 2021 Category: Gastroenterology Source Type: research

Ovarian metastases from colorectal cancer in young women: a systematic review of the literature
ConclusionsThis review showed that approximately one in twenty young female colorectal cancer patients will present with or develop ovarian metastases. Since outcome of this specific oncological pathology is often dismal, this finding is clinically relevant. It demonstrates the need to develop strategies to lower the incidence of ovarian metastases with adequate treatment and counseling of these patients. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - November 14, 2021 Category: Gastroenterology Source Type: research

Surgical management of splenic flexure colon cancer: a retrospective propensity-matched study comparing open and minimally invasive approaches using the national cancer database
ConclusionThe optimal approach for surgical management of splenic flexure colon cancer has not been standardized given its rarity and exclusion from randomized controlled trials. Our retrospective review suggests that minimally invasive resection of splenic flexure colon cancers in carefully selected patients is associated with equivalent oncologic outcomes as well as improved short and long-term survival compared to an open approach. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - November 14, 2021 Category: Gastroenterology Source Type: research

Survival rates and prognostic factors in right- and left-sided colon cancer stage I –IV: an unselected retrospective single-center trial
ConclusionLaterality disclosed no significant effect on the overall prognosis of colon cancer patients. However, group differences and distinct survival predictors could be identified in rCC and lCC patients. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - November 14, 2021 Category: Gastroenterology Source Type: research

Multicenter phase II clinical study of the efficiency and safety of capecitabine plus intermittent oxaliplatin with bevacizumab as first-line therapy in patients with metastatic colorectal cancer (VOICE trial)
ConclusionCAPOX plus bevacizumab therapy with a preplanned intermittent oxaliplatin strategy consisting of brief five-cycle induction therapy, five-cycle maintenance therapy with capecitabine plus bevacizumab, and five-cycle reintroduction therapy consisting of CAPOX plus bevacizumab is safe and effective for mCRC patients.Trial registrationUMIN ID: 000,005,732, date of registration: June 7, 2011.  https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000006695 (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - November 14, 2021 Category: Gastroenterology Source Type: research

Short-, long-, and very long-term results of secondary anterior sphincteroplasty in 20 patients with obstetric injury
ConclusionInitial improvement of anal incontinence attenuated with time, in particular from short- to long-term follow-up. Patients with neuropathy experienced no improvement of incontinence. Beyond stoma formation, in compliant patients, one should consider other treatment options like sacral nerve stimulation and neosphincter formation. (Source: International Journal of Colorectal Disease)
Source: International Journal of Colorectal Disease - November 14, 2021 Category: Gastroenterology Source Type: research