Pub Date : 2026-02-01Epub Date: 2025-11-11DOI: 10.1097/DCR.0000000000004014
Alexander R P K M van Renterghem, Adrianus M van der Holst, Sander van Kuijk, Eric H J Belgers, Marielle Romberg-Camps, Marieke Pierik, Laurents P S Stassen
<p><strong>Background: </strong>Crohn's disease causes chronic intestinal inflammation, often requiring surgery. Postoperative recurrence is common, especially at the anastomosis, with varying recurrence rates.</p><p><strong>Objective: </strong>Identifying risk factors for recurrence is crucial for optimizing treatment. This study aims to assess traditional and novel risk factors, including histological factors, for recurrence in patients undergoing ileocolic resection in a deeply phenotyped regional cohort.</p><p><strong>Design: </strong>A retrospective, multicenter cohort study.</p><p><strong>Settings: </strong>Two large referral medical centers in South Limburg, The Netherlands, with access to integrated electronic health records and scanned historical records. Data on demographics, Crohn's disease characteristics, and perioperative findings were collected, and factors influencing recurrence were analyzed.</p><p><strong>Patients: </strong>A total of 289 consecutive patients aged 16 years or older undergoing ileocolic resection between January 2003 and December 2017 with a confirmed diagnosis of Crohn's disease according to European Crohn's and Colitis Organisation criteria. Patients were followed for a mean of 7.02 years.</p><p><strong>Intervention: </strong>No experimental interventions were administered. Surgical treatment consisted of standard ileocolic resection performed either open or laparoscopically.</p><p><strong>Main outcome measures: </strong>The primary outcome was postoperative recurrence, defined as clinical, biochemical, endoscopic, or surgical recurrence. Cox proportional hazards models were used to identify independent predictors.</p><p><strong>Results: </strong>Over a mean follow-up of 7.02 years, 189 (65.4%) developed recurrence. Multivariable analysis identified smoking and pathologic margin involvement as significant risk factors for clinical recurrence. Montreal or B3 classification and open surgery were protective. Surgical recurrence was lower in patients undergoing open surgery.</p><p><strong>Limitations: </strong>The retrospective design may introduce selection and information bias. Surveillance and prophylactic therapy were not standardized.</p><p><strong>Conclusions: </strong>This study reinforces the role of smoking, disease behavior, resection margin involvement, and perianal disease as key risk factors for recurrence after ileocolic resection. Harmonizing definitions, data collection, and treatment protocols through international collaboration is essential for advancing clinical management and facilitating large-scale prospective studies. See Video Abstract .</p><p><strong>Recurrencia tras reseccin ileoclica por enfermedad de crohn nuevos avances en la bsqueda de factores de riesgo: </strong>ANTECEDENTES:La enfermedad de Crohn causa inflamación intestinal crónica, que a menudo requiere cirugía. La recurrencia posoperatoria es frecuente, especialmente en la anastomosis, con tasas de recurrencia variables.OBJETIVO:
{"title":"Recurrence After Ileocolic Resection for Crohn's Disease: Further Unraveling the Search for Risk Factors.","authors":"Alexander R P K M van Renterghem, Adrianus M van der Holst, Sander van Kuijk, Eric H J Belgers, Marielle Romberg-Camps, Marieke Pierik, Laurents P S Stassen","doi":"10.1097/DCR.0000000000004014","DOIUrl":"10.1097/DCR.0000000000004014","url":null,"abstract":"<p><strong>Background: </strong>Crohn's disease causes chronic intestinal inflammation, often requiring surgery. Postoperative recurrence is common, especially at the anastomosis, with varying recurrence rates.</p><p><strong>Objective: </strong>Identifying risk factors for recurrence is crucial for optimizing treatment. This study aims to assess traditional and novel risk factors, including histological factors, for recurrence in patients undergoing ileocolic resection in a deeply phenotyped regional cohort.