[Surgical technique and effect of the pulsatile tinnitus associated with sigmoid sinus on the dominant side of reflux].

Objective:To explore the effect of surgical treatment of the pulsatile tinnitus associated with sigmoid sinus on the dominant side of reflux. Methods:The clinical data of 43 patients with reflux dominant side pulsating tinnitus admitted by the same doctor from 2017 to 2023 were retrospectively studied to observe the curative effect of surgical treatment. Operation method: The sound insulation barrier was established by repair technique of bone wall defect of sigmoid sinus with "capping method", without changing the blood flow and blood vessel wall of sigmoid sinus. Results:No surgical complications occurred in all patients. During the follow-up period of 3 months to 6.9 years, 14 patients（32.6%） were cured, 18 patients（41.9%） were significantly effective, 4 patients（9.3%） were effective, and 7 patients（16.3%） were ineffective. The difference of tinnitus grade before and after surgery was statistically significant. Conclusion:In this group of cases, the sound insulation barrier was established by "capping method" technique of repairing bone wall defect of sigmoid sinus, which effectively avoided the disturbance of hemorheology status and vascular wall, thus avoiding the risk of venous wall stenosis and thrombosis on the dominant reflux side. The surgical method was easy to master, and the curative effect was significant, which was worthy of clinical promotion.

Two cases of sigmoid colon cancer with intussusception prolapsing through the anus in adults: consideration of preoperative reduction and surgical approaches: case reports.

Background: Adult intussusception is a rare condition that is often associated with a high incidence of malignancy. The optimal management strategy remains controversial, particularly regarding the necessity for bowel reduction before resection. To date, there is a paucity of data on adult intussusception in the English literature. We present two cases of sigmoid colon cancer with intussusception prolapsing through the anus and highlight the different surgical approaches. Case Description: Case 1: an 84-year-old woman presented with sigmoid colon prolapse and biopsy-confirmed adenocarcinoma. Urgent surgery revealed intussusception. Despite unsuccessful manual reduction, the Hutchinson technique successfully resolved the intussusception. Resection with a temporary colostomy was performed. Histopathological examination revealed mucinous adenocarcinoma without metastasis; the patient recovered well. Case 2: a 76-year-old woman with sigmoid colon prolapse presented with abdominal pain and blood-streaked stools. Emergency surgery was performed because of failed reduction attempts and persistent symptoms. Intussusception resolution was achieved through transanal insertion of a circular sizer. Resection with temporary colostomy was performed, after which tubular adenocarcinoma was identified. The patient remains symptom-free 3 years post-surgery. Conclusions: Choice of the surgical approach depends on the ease of intussusception reduction. In cases wherein reduction is straightforward, routine preoperative examinations are preferred given the low risk of injury or cancer cell dissemination. Conversely, in situations such as ours, gentle reduction under general anesthesia might be crucial. In addition, laparoscopic surgery could be beneficial. Importantly, accumulation of reports on adult intussusception could contribute to the standardization of this approach.

Ischemic Sigmoid Colon Presenting As Hemoperitoneum From an Avulsed Mesocolon During Colonoscopy: A Case Report and Literature Review.

Colonoscopy has proven efficacy for both screening and diagnostic purposes. Although the risk of complications during colonoscopy is low, it is not negligible. As such, we present the case of a 72-year-old male patient who presented with abdominal pain and positive peritoneal signs post-colonoscopy. He was found to have anemia and acute on chronic kidney disease. An abdominal CT scan found evidence of hemoperitoneum. Subsequently, he underwent a diagnostic laparoscopy converted into an open exploratory laparotomy to identify the source of bleeding, an avulsed mesocolon. A review of the literature regarding colonoscopy and associated complications is discussed, highlighting the importance of risk stratification to better treat patients and prognosticate outcomes.

Endoscopic Resection of a Cavernous Hemangioma in the Sigmoid Colon: A Case Report.

Hemangiomas in the gastrointestinal tract are extremely rare, benign vascular tumors, known for their associated complication of bleeding. They are usually difficult to diagnose, despite the characteristic definition of radiolucent phleboliths on radiology and purplish, tannish brown nodule or polyp on endoscopy. Surgical resection is the treatment of choice. We describe a rare case of sigmoid colon cavernous hemangioma in a 49-year-old male who underwent colonoscopy for lower abdominal pain and revealed a large pedunculated polyp in the sigmoid colon measuring 1.7 cm in diameter. The hemangioma was completely resected endoscopically via hot snare with a favorable outcome.

