Jody Parker, Giles Greene, Jared Torkington, Sunil Dolwani
Background and study aims: Evidence suggests that improving polyp detection rates may reduce the risk of post-colonoscopy colorectal cancer (PCCRC). This study aimed to assess the impact of key performance indicators amongst screening colonoscopists on the future risk of advanced polyps and colorectal cancer diagnoses within 3-years of screening colonoscopy.
Patients and methods: This was a retrospective cohort study of patients undergoing screening colonoscopy. Endpoints of advanced polyps or colorectal cancer were identified by analysis of linked healthcare data through the Secure Anonymised Information Linkage Databank. A multivariate Cox regression analysis assessed the impact of colonoscopist's key performance indicators on the outcomes.
Results: 5807 patients were included, with a median follow-up of 60.1 months. There were 0.9% (n = 51) interval advanced polyps and 0.5% (n = 27) colorectal cancers identified with a median time to diagnosis of 19.8 and 39.2 months, respectively. PCCRC rate was 3.8%. The median colonoscopist polyp detection rates were 62.2% with an adenoma detection rate of 50.9%. There was minimal variation in outcomes of advanced polyp or colorectal cancer diagnoses within this group of screening colonoscopists, with no impact demonstrated of increasing improvement of the assessed key performance indicators on this.
Conclusions: It appears there may not be a relationship between increasing performance indicators and better clinical outcomes within this group of high performing colonoscopists. It is likely this will vary depending on the study population and pre test probability of disease. This knowledge may contribute to identifying thresholds that may be utilised in training, surveillance recommendations, new technology and screening programmes.
{"title":"The potential impact of screening colonoscopy quality on post colonoscopy colorectal cancer: An analysis of linked data.","authors":"Jody Parker, Giles Greene, Jared Torkington, Sunil Dolwani","doi":"10.1111/codi.70445","DOIUrl":"https://doi.org/10.1111/codi.70445","url":null,"abstract":"<p><strong>Background and study aims: </strong>Evidence suggests that improving polyp detection rates may reduce the risk of post-colonoscopy colorectal cancer (PCCRC). This study aimed to assess the impact of key performance indicators amongst screening colonoscopists on the future risk of advanced polyps and colorectal cancer diagnoses within 3-years of screening colonoscopy.</p><p><strong>Patients and methods: </strong>This was a retrospective cohort study of patients undergoing screening colonoscopy. Endpoints of advanced polyps or colorectal cancer were identified by analysis of linked healthcare data through the Secure Anonymised Information Linkage Databank. A multivariate Cox regression analysis assessed the impact of colonoscopist's key performance indicators on the outcomes.</p><p><strong>Results: </strong>5807 patients were included, with a median follow-up of 60.1 months. There were 0.9% (n = 51) interval advanced polyps and 0.5% (n = 27) colorectal cancers identified with a median time to diagnosis of 19.8 and 39.2 months, respectively. PCCRC rate was 3.8%. The median colonoscopist polyp detection rates were 62.2% with an adenoma detection rate of 50.9%. There was minimal variation in outcomes of advanced polyp or colorectal cancer diagnoses within this group of screening colonoscopists, with no impact demonstrated of increasing improvement of the assessed key performance indicators on this.</p><p><strong>Conclusions: </strong>It appears there may not be a relationship between increasing performance indicators and better clinical outcomes within this group of high performing colonoscopists. It is likely this will vary depending on the study population and pre test probability of disease. This knowledge may contribute to identifying thresholds that may be utilised in training, surveillance recommendations, new technology and screening programmes.</p>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 4","pages":"e70445"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How to avoid APR after failure of organ preservation in ultra-low rectal cancer? A video vignette.","authors":"Irene Maya, Barbara Noiret, Quentin Denost","doi":"10.1111/codi.70458","DOIUrl":"https://doi.org/10.1111/codi.70458","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 4","pages":"e70458"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nilofer Husnoo, Ruchika Nongrum, Thomas Hall, Alexandra E. Whitman, Lynda Wyld, Alan J. Lobo, Jenna L. Morgan, Deborah Hawkins, Steven R. Brown, EBRIC Collaborators
Background
Medical therapy is often favoured in the treatment of ileocaecal Crohn's disease (CD), with surgery often reserved for treatment failure. Data from the ‘pre-biological’ era suggest that most patients who had an ileocolic resection for CD would have preferred to have surgery sooner. We revisited this observation in the current era and assessed decision-regret relating to surgery.
Methods
A multicentre cross-sectional survey was conducted across nine centres in the United Kingdom with adult patients who had their first ileocolic resection for isolated terminal ileal or ileocolic CD in the 7 years preceding the study. Primary outcomes were patient preference for timing of resection and decision-regret scale score (DRS).
