Pub Date : 2025-01-01Epub Date: 2024-10-22DOI: 10.1097/DCR.0000000000003543
Nathan C English, Burkely P Smith, Abiha Abdullah, Princy Gupta, Wendelyn M Oslock, Bayley A Jones, Lauren N Wood, Manu Kaushik, Quince-Xhosa D Gibson, Lacey Swenson, Rebecca A Young, Drew J Gunnells, Gregory D Kennedy, Daniel I Chu, Robert H Hollis
<p><strong>Background: </strong>Rural patients experience a higher incidence of and mortality from colorectal cancer. Ensuring high-quality screening is essential to address these disparities.</p><p><strong>Objective: </strong>To investigate whether socioecological determinants of health are associated with colonoscopy quality in rural Alabama.</p><p><strong>Design: </strong>Retrospective review.</p><p><strong>Setting: </strong>Data across 3 rural hospitals in Alabama from August 2021 to July 2023.</p><p><strong>Patients: </strong>We included adults (aged 18 years or older) who underwent screening or diagnostic colonoscopy and completed a validated survey that measures socioecological determinants of health.</p><p><strong>Main outcome measures: </strong>Primary outcomes included bowel preparation quality, cecal intubation, and adenoma detection rate. We linked the survey responses to these quality metrics to identify factors associated with outcomes. Analyses included the χ 2 , Fisher exact, and Kruskal-Wallis rank-sum tests, with a p value of < 0.05 considered statistically significant.</p><p><strong>Results: </strong>The 84 patients surveyed were 66.7% men, 50.0% Black, and had a median age of 64 years. Optimal bowel preparation was present in 88.0%, successful cecal intubation was observed in 89.3%, and the overall adenoma detection rate was 45.8%. Patients with suboptimal bowel preparation described lower rates of internet access (60.0% vs 87.4%, p < 0.05), more difficulty in understanding written information (30.0% vs 1.4%, p < 0.05), and lacked a sense of responsibility for their health (30.0% vs 51.4%, p < 0.05) compared to those having optimal bowel preparation. Those with unsuccessful cecal intubations had lower physician trust (55.6% vs 73.3%, p < 0.05), whereas patients with successful cecal intubations were more confident in preventing health-related problems (53.3% vs 33.3%, p < 0.05) and had a more supportive social environment (72.0% vs 66.7%, p < 0.05).</p><p><strong>Limitations: </strong>Retrospective design and small sample size limiting multivariable analyses.</p><p><strong>Conclusion: </strong>In rural Alabama, lower health literacy, internet access, and physician trust were associated with low-quality colonoscopy, whereas a higher patient sense of responsibility and a supportive social environment were associated with higher-quality metrics. These findings identify potential targets for improving colonoscopy quality in rural settings. See Video Abstract.</p><p><strong>Determinantes socioecolgicos de la salud y la calidad de la colonoscopia en las zonas rurales de alabama: </strong>ANTECEDENTES:Los pacientes rurales sufren una mayor incidencia y mortalidad por cáncer colorrectal. Garantizar un cribado de alta calidad es esencial para abordar estas disparidades.OBJETIVO:Investigar si los determinantes socioecológicos de la salud están asociados con la calidad de la colonoscopia en las zonas rurales de Alabama.DISEÑO:Revisión re
{"title":"Socioecological Determinants of Health and the Quality of Colonoscopy in Rural Alabama.","authors":"Nathan C English, Burkely P Smith, Abiha Abdullah, Princy Gupta, Wendelyn M Oslock, Bayley A Jones, Lauren N Wood, Manu Kaushik, Quince-Xhosa D Gibson, Lacey Swenson, Rebecca A Young, Drew J Gunnells, Gregory D Kennedy, Daniel I Chu, Robert H Hollis","doi":"10.1097/DCR.0000000000003543","DOIUrl":"10.1097/DCR.0000000000003543","url":null,"abstract":"<p><strong>Background: </strong>Rural patients experience a higher incidence of and mortality from colorectal cancer. Ensuring high-quality screening is essential to address these disparities.</p><p><strong>Objective: </strong>To investigate whether socioecological determinants of health are associated with colonoscopy quality in rural Alabama.</p><p><strong>Design: </strong>Retrospective review.</p><p><strong>Setting: </strong>Data across 3 rural hospitals in Alabama from August 2021 to July 2023.