Annals of Coloproctology

Volume 26(1); February 2010

Review

Muscle Regeneration: Research for the Treatment of Fecal Incontinence.: Kang, Sung Bum , Lee, Taek Gu; J Korean Soc Coloproctol. 2010;26(1):1-7.; DOI: https://doi.org/10.3393/jksc.2010.26.1.1

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Fecal incontinence remains a socially isolating condition, which can have a profound impact on all aspects of quality of life. It affects 2% to 17% of people living in the community and is an iatrogenic disease that develops after a restorative proctectomy for rectal cancer. Conservative management, such as biofeedback and medication, or surgical therapy may be ineffective, the symptomatic benefit being disappointing. In a few recent reports, autologous myoblasts injected into the urinary or anal sphincter were used successfully for the treatment of incontinence, and these cells improved the muscle function. These autologous cell therapies can avoid adverse events, such as tumor formation, compared to the use of embryonic stem cells. However, the limited regenerative capacity of cell therapy has prompted the development of replacing dysfunctional muscle tissue. Regenerative medicine for functioning muscles may be a therapeutic tool for fecal incontinence in the future. Now, many challenges remain to be overcome prior to reaching the ultimate goal of a fully functional 3-D vascularized engineered muscle: These include development of highly organized 3-D scaffolds, development of scaffolds that specifically direct cellular differentiation, development of co-culture systems of multiple cell types on smart surfaces, development of vascularized constructs, reduction of serum dependence, and innervation into constructed muscle. The successful generation of functional muscle tissues requires an in-depth knowledge of both muscle tissue physiology and advanced engineering practices. The recent advances in tissue engineering technique and cell biology suggest that artificially-derived muscle constructs may be used in clinical settings in the near future.

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Feasibility of Neurovascular Antropylorus Perineal Transposition With Pudendal Nerve Anastomosis Following Anorectal Excision: A Cadaveric Study for Neoanal Reconstruction
Abhijit Chandra, Ashok Kumar, M Noushif, Nitish Gupta, Vijay Kumar, Navneet Kumar Chauhan, Vishal Gupta
Annals of Coloproctology.2013; 29(1): 7. CrossRef
Functional New Sphincter Ani Reconstruction by Using Neurovascualr Antropylorus Transposition After an Anorectal Excision
Bong Hwa Lee, Min Jung Kim, Hyoung Chul Park
Annals of Coloproctology.2013; 29(1): 5. CrossRef
Injection of porous polycaprolactone beads containing autologous myoblasts in a dog model of fecal incontinence
Sung-Bum Kang, Hye Seung Lee, Jae-Young Lim, Se Heang Oh, Sang Joon Kim, Sa-Min Hong, Je-Ho Jang, Jeong-Eun Cho, Sung-Min Lee, Jin Ho Lee
Journal of the Korean Surgical Society.2013; 84(4): 216. CrossRef

Original Articles

The Significance of Staple Line Height in a Stapled Hemorrhoidopexy.: Min, HoKyun , Kim, Hungdai , Kim, Hyungook , Han, Won Kon; J Korean Soc Coloproctol. 2010;26(1):8-11.; DOI: https://doi.org/10.3393/jksc.2010.26.1.8

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Abstract PDF: PURPOSE
In 1998, Longo introduced a novel operative technique for hemorrhoids. That technique uses a prolapse and hemorrhoid (PPH) stapler. His results showed minimal pain, short hospital stay, and rapid return to normal social life. However, a higher height of staple line yields less postoperative pain, but more residual piles, and vice versa. This study was designed to find the optimal height of the staple line for a PPH hemorrhoidopexy.
METHODS
A total of 65 consecutive patients scheduled for a PPH hemorrhoidopexy on grade II or higher internal hemorrhoids were included in this study. The hemorrhoidopexy was performed as in the literature. A purse-string suture was made 5 cm from the anal verge. Remaining piles were excised immediately after the firing of the PPH stapler. Patients were divided into 2 groups. In group A, the staple line was located above 2 cm proximal to the dentate line, and in group B, it was located below 2 cm proximal to the dentate line.
RESULTS
The mean subjective pain score of group A was 2.00, and that of group B was 1.98 (P=0.898). The mean hospital stay of group A was 2.5 days, and that of group B was 2.7 days (P=0.431). Group A returned to normal life in a mean of 7.1 days whereas group B returned to normal life in a mean of 6.8 days (P=0.474). Complications included 6 cases of voiding difficulty, 3 cases of heavy sensation in anus, 1 case of temporary fecal incontinence, and 1 case of anal pain caused by long-standing residual staples.
CONCLUSION
No meaningful relationship was found to exist between the staple line height and either pain or the number of days to return to normal life. However, the incidence of residual piles was lower in cases with a low staple line height. Therefore, the level of the staple line should be lower than it is for a conventional Longo procedure.

