Annals of Coloproctology

Volume 37(3); June 2021

Editorial

Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer,Biomarker & risk factor

Carcinoembryonic Antigen, the Most Accessible Test for Predicting Colorectal Cancer Prognosis: Exploring Alternative Roles: Sanghee Kang; Ann Coloproctol. 2021;37(3):129-130. Published online June 30, 2021; DOI: https://doi.org/10.3393/ac.2021.00493.0070

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Mbugua Simon Ngigi
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Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
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Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
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Minsung Kim, Il Tae Son, Bo Young Oh
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Letter to the Editor

Benign GI diease,Benign diesease & IBD

Comments on “Acute Colonic Volvulus in a Mexican Population: A Case Series”: Sabri Selcuk Atamanalp; Ann Coloproctol. 2021;37(3):131-132. Published online April 21, 2021; DOI: https://doi.org/10.3393/ac.2020.05.12

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Review

Malignant disease, Rectal cancer,Colorectal cancer,Biomarker & risk factor

Multifunctional Indocyanine Green Applications for Fluorescence-Guided Laparoscopic Colorectal Surgery: Gyung Mo Son, Hong-min Ahn, In Young Lee, Gi Won Ha; Ann Coloproctol. 2021;37(3):133-140. Published online June 9, 2021; DOI: https://doi.org/10.3393/ac.2021.05.07

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Indocyanine green (ICG) could be applied for multiple functions such as fluorescent tumor localization, fluorescence lymph node mapping (FLNM), and intraoperative angiography in colorectal cancer surgery. With the near-infrared (NIR) systems, colonoscopic ICG tattooing can be used to define the early colorectal cancer that cannot be easily distinguished through the serosal surface. The lymphatic pathways can be visualized under the NIR system when ICG is injected through the submucosal or subserosal layer around the tumor. Intraoperative ICG angiography can be applied to find a favorable perfusion segment before the colon transection. Although all fluorescence functions are considered essential steps in image-guided surgery, it is difficult to perform multifunctional ICG applications in a single surgical procedure at once because complex protocols could interfere with each other. Therefore, we review the multifunctional ICG applications for fluorescent tumor localization, FLNM, and ICG angiography. We also discuss the optimal protocol for fluorescence-guided colorectal surgery.

