Frederik W. Bækgaard, Anisoara Iordache, Andreas Hurup Nordholm, Peter-Martin Krarup, Nis Hallundbæk Schlesinger, Camilla Qvortrup, Henry G. Smith
Introduction
Lymph node yield (LNY) is a recognised prognostic factor in patients with colon cancer. Recent studies suggest LNY may reflect anti-tumour immune responses rather than surgical quality. Given the recognised difference in anti-tumour immunity according to mismatch repair (MMR) status, this study investigated whether LNY and its association with prognosis differed between colon cancers with deficient MMR (dMMR) and proficient MMR (pMMR).
Methods
A national retrospective cohort study using the Danish Colorectal Cancer Group (DCCG) database. Patients diagnosed with new Stage I–III colon cancers undergoing potentially curative left or right hemicolectomies between 2016 and 2022 were included. The primary outcome was LNY according to MMR status.
Results
In total of 9705 patients were included, of whom 7175 had pMMR cancers (74%). Median LNY for the whole cohort was 27. LNY <12 was seen in 178 patients (2%). dMMR cancers had higher median LNY (28 vs. 26 nodes, p < 0.001), and more patients with LNY ≥22 (73% vs. 66%, p < 0.001). No difference in the number of lymph node metastases was seen between groups. LNY <12 was associated with poorer overall survival (OS) regardless of MMR status and was independently associated with all-cause mortality. However, this effect was more marked in patients with dMMR than pMMR cancers {hazard ratio (HR) 4.23 (95% confidence interval [CI] 2.42–7.41) vs. 1.94 (1.21–3.13)}.
Conclusion
LNY was significantly higher in dMMR cancers, where low LNY also has a stronger association with prognosis. These findings support the theory that LNY reflects anti-tumour immunity rather than surgical quality.
{"title":"The prognostic impact of lymph node yield in deficient and proficient mismatch repair colon cancers: A retrospective national cohort study","authors":"Frederik W. Bækgaard, Anisoara Iordache, Andreas Hurup Nordholm, Peter-Martin Krarup, Nis Hallundbæk Schlesinger, Camilla Qvortrup, Henry G. Smith","doi":"10.1111/codi.70332","DOIUrl":"10.1111/codi.70332","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Lymph node yield (LNY) is a recognised prognostic factor in patients with colon cancer. Recent studies suggest LNY may reflect anti-tumour immune responses rather than surgical quality. Given the recognised difference in anti-tumour immunity according to mismatch repair (MMR) status, this study investigated whether LNY and its association with prognosis differed between colon cancers with deficient MMR (dMMR) and proficient MMR (pMMR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A national retrospective cohort study using the Danish Colorectal Cancer Group (DCCG) database. Patients diagnosed with new Stage I–III colon cancers undergoing potentially curative left or right hemicolectomies between 2016 and 2022 were included. The primary outcome was LNY according to MMR status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total of 9705 patients were included, of whom 7175 had pMMR cancers (74%). Median LNY for the whole cohort was 27. LNY <12 was seen in 178 patients (2%). dMMR cancers had higher median LNY (28 vs. 26 nodes, <i>p</i> < 0.001), and more patients with LNY ≥22 (73% vs. 66%, <i>p</i> < 0.001). No difference in the number of lymph node metastases was seen between groups. LNY <12 was associated with poorer overall survival (OS) regardless of MMR status and was independently associated with all-cause mortality. However, this effect was more marked in patients with dMMR than pMMR cancers {hazard ratio (HR) 4.23 (95% confidence interval [CI] 2.42–7.41) vs. 1.94 (1.21–3.13)}.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LNY was significantly higher in dMMR cancers, where low LNY also has a stronger association with prognosis. These findings support the theory that LNY reflects anti-tumour immunity rather than surgical quality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emeric Boisteau, Marc Aubry, Claire Gouriou, Charlène Brochard, Laurent Siproudhis, Eric Ogier-Denis, Astrid Lièvre
Aim
High-grade squamous intraepithelial lesions (HSILs) of the anus are at risk of progression to anal squamous cell carcinoma (ASCC). However, most HSILs spontaneously regress, while treatment efficacy is debated and associated with side effects. No clear clinical predictors for anal HSIL regression have been validated to date. We aimed to identify molecular biomarkers that predict the regression of anal HSIL.
