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How to evaluate fluorescent image obtained during ICG lymphangiography for colon cancer?-A video vignette. 如何评价结肠癌ICG淋巴管造影所得的荧光图像?-一个视频短片。
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-02-01 DOI: 10.1111/codi.70405
Lidiia Panaiotti, Aleksei Karachun, Anastasia Muravtseva, Tatyana Golovanova, Marya Khaetskaya, Mikhail Shkatov, Aleksei Petrov
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引用次数: 0
British Society of Gastroenterology and Association of Coloproctology of Great Britain and Ireland position on tranexamic acid in upper and lower gastrointestinal bleeding. 英国胃肠病学协会和英国及爱尔兰结肠直肠病学协会对氨甲环酸在上、下消化道出血中的作用的立场。
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-02-01 DOI: 10.1111/codi.70404
Nigel Trudgill, Katie Yeadon, Matthew Kurien
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引用次数: 0
Risk factors for conditional survival and lymph node metastases in appendiceal adenocarcinoma. 阑尾腺癌有条件生存和淋巴结转移的危险因素。
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-02-01 DOI: 10.1111/codi.70388
Lauren Weaver, Shelbi Olson, Shreya Gupta, Sarah L Mott, Lindsay Welton, Alexander Troester, Niccolo Allievi, Wolfgang B Gaertner, Imran Hassan, Paolo Goffredo

Aim: Right hemicolectomy is the standard procedure for appendiceal adenocarcinoma to ensure adequate lymph node sampling. However, due to biological diversity, appendiceal adenocarcinoma has a wide survival range. Therefore, this study investigated risk factors associated with lymph node metastases and conditional overall survival, or the probability of surviving an additional 2 years after treatment, which may provide a more dynamic estimate of survival.

Method: A retrospective cohort study was conducted using the National Cancer Database to identify adults undergoing segmental colectomy for stage I-III appendiceal adenocarcinoma from 2004 to 2018. Cox regression models estimated patient and treatment effects on risk of lymph node metastases and survival outcomes.

Results: Of 3185 patients, 24% had nodal metastases. Probability of lymph node involvement increased with higher tumour grade, non-mucinous and signet cell histology, and advanced T stages. Overall, 5-year survival was 79%. After 2 years, 2716 patients (85%) survived, with 86% of that cohort surviving to 5 years. Age > 70, public or no insurance, higher grade, increasing pathological T stage and nodal metastases were associated with worse 2-year conditional overall survival (all p < 0.05).

Conclusion: In this national cohort, one-fourth of appendiceal adenocarcinoma patients had nodal metastases, which were associated with worse prognosis, validating the importance of segmental colectomy in staging and management. Although patients who survived at least 2 years had improved long-term outcomes, those with higher T stage, tumour grade or nodal involvement remained at elevated risk of mortality and may need prolonged close surveillance.

目的:右半结肠切除术是阑尾腺癌的标准手术,以确保足够的淋巴结采样。然而,由于生物多样性,阑尾腺癌具有广泛的生存范围。因此,本研究调查了与淋巴结转移和有条件总生存相关的危险因素,或治疗后额外存活2年的概率,这可能提供更动态的生存估计。方法:使用国家癌症数据库进行回顾性队列研究,以确定2004年至2018年因I-III期阑尾腺癌接受节段性结肠切除术的成年人。Cox回归模型估计了患者和治疗对淋巴结转移风险和生存结果的影响。结果:3185例患者中有24%发生淋巴结转移。淋巴结受累的可能性随着肿瘤分级、非黏液和印细胞组织学以及晚期T分期的增加而增加。总体而言,5年生存率为79%。2年后,2716例患者(85%)存活,其中86%存活至5年。年龄0 ~ 70岁、公共保险或无保险、分级较高、病理T分期和淋巴结转移增加与较差的2年有条件总生存率相关(均p)。结论:在这个国家队列中,四分之一的阑尾腺癌患者有淋巴结转移,这与较差的预后相关,验证了节段性结肠切除术在分期和治疗中的重要性。尽管存活至少2年的患者的长期预后得到改善,但那些T期、肿瘤分级或淋巴结受累者的死亡风险仍然较高,可能需要长期密切监测。
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引用次数: 0
Practical use of a 3D head-mounted display in hybrid robotic and transperineal rectal surgery. 3D头戴式显示器在混合机器人和经会阴直肠手术中的实际应用。
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-02-01 DOI: 10.1111/codi.70406
Tomoaki Okada, Akinari Nomura, Kenta Horita, Susumu Inamoto, Yoshiharu Sakai

