Pub Date : 2025-02-01Epub Date: 2024-11-13DOI: 10.1097/DCR.0000000000003601
Brian N Williams, Marjun Philip N Duldulao
{"title":"Rectourethral Fistula: Evaluation and Management.","authors":"Brian N Williams, Marjun Philip N Duldulao","doi":"10.1097/DCR.0000000000003601","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003601","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 2","pages":"139-142"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028349","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 : 2025-02-01Epub Date: 2024-11-15DOI: 10.1097/DCR.0000000000003576
Juan Manuel Romero-Marcos, Carlota Cuenca-Gómez, Sandra González-Abós, Jaime-Gerardo Sampson-Dávila, Juan Altet-Torne, Salvador Llopis-Mestre, Salvadora Delgado-Rivilla
{"title":"Transanal Excision of a Retrorectal Tumor.","authors":"Juan Manuel Romero-Marcos, Carlota Cuenca-Gómez, Sandra González-Abós, Jaime-Gerardo Sampson-Dávila, Juan Altet-Torne, Salvador Llopis-Mestre, Salvadora Delgado-Rivilla","doi":"10.1097/DCR.0000000000003576","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003576","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 2","pages":"e48"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028351","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 : 2025-02-01Epub Date: 2024-11-08DOI: 10.1097/DCR.0000000000003542
Shixian Wang, Kangling Du, Lei Cao, Zhen Guo, Jianfeng Gong, Weiming Zhu, Yi Li
<p><strong>Background: </strong>Even in the biological era, permanent stoma is not uncommon in patients with Crohn's Disease.</p><p><strong>Objective: </strong>This study aimed to investigate the incidence and risk factors of permanent stoma in Crohn's disease patients and provide clinical evidence for reducing this disabling outcome.</p><p><strong>Design: </strong>Consecutive patients with Crohn's disease who underwent ostomies in the past decade were reviewed.</p><p><strong>Settings: </strong>The study was conducted in a tertiary referral hospital.</p><p><strong>Patients: </strong>Four hundred fifty-seven patients with Crohn's disease were divided into temporary stoma and permanent stoma groups based on stoma reversal or not. A permanent stoma was defined as a stoma that had not been reversed or closed for at least 2 years.</p><p><strong>Main outcome measures: </strong>The incidence, risk factors, and long-term outcomes of permanent stomas were reported.</p><p><strong>Results: </strong>The rate of permanent stoma was 4.0% in our surgical cohort. The mean age at the time of permanent stoma creation was 36.0 (28.0-45.0) years. The annual incidence of permanent stoma had declined significantly in the past 10 years (p = 0.033). Our study showed that the independent risk factors for permanent stoma formation included female sex, previous operation for Crohn's disease, the presence of rectal disease, subtotal colectomy, and rectal resection. Interestingly, long-term follow-up found that the active distal colorectal lesion was independently associated with the requirement of subsequent surgery.</p><p><strong>Limitations: </strong>The study was limited by its retrospective nature.</p><p><strong>Conclusions: </strong>Although the incidence of permanent stoma in patients with Crohn's disease showed a downward trend in the past 10 years, effective treatments based on relevant risk factors should be used to prevent permanent stoma and control subsequent surgical recurrence. See Video Abstract.</p><p><strong>Incidencia y factores de riesgo de no reversin del estoma en pacientes con enfermedad de crohn estudio de un solo centro: </strong>ANTECEDENTES:Incluso en la era biológica, el estoma permanente no es poco común en pacientes con enfermedad de Crohn.OBJETIVO:Este estudio tuvo como objetivo investigar la incidencia y los factores de riesgo del estoma permanente en pacientes con enfermedad de Crohn y proporcionar evidencia clínica para reducir este resultado discapacitante.DISEÑO:Se revisaron pacientes consecutivos con enfermedad de Crohn que se sometieron a ostomías en la última década.ESCENARIO:El estudio se realizó en un hospital de referencia terciario.PACIENTES:457 pacientes con enfermedad de Crohn se dividieron en los grupos de estoma temporal y estoma permanente según si se había revertido o no el estoma. Un estoma permanente se definió como un estoma que no se había revertido o cerrado durante al menos dos años.PRINCIPALES MEDIDAS DE RESULTADOS:Se i