Results
Data from 171 completed surveys were analysed. Eighty (46.8%) patients were satisfied with the timing of surgery; 43.2% (74/171) wished they had surgery sooner and experienced a higher proportion of open procedures. The median DRS was 5/100. The only significant predictor of regret was a lower degree of involvement in shared decision-making (SDM). Nearly half believed surgery to only be an option after all medical therapies had failed.
Conclusion
The proportion who felt that their resection was left too late (43%) is still significant, despite being lower compared to the ‘pre-biological’ era (75% in a previous similar study). Patients' regret relating to their first resection is generally low, especially when they are involved in SDM. However, SDM remains suboptimal. There is an urgent need for improved counselling and earlier surgical consideration in isolated ileocaecal CD, supported by multidisciplinary input.
{"title":"Timing of ileocolic resection for Crohn's disease: A survey of the patient perspective in the ‘biological’ era","authors":"Nilofer Husnoo, Ruchika Nongrum, Thomas Hall, Alexandra E. Whitman, Lynda Wyld, Alan J. Lobo, Jenna L. Morgan, Deborah Hawkins, Steven R. Brown, EBRIC Collaborators","doi":"10.1111/codi.70440","DOIUrl":"10.1111/codi.70440","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Medical therapy is often favoured in the treatment of ileocaecal Crohn's disease (CD), with surgery often reserved for treatment failure. Data from the ‘pre-biological’ era suggest that most patients who had an ileocolic resection for CD would have preferred to have surgery sooner. We revisited this observation in the current era and assessed decision-regret relating to surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multicentre cross-sectional survey was conducted across nine centres in the United Kingdom with adult patients who had their first ileocolic resection for isolated terminal ileal or ileocolic CD in the 7 years preceding the study. Primary outcomes were patient preference for timing of resection and decision-regret scale score (DRS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from 171 completed surveys were analysed. Eighty (46.8%) patients were satisfied with the timing of surgery; 43.2% (74/171) wished they had surgery sooner and experienced a higher proportion of open procedures. The median DRS was 5/100. The only significant predictor of regret was a lower degree of involvement in shared decision-making (SDM). Nearly half believed surgery to only be an option after all medical therapies had failed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The proportion who felt that their resection was left too late (43%) is still significant, despite being lower compared to the ‘pre-biological’ era (75% in a previous similar study). Patients' regret relating to their first resection is generally low, especially when they are involved in SDM. However, SDM remains suboptimal. There is an urgent need for improved counselling and earlier surgical consideration in isolated ileocaecal CD, supported by multidisciplinary input.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13044388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Value of faecal calprotectin levels in patients with perianal fistula: A new direction.","authors":"Pankaj Garg, Vipul D Yagnik, G Mahak","doi":"10.1111/codi.70451","DOIUrl":"https://doi.org/10.1111/codi.70451","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 4","pages":"e70451"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniela Rega, Antonio Luberto, Teresa Pagano, Massimiliano Di Marzo, Manuela Brighi, Fabio Carbone, Paolo Delrio
{"title":"Single-port robotic transanal minimally invasive surgery (SP-rTAMIS) with full-thickness rectal advancement flap: A video vignette.","authors":"Daniela Rega, Antonio Luberto, Teresa Pagano, Massimiliano Di Marzo, Manuela Brighi, Fabio Carbone, Paolo Delrio","doi":"10.1111/codi.70454","DOIUrl":"https://doi.org/10.1111/codi.70454","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 4","pages":"e70454"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pankaj Kumar, Kanishka Das, Monika Gureh, D Avinash Varma
{"title":"Posterior sagittal anorectoplasty in adults with anorectal malformation: A surgical video correspondence-A video vignette.","authors":"Pankaj Kumar, Kanishka Das, Monika Gureh, D Avinash Varma","doi":"10.1111/codi.70457","DOIUrl":"https://doi.org/10.1111/codi.70457","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 4","pages":"e70457"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The optimal timing for seton removal in perianal fistulizing Crohn's disease (PFCD) remains unclear. Therefore, we examined the range of reported timing strategies and their association with clinical outcomes.
Methods: We systematically searched PubMed, Web of Science, Cochrane Library and Ichushi-Web for studies published from January 1990 to June 2025. Eligible studies included adult patients with PFCD who underwent seton placement and reported removal timing and clinical outcomes. Healing and recurrence rates were pooled using a random effects model. Subgroup analyses evaluated seton removal timing (<34 vs. ≥34 weeks) and biologic and antibiotic usage.