The Necessity of a Routine Interval Appendectomy Necessary in Adults?: Initial Experience.: Park, Jong Deok , Lee, Chang Ho , Kim, Jong Hun , Kim, Yong Kon , Lee, Min Ro; J Korean Soc Coloproctol. 2010;26(1):12-16.; DOI: https://doi.org/10.3393/jksc.2010.26.1.12

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Abstract PDF: PURPOSE
The traditional management of a periappendiceal abscess or a perforated appendicitis has been initial conservative treatment, followed by an interval appendectomy (IA). However, the necessity of the interval appendectomy has been questioned by an increasing number of studies recently. The purpose of this study was to clarify the role of conservative treatment, instead of IA, in managing a perforated appendicitis or a periappendiceal abscess after successful initial conservative treatment.
METHODS
We prospectively studied 26 out of 80 patients who had been admitted for a perforated appendicitis or a periappendiceal abscess to Chonbuk National University Hospital from March 2005 to December 2007. These 26 patients were initially treated by using conservative treatment instead of surgery. We analyzed these 26 patients' progression and prognosis after treatment. The IAs were conducted at intervals of 6 to 12 wk after colonoscopy when the patient wanted an operation.
RESULTS
Twenty-three out of 26 (88.5%, 23/26) patients were improved after initial conservative treatment. Only 3 patients who were not improved were managed surgically. Four out of 23 patients who were relieved by conservative treatment underwent an IA voluntarily at intervals of 6 to 12 wk. Of the remaining 19 patients without IA, 1 patient (5%, 1/19) suffered a recurrence after 6 mo, and an appendectomy was performed. Eighteen (78%, 18/23) patients without an IA have shown no recurrence for 15 mo, and they are still being followed up.
CONCLUSION
We conclude that a routine IA after successful initial conservative treatment for a perforated appendicitis or a periappendiceal abscess seems unnecessary. Those patients should undergo colonoscopy to detect any underlying diseases and to rule out coexistent colorectal cancer.

Efficacy of a Laparoscopic Appendectomy When Performed by Surgeons Early in Their Laparoscopic Training Courses.: Joo, Kyu Hwa , Son, Byung Ho , Kim, Hyung Ook , Hwang, Sang Il , Kim, HungDai , Han, Won Kon; J Korean Soc Coloproctol. 2010;26(1):17-21.; DOI: https://doi.org/10.3393/jksc.2010.26.1.17

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Abstract PDF

PURPOSE
Laparoscopic surgery has many advantages and has been a popular method for the treatment of various diseases. Although a laparoscopic appendectomy (LA) is now a common practice, it has not yet become the treatment of choice for appendicitis of inexperienced surgeons in their early days of individual laparoscopic training courses. The purpose of this study was to compare the results obtained by inexperienced surgeons to those obtained by experienced surgeons.
METHODS
From May 2007 to January 2008, 130 patients underwent a LA at our department. The surgeries were performed by three surgeons. The patients were divided into 2 groups. In Group I, the LAs were performed by one surgeon who was experienced with laparoscopic procedures, and in Group II, the LAs were performed by two surgeons who were relatively inexperienced with laparoscopic procedures. We retrospectively reviewed patient's medical records for age, sex, previous abdomen operation history, operation method, operation time, surgical complications, length of hospital stay, and the time to resume soft diet.
RESULTS
The age was younger in Group I (29.8+/-18.2 vs. 36.0+/-16.0 yr, P=0.041). The operation time was longer in Group II (48.4+/-28.7 vs. 64.1+/-30.0 min, P=0.003). In Group I, wound infections developed in 4 cases. In Group II, wound infections developed in 7 cases, and an intraabdominal abscess developed in 1 case. The differences in conversion rates, times to start of diet, uses of analgesics, and hospital stays were not statistically significant.
CONCLUSION
Even though an inexperienced surgeon performs the LA for acute appendicitis, there are no differences in postoperative complications and returns to daily activities compared to a LA performed for acute appendicitis by an experienced surgeon. LA is a safe method for the treatment of acute appendicitis for surgeons who are new to laparoscopic procedures.

