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Biomarkers of the future in colorectal cancer F. Kamel 1,2, M. Soloviev 2, P. Nisar 1 1 St Peters Hospital, Chertsey, UK; 2 Royal Holloway University of London, Egham, UK B Introduction: b Colorectal cancer (CRC) remains the third most common cause of cancer-related deaths in the United Kingdom. Despite the extensive impact of anal fistula on QoL, there is a lack of patient-centred, disease-specific QoL measurement instruments. B Conclusion: b We have developed an Anal Fistula Quality of Life scale (AF-QoL), a comprehensive, disease-specific patient-reported outcome measure (PROM) assessing QoL in patients with cryptoglandular anal fistula. [Extracted from the article]

B Short description b A video demonstrating para-aortic node dissection facilitated by a complete mesocolic excision for a cancer with isolated para-aortic node metastasis. Co-primary end points were stent patency up to 6 months post-stenting and QoL at 3 months (30 days for patients who die before 3 months) measured using the QLQ-C30 global health score. Of these, 245 patients (65%) survived 6 months post-stent insertion and 257 patients (68%) contributed to QoL assessment. [Extracted from the article]

Despite no measurable disease on CT, peritoneal disease was found at surgery in 39% of CRS/HIPEC patients, thereby supporting risk-reducing CRS/HIPEC as an intervention in LAMN II patients deemed high risk of peritoneal dissemination. B Results: b There were 1068 patients - 65 patients declined investigations, 11 are pending, leaving 992 patients for analysis. 6 out of the seven patients should have been excluded from FIT pathway as one patient had a palpable mass, two patients had weight loss and four patients were anaemic. Patient demographics, haemorrhoid grade, disease duration, previous treatments tried, and complications and return-to-normal activity were captured via an online patient management system and subsequent patient questionnaire. ES was less likely for: patients aged over 80, with odds ratios (ORs) across conditions from 0.15 to 0.84 versus those aged under 40; the most deprived, ORs 0.83 to 0.92, versus least deprived; and Asian patients, ORs 0.72 to 0.88, versus White patients. [Extracted from the article]

141 patients were randomized to colorectal surgery with fluorescence angiography (intervention group) and 139 patients had surgery only (control group). SP 1 sp Department of Surgery,St Olavs Hospital, trondheim University Hospital, Trondheim, Norway, SP 2 sp Department of Surgery, Oslo University Hospital, Oslo, Norway, SP 3 sp Department of Surgery, Drammen sykehus, Drammen, Norway, SP 4 sp Department of Surgery,Haukeland University Hospital, Bergen, Norway, SP 5 sp Department of Surgery, Akershus University Hospital, Lørenskog, Norway, SP 6 sp Department of Surgery,Gjøvik Sykehus, Gjøvik, Norway, SP 7 sp Department of Surgery, Stavanger University Hospital, Stavanger, Norway, SP 8 sp Departmenryt of Surgery,University Hospital of North Norway, Tromsø, Norway, SP 9 sp Department of Surgery, Akershus University Hospital, Oslo, Norway 83 LP patients were comparable to 152 PP patients for age (P = 0.2), gender (67.5% vs.65.1% males; P = 0.72), BMI (P = 0.82), ASA score (P = 0.86), previous abdominal surgery (P = 0.923), stage (P = 0.17), neoadjuvant chemoradiation (P = 0.13), distance of tumor from anal verge (5.8 ± 4.4 vs 5.5 ± 3.3; P = 0.56). 125 patients (group 1) who underwent surgery before 10 weeks from the end of chemoradiotherapy and 107 patients (group 2) who waited 10 or more weeks after the end of chemoradiotherapy. [Extracted from the article]

The article presents several medical research papers. Topics include evaluating the outcome of laparoscopic ventral mesh rectopexy for internal rectal prolapse, examining the value of the mechanical bowel preparation (MBP) in patients with Crohn's disease, and presents study for the surgical management of patients with ulcerative colitis in England and Sweden.

