Semra Demirli Atici, Aras Emre Canda, Mustafa Cem Terzi
{"title":"Laparoscopic left hemicolectomy using NICE (natural orifice intracorporeal single-stapled anastomosis and transrectal extraction) technique in an obese patient: A video vignette","authors":"Semra Demirli Atici, Aras Emre Canda, Mustafa Cem Terzi","doi":"10.1111/codi.70299","DOIUrl":"10.1111/codi.70299","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457870","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}
Jaro Van Zande, Natalie Poortmans, Sarah Violon, Magali Surmont, Ellen Van Eetvelde, Jasper Stijns
{"title":"Robotic subtotal colectomy with vertical reduction rectoplasty for refractory chronic constipation: A video vignette","authors":"Jaro Van Zande, Natalie Poortmans, Sarah Violon, Magali Surmont, Ellen Van Eetvelde, Jasper Stijns","doi":"10.1111/codi.70294","DOIUrl":"10.1111/codi.70294","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451223","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":"Rectovaginal fistula repair: Gracilis flap is not a one-size-fits-all solution","authors":"Vipul D. Yagnik, Pankaj Garg","doi":"10.1111/codi.70303","DOIUrl":"10.1111/codi.70303","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451193","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}
Matthew Kurien, Mohamed El-Siddig, Daniel James Taylor, Ulla Elfadil, Alex John Ball
Aim
To evaluate long-term colorectal cancer (CRC) incidence and faecal immunochemical test (FIT) performance in patients with low-risk symptoms over 5 years, and to examine factors influencing outcomes and mortality.
Method
We followed 3501 symptomatic patients who underwent FIT in primary care (October–December 2019) across 225 practices in England. Building on our 18-month study, patients were tracked for 5 years using primary and secondary care records to identify new cancers and deaths.
Results
Ten additional CRCs were diagnosed during extended follow-up (18–60 months), beyond the 45 identified in the first 18 months. Seven of these had initial negative FIT results. FIT sensitivity at ≥10 μg/g fell from 94.1% at 18 months to 80.0% (95% CI 67.0–89.6%) at 5 years, while specificity was 80.8% (95% CI 79.4–82.1%). The positive predictive value was 6.2% (95% CI 5.4–7.2%) and the negative predictive value 99.6% (95% CI 99.3–99.8%). Patients with negative FITs experienced a significantly longer time to CRC diagnosis than those with positive FITs (median 28 vs 1 month, HR 16.4, p < 0.001). Positive FITs were also linked to higher overall cancer risk (HR 1.63, p = 0.0076) and greater 5-year mortality (24.9% vs 11.9%, HR 2.8, p < 0.001).
Conclusion
FIT performance decreases over longer follow-up, with 12.7% of CRCs detected after initially negative results. Positive FITs were associated with increased mortality and overall cancer risk. These findings highlight the importance of robust safety-netting strategies for patients with negative FIT results.
目的：评价低危症状患者5年以上结肠直肠癌（CRC）的长期发病率和粪便免疫化学试验（FIT）表现，并探讨影响预后和死亡率的因素。方法：我们对3501名在英国225家诊所接受FIT的有症状患者（2019年10月至12月）进行了随访。在我们为期18个月的研究基础上，使用初级和二级医疗记录对患者进行了5年的跟踪，以确定新的癌症和死亡病例。结果：在延长随访（18-60个月）期间，除前18个月发现的45例外，又诊断出10例CRCs。其中7人最初的FIT结果为阴性。≥10 μg/g的FIT敏感性从18个月时的94.1%下降到5年时的80.0% (95% CI 67.0 ~ 89.6%)，特异性为80.8% （95% CI 79.4 ~ 82.1%）。阳性预测值为6.2% (95% CI为5.4 ~ 7.2%)，阴性预测值为99.6% （95% CI为99.3 ~ 99.8%）。FIT阴性的患者比FIT阳性的患者到CRC诊断的时间明显更长（中位28 vs 1个月，HR 16.4, p）。结论：随着随访时间的延长，FIT的表现会下降，在最初的阴性结果后发现了12.7%的CRC。fit阳性与死亡率和总体癌症风险增加有关。这些发现强调了强有力的安全网策略对FIT阴性患者的重要性。
{"title":"Faecal immunochemical test demonstrates modest decline in performance characteristics but additional prognostic roles: An evaluation in a symptomatic primary care cohort","authors":"Matthew Kurien, Mohamed El-Siddig, Daniel James Taylor, Ulla Elfadil, Alex John Ball","doi":"10.1111/codi.70297","DOIUrl":"10.1111/codi.70297","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate long-term colorectal cancer (CRC) incidence and faecal immunochemical test (FIT) performance in patients with low-risk symptoms over 5 years, and to examine factors influencing outcomes and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We followed 3501 symptomatic patients who underwent FIT in primary care (October–December 2019) across 225 practices in England. Building on our 18-month study, patients were tracked for 5 years using primary and secondary care records to identify new cancers and deaths.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten additional CRCs were diagnosed during extended follow-up (18–60 months), beyond the 45 identified in the first 18 months. Seven of these had initial negative FIT results. FIT sensitivity at ≥10 μg/g fell from 94.1% at 18 months to 80.0% (95% CI 67.0–89.6%) at 5 years, while specificity was 80.8% (95% CI 79.4–82.1%). The positive predictive value was 6.2% (95% CI 5.4–7.2%) and the negative predictive value 99.6% (95% CI 99.3–99.8%). Patients with negative FITs experienced a significantly longer time to CRC diagnosis than those with positive FITs (median 28 vs 1 month, HR 16.4, <i>p</i> < 0.001). Positive FITs were also linked to higher overall cancer risk (HR 1.63, <i>p</i> = 0.0076) and greater 5-year mortality (24.9% vs 11.9%, HR 