Annals of Coloproctology

Volume 29(4); August 2013

Editorials

What Should Be Done to Increase Survival in Patients With Colorectal Cancer?: Min Ro Lee, Jong Hun Kim; Ann Coloproctol. 2013;29(4):135-135. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.135

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Mechanical Bowel Preparation: Keep It or Abandon It?: Hungdai Kim; Ann Coloproctol. 2013;29(4):136-136. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.136

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Serum Carcinoembryonic Antigen for Recurrence in Colorectal Cancer Patients: Young Jin Kim; Ann Coloproctol. 2013;29(4):137-137. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.137

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Timing of Adjuvant Chemotherapy in Colorectal Cancer Patients: Moo-Jun Baek; Ann Coloproctol. 2013;29(4):138-138. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.138

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Original Articles

Investigation of Clinical Manifestations in Korean Colorectal Cancer Patients: Hye Young Koo, Kyu Joo Park, Jae Hwan Oh, Sung Bum Kang, Seong Taek Oh, Woo Yong Lee; Ann Coloproctol. 2013;29(4):139-143. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.139

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5 Citations

Abstract PDF

Purpose

Early diagnostic work-up in patients with clinical symptoms of colorectal cancer (CRC) is important to achieve good treatment results. In this study, we investigated clinical symptoms when a diagnosis of CRC was made in patients who had a surgical resection, especially focusing on the relevance of constipation to CRC.

Methods

The clinical symptoms of 17,415 CRC patients who had curative surgery from January 2010 to December 2012 were collected from 24 training hospitals of surgery.

Results

The number of symptomatic patients before the diagnosis of CRC was 11,085 (63.7%). Hematochezia or melena, abdominal pain, anemia, and constipation were more often found in female than male patients while bowel habit change was more common in male patients. Considering age, bowel habit change and hematochezia or melena were more common in patients younger than 60. Anemia and constipation, however, were more common in patients older than 60. According to the group classification based on age, patients older than 60 had experienced more constipation (P = 0.049). Moreover, patients with constipation tended to have a more advanced disease status (P < 0.001).

Conclusion

In patients who had surgery due to CRC, bleeding, abdominal pain, bowel habit change and constipation were the most frequent symptoms before diagnosis. Although whether or not constipation is a cause of CRC is unclear, it is one of the important clinical symptoms that presents in patients with CRC, and patients with a symptom of constipation tend to present with a more advanced CRC stage.

Citations

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The Role of CT-Quantified Body Composition on Longitudinal Health-Related Quality of Life in Colorectal Cancer Patients: The Colocare Study
Biljana Gigic, Johanna Nattenmüller, Martin Schneider, Yakup Kulu, Karen L. Syrjala, Jürgen Böhm, Petra Schrotz-King, Hermann Brenner, Graham A. Colditz, Jane C. Figueiredo, William M. Grady, Christopher I. Li, David Shibata, Erin M. Siegel, Adetunji T. T
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Constipation Risk in Patients Undergoing Abdominal Surgery
Sevim Celik, Nurdan Yalcin Atar, Nilgun Ozturk, Guler Mendes, Figen Kuytak, Esra Bakar, Duygu Dalgiran, Sumeyra Ergin
Iranian Red Crescent Medical Journal.2015;[Epub] CrossRef
Commentary on "Data on the Characteristics and the Survival of Korean Patients With Colorectal Cancer From the Korea Central Cancer Registry"
Mohammad Mohammadianpanah
Annals of Coloproctology.2014; 30(3): 151. CrossRef

Data on the Characteristics and the Survival of Korean Patients With Colorectal Cancer From the Korea Central Cancer Registry: Hyoung-Chul Park, Aesun Shin, Byung-Woo Kim, Kyu-Won Jung, Young-Joo Won, Jae Hwan Oh, Seung-Yong Jeong, Chang Sik Yu, Bong Hwa Lee; Ann Coloproctol. 2013;29(4):144-149. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.144

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34 Citations

Abstract PDF

Purpose

The incidence rates of colorectal cancer (CRC) in Korea have been increasing during the past decade. Therefore, it is important to understand the characteristics, including survival, of Korean CRC patients. The aim of this study was to use the nationwide cancer registry to evaluate the characteristics of Korean CRC, focusing on the survival, according to tumor location, sex, and specific age groups.

Methods

Using the Korea Central Cancer Registry (KCCR), we analyzed a total of 226,352 CRC cases diagnosed from 1993 to 2010. The five-year relative survivals were compared for the proximal colon, the distal colon, and the rectum. Survival rates were compared between men and women and between patients of young age (less than 40 years old) and patients of advanced age (70 years old or older).