Citations

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Learning curve in laparoscopic appendectomy: training strategy of laparoscopic surgery
Hyung Ook Kim
Annals of Coloproctology.2022; 38(3): 276. CrossRef
A Clinical Comparison of Laparoscopic versus Open Appendectomy for Complicated Appendicitis
Sun Gu Lim, Eun Jung Ahn, Seong Yup Kim, Il Yong Chung, Jong-Min Park, Sei Hyeog Park, Kyoung Woo Choi
Journal of the Korean Society of Coloproctology.2011; 27(6): 293. CrossRef

Management of Right Colon Diverticulitis.: Jang, Jong Ik , Lim, Yang Soo , Choi, Jong Woo , Lee, Yoon Sik; J Korean Soc Coloproctol. 2010;26(1):22-28.; DOI: https://doi.org/10.3393/jksc.2010.26.1.22

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Abstract PDF

PURPOSE
There are still many controversial aspects in the management of right colon diverticulitis. The aim of this study is to find an appropriate treatment for right colon diverticulitis.
METHODS
We retrospectively reviewed the medical records of 88 patients who were admitted with right colon diverticulitis to Wallace Memorial Baptist Hospital from January 2001 to December 2007.
RESULTS
The patients enrolled in this study included 52 men and 36 women. The mean age was 39.6 yr, ranging from 13 to 84 yr. Fifty-four of 88 patients underwent conservative treatment for right colon diverticulitis, and 34 of 88 patients underwent operative treatment. There were 5 cases of recurrence in the conservative treatment group, but there were no cases of recurrence in the operative treatment group. We experienced 43 cases with right colon diverticulitis at the operational fields, including 9 cases that underwent conservative treatment after an appendectomy: eleven cases that underwent conservative treatment after an appendectomy or an appendectomy with diverticulectomy, 19 cases that underwent an ileocecectomy, and 13 cases that underwent a right hemicolectomy. There were no statistically significant difference in complications among 3 groups (P=0.148). However, there were statistical differences among the 3 groups in the length of hospital stay (P=0.016), and the use of intravenous antibiotics (P<0.001), and the use of oral antibiotics (P=0.019).
CONCLUSION
When the preoperative diagnosis is exact, uncomplicated right colon diverticulitis can be managed by conservative treatment. On the other hand, an ileocecectomy or a right hemicolectomy is the proper treatment for complicated right colon diverticulitis. However, if uncomplicated right colon diverticulitis is diagnosed intraoperatively, conservative treatment or a diverticulectomy should be considered.

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Primary epiploic appendagitis: Reconciling CT and clinical challenges
Jamel Saad, Hussein Ali Mustafa, Asem Mohamed Elsani, Fawaz Alharbi, Saad Alghamdi
Indian Journal of Gastroenterology.2014; 33(5): 420. CrossRef
Management of Right Colonic Uncomplicated Diverticulitis: Outpatient Versus Inpatient Management
Hyoung‐Chul Park, Byoung Seup Kim, Bong Hwa Lee
World Journal of Surgery.2011;[Epub] CrossRef
Clinical Characteristics of Primary Epiploic Appendagitis
Young Un Choi, Pyong Wha Choi, Yong Hwan Park, Jae Il Kim, Tae Gil Heo, Je Hoon Park, Myung Soo Lee, Chul Nam Kim, Surk Hyo Chang, Jeong Wook Seo
Journal of the Korean Society of Coloproctology.2011; 27(3): 114. CrossRef
A Case of Ascending Colon Diverticulitis with Perforation in a Child
Joon Woo Baek, Jae Young Shin, Jee Hyun Lee, So Young Jung, Ah Young Jung, Jeong Won Kim, Kon Hee Lee
Korean Journal of Pediatric Gastroenterology and Nutrition.2010; 13(2): 193. CrossRef

The Prognostic Factors and Severity Index in Fournier's Gangrene.: Kim, Kwang Min , Seong, Seung Hoon , Won, Dal Yeon , Ryu, Hoon , Kim, Ik Yong; J Korean Soc Coloproctol. 2010;26(1):29-33.; DOI: https://doi.org/10.3393/jksc.2010.26.1.29