Citations

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Factors Affecting the Efficiency of Near-Infrared Indocyanine Green (NIR/ICG) in Lymphatic Mapping for Colorectal Cancer: A Systematic Review
Irina Shevchenko, Dragos Serban, Ana Maria Dascalu, Laura Tribus, Catalin Alius, Bogdan Mihai Cristea, Andra Iulia Suceveanu, Daniel Voiculescu, Dan Dumitrescu, Florin Bobirca, Adrian Paul Suceveanu, Dragos Eugen Georgescu, Crenguta Sorina Serboiu
Cureus.2024;[Epub] CrossRef
Developments in the Use of Indocyanine Green (ICG) Fluorescence in Colorectal Surgery
Shayan Khalafi, Cristina Botero Fonnegra, Ana Reyes, Vanessa W. Hui
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Changle Li, Changyu Zhang, Wenkai Liu, Jia Liu, Wanying Ma, Chengyuan Lv, Zhuoran Xia, Yingchao Chen, Hua Gu, Wen Sun, Jianjun Du, Jiangli Fan, Xiaojun Peng
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Yu-Hsiang Lee, Cai-Sin Chen
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Alexander A. Gaidarski III, Marco Ferrara
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Kazuki Ueda, Hokuto Ushijima, Junichiro Kawamura
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Michael G. Fadel, Mosab Ahmed, Gianluca Pellino, Shahnawaz Rasheed, Paris Tekkis, David Nicol, Christos Kontovounisios, Erik Mayer
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Yu-Hsiang Lee, Uyen Nu Thu Pham
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Zhang-Yi Dai, Cheng Shen, Xing-Qi Mi, Qiang Pu
Frontiers in Surgery.2023;[Epub] CrossRef
Lymphatic Mapping in Colon Cancer Depending on Injection Time and Tracing Agent: A Systematic Review and Meta-Analysis of Prospective Designed Studies
Katharina Lucas, Nathaniel Melling, Anastasios D. Giannou, Matthias Reeh, Oliver Mann, Thilo Hackert, Jakob R. Izbicki, Daniel Perez, Julia K. Grass
Cancers.2023; 15(12): 3196. CrossRef
The Safe Values of Quantitative Perfusion Parameters of ICG Angiography Based on Tissue Oxygenation of Hyperspectral Imaging for Laparoscopic Colorectal Surgery: A Prospective Observational Study
Gyung Son, Armaan Nazir, Mi Yun, In Lee, Sun Im, Jae Kwak, Sang-Ho Park, Kwang-Ryul Baek, Ines Gockel
Biomedicines.2023; 11(7): 2029. CrossRef
Intraoperative fluorescence mapping of lymph nodes in colon cancer
Yu.A. Streltsov, M.A. Danilov, K.V. Shishin, A.V. Leontiev, A.B. Baychorov, V.V. Tsvirkun
Endoskopicheskaya khirurgiya.2023; 29(4): 5. CrossRef
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Zavier Yongxuan Lim, Swetha Mohan, Sunder Balasubramaniam, Saleem Ahmed, Caroline Ching Hsia Siew, Vishal G Shelat
World Journal of Gastrointestinal Surgery.2023; 15(9): 1841. CrossRef
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Gyung Mo Son, Mi Sook Yun, In Young Lee, Sun Bin Im, Kyung Hee Kim, Su Bum Park, Tae Un Kim, Dong-Hoon Shin, Armaan M. Nazir, Gi Won Ha
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Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
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Advancements and challenges in minimally invasive surgery training among general-surgery residents in Thailand
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How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han
The Ewha Medical Journal.2023;[Epub] CrossRef
Descenso en el valor de pulsioximetría tras administración intravenosa de verde de indocianina. Un artefacto no recogido en ficha técnica
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Revista Española de Anestesiología y Reanimación.2022; 69(9): 608. CrossRef
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Brij Madhok, Kushan Nanayakkara, Kamal Mahawar
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In Ja Park
The Ewha Medical Journal.2022; 45(1): 3. CrossRef
Near-infrared fluorescence imaging guided surgery in colorectal surgery
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Cristopher Varela, Manar Nassr, Azharuddin Razak, Nam Kyu Kim
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P. S. Russell, R. Velivolu, V. E. Maldonado Zimbrón, J. Hong, I. Kavianinia, A. J. R. Hickey, J. A. Windsor, A. R. J. Phillips
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Ahmed Refaat, May Lin Yap, Geoffrey Pietersz, Aidan Patrick Garing Walsh, Johannes Zeller, Blanca del Rosal, Xiaowei Wang, Karlheinz Peter
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Cureus.2022;[Epub] CrossRef
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Annals of Coloproctology.2021; 37(6): 434. CrossRef

Original Articles

Benign proctology,Surgical technique

Endorectal Advancement Flap With Muscular Plication in Anovaginal and Anterior Perineal Fistulas: Axel Egal, Isabelle Etienney, Patrick Atienza; Ann Coloproctol. 2021;37(3):141-145. Published online May 15, 2020; DOI: https://doi.org/10.3393/ac.2020.04.10.1

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Abstract PDF

Purpose
Endorectal mucosal advancement flap with muscular plication can ensure complete closure of anovaginal fistulas and preserve continence. The aim of this retrospective study was to show indications might be broadened to include anoperineal fistulas.
Methods
This retrospective study gathered all available data from patients with anovaginal or anterior perineal fistulas who underwent transanal advancement flap repair with muscular plication. A loose seton was passed in the fistula track prior to surgery in all patients. Fistula healing was defined as fistula closure during proctological examination associated with complete resolution of symptoms.
Results
Thirty-five patients were included from January 2011 to March 2017. Causes of fistula were various, mostly post-operative (34.3%, n = 12), obstetrical (17.1%, n = 6) and inflammatory (14.3%, n = 5). Success rate was 65.2%. Fistula healing was obtained in 60.0% of patients with Crohn disease in remission. Closure rate was higher in anterior perineal fistulas (89.0%) than in anovaginal fistulas (63.6%) even if it did not reach statistical significance. Slight fecal continence disorders were noted in 2 women (5.7%).
Conclusion
This study demonstrates the efficacy of transanal advancement flap repair with muscular plication for anovaginal and anterior perineal fistulas. Similar closure rates and smaller postoperative incontinence rates compared to the classical technique make this surgery an optimal solution whose efficacy appears to be sustainable over time.

