Techniques in Coloproctology结直肠肛门诊疗技术
Techniques in Coloproctology(英文缩写 TECH COLOPROCTOL),ISSN 1123-6337,eISSN 1128-045X,中文译名:结直肠肛门诊疗技术 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-11-01 至 2026-10-31，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 3.699 | Q1 |
| 2022 | 3.300 | Q1 |
| 2023 | 2.700 | Q1 |
| 2024 | 2.900 | Q1 |
| 2025 | 2.600 | Q2 |
Techniques in Coloproctology 最新收录文献
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1. Indocyanine green fluorescence angiography for prevention of anastomotic leak in colorectal surgery: a graded systematic review and meta-analysis with trial sequential analysis of randomized controlled trials.
1. 吲哚菁绿荧光血管造影预防结直肠手术吻合口漏：一项随机对照试验的分级系统评价与荟萃分析及试验序贯分析PMID:日期:2026-09-23Anastomotic leak (AL) is a major driver of morbidity after colorectal resection. Indocyanine-green fluorescence angiography (ICG-FA) provides real-time intraoperative perfusion assessment, but its impact across randomized trials remains debated. This review aims to evaluate the efficacy and safety of ICG-FA compared with conventional intraoperative assessment in preventing AL in colorectal surgery. A systematic review and a meta-analysis was conducted in accordance with the PRISMA guidelines, including RCTs comparing ICG-FA with conventional assessment. The primary outcome was overall AL; secondary outcomes included leak grade, anatomic location, operative metrics, and change in surgical plan (CISP). Pooled risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI) were calculated using random- or fixed-effects models. Trial sequential analysis (TSA) was used to evaluate evidence sufficiency. Eight RCTs (n = 4712) met the inclusion criteria. ICG-FA reduced overall AL versus control (risk ratio [RR] 0.68, 95% CI 0.58-0.81; I = 0%). The absolute risk reduction was 3.6%, yielding a number needed to treat of around 24 to prevent one leak. TSA crossed the superiority boundary for the primary endpoint, indicating sufficient evidence of the assumed control risk and effect size. Benefits were more apparent for left-sided anastomoses and for lower-grade leaks (A and A + B), whereas severe (Grade C) leaks and reoperation did not differ significantly. Overall complications showed a small relative reduction, but TSA indicated insufficient information size. Other safety outcomes (surgical site infection, ileus, mortality) were similar between groups. High-certainty evidence demonstrates that ICG-FA reduces overall and low-grade AL, principally in left-sided resections, without prolonging operative time. ICG-FA should be considered an evidence-based adjunct to optimize perfusion assessment in colorectal surgery. PROSPERO CRD420251139372.
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2. Does robotics add value in Hartmann's reversal? A PRISMA-based systematic review and meta-analysis of perioperative outcomes.
2. 机器人技术在哈特曼逆转术中是否具有附加价值？基于PRISMA的系统评价与围手术期结局的荟萃分析PMID:日期:2026-08-14Reversal of Hartmann's procedure is technically demanding and occasionally performed via open surgery, which is associated with substantial morbidity. Minimally invasive approaches have expanded, yet comparative evidence between robotic and laparoscopic reversal remains limited. We conducted a systematic review and meta-analysis to compare perioperative outcomes of both approaches. Databases were searched through 20 July 2026. Studies reporting outcomes after laparoscopic and/or robotic Hartmann's reversal were included. Random-effects meta-analyses were performed with preplanned subgroup comparisons (robotic versus laparoscopic). Pooled estimates were reported with 95% confidence intervals; heterogeneity was assessed using I. Evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Sixty-five studies comprising >10,000 patients were included. Operative time was significantly longer with robotics (274.6 versus 176.04 min; P = 0.018). Robotic studies reported lower pooled surgical site infection rates (4% versus 6%; P = 0.02) and shorter length of hospital stay (4.2 versus 8.0 days; P < 0.001). Conversion to open surgery pooled rate was lower in robotic studies (7% versus 14%), yet the subgroup difference did not reach statistical significance. Robotic Hartmann's reversal was associated with longer operative time, while pooled analyses showed lower surgical site infection rates and shorter hospital stay than pooled laparoscopic reversal. However, the current robotic evidence base remains limited and is largely derived from indirect comparisons and pooled single-arm analyses. Higher-quality comparative data are needed to define patient selection, cost, and benefit.