Iatrogenic ureteral injury diagnosed after colon cancer surgery: A case report of a rare and challenging complication.

INTRODUCTION: Iatrogenic ureteral injury (IUI) is an unfortunate and rare complication during colorectal surgery. While IUI remains a rare event, short and long-term complications are life-threatening ranging from intraperitoneal urinoma to septic shock and a serious risk of permanent renal failure. CASE PRESENTATION: An 88-year-old patient was admitted with symptoms of large bowel obstruction and underwent a laparotomy with a discharge colostomy. A week later, a second laparotomy was required for a non-functional retracted stoma, revealing a perforation in a sigmoid tumor. The patient then had an oncological sigmoidectomy with Hartman's colostomy. Postoperative findings indicated a left ureteral injury. Three weeks later, a ureterostomy was performed. Unfortunately, the patient succumbed to heart failure one week after the ureterostomy. DISCUSSION: Low anterior and abdominoperineal resection of the rectum, along with sigmoid resection are the most frequent causes of ureteral injury in digestive surgery. The primary objective of management is to establish a continuous flow of urine to avert potential complications. Preventing IUI in colorectal surgery is of paramount importance. This process initiates in the preoperative phase with a meticulous assessment of ureteral and colic anatomy through comprehensive review of preoperative imaging. CONCLUSION: IUI remains a seldom-seen, and yet a very serious complication in colorectal surgery. It is imperative to prioritize both preoperative and intraoperative measures to prevent IUI, ensuring optimal outcomes. When the diagnosis of a IUI is established, a treatment strategy should be meticulously devised and executed by a skilled and experienced surgeon.

Topographic anatomy of the endolymphatic sac: a pilot cadaveric dissection study.

PURPOSE: The precise location of the endolymphatic sac (ES) may be difficult during surgical approaches. This morphometric study aimed to determine the exact location of ES in adult human cadavers for the management of pathologies such as Meniere's disease. METHODS: Twenty temporal bones of 10 adult cadavers (mean age: 70 ± 13.40 years, range: 45-92 years; sex: 4 males and 6 females) fixed with 10% formalin were bilaterally dissected to obtain numeric data about the location of ES. RESULTS: Distances of ES to the posterior semicircular canal (PSC), Donaldson line (DL), sigmoid sinus (SS) and sinodural angle (SA) were found as 2.76 ± 1.18 (0.96-5.58) mm, 1.74 ± 1.13 (0.58-5.07) mm, 2.30 ± 1.09 (0.54-4.91) mm and 16.04 ± 3.15 (9.82-22.18) mm, respectively. In addition, the angle between the tangents passing through the cortical bone (CB) and SS was determined as 35.37°±11.32° (21.30°-60.58°). No statistical difference was found between right-left or male-female measurements (p > 0.05). CONCLUSION: DL, SS, and PSC are essential anatomical landmarks for determining the location of ES. The spatial location of SS, including its depth to the cortical bone and the distance to anteriorly located anatomical structures of the mastoid cavity consisting of the facial nerve and PSC, is believed to be underlined for ES surgery. Our data may be used as a database to further define the relationship between ES and adjacent anatomical structures (SS, PSC, etc.) during the application of surgical approaches.

Elevated Procalcitonin Levels can Occur in Bacterial Infections and also in Medullary Thyroid Carcinoma.

Medullary thyroid carcinoma (MTC) is a rare and challenging type of thyroid cancer originating from parafollicular cells (C cells) that produce calcitonin. Diagnosing and monitoring this carcinoma can be complex due to its unique biomarkers. Procalcitonin (PCT), a precursor of calcitonin, and carcinoembryonic antigen (CEA) are important markers for MTC. Elevated PCT levels, particularly when they remain high post-infection treatment, and elevated CEA levels are significant indicators for suspecting MTC. This report emphasises the diagnostic and prognostic importance of these biomarkers in MTC, highlighting their roles in detecting and monitoring disease progression. Integrating PCT and CEA measurements into routine clinical practice can enhance detection, provide understanding of therapeutic responses and aid in the effective management of MTC. LEARNING POINTS: Procalcitonin (PCT) is a more stable and reliable biomarker than calcitonin for diagnosing and monitoring medullary thyroid carcinoma (MTC).Elevated carcinoembryonic antigen (CEA) levels effectively monitor MTC progression, especially when calcitonin levels are inconsistent.Incorporating PCT and CEA measurements into routine practice enhances MTC management, providing reliable biomarkers for diagnosis and monitoring.

