The effect of minimally invasive surgery on thirty-day postoperative outcomes of frail patients undergoing emergency colon resections.

Background: Frail patients have poor outcomes after emergent colon surgery. While minimally invasive surgery has shown improved outcomes in the general patient population undergoing colectomy, the benefits in frail patients are unknown.

Methods: We identified frail patients who underwent urgent or emergent colon resections from 2017 to 2021 in the National Surgical Quality Improvement Program database.

Association of CASP8 rs3834129 and CTGF rs6918698 genotypes with susceptibility to colorectal cancer in a Mexican population.

Connective tissue growth factor (CTGF) and Caspase 8 (CASP8) have been implicated in cancer development and progression. Variants such as CASP8 rs3834129 (-652 6N I/D) and CTGF rs6918698 (-945 C>G) have been associated with several cancers, although their association is still debated between populations. This study investigates the possible association between the CASP8 rs3834129 and CTGF rs6918698 variants with  colorectal cancer (CRC) in Mexican patients.

Pelvic inlet closure with bladder peritoneal flap reduces postoperative ileus after abdominoperineal resection.

Background: Abdominoperineal resection (APR) is the standard treatment for locally advanced distal rectal cancer (LADRC) following neoadjuvant treatment when sphincter-preserving procedures are inapplicable. However, complications such as perineal site infection, perineal hernia and postoperative ileus remain ongoing challenges. We aimed to compare the rate of postoperative ileus due to pelvic incarceration in APR patients with/without pelvic inlet closure.

Splenic flexure mobilization: does body topography matter?

Background: Splenic flexure mobilization can be technically challenging, and its oncological benefits remain uncertain. This study aims to explore the relationship between patient and clinical characteristics and splenic flexure mobilization time as well as the implications of prolonged splenic flexure mobilization duration.

Methods: This retrospective cohort study includes 105 patients who underwent laparoscopic distal colorectal cancer surgery between 2013 and 2018.

Linear endo-ultrasonographic signs of muscularis propria invasion in early rectal cancer.

Background And Study Aim: Local resection of early rectal cancer is being increasingly used. With invasion of the muscularis propria layer of the rectal wall, the risk of lymph node metastasis becomes too high to consider this the optimal oncological treatment. Therefore, a diagnosis of muscular invasion is important before attempting local resection; however, endoscopic and magnetic resonance imaging (MRI) images have limitations, such as overstaging (26-31%).

Short- and long-term impact of the TaTME learning process: a single institutional study.

Background: Transanal total mesorectal excision (TaTME) is a promising and innovative approach for lower rectal cancer but requires high technical skill and learning process that can affect patient outcomes. We aimed to determine the learning curve of TaTME and then to assess its impact on 5-year oncologic outcomes.

Methods: Over a 54-month period, 94 patients underwent TaTME by experienced laparoscopic colorectal surgeons at our department.

Relationships between the Microbiome and Response to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer.

Purpose: This study aimed to investigate the dynamic changes in the microbiome of patients with locally advanced rectal cancer (LARC) undergoing neoadjuvant chemoradiotherapy (nCRT), focusing on the relationship between the microbiome and response to nCRT.

Materials And Methods: We conducted a longitudinal study involving 103 samples from 26 patients with LARC. Samples were collected from both the tumor and normal rectal tissues before and after nCRT.

Reconstruction of the pelvic floor and perineal wound after extralevator abdominoperineal resection of the rectum.

This article presents an innovative technique for perineal wound reconstruction following extralevator abdominoperineal excision (ELAPE) in rectal cancer surgery. The authors trace the evolution of surgical methods for rectal cancer treatment, from W.E.

Early rectal neoplasm in dual-layer spectral detector computed tomography: dual-layer spectral computed tomography (CT) images improve tumor detection and staging.

Background: Early rectal neoplasms can be treated endoscopically with good prognosis, yet usually present with unspecific or an absence of signs and symptoms and are detected largely by invasive endoscopy with less compliance to screening. The purpose of this cross-sectional study was to explore the diagnostic value of dual-layer spectral detector computed tomography (DSCT) imaging for early rectal neoplasm.

