Aim: To report long-term oncological outcomes and organ preservation rate with a chemoradiotherapy-consolidation chemotherapy (CRT-CNCT) treatment for locally advanced rectal cancer (LARC). Method: Retrospective analysis of prospectively maintained database was performed. Oncological outcomes of mid-low LARC patients (n=60) were analyzed after a follow-up of 63 (50–83) months. Patients with clinical complete response (cCR) were treated with the watch-and-wait (WW) protocol. Patients who could not achieve cCR were treated with total mesorectal excision (TME) or local excision (LE). Results: Thirty-nine (65%) patients who achieved cCR were treated with the WW protocol. TME was performed in 15 (25%) patients and LE was performed in 6 (10%) patients. During the follow-up period, 10 (25.6%) patients in the WW group had regrowth (RG) and 3 (7.7%) had distant metastasis (DM). Five-year overall survival (OS) and disease-free survival (DFS) were 90.1% and 71.6%, respectively, in the WW group. Five-year OS and DFS were 94.9% (95% CI: 88–100%) and 80% (95% CI: 55.2–100%), respectively, in the RG group. For all patients (n=60), 5-year TME-free DFS was 57.3% (95% CI: 44.3–70.2%) and organ preservation-adapted DFS was 77.5% (95% CI: 66.4–88.4%). For the WW group (n=39), 5-year TME-free DFS was 77.5% (95% CI: 63.2–91.8%) and organ preservation-adapted DFS was 85.0% (95% CI: 72.3–97.8%). Conclusion: CRT-CNCT provides cCR as high as 2/3 of LARC patients. Regrowths, developed during follow-up, can be successfully salvaged without causing oncological disadvantage if strict surveillance is performed.

Purpose: Laparoscopic Transabdominal Preperitoneal (TAPP) videos on YouTube and WebSurg have an important place in surgical training. However, there are differences between these platforms in terms of training quality and compliance with standard surgical steps. The aim of this study was to compare laparoscopic TAPP videos on YouTube (limited to individually uploaded content) and WebSurg in terms of surgical technique and educational quality. Methods: Twelve videos meeting specific criteria were selected from both platforms. The 2 groups were compared using the 9 Commandments, which assessed compliance with surgical steps, and the Procedure Presentation Score (PPS), which assessed video quality/educational content. Data on video characteristics, such as view count, publication date, and duration, were also collected. Results: Although YouTube videos reached more viewers, WebSurg videos had higher compliance with the 9 Commandments (WebSurg median score 8/9 vs. YouTube median score 5/9, p < 0.01). In addition, WebSurg videos had higher PPS scores (median: 8) than YouTube videos (median: 5) ( p = 0.02). Conclusion: When utilizing online video platforms for surgical training, institutional training platforms such as WebSurg should be preferred. When the videos included here were compared with YouTube in the light of the defined criteria; it was seen that YouTube videos were not of sufficient quality.

Purpose Diverting ileostomies are commonly performed to prevent morbidity and mortality caused by colorectal anastomotic leakage. However, many complications may develop due to loop ileostomy itself and its reversal. In this study, we aimed to compare the outcomes of completely diverted tube ileostomy and conventional loop ileostomy. Methods The study was designed prospectively, and operations were performed by the same surgeon at a single center. Completely diverted tube ileostomy with the rubber strip was performed in 20 consecutive patients, and loop ileostomy was performed in the next 20 consecutive patients who needed diverting stoma. The primary outcome of the study is to compare the overall complication rates in both techniques. Length of hospital stay, achieving complete diversion, and length of time with a stoma were evaluated as secondary outcomes. Results There were no significant differences in the demographic characteristics between the two groups. Complete diversion was achieved in both groups. The number of patients who developed any kind of complications during the observation period was significantly higher in the loop ileostomy group in comparison with the tube ileostomy group (13 (65%) versus 3 (15%), respectively (p=0.002)). The median time with a stoma was significantly higher in the loop ileostomy group compared to the tube ileostomy group (270 days (range: 56-443) versus 21 days (range: 14-28), respectively (p<0.001)). Conclusion Completely diverted tube ileostomy causes fewer complications, provides a cost advantage, and does not require surgery for stoma closure.

Total mesorectal excision quality as a predictor of overall survival in rectal cancer: A retrospective cohort study - Turkish Journal of Surgery