Flow Analysis of Central Venous Outflow Tract: A New Approach to Understanding Pulse-Synchronous Tinnitus.

OBJECTIVE: Pulse-synchronous tinnitus (PST) has been linked to multiple anatomical variants of the central venous outflow tract (CVOT) including sigmoid sinus (SS) dehiscence and diverticulum. This study investigates flow turbulence, pressure, and wall shear stress along the CVOT and proposes a mechanism that results in SS dehiscence and PST. STUDY DESIGN: Case series. SETTING: Tertiary Academic Center. METHODS: Venous models were reconstructed from computed tomography scans of 3 patients with unilateral PST. Two models for each patient are obtained: a symptomatic and contralateral asymptomatic side. A turbulent model-enabled commercial flow solver was used to simulate the pulsatile blood flow over the cardiac cycle through the models. Fluid flow through the transverse and SS junction was analyzed to observe the velocity, pressure, turbulent kinetic energy (TKE), and shear stress over a simulated cardiac cycle. RESULTS: Fluid flow on the symptomatic side showed increased vorticity in the presence of an SS diverticulum. Higher TKE with periodicity following the cardiac cycle was observed on the symptomatic side, and a sharp increase was observed if SS diverticulum was present. Shear stress was highest near the narrowest segments of the vessel. Pressure was observed to be lower on the symptomatic side at the transverse-SS junction for all 3 patients. CONCLUSION: Computational fluid dynamics modeling of blood flow through the CVOT in PST suggests that low pressure may be the cause of dehiscence, and tinnitus may result from periodic increases in TKE.

What should otolaryngologists know about dural venous sinus stenting?

Dural venous sinus stenting is an emerging and exciting area in otolaryngology in collaboration with neurosurgeons and neuroradiologists. The first cases were reported 20 years ago. It is now considered part of the routine treatment of increased intracranial pressure due to transverse sinus stenosis. ENT doctors are the first to see these patients in their clinics, as sinus headaches, pulsating tinnitus, and dizziness are the most common symptoms. Previously, with limited success, high-dose diuretics and intracranial shunts had been the only options for treating these patients. Other methods, such as covering the sigmoid sinuses with graft material, appear to cause a sudden increase in intracranial pressure that can lead to blindness and even death. This overview summarizes the clinical and imaging characteristics of patients who will benefit from endovascular sinus stenting for elevated intracranial pressure.

A Case Report of Mandibular Gingival Metastasis From Sigmoid Colon Adenocarcinoma With Phenotypical Transformation Into Neuroendocrine Carcinoma.

This case report presents a 59-year-old female patient with mandibular gingival metastasis from adenocarcinoma of the sigmoid part of the colon, who underwent radical colectomy with simultaneous hysterectomy involving and left oophorectomy (due to tumor involvement) eight years ago. Because of metastatic spread to the liver, a partial left lateral lobectomy was performed, and because of a metastatic lesion in the left adrenal gland, the latter was excised and a partial resection of the left kidney was performed. The patient was given a number of courses of chemotherapy, target therapy, and immunotherapy. In 2024, because of a tumor mass in the oral cavity that was growing and interfering with normal nutrition and speech, she was hospitalized and a radical resection of the lesion was performed along with the involved underlying bone of the lower jaw on the right. The morphological analysis revealed metastasis from large cell neuroendocrine carcinoma and the immunohistochemical stains verified the gastrointestinal origin of the lesion. The lesion was accepted as being a result of the phenotypical transformation of the primary adenocarcinoma of the sigmoid colon. The patient had a normal postoperative period and a smoothly healing wound and continued to be under the management of clinical oncologists supporting chemo-, targeted, and immunotherapy. However, five months after the appearance of the lesion and three months after its surgical removal, after a serious deterioration of her general condition, she passed away at home.

Long-Term Outcomes of the Restoration of Uterovaginal Continuity and Vaginoplasty-Utero-Colo-Neovaginoplasty-in Cervicovaginal Agenesis Using the Sigmoid Colon.