</p><p><strong>Patients: </strong>We included adults (aged 18 years or older) who underwent screening or diagnostic colonoscopy and completed a validated survey that measures socioecological determinants of health.</p><p><strong>Main outcome measures: </strong>Primary outcomes included bowel preparation quality, cecal intubation, and adenoma detection rate. We linked the survey responses to these quality metrics to identify factors associated with outcomes. Analyses included the χ 2 , Fisher exact, and Kruskal-Wallis rank-sum tests, with a p value of < 0.05 considered statistically significant.</p><p><strong>Results: </strong>The 84 patients surveyed were 66.7% men, 50.0% Black, and had a median age of 64 years. Optimal bowel preparation was present in 88.0%, successful cecal intubation was observed in 89.3%, and the overall adenoma detection rate was 45.8%. Patients with suboptimal bowel preparation described lower rates of internet access (60.0% vs 87.4%, p < 0.05), more difficulty in understanding written information (30.0% vs 1.4%, p < 0.05), and lacked a sense of responsibility for their health (30.0% vs 51.4%, p < 0.05) compared to those having optimal bowel preparation. Those with unsuccessful cecal intubations had lower physician trust (55.6% vs 73.3%, p < 0.05), whereas patients with successful cecal intubations were more confident in preventing health-related problems (53.3% vs 33.3%, p < 0.05) and had a more supportive social environment (72.0% vs 66.7%, p < 0.05).</p><p><strong>Limitations: </strong>Retrospective design and small sample size limiting multivariable analyses.</p><p><strong>Conclusion: </strong>In rural Alabama, lower health literacy, internet access, and physician trust were associated with low-quality colonoscopy, whereas a higher patient sense of responsibility and a supportive social environment were associated with higher-quality metrics. These findings identify potential targets for improving colonoscopy quality in rural settings. See Video Abstract.</p><p><strong>Determinantes socioecolgicos de la salud y la calidad de la colonoscopia en las zonas rurales de alabama: </strong>ANTECEDENTES:Los pacientes rurales sufren una mayor incidencia y mortalidad por cáncer colorrectal. Garantizar un cribado de alta calidad es esencial para abordar estas disparidades.OBJETIVO:Investigar si los determinantes socioecológicos de la salud están asociados con la calidad de la colonoscopia en las zonas rurales de Alabama.DISEÑO:Revisión re","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"107-118"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460467","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 : 2025-01-01Epub Date: 2024-10-23DOI: 10.1097/DCR.0000000000003549
Tenghui Zhang, Zeqian Yu, Yi Xu, Lei Zhao, Feng Zhu, Yan Zhou, Lili Gu, Jianfeng Gong
<p><strong>Background: </strong>Pouchitis is the most common complication after IPAA for ulcerative colitis. The protective effect of tryptophan metabolites on the mucosal barrier may be effective for treating pouchitis. The role of tryptophan metabolites on pouchitis remained unclear.</p><p><strong>Objective: </strong>We aimed to establish a murine model of dextran sulfate sodium-induced pouchitis to examine the roles of tryptophan metabolites in its pathogenesis.</p><p><strong>Design: </strong>This is a study that combines clinical patient data and animal research. A total of 22 patients were enrolled: 5 patients with familial adenomatous polyposis after IPAA, 8 patients with ulcerative colitis after IPAA with pouchitis, and 9 patients with ulcerative colitis after IPAA with normal pouch. The demographic data and fecal samples of patients were collected. Male C57BL/6 mice were purchased from a licensed breeder and underwent IPAA to establish a murine model of the pouch. The blood, feces, and tissues of mice were collected.</p><p><strong>Settings: </strong>This study was performed in an academic medical center in China.</p><p><strong>Interventions: </strong>The demographic data of patients were observationally collected. The mice that underwent IPAA were divided into a control group that received a chow diet and 5 study groups: 1) dextran sulfate sodium, 2) 6-formylindolo[3,2-b] carbazole + dextran sulfate sodium, 3) high tryptophan diet + dextran sulfate sodium, 4) CH-223191 + dextran sulfate sodium, and 5) indole-3-carboxaldehyde + dextran sulfate sodium. Animals were euthanized after receiving dextran sulfate sodium for 7 days.