{"title":"Incidence and Risk Factors for Nonreversal of Stoma in Patients With Crohn's Disease: A Single-Center Study.","authors":"Shixian Wang, Kangling Du, Lei Cao, Zhen Guo, Jianfeng Gong, Weiming Zhu, Yi Li","doi":"10.1097/DCR.0000000000003542","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003542","url":null,"abstract":"<p><strong>Background: </strong>Even in the biological era, permanent stoma is not uncommon in patients with Crohn's Disease.</p><p><strong>Objective: </strong>This study aimed to investigate the incidence and risk factors of permanent stoma in Crohn's disease patients and provide clinical evidence for reducing this disabling outcome.</p><p><strong>Design: </strong>Consecutive patients with Crohn's disease who underwent ostomies in the past decade were reviewed.</p><p><strong>Settings: </strong>The study was conducted in a tertiary referral hospital.</p><p><strong>Patients: </strong>Four hundred fifty-seven patients with Crohn's disease were divided into temporary stoma and permanent stoma groups based on stoma reversal or not. A permanent stoma was defined as a stoma that had not been reversed or closed for at least 2 years.</p><p><strong>Main outcome measures: </strong>The incidence, risk factors, and long-term outcomes of permanent stomas were reported.</p><p><strong>Results: </strong>The rate of permanent stoma was 4.0% in our surgical cohort. The mean age at the time of permanent stoma creation was 36.0 (28.0-45.0) years. The annual incidence of permanent stoma had declined significantly in the past 10 years (p = 0.033). Our study showed that the independent risk factors for permanent stoma formation included female sex, previous operation for Crohn's disease, the presence of rectal disease, subtotal colectomy, and rectal resection. Interestingly, long-term follow-up found that the active distal colorectal lesion was independently associated with the requirement of subsequent surgery.</p><p><strong>Limitations: </strong>The study was limited by its retrospective nature.</p><p><strong>Conclusions: </strong>Although the incidence of permanent stoma in patients with Crohn's disease showed a downward trend in the past 10 years, effective treatments based on relevant risk factors should be used to prevent permanent stoma and control subsequent surgical recurrence. See Video Abstract.</p><p><strong>Incidencia y factores de riesgo de no reversin del estoma en pacientes con enfermedad de crohn estudio de un solo centro: </strong>ANTECEDENTES:Incluso en la era biológica, el estoma permanente no es poco común en pacientes con enfermedad de Crohn.OBJETIVO:Este estudio tuvo como objetivo investigar la incidencia y los factores de riesgo del estoma permanente en pacientes con enfermedad de Crohn y proporcionar evidencia clínica para reducir este resultado discapacitante.DISEÑO:Se revisaron pacientes consecutivos con enfermedad de Crohn que se sometieron a ostomías en la última década.ESCENARIO:El estudio se realizó en un hospital de referencia terciario.PACIENTES:457 pacientes con enfermedad de Crohn se dividieron en los grupos de estoma temporal y estoma permanente según si se había revertido o no el estoma. Un estoma permanente se definió como un estoma que no se había revertido o cerrado durante al menos dos años.PRINCIPALES MEDIDAS DE RESULTADOS:Se i","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 2","pages":"217-226"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028301","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 : 2025-02-01Epub Date: 2024-11-08DOI: 10.1097/DCR.0000000000003476
Mathilde M O'Dell, Daniel Steffens, Kate White, Charlotte S H Johnstone, Michael J Solomon, Killian G M Brown, Cherry E Koh
<p><strong>Background: </strong>While pain may persist for patients who undergo pelvic exenteration for treatment of locally recurrent rectal cancer, studies exploring patient experience of postoperative pain and its management remain limited.</p><p><strong>Objective: </strong>This study aimed to explore patient experiences of postoperative chronic pain and management after pelvic exenteration.</p><p><strong>Design: </strong>Qualitative cohort study of patients who have undergone pelvic exenteration for locally recurrent rectal cancer.</p><p><strong>Settings: </strong>The study was conducted through one-to-one semi-structured telephone interviews.</p><p><strong>Patients: </strong>Seventeen patients with locally recurrent rectal cancer who underwent pelvic exenteration between January 2018 and December 2020 were included.