Background: With the widespread adoption of robotic surgical platforms, a hybrid approach for rectal cancer combining abdominal robotic surgery with transanal or transperineal total mesorectal excision (TME) technique has been introduced. However, in this two-team approach, the docked robotic arms extend over the patient and frequently obstruct the transanal surgeon's line of sight, making it difficult to view the operative monitor and causing excessive cervical rotation and neck strain. To address this ergonomic issue, we implemented a three-dimensional head-mounted display (3D-HMD) using 3D View Vision system (FA. System Engineering Co., Ehime, Japan), which provides stereoscopic, high-definition visualization regardless of head position.

Materials and methods: The system offers 3840 × 1080-pixel resolution, minimal latency, light weight, and seamless switching between robotic and transperineal views, and images from both 2D and 3D endoscopes can be converted to stereoscopic 3D. The transperineal surgeon wore the 3D-HMD during transperineal TME and lateral pelvic lymph node dissection in coordination with the abdominal robotic team. Using this set-up, five abdominoperineal resections and one total pelvic exenteration were performed, all with bilateral lateral pelvic lymph node dissection.

Results: The median operating time was 530 min, with a median 3D-HMD usage of 315 min. The surgeon subjectively reported no cervical discomfort, visual disturbance, or device-related fatigue, and the visual field remained stable throughout the prolonged procedures.

Conclusion: The integration of a 3D-HMD into a hybrid two-team approach was feasible and subjectively well tolerated, providing high-resolution stereoscopic visualization without reported cervical discomfort.

背景:随着机器人手术平台的广泛采用,一种将腹部机器人手术与经肛门或经会阴全肠系膜切除(TME)技术相结合的直肠癌混合入路已经被引入。然而,在这种两组方法中,对接的机械臂延伸到患者身上,经常阻碍经肛门外科医生的视线,使其难以看到手术监护仪,并造成过度的颈椎旋转和颈部劳伤。为了解决这个人体工程学问题,我们使用3D视觉系统(FA)实现了一个三维头戴式显示器(3D- hmd)。系统工程公司,爱母,日本),它提供立体,高清晰度的可视化,无论头部位置。材料和方法:该系统提供3840 × 1080像素的分辨率,最小延迟,重量轻,在机器人和经会阴视图之间无缝切换,2D和3D内窥镜的图像都可以转换为立体3D。经会阴外科医生佩戴3D-HMD进行经会阴TME和骨盆外侧淋巴结清扫,与腹部机器人团队协调。使用这种装置,进行了5次腹部会阴切除和1次全盆腔切除,所有手术均伴有双侧盆腔淋巴结清扫。结果:手术时间中位数为530 min, 3D-HMD使用时间中位数为315 min。外科医生主观上报告没有颈椎不适、视力障碍或器械相关疲劳,并且在整个延长的手术过程中视野保持稳定。结论:将3D-HMD整合到混合两组方法中是可行的,主观上耐受良好,提供高分辨率立体可视化,无颈椎不适报告。
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引用次数: 0
TAMIS procedure for a recurrent rectal lesion at anastomotic site—A video vignette 吻合口复发性直肠病变的TAMIS手术-视频片段。
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-31 DOI: 10.1111/codi.70389
Ejaz Ahmed Latif, Ali Toffaha, Ammar Aleter, Amjad Parvaiz, Mohamed Abu Nada, Mohamed Kurer
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引用次数: 0
Translating rectopexy practice variability into precision care innovative directions 将直肠矫正术实践的可变性转化为精准护理的创新方向。
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-31 DOI: 10.1111/codi.70391
Zejun Song, Yiqi Guo
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引用次数: 0
When the colon falls short: A technical note on tension-free colorectal anastomosis via duodenal window – A video vignette 当结肠不通畅时:经十二指肠窗无张力结直肠吻合术的技术说明-视频片段。
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-31 DOI: 10.1111/codi.70384
Pablo Baeza-Ibáñez, Valentina Maluenda-Almonacid
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引用次数: 0
Diagnostic utility of bowel ultrasonography in adults with inflammatory bowel disease: An updated systematic review and meta-analysis 肠超声检查在成人炎症性肠病诊断中的应用:一项最新的系统综述和荟萃分析。
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-30 DOI: 10.1111/codi.70370
Hareesha Rishab Bharadwaj, Syed Hasham Ali, Hassam Ali, Priyal Dalal, Aditya Gaur, Sushil Rayamajhi, Arkadeep Dhali, Umar Akram, Thai Hau Koo, Yash Shah, Fariha Hasan, Dushyant Singh Dahiya

