Introduction: Anastomotic leakage (AL) in colorectal surgery occurs with an incidence of up to 20%. Bowel perfusion is deemed to be one of the most important factors for anastomotic healing. However, not much is known about its variability during colorectal surgery and its impact on the outcome. Therefore, this study aims to evaluate serosal oxygen saturation patterns during colorectal resections with visible light spectroscopy (VLS).
Materials And Methods: Bowel perfusion in patients undergoing left-sided colorectal resections was assessed at different timepoints during surgery using VLS on the colonic serosa. The primary outcome parameter was serosal oxygen saturation (StO2) at the anastomosis during different timepoints of surgery.
Results: We included 50 patients who underwent colorectal resection for bowel cancer (58%) and diverticular disease (34%). StO2 at the proximal site of the anastomosis increased significantly throughout the surgery (mean difference 3.61%; 95% CI -6.22 to -1.00; p = 0.008). However, aberrancy from this identified perfusion pattern had no impact on the postoperative outcome.
Conclusion: During colorectal resections, we could demonstrate an increase of the colonic StO2 throughout surgery. Appearance of AL was not associated with lower StO2, underlining the multifactorial genesis of developing AL.
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http://dx.doi.org/10.1159/000514921 | DOI Listing |
J Invest Surg
January 2025
Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
Background: The prognostic value of tumor regression grade (TRG) after neoadjuvant chemoradiotherapy for rectal cancer is inconsistent in the literature. Both TRG and post-therapy lymph node (ypN) status could reflect the efficacy of neoadjuvant therapy. Here, we explored whether TRG combined with ypN status could be a prognostic factor for MRI-based lymph node-positive (cN+) rectal cancer following neoadjuvant chemoradiotherapy.
View Article and Find Full Text PDFExp Ther Med
February 2025
Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan.
The present study aimed to investigate the role of a recombinant protein based on human collagen type I (RCPhC1) as a scaffold in maintaining the human tumor microenvironment within a patient-derived tumor xenograft (PDTX) model. RCPhC1, synthesized under animal component-free conditions, was explored for its potential to support the human-specific stroma associated with tumor growth. PDTX models were established using resected colorectal cancer liver metastasis specimens, and stromal cell populations from humans and mice were compared using three scaffolds: No scaffold (control), Matrigel and recombinant human collagen type I, across two passages.
View Article and Find Full Text PDFACG Case Rep J
January 2025
Department of Medicine, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA.
While hematochezia is common in Crohn's disease (CD), severe gastrointestinal hemorrhage causing hemodynamic instability is rare. Strictures, another frequent complication, usually cause obstructive symptoms. We report the first case of hemorrhagic shock from ulcerated ileal strictures as the initial presentation of CD.
View Article and Find Full Text PDFBiomed Eng Lett
January 2025
Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea.
In recent years, robotic assistance has become increasingly used and applied in minimally invasive surgeries. A new cooperative surgical robot system that includes a joystick-guided robotic scope holder was developed in this study, and its feasibility for use in minimally invasive abdominal surgery was evaluated in a preclinical setting. The cooperative surgical robot consists of a six-degree-of-freedom collaborative robot arm and a one-degree-of-freedom bidirectional telescopic end-effector specializing in surgical assistance.
View Article and Find Full Text PDFInt J Colorectal Dis
January 2025
Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Purpose: The Japanese Grade Classification based on the status of pulmonary and mesenteric nodal metastases and the presence of extrapulmonary metastases had a prognostic value in patients with colorectal lung metastases previously. Because the survival of such patients has improved in the era of conversion therapy, this classification needs to be reaudited.
Methods: This study reviewed the treatment sequences of 126 colorectal cancer patients with synchronous lung metastases between 2010 and 2022 at our hospital.
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