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Clinical Management of Colorectal and Rectal Surgery

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

Deadline for manuscript submissions: closed (15 September 2024) | Viewed by 6173

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Dr. Tim Lubbers

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Guest Editor

Department of Surgery, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
Interests: gastroenterology; inflammation; innate immunity; nutrition; metabolism; surgery
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Special Issue Information

Dear Colleagues,

Colorectal surgery refers to surgical procedures performed on the colon and rectum for various conditions including colorectal cancer, inflammatory bowel disease, diverticulitis and other diseases. These colorectal conditions seriously interfere with the normal function of our intestines. Surgery can be an effective modality to treat several stages of these diseases. In surgery, laparoscopic surgery has been widely accepted. Some other technologies, such as single-incision laparoscopic surgery, robotic technology, augmented reality and natural orifice specimen extraction, are evolving.

The clinical management of colorectal surgery involves a comprehensive multi-modal approach to optimize patient outcomes. Preoperative assessment includes a thorough evaluation of the patient’s medical history and physical examination, including physical fitness and diagnostic tests such as colonoscopy and imaging studies. Prehabilitation has been gaining increasing interest over the past decade. Intraoperative care aims to reduce intra-abdominal pressure during laparoscopy, goal-directed infusion and the maintainance of homeostasis where possible. Postoperative care focuses on pain management, enhanced recovery after surgery and rehabilitation.

This Special Issue aims to provide a communication platform for the clinical management of colorectal and rectal surgery. We, therefore, encourage submissions of papers describing related original research, experiences of surgical techniques, or reviews about colorectal and rectal surgery.

Dr. Tim Lubbers
Guest Editor

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 surgery
surgical management
surgical techniques
laparoscopic surgery
patient outcome

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Research

13 pages, 1095 KiB

Open AccessArticle

The Impact of Surgery-Related Emotional Distress on Long-Term Outcome After Colorectal Surgery: An Observational Follow-Up

by Ann-Kathrin Lederer, Ines Manteufel, Agnes Knott, Alexander Müller, Lampros Kousoulas, Paul G. Werthmann, Alexandra C. Klein and Roman Huber

J. Clin. Med. 2024, 13(21), 6406; https://doi.org/10.3390/jcm13216406 - 25 Oct 2024

Viewed by 1385

Abstract

Background: Preoperative emotional distress has been linked to adverse health outcomes, diminished quality of life, increased symptom burden after surgery, and poorer postoperative outcomes. Therefore, this study aimed to assess the impact of perioperative emotional distress on the long-term outcomes of patients undergoing colorectal surgery. Methods: We conducted a follow-up study of a previously conducted observational study of colorectal surgery patients who underwent surgery at the University Medical Centre Freiburg, Germany, between April 2018 and February 2020. Initially, all the patients completed a multidimensional mood questionnaire (MDMQ) preoperatively and on postoperative days 3, 6, and 9. From June to November 2021, these patients were contacted again to capture the results of MDMQ at least one year after surgery and to assess the rate of late complications, quality of life, dietary changes, and overall health. Results: Of the original 80 patients, 51 took part in the follow-up study (55% female, on average 59 years old), on average 30 months after the operation. The average mood results of the surgical patients returned to those of the normal population. Most patients (80%) did not feel that their quality of life was affected by the surgery. Satisfaction with the surgical outcome averaged 8.5 out of 10, while current health was rated at 6.8 out of 10. Emotional distress levels varied over time, with mood and arousal improving significantly postoperatively. Late complications were reported by 28% of the patients, but there were no significant differences in the MDMQ scores, health status, or satisfaction between those with and without complications. Conclusions: The results indicate that there is no association between the emotional strain measured by the MDMQ and the occurrence of late postoperative complications. Full article

(This article belongs to the Special Issue Clinical Management of Colorectal and Rectal Surgery)

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11 pages, 2027 KiB

Open AccessArticle

Achieving Textbook Outcomes in Colorectal Cancer Surgery Is Associated with Improved Long-Term Survival: Results of the Multicenter Prospective Cohort Study

by Marius Kryzauskas, Augustinas Bausys, Vilius Abeciunas, Austeja Elzbieta Degutyte, Klaudija Bickaite, Rimantas Bausys and Tomas Poskus

