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Recent Advancements and Challenges in Colorectal Surgery
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Recent Advancements and Challenges in Colorectal Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: closed (25 July 2024) | Viewed by 3744

Special Issue Editors

Dr. Georgios D. Lianos

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Guest Editor
Department of Surgery, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
Interests: colorectal cancer; minimally invasive surgery; surgical oncology; personalized cancer medicine
Dr. Christina Bali

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Guest Editor
Department of Surgery, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
Interests: colorectal cancer; minimally invasive surgery; surgical oncology; personalized cancer medicine
Prof. Dr. Konstantinos Vlachos

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Guest Editor
Department of Surgery, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
Interests: colorectal cancer; minimally invasive surgery; surgical oncology; personalized cancer medicine
Prof. Dr. Michail Mitsis

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Guest Editor
Department of Surgery, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
Interests: colorectal surgery; laparotomy; minimally invasive surgery; surgical oncology; personalized cancer medicine

Special Issue Information

Dear Colleagues,

Colorectal cancer represents one of the most common cancers in the world. The treatment and screening of colorectal cancer has significantly evolved the last twenty years. However, colorectal cancer is still a ‘deadly’ cancer. Due to the prognostic value of lymphadenectomy, the use of multimodal strategies, and research on molecular pathways, we hope that the mortality rate will significantly decrease in the future. Furthermore, the potential role of minimally invasive (laparoscopic and robotic) approaches and the impact of ERAS protocols have been under investigation in large trial studies. Current treatment approaches, multimodal management, minimally invasive treatment, the use of fluorescent methods, the role of multidisciplinary meetings, progress in treating advanced diseases, screening in early stages, and much more will be discussed in this Special Issue. We hope to investigate all aspects of colorectal cancer research. We await receiving original articles, reviews, systematic reviews, metanalyses, and clinical research. With this Special Issue, we aim also to provide a ‘view’ of the future of colorectal cancer treatment.

Dr. Georgios D. Lianos
Dr. Christina Bali
Prof. Dr. Konstantinos Vlachos
Prof. Dr. Michail Mitsis
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. Journal of Clinical Medicine 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 cancer
  • tumorigenesis
  • precision oncology
  • minimally invasive approaches
  • fluorescent methods
  • extended lymphadenectomy
  • multimodal management

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Published Papers (3 papers)