INTRODUCTION AND HYPOTHESIS: Congenital cervicovaginal agenesis in the presence of a functional endometrium is a rare Müllerian anomaly. The management ranges from hysterectomy historically to various reconstructive procedures more recently. We report our experience with utero-colo-vaginoplasty in the management of this anomaly and its long-term follow-up. METHODS: The case records of all the patients with vaginal or cervicovaginal agenesis in our hospital from January 2002 to December 2019 were reviewed retrospectively. The patients were then called for an outpatient visit and examined in detail. The anatomical variations, surgical procedures and outcomes were recorded and analysed. RESULTS: Sixteen patients aged 14 to 26 years were included during the study period. They presented with cyclical painful cryptomenorrhea. Magnetic resonance imaging (MRI) confirmed cervicovaginal or distal vaginal agenesis. All the patients underwent utero-colo-vaginoplasty. Intraoperative rectal injury led to post-operative faecal leak from the perineal wound in one patient in the post-operative period. Restoration of painless menstrual flow was possible in all 16 cases. Long-term complications were seen in 4 patients. These were stenosis of the perineal neovaginal orifice in 2 patients, obstruction at colo-uterine anastomosis in 1 patient and mucosal prolapse at the neovagina in 1 patient. Three of these patients needed secondary surgical procedures. Five were sexually active and reported consummation of penetrative intercourse. None of them had conceived. CONCLUSION: In our experience, utero-colo-vaginoplasty allows for regular painless menstruation and coitus with minimal long-term complications. The sole disadvantage is the failure to conceive.

Ingested Foreign Bodies in the Sigmoid Colon Requiring Earlier Intervention in Patients With Prior Hysterectomy.

The use of dentures and dental plates is widespread in the adult population. Accidental ingestion of these foreign objects is not uncommon, with the majority of patients having an uneventful passage of the object through the gastrointestinal tract. Of those patients requiring intervention, endoscopy is the most common, followed by surgical removal. We discuss a case of a patient with prior pelvic surgery and diverticulosis causing severe angulation of the bowel, resulting in non-passage of the foreign object requiring surgical intervention.

A rare case of leiomyosarcoma with a pleomorphic component of the sigmoid colon.

A 66-year-old man presented to our institution with a positive fecal occult blood test and lower abdominal pain. Although a tumor was found in the sigmoid colon, biopsy and imaging studies failed to enable the diagnosis of the cancer, and the patient underwent surgery for treatment and diagnosis. The tumor had two distinct areas with differing features shown both histopathologically and on imaging; it was thus diagnosed as a leiomyosarcoma of the sigmoid colon with a pleomorphic component. Here, we describe a rare case of leiomyosarcoma of the sigmoid colon with a pleomorphic component. There are no reports of leiomyosarcoma with pleomorphic components arising in the colon in the literature; thus, the recurrence and metastatic characteristics are unknown. Therefore, accumulating cases in the literature may provide valuable insights into diagnosing and treating these rare tumors.

Sigmoid volvulus-Can CT features predict outcomes and recurrence?

OBJECTIVES: Sigmoid volvulus (SV) is a common cause of bowel obstruction, especially in older patients. SV can be mesenteroaxial (M-SV) or organoaxial (O-SV). The purpose of this study was to assess if CT findings in SV are associated with clinical outcomes. including recurrence, choice of management, and mortality. MATERIALS AND METHODS: This study includes patients with SV and a CT within 24 hours of presentation. CT features, including mesenteraoxial/organoaxial arrangement, direction of rotation, transition points, distension, whirl-sign, ischemia, and perforation were determined. Demographics, treatment, recurrence, and outcome data were recorded. RESULTS: One hundred and seventeen cases were diagnosed in 80 patients (54 male). The mean age was 70 years (± 17.1). M-SV and O-SV were equally prevalent (n = 39 vs. n = 41, respectively). M-SV was significantly more common with anticlockwise rotation in the axial plane (p = 0.028) and clockwise rotation in the coronal plane (p = 0.015). All patients with imaging features of ischemia underwent surgery (n = 6). There was no significant difference in outcome variables (30-day mortality, 30-day readmission, recurrence) between the O-SV and M-SV groups. The degree of bowel distension on initial presentation was a significant predictor of recurrence, with ≥ 9 cm vs < 9 cm associated with an increased odds of any recurrence (OR: 3.23; 95%CI: 1.39-7.92). CONCLUSION: In SV, sigmoid distension of more than 9 cm at baseline CT was associated with an increased risk of recurrence. Imaging features of ischemia predicted surgical over endoscopic intervention. Organoaxial and mesenteroaxial SV had similar prevalence, but the type of volvulus was not associated with clinical outcomes or choice of management. CLINICAL RELEVANCE STATEMENT: There is a risk of recurrent sigmoid volvulus with colonic distension greater than 9 cm. This work, comparing volvulus subtypes, shows that this finding at the initial presentation could expedite consideration for surgical management. KEY POINTS: Reports of outcomes for different subtypes and rotational directions of volvuli have been contradictory. No difference in measured outcomes was found between subtypes; distension ≥ 9 cm predicted recurrence. CT features can aide management of sigmoid volvulus and can prompt surgical intervention.

