Iranian Journal of Colorectal Research
Volume:11 Issue: 3, Sep 2023

Obesity is a multifactorial disease defined by excessive adiposity, posing a health risk byincreasing the risk of noncommunicable diseases. We aimed to investigate the relationship between personalitytraits and physical-social anxiety in overweight women seeking bariatric surgery.

An applied and descriptive-correlational design was used in this cross-sectional study. Theparticipants were overweight women who had applied for bariatric surgery and went to the hospital; a totalof 110 people were selected through convenience sampling. The participants completed questionnaires ondemographic characteristics, personality (neuroticism-extroversion-openness [NEO] personality inventory),and physical-social features. Data were analyzed using SPSS software via regression and correlation analysisat a significance level of P≤0.01.

We found a positive relationship between neuroticism and physical-social anxiety (P≤0.01). Conversely,extraversion, agreeableness, openness, and conscientiousness exhibited negative associations with physicalsocial anxiety (P≤0.01).

Our study indicates that neuroticism is a positive and significant predictor of physical-socialanxiety, while extraversion, agreeableness, conscientiousness, and openness are negative predictors of physicalstress. These findings highlight the importance of considering personality traits in understanding the physicalsocial anxiety of overweight women seeking bariatric surgery.

Colorectal cancer is the 3rd most common cancer affecting males and females in most western countries and is leading cause of cancer related deaths. . Transanal total mesorectal excision (TaTME) was introduced for mid and lower rectal cancer and is proposed to allow a precise mesorectal dissection through better visualization in anatomically limited pelvis.

Obective:

 To check the feasibility of Transanal Total Mesorectal Excision in terms of:- Quality of TME, Circumferential resection margin positivity, Lymph node yield, Operation time, Mean blood loss, Postoperative complications, Conversion rate, Hospital stay.

Out of the total patients studied, 34 patients(97.2%) had normal distal resection margin and only 1patient(2.8%) had positive distal resection margin. only 2(5.8%) patients were having positive circumferential resection margin while rest of 33 patients(94.2%) CRM was normal. The mean average of the tumor distance from anal verge was 4.97 cm with minimum 3cm and maximum7cm. The mean average of lymph node yield was 7.86 with minimum number of lymph nodes 5 and maximum 11 and standard deviation 1.734. The average mean of operation time was 2.095 hours with maximum time 3.5 hours and minimum time 1.3 hours with standard deviation of 0.4608. Mean average blood loss was 48.57ml with maximum blood loss 80ml and minimum of 30ml only with standard deviation 11.917. 25 patients with no post op complications at 1 month (71.4%),3 patients with UTI(8.6%), Surgical site infections in 2 patients(5.7%),AKI 1(2.9%),Anastamotic leak 1(2.9%), Incontinence 1(2.9%), stromal retraction 1(2.9%) and recto vaginal fistula 1(2.9%) patient. Out of the total patient studied, 31 patients were having no complication at 3 months(88.6%) followed by Sub acute intestinal obstruction in 2(5.7%) and sexual dysfunction in 2 patients(5.7%).

The present study suggest that Transanal TME is a feasible method for oncologic resection of locally advanced mid- and distal-rectal cancer with curative intent.

Curative resection with adequate margin is a principle in gastroesophageal junction cancers. There is still no comprehensive agreement on the length of the negative proximal margin after total gastrectomy in Siewert II and III tumors. Extending the proximal negative margin in this anatomical region is very difficult in some cases and can cause more complications for the patients.

In a prospective cross-sectional study, 35 patients with GEJ Sievert II and III adenocarcinomas who underwent total radical gastrectomy from 2017 to 2020 were included in the study. proximal margin length was measured immediately after resection in operation room. Then Patients were evaluated for local recurrence at anastomosis site after two years by endoscopic examination. The relationship between negative proximal margin length and local recurrence rate and overall survival was evaluated .

about 35 patients were included in the study. twenty-nine(82.9%) had negative proximal margin, and 6 (17.1%) cases had positive proximal margin. The least negative proximal margin length was 0.1cm, and the most were 5cm. The mean margin was 2cm (2±1.6). Based on the endoscopic and pathologic findings, the local recurrence at the anastomosis site was 20% in two years of follow-up. The incidence of local tumor recurrence was higher in patients with positive margins versus patients with negative ones (11.4% versus 8.6%, p value= 0.0071). There is no significant statistical relationship between the negative proximal margin length and the incidence of local anastomotic recurrence.