Whilst it is certainly true that such variables are prognostic, these are factors known only after the surgery and cannot in themselves cause NSAID exposure. The use of postoperative non-steroidal anti-inflammatory drugs (NSAIDs) in the setting of colorectal cancer surgery is still a subject of debate, which we heartily welcome. We certainly concur with Mufaddal et al. that randomized trials are needed to effectively answer the question whether NSAIDs are beneficial in colorectal cancer surgery, and hope that our paper might encourage such efforts. [Extracted from the article]

The overburdening of colorectal out-patient clinics necessarily leads to delays in time from referral to consultation and subsequent clinic attendance. This study aimed to ascertain the feasibility of ‘paper clinic’ follow-up rather than all patients receiving a routine follow-up appointment following investigation. A more efficient outpatient follow-up process should reduce unnecessary follow-up, thereby facilitating the speedy investigation and diagnosis of patients through changes in clinic profiles. From August 2001 all patients seen in the outpatient clinic of one (part time) Consultant colorectal surgeon, who required investigation, were prospectively recorded on a ‘paper clinic’ form. These patients were given the necessary test request forms but were not given a further outpatient appointment. The results of the investigations were reviewed, together with the patients' medical records at a formal fortnightly ‘paper clinic’ session carried out by the Consultant and Nurse Consultant, and a treatment plan derived. Patients then followed one of 5 follow-up pathways and were notified in writing with a copy to their GP. During a 24-month period a total of 897 patients were reviewed using the ‘paper clinic’ follow-up system. Of these, 285 (31.8%) patients were discharged without further follow-up. In a given 3-month period when the clinic was well established, 152 patients were reviewed, of whom 27% were discharged from follow-up, 17% received SOS appointments, 13% required further investigation (and consequently were returned to ‘paper clinic’ follow-up), and 7% received Nurse led follow-up. In this 3-month period 64% of patients reviewed by ‘paper clinic’ follow-up did not return to Surgical Outpatient's and 12% received a Surgical Outpatient appointment for review. ‘Paper clinic’ follow-up is an effective and feasible follow-up alternative, resulting in a major decrease in outpatient follow-up burden. This has allowed the redesign of the outpatient clinic profile allowing for an increase in new urgent slots, and more rapid clinic follow up review of those patients who need it. Re-design and rationalization of existing services can result in considerable service improvement. Expanding clinics should not be considered the only option when faced with capacity and demand issues. [ABSTRACT FROM AUTHOR]

Aim: Low anterior resection syndrome (LARS) has a large impact on patients' quality of life. Several heterogeneous intervention pathways are suggested in the literature. The steps and timing of the different steps in the pathways are unclear. This systematic scoping review aims to map the range of intervention pathways for LARS after sphincter‐saving rectal cancer surgery. Methods: A search was undertaken on four databases (CINAHL, EMBASE, PubMed, and Web of Science). Any type of paper describing intervention pathways for patients with LARS following sphincter‐saving surgery was included. Excluded were patients with a stoma, no full paper, no intervention pathway and not being written in English or Dutch. The review was registered with Open Science Framework (10.17605/OSF.IO/JB5H8). Narrative synthesis of the results was performed by charting and summarising key results. Results: A total of 373 records were screened and 12 papers were included. There was a high variability among the intervention pathways, including which patients should be included. The number of pathway steps ranged from 2–6. Most intervention pathways were treatment‐led. Intervention options ranged from conservative measures to a permanent stoma. Pathway flow was highly variable and sometimes not well described, with different or no timings provided for the start, progression, or end of the pathways. Three studies discussed the use of a nurse to coordinate the pathway. Conclusion: This systematic scoping review shows that despite similarities in treatment options there are variations in which treatments are included, when treatments should be instigated, and even which patients should be treated. [ABSTRACT FROM AUTHOR]

The article presents abstracts of several articles related to colorectal disease which include "Urogenital dysfunction three years after abdominoperineal excision," by A. Ledebo and colleagues, "Long-term experience of magnetic anal sphincter augmentation in patients with faecal incontinence," by J. Sugrue and colleagues, and "Multivisceral resection for locally advanced colon and rectal cancer," by M. Verstegen and colleagues.

The article presents abstracts of articles on colorectal surgery topics including "An aggressive management of acute mesenteric ischemia is associated with satisfactory long-term survival and functional outcomes," by L. Maggiori and colleagues, "Rectal cancer risk after colectomy in ulcerative colitis patients," by M. Abdalla and colleagues, and "Diverticulitis and the age factor - does age matter?," by N. Horesh and colleagues.