</p><p><strong>Main outcome measures: </strong>Semi-structured interviews explored participants' experiences of pain, including its impact on life and management strategies, at 6 and 12 months after exenteration. Interview transcripts were analyzed by two researchers using inductive thematic analysis.</p><p><strong>Results: </strong>Participant experiences of pain after exenteration are reflected by three identified themes: 1) adapting to long-term consequences of pelvic exenteration, including pain; 2) reluctance to take pain medications; and 3) engaging a multidisciplinary care team is essential to post-pelvic exenteration chronic pain management. Several participants reported ongoing intermittent pain after surgery that significantly affected various aspects of their lives. This prompted participants to adapt their lifestyles and explore alternative pain relief methods because some were hesitant to rely on analgesics.</p><p><strong>Limitations: </strong>The small sample size from a single center, whereby all patients underwent curative pelvic exenteration for lower recurrent rectal cancer, with none undergoing the procedure for palliation, limits the generalizability of the results of this study.</p><p><strong>Conclusions: </strong>Although chronic pain after pelvic exenteration for locally recurrent rectal cancer interferes with patient's postoperative quality of life, analgesia use was influenced by pain habituation and fear of dependence on pain medications. Our findings emphasize the need to further investigate a multidisciplinary approach, including nonpharmacological methods, for optimization of pain outcomes after pelvic exenteration. See Video Abstract .</p><p><strong>Experiencias de pacientes sobre el dolor a largo plazo y su manejo tras la exenteracin plvica por cncer rectal con recidiva local un estudio cualitativo: </strong>ANTECEDENTES:Aunque el dolor puede persistir en los pacientes que se someten a una exanteración pélvica para el tratamiento del cáncer rectal localmente recurrente, los estudios que exploran la experiencia del paciente con el dolor post operatorio y su manejo siguen siendo limitados.OBJETIVO:Este
{"title":"Patient Experiences of Long-term Pain and Pain Management Following Pelvic Exenteration for Locally Recurrent Rectal Cancer: A Qualitative Study.","authors":"Mathilde M O'Dell, Daniel Steffens, Kate White, Charlotte S H Johnstone, Michael J Solomon, Killian G M Brown, Cherry E Koh","doi":"10.1097/DCR.0000000000003476","DOIUrl":"10.1097/DCR.0000000000003476","url":null,"abstract":"<p><strong>Background: </strong>While pain may persist for patients who undergo pelvic exenteration for treatment of locally recurrent rectal cancer, studies exploring patient experience of postoperative pain and its management remain limited.</p><p><strong>Objective: </strong>This study aimed to explore patient experiences of postoperative chronic pain and management after pelvic exenteration.</p><p><strong>Design: </strong>Qualitative cohort study of patients who have undergone pelvic exenteration for locally recurrent rectal cancer.</p><p><strong>Settings: </strong>The study was conducted through one-to-one semi-structured telephone interviews.</p><p><strong>Patients: </strong>Seventeen patients with locally recurrent rectal cancer who underwent pelvic exenteration between January 2018 and December 2020 were included.</p><p><strong>Main outcome measures: </strong>Semi-structured interviews explored participants' experiences of pain, including its impact on life and management strategies, at 6 and 12 months after exenteration. Interview transcripts were analyzed by two researchers using inductive thematic analysis.</p><p><strong>Results: </strong>Participant experiences of pain after exenteration are reflected by three identified themes: 1) adapting to long-term consequences of pelvic exenteration, including pain; 2) reluctance to take pain medications; and 3) engaging a multidisciplinary care team is essential to post-pelvic exenteration chronic pain management. Several participants reported ongoing intermittent pain after surgery that significantly affected various aspects of their lives. This prompted participants to adapt their lifestyles and explore alternative pain relief methods because some were hesitant to rely on analgesics.</p><p><strong>Limitations: </strong>The small sample size from a single center, whereby all patients underwent curative pelvic exenteration for lower recurrent rectal cancer, with none undergoing the procedure for palliation, limits the generalizability of the results of this study.