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Abstract PDF

PURPOSE
Fournier's disease is polymicrobial necrotizing fasciitis of the perineal, perianal, or genital areas. The objective of this study was to investigate patients with Fournier's gangrene and to determine risk factors that affect mortality.
METHODS
This study was a retrospective clinical study. Clinical presentations and outcomes of surgical treatments were evaluated in 27 patients with Fournier's gangrene that were treated in a single institution from January 2000 to March 2009.
RESULTS
The mean age of patients was 52.8+/-14.4 yr, and the male-to-female ratio was 25:2. Among the predisposing factors, diabetes mellitus was the most common (n=8, 29.6%). The most common infection source was anorectal (n=16, 59.3%). Sepsis on admission was detected in 16 cases (59.3%). Four patients died during treatment, for an overall mortality of 14.8%. A logistic regression test showed a Fournier's gangrene severity index greater than 9 and sepsis on admission to be prognostic factors.
CONCLUSION
The mortality rate was higher in patients with sepsis on admission and with a Fournier's gangrene severity index greater than nine.

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Effect of Sarcopenia on Mortality and Morbidity in Patients With Fournier’s Gangrene
Deniz Tazeoglu, Sami Benli, Ahmet Cem Esmer, Tahsin Colak, Feramuz Demir Apaydin
The American Surgeon™.2023; 89(12): 5527. CrossRef
Biomarkers to predict mortality in patients with Fournier’s gangrene admitted to the intensive care unit after surgery in South Korea
In Sik Shin, Seong Chan Gong, Sanghyun An, Kwangmin Kim
Acute and Critical Care.2023; 38(4): 452. CrossRef
Delta neutrophil index as a prognostic factor for mortality in patients with Fournier's gangrene
In Sik Shin, Seong Chan Gong, Sanghyun An, Kwangmin Kim
International Journal of Urology.2022; 29(11): 1287. CrossRef
Intérêt de l’index de sévérité de la gangrène de Fournier dans la prédiction des facteurs pronostiques de la mortalité
S.M. Moudouni, S. Arza, A. Benhaddou, K.H. Baka, M.A. Lakmichi, Z. Dahami, I. Sarf
African Journal of Urology.2017; 23(4): 347. CrossRef
Prognostic factors and treatment outcomes for patients with Fournier's gangrene: a retrospective study
Kyung Sook Hong, Hee Jung Yi, Ryung‐Ah Lee, Kwang Ho Kim, Soon Sup Chung
International Wound Journal.2017; 14(6): 1352. CrossRef
Clinical Practice Guidelines for Soft Tissue Infections

Infection & Chemotherapy.2012; 44(4): 213. CrossRef

Application of a Scoring System to the Diagnosis of Acute Appendicitis.: Kim, June Young , Choi, Seok Ho , Cha, Jin Woo , Byun, Chang Kyu , Koh, Young Taek , Seo, Dong Yup; J Korean Soc Coloproctol. 2010;26(1):34-38.; DOI: https://doi.org/10.3393/jksc.2010.26.1.34

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Abstract PDF

PURPOSE
Acute appendicitis is one of the most common diseases requiring surgical treatment. Delayed diagnosis, which causes complications like perforation of the appendix, abscess formation, or misdiagnosis, leads to unnecessary surgery. Many scoring systems have been suggested for the diagnosis of acute appendicitis. This study aims to evaluate the clinical value of previous scoring systems.
METHODS
This study was conducted with a total of 270 patients who had visited the National Police Hospital (NPH) Emergency Room for acute abdominal symptoms from January to June 2008. The Alvarado and the Ohmann scores were applied retrospectively based on the patients' records. We found 3 criteria which were relatively objective and clinically meaningful; then, we designed a new 10 points scoring system.
RESULTS
The sensitivity and the specificity of the Alvarado scoring system were 83.23% and 64.42%, respectively, whereas those of the Ohmann scoring system were 74.85% and 66.35%, respectively. The sensitivity and the specificity of the NPH scoring system were found to be 78.4% and 68.9%, respectively. The Ohmann scoring system showed a little lower sensitivity, and the NPH scoring system showed a little higher specificity, but the differences were not statistically significant.
CONCLUSION
Our study indicates that the scoring systems considered are not useful diagnostic methods for primary screening and diagnosis of acute appendicitis.