Methods: Patients who underwent DSCT for evaluation of rectal lesion or routine examination between September 2022 to September 2023 at West China Hospital were prospectively included and identified as group A (control, n=76), group B (rectal advanced adenomas and ≤T1 rectal cancer, n=59), and group C (≥T2 staging rectal cancer, n=74).

Diagnostic Challenges due to a Germline Missense MSH2 Variant in a Patient With Immunotherapy-Responsive Locally Advanced Rectal Adenocarcinoma.

Background: Rapid and accurate identification of mismatch repair (MMR) deficiency and Lynch syndrome is critical in the prognostication and clinical management of patients with colorectal carcinoma.

Case Description: We describe here a young woman who developed a locally aggressive rectal adenocarcinoma with intact MMR protein expression by immunohistochemistry and absence of histologic evidence of MMR deficiency-associated increased tumoral immune response. Germline DNA-targeted sequencing identified MSH2 variant p.

Assessing intra- and interfraction motion and its dosimetric impacts on cervical cancer adaptive radiotherapy based on 1.5T MR-Linac.

Purpose: The purpose of this study was to quantify the intra- and interfraction motion of the target volume and organs at risk (OARs) during adaptive radiotherapy (ART) for uterine cervical cancer (UCC) using MR-Linac and to identify appropriate UCC target volume margins for adapt-to-shape (ATS) and adapt-to-position (ATP) workflows. Then, the dosimetric differences caused by motion were analyzed.

Methods: Thirty-two UCC patients were included.

Whole slide image based prognosis prediction in rectal cancer using unsupervised artificial intelligence.

Background: Rectal cancer is a common cancer worldwide and lacks effective prognostic markers. The development of prognostic markers by computational pathology methods has attracted increasing attention. This paper aims to construct a prognostic signature from whole slide images for predicting progression-free survival (PFS) of rectal cancer through an unsupervised artificial intelligence algorithm.

Long-term outcomes of S-1 and oxaliplatin neoadjuvant chemotherapy with total mesorectal excision and lateral lymph node dissection for rectal cancer.

Purpose: Chemoradiotherapy (CRT) for rectal cancer is limited by its harmful side effects and its insufficient benefit on lateral lymph node metastases. The purpose of this study was to evaluate the long-term outcomes of S-1 and oxaliplatin with total mesorectal excision (TME) and lateral lymph node dissection (LLND) without radiation for rectal cancer.

Methods: The inclusion criteria were patients with stage II or III rectal cancer located within 10 cm from the anal verge.

Estimation of adaptive radiation therapy requirements for rectal cancer: a two-center study.

Background: Rectal cancer patients are potential beneficiaries of adaptive radiotherapy (ART) which demands considerable resources. Currently, there is no definite guidance on what kind of patients and when will benefit from ART. This study aimed to develop and validate a methodology for estimating ART requirements in rectal cancer before treatment course.

Primary anorectal mammary-like adenocarcinoma: a potential diagnostic pitfall with conventional colorectal adenocarcinoma.

Anogenital mammary-like glands (AGMLGs) are present in the anogenital region that bear striking morphologic and protein-expression similarities to mammary glands in the breast. AGMLGs can give rise to both benign and malignant lesions which mimic primary breast lesions. Herein, we report two mammary-type adenocarcinomas arising from AGMLGs, including one in the previously unreported site of the rectum.

Radiotherapy & total neoadjuvant therapy for recurrent rectal cancer in previously irradiated patients, (RETRY): a multicenter prospective observational study.

Background: Local recurrence of rectal cancer (LRRC) previously treated with radiotherapy is associated with a poor prognosis. Historically, the integration of radiotherapy (RT) with surgery has improved the likelihood of complete resections (R0) and, consequently, enhanced survival. Unfortunately, many LRRC cases are not amenable to surgical intervention.

Continuous prediction for tumor mutation burden based on transcriptional data in gastrointestinal cancers.

Background: Tumor mutation burden (TMB) has been considered a biomarker for utilization of immune checkpoint inhibitors(ICIs), but whole exome sequencing(WES) and cancer gene panel(CGP) based on next generation sequencing for TMB detection are costly. Here, we use transcriptome data of TCGA to construct a model for TMB prediction in gastrointestinal tumors.

Methods: Transcriptome data, somatic mutation data and clinical data of four gastrointestinal tumors from TCGA, including esophageal cancer (ESCA), stomach adenocarcinoma (STAD), colon adenocarcinoma (COAD) and rectal adenocarcinoma (READ).

