Colon and Rectal Surgery

3-Mercaptopyruvate Sulfurtransferase (3-MST) Regulates Tumor Angiogenesis and Growth in Colorectal Cancer Katie Rouse, BS University of Texas Medical Branch, Galveston, TX Introduction: Metastatic colorectal cancer (mCRC) remains a leading cause of cancer-related mortality, with limited success in current anti-angiogenic therapies due to resistance and recurrence. Hydrogen sulfide (H2S) has emerged as a regulator of angiogenesis, with 3-mercaptopyruvate sulfurtransferase (3-MST) identified as a key enzyme in H2S production. While 3-MST contributes to physiological angiogenesis, its role in tumor-associated vasculature remains unclear. This study investigates the impact of endothelial 3-MST depletion on tumor angiogenesis and colorectal cancer progression. Methods: Lentiviral-mediated knockdown of 3-MST was performed in human endothelial cells, and functional assays assessed proliferation, tube formation, and permeability in response to tumor cell-conditioned media. In vivo, colorectal cancer xenografts were generated in athymic nude mice co-injected with wild-type or 3-MST-silenced endothelial cells. Additionally, a syngeneic colorectal cancer model was used in immunocompetent 3-MST knockout (KO) mice to evaluate tumor burden, proliferation, and vascularization via histological and immunohistochemical analysis. Results: 3-MST knockdown impaired endothelial proliferation, tube formation, and barrier integrity in vitro. In xenograft models, 3-MST depletion led to reduced tumor uptake, decreased tumor growth, and increased necrosis. Syngeneic 3-MST KO mice exhibited significantly lower tumor burden, reduced vascular density, and decreased tumor cell proliferation compared to wild-type controls. Conclusion: Endothelial 3-MST plays a critical role in colorectal cancer-associated angiogenesis, influencing tumor progression and vascular integrity. Targeting 3-MST may provide a novel therapeutic approach to disrupt tumor angiogenesis and enhance existing anti-angiogenic treatments in mCRC. Accuracy of MRI in the Diagnosis of Suspicious Rectal Lesion Mustafa Oruc, MD, Josh Sommovilla, MD, Hermann P Kessler, MD, PhD, FACS, David Liska, MD, FACS, Michael A Valente, DO, FACS, Scott R Steele, MD, FACS, Emre Gorgun, MD, FASCRS, FACS Cleveland Clinic, Cleveland, OH; Cleveland Clinic, Shaker Heights, OH Introduction: Management of suspicious rectal polyps is challenging, as they may be benign on endoscopic biopsy while malignancy cannot be excluded. MRI is widely used for diagnosis and staging of rectal cancer, but its accuracy in diagnosing an invasive cancer in the setting of a suspicious polyp remains uncertain. This may lead to misclassification and overtreatment. This study evaluates the diagnostic accuracy of MRI in rectal lesion with premalignant biopsy by comparing MRI staging with final pathology. Methods: A retrospective review was conducted on all patients between 2014 and 2024 with benign preoperative pathology who underwent MRI due to clinical suspicion, followed by local excision (transanal minimally invasive surgery or endoscopic submucosal dissection). Data included preoperative pathology, MRI-based TNM staging, and final pathology. MRI staging was compared with final pathology to assess diagnostic accuracy. Results: Among 89 patients, preoperative MRI staging classified 77 (87%) as malignant [T (1-3), N (0,1)] however, final pathology confirmed malignancy in only 23 (30%). Conversely, MRI classified 12 patients as benign (T0N0), but malignancy was later confirmed in 4. MRI suggested T2N0 or higher stage tumor in 37 cases, yet 65% (24) were benign. Among 27 patients with confirmed malignancy on final pathology, preoperative MRI diagnosed an invasive lesion in 23 patients. Hence, MRI demonstrated a sensitivity of 85%, specificity of 13%, positive predictive value of 30%, and negative predictive value of 67% (Figure 1). Conclusion: MRI has limited accuracy in evaluating suspicious rectal polyps. Even if malignancy is suggested on MRI, clinicians should prioritize endoscopic evaluation and local excision for suspicious rectal polyps with benign biopsy.Figure 1Addressing Biopsychosocial Support Needs of Older Adults Undergoing Fecal Ostomy Surgery: A Qualitative Work in Progress Jana H Zeineddine, MD, Christy E Cauley, MD, FACS, Zara Cooper, MD, FACS, Mary E Brindle, MD, MPH, Christine Ritchie, MD, MSPH Massachusetts General Hospital, Boston, MA; Brigham and Women’s Hospital, Boston, MA; Cumming School of Medicine, University of Calgary, Calgary, AB, Canada Introduction: Older adults recovering from fecal ostomy operation require biopsychosocial support. This study aims to determine support needs from patient and care-partner perspectives. Methods: We conducted a qualitative study with adults age 65+ years, 30-90 days post-ostomy operation and care-partners 18+ years old, using individual interviews from a single clinic. Using a modified framework method, we arranged data into themes and sub-themes through rapid analysis. Results: From November 2024 to present, 8 