Background

Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), necessitates frequent disease monitoring to guide management. While colonoscopy remains the gold standard for assessing disease activity, its invasive nature limits its feasibility. Bowel ultrasonography (BUS) has emerged as a noninvasive alternative.

Objective

This systematic review and meta-analysis evaluate the diagnostic accuracy of BUS in detecting IBD activity compared to colonoscopy.

Methods

A comprehensive literature search of PubMed, CINAHL and Embase was conducted, including 37 studies evaluating BUS modalities such as colour Doppler, small intestine contrast ultrasonography (SICUS) and contrast-enhanced ultrasound (CEUS). Pooled sensitivity, specificity, diagnostic odds ratios (DOR) and likelihood ratios were calculated. Subgroup analyses were performed based on diagnostic modality and IBD subtype.

Results

The overall pooled sensitivity and specificity of BUS in IBD were 90.0% and 83.5%, respectively. SICUS had the highest sensitivity (95.0%), while BUS with colour Doppler had the highest specificity (85.1%). CEUS demonstrated the highest DOR (75.52). BUS performed best in detecting postoperative CD recurrence (sensitivity 91.9%, DOR 61.9). Meta-regression identified surgical anastomosis type as a significant predictor of diagnostic performance.

Conclusion

BUS is a highly effective noninvasive imaging modality for diagnosing and monitoring IBD. Its accuracy varies by modality, with SICUS optimal for screening and colour Doppler BUS for confirmation. Future studies should standardize BUS protocols and evaluate its role alongside MRI and CT enterography.

