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Malaysian Society of Colorectal Surgeons (MSCRS)

Sagap I, Roslani A

Colorectal Dis, 2021 Mar;23(3):574-575.
PMID: 33760343 DOI: 10.1111/codi.15594
Matched MeSH terms: Colorectal Surgery*
Artificial intelligence in colorectal surgery: an AI-powered systematic review

Spinelli A, Carrano FM, Laino ME, Andreozzi M, Koleth G, Hassan C, et al.

Tech Coloproctol, 2023 Aug;27(8):615-629.
PMID: 36805890 DOI: 10.1007/s10151-023-02772-8

Artificial intelligence (AI) has the potential to revolutionize surgery in the coming years. Still, it is essential to clarify what the meaningful current applications are and what can be reasonably expected. This AI-powered review assessed the role of AI in colorectal surgery. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compliant systematic search of PubMed, Embase, Scopus, Cochrane Library databases, and gray literature was conducted on all available articles on AI in colorectal surgery (from January 1 1997 to March 1 2021), aiming to define the perioperative applications of AI. Potentially eligible studies were identified using novel software powered by natural language processing (NLP) and machine learning (ML) technologies dedicated to systematic reviews. Out of 1238 articles identified, 115 were included in the final analysis. Available articles addressed the role of AI in several areas of interest. In the preoperative phase, AI can be used to define tailored treatment algorithms, support clinical decision-making, assess the risk of complications, and predict surgical outcomes and survival. Intraoperatively, AI-enhanced surgery and integration of AI in robotic platforms have been suggested. After surgery, AI can be implemented in the Enhanced Recovery after Surgery (ERAS) pathway. Additional areas of applications included the assessment of patient-reported outcomes, automated pathology assessment, and research. Available data on these aspects are limited, and AI in colorectal surgery is still in its infancy. However, the rapid evolution of technologies makes it likely that it will increasingly be incorporated into everyday practice.

Matched MeSH terms: Colorectal Surgery*
ALEXIS O-Ring wound retractor vs conventional wound protection for the prevention of surgical site infections in colorectal resections(1)

Cheng KP, Roslani AC, Sehha N, Kueh JH, Law CW, Chong HY, et al.

Colorectal Dis, 2012 Jun;14(6):e346-51.
PMID: 22568647 DOI: 10.1111/j.1463-1318.2012.02943.x

Surgical site infection (SSI) remains a common postoperative morbidity, particularly in colorectal resections, and poses a significant financial burden to the healthcare system. The omission of mechanical bowel preparation, as is performed in enhanced recovery after surgery programmes, appears to further increase the incidence. Various wound protection methods have been devised to reduce the incidence of SSIs. However, there are few randomized controlled trials assessing their efficacy. The aim of this study is to investigate whether ALEXIS wound retractors with reinforced O-rings are superior to conventional wound protection methods in preventing SSIs in colorectal resections.

Matched MeSH terms: Colorectal Surgery/adverse effects*; Colorectal Surgery/instrumentation*
Fulltext Outcome of emergency colorectal cancer admissions is determined primarily by physical status

Mohamad Yunus A, Mohd Dun S

JUMMEC, 1996;1:29-32.

A retrospective cohort study of 206 consecutive patients with colorectal cancer presenting to three general surgeons in the University Hospital, Kuala Lumpur over a 3-year period is reported. In all, 184 patients had an operation and are grouped according to whether their operation was within 24 hours of admission (n=16), more than 24 hours after admission (n=38), or elective (n=130). Operative mortalities for these groups were 15.9%,15.2Â°/o and 6.5%, respectively, significantly higher in both the emergency groups. Delayed surgery to allow complete resuscitation did not improve the operative mortality when compared with those patients having urgent surgery. Both groups of emergency patients, delayed (27%) and urgent (19%), showed poorer 5-year survival than the electively treated patients (36%), many dying of non-cancer causes. Patients who undergo emergency surgery for colorectal carcinoma are more l i k e l y to be in poorer physical condition than the patients undergoing elective surgery for the same condition. It appears that the physical status is the principal determinant of outcome after emergency colorectal surgery rather than any other factor. KEYWORDS: colorectal cancer, emergency, outcome