</p><p><strong>Conclusions: </strong>Although chronic pain after pelvic exenteration for locally recurrent rectal cancer interferes with patient's postoperative quality of life, analgesia use was influenced by pain habituation and fear of dependence on pain medications. Our findings emphasize the need to further investigate a multidisciplinary approach, including nonpharmacological methods, for optimization of pain outcomes after pelvic exenteration. See Video Abstract .</p><p><strong>Experiencias de pacientes sobre el dolor a largo plazo y su manejo tras la exenteracin plvica por cncer rectal con recidiva local un estudio cualitativo: </strong>ANTECEDENTES:Aunque el dolor puede persistir en los pacientes que se someten a una exanteración pélvica para el tratamiento del cáncer rectal localmente recurrente, los estudios que exploran la experiencia del paciente con el dolor post operatorio y su manejo siguen siendo limitados.OBJETIVO:Este","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"209-216"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603571","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 : 2025-02-01Epub Date: 2024-11-12DOI: 10.1097/DCR.0000000000003188
William C Cirocco
{"title":"Garnet W. Ault, M.D.: The First Canadian President of the American Proctologic Society.","authors":"William C Cirocco","doi":"10.1097/DCR.0000000000003188","DOIUrl":"10.1097/DCR.0000000000003188","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"131-138"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616553","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 : 2025-02-01Epub Date: 2024-11-08DOI: 10.1097/DCR.0000000000003485
William C Chapman, Emre Gorgun, Sumeyye Yilmaz, David R Rosen, Michael A Valente, Joshua Sommovilla, Arielle E Kanters, Andrei S Purysko, Alok A Khorana, Smitha S Krishnamurthi, Sudha R Amarnath, Hermann Kessler, Scott R Steele, David Liska
<p><strong>Background: </strong>Among patients with rectal cancer treated with total neoadjuvant therapy, it is unclear whether early, postinduction restaging is associated with final tumor response. If so, interim restaging may alter rectal cancer decision-making.</p><p><strong>Objective: </strong>To determine whether postinduction restaging with endoscopy and MRI is associated with final tumor response.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>US tertiary care institution accredited by the National Accreditation Program for Rectal Cancer.</p><p><strong>Patients: </strong>Patients with biopsy-proven rectal cancer who underwent total neoadjuvant therapy with interim (postinduction) restaging.</p><p><strong>Main outcome measures: </strong>Association between response assessment on postinduction restaging and final treatment response.</p><p><strong>Results: </strong>One hundred seven patients were analyzed. Patients with postinduction magnetic resonance tumor response grade 1 and 2 or complete endoscopic response were significantly more likely (OR 5.4, p < 0.01 and OR 3.7, p = 0.03, respectively) to ultimately achieve a final complete response. Likewise, the odds of a final incomplete response were significantly higher for patients with postinduction composite partial (OR 4.1, p < 0.01) or minimal (OR 12.0, p < 0.01) responses.</p><p><strong>Limitations: </strong>Retrospective analysis and lack of detailed subclassification of partial endoscopic response may have limited the conclusions of these data. The limited sample size may also have biased these conclusions.</p><p><strong>Conclusions: </strong>Tumor response to induction therapy is associated with the ultimate treatment response to total neoadjuvant therapy among complete or minimal responders; the significance of a partial interim response remains unclear. See Video Abstract .</p><p><strong>Est asociada la reestadificacin temprana postinduccin del cancer de recto sometido a terapia neoadyuvante total con la respuesta teraputica final: </strong>ANTECEDENTES:Entre los pacientes con cáncer de recto tratados con terapia neoadyuvante total, no está claro si la re-estadificación temprana posterior a la inducción está asociada con la respuesta tumoral final. De ser así, la re-estadificación provisoria podría alterar la toma de decisiones sobre el cáncer rectal.OBJETIVO:Determinar si la re-estadificación posterior a la inducción con endoscopia y resonancia magnética están asociadas con la respuesta tumoral final.DISEÑO:Estudio de cohorte retrospectivoESCENARIO:Institución de atención terciaria de Estados Unidos, certificada por el Programa Nacional de Acreditación para el Cáncer de Recto.PACIENTES:Pacientes con cáncer rectal confirmado por biopsia que fueron sometidos a terapia neoadyuvante total con re-estadificación provisoria (posterior a la inducción).PRINCIPALES MEDIDAS DE RESULTADOS:La asociación entre la evaluación de la respuesta en la re-es