In 1935 two young neurologists, Derek Denny-Brown and E. Graeme Robertson, published an article explaining the mechanisms underlying human defaecation based on a manometric study in patients with sacral root and spinal cord lesions, and normal subjects. This article is still routinely cited in studies of rectal and sphincter ani function. Unfortunately, however, the article itself is not written well, being composed of long convoluted sentences and containing 79 often indecipherable figures. Difficult-to-understand articles were common to the publications of Denny-Brown, who became one of the most prominent neurologists of the twentieth century. In accord with our prior work explaining Denny-Brown and Robertson's earlier paper on micturition, we provide here what we hope is a clear explanation of the methods and results in their study on defaecation. [ABSTRACT FROM AUTHOR]

The article presents abstracts on topics including quality of life after rectal cancer treatment, percutaneous tibial nerve stimulation for faecal incontinence, and rectal prolapse treatment.

The article presents abstracts related to medical topics including non invasive detection of colorectal cancer using urinary volatile organic compounds, stoma reversal after anterior resection for rectal cancer and the impact of laparoscopy on incisional hernia rates.

The article presents several abstracts on medical topics which include the impact of complete mesocolic excision (CME) in the survival of patients with colon cancer, the effect of bowel dysfunction on patient's quality of life after undergoing resection for rectal cancer, and the assessment of the effectivity of partial mesorectal excision (PME) as treatment for proximal tumors.

The article presents abstracts on colon cancer including survival difference between left and right-sided colon cancer, colorectal neoplasia screening using immunochemical faecal occult blood test (FIT) in Singapore and the impact of laparoscopic colorectal surgery in managing liver metastases.

The article presents abstracts related to colorectal diseases which include the potential use of laparoscopic rectosigmoid resection with transanal specimen extraction to treat patients, the use of laparoscopic coloanal anastomosis to cure patients with rectal cancer, and the utility of microsatellite instability and immunohistochemistry in families with suspected Lynch syndrome.

In the absence of an internationally agreed classification of haemorrhoids, evaluation of the ever increasing number of therapeutic options available is impossible. A new classification is proposed which relates symptoms to our knowledge of haemorrhoidal development, the use of which should provide a more accurate way of comparing treatments and in the evaluation of new techniques. The evidence for such a classification is presented in detail. [ABSTRACT FROM AUTHOR]

Abstract An international working party with experience in the performance of an alternative haemorrhoid operation through the use of the circular stapler was convened for the purpose of developing a consensus as to the criteria for undertaking this procedure. The agenda consisted of first, naming the operation; second, the indications and contra-indications for its performance; and third, the preferred surgical technique. Among the recommendations for individuals who plan to embark on this surgery are that experience with anorectal surgery and an understanding of anorectal anatomy are requisites; experience with circular stapling devices is essential; and the surgeon must attend a formal course which should include lectures, videos, the application of the instrument in models, and observation of the operation as performed by a surgeon recognized by his or her peers—leading ultimately to undertaking the procedure while being observed by an experienced surgeon. Following satisfactory completion of the above, independent responsibility should be determined by an individual's department of surgery. [ABSTRACT FROM AUTHOR]

Reveals findings from papers presented before the Section of Coloproctology of the Royal Society of Medicine. 'Transanal Endoscopic Rectal Mucosal Ablation in the surgical treatment of ulcerative colitis'; 'Local repair has poor results in treatment of vaginal fistulae in Crohn's Disease'; 'Long term follow-up is required to detect recurrence following rectal cancer surgery.'

Reveals findings from papers presented before the Section of Coloproctology of the Royal Society of Medicine. 'Intensive structured training improves colonoscopy skills in one week'; 'Tumor immunotherapy--a novel treatment for colorectal cancer'; 'An Approach to hemorrhoids.'