patients and 2 care partners completed 1:1 semi-structured interviews. Most participants mentioned needing multiple care partners for support. Care partners provided support in person and remotely (eg, via telephone). Most patients performed ostomy changes alone or asked 1 care partner to help, due to reluctance to involve other care partners or aversion of care partners to perform ostomy care. Overall, care partners assisted in emotional support, independent activities of daily living (eg, cooking, cleaning), transportation to medical visits, coordinating care (eg, primary care visits, physical therapy), and ostomy care. Participants noted that the high-level support needed after operation was unexpected and beyond provided anticipatory guidance. One care partner noted significant financial strain. When discussing an intervention to support older patients undergoing ostomy surgery, participants identified the need for 1) practical ostomy management education, 2) psychological/emotional support, 3) improved anticipatory guidance and 4) help with coordinating supply deliveries (pouches). Intervention barriers included privacy, transportation, time, health literacy and cultural/language. Conclusion: There are addressable challenges older adults face after ostomy operation, including need for cognitive aides for ostomy education, psychological/emotional support to improve self-efficacy, and anticipatory guidance from surgical teams. Advantages of Magnetic Compression in Rat Colonic Anastomosis: A Comparative Study with a Transcriptomic Perspective Miaomiao Zhang, PhD, Shuqin Xu, PhD, Long Liu, PhD, Yuning Shao, PhD, Yi Lyu, PhD, MD, Xiaopeng Yan, MD, PhD The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China Introduction: Our previous research has demonstrated that, compared with suture-based colorectal anastomosis, magnetic compression anastomosis results in a visibly smoother and more even anastomotic site. Hematoxylin and eosin (HE) and Masson staining show a continuous mucosal layer, less collagen in the muscular layer, and reduced granuloma formation. However, the reasons behind these differences warrant further investigation. Methods: Twenty male Sprague-Dawley rats (200-230 g) were randomly divided into a magnetic compression anastomosis (MCA) group and a suture (control) group. The survival rates, and histological and transcriptomic profiles of the anastomotic sites were compared. Results: The survival rate of the MCA group (100%) was significantly higher than that of the control group (70%). Histological examination showed improved tissue alignment and more continuous mucosal surfaces in the MCA group. Transcriptomic analysis revealed that differentially expressed genes between the MCA and control groups were highly enriched in immune-inflammatory pathways. PPI network analysis identified IL-1β as a key molecule, with significantly elevated in the MCA group (Figure 1). Conclusion: MCA is a for anastomosis in Transcriptomic analysis that IL-1β may a role in the of MCA in anastomotic or and in Cancer MD, MD, MD, PhD, MPH, MD, FACS, FACS, MD, FACS University of University of University of Introduction: the that positive in colorectal cancer patients may tumor than a study stage colorectal cancer patients that was with an increased of positive We to these using a Methods: Adults with stage were identified in the Cancer the between patient and the of positive the of and on Results: patients, were stage stage and stage was in and of stage and was significantly with positive for stage cancer but stage and 1). were with lower survival for lower of for stage but stage or Conclusion: This study that is with higher of positive in stage the of a retrospective these the need for including the evaluation of to of with N in and FACS University, Introduction: a cause of and results from reduced to and diagnostic This study evaluates the diagnostic and of using and to improve and Methods: A study of patients with was conducted a was assessed using suggested local reduced in were by and with minimally invasive or surgical were assessed by and Results: was the leading followed by and in improved in 85%, and showed the success followed by surgical with with in Conclusion: and of and provide to intervention and improved patient in and of the in Colorectal Using to MD, MD, FACS, R MD, FACS, MD, University of Texas Medical Branch, Galveston, TX Introduction: to the anastomosis is a in colorectal surgery to anastomotic is widely used to evaluate to the anastomosis but may be in of or supply is a that of tissue the need for comparing and in colorectal surgery are Methods: A retrospective was performed a single undergoing colorectal surgery an anastomosis underwent of a of and of an anastomosis using and a was between and were in the and were Results: A of patients underwent colorectal surgery between and were identified with One due to and to show in due to The was between and in the patients data was the of and was and (Figure 1). Conclusion: is to for of in colorectal analysis of tissue need for