{"title":"Is Early, Postinduction Restaging of Rectal Cancer Undergoing Total Neoadjuvant Therapy Associated With Ultimate Treatment Response?","authors":"William C Chapman, Emre Gorgun, Sumeyye Yilmaz, David R Rosen, Michael A Valente, Joshua Sommovilla, Arielle E Kanters, Andrei S Purysko, Alok A Khorana, Smitha S Krishnamurthi, Sudha R Amarnath, Hermann Kessler, Scott R Steele, David Liska","doi":"10.1097/DCR.0000000000003485","DOIUrl":"10.1097/DCR.0000000000003485","url":null,"abstract":"<p><strong>Background: </strong>Among patients with rectal cancer treated with total neoadjuvant therapy, it is unclear whether early, postinduction restaging is associated with final tumor response. If so, interim restaging may alter rectal cancer decision-making.</p><p><strong>Objective: </strong>To determine whether postinduction restaging with endoscopy and MRI is associated with final tumor response.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>US tertiary care institution accredited by the National Accreditation Program for Rectal Cancer.</p><p><strong>Patients: </strong>Patients with biopsy-proven rectal cancer who underwent total neoadjuvant therapy with interim (postinduction) restaging.</p><p><strong>Main outcome measures: </strong>Association between response assessment on postinduction restaging and final treatment response.</p><p><strong>Results: </strong>One hundred seven patients were analyzed. Patients with postinduction magnetic resonance tumor response grade 1 and 2 or complete endoscopic response were significantly more likely (OR 5.4, p < 0.01 and OR 3.7, p = 0.03, respectively) to ultimately achieve a final complete response. Likewise, the odds of a final incomplete response were significantly higher for patients with postinduction composite partial (OR 4.1, p < 0.01) or minimal (OR 12.0, p < 0.01) responses.</p><p><strong>Limitations: </strong>Retrospective analysis and lack of detailed subclassification of partial endoscopic response may have limited the conclusions of these data. The limited sample size may also have biased these conclusions.</p><p><strong>Conclusions: </strong>Tumor response to induction therapy is associated with the ultimate treatment response to total neoadjuvant therapy among complete or minimal responders; the significance of a partial interim response remains unclear. See Video Abstract .</p><p><strong>Est asociada la reestadificacin temprana postinduccin del cancer de recto sometido a terapia neoadyuvante total con la respuesta teraputica final: </strong>ANTECEDENTES:Entre los pacientes con cáncer de recto tratados con terapia neoadyuvante total, no está claro si la re-estadificación temprana posterior a la inducción está asociada con la respuesta tumoral final. De ser así, la re-estadificación provisoria podría alterar la toma de decisiones sobre el cáncer rectal.OBJETIVO:Determinar si la re-estadificación posterior a la inducción con endoscopia y resonancia magnética están asociadas con la respuesta tumoral final.DISEÑO:Estudio de cohorte retrospectivoESCENARIO:Institución de atención terciaria de Estados Unidos, certificada por el Programa Nacional de Acreditación para el Cáncer de Recto.PACIENTES:Pacientes con cáncer rectal confirmado por biopsia que fueron sometidos a terapia neoadyuvante total con re-estadificación provisoria (posterior a la inducción).PRINCIPALES MEDIDAS DE RESULTADOS:La asociación entre la evaluación de la respuesta en la re-es","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"190-198"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616558","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 : 2025-02-01Epub Date: 2025-01-21DOI: 10.1097/01.dcr.0001098256.91684.24
{"title":"Colon and Rectal Surgery Regional Society Meetings.","authors":"","doi":"10.1097/01.dcr.0001098256.91684.24","DOIUrl":"https://doi.org/10.1097/01.dcr.0001098256.91684.24","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 2","pages":"e100-e101"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028137","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 : 2025-02-01Epub Date: 2024-11-08DOI: 10.1097/DCR.0000000000003412