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4. The BioSynIRS trial: biologic versus synthetic mesh for multicompartment pelvic floor reconstruction.
4. BioSynIRS试验：生物补片与合成补片在多腔室盆底重建中的比较PMID:日期:2026-08-07Selected patients with obstructed defecation syndrome (ODS) and concomitant pelvic organ prolapse (POP) may require laparoscopic resection rectopexy (L-RRP) with laparoscopic sacrocolpopexy (L-SCP). This trial compared the safety and efficacy of biologic versus synthetic mesh (BM or SM) in L-SCP. In this single-center randomized pilot trial, 30 women with severe ODS underwent combined L-RRP and L-SCP using either a BM or SM. The primary endpoint was the severe adverse event rate. Secondary endpoints included functional and anatomical outcomes related to ODS and POP. Follow-up was complete at 12 months for all patients. The 30 patients (15 per group) had similar baseline characteristics, comparable frequency of additional surgical procedures, longer operative time in the SM group, lower pain in the BM group, similar length of hospital stay, comparable adverse event rates, and no mesh-related complications. Severe adverse events were reported by two patients (13%) in the BM group versus five (33%) in the SM group. Functional outcomes and POP-Q scores significantly improved in both groups (p < 0.01), urinary incontinence was unchanged, and there were three cases of ODS recurrence at 12 months. The main limitation of this study is its pilot design with a limited sample size and short follow-up, precluding definitive conclusions regarding long-term durability and rare adverse events. No significant differences in safety were detected between biologic and synthetic mesh; functional and anatomical outcomes improved similarly. Given the pilot design and limited sample size, these findings support the feasibility, but not equivalence or non-inferiority, of the biologic mesh. Adequately powered trials are required to confirm these findings and to evaluate the long-term durability of the biologic mesh. Trial registration at ClinicalTrials.gov (NCT06245577) and at the German Clinical Trials Register (DRKS00033079).
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5. Delayed secondary repair of third- and fourth-degree obstetric anal sphincter injuries: a randomized controlled trial comparing overlapping versus end-to-end sphincter repair.
5. 三度和四度产科肛门括约肌损伤的延迟二期修复：重叠式与端端括约肌修复术的随机对照试验PMID:日期:2026-08-06[中文摘要] 继发性肛门括约肌修补在产科肛门括约肌损伤（OASI）初次修补后需要进行的病例中不足3%。尽管越来越多的证据对早期与延迟继发性修补进行了比较，但继发性OASI的传统且最常见的处理方式仍是延迟修补。本研究比较了在OASI延迟继发性修补中重叠式与端端括约肌修补技术的临床和功能结局。在这项单中心随机对照试验中，40例初次修补后发生Ⅲ度或Ⅳ度OASI且伤口裂开的女性按1：1随机分配至重叠式括约肌成形术或端端对合术。评估在术前及术后2周、3、6和12个月进行。主要结局为12个月时的Wexner失禁评分。分析采用符合方案集分析，并进行意向性治疗敏感性分析。38例女性纳入符合方案集分析（重叠式组n=18；端端组n=20）。重叠式组有2例患者失访。重叠式组的手术时间显著更长（121.3±5.5 vs 102.8±6.3分钟；p<0.001）。重叠式修补导致平均Wexner评分显著更低（0.5±0.2 vs 2.2±0.8；p<0.001），完全控便率更高（Wexner≤5：100% vs 85%；p=0.03）。重叠式组伤口愈合时间更短（23.3±4.8 vs 26.9±5.5天；p=0.08），总体并发症更低（11.1% vs 30.0%）。肛内超声Starck评分和测压参数显示出一致倾向于重叠式修补的趋势，尽管这些差异无统计学意义。在延迟继发性OASI修补中，当结合细致的肌肉游离和标准化术后方案时，重叠式括约肌成形术较端端修补提供更优的控便结局和更低的并发症率。这些发现支持将重叠式修补作为该情形下的首选技术。
