Seminars in Colon and Rectal Surgery最新文献

英文中文

Global perspectives on young-onset colorectal cancer: epidemiology, challenges, and advances 年轻发病结直肠癌的全球视角：流行病学、挑战和进展

IF 0.5 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-07-22 DOI: 10.1016/j.scrs.2025.101118

Drew Goldberg , Erica Pettke

Colorectal cancer (CRC) is one of the most prevalent malignancies worldwide. It is thought to mainly affect older populations, typically considered those aged 50 or above. Recent trends have shown that CRC in patients younger than 50 years old, known as early onset colorectal cancer (EOCRC), is on the rise while rates of disease in older populations have leveled off or even decreased in many places. This alarming trend is described globally, with a clear relationship between highly developed nations and EOCRC disease burden. More granular disease drivers remain elusive but have been linked to diet, lifestyle, genetic predispositions, and environmental exposure. The clinical, genetic, and histological characteristics of EOCRC imply it is a separate oncologic entity from CRC within older populations. Challenges in management of global EOCRC include standardized clinical guidance, diagnostic consensus, and treatment strategies. Advancements in care have allowed for improved public awareness and disease risk prediction. The pattern of global EOCRC trends represents a significant population health concern, and as such deserves increased attention from clinicians, patients, and the public alike.

结直肠癌（CRC）是世界上最常见的恶性肿瘤之一。它被认为主要影响老年人，通常被认为是50岁或以上的人。最近的趋势表明，50岁以下患者的结直肠癌，即早发性结直肠癌（EOCRC），呈上升趋势，而在许多地方，老年人群的发病率持平甚至下降。这一令人震惊的趋势在全球范围内得到了描述，高度发达国家与EOCRC疾病负担之间存在明确的关系。更多的颗粒状疾病驱动因素仍然难以捉摸，但与饮食、生活方式、遗传易感性和环境暴露有关。EOCRC的临床、遗传和组织学特征表明，在老年人群中，它是一种独立于CRC的肿瘤实体。全球EOCRC管理面临的挑战包括标准化临床指导、诊断共识和治疗策略。医疗方面的进步提高了公众意识和疾病风险预测。全球EOCRC趋势的模式代表了一个重要的人口健康问题，因此值得临床医生、患者和公众的更多关注。

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引用次数: 0

Watch and wait in early onset rectal cancer patients: A review of the literature 观察和等待早发直肠癌患者：文献综述

IF 0.5 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-07-03 DOI: 10.1016/j.scrs.2025.101117

Melissa K Drezdzon , Carrie Y Peterson

Introduction

Despite the general decline in rectal cancer diagnoses, early onset rectal cancer (EORC) diagnoses are increasing. Meanwhile, Watch and Wait (WW) surveillance for patients with complete clinical response to neoadjuvant therapy is gaining popularity. While outcomes for WW are good, there may be hesitancy enrolling younger patients. This review aimed to evaluate literature examining WW in EORC patients.

Methods

A systematic literature review was conducted and full-text, peer-reviewed manuscripts were assessed for eligibility. A single study, “Watch and Wait After a Clinical Complete Response in Rectal Cancer Patients Younger than 50 Years,” by Bahadoer et al. (2021) was identified.

Results

The study included 199 EORC patients followed for a mean of 3.2 years. Compared to older patients, EORC patients had higher overall survival, and similar rates of disease-free survival and local recurrence.

Discussion

The results of the identified study are encouraging, however, there is a paucity of data on WW in EORC patients, including not only clinical outcomes but surveillance compliance and barriers that might inform treatment decision-making. Decisions regarding WW in EORC patients should be made on an individual case after thorough discussion with patients.