背景:炎症性肠病(IBD),包括克罗恩病(CD)和溃疡性结肠炎(UC),需要频繁的疾病监测来指导治疗。虽然结肠镜检查仍然是评估疾病活动的金标准,但其侵入性限制了其可行性。肠超声检查(BUS)已成为一种无创的替代方法。目的:本系统综述和荟萃分析比较了BUS在检测IBD活动性方面与结肠镜检查的诊断准确性。方法:综合检索PubMed、CINAHL、Embase等文献,纳入彩色多普勒、小肠对比超声(SICUS)、增强超声(CEUS)等评价BUS的37项研究。计算了合并敏感性、特异性、诊断优势比(DOR)和似然比。根据诊断方式和IBD亚型进行亚组分析。结果:BUS在IBD中的总体敏感性和特异性分别为90.0%和83.5%。SICUS的灵敏度最高(95.0%),而BUS与彩色多普勒的特异性最高(85.1%)。超声造影DOR最高(75.52)。BUS在检测术后CD复发方面表现最佳(敏感性91.9%,DOR 61.9)。meta回归确定手术吻合类型是诊断性能的重要预测因子。结论:BUS是诊断和监测IBD的一种有效的无创成像方式。其准确性因模式而异,SICUS最适合筛查,彩色多普勒BUS用于确认。未来的研究应标准化BUS方案,并评估其与MRI和CT肠造影的作用。
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引用次数: 0
Rectal cancer following radiotherapy for prostate cancer: A propensity-matched analysis 前列腺癌放疗后直肠癌:倾向匹配分析。
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-28 DOI: 10.1111/codi.70365
M. Goldenshluger, M. A. Abbas, M. Belkovsky, A. Alipouriani, K. Erozkan, G. Alon, M. A. Valente, S. R. Steele, S. D. Holubar, D. Liska, E. Gorgun
<div> <section> <h3> Aim</h3> <p>Patients who have previously received radiation therapy for primary prostate cancer (PPC) face an elevated risk of developing secondary rectal cancer (SRC). However, the clinical presentation, surgical outcomes, and oncological results of SRC in this context remain poorly characterized.</p> <p>This study aims to compare the clinical and pathological features, as well as treatment outcomes, of patients with primary rectal cancer (PRC) and those with SRC following radiation for prostate cancer.</p> </section> <section> <h3> Methods</h3> <p>Retrospective cohort study using univariate and propensity-matched analyses.</p> <p>Data extracted from electronic medical records at a single tertiary institution [2001–2021].</p> <p>Male patients with rectal cancer (RC) who underwent oncological resection with or without a prior history of prostate cancer radiation. Patients with a <3-year interval between radiotherapy and RC diagnosis were excluded. The main outcome measures were pathological analysis, postoperative complications and overall survival.</p> </section> <section> <h3> Results</h3> <p>Out of 1,755 patients with RC, 50 cases (2.9%) had SRC. Forty-three out of the 50 patients were included in the analysis. The median time from radiotherapy to SRC diagnosis was 8 ± 4 years (IQR). Patients with SRC were older, with a mean age of 73.7 ± 8.5 versus 61.1 ± 13 years in the control group (<i>p</i> < 0.001), and a higher American Society of Anaesthesiologists (ASA) score (<i>p</i> = 0.006). Most SRCs were distal with a median distance from the anal verge of 4.25 cm (IQR 9.5 cm). Only seven patients (16.3%) in the SRC group received neoadjuvant radiation therapy versus 764 (44.8%) of PRC (<i>p</i> = 0.001). SRC patients required more extensive surgical interventions, including abdominoperineal resection (46.5% vs. 29.9%), pelvic exenteration (4.7% vs. 0.4%), and fewer sphincter-preserving procedures, including low anterior resection (48.8% vs. 68.2%) and transanal resection (0% vs. 1.5%) (<i>p</i> = 0.02). Propensity score matching with a 1:2 ratio matching for age, body mass index (BMI), ASA score, type of surgery, and pathological staging revealed no differences between the groups regarding tumour differentiation, staging, or postoperative complications. Survival analysis at 6 years showed no significant difference in overall survival between the SRC (53.2%, 95% CI: 35%–71%) and PRC (50.3%, 95% CI: 36%–64%) groups (<i>p</i> = 0.61).</p> </section> <section> <h
目的:先前接受过原发性前列腺癌(PPC)放射治疗的患者患继发性直肠癌(SRC)的风险升高。然而,在这种情况下,SRC的临床表现、手术结果和肿瘤结果仍然缺乏特征。本研究旨在比较原发性直肠癌(PRC)患者和SRC患者在前列腺癌放疗后的临床和病理特征以及治疗结果。方法:回顾性队列研究,采用单变量分析和倾向匹配分析。数据摘自单一高等教育机构的电子病历[2001-2021]。有或没有前列腺癌放疗史的男性直肠癌(RC)患者行肿瘤切除术。结果:在1755例RC患者中,50例(2.9%)发生了SRC。50名患者中的43名被纳入分析。从放疗到SRC诊断的中位时间为8±4年(IQR)。SRC患者年龄较大,平均年龄为73.7±8.5岁,对照组为61.1±13岁(p局限性:回顾性设计和对单一机构电子病历的依赖)。结论:PPC患者在放疗后10年出现SRC。SRC患者通常年龄较大,合并症较多。与PRC患者相比,接受新辅助治疗的SRC患者较少,并且作为一个群体,与PRC患者相比,需要更广泛的手术,括约肌保留率更低。尽管存在这些差异,与PRC患者相比,SRC患者具有相似的病理结果和总生存期。
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引用次数: 0
Experiences of LGB patients undergoing colorectal cancer surgery: A focus on sexuality 结直肠癌手术中LGB患者的经验:对性的关注。
IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-28 DOI: 10.1111/codi.70375
Anna Provoost, Louis Onghena, Khushi Jeswani, Yves van Nieuwenhove, Eva Pape, Gabrielle H. van Ramshorst