</p><p><strong>Main outcome measures: </strong>Fecal tryptophan metabolite level and microbiome composition, the severity of pouchitis, intestinal mucosal barrier function, and activation of the aryl hydrocarbon receptor-interleukin 22 pathway were assessed.</p><p><strong>Results: </strong>Patients with pouchitis had lower fecal microbial diversity and indole-3-acetic acid levels. In the murine pouchitis model, high tryptophan diet increased fecal levels of 3-indoleglyoxylic acid, indole-3-aldehyde, and indole. A high tryptophan diet and intraperitoneal aryl hydrocarbon receptor ligand 6-formylindolo[3,2-b] carbazole injection alleviated pouchitis. Tryptophan metabolites improved pouch mucosal barriers. Aryl hydrocarbon receptor inhibitors exacerbated experimental pouchitis and disrupted the mucosal barrier; however, the aryl hydrocarbon receptor ligand indole-3-carboxaldehyde reversed this effect.</p><p><strong>Limitations: </strong>This study was limited by a small human sample size and lacked an aryl hydrocarbon receptor knockout mouse model.</p><p><strong>Conclusions: </strong>A high tryptophan diet and aryl hydrocarbon receptor ligand alleviated dextran sulfate sodium-induced pouchitis in a murine IPAA model, which might be achieved through regulating epithelial tight junctions and promoting goblet cell differentia
{"title":"Tryptophan Metabolites Improve Intestinal Mucosal Barrier via the Aryl Hydrocarbon Receptor-Interleukin-22 Pathway in Murine Dextran Sulfate Sodium-Induced Pouchitis.","authors":"Tenghui Zhang, Zeqian Yu, Yi Xu, Lei Zhao, Feng Zhu, Yan Zhou, Lili Gu, Jianfeng Gong","doi":"10.1097/DCR.0000000000003549","DOIUrl":"10.1097/DCR.0000000000003549","url":null,"abstract":"<p><strong>Background: </strong>Pouchitis is the most common complication after IPAA for ulcerative colitis. The protective effect of tryptophan metabolites on the mucosal barrier may be effective for treating pouchitis. The role of tryptophan metabolites on pouchitis remained unclear.</p><p><strong>Objective: </strong>We aimed to establish a murine model of dextran sulfate sodium-induced pouchitis to examine the roles of tryptophan metabolites in its pathogenesis.</p><p><strong>Design: </strong>This is a study that combines clinical patient data and animal research. A total of 22 patients were enrolled: 5 patients with familial adenomatous polyposis after IPAA, 8 patients with ulcerative colitis after IPAA with pouchitis, and 9 patients with ulcerative colitis after IPAA with normal pouch. The demographic data and fecal samples of patients were collected. Male C57BL/6 mice were purchased from a licensed breeder and underwent IPAA to establish a murine model of the pouch. The blood, feces, and tissues of mice were collected.</p><p><strong>Settings: </strong>This study was performed in an academic medical center in China.</p><p><strong>Interventions: </strong>The demographic data of patients were observationally collected. The mice that underwent IPAA were divided into a control group that received a chow diet and 5 study groups: 1) dextran sulfate sodium, 2) 6-formylindolo[3,2-b] carbazole + dextran sulfate sodium, 3) high tryptophan diet + dextran sulfate sodium, 4) CH-223191 + dextran sulfate sodium, and 5) indole-3-carboxaldehyde + dextran sulfate sodium. Animals were euthanized after receiving dextran sulfate sodium for 7 days.</p><p><strong>Main outcome measures: </strong>Fecal tryptophan metabolite level and microbiome composition, the severity of pouchitis, intestinal mucosal barrier function, and activation of the aryl hydrocarbon receptor-interleukin 22 pathway were assessed.</p><p><strong>Results: </strong>Patients with pouchitis had lower fecal microbial diversity and indole-3-acetic acid levels. In the murine pouchitis model, high tryptophan diet increased fecal levels of 3-indoleglyoxylic acid, indole-3-aldehyde, and indole. A high tryptophan diet and intraperitoneal aryl hydrocarbon receptor ligand 6-formylindolo[3,2-b] carbazole injection alleviated pouchitis. Tryptophan metabolites improved pouch mucosal barriers. Aryl hydrocarbon receptor inhibitors exacerbated experimental pouchitis and disrupted the mucosal barrier; however, the aryl hydrocarbon receptor ligand indole-3-carboxaldehyde reversed this effect.