Method
In this retrospective translational study, 79 patients who were diagnosed with anal HSIL from a prospective clinical cohort in a tertiary unit of proctology were included. We performed RNA-Seq for 63 samples and whole-exome analysis for 52 samples. HSILs were divided into two groups according to their evolution: regressors or non-regressors. We used samples for training and others for validation, in accordance with the methods of the laboratory for RNA extraction. Cox proportional hazard models were fitted to identify the main prognostic factors associated with disease evolution.
Results
In the univariate analysis, the absence of tobacco consumption and the absence of HSIL treatment were associated with regression. The quality and quantity of the libraries were correct enough for analysis for 57.7% of the samples (30/52). A total of 162 genes were differentially expressed between the regressor and stable groups in both cohorts of training and validation. However, after adjustment for clinical factors and correction of the p-value for multiple testing, no molecular biomarker was strongly associated with disease evolution.
Conclusion
No robust candidate genes predictive of HSIL regression were identified in this study.
{"title":"Can we predict regression of anal high-grade squamous intraepithelial lesions using molecular biomarkers?","authors":"Emeric Boisteau, Marc Aubry, Claire Gouriou, Charlène Brochard, Laurent Siproudhis, Eric Ogier-Denis, Astrid Lièvre","doi":"10.1111/codi.70322","DOIUrl":"10.1111/codi.70322","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>High-grade squamous intraepithelial lesions (HSILs) of the anus are at risk of progression to anal squamous cell carcinoma (ASCC). However, most HSILs spontaneously regress, while treatment efficacy is debated and associated with side effects. No clear clinical predictors for anal HSIL regression have been validated to date. We aimed to identify molecular biomarkers that predict the regression of anal HSIL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>In this retrospective translational study, 79 patients who were diagnosed with anal HSIL from a prospective clinical cohort in a tertiary unit of proctology were included. We performed RNA-Seq for 63 samples and whole-exome analysis for 52 samples. HSILs were divided into two groups according to their evolution: regressors or non-regressors. We used samples for training and others for validation, in accordance with the methods of the laboratory for RNA extraction. Cox proportional hazard models were fitted to identify the main prognostic factors associated with disease evolution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the univariate analysis, the absence of tobacco consumption and the absence of HSIL treatment were associated with regression. The quality and quantity of the libraries were correct enough for analysis for 57.7% of the samples (30/52). A total of 162 genes were differentially expressed between the regressor and stable groups in both cohorts of training and validation. However, after adjustment for clinical factors and correction of the p-value for multiple testing, no molecular biomarker was strongly associated with disease evolution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>No robust candidate genes predictive of HSIL regression were identified in this study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70322","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To describe a sequential minimally invasive strategy for concurrent excision of dual pararectal and perianal cystic lesions.
Method
We report a case of concurrent pararectal and perianal cystic lesions excised during a single operation sequentially with two different approaches. A robotic transabdominal approach was used for the deep pararectal cyst, followed by a direct perianal approach for the superficial perianal cyst. The operative details and postoperative immediate outcomes were reported.
Results
The robotic approach provided excellent visualization and precise dissection in the deep pelvic space, while the perianal approach allowed direct access for the superficial perianal cyst. Both lesions were completely excised with uneventful postoperative recovery. Histopathology confirmed benign lesions.
Conclusion
Sequential use of robotic and perianal approaches enables safe and complete excision of two anatomically distinct pelvic and perianal cysts in a single operation. This case underscores the importance of anatomy-based, tailored surgical planning and highlights the educational value of combining techniques for dual lesions.
