Cristina Reguero Fernández, Omar Carreño-Sáenz, José Bueno Lledó, Providencia García Pastor, Santiago Bonafé Diana, Victoria Pareja Ibars, Salvador Pous Serrano
{"title":"Keyhole laparoscopic technique for parastomal hernia repair with prior optimization using botulinum toxin and pneumoperitoneum—A video vignette","authors":"Cristina Reguero Fernández, Omar Carreño-Sáenz, José Bueno Lledó, Providencia García Pastor, Santiago Bonafé Diana, Victoria Pareja Ibars, Salvador Pous Serrano","doi":"10.1111/codi.70354","DOIUrl":"10.1111/codi.70354","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145888159","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":"Post-operative sarcopenia kinetics as an emerging target for improved colorectal cancer outcomes","authors":"Xinyi Xiong, Qian Cao, Guang Yang","doi":"10.1111/codi.70337","DOIUrl":"10.1111/codi.70337","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862294","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}
Simona F, Jan B, Christine N, Wladyslawa C. ‘And don't say everything will be normal!’: An international cross-sectional survey on the patients’ unmet sexual wellbeing needs after ostomy formation. Colorectal Dis. 2025;27(10):1–10.
The author names in the original published version appeared with given names and surnames in inverse order. They were presented as:
Simona Fourie, Jan Bornschein, Christine Norton, Wladyslawa Czuber-Dochan
This has now been corrected.
We apologize for this error.
Simona F, Jan B, Christine N, Wladyslawa C.不要说一切都会恢复正常！：一项关于造口术后患者未满足的性健康需求的国际横断面调查。大肠癌杂志，2025;27(10):1-10。在最初出版的版本中，作者的名字和姓氏以相反的顺序出现。正确的作者名字应该是：Simona Fourie， Bornschein Jan, Norton Christine, Czuber-Dochan Wladyslawa。这已经被更正了。我们为这个错误道歉。
{"title":"Correction to ‘‘And don't say everything will be normal!’: An international cross-sectional survey on the patients' unmet sexual wellbeing needs after ostomy formation’. 2025:27(10):1–10","authors":"","doi":"10.1111/codi.70350","DOIUrl":"10.1111/codi.70350","url":null,"abstract":"<p>Simona F, Jan B, Christine N, Wladyslawa C. ‘And don't say everything will be normal!’: An international cross-sectional survey on the patients’ unmet sexual wellbeing needs after ostomy formation. <i>Colorectal Dis</i>. 2025;27(10):1–10.</p><p>The author names in the original published version appeared with given names and surnames in inverse order. They were presented as:</p><p>Fourie Simona, Bornschein Jan, Norton Christine, Czuber-Dochan Wladyslawa</p><p>The correct author names should read:</p><p>Simona Fourie, Jan Bornschein, Christine Norton, Wladyslawa Czuber-Dochan</p><p>This has now been corrected.</p><p>We apologize for this error.</p>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70350","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145854630","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}
Charles T. West, Yousif Salem, Siddharth Jain, Lewis Matthews, Julian Smith, Marios Nicolaou, Hideaki Yano, Malcolm A. West, Alex H. Mirnezami
Aim
Pelvic exenteration (PE) is the only curative option for extensive pelvic cancers. Advances have facilitated increasingly complex resectional and reconstructive components, including per-operative oncological adjuncts such as intraoperative radiotherapy. Cumulatively, these components increase operative duration beyond what is feasible within a single conventional operating day. Two-day/two-stage PE addresses this, but little is known about this approach. This study aims to evaluate the feasibility, safety and medium-term outcomes of a two-day/two-stage PE.
Method
Consecutive patients (2010–2025) from a prospectively maintained high-volume PE unit database (n = 373) undergoing two-day/two-stage PE were compared against a matched control cohort of single-day cases lasting ≥15 h. EQ5D-5L and decision regret scores were longitudinally collected after 2021. Surgical, oncological and health-related quality-of-life outcomes were evaluated.