Results

The 5-year survival rates were improved in all subsites between 1993 and 2010. Distal colon cancer showed favorable survival compared to proximal colon or rectal cancer. Females demonstrated worse survival for local or regional cancers, and this difference was significant in for patients in their seventies. Young patients (<40 years old) showed better survival rates for overall and proximal colon cancer comparable to those for older patients (≥40 years old), but advanced age patients (≥70 years old) had worse survivals for all tumor subsites compared to their younger counterparts (<70 years old). These trends were similar in distant CRC.

Conclusion

Korean CRC has certain distinct characteristics of survival according to tumor location, sex, and age. Despite the limitations of available data, this study contributes to a better understanding of survival differences in Korean CRC.

Citations

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What Should Be Done to Increase Survival in Patients With Colorectal Cancer?
Min Ro Lee, Jong Hun Kim
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Optimal Time of Initiating Adjuvant Chemotherapy After Curative Surgery in Colorectal Cancer Patients: Kyu Min Kang, Kyung Sook Hong, Gyoung Tae Noh, Bo-Young Oh, Soon Sup Chung, Ryung-Ah Lee, Kwang Ho Kim; Ann Coloproctol. 2013;29(4):150-154. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.150

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Abstract PDF

Purpose

Adjuvant chemotherapy is routinely recommended for locally advanced colorectal cancer (CRC). There are very few data for the optimal starting date of adjuvant chemotherapy after the surgery. This study aimed to evaluate the effectiveness of earlier adoption of adjuvant chemotherapy after curative surgery for stage III CRC.

Methods

In this study, 159 patients with stage III CRC, who had undergone a curative resection, were enrolled retrospectively. Patients were categorized into 3 groups representing different timings to initiate the chemotherapy; less than 2 weeks (group 1), 3 to 4 weeks (group 2), and more than 5 weeks (group 3). The overall survival rate (OS) and the relapse-free survival rate (RFS) were analyzed to evaluate the effectiveness of adjuvant chemotherapy.

Results

The 5-year OSs of the patients were 73.7% in group 1, 67.0% in group 2, and 55.2% in group 3. The 5-year RFSs of the patients were 48.8% in group 1, 64.7% in group 2, and 57.1% in group 3. There were no significant differences in either the OS or the RFS (P = 0.200, P = 0.405).

Conclusion

Starting chemotherapy earlier than 6 weeks after surgery does not show any significant difference. Thus, although adjuvant chemotherapy should preferably begin within 6 weeks, the starting date should not necessarily be hastened, and the patient's general condition should be taken into consideration.

Citations

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Minimally Invasive Approach Provides Oncological Benefit in Patients with High Risk of Very Early Recurrence (VER) After Surgery for Intrahepatic Cholangiocarcinoma (iCCA)
Francesca Ratti, Cecilia Maina, Lucrezia Clocchiatti, Rebecca Marino, Federica Pedica, Andrea Casadei Gardini, Francesco De Cobelli, Luca Antonio Maria Aldrighetti
Annals of Surgical Oncology.2024; 31(4): 2557. CrossRef
The optimal time of starting adjuvant chemotherapy after curative surgery in patients with colorectal cancer
Yuchong Yang, Yao Lu, Hui Tan, Ming Bai, Xia Wang, Shaohua Ge, Tao Ning, Le Zhang, Jingjing Duan, Yansha Sun, Rui Liu, Hongli Li, Yi Ba, Ting Deng
BMC Cancer.2023;[Epub] CrossRef
Apurinic/apyrimidinic endonuclease 1 is associated with poor prognosis after curative resection followed by adjuvant chemotherapy in patients with stage III colon cancer
Ji Hyeong Song, Myung Sun Lee, Eun Young Cha, Kyung Ha Lee, Ji Yeon Kim, Jin Soo Kim
Korean Journal of Clinical Oncology.2022; 18(1): 1. CrossRef
Impact of the Time Interval Between Primary Debulking Surgery and Start of Adjuvant Chemotherapy in Advanced Epithelial Ovarian Cancer
Hao Lin, Wen-Hsin Chen, Chen-Hsuan Wu, Yu-Che Ou, Yu-Jen Chen, Ying-Yi Chen, Yu-Han Lin, Hung-Chun Fu
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Sara Kaveh, Parvin Ebrahimi, Aziz Rezapour, Masoud Mozafari, Kourosh Sayehmiri
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Timing of Adjuvant Chemotherapy in Colorectal Cancer Patients
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Diagnostic Accuracy of Elevated Serum Carcinoembryonic Antigen for Recurrence in Postoperative Stage II Colorectal Cancer Patients: Comparison With Stage III: Ho Seung Kim, Min Ro Lee; Ann Coloproctol. 2013;29(4):155-159. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.155

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Abstract PDF

Purpose

Elevated levels of serum carcinoembryonic antigen (CEA) following a curative resection of colorectal cancer (CRC) indicate recurrence; however, the levels of CEA may be elevated above the normal limit without recurrence. The aim of this study is to analyze the diagnostic accuracy of elevated serum CEA for predicting recurrence in postoperative stage II and stage III CRC patients.