</p><p><strong>Design: </strong>A retrospective, multicenter cohort study.</p><p><strong>Settings: </strong>Two large referral medical centers in South Limburg, The Netherlands, with access to integrated electronic health records and scanned historical records. Data on demographics, Crohn's disease characteristics, and perioperative findings were collected, and factors influencing recurrence were analyzed.</p><p><strong>Patients: </strong>A total of 289 consecutive patients aged 16 years or older undergoing ileocolic resection between January 2003 and December 2017 with a confirmed diagnosis of Crohn's disease according to European Crohn's and Colitis Organisation criteria. Patients were followed for a mean of 7.02 years.</p><p><strong>Intervention: </strong>No experimental interventions were administered. Surgical treatment consisted of standard ileocolic resection performed either open or laparoscopically.</p><p><strong>Main outcome measures: </strong>The primary outcome was postoperative recurrence, defined as clinical, biochemical, endoscopic, or surgical recurrence. Cox proportional hazards models were used to identify independent predictors.</p><p><strong>Results: </strong>Over a mean follow-up of 7.02 years, 189 (65.4%) developed recurrence. Multivariable analysis identified smoking and pathologic margin involvement as significant risk factors for clinical recurrence. Montreal or B3 classification and open surgery were protective. Surgical recurrence was lower in patients undergoing open surgery.</p><p><strong>Limitations: </strong>The retrospective design may introduce selection and information bias. Surveillance and prophylactic therapy were not standardized.</p><p><strong>Conclusions: </strong>This study reinforces the role of smoking, disease behavior, resection margin involvement, and perianal disease as key risk factors for recurrence after ileocolic resection. Harmonizing definitions, data collection, and treatment protocols through international collaboration is essential for advancing clinical management and facilitating large-scale prospective studies. See Video Abstract .</p><p><strong>Recurrencia tras reseccin ileoclica por enfermedad de crohn nuevos avances en la bsqueda de factores de riesgo: </strong>ANTECEDENTES:La enfermedad de Crohn causa inflamación intestinal crónica, que a menudo requiere cirugía. La recurrencia posoperatoria es frecuente, especialmente en la anastomosis, con tasas de recurrencia variables.OBJETIVO:","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"191-200"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145488181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-06-05DOI: 10.1097/DCR.0000000000003703
Andrew Hu, Benjamin Gallant, Thomas Peponis
{"title":"Chemodenervation of the Internal Anal Sphincter With Botox Injection.","authors":"Andrew Hu, Benjamin Gallant, Thomas Peponis","doi":"10.1097/DCR.0000000000003703","DOIUrl":"10.1097/DCR.0000000000003703","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"261"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-11-13DOI: 10.1097/DCR.0000000000004039
Qianqian Ye, Qingming Wang
{"title":"Ligation of the Intersphincteric Fistula Tract in Crohn's Ileal Pouch Fistulas: Clinical Value and Research Opportunities.","authors":"Qianqian Ye, Qingming Wang","doi":"10.1097/DCR.0000000000004039","DOIUrl":"10.1097/DCR.0000000000004039","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"267"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-01-15DOI: 10.1097/DCR.0000000000004106
{"title":"February 2026 Translations.","authors":"","doi":"10.1097/DCR.0000000000004106","DOIUrl":"https://doi.org/10.1097/DCR.0000000000004106","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"69 2","pages":"274-308"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-11-05DOI: 10.1097/DCR.0000000000004006
