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Diagnosis and Management of Colorectal Diseases, 2nd Edition
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Diagnosis and Management of Colorectal Diseases, 2nd Edition

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 30 June 2027 | Viewed by 4209

Editors

Dr. Filippo Carannante

E-Mail Website
Guest Editor
Unit of Colorectal Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128 Roma, Italy
Interests: abdominal surgery; minimally invasive surgery; colorectal surgery; colorectal cancer; IBD; image-guided surgery; rectal functional disorders; ERAS
Special Issues, Collections and Topics in MDPI journals
Dr. Guglielmo Niccolò Piozzi

E-Mail Website
Guest Editor
Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth PO6 3LY, UK
Interests: colorectal cancer; robotic surgery; intersphincteric resection; complete mesocolic excision; advanced lymphadenectomy; surgical techniques
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue, entitled “Diagnosis and Management of Colorectal Diseases, 2nd Edition”, delves into the latest advancements and challenges in this field of research. It will showcase cutting-edge research relating to early detection methods, innovative surgical techniques, and non-invasive therapeutic options for a broad spectrum of colorectal conditions. The contributors, comprising renowned experts and emerging scholars, will provide comprehensive insights into etiology, diagnosis, and management strategies tailored to enhance patient outcomes and quality of life. This comprehensive collection seeks to serve as a vital resource for clinicians, researchers, and healthcare professionals alike, fostering a deeper understanding and improved care for those affected by colorectal diseases.

Dr. Filippo Carannante
Dr. Guglielmo Niccolò Piozzi
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 250 words) can be sent to the Editorial Office for assessment.

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-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly 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 2600 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 diseases
  • markers
  • diagnosis
  • prognosis
  • screening

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Published Papers (5 papers)