{"title":"Sequential robotic and perianal approaches for excision of dual pararectal and perianal cystic lesions: A video vignette","authors":"Mahmood Al-Dhaheri, Ali Toffaha, Mooza Alhail, Ammar Aleter, Ejaz Latif, Amjad Parvaiz","doi":"10.1111/codi.70326","DOIUrl":"10.1111/codi.70326","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To describe a sequential minimally invasive strategy for concurrent excision of dual pararectal and perianal cystic lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We report a case of concurrent pararectal and perianal cystic lesions excised during a single operation sequentially with two different approaches. A robotic transabdominal approach was used for the deep pararectal cyst, followed by a direct perianal approach for the superficial perianal cyst. The operative details and postoperative immediate outcomes were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The robotic approach provided excellent visualization and precise dissection in the deep pelvic space, while the perianal approach allowed direct access for the superficial perianal cyst. Both lesions were completely excised with uneventful postoperative recovery. Histopathology confirmed benign lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Sequential use of robotic and perianal approaches enables safe and complete excision of two anatomically distinct pelvic and perianal cysts in a single operation. This case underscores the importance of anatomy-based, tailored surgical planning and highlights the educational value of combining techniques for dual lesions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Metincan Erkaya, Florentina Dermuth, Jeongyoon Moon, Mustafa Oruc, Emre Gorgun
{"title":"Single-port robotic completion proctectomy with J-pouch formation using the Bubble Port: A video vignette","authors":"Metincan Erkaya, Florentina Dermuth, Jeongyoon Moon, Mustafa Oruc, Emre Gorgun","doi":"10.1111/codi.70328","DOIUrl":"10.1111/codi.70328","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leticia Pérez-Santiago, Noelia Alonso Gracia, Julieta Puente-Monserrat, Luis Esteban Igual, Stephanie Anne García-Botello, Alejandro Espí Macías
{"title":"Dartos muscle flap for radiation-induced rectourethral fistula – A video vignette","authors":"Leticia Pérez-Santiago, Noelia Alonso Gracia, Julieta Puente-Monserrat, Luis Esteban Igual, Stephanie Anne García-Botello, Alejandro Espí Macías","doi":"10.1111/codi.70323","DOIUrl":"10.1111/codi.70323","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Colorectal Luminal pull-through trans-Anal StaPling (CLASP) in ultra-low anterior resection for lower third rectal cancer: A video vignette","authors":"Karthikeyan Parthasarathy, Syed Althaf, Srinivas Chunduri, Pavan Sugoor","doi":"10.1111/codi.70324","DOIUrl":"10.1111/codi.70324","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bernardo Fontel Pompeu, Giulia Luiza Garcia, Gabriel Leal Barone, Isabela Oliveira Rosa, Lucas Soares de Souza Pinto Guedes, Lucas Monteiro Delgado, Claudia Theis, Leonardo de Melo Del Grande, Sergio Mazzola Poli de Figueiredo, Fernanda Bellotti Formiga
Background
Excisional haemorrhoidectomy is often associated with intense post-operative pain and delayed recovery. Bacterial colonization may contribute to this discomfort, and metronidazole has been proposed as an analgesic adjunct. This study compared the analgesic efficacy of topical metronidazole with oral metronidazole.
Methods
A systematic search was conducted in PubMed, Scopus, and the Cochrane Central Register through May 2025. Randomized controlled trials comparing topical metronidazole with oral metronidazole for post-operative pain after haemorrhoidectomy were included. Visual analogue scale (VAS) scores on post-operative days 1, 3, and 7 were pooled. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was assessed with the I2 statistic. Risk of bias (RoB 2) and certainty of evidence (GRADE) were evaluated.
Results
Four RCTs involving 439 patients (218 topical, 221 oral) met inclusion criteria. No significant differences were found between topical and oral metronidazole at day 1 (MD –0.1; 95% CI –0.3 to 0.2; I2 = 25%), day 3 (MD –0.4; 95% CI –1.3 to 0.6; I2 = 94%), or day 7 (MD –0.2; 95% CI –1.0 to 0.5; I2 = 90%).
Conclusion
Topical and oral metronidazole showed similar short-term analgesic efficacy after haemorrhoidectomy.