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Research

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12 pages, 1415 KiB  
Article
Could Flow Cytometry Provide New Prognostic Markers in Colorectal Cancer?
by Vaia Georvasili, Georgios Markopoulos, Evangeli Lampri, Georgios Lianos, George Vartholomatos, Michail Mitsis and Christina Bali
J. Clin. Med. 2024, 13(16), 4753; https://doi.org/10.3390/jcm13164753 - 13 Aug 2024
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Abstract
Background/Objectives: Colorectal cancer (CRC) is still accompanied by significant mortality, which poses the necessity of novel markers to predict treatment success and patient survival. This study aims to evaluate the prognostic and survival impact of flowytometry (FC) in CRC patients. Methods: [...] Read more.
Background/Objectives: Colorectal cancer (CRC) is still accompanied by significant mortality, which poses the necessity of novel markers to predict treatment success and patient survival. This study aims to evaluate the prognostic and survival impact of flowytometry (FC) in CRC patients. Methods: In this prospective study, 106 surgically resectable CRC patients were included. Tissue specimens from tumor and normal mucosa were collected and analyzed by FC. DNA and tumor index were calculated. In a subgroup of 46 patients, the CD26 expression on tumor cells was estimated. These parameters were compared with patients’ tumor characteristics as stage, histology data, responsiveness to treatment, metastasis/recurrence, and, finally, patients’ survival to identify possible new biomarkers. Results: The overall survival and the disease-specific survival in our study group was 76% and 72%, respectively, during the 7-year follow up period. Diploid tumors had better median survival than the aneuploid ones. The DNA index had significant correlation to the tumor index and response to neoadjuvant treatment. Similarly, the tumor index was also significantly related to the response to neoadjuvant treatment. Patients with a higher tumor index had worst survival rates. Surprisingly, CD26 levels were not associated with any of the parameters examined and were negatively related to tumor stage and differentiation. Conclusions: FC is a rapid and reliable method of cell analysis. In CRC, it has been used for prognostic and diagnostic purposes. In this study, we have shown that DNA and tumor index could become predictive biomarkers of tumor response to neoadjuvant treatment and survival of resectable CRC patients. Full article
(This article belongs to the Special Issue Recent Advancements and Challenges in Colorectal Surgery)
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10 pages, 529 KiB  
Article
The Impact of Mechanical Bowel Preparation and Oral Antibiotics in Colorectal Cancer Surgery (MECCA Study): A Prospective Randomized Clinical Trial
by Maximos Frountzas, Victoria Michalopoulou, Georgia Georgiou, Despoina Kanata, Maria Matiatou, Despina Kimpizi, Georgia Matthaiou, Spilios Spiliotopoulos, Dimitrios Vouros, Konstantinos G. Toutouzas and George E. Theodoropoulos
J. Clin. Med. 2024, 13(4), 1162; https://doi.org/10.3390/jcm13041162 - 19 Feb 2024
Cited by 1 | Viewed by 1521
Abstract
Background: Colorectal cancer surgery has been associated with surgical site infections (SSIs), leading to an increase in postoperative morbidity, length of stay and total cost. The aim of the present randomized study was to investigate the relationship between the preoperative administration of oral [...] Read more.
Background: Colorectal cancer surgery has been associated with surgical site infections (SSIs), leading to an increase in postoperative morbidity, length of stay and total cost. The aim of the present randomized study was to investigate the relationship between the preoperative administration of oral antibiotic therapy and SSI rate, as well as other postoperative outcomes in patients undergoing colorectal cancer surgery. Material and Methods: Patients who underwent colorectal cancer surgery in a university surgical department were included in the present study. Patients were randomized into two groups using the “block randomization” method. The intervention group received three doses of 400 mg rifaximin and one dose of 500 mg metronidazole per os, as well as mechanical bowel preparation the day before surgery. The control group underwent only mechanical bowel preparation the day before surgery. The study has been registered in ClinicalTrials.gov (NCT03563586). Results: Two hundred and five patients were finally included in the present study, 97 of whom received preoperative antibiotic therapy per os (intervention group). Patients of this group demonstrated a significantly lower SSI rate compared with patients who did not receive preoperative antibiotic therapy (7% vs. 16%, p = 0.049). However, preoperative antibiotic administration was not correlated with any other postoperative outcome (anastomotic leak, overall complications, readmissions, length of stay). Conclusions: Preoperative antibiotic therapy in combination with mechanical bowel preparation seemed to be correlated with a lower SSI rate after colorectal cancer surgery. Full article
(This article belongs to the Special Issue Recent Advancements and Challenges in Colorectal Surgery)
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Review

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12 pages, 2843 KiB  
Review
Developments in the Use of Indocyanine Green (ICG) Fluorescence in Colorectal Surgery
by Shayan Khalafi, Cristina Botero Fonnegra, Ana Reyes and Vanessa W. Hui
J. Clin. Med. 2024, 13(14), 4003; https://doi.org/10.3390/jcm13144003 - 9 Jul 2024
Viewed by 977
Abstract
Indocyanine Green (ICG) has significantly advanced minimally invasive surgery. It is widely recognized for its ability to visualize blood vessel patency in real-time across various surgical specialties. While its primary use in colorectal surgery is to evaluate anastomoses for leaks, numerous other applications [...] Read more.
Indocyanine Green (ICG) has significantly advanced minimally invasive surgery. It is widely recognized for its ability to visualize blood vessel patency in real-time across various surgical specialties. While its primary use in colorectal surgery is to evaluate anastomoses for leaks, numerous other applications have been documented in the literature. In this review, we aim to explore both established and emerging applications of ICG fluorescence in colorectal surgery, with the goal of improving patient outcomes. This includes preoperative tumor marking and the detection of metastatic disease. Some applications, such as lymphatic mapping, require further research to determine their impact on clinical practices. Conversely, others, like the intraoperative localizations of ureters, necessitate additional procedures and are not yet widely accepted by the surgical community. However, the development of alternative compounds could offer better solutions. Future research should focus on areas like quantitative ICG and protocol standardization in prospective multicenter studies. Full article
(This article belongs to the Special Issue Recent Advancements and Challenges in Colorectal Surgery)
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