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The Alvarado Score Is the Most Impactful Diagnostic Tool for Appendicitis: A Bibliometric Analysis
Nadir Noureldin Abdella Bahta, Philine Zeinert, Jacob Rosenberg, Siv Fonnes
Journal of Surgical Research.2023; 291: 557. CrossRef
Many diagnostic tools for appendicitis: a scoping review
Nadir Noureldin Abdella Bahta, Jacob Rosenberg, Siv Fonnes
Surgical Endoscopy.2023; 37(5): 3419. CrossRef

Pretreatment Serum CEA as a Prognostic Factor for Rectal Cancer Treated with Preoperative Chemoradiotherapy.: Kim, Kyu Hyung , Oh, Jae Hwan , Choi, Hyo Seong , Park, Ji Won , Park, Seong Chan , Kim, Dae Yong , Chang, Hee Jin , Baek, Ji Yeon , Kim, Sun Young; J Korean Soc Coloproctol. 2010;26(1):39-44.; DOI: https://doi.org/10.3393/jksc.2010.26.1.39

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Abstract PDF

PURPOSE
Preoperative serum carcinoembryonic antigen (s-CEA) is well known to be a prognostic factor in patients with colorectal cancer. However, the prognostic effect of s-CEA in patients with rectal cancer treated with preoperative chemoradiotherapy (CRT) has not been well studied. The aim of this study is to evaluate the prognostic value of pretreatment s-CEA for rectal cancer treated with preoperative CRT.
METHODS
This study analyzed the data of 436 patients who received preoperative CRT and underwent curative surgery for locally advanced rectal cancer from January 2002 to July 2007. Patients were categorized into two groups according to pretreatment CEA levels: < or =10 and >10 ng/mL. The disease-free survivals between the two groups were compared.
RESULTS
The three-year disease-free survival rates of the CEA < or =10 ng/mL group and the CEA >10 ng/mL group were 80.4% and 67.3%, respectively (P=0.002). Multivariate analysis revealed the following independent risk factor for recurrence: pretreatment CEA >10 ng/mL (hazard ratio [HR] 1.616; 95% confidence interval [CI], 1.007 to 2.594; P=0.047), positive lymph node status (HR, 2.580; 95% CI, 1.625 to 4.094; P<0.001), and positive circumferential resection margin (HR, 1.889; 95% CI, 1.035 to 3.446; P=0.038).
CONCLUSION
Pretreatment s-CEA (cutoff value 10 ng/mL) may be a prognostic factor for disease-free survival in rectal cancer patients treated with preoperative CRT and surgery.

Citations

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Factors predicting oncologic outcomes in patients with fewer than 12 lymph nodes retrieved after curative resection for colon cancer
Jung Wook Huh, Chang Hyun Kim, Hyeong Rok Kim, Young Jin Kim
Journal of Surgical Oncology.2012; 105(2): 125. CrossRef
Factors Influencing Oncological Outcomes in Patients Who Develop Pulmonary Metastases After Curative Resection of Colorectal Cancer
Chang Hyun Kim, Jung Wook Huh, Hun Jin Kim, Sang Woo Lim, Sang Yun Song, Hyeong Rok Kim, Kook Joo Na, Young Jin Kim
Diseases of the Colon & Rectum.2012; 55(4): 459. CrossRef

Association of RNase3 Polymorphisms with the Risk of Colorectal Cancer.: Kim, Yong , Kang, Dong Baek , Lee, Jeong Kyun , Lee, Young Hwan , Kang, In Hong , Chae, Soo Cheon , Yang, Yun Sik , Park, Won Cheol; J Korean Soc Coloproctol. 2010;26(1):45-52.; DOI: https://doi.org/10.3393/jksc.2010.26.1.45