[英文摘要] Secondary anal sphincter repair is necessary in fewer than 3% of cases following primary repair of obstetric anal sphincter injuries (OASI). Although there is some growing evidence comparing early and delayed secondary repairs, the traditional and most common way to manage secondary OASI is still delayed repair. This study compared clinical and functional outcomes of overlapping versus end-to-end sphincter repair techniques in delayed secondary repair of OASI. In this single-center randomized controlled trial, 40 women with third- or fourth-degree OASI and wound dehiscence after primary repair were randomized 1:1 to overlapping sphincteroplasty or end-to-end approximation. Assessments were performed preoperatively and at 2 weeks, 3, 6, and 12 months. The primary outcome was the Wexner incontinence score at 12 months. Analysis was per-protocol with intention-to-treat sensitivity analysis. Thirty-eight women were included in the per-protocol analysis (overlapping n = 18; end-to-end n = 20). Two patients in the overlapping group were lost to follow-up. Operative time was significantly longer in the overlapping group (121.3 ± 5.5 vs 102.8 ± 6.3 min; p < 0.001). The overlapping repair resulted in a significantly lower mean Wexner score (0.5 ± 0.2 vs 2.2 ± 0.8; p < 0.001) and higher rate of complete continence (Wexner ≤ 5: 100% vs 85%; p = 0.03). Time to wound healing was shorter (23.3 ± 4.8 vs 26.9 ± 5.5 days; p = 0.08) and overall complications were lower (11.1% vs 30.0%) in the overlapping group. Endoanal ultrasound Starck scores and manometry parameters showed consistent trends favoring overlapping repair, although these differences were not statistically significant. In delayed secondary OASI repair, overlapping sphincteroplasty provided superior continence outcomes and lower complication rates than end-to-end repair, when combined with meticulous muscle mobilization and a standardized postoperative regimen. These findings support overlapping repair as the preferred technique in this setting.
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6. Clinical outcomes of transvaginal fistulectomy and internal orifice closure in rectovaginal fistulas secondary to stapled prolapsectomy: a monocentric case series.
PMID:日期:2026-07-20Rectovaginal fistula (RVF) is a rare but severe complication of stapled prolapsectomy (SP), resulting from inadvertent inclusion of the posterior vaginal wall within the stapler line. RVFs secondary to SP represent a distinct iatrogenic subtype, characterized by a short, low-lying fistulous tract and localized ischemic tissue damage. We evaluated the feasibility and outcomes of a transvaginal repair strategy consisting of inverse T-shaped colpotomy, transvaginal fistulectomy, closure of the rectal defect from the vaginal side, and layered reconstruction without fecal diversion in patients with early RVF after SP. This monocentric, retrospective observational study included adult female patients treated for RVF secondary to SP between January 2023 and April 2025. All patients underwent transvaginal fistulectomy with internal orifice closure without protective stoma. Demographic data, fistula characteristics, operative details, postoperative outcomes, and healing at 6 and 12 months were analyzed. Four consecutive patients were included. Median age was 60 years (range 54-74), and median BMI was 23.5 kg/m (range 20-25). Median time from SP to RVF repair was 18 days (range 15-30). Median operative time was 91 min (range 45-110). No intraoperative or postoperative complications occurred (Clavien-Dindo grade 0). At both 6- and 12-month follow-up, all patients demonstrated complete clinical healing, with no persistence, recurrence, or late complications. Transvaginal fistulectomy with internal orifice closure without fecal diversion could be a safe and effective surgical option for RVF secondary to SP. Given the limitations of this small retrospective single-cohort series, these findings should be considered preliminary. Number CET 371-2025, date of registration 12/11/2025, retrospectively registered.