Results
Twenty-seven patients underwent two-day/two-stage PE, and 38 had one-day PE; more anal cancers were in the two-day/two-stage group (p = 0.012); median follow-up was 24.2 months. No 90-day mortalities occurred; 3-year overall survival was 54.4% for two-day/two-stage PE and 70.5% for one-day PE (p = 0.31); and R0-resection rates were 82% and 76%, respectively (p = 0.76). Major morbidity occurred in 56% and 47% (p = 0.62), with a median length of stay of 37 and 27 days (p = 0.07) and intensive care days of 5 and 3 (p = 0.08). 12-month EQ5D-5L utility scores were 0.79 and 0.81 (p = 0.96), with low 12-month decision regret in both groups (p = 0.15).
Conclusion
Two-day/two-stage PE is safe and feasible, potentially representing the only option for highly selected patients needing high-complexity PE with multiple components. Although equivalent R0-resections were obtained, medium-term oncological outcomes were poorer in patients undergoing two-day/two-stage interventions.
{"title":"Prospective case-control cohort analysis of two-day/two-stage pelvic exenteration surgery: Safety, feasibility, acceptability and medium-term outcomes","authors":"Charles T. West, Yousif Salem, Siddharth Jain, Lewis Matthews, Julian Smith, Marios Nicolaou, Hideaki Yano, Malcolm A. West, Alex H. Mirnezami","doi":"10.1111/codi.70353","DOIUrl":"10.1111/codi.70353","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Pelvic exenteration (PE) is the only curative option for extensive pelvic cancers. Advances have facilitated increasingly complex resectional and reconstructive components, including per-operative oncological adjuncts such as intraoperative radiotherapy. Cumulatively, these components increase operative duration beyond what is feasible within a single conventional operating day. Two-day/two-stage PE addresses this, but little is known about this approach. This study aims to evaluate the feasibility, safety and medium-term outcomes of a two-day/two-stage PE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Consecutive patients (2010–2025) from a prospectively maintained high-volume PE unit database (<i>n</i> = 373) undergoing two-day/two-stage PE were compared against a matched control cohort of single-day cases lasting ≥15 h. EQ5D-5L and decision regret scores were longitudinally collected after 2021. Surgical, oncological and health-related quality-of-life outcomes were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-seven patients underwent two-day/two-stage PE, and 38 had one-day PE; more anal cancers were in the two-day/two-stage group (<i>p</i> = 0.012); median follow-up was 24.2 months. No 90-day mortalities occurred; 3-year overall survival was 54.4% for two-day/two-stage PE and 70.5% for one-day PE (<i>p</i> = 0.31); and R0-resection rates were 82% and 76%, respectively (<i>p</i> = 0.76). Major morbidity occurred in 56% and 47% (<i>p</i> = 0.62), with a median length of stay of 37 and 27 days (<i>p</i> = 0.07) and intensive care days of 5 and 3 (<i>p</i> = 0.08). 12-month EQ5D-5L utility scores were 0.79 and 0.81 (<i>p</i> = 0.96), with low 12-month decision regret in both groups (<i>p</i> = 0.15).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Two-day/two-stage PE is safe and feasible, potentially representing the only option for highly selected patients needing high-complexity PE with multiple components. Although equivalent R0-resections were obtained, medium-term oncological outcomes were poorer in patients undergoing two-day/two-stage interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12748039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145854582","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":"Ileoanal pouch surgery in 2026","authors":"Guy Worley","doi":"10.1111/codi.70352","DOIUrl":"10.1111/codi.70352","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145849104","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}
Lucas Monteiro Delgado, Gabriel Leal Barone, Giulia Luiza Garcia, Henrique Vaz da Mota, Giovanna Barbaroto Pilon, Lucas Soares de Souza Pinto Guedes, Sérgio Mazzola Poli de Figueiredo, Bernardo Fontel Pompeu, Fernanda Bellotti Formiga
Background
Extended left hemicolectomies may result in a short transverse colon and excessive mesenteric tension, precluding a tension-free anastomosis. The Deloyers procedure is a colonic rotation technique that facilitates anastomosis without total colectomy. This study aimed to evaluate short-term outcomes following the Deloyers procedure in patients undergoing left-sided colorectal resections.