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Research

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20 pages, 5290 KB  
Article
Preoperative Skeletal Muscle Index as an Independent Predictor of Anastomotic Leakage After Colorectal Cancer Surgery: A Retrospective Cohort Study
by Mehmet Baykan, Tuba Yücel Uçarkuş, Gökçe Ersolak and İsmail Altintop
Diagnostics 2026, 16(16), 2581; https://doi.org/10.3390/diagnostics16162581 - 15 Aug 2026
Viewed by 149
Abstract
Background: Anastomotic leakage remains the most feared complication after colorectal cancer surgery, and reliable preoperative risk stratification is still evolving. The skeletal muscle index (SMI), derived from routine computed tomography, offers an objective, widely available measure of muscle mass. This study evaluated whether [...] Read more.
Background: Anastomotic leakage remains the most feared complication after colorectal cancer surgery, and reliable preoperative risk stratification is still evolving. The skeletal muscle index (SMI), derived from routine computed tomography, offers an objective, widely available measure of muscle mass. This study evaluated whether a low preoperative SMI predicts anastomotic leakage after colorectal cancer resection. Methods: We retrospectively screened 550 consecutive patients who underwent colorectal cancer resection with primary anastomosis at a single tertiary referral centre between 2018 and 2024, of whom 468 satisfied the eligibility criteria and formed the analytic cohort. Skeletal muscle area was measured on preoperative axial computed tomography at the third lumbar vertebra and normalised to the height squared to obtain the SMI. Anastomotic leakage was defined according to the International Study Group of Rectal Cancer criteria. Receiver operating characteristic analysis identified a single pragmatic SMI cut-off. Group comparisons used Mann–Whitney U and chi-square tests, and independent predictors were assessed by multivariable logistic regression. Results: Anastomotic leakage occurred in 33 of 468 patients (7.1%). Patients who developed leakage had a significantly lower mean SMI than those who did not (40.0 cm2/m2 vs. 46.8 cm2/m2, p = 0.005). An SMI below 48.6 cm2/m2 predicted leakage with 90.9% sensitivity, 38.2% specificity, and a 98.2% negative predictive value (area under the curve 0.646). Because specificity (38.2%) and positive predictive value (10.0%) were low, the index performed as a rule-out marker: a preserved SMI identified a low-risk subgroup, whereas a low-SMI had limited positive predictive value. The leakage rate reached 10.0% in the low SMI group versus 1.8% in the high-SMI group (p = 0.0008). Following multivariable analysis, low SMI was the only independent predictor of anastomotic leakage (adjusted odds ratio: 5.67, 95% confidence interval: 1.69 to 19.01, p = 0.005). Conclusions: A low preoperative SMI independently increased the odds of anastomotic leakage almost six-fold after colorectal cancer surgery, while its high negative predictive value identified a large group of patients at very low risk. Routine SMI assessment on existing staging computed tomography may strengthen preoperative risk stratification at no additional cost or radiation. Full article
(This article belongs to the Special Issue Diagnosis and Management of Colorectal Diseases, 2nd Edition)
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20 pages, 1282 KB  
Article
Emergency Diagnostic Phenotypes and Differential Survival in Colorectal Cancer: A Real-World Cohort Study
by Alexandru-Marian Vieru, Sergiu-Marian Cazacu, Maria-Lorena Mustață, Virginia-Maria Rădulescu, Petrică Popa and Tudorel Ciurea
Diagnostics 2026, 16(16), 2487; https://doi.org/10.3390/diagnostics16162487 - 7 Aug 2026
Viewed by 226
Abstract
Background/Objectives: Emergency presentation in colorectal cancer (CRC) is commonly regarded as a uniformly high-risk condition, although clinically distinct emergency phenotypes may carry substantially different prognostic implications. We aimed to characterise emergency diagnostic phenotypes, bowel obstruction, perforation, severe stenosis, and lower gastrointestinal bleeding, [...] Read more.
Background/Objectives: Emergency presentation in colorectal cancer (CRC) is commonly regarded as a uniformly high-risk condition, although clinically distinct emergency phenotypes may carry substantially different prognostic implications. We aimed to characterise emergency diagnostic phenotypes, bowel obstruction, perforation, severe stenosis, and lower gastrointestinal bleeding, and to examine their associations with treatment allocation, perioperative mortality, and overall survival after adjustment for recorded covariates. Methods: We performed a retrospective, real-world cohort study of 1051 consecutive patients with CRC diagnosed between 2018 and 2021 at a tertiary referral centre. Patients were assigned to four mutually exclusive groups using a classification defined before outcome analysis (obstructive–perforative, stenotic, haemorrhagic, elective). Overall survival was assessed using Kaplan–Meier analysis and multivariable Cox regression, with formal testing of the proportional hazards assumption. Results: Emergency presentation occurred in 43.7% of patients but was markedly heterogeneous. Metastatic burden did not differ across phenotypes (p = 0.122). The obstructive–perforative phenotype showed the least favourable outcomes: perioperative mortality was 11.5%, and it remained associated with mortality after adjustment for recorded covariates (HR 1.58, 95% CI 1.25–2.00; p < 0.001), with hazard ratios ranging from 1.33 to 1.69 across six model specifications. Haemorrhagic presentation was rectal-predominant and behaved favourably, with survival comparable to elective diagnosis. Among 30-day survivors, the excess hazard was attenuated but persisted (HR 1.39, 95% CI 1.04–1.86). Conclusions: Emergency presentation in CRC is not a monolithic risk category. Recognising the presenting phenotype may offer a pragmatic framework for provisional risk characterisation at diagnosis, but external validation and adjustment for patient-level comorbidity and performance status are required before routine clinical use. Full article
(This article belongs to the Special Issue Diagnosis and Management of Colorectal Diseases, 2nd Edition)
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23 pages, 1189 KB  
Article
Atherogenic Lipid Indices in Colorectal Cancer: Metabolic Associations and Survival Outcomes
by Răzvan Alexandru Marinescu, Daniela Marinescu, Lidia Boldeanu, Ana-Maria Ciurea, Marius Bică, Ștefan Pătrașcu, Victor Dan Eugen Strâmbu, Petru Adrian Radu, Petrica Popa, Mohamed-Zakaria Assani, Mihail Virgil Boldeanu and Valeriu Șurlin
Diagnostics 2026, 16(5), 810; https://doi.org/10.3390/diagnostics16050810 - 9 Mar 2026
Viewed by 724
Abstract
Background/Objectives: Type 2 diabetes mellitus (T2DM) and atherogenic dyslipidemia have been implicated in colorectal cancer (CRC) development, but their prognostic relevance after cancer diagnosis remains unclear. This study aimed to evaluate the association between T2DM, lipid-derived atherogenic indices, and survival outcomes in patients [...] Read more.
Background/Objectives: Type 2 diabetes mellitus (T2DM) and atherogenic dyslipidemia have been implicated in colorectal cancer (CRC) development, but their prognostic relevance after cancer diagnosis remains unclear. This study aimed to evaluate the association between T2DM, lipid-derived atherogenic indices, and survival outcomes in patients with CRC. Methods: We conducted a retrospective cohort study including 240 CRC patients, of whom 60 had coexisting T2DM. Overall survival (OS) and disease-free survival (DFS) were analyzed using the Kaplan–Meier (KM) method and log-rank tests. In the absence of recurrence-specific data, DFS was defined as time to death or last follow-up. Lipid-related indices, including the atherogenic index of plasma (AIP), atherogenic coefficient (AC), remnant cholesterol (RC), non-high-density lipoprotein cholesterol (non-HDL-C), triglyceride–glucose (TyG) index, and triglyceride-to-HDL cholesterol ratio (TG/HDL-C), were evaluated by tertiles in KM analyses. Multivariable Cox proportional hazards models were constructed to assess the independent prognostic value of AIP, AC, and RC (entered separately as a continuous variable standardized to 1 standard deviation), adjusted for age, sex, adjuvant chemotherapy, radiotherapy, and T2DM status. Sensitivity analyses were performed in stage III–IV patients. Results: During follow-up, 28 deaths occurred. OS did not differ significantly between CRC patients and those with CRC coexisting with T2DM (log-rank p-values = 0.220). DFS analyses showed no significant differences across tertiles of any lipid-related index (all log-rank p-values > 0.05), with overlapping survival curves and no consistent dose–response patterns. In adjusted Cox models, AIP (hazard ratio [HR] per 1 SD = 0.71, 95% CI 0.48–1.06), AC (HR = 0.72, 95% CI 0.44–1.20), and RC (HR = 0.66, 95% CI 0.39–1.12) were not independently associated with DFS. Results were consistent in advanced-stage disease (stage III–IV). Conclusions: In this cohort of patients with CRC, neither T2DM nor lipid-derived indices reflecting atherogenic dyslipidemia and insulin resistance were independently associated with OS or DFS. These findings help refine the clinical interpretation of lipid-derived biomarkers in CRC, suggesting limited prognostic utility beyond established oncologic factors. Full article
(This article belongs to the Special Issue Diagnosis and Management of Colorectal Diseases, 2nd Edition)
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15 pages, 5699 KB  
Article
Short-Term Efficacy and Safety of Elobixibat for Chronic Constipation Assessed by Rectal Ultrasonography: A Retrospective Observational Study
by Momoko Tsuda, Tomoyuki Onodera, Kanako Konishi, Norishige Maiya, Mio Matsumoto, Kimitoshi Kubo, Sayaka Kudo, Yoshiyuki Hosoi and Mototsugu Kato
Diagnostics 2026, 16(2), 354; https://doi.org/10.3390/diagnostics16020354 - 21 Jan 2026
Viewed by 1929
Abstract
Background/Objectives: Ultrasonography (US) is a non-invasive and repeatable examination for evaluating chronic constipation. However, few studies have explored treatment decisions based on rectal US findings. To date, the efficacy and safety of elobixibat have not been evaluated using rectal US classification in patients [...] Read more.
Background/Objectives: Ultrasonography (US) is a non-invasive and repeatable examination for evaluating chronic constipation. However, few studies have explored treatment decisions based on rectal US findings. To date, the efficacy and safety of elobixibat have not been evaluated using rectal US classification in patients with chronic constipation. This study aimed to evaluate the short-term efficacy and safety of elobixibat in patients with chronic constipation classified as “no fecal retention” by rectal US. Methods: We retrospectively analyzed 32 patients with chronic constipation who underwent rectal US and received elobixibat (10 mg/day) between May 2019 and December 2024. Rectal US findings classified patients into four groups: no fecal retention, fecal retention without hard stools, fecal retention with hard stools, and gas retention. The primary endpoint was the response rate of spontaneous bowel movements (SBMs) within 3 days after starting elobixibat in the “no fecal retention” group. Results: Among 18 patients in the “no fecal retention” group, 94.4% achieved SBMs within 3 days, indicating a favorable short-term response. Adverse events included abdominal distension and abdominal pain, each observed in one patient (3.1%). Conclusions: Elobixibat was effective and well tolerated in patients with chronic constipation classified by rectal US findings. Full article
(This article belongs to the Special Issue Diagnosis and Management of Colorectal Diseases, 2nd Edition)
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Review

