30-Second Takeaway
- Favor **β-lactam prophylaxis** for elective colorectal surgery when possible; non-β-lactams carry higher adjusted SSI risk.
- For suspected early right colon cancer post-endoscopic resection, **D2 dissection** may be adequate; central nodes were uninvolved.
- Local **PDRN injection** during Crohn perianal fistula surgery improved closure rates and shortened healing in a small series.
- CAD-assisted colonoscopy modestly increases polyp yield and surveillance intensity, especially in FIT-positive patients, without clear overall ADR superiority.
- Central obesity and socioeconomic gradients strongly influence colorectal cancer burden, underscoring prevention counseling and access to high-quality care.
Week ending April 18, 2026
Colorectal surgery updates: infection prevention, operative extent, IBD care, and evolving neoplasia risk
β-lactam prophylaxis lowers SSI risk vs non-β-lactam alternatives in elective colorectal surgery
In 20,140 elective colorectal procedures, β-lactam prophylaxis had fewer 30-day SSIs than non-β-lactam alternatives (6.2% vs 8.4%). After adjustment, β-lactams were associated with a 26% lower SSI risk (ARR 0.74; 95% CI, 0.63-0.87). β-lactam recipients more often received guideline-concordant dosing and timing, yet concordance itself was not independently linked to SSI risk. These data support choosing a β-lactam regimen whenever allergy history and local resistance patterns safely permit in elective colorectal surgery.
CAD-assisted colonoscopy adds diminutive adenomas and increases surveillance in high-risk cohorts
Among 1356 patients, CAD-assisted colonoscopy was noninferior but not superior to standard high-definition exams for ADR (58.5% vs 53.3%). CAD increased adenomas per colonoscopy (1.41 vs 1.20; P = .01), mainly via additional diminutive adenomas. In 864 FIT-positive patients, CAD significantly improved ADR (65.3% vs 57.4%; AOR 1.39) and adenomas per colonoscopy. Sessile serrated lesion detection was similar between arms, but CAD led to more intensive USMSTF surveillance recommendations, especially in FIT-positive patients.
Central nodal metastasis is rare in suspected early right-sided colon cancer post-endoscopic resection
This series included 119 patients undergoing additional right colectomy after endoscopic treatment of clinically early right-sided colon cancer. Nodal metastases occurred in 10.1%, but all positive nodes were peritumoral or pericolic; none involved superior mesenteric stations. Mean nodal yield approached 40 nodes, and only one patient (0.8%) developed distant recurrence over roughly 4 years. Findings suggest D2 lymphadenectomy may be sufficient for this narrowly defined early-stage, post-endoscopic cohort, questioning routine CME with central ligation.
References
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Additional Reads
Optional additional studies from this edition.