Methods
A systematic review and meta-analysis were conducted using PubMed, Scopus and the Cochrane Central Register to identify observational studies published up to March 2025. Continuous outcomes were pooled as means with 95% confidence intervals (CIs) and binary outcomes as proportions. Heterogeneity was assessed using the I2 statistic and Cochrane Q-test. All analyses were performed using R (v4.4.1).
Results
Thirteen studies including 287 patients undergoing the Deloyers procedure were analysed. The pooled mean operating time was 256.7 min (95% CI, 188.5–349.6), intraoperative blood loss was 327.5 mL (95% CI, 227.9–470.6) and the perioperative transfusion rate was 25% (95% CI, 16%–35%). Postoperative recovery outcomes included a mean hospital stay of 9.9 days (95% CI, 7.6–12.9), an ileus rate of 15% (95% CI, 7%–30%) and an average of 2.9 bowel movements per day (95% CI, 2.4–3.5). Reported complications included Clavien–Dindo grade I–II events in 36% of patients (95% CI, 14%–66%) and grade III–IV events in 12% (95% CI, 5%–24%). The pooled rate of surgical site infection was 13% (95% CI, 4%–34%), small bowel obstruction 6% (95% CI, 0%–35%) and anastomotic leakage 1% (95% CI, 0%–7%). The overall mortality rate was 0% (95% CI, 0%–1%), with two deaths reported in patients with significant comorbidities and advanced oncological disease.
Conclusion
The Deloyers procedure is a feasible surgical alternative in patients requiring extended left-sided colectomy, providing acceptable operative times, functional recovery and complication rates. It may help avoid total colectomy in anatomically complex cases.
{"title":"Outcomes of the Deloyers procedure: A systematic review and meta-analysis of proportions","authors":"Lucas Monteiro Delgado, Gabriel Leal Barone, Giulia Luiza Garcia, Henrique Vaz da Mota, Giovanna Barbaroto Pilon, Lucas Soares de Souza Pinto Guedes, Sérgio Mazzola Poli de Figueiredo, Bernardo Fontel Pompeu, Fernanda Bellotti Formiga","doi":"10.1111/codi.70346","DOIUrl":"10.1111/codi.70346","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Extended left hemicolectomies may result in a short transverse colon and excessive mesenteric tension, precluding a tension-free anastomosis. The Deloyers procedure is a colonic rotation technique that facilitates anastomosis without total colectomy. This study aimed to evaluate short-term outcomes following the Deloyers procedure in patients undergoing left-sided colorectal resections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis were conducted using PubMed, Scopus and the Cochrane Central Register to identify observational studies published up to March 2025. Continuous outcomes were pooled as means with 95% confidence intervals (CIs) and binary outcomes as proportions. Heterogeneity was assessed using the <i>I</i><sup>2</sup> statistic and Cochrane <i>Q</i>-test. All analyses were performed using R (v4.4.1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirteen studies including 287 patients undergoing the Deloyers procedure were analysed. The pooled mean operating time was 256.7 min (95% CI, 188.5–349.6), intraoperative blood loss was 327.5 mL (95% CI, 227.9–470.6) and the perioperative transfusion rate was 25% (95% CI, 16%–35%). Postoperative recovery outcomes included a mean hospital stay of 9.9 days (95% CI, 7.6–12.9), an ileus rate of 15% (95% CI, 7%–30%) and an average of 2.9 bowel movements per day (95% CI, 2.4–3.5). Reported complications included Clavien–Dindo grade I–II events in 36% of patients (95% CI, 14%–66%) and grade III–IV events in 12% (95% CI, 5%–24%). The pooled rate of surgical site infection was 13% (95% CI, 4%–34%), small bowel obstruction 6% (95% CI, 0%–35%) and anastomotic leakage 1% (95% CI, 0%–7%). The overall mortality rate was 0% (95% CI, 0%–1%), with two deaths reported in patients with significant comorbidities and advanced oncological disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Deloyers procedure is a feasible surgical alternative in patients requiring extended left-sided colectomy, providing acceptable operative times, functional recovery and complication rates. It may help avoid total colectomy in anatomically complex cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12722197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809958","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":"Robotic management of a diverticular sigmoido-vesical fistula using ureteric ICG guidance and total intracorporeal anastomosis – A video vignette","authors":"Giulia Staccini, Dimitrios Christoforidis, Sotirios Georgios Popeskou","doi":"10.1111/codi.70345","DOIUrl":"10.1111/codi.70345","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809953","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}
Michael Okocha, Carlotta La Raja, Stella Nikolaou, Hannah Cuthbert, Ahmad Nasasra, Carolynne J. Vaizey, Gregory P. Thomas
Introduction
Faecal incontinence (FI) remains a debilitating condition with considerable psychosocial burden. Rechargeable sacral neuromodulation (rSNM) systems offer extended battery longevity and MRI compatibility, potentially reducing surgical burden. However, real-world data on their efficacy, safety and acceptability remain limited.
