Resumo em Inglês:

Abstract Background Colorectal cancer (CRC) is the third most commonly diagnosed malignancy and the second leading cause of cancer-related death worldwide. The adenoma detection rate (ADR), based on pathology-confirmed adenomas, is a key quality indicator for colonoscopy and a surrogate marker for its effectiveness in CRC prevention. Materials and Methods We conducted a retrospective cross-sectional study of all sedated colonoscopies performed at Mehrgan Hospital, Kerman, Iran, between 1399 and 1403 (2020–2024). Patient demographic data (age, sex) and histopathological findings were recorded. The ADR was calculated as the proportion of colonoscopies with at least one pathology-confirmed adenoma. Associations between ADR and demographic variables were assessed using Chi-squared and independent t-tests, with significance set at p < 0.05. Results A total of 6,428 sedated colonoscopies were reviewed (mean age: 53.5 ± 15.0 years; 47.3% male). The rate of pathology-confirmed ADR was 13.3%, being significantly higher in men than in women, also increasing with age, particularly among patients ≥ 45 years (p < 0.01). Tubular adenomas were the most common histologic subtype, followed by tubulovillous and villous. Conclusion The pathology-confirmed ADR observed in this study was within international quality benchmarks. Male sex and older age were significantly associated with higher detection rates. This underscores the need for targeted screening strategies and, potentially, earlier CRC screening initiation in Iran.

Resumo em Inglês:

Abstract Introduction Ureteral injury during laparoscopic surgery for diverticular disease remains an uncommon but clinically significant issue. Chronic inflammation and fibrosis frequently obscure retroperitoneal anatomy. Objective To describe a workflow-integrated technique using a fully intraluminal indocyanine green (ICG)-emitting ureteral stent that enables on-demand overlay visualization using a single near-infrared (NIR) platform. Materials and Methods A fully intraluminal ICG-emitting ureteral stent was placed cystoscopically before surgery. During laparoscopy, NIR overlay mode was activated selectively at predefined high-risk steps: before peritoneal incision, during medial-to-lateral dissection around the inferior mesenteric vessels, and after colonic mobilization. Fluorescent signals were superimposed on white-light imaging to confirm ureteral position without interrupting dissection. Results Overlay visualization allowed rapid and repeatable confirmation of ureter location. Real-time shared situational awareness was improved for the entire operative team. No intraoperative ureteral injury occurred. Adverse events were limited to those attributable to cystoscopic stent placement. Conclusion On-demand overlay visualization using a fully intraluminal ICG-emitting ureteral stent represents a practical adjunct in laparoscopic surgery for complex diverticular disease. This technique supports organ-preserving surgery by enabling continuous dissection with real-time ureter awareness using a single imaging system.