Multiplex attacks in sigmoid volvulus.

Objectives: Sigmoid volvulus (SV) recurs in about one quarter of the patients, whereas multiplex (≥3) attacks are quite rare and attacks with five or more times are extremely rare. The aim of this study was to evaluate multiplex SV attacks in our series and worldwide data. Methods: In Ataturk University Faculty of Medicine Department of General Surgery, among 1,071-case SV series, data were evaluated retrospectively in 612 patients, while prospectively in 459 with respect to age, gender, previous volvulus attacks, and prognosis. Worldwide data were obtained from Web of Science database and they were compared with our results. Results: Mean SV attack count, multiple- (≥2) and multiplex- (≥3) attack rates were 1.4, 26.1%, and 4.2%, respectively, in our series, while they were 1.7, 26.7%, and 3.2%, respectively, in worldwide data (p>0.05, in all). In our series, recurrence rates were 26.1%, 19.3%, and 51.2%, respectively, (p<0.001, in all), while mortality rates were 7.3%, 13.7%, and 19.5%, respectively, (p<0.001, in all) in single-, double-, and multiplex- (≥3) attack patients. Conclusion: Although multiplex (≥3) attacks are uncommon in SV, when it goes up, elective surgery must be considered in selected cases to avoid repetitive attacks and related high mortality.

Endovascular stenting using a sagittal sinus approach for sigmoid sinus wall dehiscence related to intractable pulsatile tinnitus: a case series.

BACKGROUND: Sigmoid sinus wall dehiscence can lead to pulsatile tinnitus with a significant decrease in quality of life, occasionally leading to psychiatric disorders. Several surgical and endovascular procedures have been described for resolving dehiscence. Within endovascular procedures, the sagittal sinus approach could be a technical alternative for tracking and accurate stent positioning within the sigmoid sinus when the jugular bulb anatomy is unfavorable. CASE PRESENTATION: A retrospective case series of three patients with pulsatile tinnitus due to sigmoid sinus wall dehiscence without intracranial hypertension was reviewed from January 2018 to January 2022. From the participants enrolled, the median age was 50.3 years (range 43-63), with 67% self-identifying as female and 33% as male. They self-identified as Hispanic. Sigmoid sinus dehiscence was diagnosed using angiotomography, and contralateral transverse sinus stenosis was observed in all patients. Patients underwent surgery via a navigated endovascular sagittal sinus approach for sigmoid sinus stenting. No neurological complications were associated with the procedure. Pulsatile tinnitus improved after the procedure in all patients. CONCLUSIONS: Superior sagittal sinus resection for sigmoid sinus wall stenting is a safe and effective technique. Pulsatile tinnitus due to sigmoid sinus wall dehiscence could be treated using the endovascular resurfacing stenting technique. However, further research is needed to evaluate the potential benefit of contralateral stenting for removing sinus dehiscence when venous stenosis is detected. However, resurfacing sigmoid sinus wall dehiscence results in symptomatic improvement.

Laparoscopic Sigmoid Vaginoplasty for the Treatment of Mayer-Rokitansky-Kuster-Hauser Syndrome in a Single Center: 20 years' Experience.