In total gastrectomy for Siewert II and III gastric cardia tumors, it is necessary to reach the negative proximal margin in all tumor stages; however, the length of the negative proximal margin has no effect on the rate of local recurrence at the anastomosis site.

From 2008 to 2020, colorectal cancer (CRC) incidence and mortality have increased approximately 50% and 47% respectively in South-Eastern Asia (SEA). The human development index (HDI) influences various lifestyle choices and level of physical activity that may contribute to the prevalence of CRC in this region, distinct from factors related to medical or hereditary history. This review aims to assess and illustrate the effects and correlate of the HDI with the age-standardized rates (ASR) for CRC incidence and mortality in SEA.

The ASR for CRC incidence and mortality in each SEA country were sourced from GLOBOCAN 2020. The HDI for 2020 in each country was obtained from the Human Development Reports.

Statistical analysis indicates a significant positive correlation of 0.847 (p=0.0001) and 0.832 (p=0.002) between HDI and ASR for incidence and mortality, respectively.

A high HDI in a country has dual effects, boosting the economy while potentially compromising public health. Very high HDI nations have demonstrated that screening programs can effectively lower ASR incidence and mortality of CRC. However, regrettably, CRC screening is not viable for many SEA countries due to resource constraints. Besides screening, diet and lifestyle also significantly contribute to reducing CRC burdens. Medium HDI countries, despite lacking a well-developed economy, maintain low ASR for incidence and mortality, indicating that non-processed meat, a diet low “westernized” food, and a physically active lifestyle aid in reducing CRC prevalence.

The worldwide age-standardized incidence and mortality rates of rectal cancer are estimated to be 7.6 and 3.3 per 100,000, respectively (1). Previous literature suggests that low anterior resection (LAR) may be superior to abdominoperineal resection (APR) for rectal cancer, with better 5-year survival, local recurrence rate, oncological outcomes, and prognosis (2). However, it is reported that around 41% of patients who underwent LAR experience major low anterior resection syndrome (LARS) one year after surgery. LARS is characterized by fecal and gas incontinence, diarrhea, urgency or frequency of stools, sensation of incomplete emptying, and clustering of bowel motions (3) . These symptoms are reported to persist over time and influence health related quality of life (4), functional bowel symptoms may also occur after sigmoid resection (5) . Despite assessing the effects of several therapeutic strategies in reducing the LARS symptoms, its treatment is still challenging (6) .Perturbation of the gut microbiome has been linked to numerous chronic diseases, such as obesity, endocrine disorders, gastrointestinal diseases, cancer, cardiovascular diseases, etc.(7).

Dear Editor, I read with great interest the publication entitled “Comparative Analysis of Fistulotomy and Fistulectomy in Managing Low Anal Fistulas” by Mohammad Shahbaz et al. (1). Authors prospectively analyzed data from 90 patients aged above18 years with a low-lying anal fistula, comparing the outcomes of fistulatomy and fistulectomy surgery on two 45 people in each groups. Since this study is a type of clinical trial study, some points are stated regarding this issue. 1- One of the most important issues in clinical trials, especially in non-randomized clinical trials (including this study), is the use of a blinded outcome assessor. In this study, there is no explain about the outcome assessors, who checked the outcomes like VAS score, anal swelling, incontinence, and infection in the postoperative intervals between the 2 groups. Therefore, it should be considered as one of the limitations of this study.2- In this study, the indicator of the difference between the two groups in the investigated outcome, was statistical significance (“p value”). While it would be better to use appropriated effect sizes (Odds Ratio or Standardize Mean Difference) considering the dependence of “p value” on sample size and different statistical power of statistical tests (2).