The stimulated gracilis neo-anal sphincter (SGNS) has become accepted as a treatment for end stage faecal incontinence. The multiplicity of stages of the traditional SGNS procedure and the disfiguring long leg wound remain problems. We used a singlestaged operation, and an endoscopic approach to mobilize the gracilis muscle from the leg. [ABSTRACT FROM AUTHOR]

Background Internal anal sphincter tone depends on the intrinsic myogenic properties of smooth muscle and external neural influences, specifically a continuous sympathetic input. Reduction of maximum resting anal canal pressure (MRP) increases the vascularity of ischaemic chronic anal fissures and promotes healing. Methods Ten patients with chronic anal fissures (median age 35.5 (28-65) years) and 10 healthy volunteers (median age 28 (21-38) years) were administered 20 mg indoramin (α[sub 1]-antagonist) or 4 mg salbutamol (&beta[sub 2]-agonist) orally in a doubleblinded manner. MRP, pulse, and blood pressure were measured prior to and at hourly intervals until 3 h after administration. Results Patients with chronic anal fissures had a significantly higher MRP compared with volunteers (P < 0.05, MannWhitney U-test). In each group there was a significant reduction in MRP at 1, 2 and 3 h (P < 0.05, Wilcoxon signed ranks test). Indoramin and salbutamol demonstrated no significant difference in effect when comparing reduction of MRP in patients and volunteers (Mann-Whitney U-test). The reduction in patients' MRP at 3 h was comparable to that after lateral sphincterotomy. Tremors were noted with salbutamol in four volunteers, and five patients. Three patients complained of light-headedness with indoramin without a significant change in diastolic blood pressure. The reduction in MRP in subjects who took indoramin did not correlate with a reduction in diastolic blood pressure (Pearson correlation coefficient, r = 0. 166, P = NS). Conclusion Oral indoramin causes a sustained reduction in MRP, without serious side effects, and may have a beneficial role in the treatment of anal fissures. (MRP - maximum resting anal canal pressure). [ABSTRACT FROM AUTHOR]

Aim: Rectal prolapse is considered rare in men but the prevalence can be high in certain populations. It is unclear which surgical approach offers lower recurrence rates and better functional outcomes in men. The aim of this work was to determine the recurrence rates, complications and functional outcomes after prolapse surgery in men. Method: The MEDLINE, EMBASE and Scopus databases were systematically searched to identify studies on outcomes following surgical management of full‐thickness rectal prolapse in men (over 18 years of age) published between 1951 and September 2022. Outcomes of interest included recurrence rate after surgery, bowel function, urinary function, sexual function and postoperative complications. Results: Twenty‐eight studies involving 1751 men were included. Two papers focused exclusively on men. Twelve studies employed a mixture of abdominal approaches, ten employed perineal approaches and six compared both. The recurrence rate varied across studies, ranging from 0% to 34%. Sexual and urinary function were poorly reported, but the incidence of dysfunction appears low. Conclusion: The outcomes of rectal prolapse surgery in men are poorly studied with small sample sizes and variable outcomes reported. There is insufficient evidence to recommend a specific repair approach based on the recurrence rate and functional outcomes. Further studies are required to identify the optimal surgical approach for rectal prolapse in men. [ABSTRACT FROM AUTHOR]

The article presents various medical researches. Topics include evaluating the efficacy of sacral nerve stimulation in patients with chronic constipation or obstructed defecation syndrome (ODS), examining the association of obesity with postoperative complications, and examining the benefits of modified Dutch anastomotic leakage score (DULK) for early detection of anastomotic leakage after colorectal surgery.

52 patients rated their operation 0-9 and 69 patients rated their operation 10 on their follow-up visit. Of the 410 patients, 234 (57.1%) gave complete responses to the questionnaires before and after surgery, of whom 126 (53.8%) and 119 (50.8%) did not have severe erectile and ejaculatory dysfunction before surgery, respectively. Sexual dysfunction occurred in almost half of the patients after rectal cancer surgery, and laparoscopy contributed to decreased postoperative male sexual dysfunction. [Extracted from the article]

The article presents several medical research papers. Topics include evaluating the safety and feasibility of laparoscopic surgery for locally recurrent rectal cancer (LRRC), using PI3K/AKT/mTOR inhibition pathways for anal cancer, and discussing the role of primary tumor resection in colorectal cancer patients with asymptomatic and synchronous unresectable metastasis.