Method
This single-centre observational cohort study evaluated 37 patients who received rSNM (InterStim™ Micro) for FI between August 2020 and August 2022. Patients completed validated questionnaires (St Mark's FI Score, Rockwood FIQOL, SF-36) and a structured telephone interview assessing functional outcomes, adverse events and device satisfaction. Clinical records were reviewed for surgical and 3- to 5-year follow-up data.
Results
Median age was 63 years; 61% had a history of obstetric injury. Twenty-eight patients received rSNM as a replacement for non-rechargeable systems. Device satisfaction was low: 62% expressed regret and 96% reported challenges with charging. Connectivity issues affected 86% of patients. Six patients underwent device explantation and two required lead revision. Rockwood FIQOL and SF-36 scores indicated persistent impairment in lifestyle, emotional well-being and social functioning. Improvements in continence scores were modest and below expectations.
Conclusion
Despite theoretical advantages, rSNM provided limited clinical benefit in this cohort. High rates of dissatisfaction, management difficulties and surgical revisions raise concerns about its broader applicability. While the smaller device may suit select patients, non-rechargeable systems with extended battery life may represent a more acceptable first-line option. Further studies are needed to better define the role of rSNM in FI management.
{"title":"Outcomes of rechargeable sacral neuromodulation for faecal incontinence: A single-centre observational study","authors":"Michael Okocha, Carlotta La Raja, Stella Nikolaou, Hannah Cuthbert, Ahmad Nasasra, Carolynne J. Vaizey, Gregory P. Thomas","doi":"10.1111/codi.70344","DOIUrl":"10.1111/codi.70344","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Faecal incontinence (FI) remains a debilitating condition with considerable psychosocial burden. Rechargeable sacral neuromodulation (rSNM) systems offer extended battery longevity and MRI compatibility, potentially reducing surgical burden. However, real-world data on their efficacy, safety and acceptability remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This single-centre observational cohort study evaluated 37 patients who received rSNM (InterStim™ Micro) for FI between August 2020 and August 2022. Patients completed validated questionnaires (St Mark's FI Score, Rockwood FIQOL, SF-36) and a structured telephone interview assessing functional outcomes, adverse events and device satisfaction. Clinical records were reviewed for surgical and 3- to 5-year follow-up data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median age was 63 years; 61% had a history of obstetric injury. Twenty-eight patients received rSNM as a replacement for non-rechargeable systems. Device satisfaction was low: 62% expressed regret and 96% reported challenges with charging. Connectivity issues affected 86% of patients. Six patients underwent device explantation and two required lead revision. Rockwood FIQOL and SF-36 scores indicated persistent impairment in lifestyle, emotional well-being and social functioning. Improvements in continence scores were modest and below expectations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite theoretical advantages, rSNM provided limited clinical benefit in this cohort. High rates of dissatisfaction, management difficulties and surgical revisions raise concerns about its broader applicability. While the smaller device may suit select patients, non-rechargeable systems with extended battery life may represent a more acceptable first-line option. Further studies are needed to better define the role of rSNM in FI management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12719927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145803265","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}
Charlotte El-Sayed, Zoe Garoufalia, Joshua Richard Burke
{"title":"The hidden cost of innovation: Are we neglecting surgical training in the robotic era?","authors":"Charlotte El-Sayed, Zoe Garoufalia, Joshua Richard Burke","doi":"10.1111/codi.70348","DOIUrl":"10.1111/codi.70348","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793500","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}
Ruth Walsh, Caitlin Fanning, Paolo Meneghesso, Emmet J. Andrews, Ben Creavin, Micahel Devine, Michael Flanagan, Niamh M. Foley, Patrick Jordan, Niall Kennedy, M. Faraz Khan, Jurgen Mulsow, Lauren V. O'Connell, Edward Tobias Pring, Éanna J. Ryan, Des P. Toomey, Ronan A. Cahill
Aim
Anastomotic leak (AL) following rectal cancer resection is a devastating complication. This study describes Irish colorectal surgeons' approaches towards AL prevention, diagnosis and management and their emotional response to its occurrence.