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7. Predictors of ileal pouch-anal anastomosis failure in ulcerative colitis: a European tertiary referral center experience.
7. 溃疡性结肠炎中回肠储袋肛管吻合术失败的预测因素：欧洲三级转诊中心的经验PMID:日期:2026-07-17Total proctocolectomy with ileal pouch-anal anastomosis serves as the standard surgical treatment for medically refractory ulcerative colitis, yet long-term pouch failure remains a significant clinical challenge. This study aimed to identify independent predictors of pouch failure and to develop a practical clinical nomogram for individualized risk assessment. A retrospective cohort study was conducted utilizing a prospectively maintained database at a European tertiary referral center, analyzing procedures performed between December 2005 and June 2025. The study included 851 adult patients with a confirmed histologic diagnosis of ulcerative colitis who underwent restorative surgery. The primary outcome was pouch failure, defined as permanent pouch excision or indefinite fecal diversion. Independent predictors were identified using penalized logistic regression modeling to build a predictive risk tool. Over a median follow-up of 37.0 months for the entire cohort, pouch failure occurred in 4.7% of patients (n = 40). Among patients who experienced pouch loss, the median time to failure was 29.4 months. The majority of these failures manifested after 12 months and were primarily driven by severe fistulae and chronic leaks. Preoperative biologic therapy emerged as the sole independent predictor of pouch failure. Handsewn anastomoses and non-standard pouch configurations also demonstrated strong associations with failure. A five-variable clinical nomogram was constructed to provide individualized failure probabilities. While overall pouch failure rates remain low in specialized centers, exposure to preoperative biologic therapy significantly elevates this risk. The newly developed nomogram provides a valuable, evidence-based tool for tailored surgical counseling and personalized patient management.
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8. Endoanal ultrasound-measured internal anal sphincter changes after nonablative 1470-nm diode laser therapy for anal incontinence: a prospective single-arm pilot study.
8. 肛门内超声测量的内肛门括约肌在非消融1470nm二极管激光治疗肛门失禁后的变化：一项前瞻性单臂初步研究PMID:日期:2026-07-16Fecal incontinence (FI) is a debilitating condition that may be associated with structural abnormalities of the anal sphincter complex. Nonablative anal laser therapy has been proposed as a minimally invasive treatment option; however, its anatomical correlates remain insufficiently defined. The objectives of this study were to evaluate endoanal ultrasound (EAUS)-detected changes in internal anal sphincter (IAS) morphology after nonablative 1470-nm diode laser therapy and to explore their association with clinical outcomes. In this prospective single-arm pilot study, 30 patients with mild-to-moderate FI and IAS defects or atrophy underwent up to six sessions of nonablative 1470-nm diode laser therapy. EAUS was performed before and after treatment to assess IAS thickness, IAS length, and defect length. Clinical response was assessed using the Wexner score, and anorectal manometry and Fecal Incontinence Quality of Life (FIQL) scores were evaluated. A total of 24 patients completed treatment and post-treatment reassessment. EAUS demonstrated small but statistically significant increases in IAS thickness and length, with a concomitant reduction in IAS defect length (p < 0.05). Symptomatic improvement was observed in 17/24 completing patients (70.8%) and was more frequent among patients with isolated IAS defects than among those with combined IAS and external anal sphincter defects. Greater reduction in IAS defect length was associated with clinical improvement (p = 0.015). Adverse events were generally transient; however, six patients discontinued treatment, including four owing to pain or burning sensation. In this uncontrolled pilot study, nonablative 1470-nm diode laser therapy was associated with EAUS-detected IAS changes and symptomatic improvement in selected patients with FI. Because of the absence of a control group, small absolute sonographic changes, and limited follow-up, these findings should be interpreted as preliminary and require confirmation in controlled studies with standardized imaging and functional assessment.