Matched MeSH terms: Colorectal Surgery
Current surgical treatment of obstructed defecation among selected European opinion leaders in pelvic floor surgery

Kim M, Meurette G, Ragu R, Lehur PA

Tech Coloproctol, 2016 Jun;20(6):395-399.
PMID: 27170284 DOI: 10.1007/s10151-016-1473-z

BACKGROUND: The aim of this study was to perform a survey on the surgical management of obstructed defecation (OD) across advocated selected coloproctological experts across Europe.
METHODS: Surgeons from 42 centers of coloproctology in Europe were asked to complete a questionnaire, including seven questions about their past and present operative treatment strategy for patients with OD.
RESULTS: The questionnaire was completed by 32 experts of pelvic floor surgery in 13 European countries. All but one indicated that they consider surgical treatment for OD. Seventy-four percent of these have been using transanal stapled rectal resection (STARR) and 96 % transabdominal rectopexy. While only 65 %, who have begun performing STARR are still using transanal resection, the technique is still being used by all surgeons performing abdominal procedures. Rectopexy only, STARR only, or both approaches are offered by 52, 3, and 45 % of surgeons, respectively.
CONCLUSIONS: The use of STARR in the treatment of OD is decreasing among European opinion leaders in the field of pelvic floor surgery, while the application of transabdominal procedures continues.

Matched MeSH terms: Colorectal Surgery/methods; Colorectal Surgery/statistics & numerical data*
Common proctological conditions

Monro JK

Journal of the Malaya Branch of the British Medical Association, 1940;3:396-9.

Matched MeSH terms: Colorectal Surgery
Serum Procalcitonin Predicts Anastomotic Leaks in Colorectal Surgery

Hayati F, Mohd Azman ZA, Nasuruddin DN, Mazlan L, Zakaria AD, Sagap I

Asian Pac J Cancer Prev, 2017 07 27;18(7):1821-1825.
PMID: 28749112

Background: Anastomotic leaks in colorectal surgery results in a high morbidity and mortality rate. Serum procalcitonin levels is known as a sensitive and specific marker of sepsis and could be use as a marker for early detection of a leak allowing early intervention. It may help a clinician decide to perform a CT scan even earlier especially when the diagnosis of a leak is uncertain. The aim of this study is to determine whether serum procalcitonin is a good predictor of anastomotic leak in colorectal surgery. Methodology: Between July 2014 until October 2015, 70 patients undergoing colorectal surgery were prospectively analyzed in a single-center tertiary teaching hospital. Demographic and surgical data were obtained. Serum procalcitonin was taken before surgery and at day 3 (72 hours) postoperatively. During the postoperative period, the patients were observed in the ward for features of anastomotic leak and if present, it was managed accordingly. The primary outcome was to prospectively determine an association between serum procalcitonin levels and an anastomotic leak in patients who underwent colorectal surgery with a primary anastomosis. Result: The rate of anastomotic leak was 4.5% (3 patients) with a mortality rate of 4.3% (3 patients). A rise in serum procalcitonin was statistically significant among patients with anastomotic leak. The optimal procalcitonin cut-off level at postoperative day 3 was 5.27 ng/mL, resulting in 100% sensitivity, 85% specificity, 23% positive predictive value and 100% negative predictive value. Nevertheless, none of the variables showed statistical significance with an anastomotic leak. Conclusion: Procalcitonin is a reliable biochemical marker to help diagnose anastomotic leak in colorectal surgery. Our study has shown that a level of 5 times beyond normal is statistically significant and a value of more than 5.27 ng/mL is confirmatory of a leak.

Matched MeSH terms: Colorectal Surgery
Antibiotic prophylaxis in elective colorectal surgery

Gul YA, Lian LH, Jabar FM, Moissinac K

ANZ J Surg, 2002 Apr;72(4):275-8.
PMID: 11982514

Antibiotics are often administered in elective colorectal surgery to prevent wound infection. The tendency for surgeons to prolong the administration of prophylactic antibiotic therapy in the postoperative period is a well-known fact. The aim of this study was to elucidate the pattern of prophylactic antibiotic utilization in elective colorectal surgery and to determine if evidence-based medicine is employed in relation to this practice.

Matched MeSH terms: Colorectal Surgery*