Juan Guillermo Cala

Coloproctólogo - Cirugía y endoscopia colorrectal.
Hospital universitario Mayor Méderi.

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

Tips for Colon Polypectomy

I would also add: have clips and injector needles available, know how to perform a submucosal cushion, do not perform polypectomy in dirty colon

[Malcolm Tan @IBDGastroDocSg]

The Mesenteric Excision Debate in Crohn's Disease: SPICY vs. MESOCOLIC. ✂️

1/ To resect or not to resect the mesentery? 🤔We finally have prospective RCT data. #IBD #ColorectalSurgery #Gastroenterology

[BJS @BJSurgery]

Anastomotic leak after colorectal surgery: current landscape and future directions
➡️ https://t.co/JhVNo8RuJQ

🔗 Anastomotic leak remains one of the most feared complications after colorectal surgery, with major consequences including sepsis, reoperation, permanent stoma, and poorer oncological outcomes
📊 Leak rates remain substantial despite modern care: 3–6% after ileocolic anastomoses and up to 10–20% after low colorectal anastomoses
🧬 Anastomotic healing is multifactorial, involving surgical technique, perfusion, host immune response, and the gut microbiome
💡 ICG fluorescence angiography may improve perfusion assessment, particularly in rectal cancer surgery, but standardized quantitative thresholds are still needed
🦠 The microbiome is emerging as a key contributor, with collagenase-producing bacteria potentially weakening the anastomosis
🎯 Future prevention will likely require personalized risk stratification and targeted interventions rather than a one-size-fits-all approach

Work by Jack A Helliwell , Aaron Quyn , David G Jayne

#SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide #colorectalsurgery #StepUp4CRC @FightCRC @ACPGBI #ERAS @dice_europe #Crohn #proctology @Dukes_Club @ACPGBI_EduTrain @AECP_FAECP @PelvExGroup @escp_tweets @YouESCP #TeachMeColoproctology
#Some4COLoprocto

[Keith Siau @drkeithsiau]

Reminder of the pre-procedure ergonomics checklist for endoscopy 💡🔦

[Dr Rupam Manna MD @DrRupamOncology]

🚨 High-Yield Visual Algorithm: Metastatic Colorectal Cancer (mCRC) – Line of Management 🚨

Biology-driven. Personalized. Exam-ready.

Covers:
✅ Initial assessment + mandatory molecular profiling (RAS, BRAF V600E, MSI-H/dMMR, HER2, NTRK)
✅ Treatment intent (resectable vs unresectable vs oligometastatic)
✅ First-line therapy by subtype (MSS vs MSI-H, sidedness, RAS/BRAF status)
✅ Anti-EGFR vs anti-VEGF decisions, triplet chemo, IO for MSI-H
✅ Maintenance, second-line backbone switch, later lines & targeted options
✅ Conversion therapy, surgery/local therapy & summary flow

Save it. Share it. Teach it.

#CRC #ColorectalCancer #mCRC #Oncology #MedTwitter #CancerResearch #Gastroenterology

[Dr Rupam Manna MD @DrRupamOncology]

💊 5-FU vs Capecitabine – Comprehensive High-Yield Comparison of Fluoropyrimidines
My latest infographic breaks it down:
• Mechanism, tumor-selective activation & PK differences
• Toxicity showdown (Hand-Foot Syndrome vs myelosuppression)
• DPD deficiency (critical screening + management)
• Leucovorin modulation, administration routes & regimens (FOLFOX vs CAPOX/XELOX)
• Clinical indications, practical tips & exam pearls
Perfect for daily oncology practice and boards.
Save it. Share it. Use it.
Which one do you prefer in your practice — 5-FU or Capecitabine? 👇
#Oncology #MedEd #GIOncology #Chemotherapy #5FU #Capecitabine #PrecisionOncology #ASCO #NCCN

[Dr Rupam Manna MD @DrRupamOncology]

📊 Locally Advanced Rectal Cancer (LARC) Management – High-Yield Infographic!
My latest comprehensive visual guide covering:
✅ Definition, high-risk features & MRI-based risk stratification
✅ Total Neoadjuvant Therapy (TNT) as the new standard (consolidation preferred)
✅ Key trials (RAPIDO, PRODIGE 23, OPRA) + Short vs Long-course RT
✅ Surgery (TME), organ preservation (Watch & Wait for cCR)
✅ Selective adjuvant therapy & practice-changing immunotherapy in MSI-H/dMMR (Dostarlimab)
✅ Practical final algorithm (exam-ready & clinic-friendly!)
Fully aligned with NCCN/ESMO guidelines – designed for quick reference by fellows, residents & practicing oncologists.
Save it 📌 Share it with your team & trainees 👇
What’s your go-to TNT strategy in LARC? Feedback & discussions welcome!
#LARC #RectalCancer #ColorectalCancer #Oncology #TNT #WatchAndWait #MedEd #OncoTwitter #MedTwitter