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23 pages, 907 KB  
Review
IQGAP Family Proteins in Colorectal Cancer: Molecular Mechanisms and Prognostic Implications
by Catherine Keiko Gunawan, Anton Sumarpo, Budiono Raharjo and Ida Parwati
Diagnostics 2026, 16(14), 2153; https://doi.org/10.3390/diagnostics16142153 - 9 Jul 2026
Viewed by 509
Abstract
Colorectal cancer (CRC) remains a leading cause of cancer-related morbidity and mortality worldwide, and the molecular mechanisms driving its progression and metastasis remain incompletely understood. Increasing evidence highlights the role of IQ motif-containing GTPase-activating proteins (IQGAPs)—a family of scaffold proteins consisting of IQGAP1, [...] Read more.
Colorectal cancer (CRC) remains a leading cause of cancer-related morbidity and mortality worldwide, and the molecular mechanisms driving its progression and metastasis remain incompletely understood. Increasing evidence highlights the role of IQ motif-containing GTPase-activating proteins (IQGAPs)—a family of scaffold proteins consisting of IQGAP1, IQGAP2, and IQGAP3—in regulating multiple signaling pathways involved in tumor development. This narrative review provides an overview of the molecular roles of IQGAP family proteins in CRC, focusing on their involvement in oncogenic signaling and their potential prognostic significance. Current evidence suggests that IQGAP family members play distinct and sometimes opposing roles in CRC biology. IQGAP1 is frequently overexpressed and acts as a scaffold that activates ERK/MAPK and β-catenin signaling, promoting proliferation, invasion, and metastasis. In contrast, IQGAP2 exhibits tumor-suppressive properties, with reduced expression associated with more aggressive disease and unfavorable outcomes. Meanwhile, IQGAP3 has emerged as a potential oncogenic driver, where its upregulation correlates with enhanced tumor growth, metastatic potential, and poorer survival, possibly through PI3K-related signaling. Together, these findings highlight the context-dependent roles of IQGAP proteins in CRC and suggest their potential as novel biomarkers and therapeutic targets. Further validations are needed to explore the clinical utility of IQGAP proteins in CRC. Full article
(This article belongs to the Special Issue Diagnosis and Management of Colorectal Diseases, 2nd Edition)
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