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Abstract PDF: PURPOSE
RNase3 is a secretory ribonuclease found in eosinophilic leukocytes and is involved in the innate immune system. Its cytotoxic activity is effective against a wide range of pathogens. Generally, high levels of RNase3 have been reported in cases of active asthma and allergic diseases. However, a relationship between RNase3 and colon cancer has not yet been reported. We performed a case-control study to examine the relationship between RNase3 polymorphisms and the risk of colorectal cancer in Korean people.
METHODS
Blood sampling of each group was performed, TaqMan in g.-550A>G, PCR-RFLP in g.371C>G, and high resolution melting (HRM) in g.499C>G were analyzed. As results, the three SNPs, g.-550A>G, g.371C>G, and g.499C>G, in RNase3 and their haplotypes were analyzed.
RESULTS
The genotype and the allele frequencies of RNase3 g.-550A>G and g.371C>G were not significantly associated with increased risk for colon cancer compared to the control group, but the RNase3 g.499C>C genotype was associated with a significantly increased risk for colorectal cancer compared to the control group (P=0.001). Also, the RNase3 g.499C>C genotype was more specifically associated with a significantly increased risk for right colon cancer than left colon cancer (P<0.001). In haplotypes of RNase3 SNPs, g.-550G, g.371C, and g.499G were significantly associated with colorectal cancer (P=0.019): more specifically, left colon cancer and rectal cancer than right colon cancer (P=0.048).
CONCLUSION
The RNase3 g.499C>G polymorphism may have an influence on colorectal cancers and may have a more specific influence on right colon cancer than left colon cancer and on rectal cancer. However, the significance of the RNase3 g.-550A>G and g.371C>G polymorphisms need careful interpretation and require confirmation in larger studies.

A Study of Epigenetic Alteration of the Bone Morphogenetic Protein-2 Gene in Human Colorectal Cancer.: Jang, Yong Sun , Kim, Kwang , Yun, Min Young , Choi, Sun Keun , Kim, Kyung Rae , Jang, Jun Hyeog , Koo, Ji Hoe; J Korean Soc Coloproctol. 2010;26(1):53-61.; DOI: https://doi.org/10.3393/jksc.2010.26.1.53

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Abstract PDF: PURPOSE
Bone morphogenetic proteins (BMPs) are members of the transforming growth factor-beta family and play an important role in cellular growth. Recent reports suggest that exogenous bone morphogenetic protein-2 (BMP-2) acts as an antiproliferative agent in a variety of cell lines. We will study whether BMP-2 is altered in human colorectal cancer.
METHODS
We analyzed 40 colorectal cancer cases and 6 colorectal cancer cell lines by using reverse transcription-polymerase chain reaction (RT-PCR) to determine the expression of BMP-2.
RESULTS
Thirteen of 40 colorectal cancers (33%) and 3 of 6 colorectal cancer cell lines (50%) revealed decreased expression of BMP-2. The rates of decreased expression were 0% (0/7), 42.1% (8/19), 28.6% (2/7), 33.3% (2/6), and 100% (1/1) in stages I, II, III, and IV, respectively. Histologically, the rates were 33.3% (2/6), 32.2% (10/21), 50% (1/2), and 0% (0/1) in well-differentiated, moderately-differentiated, poorly-differentiated and mucinous cancers, respectively. As for location, the rates for colon and rectal cancers were 27.8% (5/18) and 36.4% (8/22), respectively. We identified methylation in the CpG island of the BMP-2 gene in 60% of colorectal cancer cells and in 50% of colorectal cancer cell lines. The 13 cases without BMP-2 gene expression showed no significant correlation with clinicopathological factors. Epigenetic silencing through DNA methylation is one of the key steps during carcinogenesis.
CONCLUSION
We found, through an analysis using the methylation-specific polymerase chain reaction technique, CpG island methylation of the BMP-2 promoter region in colorectal cancer. Thus, aberrant BMP-2 methylation and the resultant loss of BMP-2 expression may be related to colorectal carcinogenesis.

Expression of LDH-5 in Colorectal Carcinomas: Correlation with Prognosis and Tumor Angiogenesis.: Ahn, Tae Sung , Kim, Chang Jin , Jung, Dong Jun , Park, Dong Guk , Cho, Sung Woo , Kim, Sung Young , Lee, Moon Soo , Kim, Chang Ho , Cho, Moo Sik , Baek, Moo Jun; J Korean Soc Coloproctol. 2010;26(1):62-68.; DOI: https://doi.org/10.3393/jksc.2010.26.1.62