Radical prostatectomy outcomes of prostate cancer cases: Insights from a leading surgeon's experience in Azerbaijan.

Objective: Prostate cancer is a significant health concern worldwide and ranks as the 4th most frequent cancer among men in Azerbaijan. While robot-assisted laparoscopic radical prostatectomy is the preferred surgical technique in many countries, open retropubic radical prostatectomy (ORP) remains the primary treatment option in Azerbaijan due to limited access to robotic surgical systems. This study aims to analyze the outcomes of ORP in patients with local and locally advanced prostate cancer.

Initial experience and results of robotic lateral pelvic lymph node dissection in locally advanced rectal cancer-a single center experience of 17 consecutive procedures.

Purpose: We have evaluated lateral pelvic lymph node dissection (LPLND) in combination with rectal resection in the treatment of locally advanced rectal cancer in a specialized colorectal surgical department with a focus on safety and feasibility.

Methods: The study analyzed surgical-pathologic outcomes in 17 consecutive patients who underwent robotic LPLND and rectal resection between May 2018 and June 2024 at a high-volume colorectal cancer center in Denmark. Patients were selected for the procedure based on lateral lymph node (LLN) diameter ≥ 8 mm before and ≥ 5 mm after neoadjuvant treatment.

Systemic Therapy for Stage I-III Anal Squamous Cell Carcinoma: ASCO Guideline.

Purpose: To provide evidence-based guidance for clinicians who treat patients with stage I-III anal cancer.

Methods: A systematic review of the literature conducted by the Minnesota Evidence-based Practice Center provided the evidence base for this guideline. An ASCO Expert Panel reviewed this evidence and came to consensus on a set of evidence-based recommendations.

Evaluating the necessity of colonoscopy in patients under 40 with rectal bleeding: insights from a large-scale retrospective analysis.

Purpose: Bleeding per rectum (BPR) is a common clinical presentation, and colonoscopy is the gold standard for evaluating patients aged ≥ 45 years. However, its role in younger patients remains unclear. This study evaluated the appropriateness of colonoscopy in patients < 40 years of age who presented with BPR.

Comparing the Management Recommendations of Large Language Model and Colorectal Cancer Multidisciplinary Team: A Pilot Study.

Background: Management of anorectal cancers requires a multidisciplinary team approach. Recently, large language models have been suggested as potential tools for various applications in health care.

Objective: Assess suggested management recommendations provided by a generative artificial intelligence chatbot with those of a colorectal cancer multidisciplinary team to evaluate applicability in clinical settings.

Case Report: Robotic Repair of a Perineal Hernia Following Abdominoperineal Resection.

Introduction: Perineal hernias, protrusions through the pelvic diaphragm, are a rare complication post-abdominoperineal resection. The shift to extralevator APR techniques could be linked to a potential increase in these hernias. This case series evaluates the surgical management of perineal hernias, focusing on the evolving role of robotic surgery.

Total intravenous or inhalational volatile anaesthesia and survival after colorectal cancer surgery: a Swedish national registry study.

Introduction: Retrospective studies suggest that inhalational volatile anaesthetic agents may contribute to an increased risk of metastasis and reduction in survival rates when used during cancer surgery. This relationship may vary between cancer types due to different tumour biology and differences in surgical procedures. This study aimed to investigate the relationship between the type of anaesthetic used for maintenance of anaesthesia (propofol or inhalational volatile anaesthetic agent) and survival in patients with stage 1-3 colorectal cancer who underwent resection surgery under general anaesthesia in Sweden between 2014 and 2019.

[Metastatic Lung Tumor with Bronchial Cast Shadow in Which Intraoperative Bronchoscopy Was Useful During Robotic Surgery].

A man in his 60s, who had undergone surgery for rectal cancer, liver metastases, and lung metastasis, had a past history of myocardial infarction and ventricular fibrillation with reduced cardiac functions. He was referred to our department because of a pulmonary nodule shadow in the S2 right upper lobe and a bronchial cast shadow along the B2 bronchus. Robot-assisted thoracoscopic right S2 segmentectomy was performed and intraoperative bronchoscopy revealed a polyp-like tumor within B2a.