Janet S Lee, Heather Carmichael, Brandon A Bellen, Bethany M Kwan, Misha Huang, Margaret E Clinton, Kelly J Bookman, Jon D Vogel
<p><strong>Background: </strong>European studies have demonstrated that acute uncomplicated sigmoid diverticulitis can be managed without antibiotics in select patients. However, routine use of antibiotics remains prevalent for this disease in the United States.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of a quality improvement initiative implemented to reduce antibiotic use in patients with acute uncomplicated sigmoid diverticulitis discharged from the emergency department.</p><p><strong>Design: </strong>Retrospective study comparing preintervention and postintervention periods.</p><p><strong>Settings: </strong>A single academic institution in an urban setting.</p><p><strong>Patients: </strong>From June 2022 to June 2024, 189 patients presented to the emergency department with imaging-confirmed acute uncomplicated sigmoid diverticulitis: 81 patients in the preintervention group and 108 patients in the postintervention group. In the postintervention group, 66 patients received antibiotics, whereas 42 patients did not.</p><p><strong>Interventions: </strong>In June 2023, a diverticulitis clinical pathway was implemented in the electronic health record, accompanied by educational intervention for emergency department providers.</p><p><strong>Main outcome measures: </strong>Antibiotic prescribing and clinical outcomes.</p><p><strong>Results: </strong>The postintervention group demonstrated a significant reduction in the use of antibiotics, including oral antibiotics ( p < 0.001). There was no difference in the use of intravenous antibiotics. No differences were observed in subsequent antibiotic use, return visits to the emergency department, hospitalization, drainage procedures, or emergency surgery within 90 days between the 2 groups. In the postintervention group, no differences were noted in diverticulitis-related return to the emergency department, hospitalization, drainage procedures, or emergency surgery within 90 days between patients who received antibiotics and those who did not.</p><p><strong>Limitations: </strong>Retrospective, single-center study.</p><p><strong>Conclusions: </strong>Before this study, guidelines recommending the omission of antibiotics in acute uncomplicated sigmoid diverticulitis were poorly adopted in our emergency department. The introduction of the electronic health record-based diverticulitis pathway and provider education were associated with a reduction in antibiotic use for acute uncomplicated sigmoid diverticulitis without compromising patient outcomes. See Video Abstract .</p><p><strong>Tratamiento ambulatorio de la diverticulitis sigmoidea aguda la educacin y una va clnica redujeron el uso de antibiticos sin comprometer los resultados clnicos: </strong>ANTECEDENTES:Estudios europeos han demostrado que la diverticulitis sigmoidea aguda no complicada puede tratarse sin antibióticos en determinados pacientes. Sin embargo, el uso rutinario de antibióticos sigue siendo frecuent
{"title":"Outpatient Management of Acute Sigmoid Diverticulitis: Education and a Clinical Pathway Reduced Antibiotic Use Without Compromise in Clinical Outcomes.","authors":"Janet S Lee, Heather Carmichael, Brandon A Bellen, Bethany M Kwan, Misha Huang, Margaret E Clinton, Kelly J Bookman, Jon D Vogel","doi":"10.1097/DCR.0000000000004006","DOIUrl":"10.1097/DCR.0000000000004006","url":null,"abstract":"<p><strong>Background: </strong>European studies have demonstrated that acute uncomplicated sigmoid diverticulitis can be managed without antibiotics in select patients. However, routine use of antibiotics remains prevalent for this disease in the United States.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of a quality improvement initiative implemented to reduce antibiotic use in patients with acute uncomplicated sigmoid diverticulitis discharged from the emergency department.</p><p><strong>Design: </strong>Retrospective study comparing preintervention and postintervention periods.