Methods

A total of 336 stage II and stage III CRC patients who underwent a curative resection between January 2005 and October 2009 were enrolled. Sensitivities, specificities, positive predictive values (PPVs), negative predictive values (NPVs), likelihood ratios and post-test probabilities of recurrence associated with elevated CEA were analyzed and compared.

Results

The median follow-up duration was 45 months (36 to 134 months). Twenty-seven of 189 stage II patients (14.3%) and 52 of 147 stage III patients (35.4%) developed recurrence during the follow-up period. Sensitivities, specificities, PPVs, and NPVs of elevated CEA were 37.0%, 91.4%, 41.7%, and 89.7%, respectively, in stage II patients and 46.2%, 90.5%, 72.7%, and 75.4% in stage III patients. Post-test probabilities of recurrence associated with elevated CEA were 41.8% in stage II patients and 71.9% in stage III patients.

Conclusion

The predictive performance of the probability of recurrence associated with elevated serum CEA after a curative resection in stage II CRC patients is lower than that in stage III CRC patients.

Citations

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Significance of carcinoembryonic antigen detection in the early diagnosis of colorectal cancer: A systematic review and meta-analysis
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Blood CEA levels for detecting recurrent colorectal cancer
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Value of Dual Assessment of Carcinoembryonic Antigen and Fluorine-18-Fluoro-Deoxyglucose Positron Emission Tomography in Colorectal Cancer Recurrence
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Serum Carcinoembryonic Antigen for Recurrence in Colorectal Cancer Patients
Young Jin Kim
Annals of Coloproctology.2013; 29(4): 137. CrossRef

Mechanical Bowel Preparation and Prophylactic Antibiotic Administration in Colorectal Surgery: A Survey of the Current Status in Korea: Byung Mo Kang, Kil Yeon Lee, Sun Jin Park, Suk-Hwan Lee; Ann Coloproctol. 2013;29(4):160-166. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.160

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18 Citations

Abstract PDF

Purpose

The usefulness of mechanical bowel preparation (MBP) in colon surgery was recently challenged by many multicenter clinical trials and meta-analyses. The objectives of this study were to investigate current national opinions about MBP and prophylactic antibiotics (PA) and to provide preliminary data for developing future Korean guidelines for MBP and PA administration in colorectal surgery.

Methods

A questionnaire was mailed to 129 colorectal specialists. The questionnaires addressed the characteristics of the hospital, the MBP methods, and the uses of oral and intravenous antibiotics.

Results

A total of 73 questionnaires (56.6%) were returned. First, in regard to MBP methods, most surgeons (97.3%) used MBP for a mean of 1.36 days. Most surgeons (98.6%) implemented whole bowel irrigation and used polyethylene glycol (83.3%). Oral antibiotic use was indicated in over half (52.1%) of the responses, the average number of preoperative doses was three, and the mean time of administration was 24.2 hours prior to the operation. Finally, the majority of responders stated that they used intravenous antibiotics (95.9%). The responses demonstrated that second-generation cephalosporin-based regimens were most commonly prescribed, and 75% of the surgeons administered these regimens until three days after the operation.

Conclusion

The results indicate that most surgeons used MBP and intravenous antibiotics and that half of them administered oral PA in colorectal surgery preparations. The study recommends that the current Korean guidelines should be adapted to adequately reflect the medical status in Korea, to consider the medical environment of the various hospitals, and to establish more accurate and relevant guidelines.

Citations

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A meta‐analysis of the risk factors for surgical site infection in patients with colorectal cancer
Yani Chen, Hua Guo, Tian Gao, Jiale Yu, Yujia Wang, Haiquan Yu
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Preoperative mechanical bowel preparation using conventional versus hyperosmolar polyethylene glycol-electrolyte lavage solution before laparoscopic resection for colorectal cancer (TLUMP test): a phase III, multicenter randomized controlled non-inferiori
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The risk of surgical site infection of oral sulfate tablet versus sodium picosulfate for bowel preparation in colorectal cancer surgery: a randomized clinical trial
Sung Sil Park, Sung Chan Park, Dong-Eun Lee, Dong Woon Lee, Kiho Yu, Hyoung-Chul Park, Chang Won Hong, Dae Kyung Sohn, Kyung Su Han, Bun Kim, Byung Chang Kim, Jae Hwan Oh
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Ik Yong Kim
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Zhaohui Xu, Hui Qu, George Kanani, Zhong Guo, Yanying Ren, Xin Chen
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Case Reports