Aim The aim of this study was to compare the methodological quality and input paper characteristics of systematic reviews and meta-analyses reported in the medical and surgical literature by performing a systematic 'overview of reviews'. Ulcerative colitis ( UC) and Crohn's disease ( CD) were used as the framework for this comparison as they are relatively common serious conditions, with both medical and surgical options for therapy. Method Medline, Embase, CINHAL and the Cochrane Database were searched to November 2013. Eligible papers were systematic reviews or meta-analyses that considered a question of therapy in CD or UC. Two independent reviewers selected the papers, extracted the data and scored their methodology using the AMSTAR scoring system. The papers were categorized into medical therapy (M), surgical therapy (S) or medical and surgical therapy ( MS) groups. Following retrieval of the sample of meta-evidence papers, the original input studies used in their creation were identified and a search of Medline, Embase, CINHAL and the Cochrane Database was performed. A team of researchers then examined the collection of papers for bibliographic and financial information. Results Five hundred papers were identified in the meta-evidence search, of which 118 were deemed eligible. There was a difference in the AMSTAR-rated average quality of the papers between the S and M group (S 7.36 vs M 8.75, P = 0.01). On average S papers were published in journals with a lower impact factor (S 3.26, M 5.04, MS 5.30, P < 0.001). S papers also showed more heterogeneity ( I2; S 37%, M 24%, MS 10%, P < 0.001). Some 25% of S meta-analyses used data-sets with significant heterogeneity ( I2 > 75%), compared with 8% of M meta-analyses and 3% of the MS meta-analyses. Some 5% of S papers were done on data sets that had I2 values > 90%. There was no difference in the average number of papers assessed in each group, the average number of patients per meta-paper, the average time covered by the reviews, the average number of papers considered within each meta-analysis, or the average number of patients considered within each meta-analysis. Considering the conclusions of each meta-analysis, S meta-evidence was 50% more likely than M meta-evidence to be unable to make recommendations for practice. A total of 1499 original input papers were identified, of which 283 were used in more than one review. Within the non-repeated papers ( n = 1023) the average impact factor within the S group was lower than that of the M and the MS groups (3.720 vs 11.230 vs 7.563, respectively; ANOVA P < 0.001). M papers had higher rates of pharmaceutical sponsorship than S papers (M 56% vs S 1%) and twice the level of government support (M 16% vs S 8%). Of note, 21% of M papers had corporate sponsorship but did not list any conflict of interest. Conclusion Compared with M meta-analyses, S meta-analyses in the UC and CD domain are more likely to be of poorer methodological quality, are of a greater degree of heterogeneity and less often offer a positive conclusion. The papers used to generate meta-evidence in M papers have a greater degree of corporate and government sponsorship, and are more likely to come from journals with higher impact factors. [ABSTRACT FROM AUTHOR]

Aim: Several papers have been published about the risk of recurrence after an attack of diverticulitis treated conservatively. However, very few papers have been devoted to the risk of postoperative recurrence of diverticulitis (PRD) after prophylactic sigmoidectomy (PS). The aim of this work was to report the rate of PRD after PS and to assess possible risk factors for recurrence after surgery. Method: All consecutive patients who underwent elective laparoscopic PS for diverticulitis between 2005 and 2019 were retrospectively included. PRD was assessed. Results: Three hundred and sixty four patients (199 men, mean age 54 ± 13 years) were included. Among these, 26 (7%) presented with 1.7 ± 1 (range 1–4) episodes of recurrence of diverticulitis after a mean delay of 44 ± 39 months (1 month–11 years) after surgery. Patients who presented with postoperative recurrence of diverticulitis were younger (46 ± 11 vs. 55 ± 13 years, p = 0.002) and more frequently had uncomplicated diverticulitis [15/26 (58%) vs. 97/338 (29%), p = 0.002] and more than two previous episodes before PS [17/26 (65%) vs. 132/338 (39%), p = 0.009] than patients without PRD. After multivariate analysis, two independent risk factors for PRD were identified: patients with more than two episodes before PS (OR = 3.3, 95% CI = 1.2–9, p = 0.005) and age < 50 years (OR = 4.5, 95% CI = 2–11, p = 0.001). If both factors were present, recurrence reached 18% (9/51). Conclusion: Postoperative recurrence of diverticulitis is rare (7%) after PS for diverticulitis. Some patients (i.e. those with more than two episodes before PS and/or age <50 years) could be exposed to a higher risk of recurrence (up to 18%), making prophylactic surgery questionable in these patients. [ABSTRACT FROM AUTHOR]

Abstracts of papers on colorectal pathology are presented. They include "Diagnostic Precision of Anti-Saccharomyces cerevisiae Antibodies and Perinuclear Anti-Neutrophil Cytoplasmic Antibodies in Inflammatory Bowel Disease," "Multimodal Approach to the Prognosis of Recurrent Diverticulitis," and "The frequency of the sampling response does not determine urge to defecate in patients with constipation: A study using semi-ambulatory anorectal physiology."