背景：切除性痔疮切除术常伴有术后剧烈疼痛和延迟恢复。细菌定植可能导致这种不适，甲硝唑已被建议作为一种镇痛辅助药物。本研究比较了外用甲硝唑与口服甲硝唑的镇痛效果。方法：系统检索PubMed、Scopus和Cochrane Central Register，检索时间截止到2025年5月。包括比较局部甲硝唑和口服甲硝唑治疗痔疮切除术后疼痛的随机对照试验。将术后第1、3、7天的视觉模拟评分（VAS）进行汇总。使用随机效应模型计算95%置信区间（ci）的平均差异（md）。采用I2统计量评估异质性。评估偏倚风险（RoB 2）和证据确定性（GRADE）。结果：4项随机对照试验共纳入439例患者（218例局部，221例口服），符合纳入标准。在第1天（MD -0.1; 95% CI -0.3至0.2;I2 = 25%）、第3天（MD -0.4; 95% CI -1.3至0.6;I2 = 94%）或第7天（MD -0.2; 95% CI -1.0至0.5;I2 = 90%），局部和口服甲硝唑无显著差异。结论：甲硝唑与口服甲硝唑在痔疮切除术后具有相似的短期镇痛效果。
{"title":"Topical versus oral metronidazole for post-haemorrhoidectomy pain: A systematic review and meta-analysis of randomized controlled trials","authors":"Bernardo Fontel Pompeu, Giulia Luiza Garcia, Gabriel Leal Barone, Isabela Oliveira Rosa, Lucas Soares de Souza Pinto Guedes, Lucas Monteiro Delgado, Claudia Theis, Leonardo de Melo Del Grande, Sergio Mazzola Poli de Figueiredo, Fernanda Bellotti Formiga","doi":"10.1111/codi.70321","DOIUrl":"10.1111/codi.70321","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Excisional haemorrhoidectomy is often associated with intense post-operative pain and delayed recovery. Bacterial colonization may contribute to this discomfort, and metronidazole has been proposed as an analgesic adjunct. This study compared the analgesic efficacy of topical metronidazole with oral metronidazole.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was conducted in PubMed, Scopus, and the Cochrane Central Register through May 2025. Randomized controlled trials comparing topical metronidazole with oral metronidazole for post-operative pain after haemorrhoidectomy were included. Visual analogue scale (VAS) scores on post-operative days 1, 3, and 7 were pooled. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was assessed with the <i>I</i><sup>2</sup> statistic. Risk of bias (RoB 2) and certainty of evidence (GRADE) were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four RCTs involving 439 patients (218 topical, 221 oral) met inclusion criteria. No significant differences were found between topical and oral metronidazole at day 1 (MD –0.1; 95% CI –0.3 to 0.2; <i>I</i><sup>2</sup> = 25%), day 3 (MD –0.4; 95% CI –1.3 to 0.6; <i>I</i><sup>2</sup> = 94%), or day 7 (MD –0.2; 95% CI –1.0 to 0.5; <i>I</i><sup>2</sup> = 90%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Topical and oral metronidazole showed similar short-term analgesic efficacy after haemorrhoidectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145630856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. V. O'Connell, P. Jordan, J. Aird, N. O'Farrell, D. Cowzer, A. C. Rogers
Background
Signet ring colorectal cancer (SRC) is a rare histological subtype associated with young patients and worse outcomes. Its incidence is anticipated to increase with the rising rate of early-onset colorectal cancer. There is little literature on the benefit of adjuvant systemic therapy in this patient cohort.
Methods
A systematic review of the literature was undertaken to evaluate the response of SRC to adjuvant systemic therapy. The study was pre-registered in the PROSPERO database. The MEDLINE/PubMed, EMBASE, Scopus, Web of Science and CENTRAL databases were searched for pertinent articles. Articles published from inception to June 2025 were retrieved and assessed by two independent reviewers.
Results
Of the initial 31 studies retrieved, four were deemed eligible for inclusion, with a total number of 6900 patients. All were population-based retrospective cohort studies. All studies demonstrated a statistically significant survival benefit for adjuvant therapy in non-metastatic SRC.
Conclusions
Adjuvant systemic therapy has a beneficial impact on survival in Stage III SRC, and should be utilised in patients with adequate performance status. The benefit in Stage II remains unclear.