Pablo Baeza, Mónica B Martínez-Mardones, María Elena Molina
{"title":"Low Rectovaginal Fistula Repair: Full Cutaneous Martius Flap.","authors":"Pablo Baeza, Mónica B Martínez-Mardones, María Elena Molina","doi":"10.1097/DCR.0000000000003412","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003412","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 2","pages":"e51-e52"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028345","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 : 2025-02-01Epub Date: 2024-11-07DOI: 10.1097/DCR.0000000000003548
Hillary Mabeya, Carolyne Aluku, Claud D Crosby, Anna R Spivak, Phantila Haruethaivijitchock, Arun Rojanasakul, Meena Dhir, Maher A Abbas
{"title":"Complex Pelvic Fistulas in African Women: The Challenges and Opportunities of an Ongoing Epidemic.","authors":"Hillary Mabeya, Carolyne Aluku, Claud D Crosby, Anna R Spivak, Phantila Haruethaivijitchock, Arun Rojanasakul, Meena Dhir, Maher A Abbas","doi":"10.1097/DCR.0000000000003548","DOIUrl":"10.1097/DCR.0000000000003548","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"144-153"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603567","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 : 2025-02-01Epub Date: 2024-11-07DOI: 10.1097/DCR.0000000000003587
Sarah N Anwar, Gabrielle E Dombek, Caroline E Hayes, Maggie J McMahon, Cody Munroe, Jonathan S Abelson, Jason F Hall, David A Kleiman, Angela H Kuhnen, Peter W Marcello, Julia T Saraidaridis
<p><strong>Background: </strong>For patients with recurrent diverticulitis, the trigger to proceed to elective sigmoid colectomy is unclear. Current clinical practice guidelines suggest that this is an individualized decision between surgeon and patient.</p><p><strong>Objective: </strong>To assess the long-term risk of diverticulitis recurrence and determine predictors of recurrent disease.</p><p><strong>Design: </strong>Retrospective case series.</p><p><strong>Setting: </strong>Tertiary care center.</p><p><strong>Patients: </strong>Consecutive patients with CT-proven diverticulitis who presented as inpatient or outpatient between 2002 and 2008.</p><p><strong>Interventions: </strong>Incidence of diverticulitis recurrence was determined via medical record review and questionnaire.</p><p><strong>Main outcome measures: </strong>Risk of recurrent diverticulitis or surgery for diverticulitis.</p><p><strong>Results: </strong>A total of 753 patients with first-time diverticulitis were identified. The patients had a mean age of 61.5 years (SD 15.3). The median follow-up was 13.2 years (interquartile range, 3.8-18.3). There were 486 patients (64.5%) alive at the time of follow-up. During the initial presentation, 29 patients (3.9%) required Interventional Radiology drainage and 37 (4.9%) required emergency surgery. Forty-three patients (5.7%) underwent elective surgery after the initial presentation and 77 (10.2%) underwent surgery after more than 1 episode. Of those who did not undergo surgery for the first episode, 353 (52.4%) experienced recurrent disease with a median time to recurrence of 2.9 years (interquartile range, 0.83-8.5 years). On multivariate analysis, female sex (HR 1.28, p = 0.04), sigmoid disease (HR 1.35, p = 0.03), smoldering disease (HR 3.17, p < 0.01), length of involved segment >5 cm (HR 1.28, p = 0.04), and maximum fat stranding diameter >1.8 cm (HR 1.29, p = 0.03) were associated with disease recurrence. Kaplan-Meier estimates of freedom from recurrence were 73.1% (69.6%-76.3%) at 1 year, 47.9% (44.0%-51.6%) at 5 years, and 34.6% (31.0%-38.2%) at 10 years after initial presentation.</p><p><strong>Limitations: </strong>Retrospective design.</p><p><strong>Conclusions: </strong>After a single episode of diverticulitis, the incidence of recurrence is more than 50% on long-term follow-up. Variables such as female sex, sigmoid disease, smoldering disease, length of involved segment >5 cm, and maximum fat stranding diameter >1.8 cm were associated with an increased risk of recurrence. These findings should be considered when counseling patients on the decision to proceed with elective colectomy. See Video Abstract .</p><p><strong>Seguimiento a largo plazo tras un episodio inicial de diverticulitis una actualizacin de aos: </strong>ANTECEDENTES:En el caso de los pacientes con diverticulitis recurrente, no está claro el factor desencadenante para proceder a una colectomía sigmoidea electiva. Las guías de práctica clínica actuales sugieren
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