Purpose

This study aimed to delineate the existing knowledge regarding the impact of colorectal cancer surgery on the sexuality of LGB patients, highlighting the need for culturally competent care tailored to their unique needs.

Methods

A comprehensive search was conducted from October 2024 onwards across PubMed, Embase, CINAHL, Google Scholar, Web of Science, Scopus, PsychINFO, Cochrane Library, and Joanna Briggs Institute using the MeSH terms ‘sexual and gender minorities’, ‘colorectal surgery’, ‘colorectal neoplasms’ and ‘sexuality’. Inclusion criteria required LGB patients over 18 years, at least 50% of the sample diagnosed with colorectal cancer and treated operatively. All studies were critically appraised.

Results

Six studies from the UK and the US were included. Sample size ranged from 1 to 480. Participants identifying as LGB ranged from 26.4 to 100%. Key findings revealed LGB patients experience similar physical consequences to heterosexual patients (erectile and ejaculatory dysfunction, dyspareunia, vaginal dryness), but implications might differ, e.g., regarding anal intercourse. A lower mental quality of life was reported, including body image issues related to stomas. Relationship challenges and intimacy issues were highlighted. The cultural competence of healthcare providers has a significant influence on patient experiences, highlighting a gap in inclusive care. Critical appraisal revealed both methodological strengths and weaknesses.

Conclusion

This review highlighted the sexual health challenges of LGB patients after colorectal cancer surgery, with issues like sexual function and mental wellbeing often being underreported. Cultural competence training for healthcare providers and integrating patients' partners into cancer care are crucial for a holistic approach.

目的:本研究旨在描述关于结直肠癌手术对LGB患者性取向影响的现有知识,强调需要针对他们的独特需求量身定制具有文化能力的护理。方法:从2024年10月起在PubMed、Embase、CINAHL、b谷歌Scholar、Web of Science、Scopus、PsychINFO、Cochrane Library和Joanna Briggs Institute进行全面检索,使用MeSH术语“性和性别少数群体”、“结直肠外科”、“结直肠肿瘤”和“性”。纳入标准要求18岁以上的LGB患者,至少50%的样本被诊断为结直肠癌并接受手术治疗。所有的研究都经过严格的评价。结果:纳入了来自英国和美国的6项研究。样本量从1到480。认同为LGB的参与者从26.4%到100%不等。主要研究结果显示,LGB患者与异性恋患者经历相似的生理后果(勃起和射精功能障碍、性交困难、阴道干燥),但含义可能有所不同,例如,在肛交方面。据报道,精神生活质量较低,包括与气孔有关的身体形象问题。强调了关系挑战和亲密问题。医疗保健提供者的文化能力对患者体验有重大影响,突出了包容性护理的差距。批判性评价揭示了方法论的优点和缺点。结论:本综述强调了结直肠癌手术后LGB患者的性健康挑战,性功能和心理健康等问题往往被低估。对医疗保健提供者进行文化能力培训,并将患者的合作伙伴纳入癌症护理中,这对整体方法至关重要。
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引用次数: 0
期刊
Colorectal Disease
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