Colon Cancer After Acute Diverticulitis Treatment: Kwang Hoon Oh, Koon Hee Han, Eun Jung Kim, Je Hoon Lee, Kyu Un Choi, Myung Sik Han, Jae Hong Ahn, Gab Jin Cheon; Ann Coloproctol. 2013;29(4):167-171. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.167

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Abstract PDF

Diverticulitis is the most common clinical complication of diverticular disease, affecting 10-25% of the patients with diverticula. The prevalences of diverticulitis and colon cancer tend to increase with age and are higher in industrialized countries. Consequently, diverticulitis and colon cancer have been reported to have similar epidemiological characteristics. However, the relationship between these diseases remains controversial, as is the performance of routine colonoscopy after an episode of diverticulitis to exclude colon cancer. Recently, we experienced three cases of colon cancer after treating acute diverticulitis, based on which we suggest the importance of follow-up colonoscopy after acute diverticulitis.

Citations

Citations to this article as recorded by

Role of endoscopy after an acute episode of diverticulitis
Liliane C. Meireles, Samuel R. Fernandes, Luis C. Ribeiro, José Velosa
European Journal of Gastroenterology & Hepatology.2015; 27(12): 1429. CrossRef
Why perform colonoscopy following acute diverticulitis of the colon?
Antonio Tursi
Surgical Endoscopy.2014; 28(11): 3260. CrossRef
Diagnosis and Treatment of Colon Diverticulitis
Geom Seog Seo, Suck Chei Choi
Korean Journal of Medicine.2013; 85(6): 563. CrossRef

Chronic Pelvic Abscedation After Completion Proctectomy in a Rectal Stump Insufficiency; Treatment With Gracilis Muscle Flap Following Vacuum Assisted Closure Therapy: Fatma Ayca Gultekin, Bekir Hakan Bakkal, Sait Tayfun, Orhan Babuccu, Mustafa Comert; Ann Coloproctol. 2013;29(4):172-176. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.172

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40 Download
5 Citations

Abstract PDF

Presacral abscess formation due to rectal stump insufficiency following Hartmann procedure is very rare complication. If the abscess cavity is large, it might delay the reversal of the stoma and will probably result in a devastating future functioning of the neorectum. Moreover, very invasive treatments will be required in order to prevent severe septic complications. We present the case of a 58-year-old man with a past history of Hartmann procedure for a low rectal carcinoma who presented with rectal stump insufficiency and a large presacral abscess. Following extensive debridement and rectal stump resection, a vacuum-assisted closure (VAC) system was applied to the large abscess cavity to facilitate gracilis muscle flap reconstruction and to optimize wound healing. The satisfactory results showed in the present report led us to favor a combination of VAC therapy and a gracilis muscle flap in intrapelvic and perineal reconstruction in the case of large defects associated with high risks of septic complications.

Citations

Citations to this article as recorded by

Terapia combinada de irrigación-succión endoluminal para el manejo de absceso de muñón rectal. Reporte de caso
Ricardo Alberto Pulido-López, Nubia Andrea Ramírez-Buensuceso-Conde, Jorge Adrián Romero-Sánchez, Humberto Gustavo Martínez-Martínez, Carlos Armando Navarro-Castañeda, Erick César Ochoa-Contreras
Revista Mexicana de Cirugía Endoscópica.2023; 24(1-4): 38. CrossRef
Intra-muscular course of gracilis pedicle in reconstructive surgery – an important anatomic variant
Dimitrios Kanakopoulos, Mohamed A. Radhi, Omar Dawood, George Christopoulos, Tomas Tickunas, Christopher Macdonald, Andrew Mellington
JPRAS Open.2021; 29: 41. CrossRef
Endoluminal negative pressure therapy in colorectal anastomotic leaks
G. I. Popivanov, V. M. Mutafchiyski, R. Cirocchi, S. D. Chipeva, V. V. Vasilev, K. Ts. Kjossev, M. S. Tabakov
Colorectal Disease.2020; 22(3): 243. CrossRef
Staging resection and reconstruction with temporary wound VAC coverage in a case of giant cystosarcoma phyllodes of the breast
D.R. Heller, C. Rohde, P. Ananthakrishnan
International Journal of Surgery Case Reports.2015; 6: 84. CrossRef
Perineal Wound Healing After Abdominoperineal Resection for Rectal Cancer
Adam Bobkiewicz, Tomasz Banasiewicz, Lukasz Krokowicz, Jacek Paszkowski, Jacek Hermann, Stanislaw Malinger, Michal Drews
Diseases of the Colon & Rectum.2015; 58(2): e18. CrossRef

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