尽管直肠癌诊断率普遍下降，但早发性直肠癌（EORC）诊断率正在上升。与此同时，观察和等待（WW）监测对新辅助治疗有完全临床反应的患者越来越受欢迎。虽然WW的结果很好，但招收年轻患者可能存在犹豫。本综述旨在评价有关EORC患者WW的文献。方法进行系统文献综述，并对全文、同行评议稿件进行合格性评估。Bahadoer等人（2021）的一项研究“观察并等待50岁以下直肠癌患者临床完全缓解后”得到了确认。结果本研究纳入199例EORC患者，平均随访时间3.2年。与老年患者相比，EORC患者的总生存率更高，无病生存率和局部复发率相似。该研究的结果令人鼓舞，然而，关于EORC患者WW的数据缺乏，不仅包括临床结果，还包括可能为治疗决策提供信息的监测依从性和障碍。EORC患者的WW应在与患者充分讨论后根据个案作出决定。

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引用次数: 0

Fertility considerations young onset CRC 生育方面的考虑，早发性结直肠癌

IF 0.5 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-07-03 DOI: 10.1016/j.scrs.2025.101119

Jared Matson MD, Shanglei Liu MD MAS

The incidence of young-onset colorectal cancer (YOCRC) is rising. This patient population often presents with advanced disease and is treated more aggressively, raising unique challenges—particularly regarding fertility and sexual function. This chapter explores the multifaceted impact of YOCRC treatment on fertility and the importance of early reproductive counseling. YOCRC patients frequently undergo multimodal therapy, including chemotherapy, radiation, and surgery—all of which can impair fertility. Chemotherapeutic agents like oxaliplatin and irinotecan are known to be gonadotoxic, with variable long-term effects in both men and women. Pelvic radiation carries high risks for both gonadal failure and uterine or testicular dysfunction. Surgical interventions can damage reproductive organs or alter anatomical and hormonal function, leading to infertility. Fertility preservation methods—including sperm or oocyte cryopreservation, embryo freezing, ovarian transposition, and tissue cryopreservation—offer patients the possibility of future biological parenthood but require early intervention. Additionally, sexual dysfunction is common, driven by nerve damage, radiation effects, anatomical changes, and psychological distress, all of which may further impair reproductive potential. Given that YOCRC patients are often first evaluated by surgeons, it is critical for providers to discuss fertility and sexual health early and refer patients to reproductive specialists. Improved provider awareness and proactive counseling can help preserve future family-building options and enhance quality of life for this growing patient population.

年轻型结直肠癌（YOCRC）的发病率正在上升。这类患者通常表现为疾病晚期，需要更积极的治疗，这带来了独特的挑战，特别是在生育和性功能方面。本章探讨了YOCRC治疗对生育的多方面影响以及早期生殖咨询的重要性。YOCRC患者经常接受多模式治疗，包括化疗、放疗和手术——所有这些都会损害生育能力。像奥沙利铂和伊立替康这样的化疗药物已知具有促性腺毒性，对男性和女性都有不同的长期影响。盆腔放疗对性腺功能衰竭和子宫或睾丸功能障碍都有很高的风险。手术干预可能损害生殖器官或改变解剖和激素功能，导致不孕。生育保存方法——包括精子或卵母细胞冷冻保存、胚胎冷冻、卵巢转位和组织冷冻保存——为患者提供了未来生养的可能性，但需要早期干预。此外，性功能障碍是常见的，由神经损伤、辐射效应、解剖改变和心理困扰驱动，所有这些都可能进一步损害生殖潜力。鉴于YOCRC患者通常首先由外科医生进行评估，提供者早期讨论生育和性健康并将患者转介给生殖专家至关重要。提高提供者的意识和积极主动的咨询可以帮助维护未来的家庭建设的选择和提高生活质量，为日益增长的患者群体。

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引用次数: 0

Young-onset colorectal cancer quality of life and psychosocial concerns 年轻发病结直肠癌的生活质量和社会心理问题

IF 0.5 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-07-03 DOI: 10.1016/j.scrs.2025.101120

Jaewon J Lee, Kristen E Dougherty, Karyn B Stitzenberg

Colorectal cancer (CRC) in younger adults poses unique challenges in multiple quality of life domains. There are numerous potential downstream effects of CRC treatments (surgery, chemotherapy, and radiation therapy) that may be felt more deeply by younger patients, not just in physical symptoms but also in emotional, psychological, and social aspects of their lives. Many of these domains overlap, and the effects are difficult to quantify, but healthcare providers need to be aware of the consequences that CRC diagnosis and its treatment can have on younger adults. Herein, we review the quality of life and psychosocial concerns related to young-onset CRC spanning from perceived physical symptoms to stressors in finances, occupation, interpersonal relationships, and fear of cancer recurrence.