Methods
A qualitative study was conducted using semi-structured interviews with senior colorectal trainees, fellows and consultants in Irish rectal cancer centres. Descriptive statistics summarised clinical approaches and thematic analysis (using NVivo software) explored emotional responses.
Results
Fifteen colorectal surgeons (13 male) from six Irish rectal cancer centres participated. Anastomotic height, tension and perfusion were rated the most important risk factors for AL. All surgeons routinely bowel-prepped patients though regimes varied significantly. Only 33.3% of surgeons routinely place intraoperative drains. 100% conduct routine air leak tests whereas 40.0% routinely use ICG perfusion testing. For AL management, only 6.7% use a fixed protocol approach with the majority individualising their decisions on clinical status, defunctioning stoma presence and defect size. Thematic analysis regarding emotional impact identified (1) profound psychological impact (especially among consultants) including guilt and self-blame following AL modulated by professional experience; (2) impact on professional confidence including doubt in surgical judgement and changed decision-making following a case of AL and (3) reliance on peers and mentors for emotional support and recognition of the multifactorial nature of AL as a coping mechanism.
Conclusion
There is notable variability in surgeons' approach to AL following rectal cancer resection with a general instinctive emotional response of ‘disappointment’ both for the patient and in themselves when AL occurs.
{"title":"Colorectal surgeons' perspectives and emotional responses to anastomotic leakage following rectal cancer resection","authors":"Ruth Walsh, Caitlin Fanning, Paolo Meneghesso, Emmet J. Andrews, Ben Creavin, Micahel Devine, Michael Flanagan, Niamh M. Foley, Patrick Jordan, Niall Kennedy, M. Faraz Khan, Jurgen Mulsow, Lauren V. O'Connell, Edward Tobias Pring, Éanna J. Ryan, Des P. Toomey, Ronan A. Cahill","doi":"10.1111/codi.70338","DOIUrl":"10.1111/codi.70338","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Anastomotic leak (AL) following rectal cancer resection is a devastating complication. This study describes Irish colorectal surgeons' approaches towards AL prevention, diagnosis and management and their emotional response to its occurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative study was conducted using semi-structured interviews with senior colorectal trainees, fellows and consultants in Irish rectal cancer centres. Descriptive statistics summarised clinical approaches and thematic analysis (using NVivo software) explored emotional responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen colorectal surgeons (13 male) from six Irish rectal cancer centres participated. Anastomotic height, tension and perfusion were rated the most important risk factors for AL. All surgeons routinely bowel-prepped patients though regimes varied significantly. Only 33.3% of surgeons routinely place intraoperative drains. 100% conduct routine air leak tests whereas 40.0% routinely use ICG perfusion testing. For AL management, only 6.7% use a fixed protocol approach with the majority individualising their decisions on clinical status, defunctioning stoma presence and defect size. Thematic analysis regarding emotional impact identified (1) profound psychological impact (especially among consultants) including guilt and self-blame following AL modulated by professional experience; (2) impact on professional confidence including doubt in surgical judgement and changed decision-making following a case of AL and (3) reliance on peers and mentors for emotional support and recognition of the multifactorial nature of AL as a coping mechanism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is notable variability in surgeons' approach to AL following rectal cancer resection with a general instinctive emotional response of ‘disappointment’ both for the patient and in themselves when AL occurs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145773803","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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