2.8, <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>FIT performance decreases over longer follow-up, with 12.7% of CRCs detected after initially negative results. Positive FITs were associated with increased mortality and overall cancer risk. These findings highlight the importance of robust safety-netting strategies for patients with negative FIT results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451203","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":"Comment on ‘A phase III randomized trial evaluating the quality of life impact of a tailored versus systematic use of defunctioning ileostomy following total mesorectal excision for rectal cancer—GRECCAR 17 trial protocol’","authors":"Nikita N. Burlov","doi":"10.1111/codi.70300","DOIUrl":"10.1111/codi.70300","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437597","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}
Paul F. Vollebregt, Coen I. M. Baeten, Asbjørn M. Drewes, Franco Marinello, Jacopo Martelluci, Mira Mekhael, Karen Nugent, Andreas D. Rink, Harald Rosen, S. Mark Scott, Peter Ernst Slattenschek, Frank Zerbib, Peter Christensen, The ADVISABLE Working Group
Aim
The aims of the study were to: (1) update a systematic review on the efficacy of transanal irrigation (TAI) in patients with chronic constipation (CC) and/or faecal incontinence (FI); (2) provide guidance on the position of TAI in the treatment pathway of CC and FI; and (3) discuss knowledge gaps and areas of future research.
Method
A collaborative of 11 experts (gastroenterologists, colorectal surgeons, and clinical scientists) from eight European countries was established. The expert group was divided into three main groups, with each group leading a specific section (systematic review, treatment pathway, and knowledge gaps). A previously published systematic review on TAI was updated by conducting an additional search on 12 April 2025. Studies on TAI in specific subgroups (neurogenic bowel dysfunction, low anterior resection syndrome) were excluded.
Results
Sixteen studies involving 1567 (range 16–507) patients were included. Only one underpowered randomised trial was performed, which demonstrated that high-volume TAI may be more effective than low-volume TAI in patients with CC. Most other studies (observational) showed improvement in symptoms and/or quality of life to some extent, with a large variation in outcomes used. Treatment discontinuation was reported in 3–57% of patients. The position of TAI in the treatment pathway of CC and FI was proposed, and 13 knowledge gaps were provided.
Conclusion
TAI may be an effective treatment in patients with CC and/or FI. There is a need for randomised controlled trials to study its efficacy and current knowledge gaps.
{"title":"Transanal irrigation: Bridging the gap in treatment for chronic constipation and/or faecal incontinence—A systematic review and management guidance","authors":"Paul F. Vollebregt, Coen I. M. Baeten, Asbjørn M. Drewes, Franco Marinello, Jacopo Martelluci, Mira Mekhael, Karen Nugent, Andreas D. Rink, Harald Rosen, S. Mark Scott, Peter Ernst Slattenschek, Frank Zerbib, Peter Christensen, The ADVISABLE Working Group","doi":"10.1111/codi.70274","DOIUrl":"https://doi.org/10.1111/codi.70274","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aims of the study were to: (1) update a systematic review on the efficacy of transanal irrigation (TAI) in patients with chronic constipation (CC) and/or faecal incontinence (FI); (2) provide guidance on the position of TAI in the treatment pathway of CC and FI; and (3) discuss knowledge gaps and areas of future research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A collaborative of 11 experts (gastroenterologists, colorectal surgeons, and clinical scientists) from eight European countries was established. The expert group was divided into three main groups, with each group leading a specific section (systematic review, treatment pathway, and knowledge gaps). A previously published systematic review on TAI was updated by conducting an additional search on 12 April 2025. Studies on TAI in specific subgroups (neurogenic bowel dysfunction, low anterior resection syndrome) were excluded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixteen studies involving 1567 (range 16–507) patients were included. Only one underpowered randomised trial was performed, which demonstrated that high-volume TAI may be more effective than low-volume TAI in patients with CC. Most other studies (observational) showed improvement in symptoms and/or quality of life to some extent, with a large variation in outcomes used. Treatment discontinuation was reported in 3–57% of patients. The position of TAI in the treatment pathway of CC and FI was proposed, and 13 knowledge gaps were provided.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TAI may be an effective treatment in patients with CC and/or FI. There is a need for randomised controlled trials to study its efficacy and current knowledge gaps.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70274","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407296","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":"Comment on: Long-term perineal wound healing after proctectomy in IBD—Further considerations for patient factors and surgical technique","authors":"Dongmei Luo, Shihang Bao","doi":"10.1111/codi.70293","DOIUrl":"10.1111/codi.70293","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145399939","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}