结直肠癌（CRC）在年轻人的多个生活质量领域提出了独特的挑战。结直肠癌治疗（手术、化疗和放疗）有许多潜在的下游效应，年轻患者可能会更深刻地感受到，不仅在身体症状上，而且在他们生活的情感、心理和社会方面。许多这些领域重叠，其影响难以量化，但医疗保健提供者需要意识到结直肠癌的诊断和治疗对年轻人的影响。在此，我们回顾了与年轻发病的CRC相关的生活质量和社会心理问题，从感知到的身体症状到经济、职业、人际关系和对癌症复发的恐惧等压力源。

引用次数: 0

Sponsorship, mentorship, and coaching: Navigating the path to surgical leadership 赞助、指导和指导：引导外科领导之路

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-03-21 DOI: 10.1016/j.scrs.2025.101103

Sharon L. Stein MD

Surgeons continue to acquire skills as they progress as leaders. While some skills can be achieved from practice, books, and continuing medical education, the role of sponsors, mentors, and coaching cannot be overstated in helping individuals and incorporating new skills. Sponsors are key in providing opportunities and advancement. Mentors advise from their experience, and coaches are skilled at providing perspective. Understanding the roles of sponsors, mentors, and coaches, as well as their utility in guiding a surgeon's career is discussed in the chapter.

外科医生在成为领导者的过程中不断获得技能。虽然有些技能可以从实践、书籍和继续医学教育中获得，但赞助商、导师和教练在帮助个人和吸收新技能方面的作用不能被夸大。赞助商是提供机会和晋升的关键。导师从他们的经验中提出建议，教练善于提供观点。本章将讨论赞助者、导师和教练的作用，以及他们在指导外科医生职业生涯中的作用。

引用次数: 0

The path to career advancement in surgical research 外科研究的职业发展之路

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-03-20 DOI: 10.1016/j.scrs.2025.101104

Erin Wolf Horrell MD, PhD , Alexander T Hawkins MD, MPH

Surgeon-scientists are uniquely positioned to make significant contributions to research which directly affects patient care, however, there are many barriers to a successful career in academic surgery. Surgeon-scientists must balance the demand for clinical productivity, education, and administration with the time commitment required to complete meaningful research. The challenges associated with maintaining this balance have led to a decrease in the number of individuals pursuing a career as a surgeon-scientist. There is a significant need to support surgeon-scientists as they embark on this challenging career path. This paper outlines a pathway to begin a successful career in academic surgical research and provides an approach to identifying and overcoming challenges.

外科医生具有独特的地位，可以为直接影响患者护理的研究做出重大贡献，然而，在学术外科领域取得成功的职业生涯有许多障碍。外科科学家必须平衡临床生产力、教育和管理的需求与完成有意义的研究所需的时间承诺。与保持这种平衡相关的挑战导致追求外科科学家职业的个人数量减少。当外科医生走上这条充满挑战的职业道路时，对他们的支持是非常必要的。本文概述了在学术外科研究中开始成功职业生涯的途径，并提供了识别和克服挑战的方法。

引用次数: 0

The role of surgical societies in surgical leadership and career development 外科学会在外科领导和职业发展中的作用

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-03-20 DOI: 10.1016/j.scrs.2025.101107

Sean J. Langenfeld MD

Surgical societies play a major role in leadership and career development. Understanding how different societies function on the local, regional, and national level will allow the surgeon to navigate these intimidating environments and gain priceless tools to make them more effective and successful. This chapter does not dive much into the science of leadership, but instead focuses on some of the human aspects of getting involved and finding leadership opportunities.