</p><p><strong>Limitations: </strong>This study was limited by a small human sample size and lacked an aryl hydrocarbon receptor knockout mouse model.</p><p><strong>Conclusions: </strong>A high tryptophan diet and aryl hydrocarbon receptor ligand alleviated dextran sulfate sodium-induced pouchitis in a murine IPAA model, which might be achieved through regulating epithelial tight junctions and promoting goblet cell differentia","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"77-90"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497005","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 : 2025-01-01Epub Date: 2024-09-26DOI: 10.1097/DCR.0000000000003530
Mehmet Gulmez, Pranav Hinduja, Eren Esen, Michael J Grieco, Arman Erkan, Andre da Luz Moreira, John Kirat, Feza H Remzi
<p><strong>Background: </strong>Long rectal cuff (>2 cm) and remnant mesorectum are known causes of pouch dysfunction because of obstructive defecation as well as pelvic sepsis after prolonged obstruction.</p><p><strong>Objective: </strong>The aim of this study was to report the rates and management of patients who underwent redo IPAA because of pouch failure associated with a retained mesorectum and long rectal cuff.</p><p><strong>Design: </strong>This is a retrospective study.</p><p><strong>Settings: </strong>The investigation is based on data from a quaternary IBD center.</p><p><strong>Patients: </strong>Patients undergoing redo IPAA surgery with a long rectal cuff and/or remnant mesorectum between September 2016 and September 2023 were included in the study.</p><p><strong>Main outcome measures: </strong>The main outcomes were functioning pouch rate and functional results.</p><p><strong>Results: </strong>Of the 245 patients who underwent redo IPAA surgery, 98 patients (40%) had long rectal cuff and/or remnant mesorectum. Redo IPAA in this patient group was successful (92%) at a median follow-up of 28 (18-52) months.</p><p><strong>Limitations: </strong>The retrospective nature of the study and inclusion of a single specialized center.</p><p><strong>Conclusions: </strong>Long rectal cuff and remnant mesorectum are major causes of pouch failure, which can be successfully managed with redo IPAA surgery. Nearly half of pouch failure patients who had successful redo IPAA surgery initially received unnecessary biologic therapy before coming to our center. See Video Abstract .</p><p><strong>Muon rectal largo y mesorrecto remanente son las principales causas prevenibles de disfuncin de la bolsa ileal: </strong>ANTECEDENTES:El muñon rectal largo (>2 cm) y el mesorrecto remanente son causas conocidas de disfunción de la bolsa debido a defecación obstructiva, así como de sepsis pélvica tras obstrucción prolongada.OBJETIVO:El objetivo de este estudio es informar las tasas y el tratamiento de los pacientes que se sometieron a una nueva anastomosis anal con bolsa ileal debido al fracaso de la bolsa asociado a mesorrecto remanente y el muñon rectal largo.DISEÑO:Se trata de un estudio retrospectivo.LUGAR:La investigación se basa en un centro cuaternario de enfermedad inflamatoria intestinal.PACIENTES:Se incluyeron en el estudio los pacientes sometidos a una nueva cirugía de anastomosis anal con bolsa ileal y que tenían muñon rectal largo y/o mesorrecto remanente entre septiembre de 2016 y septiembre de 2023.PRINCIPALES MEDIDAS DE VALORACIÓN:Los principales resultados fueron la tasa de funcionamiento de la bolsa y los resultados funcionales.RESULTADOS:De los 245 pacientes que se sometieron a una nueva cirugía de anastomosis anal con bolsa ileal, 98 (40%) pacientes tenían un muñon rectal largo y/o mesorrecto remanente. La repetición de la anastomosis anal con bolsa ileal en este grupo de pacientes fue exitosa (92%) en una mediana de seguimiento de 28 (18-52) mes