the of in the of of a PhD, David PhD, MD, FACS School of Medicine, Introduction: significantly patient of and In we demonstrated an increased of in the for patients years of The of study was to perform a analysis the of a into surgical for the management of Methods: with of and patients who from 1 were of operation after the were compared using the rate was used and of were from The of a was to be were Results: In patients, operation after the the and years of In patients, operation after the was but patients with a the with operation after the The of patients with a undergoing operation after the was were through sensitivity 1). Conclusion: years with a may the of with operation the than after later This model is the for the of the into clinical and for patients after after after after after after of and in A of PhD, MD, of Medicine, University, University, Hospital, University, Introduction: excision for cancer has to improve This to the rate of between and with excision for Methods: We conducted a review and of The primary was the of as the of or through the with and lower included time, anastomotic and the of and were was assessed using and Results: were included in the analysis. The rate of was lower in the group compared with operation, with a of was demonstrated excision in of of and (Figure 1). Conclusion: is the on The results that the of anastomotic and in are to in However, is to in of the of and A for in MD, MD, MD, MD, Liu, MD, MD, MD, of The Affiliated Hospital of University, China Introduction: has in surgery, to to However, of remains challenging, with integrity as as in excision and functional the need for Methods: and with a of a for and integrity This study patients. The and for patients are in the included integrity of and staining of collagen were to between and Results: significantly improved the integrity rate from to analysis revealed reduced (Figure 1). confirmed collagen in with Conclusion: and to in for or after A of and MD, MD, MD, MD, PhD, MD, MD, MD, MD, MD, MD, FACS University of University of Introduction: increased of in of local is The aims of study are to assess excision after and Methods: after local excision or and as or operation from a study were included A was performed with patients who underwent after on of from the and were survival and of local and Results: Overall, patients were included in the and in the group. Among underwent and was performed for operation operation for local or local patients were included in the the groups were for and were between the a of was in the the of and in the and were The were in the and Conclusion: to survival or or compared with after after with for A MD, MD, MD, MD, MD, MD, FACS, R MD, A MD, FACS, MD, FACS University of Massachusetts Medical MA; University School of Medicine, University of Massachusetts Medical Introduction: to is with and followed by using a but the remains We that Methods: This conducted a from to included patients undergoing for due to patients underwent an management was underwent a on days 2 or was if was was included and Results: A of patients were underwent and 2 were patients patients to 2 were negative for of was days There was or recurrence. patients were 2 for anastomotic and 2 for surgical 1). Conclusion: Our study the of with or The single may should be as after of due to and 2 2 2 2 2 of of on the of in Colorectal MD, MD, MD, PhD, MD, FACS, University of Introduction: is with lower and However, all patients to of a study to in study to assess the between and of health patients undergoing colorectal Methods: who underwent colorectal operation and in a a single in the were to the a of a data was from included Results: Among were and The age was patients in a setting and identified as The was When compared with the group patients in the group were years, and more to in an setting with in of or and and a significant with (Figure 1). Conclusion: The of a for colorectal operation is and with including and be a to in surgical of in in Undergoing Colorectal Surgery: A and MD, Medical for and Care in and and Medical Hospital, of Medical of Medical and Introduction: The of surgical has to be the colorectal operation due to from to help the of in colorectal operation by a barrier between the and the surgical but remains uncertain. Methods: We of and from to for that compared with for the of in patients undergoing colorectal We with a using a analysis was performed using R Results: We included with patients, of were to the group. The was days The of was significantly lower in the intervention group than in the control group analysis of evaluating showed a significantly lower of in the group compared with Conclusion: In of patients undergoing colorectal operation, including the significantly reduced the of in colorectal operation compared with with for A Study R Medical University, Introduction: is an with significant with surgical management the only We a novel of the and to the and Methods: the for and for and magnetic were assessed and was using and and were and were to the and with Results: A of patients with a age of years with a diagnosis of underwent the after 2 patients fecal while The patients were followed for a of There was or significant with of in all recurrence. There was significant in and Conclusion: of and to is and with However, with a is First of with of in Colorectal MD, FACS, E DO, PhD, DO, P MD, PhD, FACS Rectal University Medical Introduction: In surgery, on surgical and to This study of was with colorectal Methods: Data from colorectal using 1 from to were by and were compared with analysis of and Results: A of colorectal performed by with of were and rectal and N with and (Figure differences were significant setting were significant for A significant was between for rectal differences in were by and Conclusion: of higher was with significant colorectal were rectal and in the A in the of in Colorectal MD, PhD, MD, PhD, MD, PhD, MD, MD, FACS, MD, FACS Introduction: The of is in is by an increased of in the including and We the of to the of in an surgical Methods: From to patients undergoing colorectal operation were The were age years and colorectal surgical in an patients underwent an in the were and for the the was performed a Results: A patients were There was a significant between and an increased in assessed by who a of than the In we a significant between and Conclusion: The is a and for the of the of in colorectal be used to patients that may from a evaluation to improve in the preoperative Support and Adults Undergoing for Colorectal Cancer MPH, MD, PhD, MD, A FACS, MD, MD, FACS, MD, PhD, General Hospital, for Canada Introduction: The of study was to evaluate the between support and older adults undergoing operation for colorectal Methods: This was a study using data from the of from to patients years who underwent a or for colorectal cancer were The primary was support, as living with other living alone of need for and and were assessed using for were conducted for and ostomy Results: In patients were support while are in living alone was with reduced of to and increased need for was between support and or mortality, or were identified in with the of increased support but Conclusion: The of support patients undergoing operation for colorectal cancer was with and need for and be used as a to of Colorectal Cancer in MD, MD, MD, Hermann P Kessler, MD, PhD, FACS Cleveland Clinic, Cleveland, OH Introduction: The and are of due to the of of the is This study aims to the progression after Methods: with who were diagnosed with colorectal cancer between and were We preoperative and and and were days after operation to for or was as an in an in the of or the of in patients. Results: A of patients were included in the of were with a age of years The tumor were the and the was for of patients. and showed a the differences were significant of patients an in or of in of surgical patients, and the rate was Conclusion: Colorectal may cognitive in patients with and in the medical intervention of on MD, MD, Scott R Steele, MD, FACS, MD, David Liska, MD, FACS, MD, MD, FACS, DO, FACS, Michael A Valente, DO, FACS, Cleveland Clinic, Cleveland, OH Introduction: has to enhance in and We that the rate of This study aims to the of on these Methods: with and who underwent were in the group were to on and 1). and of fecal were compared. was as of and of on examination Results: There were patients and controls. The group a years, and a higher rate of fecal In the of patients more than 2 compared with 12 and between and was and Among patients who more than was significantly compared with in The rate was between and Conclusion: was with significant in and tissue patients with and who underwent more than and of with after of on and MD, MD, DO, FACS, MD, MD, FACS, Scott R Steele, MD, FACS, David Liska, MD, FACS, Cleveland Clinic, Cleveland, OH Introduction: is to is with in and we to the impact of on We that is with increased of fecal and decreased Methods: undergoing of a were were divided into groups on and We patient of fecal and analysis was performed to assess to recurrence. analysis was performed to impact of on Results: A of patients underwent surgical for the management of Overall, patients and patients were and were was significantly higher in the patients of fecal in and patients was as was by group impact of patients underwent a The was in and in patients Conclusion: patients an increased of significant in management on of on and in Colorectal Cancer MD, MD, MD, MD, Michael MD, MD, FACS, E MD, FACS, MD, FACS Cancer Introduction: is an in colorectal cancer and a However, its independent value and clinical This study the impact and of in primary Methods: who underwent for primary a cancer between and were with or data were excluded. and were compared on Results: patients were included age years, was identified in and was with and survival and survival were significantly in patients, the of was an independent of with positive and patients with to patients (Figure 1). between and was Conclusion: is a independent negative in to for and may be for stage with However, to