Citations

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Rectovaginal Fistulas Not Involving the Rectovaginal Septum Should Be Treated Like Anal Fistulas: A New Concept and Proposal for a Reclassification of Rectovaginal Fistulas
Pankaj Garg, Laxmikant Ladukar, Vipul Yagnik, Kaushik Bhattacharya, Gurleen Kaur
Clinical and Experimental Gastroenterology.2024; Volume 17: 97. CrossRef
Initial Clinical Outcomes Using Umbilical Cord–Derived Tissue Grafts to Repair Anovaginal Fistula
Gala M. Godoy-Brewer, Oluwafemi P. Owodunni, Alyssa M. Parian, Leonardo C. Duraes, Florin M. Selaru, Susan L. Gearhart
Diseases of the Colon & Rectum.2023; 66(2): 299. CrossRef
Modern opportunities for treatment of patients with rectovaginal fistulas: literature review
P. N. Myshentsev, S. E. Katorkin, A. I. Kuzmina
Meditsinskiy sovet = Medical Council.2023; (13): 184. CrossRef
Is It a Refractory Disease?- Fecal Incontinence; beyond Medication
Chungyeop Lee, Jong Lyul Lee
The Ewha Medical Journal.2022;[Epub] CrossRef
A case report: Trans-Anal mucosal trapezoid flap for repair of Ano-vaginal fistula
Ratna Chopra, Yadav Pramod, Garg Ankit, Pandey Shruti
Indian Journal of Colo-Rectal Surgery.2020; 3(3): 71. CrossRef

Benign GI diease,Benign diesease & IBD,Complication

High Compliance With Surgical Site Infection (SSI) Prevention Bundle Reduces Incisional SSI After Colorectal Surgery: Varut Lohsiriwat; Ann Coloproctol. 2021;37(3):146-152. Published online May 15, 2020; DOI: https://doi.org/10.3393/ac.2020.04.10.2

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Abstract PDF

Purpose
This study aimed to evaluate association between compliance with surgical site infection (SSI) prevention bundle and the development of superficial or deep incisional SSI following colorectal surgery and to evaluate the impact of incisional SSI on surgical outcomes.
Methods
A prospectively collected database of consecutive patients undergoing elective colectomy and/or proctectomy from 2011 to 2019 in a university hospital was reviewed. The association between compliance with Thailand’s SSI Prevention Bundle (10 level-1A interventions) and the incidence of incisional SSI was determined. Surgical outcomes were compared between those with incisional SSI and those without.
Results
This study included 600 patients with a median age of 64 years (range, 18–102 years). Some 126 patients (21.0%) had stoma formation and 52 (8.7%) underwent laparoscopy. The incidence of incisional SSI was 5.5% (n = 33; 32 superficial incisional SSI and 1 deep incisional SSI). Higher compliance with care bundle tended to decrease incisional SSI (P = 0.20). In multivariate analysis, compliance of 70% or more was the only dependent factor for reducing incisional SSI (odds ratio, 0.39; 95% confidence interval, 0.15 to 0.99; P = 0.047). None of individual interventions were significantly associated with a lower probability of incisional SSI. Compared with counterparts, patients with incisional SSI had a 2-day longer length of postoperative stay (6 day vs. 4 day, P < 0.001) but comparable time for gastrointestinal recovery and similar rate of 30-day mortality or readmission.
Conclusion
High compliance with SSI prevention bundle (especially ≥ 70%) reduced incisional SSI after colorectal surgery.

Citations

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Surgical Site Infection Prevention Using “Strike Teams”: The Experience of an Academic Colorectal Surgical Department
Buddhi Hatharaliyadda, Michelle Schmitz, Anne Mork, Fauzia Osman, Charles Heise, Nasia Safdar, Aurora Pop-Vicas
Journal for Healthcare Quality.2024; 46(1): 22. CrossRef
Interventions to reduce surgical site infection following elective colorectal surgery: protocol for a systematic review with narrative synthesis and GRADE recommendations
Harry Dean, Ioanna Drami, Amira Shamsiddinova, Eman Alkizwini, James Kinross, Ana Wilson, Phil Tozer, Carolynne Vaizey
Journal of Surgical Protocols and Research Methodologies.2024;[Epub] CrossRef
Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and the Society of American Gastrointestinal and Endoscopic Surgeons
Jennifer L. Irani, Traci L. Hedrick, Timothy E. Miller, Lawrence Lee, Emily Steinhagen, Benjamin D. Shogan, Joel E. Goldberg, Daniel L. Feingold, Amy L. Lightner, Ian M. Paquette
Diseases of the Colon & Rectum.2023; 66(1): 15. CrossRef
Clinical practice guidelines for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons and the Society of American Gastrointestinal and Endoscopic Surgeons
Jennifer L. Irani, Traci L. Hedrick, Timothy E. Miller, Lawrence Lee, Emily Steinhagen, Benjamin D. Shogan, Joel E. Goldberg, Daniel L. Feingold, Amy L. Lightner, Ian M. Paquette
Surgical Endoscopy.2023; 37(1): 5. CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Strategies to Reduce Post-Hemorrhoidectomy Pain: A Systematic Review
Varut Lohsiriwat, Romyen Jitmungngan
Medicina.2022; 58(3): 418. CrossRef
Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] CrossRef