Aim Most consultants participating as referees in the peer review process of papers submitted to scholarly journals have had no training or tuition. This study attempted to evaluate the effect on reviewing of a half-day course held at the Royal Society of Medicine. Method Registered consultant delegates were sent two 'doctored' papers, a case report and an original paper, well before the meeting to review at home using the standard computerized score sheet issued with referee requests by Colorectal Disease. At the start of the meeting the scores were entered into a computer as 'Before'. After each paper had been presented and then discussed, it was re-marked to give the 'After' score. The Before and After scores were compared with the post-meeting feedback forms. Results The Before and After scores provided by the participants for the two papers each reviewed were not significantly different for the questions relating to the publication/rejection decision. The Before score was higher than the After score for questions relating to the Abstract, Introduction and Method sections. Feedback forms regarding the tuition were universally positive and appreciative. Conclusion Consultants already have the expertise to decide whether a paper should be rejected. The study day appears to give an additional insight that may change an initial opinion. In general a paper scored before the meeting was scored lower after it was presented and discussed at the meeting (the tuition). [ABSTRACT FROM AUTHOR]

The article presents abstracts on topics related to rectal cancer which include the effect simvastatin on colorectal (CRC) cancer cells and the use of robotic total mesorectal excision (TME) for rectal cancer.

Presents abstracts from the Short Papers meeting of the Royal Society of Medicine. 'Permanent Sacral Nerve Stimulation for Faecal Incontinence,' by N.J. Kenefick, A., Malouf, C. Vaizey, R. Cohen, R.J. Nicholls and M.A. Kamn; 'Positron Emission Tomography for the Evaluation of Colorectal Liver Metastases,' by T.H. Arulampalam, D.C. Costa, M. Loizidou, P.J. Ell and I. Taylor.

An abstract of the article "Factors associated with adequate lymph node harvest in colorectal cancer: The clinical impact of the National Quality Assessment Program and Big Data management," by I. K. Lee and colleagues is presented.

The article presents abstracts of articles on colorectal surgery topics including "Surgical site infection following colorectal surgery: In the eye of the beholder?" by T. Hedrick and colleagues and "Factors associated with adequate lymph node harvest in colorectal cancer: The clinical impact of the National Quality Assessment Program and Big Data management," by I. K. Lee and colleagues.

An abstract of the article "ASCRS Visiting Fellow Paper Watch and wait approach following extended noeadjuvant chemoradiation for distal rectal cancer-are we getting closer to anal cancer management?," by A. Habr-Gama and colleagues is presented.

The article presents abstracts related to colorectal diseases which include "Long-term results of intraoperative pelvic hyperthermic chemotherapy for locally advanced rectal carcinoma," by M. Alekseev and E. Rybakov, "What is a safe distal resection margin in rectal cancer," by T. E. Bernstein and colleagues, and "The treatment of rectal prolapse in 2011: an international survey," by H. A. Formijne Jonkers and colleagues.

The article presents abstracts on topics related to colorectal disease which include the elucidation of tumor location's impact on mucinous carcinomas (MUC) clinicopathological features and prognosis, extent of bladder and sexual dysfunction after an open total mesorectal extension and laparoscopy, and the prevalence of cancer stem cells.

The article presents abstracts on colorectal disease which include the treatment for fecal incontinence using sacral nerve stimulation (SNS), the role of abdominal salvage surgery as a treatment strategy for impendent ileal pouch failure, and a study investigating percutaneous tibial nerve stimulation (PTNS) for the treatment of fecal incontinence.

The article presents abstracts of medical research. They include "The outcomes of stapled trans-anal rectal resection (STARR) vs. biofeedback (BF) in the treatment of defaecatory obstruction associated with rectocele, rectal intussusception and anismus. A multi-centre controlled trial," "Colonic electrical stimulation reduces bowel transit time in a chronic animal model," and "Assessment of posterior compartment prolapse: evacuation proctography or 3D-transperineal ultrasound?"

An abstract is presented of the article "Area-specific prognostic values of mesothelin in Stage II colorectal cancer: a tissue-microarray based approach" by E. Shinto and colleagues.

