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Alqarni F, Akbar T, Fatani H, Kumasaka S, Hoad CL, Spiller RC, Taylor MA, Marciani L. Experimental Measurements of the Length of the Human Colon: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2024; 14:2190. [PMID: 39410595 PMCID: PMC11475704 DOI: 10.3390/diagnostics14192190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Revised: 09/24/2024] [Accepted: 09/29/2024] [Indexed: 10/20/2024] Open
Abstract
PURPOSE Knowledge of the length of the colon is relevant to understanding physiological and pathological function. It also has implications for diagnostic and clinical interventions, as well as for the design of delayed-release drug formulations and drug disposition modeling. METHODS Over the years, a range of different experimental methods have been employed to assess colon length. These methods vary from direct measurements on cadavers and during intraoperative procedures to measurements obtained from endoscopic and medical imaging techniques. However, no systematic review or meta-analysis of these findings has yet been carried out. In this systematic review, we identified 31 published experimental studies that measured the length of the human colon and/or its segments. RESULTS We synthesized the available data, comprising colon length measurements from 5741 adults and 337 children and young people, in a meta-analysis. The data contribute to our understanding of colon morphology and may have implications for clinical practice, particularly for colonoscopy and preoperative planning of surgical resections. Additionally, this review provides potential insights into anatomical correlates of functional diseases, such as constipation. CONCLUSIONS This review highlights that non-invasive, non-destructive diagnostic imaging techniques, such as magnetic resonance imaging (MRI), can provide more physiologically relevant measurements of colon length. However, there is a need for more standardized measurement protocols and for additional pediatric data.
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Affiliation(s)
- Faiz Alqarni
- Translational Medical Sciences, Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (F.A.); (T.A.); (H.F.); (R.C.S.)
- National Institute for Health and Care Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK; (C.L.H.); (M.A.T.)
- King Saud Medical City, Ministry of Health, Riyadh 11196, Saudi Arabia
| | - Tejal Akbar
- Translational Medical Sciences, Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (F.A.); (T.A.); (H.F.); (R.C.S.)
- National Institute for Health and Care Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK; (C.L.H.); (M.A.T.)
| | - Hala Fatani
- Translational Medical Sciences, Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (F.A.); (T.A.); (H.F.); (R.C.S.)
- National Institute for Health and Care Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK; (C.L.H.); (M.A.T.)
| | - Soma Kumasaka
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan;
- Radiological Sciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Caroline L. Hoad
- National Institute for Health and Care Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK; (C.L.H.); (M.A.T.)
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - Robin C. Spiller
- Translational Medical Sciences, Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (F.A.); (T.A.); (H.F.); (R.C.S.)
- National Institute for Health and Care Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK; (C.L.H.); (M.A.T.)
| | - Moira A. Taylor
- National Institute for Health and Care Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK; (C.L.H.); (M.A.T.)
- The David Greenfield Human Physiology Unit, School of Life Sciences, University of Nottingham, Nottingham NG7 2UH, UK
| | - Luca Marciani
- Translational Medical Sciences, Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (F.A.); (T.A.); (H.F.); (R.C.S.)
- National Institute for Health and Care Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK; (C.L.H.); (M.A.T.)
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Stang A, Kluttig A. Etiologic insights from surface adjustment of colorectal carcinoma incidences: an analysis of the U.S. SEER data 2000-2004. Am J Gastroenterol 2008; 103:2853-61. [PMID: 18759825 DOI: 10.1111/j.1572-0241.2008.02087.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS The subsite-specific comparison of the incidence of carcinoma within the colorectum is complicated because the mucosal surface, and therefore the amount of epithelial cells at risk, varies among the subsites. The aim of this study was to provide the subsite-specific estimates of the colon mucosal surface and the mucosal surface-adjusted carcinoma incidence estimates of colon subsites that allow a more valid comparison of the subsite-specific incidences. METHODS We extracted subsite-specific incidence rates of colorectal carcinoma from the Surveillance, Epidemiology, and End Results (SEER) Program of the years 2000-2004. The rates were age-standardized to the U.S. standard population in the year 2000. We estimated the mucosal surface of each segment of the colorectum and calculated the surface-adjusted incidence rates by dividing the observed age-standardized incidence rates by the estimated surface areas. RESULTS After adjustment for surface area, the incidence relations among the colorectal subsites changed. Within the colon, the surface-adjusted rates tend to be highest in the cecum, followed by the vermiform appendix, ascending colon, and sigmoid colon. The rates of the transverse and descending colon are considerably lower. The surfaced-adjusted incidence of rectal carcinoma is about 12- to 23-fold higher than the rate of carcinoma of the transverse colon. CONCLUSIONS The distribution of the incidence of carcinomas is markedly influenced by the adjustment of surface area of the colorectum. Similar surface-adjusted rates of the vermiform appendix and ascending colon may implicate that these subsites share a similar etiology. Considerable differences of the surface-adjusted rates of the sigmoid colon and rectum may indicate different etiologies of carcinomas of these subsites.
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Affiliation(s)
- Andreas Stang
- Clinical Epidemiology Unit, Institute of Medical Epidemiology, Biometry and Informatics, Medical Faculty, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
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