</p><p><strong>Settings: </strong>A single academic institution in an urban setting.</p><p><strong>Patients: </strong>From June 2022 to June 2024, 189 patients presented to the emergency department with imaging-confirmed acute uncomplicated sigmoid diverticulitis: 81 patients in the preintervention group and 108 patients in the postintervention group. In the postintervention group, 66 patients received antibiotics, whereas 42 patients did not.</p><p><strong>Interventions: </strong>In June 2023, a diverticulitis clinical pathway was implemented in the electronic health record, accompanied by educational intervention for emergency department providers.</p><p><strong>Main outcome measures: </strong>Antibiotic prescribing and clinical outcomes.</p><p><strong>Results: </strong>The postintervention group demonstrated a significant reduction in the use of antibiotics, including oral antibiotics ( p < 0.001). There was no difference in the use of intravenous antibiotics. No differences were observed in subsequent antibiotic use, return visits to the emergency department, hospitalization, drainage procedures, or emergency surgery within 90 days between the 2 groups. In the postintervention group, no differences were noted in diverticulitis-related return to the emergency department, hospitalization, drainage procedures, or emergency surgery within 90 days between patients who received antibiotics and those who did not.</p><p><strong>Limitations: </strong>Retrospective, single-center study.</p><p><strong>Conclusions: </strong>Before this study, guidelines recommending the omission of antibiotics in acute uncomplicated sigmoid diverticulitis were poorly adopted in our emergency department. The introduction of the electronic health record-based diverticulitis pathway and provider education were associated with a reduction in antibiotic use for acute uncomplicated sigmoid diverticulitis without compromising patient outcomes. See Video Abstract .</p><p><strong>Tratamiento ambulatorio de la diverticulitis sigmoidea aguda la educacin y una va clnica redujeron el uso de antibiticos sin comprometer los resultados clnicos: </strong>ANTECEDENTES:Estudios europeos han demostrado que la diverticulitis sigmoidea aguda no complicada puede tratarse sin antibióticos en determinados pacientes. Sin embargo, el uso rutinario de antibióticos sigue siendo frecuent","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"209-217"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-11-17DOI: 10.1097/DCR.0000000000004047
Amalia J Stefanou, Juan L Poggio, Kelly M Tyler, Don B Colvin
{"title":"Accountable Care Organizations and the Colorectal Surgeon.","authors":"Amalia J Stefanou, Juan L Poggio, Kelly M Tyler, Don B Colvin","doi":"10.1097/DCR.0000000000004047","DOIUrl":"https://doi.org/10.1097/DCR.0000000000004047","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"69 2","pages":"160-163"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-11-07DOI: 10.1097/DCR.0000000000004016
Maxime K Collard, Benjamin Fernandez, Jean-Jacques Tuech, Charles Sabbagh, Amine Souadka, Jérôme Loriau, Jean-Luc Faucheron, Stéphane Benoist, Anne Dubois, Frédéric Dumont, Adeline Germain, Gilles Manceau, Frédéric Marchal, Léonor Benhaim, Zaher Lakkis, Hélène Meillat, Simon Derieux, Guillaume Piessen, Anaïs Laforest, Aurélien Venara, Michel Prudhomme, Cécile Brigand, Emilie Duchalais, Mehdi Ouaissi, Gil Lebreton, Philippe Rouanet, Diane Mège, Karine Pautrat, Leon Maggiori, Ian S Reynolds, Marc Pocard, Yann Parc, Quentin Denost, Jérémie H Lefevre