INTRODUCTION AND HYPOTHESIS: We investigate the feasibility, safety, and clinical therapeutic effect of laparoscopic sigmoid vaginoplasty in women with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. METHODS: We performed a retrospective case review cohort study of 56 patients with MRKHs undergoing laparoscopic sigmoid vaginoplasty in Wuhan Union Hospital between 2000 and 2020, and all patients were followed up. RESULTS: The median operating time was 165 min (120-420 min). The median hospital stay was 10 days (rang 7-15 days). A functional neovagina was created 11-15 cm in length and two fingers in breadth in all patients. No introitus stenosis was observed. No intra- or post-operative complications occurred. Two patients were lost to follow-up after 3 months of outpatient visits. Six patients had no intercourse and were required to wear a vaginal mold occasionally. None of the patients had complained of local irritation or dyspareunia. Patients who had post-surgery sexual intercourse were satisfied with their sexual life and the mean total Female Sexual Function Index (FSFI) score was 25.17 ± 0.63. The cosmetic results were excellent. CONCLUSIONS: The laparoscopic sigmoid vaginoplasty can achieve the goal of making a functional neovagina. The main advantage of this surgical technique is that it is minimally invasive and that there are fewer complications post-operation. It is an acceptable procedure for patients with MRKH syndrome.

A Symptomatic Mucinous Cystic Neoplasm of the Mesentery: A Case Report.

Mucinous cystic neoplasms (MCNs) are rare tumors primarily observed in the pancreas but occasionally found in other locations such as the retroperitoneum, ovary, liver, and spleen. These neoplasms are histologically classified based on the degree of dysplasia, with some associated with invasive carcinoma. Colorectal surgeons infrequently encounter MCNs. Mesenteric MCNs pose a diagnostic challenge secondary to their atypical location, subtle histology, and lack of specific biochemical markers. In this context, we present a case involving a 68-year-old female who initially presented with an assumed ovarian mass. Subsequent exploration revealed a 12 cm MCN situated in the sigmoid mesentery, a location seldom associated with these tumors. The patient underwent laparotomy with successful resection and recovery. Histopathological analysis confirmed the neoplasm's mucinous epithelium with a complex papillary architecture. Immunohistochemical staining supported the diagnosis, revealing positivity for CK7, SATB2, and CDX2.

Orbital Apex Metastases From Primary Colorectal Adenocarcinoma: A Rare Cause for Unilateral Vision Loss.

Colorectal cancer is one of the most common causes of cancer-related death in the United States. Although it frequently metastasizes to adjacent structures such as the liver, orbital metastases are exceedingly uncommon. Additionally, the morbidity and mortality associated with colorectal cancer appear to be shifting to a younger population, a phenomenon that is exacerbated in minority populations. We present a case of orbital metastasis from colorectal carcinoma in a young Hispanic male. This uncommon presentation of disease emphasizes the link between healthcare disparity and differential outcomes of colorectal cancer.

Competitive Risk Analysis of Prognosis in Older Adults with Sigmoid Colon Adenocarcinoma: A Population-Based Study.

BACKGROUND: The purpose of this study is to employ a competing risk model based on the Surveillance, Epidemiology, and End Results (SEER) database to identify prognostic factors for elderly individuals with sigmoid colon adenocarcinoma (SCA) and compare them with the classic Cox proportional hazards model. METHODS: We extracted data from elderly patients diagnosed with SCA registered in the SEER database between 2010 and 2015. Univariate analysis was conducted using cumulative incidence functions and Gray's test, while multivariate analysis was performed using both the Fine-Gray and Cox proportional hazards models. RESULTS: Among the 10,712 eligible elderly patients diagnosed with SCA, 5595 individuals passed away: 2987 due to sigmoid colon adenocarcinoma and 2608 from other causes. The results of one-way Gray's test showed that age, race, marital status, AJCC stage, differentiation grade, tumor size, surgical status, liver metastasis status, lung metastasis status, brain metastasis status, radiotherapy status, and chemotherapy status all affected the prognosis of SCA (P < .05). Multivariate analysis showed that sex, age, race, marital status, and surgical status affected the prognosis of SCA (P < .05). Multifactorial Fine-Gray analysis revealed that key factors influencing the prognosis of SCA patients include age, race, marital status, AJCC stage, grade classification, surgical status, tumor size, liver metastasis, lung metastasis, and chemotherapy status (P < .05). CONCLUSION: Data from the SEER database were used to more accurately estimate CIFs for sigmoid colon adenocarcinoma-specific mortality and prognostic factors using competing risk models.