外科学会在领导力和职业发展方面发挥着重要作用。了解不同社会在地方、区域和国家层面上的运作方式，将使外科医生能够在这些令人生畏的环境中穿行，并获得宝贵的工具，使他们更有效、更成功。这一章并没有深入研究领导的科学，而是集中在参与和寻找领导机会的一些人性方面。

引用次数: 0

From OR to boardroom: Transferring surgical skills to executive leadership roles 从手术室到会议室：将外科技能转化为行政领导角色

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-03-20 DOI: 10.1016/j.scrs.2025.101100

Walter R. Peters Jr. MD, MBA

Surgeons develop skills throughout their career that provide a good foundation for executive leadership. Leadership, communication, and decision making are necessary for success in the Operating Room and the Boardroom. With effective mentoring, intentional study to broaden their knowledge base, and experience gained from participation in activities outside their clinical practice, surgeons can evolve to become effective leaders within the healthcare system. Executive leadership offers surgeons a rewarding means of utilizing their knowledge, skill, and experience to serve their colleagues and their communities.

外科医生在整个职业生涯中发展技能，为行政领导提供良好的基础。领导、沟通和决策是手术室和会议室成功的必要条件。通过有效的指导，有意识的学习来扩大他们的知识基础，以及从参与临床实践之外的活动中获得的经验，外科医生可以发展成为医疗保健系统内有效的领导者。行政领导为外科医生提供了一种有益的手段，利用他们的知识、技能和经验为他们的同事和社区服务。

引用次数: 0

The role of surgical leadership and career development in the social media era 外科领导和职业发展在社交媒体时代的作用

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-03-20 DOI: 10.1016/j.scrs.2025.101106

Kristyn Kraus DO , Avery Walker MD, FACS, FASCRS

Social media has become a great tool for medical research due to its ability to reach a wide audience and provide real-time data. As social media continues to evolve, its impact on colon and rectal surgery leadership and career development will only grow. By embracing social media responsibly and leveraging its potential for professional growth, surgeons can shape the future of surgical practice and leadership in the digital age.

社交媒体已经成为医学研究的一个重要工具，因为它能够接触到广泛的受众并提供实时数据。随着社交媒体的不断发展，它对结肠和直肠手术的领导力和职业发展的影响只会越来越大。通过负责任地接受社交媒体并利用其专业成长的潜力，外科医生可以在数字时代塑造外科实践和领导力的未来。

引用次数: 0

Surgical entrepreneurship: Navigating the intersection of medicine, business and leadership 外科创业：驾驭医学、商业和领导力的交叉点

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-03-20 DOI: 10.1016/j.scrs.2025.101101

Arshad M. Bachelani MD, MMM , Mark K. Soliman MD, MBA

Surgeons possess a unique constellation of skills—adaptability, leadership, and problem-solving—that translates well to entrepreneurial ventures. This chapter outlines a framework for surgeon-entrepreneurs to identify and address unmet needs within healthcare through innovation. Beginning with ideation and problem definition, the text highlights the importance of validating market demand and engaging stakeholders early. It then describes the iterative process of prototyping and developing a minimum viable product (MVP), detailing how resource-efficient strategies can confirm feasibility and guide product refinement. Building a high-functioning team is discussed in the context of complementary expertise and shared vision, which is vital when navigating complex regulatory and financial landscapes. The chapter also explores surgeon entrepreneurs' cultural challenges, emphasizing how an entrepreneurial mindset can extend rather than detract from clinical responsibilities. By demonstrating how established surgical skills can be harnessed to create impactful new solutions, this work underscores the potential for surgeon-led ventures to improve patient care and streamline healthcare delivery on a larger scale.

外科医生拥有一系列独特的技能——适应能力、领导能力和解决问题的能力——这些技能可以很好地转化为创业企业。本章概述了外科医生企业家的框架，通过创新来识别和解决医疗保健领域未满足的需求。从构思和问题定义开始，本文强调了验证市场需求和尽早吸引利益相关者的重要性。然后描述了原型设计和开发最小可行产品（MVP）的迭代过程，详细说明了资源效率策略如何确认可行性并指导产品改进。在互补性专业知识和共同愿景的背景下讨论建立一个高功能团队，这在驾驭复杂的监管和金融环境时至关重要。本章还探讨了外科医生企业家的文化挑战，强调企业家心态如何扩展而不是减损临床责任。通过展示如何利用已建立的外科技能来创建有影响力的新解决方案，这项工作强调了外科主导的企业在更大范围内改善患者护理和简化医疗保健服务的潜力。

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