[Dr Rupam Manna MD @DrRupamOncology]

📊 Anal Canal Cancer – Management at a Glance
Organ Preservation is the Goal. Chemoradiation is the Key.
High-yield infographic covering:
✅ AJCC TNM staging
✅ Nigro regimen (5-FU + Mitomycin C + 50–54 Gy RT) – still the undisputed standard
✅ Early vs locally advanced approach
✅ Why we wait up to 6 months before calling non-response
✅ Salvage APR only for persistent/recurrent disease
✅ Metastatic first-line options & more
HPV-driven squamous cell carcinoma remains one of the most curable GI malignancies when treated with sphincter-preserving CRT.
#AnalCancer #Oncology #MedTwitter #CancerCare #MedEd
🔗 Save & share with your trainees/residents!
What’s your biggest takeaway from anal cancer management?
— Dr Rupam Manna
Medical Oncologist

[Cleveland Clinic @ClevelandClinic]

Here’s nine ways you can benefit from jogging. https://t.co/ikQUStqz5J

[Sociedad Española de Patología Digestiva (SEPD) @sepdigestiva]

✅ Colitis ulcerosa vs enfermedad de Crohn

Fuente: @pharmahub

[ClinicsColorectal @ClinicsColorect]

Have you ever wondered about the history of rectal prolapse treatment? Read more from @MCWSurgery here: https://t.co/ArlkD5aTda

[Jose Ramos Vivas @joseramosvivas]

Especial médicos🩺⚕️🏥👨🏻‍⚕️👩🏻‍⚕️.
Os dejo esta carta en JAMA. Se la pondré a mis alumnos en la próxima clase:
He elegido estas frases :
👇🏻⏰
«La medicina puede tener un significado extraordinario. Pero no puede sustituir el estar presente en tu propia vida. El mundo puede necesitarnos como médicos. Pero las personas que nos aman nos necesitan como nosotros mismos. Y ese es el rol que nadie más puede llenar.»

«La residencia refuerza la lección de que las instituciones están diseñadas para perdurar más allá de los individuos. En cambio, las familias no.»

«Creo en formar a la próxima generación. Creo en el significado de este trabajo. Lo que ha cambiado es mi disposición a absorber el desgaste sin cuestionarlo.»

«Ya no estoy dispuesta a seguir posponiendo la vida. La medicina exige mucho. Y nosotros damos profundamente. Pero no puede tomarlo todo.»

«El significado de mi trabajo es profundo. El significado de mi presencia en casa es irremplazable.»

[Cleveland Clinic @ClevelandClinic]

Our colorectal surgeon gives us an update on the colonoscopy age, colorectal cancer risk factors to consider and what other screening options are available. https://t.co/V6kfeEBmN5

[Dr Luis Felipe Cabrera Vargas MD FACS @PipeCabreraV]

Saturday surgical anatomy pearl 💎: The Luschka law: ureter crosses the external iliac artery on the right and the common iliac artery on the left ��️🗣️💡📌! #SoMe4Surgery @pferrada1 @juliomayol @SWexner @Cirbosque @futuroscirascol @drdevirgilio @jmills1955 @rbarbosa91 @DrThawaba

[Cleveland Clinic @ClevelandClinic]

Colonoscopy is the most common way to detect the disease, but it’s not the only one. A gastroenterologist discusses options for colorectal cancer screenings and how to know which is best for you. https://t.co/9MvgEE5qox

[BJS Open @BjsOpen]

Unplanned intensive care unit admission after elective colon cancer resection: population-based registry study
➡️https://t.co/JebItkofBb

This nationwide Swedish study analysed 23 891 patients who underwent elective colon cancer surgery between 2010 and 2019, and found that that 5.6% required unplanned admission to the intensive care unit. These patients had higher mortality rates and more complications, particularly when surgical reintervention was needed.

👏👏👏Sofia Dahlberg , Tomas Vedin , Ingvar Syk , Emma Larsson , Niklas Nielsen , @HBergenfeldt
#SoMe4Surgery #MedTwitter #SurgEd #Surgery @BJSAcademy @BJSurgery #colorectalsurgery #colorectalcancer @FightCRC #StepUp4CRC

[Cleveland Clinic @ClevelandClinic]

Awkward sleeping positions can put stress and strain on your body as you’re catching ZZZs, leading to pain when you should be rising and shining. But you can rest easier with a few modifications. https://t.co/oAKMddh4qp

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

How to Biopsy when Investigating Microscopic Colitis

There is no clear cut consensus on the biopsy protocol for microscopic colitis. In this article Virine et al convincingly show that a diagnosis of microscopic colitis can always be reached when evalua

[Cleveland Clinic @ClevelandClinic]

Keep your heart happy by adding any of the following 40+ items to your shopping list. https://t.co/7pLP2tliQ6

[Keith Siau @drkeithsiau]

Sites of colorectal cancer 📍 #4KMedEd
#ColorectalCancerAwarenessMonth