背景：印戒结肠直肠癌（SRC）是一种罕见的组织学亚型，与年轻患者和较差的预后相关。预计其发病率将随着早发性结直肠癌发病率的上升而增加。在该患者队列中，关于辅助全身治疗的益处的文献很少。方法系统回顾文献，评价SRC对辅助全身治疗的反应。该研究已在PROSPERO数据库中预先登记。在MEDLINE/PubMed、EMBASE、Scopus、Web of Science和CENTRAL数据库中检索相关文章。从成立到2025年6月发表的文章由两名独立审稿人检索和评估。在最初检索的31项研究中，有4项被认为符合纳入条件，总共有6900名患者。所有研究均为基于人群的回顾性队列研究。所有研究都表明，辅助治疗对非转移性SRC的生存有统计学意义。结论：辅助全身治疗对III期SRC患者的生存有有益的影响，应该在表现良好的患者中使用。第二阶段的益处尚不清楚。
{"title":"Benefit of adjuvant systemic chemotherapy in signet ring colorectal cancer: A systematic review","authors":"L. V. O'Connell, P. Jordan, J. Aird, N. O'Farrell, D. Cowzer, A. C. Rogers","doi":"10.1111/codi.70320","DOIUrl":"https://doi.org/10.1111/codi.70320","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Signet ring colorectal cancer (SRC) is a rare histological subtype associated with young patients and worse outcomes. Its incidence is anticipated to increase with the rising rate of early-onset colorectal cancer. There is little literature on the benefit of adjuvant systemic therapy in this patient cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review of the literature was undertaken to evaluate the response of SRC to adjuvant systemic therapy. The study was pre-registered in the PROSPERO database. The MEDLINE/PubMed, EMBASE, Scopus, Web of Science and CENTRAL databases were searched for pertinent articles. Articles published from inception to June 2025 were retrieved and assessed by two independent reviewers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the initial 31 studies retrieved, four were deemed eligible for inclusion, with a total number of 6900 patients. All were population-based retrospective cohort studies. All studies demonstrated a statistically significant survival benefit for adjuvant therapy in non-metastatic SRC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Adjuvant systemic therapy has a beneficial impact on survival in Stage III SRC, and should be utilised in patients with adequate performance status. The benefit in Stage II remains unclear.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
2022 European Society of Coloproctology (ESCP) CORREA Collaborating Group
Introduction
Benchmarking colorectal surgery outcomes informs quality improvement. The ESCP CORREA 2022 snapshot audit aimed to assess contemporary colorectal resection practices and short-term outcomes across European countries and beyond.
Methods
An international prospective multicentre audit was conducted in which adults undergoing elective or emergency colorectal resection during a 6-week period (January–April 2022) at participating hospitals were included. Data on patient demographics, indications, surgical approach (open, laparoscopic or robotic) and 30-day postoperative outcomes (complications, reoperation and mortality) were collected for analysis. The outcomes were analysed and compared with those of previous audits to identify trends in colorectal surgery.
Results
The study enrolled 3521 patients (56.8% men) from 216 hospitals across 53 countries. In 72.2% of the cases, the indication for resection was malignancy, followed by diverticular disease in 9.0%, Crohn's disease in 3.7% and ulcerative colitis in 2.3% of the cases. Of the surgeries, 74.4% were elective. Minimally invasive surgery was performed in 55.2% of the cases (48.7% laparoscopic and 6.5% robotic). Primary anastomosis was performed in 90.3% of the patients. The 30-day anastomotic leak rate was 7.96%; in malignant and benign diseases, the leak rates were 7.3% and 10.2%, respectively. The leak rates for right, left, anterior rectal resection, pouch and subtotal colectomy were 6.9%, 7.7%, 9.7%, 16.0% and 11.8%, respectively. In the multivariable analysis, the risk factors for leakage included male sex (9.3% vs. 6.3%, OR = 0.69, 95% CI 0.51–0.95, p = 0.023) and emergency surgery (11.4% vs. 7.1%, OR = 1.58, 95% CI 1.10–2.27, p = 0.013). Thirty-day mortality was 2.38%.
Conclusions
This large international audit provides the status of the management of colorectal surgery. This shows that minimally invasive techniques are widely adopted, and 30-day mortality is low; however, anastomotic leak rates remain persistently high. These findings highlight the ongoing need for targeted research and quality-improvement initiatives to reduce anastomotic failure and improve outcomes of colorectal surgery.
