Preservation of left colic artery in laparoscopic colorectal operation: The benefit challenge

A Nomogram for Predicting Anastomotic Stricture after Laparoscopic Radical Resection of Rectal Cancer

Background: Anastomotic stricture is a common complication following laparoscopic radical resection of rectal cancer, affecting up to 30% of patients and significantly impacting quality of life. This study aimed to develop a predictive model to identify high-risk patients and characterize stricture subtypes. Methods: Retrospective analysis of 304 patients undergoing laparoscopic rectal cancer resection (August 2019-April 2024) identified independent risk factors through multivariate logistic regression. A nomogram was developed and validated using receiver operating characteristic curves, calibration plots, and decision curve analysis. Subtype analysis compared Type I (dilatable, n = 51) and Type II (refractory, n = 38) strictures. Results: The nomogram incorporated five independent predictors: preoperative radiotherapy (odd ratio [OR] = 4.13), diverting stoma creation (OR = 6.98), lack of left colic artery preservation (OR = 3.95), anastomotic leakage (OR = 16.53), and anastomotic distance ≤3 cm (OR = 4.02), achieving an area under the curve (AUC) of .827. Type I strictures were significantly associated with diverting stoma creation (82.4% versus 39.5%, P = .004) and an anastomotic distance >3 cm (70.6% versus 36.8%, P = .001). The refined nomogram for Type II strictures demonstrated superior discrimination (AUC = .883, P < .001). Conclusion: This dual-phase nomogram effectively predicts overall anastomotic stricture risk and identifies refractory subtypes, enabling personalized postoperative management.

Elderly Rectal Cancer: An Updated Review

PURPOSE OF REVIEW

Treatment of rectal cancer patients of advanced age should be modulated by life expectancy and tolerance. Due to the rapid advance of this field, we aim to conduct an updated review of this topic.

RECENT FINDINGS

The field of elderly rectal cancer has advanced a lot. This review covers all the treatment aspects of elderly rectal cancer, including the prognostic factor, surgery, radiotherapy, chemotherapy, and palliative treatment. We also provide the future aspect of the management of elderly rectal cancer. The advancement of prognostic factor research, surgery, radiotherapy, chemotherapy, and palliative treatment has made the care of elderly rectal cancer patients better. The future of these fields should focus on the definition of the elderly and the application of particle therapy.