J. Clin. Med. 2024, 13(5), 1304; https://doi.org/10.3390/jcm13051304 - 25 Feb 2024

Cited by 7 | Viewed by 2053

Abstract

Background: The outcomes of patients with colorectal cancer greatly depend on the quality of their surgical care. However, relying solely on a single quality indicator does not adequately capture the multifaceted nature of modern perioperative care. A new tool—“Textbook Outcome” (TO)—has been suggested to provide a comprehensive evaluation of surgical quality. This study aims to examine how TO affects the long-term outcomes of colorectal cancer patients who are scheduled for surgery. Methods: The data of all patients undergoing elective colorectal cancer resection with primary anastomosis at two major cancer treatment centers in Lithuania—Vilnius University Hospital Santaros Klinikos and National Cancer Institute—between 2014 and 2018 were entered into the prospectively maintained database. The study defined TO as a composite quality indicator that incorporated seven parameters: R0 resection, retrieval of ≥12 lymph nodes, absence of postoperative complications during the intrahospital period, hospital stay duration of fewer than 14 days, no readmission within 90 days after surgery, no reinterventions within 30 days after surgery, and no 30-day mortality. Long-term outcomes between patients who achieved TO and those who did not were compared. Factors associated with failure to achieve TO were identified. Results: Of the 1524 patients included in the study, TO was achieved by 795 (52.2%). Patients with a higher ASA score (III-IV) were identified to have higher odds of failure to achieve TO (OR 1.497, 95% CI 1.203–1.863), while those who underwent minimally invasive surgery had lower odds for similar failure (OR 0.570, 95% CI 0.460–0.706). TO resulted in improved 5-year overall—(80.2% vs. 65.5%, p = 0.001) and disease-free survival (76.6% vs. 62.6%; p = 0.001) rates. Conclusions: Elective colorectal resections result in successful TO for 52.5% of patients. The likelihood of failure to achieve TO is increased in patients with a high ASA score, while minimally invasive surgery is associated with higher TO rates. Patients who fail to achieve successful surgical outcomes experience reduced long-term outcomes. Full article

(This article belongs to the Special Issue Clinical Management of Colorectal and Rectal Surgery)

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10 pages, 523 KiB

Open AccessArticle

Risk Factors Associated with Postoperative Outcomes in Diverticular Disease Undergoing Elective Colectomy—A Retrospective Cohort Study from the ACS-NSQIP Database

by Wan-Hsiang Hu, Samuel Eisenstein, Lisa Parry and Sonia Ramamoorthy

J. Clin. Med. 2023, 12(23), 7338; https://doi.org/10.3390/jcm12237338 - 27 Nov 2023

Cited by 4 | Viewed by 2090

Abstract

Recommendations for elective colectomies after recovery from uncomplicated acute diverticulitis should be individualized. The kinds of associated risk factors that should be considered for this approach remain undetermined. The aim of this study was to identify the risk factors associated with postoperative outcomes in patients with diverticular disease after receiving an elective colectomy. This is a retrospective study using the multi-institutional, nationally validated database of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP). The patients who were diagnosed with diverticular disease and received an elective colectomy were included in our risk factor analyses. Postoperative mortality, morbidity, and overall complications were measured. Univariate and multivariate analyses were used to demonstrate the risk factors. We analyzed 30,468 patients with diverticular disease, 67% of whom received an elective colectomy. The rate of 30-day mortality was 0.2%, and superficial surgical site infection was the most common postoperative morbidity (7.2%) in the elective colectomies. The independent risk factors associated with overall complications were age ≥ 75, BMI ≥ 30, smoking status, dyspnea, hypertension, current kidney dialysis, chronic steroid use, ASA III, and open colectomy. In laparoscopic colectomy, 67.5% of the elective colectomies, the associated risk factors associated with overall complications still included age ≥ 75, smoking, hypertension, chronic steroid use, and ASA III. Identification of patient-specific risk factors may inform the decision-making process for elective colectomy and reduce the postoperative complications after mitigation of those risk factors. Full article

(This article belongs to the Special Issue Clinical Management of Colorectal and Rectal Surgery)

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