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Medicina
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Recent Advances and Future Challenges in Colorectal Surgery
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Recent Advances and Future Challenges in Colorectal Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Gastroenterology & Hepatology".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 3638

Special Issue Editors

Dr. Athanasios Syllaios

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Guest Editor
First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
Interests: general surgery; colorectal surgery; laparotomy; surgery
Dr. Nikoletta Dimitriou

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Guest Editor
First Department of Surgery, Laiko General Hospital, Medical School of Athens, National and Kapodistrian University of Athens, Athens, Greece
Interests: general surgery; colorectal surgery

Special Issue Information

Dear Colleagues,

The landscape of colorectal surgery has undergone rapid transformation in recent years, marked by the integration of cutting-edge technologies and techniques into the surgical repertoire. As we navigate this dynamic field of coloproctology, the pursuit to illuminate uncharted territories remains ever-fervent, concurrent with the assimilation of innovations into clinical practice. The primary objective of this Special Issue is to provide a platform for critical examination of the impact of recent technological advancements on various facets of colorectal surgery, including surgical outcomes, perioperative patient care, postoperative recovery, overall patient experience, the impact of ERAS protocols, current treatment approaches, multimodal management, minimally invasive treatment, the use of fluorescent methods, the role of multidisciplinary meetings, progress in treating advanced diseases, and screening in early cancer stages.

We welcome manuscripts that scrutinize the role of minimally invasive modalities such as robotic surgery, laparoscopic surgery, Tamis, and TEMS, as well as those that explore the application of artificial intelligence and big data in surgical decision-making, particularly in endoscopic procedures. Additionally, contributions evaluating perioperative patient optimization, leveraging translational research in coloproctology, or comparing the outcomes of different innovative approaches to colorectal diseases are encouraged.

While priority will be accorded to high-quality, original studies, we also welcome well-designed systematic reviews, with or without meta-analysis, narrative reviews, etc., offering comprehensive insights into specific topics. The possible topics that need to be covered include colorectal and anal cancer, surgical endoscopic procedures, laparoscopic and robotic procedures, transanal excisions, diverticular disease, inflammatory bowel diseases, and other anorectal benign entities. Furthermore, other colorectal and coloproctology topics are welcome.

In essence, this Special Issue endeavors to enrich clinicians' understanding of underexplored realms within coloproctology while presenting a balanced, robust, and evidence-based overview of advancements and future prospects in the field. Submissions that delve into possible future challenges in colorectal surgery, thereby fostering discussion and exploration of avenues for further advancement, are encouraged.

Dr. Athanasios Syllaios
Dr. Nikoletta Dimitriou
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • colorectal cancer
  • IBD
  • robotic
  • laparoscopic
  • minimally invasive approaches
  • TAMIS
  • transanal
  • artificial intelligence
  • colorectal benign diseases
  • fluorescent methods

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Published Papers (2 papers)

