Diseases of the Colon and Rectum

BACKGROUND: Sacral neuromodulation is an effective treatment for fecal incontinence. OBJECTIVE: This study aimed to assess the long-term outcomes of sacral neuromodulation and establish the outcomes of patients with inactive devices. DESIGN: This is an observational study of patients treated for more than 5 years. A positive outcome was defined as a >50% reduction in fecal incontinence episodes or improvement in a symptom severity score...

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BACKGROUND: While young age of onset colorectal cancer is increasing in incidence lack of screening leads to symptomatic presentation, often with rectal bleeding. Because most cancers in patients under 50 are left-sided, flexible sigmoidoscopy is a reasonable way of investigating bleeding in these patients. OBJECTIVE: To predict which patients undergoing flexible sigmoidoscopy for outlet rectal bleeding need a full colonoscopy. DESIGN: Findings at colonoscopy were compared with published indications for colonoscopy after flexible sigmoidoscopy...

BACKGROUND: Ileostomies constitute 15-43% of readmissions after colorectal surgery, often due to dehydration and acute kidney injury. Prior institutional interventions decreased readmissions but not among patients with new ileostomies. OBJECTIVE: Evaluate readmissions among patients with new ileostomies following postoperative oral rehydration solution and standardized clinic visits. DESIGN: Retrospective analysis of prospective database. SETTINGS: Enhanced recovery colorectal surgery service...

BACKGROUND: Osteopenia, a condition in which bone mineral density is lower than normal, is a noted risk factor that leads to a shortened healthy life expectancy. OBJECTIVE: This study aimed to investigate the prognostic impact of preoperative osteopenia in colorectal cancer patients. DESIGN: This was a retrospective study. SETTING: This study was conducted at a university hospital. PATIENTS: A total of 1,086 stage I-III colorectal cancer patients who underwent curative resection...

BACKGROUND: There are few studies on the impact of a colorectal-specific technically certified surgeon on good surgical outcome for laparoscopic low anterior resection in the real world. OBJECTIVE: To evaluate the short-term outcomes of laparoscopic low anterior resection with the participation of a certified colorectal surgeon. DESIGN: This was a retrospective cohort study using Japanese nationwide database. SETTING: This study was conducted as a project for the Japan Society of Endoscopic Surgery and Japanese Society of Gastroenterological Surgery...

BACKGROUND: Macrophage-derived extracellular vesicles with microRNAs can cause and develop colon cancer. OBJECTIVE: We investigated M2 macrophage-derived extracellular vesicles and colon cancer. DESIGN: A prospective and experimental study of M2 macrophage-derived extracellular vesicles in colon cancer. SETTING: This study was completed at The Fourth Hospital of Hebei Medical University. PATIENTS: Colon cancer patients who had undergone surgical resection...

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BACKGROUND: Accurate prediction of response to neoadjuvant chemoradiotherapy is critical for subsequent treatment decisions for patients with locally advanced rectal cancer. OBJECTIVE: To develop and validate a deep learning model that based on the comparison of paired magnetic resonance imaging before and after neoadjuvant chemoradiotherapy to predict pathological complete response. DESIGN: By capturing the changes from magnetic resonance images before and after neoadjuvant chemoradiotherapy in 638 patients, we trained a multitask deep learning model for response prediction (DeepRP-RC) that also allowed simultaneous segmentation...

BACKGROUND: Due to improved survival rates, colorectal cancer patients may try to return to work. Many countries, however, have limited knowledge of their employment status. OBJECTIVE: To explore the employment status of colorectal cancer patients after surgery in Japan and the risk factors affecting the same. DESIGN: This is a prospective multicenter cohort study that uses self-administered questionnaires. Patients were recruited from June 2019 to August 2020 and were followed up for 12 months after surgery...

BACKGROUND: Transanal ileal pouch anal anastomosis is a relatively new technique aiming to reduce surgical invasiveness while providing better access to the pelvis in patients with ulcerative colitis. Currently, patients' preference on surgical approach has never been investigated. OBJECTIVE: To observe patient preference between transanal and laparoscopic ileal pouch anal anastomosis by measuring the potential risk, expressed in pouch function reduction, patients are willing to take to undergo transanal surgery...

BACKGROUND: Ureteral stents are thought to prevent or help identify ureteral injuries. Studies suggesting that ureteral stents increase the risk of postoperative acute kidney injury show inconsistent conclusions. The large ureteral stenting volume at our institution provided a unique opportunity for granular analysis not previously reported. OBJECTIVE: Determine if prophylactic ureteral stenting at colorectal surgery increases acute kidney injury. DESIGN: Retrospective analysis of colorectal operations with prophylactic ureteral stents were compared to operations without stents...

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Single-port laparoscopic surgery (SPLS) and a robotic surgical system have recently been included in contemporary colorectal surgical practice. 1-4 SPLS may result in better cosmetic outcomes, reduced postoperative incisional pain, fewer incisional hernias, minimal organ damage, and fewer wound complications. 2,5 However, SPLS for left-sided colorectal cancer is a challenging technique, even for experienced laparoscopic colorectal surgeons, owing to the difficulty of constructing instrument triangulation and using endo-staplers in the pelvic cavity from a single umbilical port with adequate distal margins...

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