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9. Correction to: surgical preference and outcomes in pilonidal sinus disease: a national multicenter study evaluating complications, recurrence, and quality of life (PISI TURKEY).
9. 更正：藏毛窦疾病的手术偏好与结局：一项评估并发症、复发及生活质量的国家多中心研究（PISI TURKEY）PMID:日期:2026-07-15该文献暂无摘要。
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10. Exercise frequency and physician burnout among colorectal surgeons in the USA: should we be worried?
10. 美国结直肠外科医生的运动频率与医生职业倦怠：我们是否应该担忧？PMID:日期:2026-07-14[中文摘要] 在美国外科医生中，职业倦怠和低生活质量较为常见。尽管自我保健习惯（如体育锻炼）与改善身心健康相关，但尚未在结直肠外科医生中进行评估。本研究旨在对美国结直肠外科医生的运动习惯进行横断面分析，评估运动与倦怠症状之间的关联，并识别该人群中常见的倦怠症状。通过全国性调查收集的横断面分析。美国结肠和直肠外科医师协会会员。不适用。不适用。倦怠症状的频率及结直肠外科医生体力活动的分析。共分析208份回复。受访者执业年限中位数为16.2年[范围0-50]。运动频率各异，13.9%报告每日活动，29.3%报告每周活动1-3天，43.3%报告每周活动4-6天。在过去6个月中，77.4%的受访者报告因工作感到倦怠，56.3%报告感到不堪重负，69.2%报告焦虑、抑郁或易怒症状。报告体力活动水平较低的受访者更可能报告感到不堪重负（p = 0.003），提示运动频率与该症状之间存在负相关关系。抑郁症状也观察到类似趋势，但未达到统计学显著性（p = 0.058）。应答率低、可能存在无应答和选择偏倚、人口学和临床数据有限，以及横断面设计无法评估因果关系。倦怠症状在美国结直肠外科医生中较为常见。较高的自我报告运动频率与某些倦怠症状（尤其是感到不堪重负）的较低报告率相关。然而，鉴于应答率低和研究设计，这些发现应谨慎解读，且不能确立因果关系。需要进一步的前瞻性研究以更好地明确体力活动与医生倦怠之间的关系。
[英文摘要] Burnout and low quality of life are common among surgeons in the USA. While self-care habits, such as physical activity, have been associated with improved well-being, they have not been evaluated among colorectal surgeons. To provide a cross-sectional analysis of exercise habits among colorectal surgeons in the USA and to evaluate the association between exercise and burnout symptoms, as well as to identify commonly reported burnout symptoms among this population. Cross-sectional analysis collected via a national survey. American Society of Colon and Rectal Surgeons members. Not applicable. Not applicable. Frequency of burnout symptoms and analysis of physical activity among colorectal surgeons. A total of 208 responses were analyzed. The respondents had a median of 16.2 [range 0-50] years in practice. Exercise frequency varied, with 13.9% reporting daily activity, 29.3% reporting activity 1-3 days per week, and 43.3% reporting activity 4-6 days per week. In the last 6 months, 77.4% of respondents reported experiencing burnout from work, 56.3% reported feeling overwhelmed, and 69.2% reported symptoms of anxiety, depression, or irritability. Respondents who reported lower levels of physical activity were more likely to report feeling overwhelmed (p = 0.003), suggesting an inverse relationship between exercise frequency and this symptom. A similar trend was observed for depressive symptoms, although this did not reach statistical significance (p = 0.058). Low response rate, potential nonresponse and selection bias, limited demographic and clinical data, and cross-sectional design preventing assessment of causal relationships. Burnout symptoms were commonly reported among colorectal surgeons in the USA. Higher self-reported exercise frequency was associated with lower reported rates of certain burnout symptoms, particularly feelings of being overwhelmed. However, given the low response rate and study design, these findings should be interpreted cautiously and do not establish a causal relationship. Further prospective studies are needed to better define the relationship between physical activity and physician burnout.