{"title":"Long Rectal Cuff and Remnant Mesorectum Are Major Preventable Causes of Ileal Pouch Failure.","authors":"Mehmet Gulmez, Pranav Hinduja, Eren Esen, Michael J Grieco, Arman Erkan, Andre da Luz Moreira, John Kirat, Feza H Remzi","doi":"10.1097/DCR.0000000000003530","DOIUrl":"10.1097/DCR.0000000000003530","url":null,"abstract":"<p><strong>Background: </strong>Long rectal cuff (>2 cm) and remnant mesorectum are known causes of pouch dysfunction because of obstructive defecation as well as pelvic sepsis after prolonged obstruction.</p><p><strong>Objective: </strong>The aim of this study was to report the rates and management of patients who underwent redo IPAA because of pouch failure associated with a retained mesorectum and long rectal cuff.</p><p><strong>Design: </strong>This is a retrospective study.</p><p><strong>Settings: </strong>The investigation is based on data from a quaternary IBD center.</p><p><strong>Patients: </strong>Patients undergoing redo IPAA surgery with a long rectal cuff and/or remnant mesorectum between September 2016 and September 2023 were included in the study.</p><p><strong>Main outcome measures: </strong>The main outcomes were functioning pouch rate and functional results.</p><p><strong>Results: </strong>Of the 245 patients who underwent redo IPAA surgery, 98 patients (40%) had long rectal cuff and/or remnant mesorectum. Redo IPAA in this patient group was successful (92%) at a median follow-up of 28 (18-52) months.</p><p><strong>Limitations: </strong>The retrospective nature of the study and inclusion of a single specialized center.</p><p><strong>Conclusions: </strong>Long rectal cuff and remnant mesorectum are major causes of pouch failure, which can be successfully managed with redo IPAA surgery. Nearly half of pouch failure patients who had successful redo IPAA surgery initially received unnecessary biologic therapy before coming to our center. See Video Abstract .</p><p><strong>Muon rectal largo y mesorrecto remanente son las principales causas prevenibles de disfuncin de la bolsa ileal: </strong>ANTECEDENTES:El muñon rectal largo (>2 cm) y el mesorrecto remanente son causas conocidas de disfunción de la bolsa debido a defecación obstructiva, así como de sepsis pélvica tras obstrucción prolongada.OBJETIVO:El objetivo de este estudio es informar las tasas y el tratamiento de los pacientes que se sometieron a una nueva anastomosis anal con bolsa ileal debido al fracaso de la bolsa asociado a mesorrecto remanente y el muñon rectal largo.DISEÑO:Se trata de un estudio retrospectivo.LUGAR:La investigación se basa en un centro cuaternario de enfermedad inflamatoria intestinal.PACIENTES:Se incluyeron en el estudio los pacientes sometidos a una nueva cirugía de anastomosis anal con bolsa ileal y que tenían muñon rectal largo y/o mesorrecto remanente entre septiembre de 2016 y septiembre de 2023.PRINCIPALES MEDIDAS DE VALORACIÓN:Los principales resultados fueron la tasa de funcionamiento de la bolsa y los resultados funcionales.RESULTADOS:De los 245 pacientes que se sometieron a una nueva cirugía de anastomosis anal con bolsa ileal, 98 (40%) pacientes tenían un muñon rectal largo y/o mesorrecto remanente. La repetición de la anastomosis anal con bolsa ileal en este grupo de pacientes fue exitosa (92%) en una mediana de seguimiento de 28 (18-52) mes","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"69-76"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343665","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 : 2025-01-01Epub Date: 2024-09-26DOI: 10.1097/DCR.0000000000003467
Anna R Spivak, Marianna Maspero, Rebecca Y Spivak, Jessica A Sankovic, Stephanie Norman, Caitlyn Deckard, Scott R Steele, Tracy L Hull
<p><strong>Background: </strong>Resection rectopexy and ventral mesh rectopexy are widely accepted surgical options for the treatment of rectal prolapse; however, reports on long-term recurrence rates and functional outcomes are lacking.</p><p><strong>Objective: </strong>We compared quality of life, long-term functional outcomes, and prolapse recurrence after resection rectopexy versus ventral mesh rectopexy.</p><p><strong>Design: </strong>We retrospectively reviewed our prospectively collected rectal prolapse surgery database.</p><p><strong>Settings: </strong>Patients who underwent resection rectopexy or ventral mesh rectopexy at our center between 2009 and 2016 were included.