H. L. Gros, S. Taha-Mehlitz, S. Erdem, M. Worni, M. Henschel, A.-K. Huber, J.-M. Gass, A. Müller, C. T. Viehl, R. Galli, D. Rodjakovic, T. Simon, S. Happ, S. Teixeira da Cunha, L. Eisner, D. Steinemann, B. Müller-Stich, M. von Strauss und Torney, J. M. Klasen
Aim
Early-onset colorectal cancer (EOCC), defined as colorectal cancer (CRC) diagnosed in patients under the age of 50, has increased alarmingly in Western countries in recent decades. Although risk factors, diagnostics and treatment approaches have been studied, the subjective experiences of EOCC patients remain underexplored. This study aimed to identify patient-perceived challenges and their unmet needs in Switzerland, a country with a high-resource healthcare system with minimal waiting times for investigations and comprehensive healthcare coverage.
Method
Nineteen semi-structured interviews were conducted between 09/2023 and 06/2024 with EOCC patients following a constructivist grounded theory approach.
Results
Participants from all cancer stages and aged between 30 and 50 years were recruited. We developed three main themes from the collected data: diagnostic delay, coping mechanisms and stigmatisation. Despite access to a well-resourced healthcare system, study participants experienced diagnostic delays, indicating the need for increased physician awareness and improved risk-based screening for high-risk individuals. Participants' key coping strategies included self-advocacy and participating in medical decision-making, like prioritising fertility preservation over rushed treatment. Participants reported fear of stigmatisation and isolation after being diagnosed. Such stigma manifested in concerns over alopecia or living with an ostomy. Finally, participants experienced an internal shift in personal priorities resulting in post-traumatic growth despite cancer diagnosis
Conclusions
EOCC challenges current clinical practices. Better physician awareness, risk-factor-based screening policies, integrated discussions about individual treatment such as potential fertility issues and targeting stigma are critical for improving the EOCC patients' journey.
{"title":"Listening to patients: A qualitative study on diagnostic delay, coping strategies and stigma in early-onset colorectal cancer","authors":"H. L. Gros, S. Taha-Mehlitz, S. Erdem, M. Worni, M. Henschel, A.-K. Huber, J.-M. Gass, A. Müller, C. T. Viehl, R. Galli, D. Rodjakovic, T. Simon, S. Happ, S. Teixeira da Cunha, L. Eisner, D. Steinemann, B. Müller-Stich, M. von Strauss und Torney, J. M. Klasen","doi":"10.1111/codi.70285","DOIUrl":"https://doi.org/10.1111/codi.70285","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Early-onset colorectal cancer (EOCC), defined as colorectal cancer (CRC) diagnosed in patients under the age of 50, has increased alarmingly in Western countries in recent decades. Although risk factors, diagnostics and treatment approaches have been studied, the subjective experiences of EOCC patients remain underexplored. This study aimed to identify patient-perceived challenges and their unmet needs in Switzerland, a country with a high-resource healthcare system with minimal waiting times for investigations and comprehensive healthcare coverage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Nineteen semi-structured interviews were conducted between 09/2023 and 06/2024 with EOCC patients following a constructivist grounded theory approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants from all cancer stages and aged between 30 and 50 years were recruited. We developed three main themes from the collected data: diagnostic delay, coping mechanisms and stigmatisation. Despite access to a well-resourced healthcare system, study participants experienced diagnostic delays, indicating the need for increased physician awareness and improved risk-based screening for high-risk individuals. Participants' key coping strategies included self-advocacy and participating in medical decision-making, like prioritising fertility preservation over rushed treatment. Participants reported fear of stigmatisation and isolation after being diagnosed. Such stigma manifested in concerns over alopecia or living with an ostomy. Finally, participants experienced an internal shift in personal priorities resulting in post-traumatic growth despite cancer diagnosis</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EOCC challenges current clinical practices. Better physician awareness, risk-factor-based screening policies, integrated discussions about individual treatment such as potential fertility issues and targeting stigma are critical for improving the EOCC patients' journey.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70285","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145371836","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}
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