Results: Overall, nine studies were included (nine observational studies). The pooled healing rate was 57% (95% confidence interval [CI], 40-73%), and the pooled recurrence rate was 31% (95% CI, 15-53%), both with substantial heterogeneity (I2 > 80%). Short-term removal (<34 weeks) achieved a healing rate of 69% (95% CI, 56-79%) vs. 46% (95% CI, 22-72%) for long-term removal (≥34 weeks) (p = 0.03). A significant correlation was found between seton removal timing and healing rate (r = -0.70, p = 0.03). The recurrence incidence was 12.7 (95% CI, 4.7-34.3) in the short-term group and 3.9 (95% CI, 0.7-21.4) in the long-term group (p = 0.09).
Conclusion: An association between seton removal timing and fistula healing was observed without a corresponding increase in recurrence. These findings should be interpreted cautiously because removal timing may reflect disease severity and treatment response rather than a causal effect.
背景：肛周瘘管性克罗恩病（PFCD）的最佳切除时间尚不清楚。因此，我们检查了报道的时间策略的范围及其与临床结果的关系。方法：系统检索PubMed、Web of Science、Cochrane Library和Ichushi-Web，检索1990年1月至2025年6月间发表的研究。符合条件的研究包括接受seton放置并报告取出时间和临床结果的成年PFCD患者。采用随机效应模型汇总治愈率和复发率。亚组分析评估了seton清除时间(结果：总共纳入了9项研究（9项观察性研究）。合并治愈率为57%(95%可信区间[CI]， 40-73%)，合并复发率为31% (95% CI, 15-53%)，两者均存在显著异质性（I2 bb0 80%）。短期切除(结论：观察到切除时间与瘘管愈合之间存在关联，而没有相应的复发增加。这些发现应谨慎解释，因为切除时间可能反映疾病的严重程度和治疗反应，而不是因果关系。
{"title":"Timing of seton removal and clinical outcomes in perianal fistulizing Crohn's disease: A systematic review and meta-analysis.","authors":"Yuki Horio, Motoi Uchino, Yusuke Tomoo, Kazunori Nomura, Kentaro Nagano, Kurando Kusunoki, Ryuichi Kuwahara, Kei Kimura, Kozo Kataoka, Tetsuya Takagawa, Masataka Ikeda, Hiroki Ikeuchi","doi":"10.1111/codi.70449","DOIUrl":"https://doi.org/10.1111/codi.70449","url":null,"abstract":"<p><strong>Background: </strong>The optimal timing for seton removal in perianal fistulizing Crohn's disease (PFCD) remains unclear. Therefore, we examined the range of reported timing strategies and their association with clinical outcomes.</p><p><strong>Methods: </strong>We systematically searched PubMed, Web of Science, Cochrane Library and Ichushi-Web for studies published from January 1990 to June 2025. Eligible studies included adult patients with PFCD who underwent seton placement and reported removal timing and clinical outcomes. Healing and recurrence rates were pooled using a random effects model. Subgroup analyses evaluated seton removal timing (<34 vs. ≥34 weeks) and biologic and antibiotic usage.</p><p><strong>Results: </strong>Overall, nine studies were included (nine observational studies). The pooled healing rate was 57% (95% confidence interval [CI], 40-73%), and the pooled recurrence rate was 31% (95% CI, 15-53%), both with substantial heterogeneity (I<sup>2</sup> > 80%). Short-term removal (<34 weeks) achieved a healing rate of 69% (95% CI, 56-79%) vs. 46% (95% CI, 22-72%) for long-term removal (≥34 weeks) (p = 0.03). A significant correlation was found between seton removal timing and healing rate (r = -0.70, p = 0.03). The recurrence incidence was 12.7 (95% CI, 4.7-34.3) in the short-term group and 3.9 (95% CI, 0.7-21.4) in the long-term group (p = 0.09).</p><p><strong>Conclusion: </strong>An association between seton removal timing and fistula healing was observed without a corresponding increase in recurrence. These findings should be interpreted cautiously because removal timing may reflect disease severity and treatment response rather than a causal effect.</p>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 4","pages":"e70449"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Does the type of second primary cancers explain survival differences in colorectal cancer sequence?","authors":"Sameh Hany Emile, Anjelli Wignakumar","doi":"10.1111/codi.70450","DOIUrl":"10.1111/codi.70450","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 4","pages":"e70450"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Methodological considerations in a radiomics–clinical machine-learning model for predicting cytoreduction completeness","authors":"Ziying Su, Shengxuan Zhang, Kezhen Wu","doi":"10.1111/codi.70443","DOIUrl":"10.1111/codi.70443","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"28 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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