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Abstract PDF: PURPOSE
Lactate dehydrogenase-5 (LDH-5) is one of five isoenzymes and is the most important for anaerobic glycolysis. LDH-5 is transcriptionally regulated by hypoxia-inducible factor (HIF). HIF plays a role in the response to hypoxia by activating genes involved in vascular remodeling, cell proliferation, and erythropoiesis. In this study, we investigated the clinicopathologic significance and angiogenesis of LDH-5 expression in colorectal cancer.
METHODS
We retrospectively reviewed the medical records of 83 patients with colorectal cancer who underwent a surgical resection at Soonchunhyang Cheonan Hospital from January 2001 to December 2003. LDH-5 and HIF-1alpha protein expressions were evaluated in 83 human colorectal cancer specimens. These factors were related to TNM stage, lymph node metastasis, vascular, neural, and lymphatic invasion, and prognosis.
RESULTS
LDH-5 was positive in 66% (55 patients) of the tumors, and HIF-1alpha was positive in 66% (55 patients) of the tumors. LDH-5 expression was significantly associated with HIF-1alpha protein expression (P<0.001). Also, LDH-5 expression was significantly associated with TNM stage and lymph node metastasis (P<0.001) while HIF-1alpha expression was significantly associated with TNM stage (P<0.001), lymph node metastasis (P<0.001), vascular invasion (P=0.011), and lymphatic invasion (P=0.005). The survival of the patients with high LDH-5 expression was worse than that of patients with low LDH-5 expression (P=0.032).
CONCLUSION
Our study shows a high expression of LDH-5 in colorectal cancer. The up-regulation of LDH-5 parallels an increase in HIF-1alpha expression. The immunohistochemical assessment of tissue LDH-5 and HIF-1alpha provides important prognostic information for colorectal carcinomas.

Survival Rate and Prognostic Factors in Perforated Colorectal Cancer Patients: A Case-Control Study.: Kim, Min Sang , Lim, Seung Woo , Park, Sung Jin , Gwak, Geumhee , Yang, Keun Ho , Bae, Byung Noe , Kim, Ki Hwan , Han, Sewhan , Kim, Hong Joo , Kim, Young Duck , Kim, Hong Yong; J Korean Soc Coloproctol. 2010;26(1):69-75.; DOI: https://doi.org/10.3393/jksc.2010.26.1.69

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Abstract PDF

PURPOSE
Perforations are rare but serious complications in colorectal cancer. Controversy exists over whether to perform a radical operation because colorectal cancer perforation is considered as an advanced stage disease, and septic complications of peritonitis have been identified as being responsible for a poor prognosis. The aim of this study was to assess the correlation between the survival rate and the clinicopathological parameters that might be used as predictive factors of the prognosis for perforated colorectal cancer.
METHODS
The analysis was based on 24 cases of perforated colorectal cancer (the case group), 48 cases of matching uncomplicated colorectal cancer (the control group), and 72 cases of the case and the control groups combined together (the combined group), all of which were identified during a 10-yr period in a single institution.
RESULTS
The five-year survival rates of the perforated colorectal cancer patients and their matching controls were similar (P=0.484). No significant differences in the locations of the cancer, the pre-operative carcinoembryonic antigen (CEA) levels, the tumor sizes, the resection margins, or the numbers of the lymph nodes harvested were found between the two groups. A univariate analysis of the prognostic factors that influenced the case group revealed that adjuvant chemotherapy (P=0.004) was significantly correlated to a better five-year survival rate. A univariate analysis of the prognostic factors that influenced the five-year survival rate of the combined group revealed that the stage (P<0.001), the pre-op CEA level (P=0.018), the angio invasion (P=0.019), the perineural invasion (P=0.019), the number of harvested lymph nodes (P=0.004), and adjuvant chemotherapy (P=0.001) were significantly correlated to the five-year survival rate. The identified independent prognostic factors in the combined group were the stage (hazard ratio, 5.20), angio-invasion (hazard ratio, 2.81), and adjuvant chemotherapy (hazard ratio, 0.17).
CONCLUSION
The clinical pathway of perforated colorectal cancer is similar to that of uncomplicated colorectal cancer. Therefore, perforated colorectal cancer patients should be recommended for treatment with the appropriate radical operation and adjuvant chemotherapy based on oncologic principles.