</p><p><strong>Patients: </strong>Two hundred twenty patients were included, of whom 208 (94%) were women; 85 (39%) underwent resection rectopexy and 135 (61%) ventral mesh rectopexy.</p><p><strong>Main outcome measures: </strong>Prolapse recurrence.</p><p><strong>Results: </strong>The resection rectopexy group was younger (median 52 vs 60 years old, p = 0.02) and had more open procedures (20% vs 9%, p < 0.001). After a median follow-up of 110 (interquartile range 94-146) months for resection rectopexy and 113 (87-137) months for ventral mesh rectopexy, recurrences occurred in 21 (26%) in the resection rectopexy and 50 (39%) in the ventral mesh rectopexy group ( p = 0.041). The median time to recurrence was 44 (18-80) months in the resection rectopexy group and 28.5 (11-52.5) months in the ventral mesh rectopexy group ( p = 0.14). There were no differences in the recurrence rate for primary prolapses in resection rectopexy versus ventral mesh rectopexy. The recurrence rate for redo prolapses was higher in the ventral mesh rectopexy group at 63% at 10 years versus 25% in the resection rectopexy group ( p = 0.006). Functional outcomes were similar between the 2 groups.</p><p><strong>Limitations: </strong>Retrospective review, recall bias.</p><p><strong>Conclusions: </strong>Long-term quality of life and functional outcomes after resection rectopexy and ventral mesh rectopexy were comparable. Ventral mesh rectopexy was associated with a higher prolapse recurrence rate after recurrent rectal prolapse repair. See Video Abstract .</p><p><strong>Calidad de vida, resultados funcionales y recurrencia despus de la rectopexia por reseccin versus la rectopexia ventral con malla para la reparacin del prolapso rectal: </strong>ANTECEDENTES:La rectopexia de resección y la rectopexia ventral con malla son opciones quirúrgicas ampliamente aceptadas para el tratamiento del prolapso rectal; sin embargo, faltan informes sobre las tasas de recurrencia a largo plazo y los resultados funcionales.OBJETIVO:Comparamos la calidad de vida, los resultados funcionales a largo plazo y la recurrencia del prolapso después de la rectopexia de resección versus la rectopexia ventral con malla.DISEÑO:Revisamos retrospectivamente nuestra base de datos de cirugía de prolapso rectal recopilada prospectivamente.EN
{"title":"Quality of Life, Functional Outcomes, and Recurrence After Resection Rectopexy Versus Ventral Mesh Rectopexy for Rectal Prolapse Repair.","authors":"Anna R Spivak, Marianna Maspero, Rebecca Y Spivak, Jessica A Sankovic, Stephanie Norman, Caitlyn Deckard, Scott R Steele, Tracy L Hull","doi":"10.1097/DCR.0000000000003467","DOIUrl":"10.1097/DCR.0000000000003467","url":null,"abstract":"<p><strong>Background: </strong>Resection rectopexy and ventral mesh rectopexy are widely accepted surgical options for the treatment of rectal prolapse; however, reports on long-term recurrence rates and functional outcomes are lacking.</p><p><strong>Objective: </strong>We compared quality of life, long-term functional outcomes, and prolapse recurrence after resection rectopexy versus ventral mesh rectopexy.</p><p><strong>Design: </strong>We retrospectively reviewed our prospectively collected rectal prolapse surgery database.</p><p><strong>Settings: </strong>Patients who underwent resection rectopexy or ventral mesh rectopexy at our center between 2009 and 2016 were included.</p><p><strong>Patients: </strong>Two hundred twenty patients were included, of whom 208 (94%) were women; 85 (39%) underwent resection rectopexy and 135 (61%) ventral mesh rectopexy.</p><p><strong>Main outcome measures: </strong>Prolapse recurrence.</p><p><strong>Results: </strong>The resection rectopexy group was younger (median 52 vs 60 years old, p = 0.02) and had more open procedures (20% vs 9%, p < 0.001). After a median follow-up of 110 (interquartile range 94-146) months for resection rectopexy and 113 (87-137) months for ventral mesh rectopexy, recurrences occurred in 21 (26%) in the resection rectopexy and 50 (39%) in the ventral mesh rectopexy group ( p = 0.041). The median time to recurrence was 44 (18-80) months in the resection rectopexy group and 28.5 (11-52.5) months in the ventral mesh rectopexy group ( p = 0.14). There were no differences in the recurrence rate for primary prolapses in resection rectopexy versus ventral mesh rectopexy. The recurrence rate for redo prolapses was higher in the ventral mesh rectopexy group at 63% at 10 years versus 25% in the resection rectopexy group ( p = 0.006). Functional outcomes were similar between the 2 groups.