An abstract is presented of the article "Recurrence and survival in patients with UT2UN0 rectal cancer (RC) treated with neoadjuvant chemoradiation (CRT) and local excision (LE): results of the ACOSOG Z6041 trial" by J. Garcia-Aguilar and colleagues.

The article presents abstracts related to medicine including the use of gabapentin in decreasing post-hemorrhoidectomy pain and the identification and exploration of novel therapeutic targets for anal cancer.

The article presents abstracts related to medical topics including the use of gabapentin in decreasing post-hemorrhoidectomy pain and the exploration and identification of therapeutic targets in anal cancer.

Aim: Anastomotic leak (AL) after colorectal resection is associated with increased rates of morbidity and mortality: potential permanent stoma formation, increased local recurrence, reduced cancer‐related survival, poor functional outcomes and associated quality of life. Techniques to reduce leak rates are therefore highly sought. Method: A literature search was performed for published full text articles using PubMed, Cochrane and Scopus databases with a focus on colorectal surgery 1990–2020. Additional papers were detected by scanning references of relevant papers. Results: A total of 53 papers were included after a thorough literature search. Techniques assessed included leak tests, endoscopy, perfusion assessment and fluorescence studies. Air‐leak testing remains the most commonly used method across Europe, due to ease of reproducibility and low cost. There is no evidence that this reduces the leak rate; however, identification of a leak intra‐operatively provides the opportunity for either suture reinforcement or formal takedown with or without re‐do of the anastomosis and consideration of diversion. Suture repair alone of a positive air‐leak test is associated with an increased AL rate. The use of fluorescence studies to guide the site of anastomosis has demonstrated reduced leak rates in distal anastomoses, is safe, feasible and has a promising future. Conclusion: Although over reliance on any assessment tool should be avoided, intra‐operative techniques with the aim of reducing AL rates are increasingly being employed. Standardization of these methods is imperative for routine use. However, in the interim it is recommended that all anastomoses should be assessed intra‐operatively for mechanical failure, particularly distal anastomoses. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to test the feasibility of a new method for systematic screening for late sequelae (LS) following colorectal cancer treatment. Method: Patients with colorectal cancer from five Danish hospitals were invited to complete a survey about LS at 3, 12, 24 and 36 months after surgery as part of their follow‐up. The survey consisted primarily of validated tools, supplemented by a few ad hoc items, measuring bowel, urinary and sexual dysfunction, pain and quality of life and an additional question regarding request for contact. Patients completed surveys electronically or on paper. Results: Of the 1721 invited patients, 1386 (80.5%) were included (1085 with colon cancer and 301 with rectal cancer) of whom 72.5% responded electronically. Patients responding electronically were 7.6 years younger than those responding on paper (P < 0.001). Since some patients answered more than once, the dataset consisted of 2361 surveys. Patients with colon cancer requested phone contact in 19.0% of the surveys, and 8.4% were referred to treatment for LS, primarily bowel dysfunction. Among patients with rectal cancer, 30.8% requested phone contact and 16.2% were referred for treatment of LS, mainly due to bowel and sexual dysfunction. Conclusion: This is the first paper investigating a new method of systematic screening for LS following colorectal cancer using electronic patient‐reported outcome measures. The study shows that in the Danish population a high response rate can be obtained with this method and that close to three‐quarters of patients respond electronically. Patients with rectal cancer had a higher need for phone contact and treatment of LS than patients with colon cancer. [ABSTRACT FROM AUTHOR]

An abstract of the article "The impact of lymph nodal positivity and its contributing pathologic factors on recurrence after curative surgery for submucosal invasive colorectal cancer," by S. Tsujinaka is presented.

Focuses on abstracts of articles on coloproctology presented at the Royal Society of Medicine's meeting in London, England. "Can Haematological Indices Predict Positive Findings of Endoscopies Performed for Anaemic Patients," by A.M.P. Schizas, R. Reid and M. George; "Immunonutrition Does Not Benefit Elective Surgical Patients Undergoing Restorative Proctocolectomy," by S.C. Mills and A.C. Windsor; "Iron Deficiency Anaemia– Useful Screening Tool for Right Sided Colon Cancers?," by Sajal Rai; "Time Up for the 2 Week Standard?," by M. A. Scott, A. Knight, K. Brown and J.R. Novell.