前言：对结直肠手术结果进行基准测试，有助于提高手术质量。ESCP CORREA 2022快照审计旨在评估欧洲及其他国家的当代结直肠癌切除实践和短期结果。方法：进行了一项国际前瞻性多中心审计，纳入了参与医院6周（2022年1月至4月）期间接受选择性或紧急结肠直肠切除术的成年人。收集患者人口统计学、适应症、手术方式（开放、腹腔镜或机器人）和术后30天结果（并发症、再手术和死亡率）的数据进行分析。对结果进行分析，并与以前的审计结果进行比较，以确定结直肠手术的趋势。结果：该研究纳入了来自53个国家216家医院的3521名患者（56.8%为男性）。72.2%的病例切除指征为恶性肿瘤，其次为憩室病（9.0%）、克罗恩病（3.7%）和溃疡性结肠炎（2.3%）。其中74.4%为选择性手术。55.2%的病例采用微创手术（48.7%为腹腔镜手术，6.5%为机器人手术）。90.3%的患者行一期吻合。30 d吻合口漏率为7.96%；在恶性和良性疾病中，泄漏率分别为7.3%和10.2%。右、左、直肠前切、袋和结肠次全切的漏率分别为6.9%、7.7%、9.7%、16.0%和11.8%。在多变量分析中，泄漏的危险因素包括男性（9.3% vs. 6.3%, OR = 0.69, 95% CI 0.51-0.95, p = 0.023）和急诊手术（11.4% vs. 7.1%, OR = 1.58, 95% CI 1.10-2.27, p = 0.013）。30天死亡率为2.38%。结论：这项大型国际审计提供了结直肠手术管理的现状。这表明微创技术被广泛采用，30天死亡率很低；然而，吻合口漏率仍然居高不下。这些发现强调了有针对性的研究和质量改进举措的持续需求，以减少吻合口衰竭和改善结直肠手术的结果。
{"title":"Towards safer colorectal surgery worldwide: Outcomes and benchmarks from the ESCP CORREA 2022 audit","authors":"2022 European Society of Coloproctology (ESCP) CORREA Collaborating Group","doi":"10.1111/codi.70281","DOIUrl":"10.1111/codi.70281","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Benchmarking colorectal surgery outcomes informs quality improvement. The ESCP CORREA 2022 snapshot audit aimed to assess contemporary colorectal resection practices and short-term outcomes across European countries and beyond.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An international prospective multicentre audit was conducted in which adults undergoing elective or emergency colorectal resection during a 6-week period (January–April 2022) at participating hospitals were included. Data on patient demographics, indications, surgical approach (open, laparoscopic or robotic) and 30-day postoperative outcomes (complications, reoperation and mortality) were collected for analysis. The outcomes were analysed and compared with those of previous audits to identify trends in colorectal surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study enrolled 3521 patients (56.8% men) from 216 hospitals across 53 countries. In 72.2% of the cases, the indication for resection was malignancy, followed by diverticular disease in 9.0%, Crohn's disease in 3.7% and ulcerative colitis in 2.3% of the cases. Of the surgeries, 74.4% were elective. Minimally invasive surgery was performed in 55.2% of the cases (48.7% laparoscopic and 6.5% robotic). Primary anastomosis was performed in 90.3% of the patients. The 30-day anastomotic leak rate was 7.96%; in malignant and benign diseases, the leak rates were 7.3% and 10.2%, respectively. The leak rates for right, left, anterior rectal resection, pouch and subtotal colectomy were 6.9%, 7.7%, 9.7%, 16.0% and 11.8%, respectively. In the multivariable analysis, the risk factors for leakage included male sex (9.3% vs. 6.3%, OR = 0.69, 95% CI 0.51–0.95, <i>p</i> = 0.023) and emergency surgery (11.4% vs. 7.1%, OR = 1.58, 95% CI 1.10–2.27, <i>p</i> = 0.013). Thirty-day mortality was 2.38%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This large international audit provides the status of the management of colorectal surgery. This shows that minimally invasive techniques are widely adopted, and 30-day mortality is low; however, anastomotic leak rates remain persistently high. These findings highlight the ongoing need for targeted research and quality-improvement initiatives to reduce anastomotic failure and improve outcomes of colorectal surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Laparoscopic total pelvic exenteration: A standardized approach – A video vignette","authors":"Karthikeyan Parthasarathy, Syed Althaf, Srinivas Chunduri, Pavan Sugoor","doi":"10.1111/codi.70319","DOIUrl":"10.1111/codi.70319","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145586087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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