Citations

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The Metastatic Lymph Node Ratio is a Crucial Criterion in Colorectal Cancer Therapy Management and Prognosis
Gülçin Harman Kamalı, Sedat Kamalı
European Archives of Medical Research.2022; 38(1): 73. CrossRef
Acute Abdomen in the Oncology Patient
Katrina McGinty
Seminars in Roentgenology.2020; 55(4): 400. CrossRef
Nonobstetrical Acute Abdomen during Pregnancy as a Consequence of Colorectal Carcinoma Perforation: Case Report and Review of the Literature
Žana Žegarac, Željko Duić, Sandra Stasenko
Case Reports in Gastrointestinal Medicine.2019; 2019: 1. CrossRef
Prognostic Value of Perineural Invasion in Colorectal Cancer: A Meta-Analysis
Yuchong Yang, Xuanzhang Huang, Jingxu Sun, Peng Gao, Yongxi Song, Xiaowan Chen, Junhua Zhao, Zhenning Wang
Journal of Gastrointestinal Surgery.2015; 19(6): 1113. CrossRef
Surgical management of obstructed and perforated colorectal cancer: still debating and unresolved issues
Rudra K Maitra, Charles A Maxwell-Armstrong
Colorectal Cancer.2013; 2(6): 573. CrossRef
Multivariate Analysis of the Survival Rate for Treatment Modalities in Incurable Stage IV Colorectal Cancer
Sung Kang Kim, Chang Ho Lee, Min Ro Lee, Jong Hun Kim
Journal of the Korean Society of Coloproctology.2012; 28(1): 35. CrossRef

Case Reports

Significance of the Change of the Anal Verge Position During Anal Surgery after Spinal Anesthesia.: Lim, Seok Won , Kim, Do Hyoung; J Korean Soc Coloproctol. 2010;26(1):76-79.; DOI: https://doi.org/10.3393/jksc.2010.26.1.76

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Abstract PDF: PURPOSE
The anal verge is the border of the lowest part of the anal canal. However, grossly, it may be difficult to identify. Therefore, to assess the precise position of the anal verge, we performed this study.
METHODS
From August 1 to 31, 2006, 40 patients having anal surgery under spinal anesthesia were selected randomly. Prior to surgery, the anal verge was marked with the patient in the Sims's position. After marking, the anus was pulled bilaterally to both sides using bandages, and the lengths of the four areas were measured with the patient in the jackknife position.
RESULTS
With the patient in the jackknife position, the anal verge was moved laterally by an average of 1.09+/-0.36 cm. The shift distance of the anal verge relative to the anal area was measured; the shift distance in the posterior direction was 1.1+/-0.30 cm, that in the anterior direction was 0.85+/-0.25 cm, that in the right lateral direction was 1.22+/-0.41 cm, and that in the left lateral direction was 1.20+/-0.34 cm. The shifted distance to the posterior area was significantly longer than that to the anterior area (P<0.05).
CONCLUSION
When performing anal surgery with the patient in the jackknife position, the anal verge is shifted to the lateral side of the anus compared to its position when the patient is in the normal position. Notably, the shift distance to the posterior area was significantly longer than that to the anterior area. By assessing the precise position of the anal verge, the surgeon can reduce the resection range of the anoderm and create an appropriate drainage wound.

Synchronous Multiple Colorectal Cancer Occurring in Polyposis.: Ham, Young Chan , Kim, Il Myung , Yun, Jin , Park, Sang Soo , Shin, Dong Gue , Kang, Seong Ku; J Korean Soc Coloproctol. 2010;26(1):80-84.; DOI: https://doi.org/10.3393/jksc.2010.26.1.80

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Abstract PDF: The frequencies of multiple synchronous carcinomas of the colon and the rectum have been reported to range from 2.1 to 6.3%. Currently, the frequency is higher in colorectal cancer patients, and the diagnosis is better due to the many diagnostic tools that have been developed. There are a few reported cases of five cancers in a patient at the same time. We report here on the case of five synchronous cancers arising from the colon and the rectum in a patient without a familial history of colon cancer or of genetic predisposing factor. The patient was a 62-yr-old woman who presented with frequently loose stool for six months and intermittent abdominal pain for two months. Colonoscopic examination revealed two adenocarcinomas, one each at the sigmoid colon and the rectum; the cancer in the sigmoid colon was obstructed at nearly 40 cm above the anal verge. Computed tomographic colonoscopy revealed many other polyps and masses in the colon and a metastatic mass at segment 8 in the liver. A total proctocolectomy and ileostomy were performed. Histologic evaluation revealed the five lesions to be adenocarcinomas invading the pericolic fat; 1 out of 30 lymph nodes was invaded by the cancer cells.

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