<p><strong>Background: </strong>The optimal time interval between the 2 surgical stages of a delayed coloanal anastomosis has not been investigated.</p><p><strong>Objective: </strong>Assess the influence of the time interval on anastomotic leakage occurrence.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>Multicentric study (30 colorectal centers).</p><p><strong>Patients: </strong>All patients who underwent delayed coloanal anastomosis (2010-2021).</p><p><strong>Main outcome measures: </strong>Anastomotic leakage in relation to the time interval between the 2 surgical stages.</p><p><strong>Results: </strong>A total of 506 patients (women 42%, median age 62.1 years) underwent delayed coloanal anastomosis, 63% immediately after a low anterior resection (primary delayed coloanal anastomosis) and 37% after failure of primary pelvic surgery as a salvage procedure (salvage delayed coloanal anastomosis). The main reasons for salvage delayed coloanal anastomosis were chronic pelvic sepsis (42%) and rectovaginal fistula (38%). The mean time interval between 2 stages was 8.6 ± 3.8 days, ranging from 1 to 22 days. In the entire cohort, the incidence of anastomotic leakage was 18% (89/506; 95% CI, 14%-21%) and the time interval did not affect its occurrence ( p = 0.529). In subgroup analysis, anastomotic leakage risk was not associated with time interval among primary delayed coloanal anastomosis patients ( p = 0.579), whereas it was for salvage delayed coloanal anastomosis patients ( p = 0.013). In salvage delayed coloanal anastomosis patients, multivariate analysis showed that a longer time interval (adjusted OR 0.89; 95 CI, 0.81-0.98; p = 0.035) and surgery in centers performing 4 or more delayed coloanal anastomoses per year (adjusted OR 0.07; 95 CI, 0.01-0.36; p = 0.011) were significantly linked to a lower risk of anastomotic leakage. Each additional day between the 2 salvage delayed coloanal anastomosis procedures was estimated to reduce the risk of anastomotic leakage by 11%.</p><p><strong>Limitations: </strong>The retrospective design.</p><p><strong>Conclusions: </strong>In the context of primary delayed coloanal anastomosis, increasing the time interval between the 2 stages of delayed coloanal anastomosis does not influence the risk of anastomotic leakage. For salvage delayed coloanal anastomosis, extending the time interval significantly reduces the risk of anastomotic leakage. See Video Abstract.</p><p><strong>Influencia del intervalo de tiempo entre las dos etapasde la anastomosis coloanal diferida en el riesgo defuga anastomtica estudio multicntrico delgrupo greccar: </strong>ANTECEDENTES:No se ha investigado el intervalo de tiempo óptimo entre las dos etapas quirúrgicas de una anastomosis coloanal diferida.OBJETIVO:Evaluar la influencia del intervalo de tiempo en la aparición de fugas anastomóticas.DISEÑO:Estudio de cohorte retrospectivo.ENTORNOS:Estudio multicéntrico (30 centros colorrectales).PACI
背景：延迟结肠肛管吻合术的两个手术阶段之间的最佳时间间隔从未被研究过。目的：探讨时间间隔对吻合口瘘发生的影响。设计：回顾性队列研究。环境：多中心研究（30个结直肠中心）。患者：所有接受延迟结肠肛管吻合术的患者（2010-2021）。主要观察指标：吻合口漏与两期手术时间间隔的关系。结果：共有506例患者（女性：42%，中位年龄：62.1岁）接受了延迟结肠肛管吻合术，63%在低位前切除术后立即接受（原发性延迟结肠肛管吻合术），37%在原发性盆腔手术失败后接受（补救性延迟结肠肛管吻合术）。慢性盆腔脓毒症（42%）和直肠阴道瘘（38%）是抢救性延迟结肠肛管吻合术的主要原因。两阶段的平均时间间隔为8.6±3.8天，范围为1 ~ 22天。在整个队列中，吻合口瘘发生率为18% (89/506,95 CI[14%, 21%])，时间间隔对吻合口瘘发生率无影响（p = 0.529）。在亚组分析中，原发性延迟性结肠肛管吻合术患者的吻合口漏风险与时间间隔无关（p = 0.579），而补救性延迟性结肠肛管吻合术患者的吻合口漏风险与时间间隔无关（p = 0.013）。多因素分析显示，较长的时间间隔（调整后的OR=0.89, 95 CI [0.81-0.98], p = 0.035）和在每年进行≥4次延迟结肠肛管吻合术的中心进行手术（调整后的OR= 0.07, 95 CI [0.01-0.36], p = 0.011）与较低的吻合口漏风险显著相关。在两次抢救性延迟结肠肛管吻合术之间每增加一天，估计可将吻合口漏的风险降低11%。局限性：回顾性设计。结论：在原发性延迟性结肠肛管吻合术中，延长两期延迟性结肠肛管吻合术的时间间隔并不影响吻合口漏的发生。对于抢救性延迟结肠肛管吻合术，延长时间间隔可显著降低吻合口漏的风险。
{"title":"Influence of Time Interval Between the 2 Stages of Delayed Coloanal Anastomosis on the Risk of Anastomotic Leakage: Multicenter Study From the GRECCAR Group.","authors":"Maxime K Collard, Benjamin Fernandez, Jean-Jacques Tuech, Charles Sabbagh, Amine Souadka, Jérôme Loriau, Jean-Luc Faucheron, Stéphane Benoist, Anne Dubois, Frédéric Dumont, Adeline Germain, Gilles Manceau, Frédéric Marchal, Léonor Benhaim, Zaher Lakkis, Hélène Meillat, Simon Derieux, Guillaume Piessen, Anaïs Laforest, Aurélien Venara, Michel Prudhomme, Cécile Brigand, Emilie Duchalais, Mehdi Ouaissi, Gil Lebreton, Philippe Rouanet, Diane Mège, Karine Pautrat, Leon Maggiori, Ian S Reynolds, Marc Pocard, Yann Parc, Quentin Denost, Jérémie H Lefevre","doi":"10.1097/DCR.0000000000004016","DOIUrl":"10.1097/DCR.0000000000004016","url":null,"abstract":"<p><strong>Background: </strong>The optimal time interval between the 2 surgical stages of a delayed coloanal anastomosis has not been investigated.