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Research

11 pages, 432 KiB  
Article
Defunctioning Ileostomy After Low Anterior Resection of Rectum: Morbidity Related to Fashioning and Closure
by Nikolaos Gouvas, Dimitrios Manatakis, Christos Agalianos, Nikoletta Dimitriou, Ioannis Baloyiannis, George Tzovaras and Evangelos Xynos
Medicina 2024, 60(11), 1864; https://doi.org/10.3390/medicina60111864 - 14 Nov 2024
Viewed by 350
Abstract
Background and Objectives: The aim of this study was to assess any predisposing factors to the morbidity of fashioning and reversal of diverting ileostomy in a prospective cohort of patients who have undergone TME and low colo-rectal or colo-anal anastomosis for rectal [...] Read more.
Background and Objectives: The aim of this study was to assess any predisposing factors to the morbidity of fashioning and reversal of diverting ileostomy in a prospective cohort of patients who have undergone TME and low colo-rectal or colo-anal anastomosis for rectal cancer. Materials and Methods: Consecutive patients with rectal cancer undergoing low anterior resection and a defunctioning loop ileostomy in three surgical units from 2016 to 2020 were included in the study and retrospectively analyzed. Results: One hundred eighty-two patients from three centres were included. Ileostomy-related mortality was 0.5%, attributed to renal failure.. Ileostomy-related morbidity was 46%. Postoperative ileus was seen in 37.4%, and dehydration in 18.8% of the patients. The readmission rate for ileostomy-related reasons was 15.4%. Stoma care was problematic in 15.7% or poor in 7% of the cases. Advanced age, male gender and obesity were independent risk factors for ileostomy-related morbidity. Ileostomy was reversed in 165 patients. The morbidity in 165 patients was 16%. Ileus was seen in 10.3%, anastomotic leak in 4.8% and wound infection in 12.7% of the cases. One patient died because of an anastomotic leak. No predisposing factors that affect the outcomes of ileostomy closure were identified. Conclusions: Diverting ileostomy-related morbidity is high. Life threatening dehydration and renal failure from ileus is more commonly seen in elderly, male and obese patients and should be anticipated. Ileostomy closure-related morbidity is low. Full article
(This article belongs to the Special Issue Recent Advances and Future Challenges in Colorectal Surgery)
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14 pages, 1089 KiB  
Article
The Value of Systemic Inflammatory Indices for Predicting Early Postoperative Complications in Colorectal Cancer
by Irina Shevchenko, Catalin Cicerone Grigorescu, Dragos Serban, Bogdan Mihai Cristea, Laurentiu Simion, Florentina Gherghiceanu, Andreea Cristina Costea, Dan Dumitrescu, Catalin Alius, Corneliu Tudor, Minodora Onisai, Sebastian Gradinaru and Ana Maria Dascalu
Medicina 2024, 60(9), 1481; https://doi.org/10.3390/medicina60091481 - 11 Sep 2024
Viewed by 2591
Abstract
Background and Objectives: Systemic inflammatory indices have been largely investigated for their potential predictive value in multiple inflammatory, infectious, and oncological diseases; however, their value in colorectal cancer is still a subject of research. This study investigates the dynamics of pre- and [...] Read more.
Background and Objectives: Systemic inflammatory indices have been largely investigated for their potential predictive value in multiple inflammatory, infectious, and oncological diseases; however, their value in colorectal cancer is still a subject of research. This study investigates the dynamics of pre- and postoperative values of NLR, PLR, SII, and MLR in patients with colorectal cancer and their predictive value for early postoperative outcomes. Materials and Methods: A 2-year retrospective cohort study was performed on 200 patients operated for colorectal adenocarcinoma. Systemic inflammatory indices were calculated based on complete blood count preoperatively and on the first and sixth postoperative days. The patients were divided into two groups based on their emergency or elective presentation. The pre- and postoperative values of serum inflammatory biomarkers and their correlations with postoperative outcomes were separately analyzed for the two study subgroups. Results: There were no significant differences in sex distribution, addressability, associated comorbidities, or types of surgery between the two groups. Patients in the emergency group presented higher preoperative and postoperative values of WBC, neutrophils, NLR, and SII compared to elective patients. The postsurgery hospital stays correlated well with pre- and postoperative day one and day six values of NLR (p = 0.001; 0.02; and <0.001), PLR (p < 0.001), SII (p = 0.037; <0.001; <0.001), and MLR (p = 0.002; p = 0.002; <0.001). In a multivariate analysis, reintervention risk was higher for emergency presentation and anemia, and lower in right colon cancer. In the emergency group, a multivariate model including age, MLR PO1, and pTNM stage was predictive for severe postoperative complications (AUC ROC 0.818). First-day postoperative inflammatory indices correlated well with sepsis, with the best predictive value being observed for the first postoperative day NLR (AUC 0.836; sensibility 88.8%; specificity 66.7%) and SII (AUC 0.796; sensitivity 66.6%; specificity 90%). For elective patients, the first postoperative day PLR and anemia were included in a multivariate model to predict Clavien–Dindo complications graded 3 or more (AUC ROC 0.818) and reintervention (AUC ROC 0.796). Conclusions: Easy-to-calculate and inexpensive systemic inflammatory biomarkers could be useful in predicting early postoperative outcomes in colorectal cancer for both elective and emergency surgery. Full article
(This article belongs to the Special Issue Recent Advances and Future Challenges in Colorectal Surgery)
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