an for in Colorectal Cancer with from a MD, PhD, FACS, FASCRS, Introduction: Colorectal cancer with of stage patients and in and may improve survival that but in is Methods: The was a study with stage rectal or stage cancer and were to daily or for a of for to with patients with in were patients with other were included for analysis. Results: patients, patients were for comparing to were in A and in were in A and in patients Conclusion: The primary was reduced in patients with clinical for of patients. and of Cancer PhD, MD, PhD, PhD, MD, FACS University of Introduction: in an to its in colorectal cancer The Cancer data analysis revealed that increased with survival in are using and in to of This study evaluates the of a on and in cancer cells. Methods: cancer cell were with for 2 were with and analysis was was assessed with and A was conducted on cells, with for Results: was reduced in the with demonstrated an increased and other and showed in cells, with control by of the by (Figure 1). Conclusion: in cancer cells, leading to increased and reduced that may be a therapeutic for cancer to current therapeutic to of in Colorectal Cancer MD, MD, MD, MD, PhD, E MD, PhD, FACS, MD, FACS, MD, FACS Cancer Introduction: A of colorectal cancer is by including and with to and its clinical led to by the of with a of This study the and of in primary Methods: undergoing for primary a cancer between and were with or data were excluded. and were compared between and Results: patients were Overall, was more in the and a survival between and was to the and less to the and were more in while and were less Conclusion: has a and higher for after surgical to and may be of in of of Cancer MD, MD, MD, MD, PhD, MD, FACS University of Introduction: of evaluates the impact of and care. However, changes and is due to the of cancer This study in cancer to key of Methods: Using the and we identified cancer patients diagnosed between and years old, with cancer and 2 were into 2 1 and a 1 and 2 1 and a 2 years identified of physical and and cancer-related Results: The study included patients and decreased diagnosis and but 2 years and from stage and of daily living were the of while positive health was was with (Figure 1). Conclusion: health and functional are critical of in cancer the of and cancer of these help and patients A Qualitative Study of in Rectal Cancer MD, MPH, PhD, MD, FACS Hospital and Medical MA; University, Introduction: The for operation in rectal cancer is to with in significant in the that and patient Methods: We conducted a qualitative study using semi-structured interviews with of and Rectal and rectal the of influencing for and barriers to analysis was used to key Results: with a of 12 years in and themes financial and challenges with older or patients more to be the of leading to significant patient with while patient and were to health emotional and patient Most a need for patient to support patient (Figure 1). Conclusion: in is by and in enhance and improve patient in of Cancer an A PhD, David MD, FACS, MD, FACS Introduction: of health on the to assess individual This study the of a on in cancer patients. Methods: Using a health network we patients as if they significant in We the independent of on patients with of the from to Results: Among patients, the age was years, with male and a and stage survival for the was Overall, of patients with with and were in and was an independent of stage diagnosis and all patients patients was an independent of Conclusion: A novel diagnosis as as This an to cancer patients an health of in the Diagnosis and Management of for A R R MD, FACS University of Texas Medical Branch, School of Medicine, Galveston, TX Introduction: is a critical diagnostic for its sensitivity and in its diagnostic are This study aims to in diagnosing and to evaluate its impact on patient Methods: This is a retrospective review of adults diagnosed with a in between and We and We patients with to Results: A of patients of a on physical these patients, underwent further patients physical There were differences in intervention on and physical and and and and only and analysis revealed to for that diagnosed and of clinical time, in management (Figure 1). Conclusion: Most patients underwent a were to significantly the the of in This study the need for clinical for to patient care and Medical for with Undergoing MD, MPH, MD, Zhang, MD, MD, MPH, FACS Medical University of Introduction: care through medical has improved in We that care an be with decreased for surgical Methods: We identified patients undergoing operation for a care from to Data were through a surgical was care the was by of was compared between groups Results: A of were analysis showed significant between patients in to or minimally invasive approach patients less operation with were compared with that 1). and operation were with while lower of Conclusion: patients decreased for surgical compared with data a to surgical patients undergoing care through an and in the First

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