</p><p><strong>Objective: </strong>Assess the influence of the time interval on anastomotic leakage occurrence.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>Multicentric study (30 colorectal centers).</p><p><strong>Patients: </strong>All patients who underwent delayed coloanal anastomosis (2010-2021).</p><p><strong>Main outcome measures: </strong>Anastomotic leakage in relation to the time interval between the 2 surgical stages.</p><p><strong>Results: </strong>A total of 506 patients (women 42%, median age 62.1 years) underwent delayed coloanal anastomosis, 63% immediately after a low anterior resection (primary delayed coloanal anastomosis) and 37% after failure of primary pelvic surgery as a salvage procedure (salvage delayed coloanal anastomosis). The main reasons for salvage delayed coloanal anastomosis were chronic pelvic sepsis (42%) and rectovaginal fistula (38%). The mean time interval between 2 stages was 8.6 ± 3.8 days, ranging from 1 to 22 days. In the entire cohort, the incidence of anastomotic leakage was 18% (89/506; 95% CI, 14%-21%) and the time interval did not affect its occurrence ( p = 0.529). In subgroup analysis, anastomotic leakage risk was not associated with time interval among primary delayed coloanal anastomosis patients ( p = 0.579), whereas it was for salvage delayed coloanal anastomosis patients ( p = 0.013). In salvage delayed coloanal anastomosis patients, multivariate analysis showed that a longer time interval (adjusted OR 0.89; 95 CI, 0.81-0.98; p = 0.035) and surgery in centers performing 4 or more delayed coloanal anastomoses per year (adjusted OR 0.07; 95 CI, 0.01-0.36; p = 0.011) were significantly linked to a lower risk of anastomotic leakage. Each additional day between the 2 salvage delayed coloanal anastomosis procedures was estimated to reduce the risk of anastomotic leakage by 11%.</p><p><strong>Limitations: </strong>The retrospective design.</p><p><strong>Conclusions: </strong>In the context of primary delayed coloanal anastomosis, increasing the time interval between the 2 stages of delayed coloanal anastomosis does not influence the risk of anastomotic leakage. For salvage delayed coloanal anastomosis, extending the time interval significantly reduces the risk of anastomotic leakage. See Video Abstract.</p><p><strong>Influencia del intervalo de tiempo entre las dos etapasde la anastomosis coloanal diferida en el riesgo defuga anastomtica estudio multicntrico delgrupo greccar: </strong>ANTECEDENTES:No se ha investigado el intervalo de tiempo óptimo entre las dos etapas quirúrgicas de una anastomosis coloanal diferida.OBJETIVO:Evaluar la influencia del intervalo de tiempo en la aparición de fugas anastomóticas.DISEÑO:Estudio de cohorte retrospectivo.ENTORNOS:Estudio multicéntrico (30 centros colorrectales).PACI","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"235-244"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-11-13DOI: 10.1097/DCR.0000000000004038
Kelly M Tyler
{"title":"How Should Transanal Endoscopic Surgery Be Coded for Successful Reimbursement?","authors":"Kelly M Tyler","doi":"10.1097/DCR.0000000000004038","DOIUrl":"10.1097/DCR.0000000000004038","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"158-159"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-11-06DOI: 10.1097/DCR.0000000000004032
Stefan D Holubar
{"title":"Venous Thromboembolism Treatment and Prophylaxis After Surgery for IBD.","authors":"Stefan D Holubar","doi":"10.1097/DCR.0000000000004032","DOIUrl":"10.1097/DCR.0000000000004032","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"164-168"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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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