</p><p><strong>Limitations: </strong>Retrospective review, recall bias.</p><p><strong>Conclusions: </strong>Long-term quality of life and functional outcomes after resection rectopexy and ventral mesh rectopexy were comparable. Ventral mesh rectopexy was associated with a higher prolapse recurrence rate after recurrent rectal prolapse repair. See Video Abstract .</p><p><strong>Calidad de vida, resultados funcionales y recurrencia despus de la rectopexia por reseccin versus la rectopexia ventral con malla para la reparacin del prolapso rectal: </strong>ANTECEDENTES:La rectopexia de resección y la rectopexia ventral con malla son opciones quirúrgicas ampliamente aceptadas para el tratamiento del prolapso rectal; sin embargo, faltan informes sobre las tasas de recurrencia a largo plazo y los resultados funcionales.OBJETIVO:Comparamos la calidad de vida, los resultados funcionales a largo plazo y la recurrencia del prolapso después de la rectopexia de resección versus la rectopexia ventral con malla.DISEÑO:Revisamos retrospectivamente nuestra base de datos de cirugía de prolapso rectal recopilada prospectivamente.EN","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"91-100"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343666","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 : 2025-01-01Epub Date: 2024-10-23DOI: 10.1097/DCR.0000000000003615
{"title":"January 2025 Translations.","authors":"","doi":"10.1097/DCR.0000000000003615","DOIUrl":"https://doi.org/10.1097/DCR.0000000000003615","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":"68 1","pages":"e10-e44"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827855","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 : 2025-01-01Epub Date: 2024-10-17DOI: 10.1097/DCR.0000000000003555
Charmee H Mehta, Michael D Honaker
{"title":"Diagnosis and Management of Anal Stenosis.","authors":"Charmee H Mehta, Michael D Honaker","doi":"10.1097/DCR.0000000000003555","DOIUrl":"10.1097/DCR.0000000000003555","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"9-12"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460450","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 : 2025-01-01Epub Date: 2024-10-23DOI: 10.1097/DCR.0000000000003568
Dilip Umakant Pathak
{"title":"Reply.","authors":"Dilip Umakant Pathak","doi":"10.1097/DCR.0000000000003568","DOIUrl":"10.1097/DCR.0000000000003568","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e9"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496999","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 : 2025-01-01Epub Date: 2024-10-23DOI: 10.1097/DCR.0000000000003571
Yingnan Hu, Wei Zhang
{"title":"Robot-Assisted Surgery for Colorectal Cancer in Adults Aged 75 Years or Older: Value for Money?","authors":"Yingnan Hu, Wei Zhang","doi":"10.1097/DCR.0000000000003571","DOIUrl":"10.1097/DCR.0000000000003571","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e8"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497004","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 : 2025-01-01Epub Date: 2024-10-22DOI: 10.1097/DCR.0000000000003519
Yvonne Ying-Ru Ng, Ameera J M S AlHasan, Paris Tekkis
{"title":"Handsewn Coloanal Anastomosis.","authors":"Yvonne Ying-Ru Ng, Ameera J M S AlHasan, Paris Tekkis","doi":"10.1097/DCR.0000000000003519","DOIUrl":"10.1097/DCR.0000000000003519","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"e3-e4"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460451","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 : 2025-01-01Epub Date: 2024-10-22DOI: 10.1097/DCR.0000000000003429
Glenn T Ault
{"title":"Shaping Graduate Medical Education: Status of the Colon and Rectal Surgery Training Program Requirements.","authors":"Glenn T Ault","doi":"10.1097/DCR.0000000000003429","DOIUrl":"10.1097/DCR.0000000000003429","url":null,"abstract":"","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":"1-4"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460466","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：