Benign proctology,Surgical technique

Two-Stage Complete Deroofing Fistulotomy Approach for Horseshoe Fistula: Successful Surgery Leaving Continence Intact: Asami Usui, Gentaro Ishiyama, Akihiko Nishio, Maiko Kawamura, Yukiko Kono, Yuji Ishiyama; Ann Coloproctol. 2021;37(3):153-158. Published online January 12, 2021; DOI: https://doi.org/10.3393/ac.2020.06.08

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Abstract PDF

Purpose
Surgery of the horseshoe fistula is challenging due to its complex configuration and sphincter muscle involvement. Complete deroofing fistulotomy for horseshoe fistula is highly curative with the eradication of all fistulous lesions but has been discredited for its high incontinence rate. It was replaced with the more conservative Hanley’s procedure leaving the lateral tracts intact, despite its issue of recurrence. Our study aimed to report the outcomes of a procedure dividing complete deroofing fistulotomy for horseshoe fistula into 2 stages to avoid impairment of sphincter function.
Methods
We retrospectively reviewed 139 patients who underwent surgery for horseshoe fistula using the 2-stage complete deroofing fistulotomy method between 2014 and 2017. The first surgery deroofed the lateral tracts with an arch-like incision severing the anococcygeal ligament. The primary lesion was also drained and curetted. A seton was placed in the primary tract which was laid open in the second surgery after the lateral wound had partially healed.
Results
Recurrence was observed in 12 patients. All were superficial recurrences except for 1, in which recurrence was confirmed in the primary lesion. Those with blind intersphincteric upward extensions had a significantly higher recurrence rate. Furthermore, patients who resided far from the hospital and could not make visits for frequent wound inspections also had a significantly higher recurrence rate. No patient had any continence issues at the end of the follow-up period.
Conclusion
Managing horseshoe fistula with the 2-stage deroofing fistulotomy approach allows for eradication of the fistula tract without compromising anal sphincter function.

Citations

Citations to this article as recorded by

Clinical efficacy of the bared external anal sphincter (BEAS) in high horseshoe-shaped anal fistulas: Protocol for a real-world, prospective cohort study
Qianqian Ye, Ye Han, Peixin Du, Min Yang, De Zheng, Zubing Mei, Qingming Wang
Heliyon.2024; 10(15): e35024. CrossRef
Evaluating the efficacy of multi-incision and tube-dragging therapy combined with laser closure for high horseshoe-shaped anal fistula: Protocol of a prospective, randomized, controlled trial
Min Yang, Zubing Mei, Qingming Wang, Ye Han, De Zheng, James Mockridge
PLOS ONE.2024; 19(9): e0307653. CrossRef
A systematic review of translation and experimental studies on internal anal sphincter for fecal incontinence
Minsung Kim, Bo-Young Oh, Ji-Seon Lee, Dogeon Yoon, Wook Chun, Il Tae Son
Annals of Coloproctology.2022; 38(3): 183. CrossRef

Malignant disease, Rectal cancer,Colorectal cancer,Biomarker & risk factor

Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Obstructing Colorectal Cancer Treated by Endoscopic Stenting as a Bridge to Surgery: Jiwei Guo, Aik Yong Chok, Hui Jun Lim, Wei Xuan Tay, Weng Kit Lye, Lasitha Bhagya Samarakoon, Emile John Tan, Ronnie Mathew; Ann Coloproctol. 2021;37(3):159-165. Published online May 28, 2021; DOI: https://doi.org/10.3393/ac.2020.05.25

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Abstract PDF Supplementary Material

Purpose
Neutrophil-to-lymphocyte ratio (NLR) has been reported to predict adverse survival outcomes among patients with colorectal cancer (CRC). This study evaluates the prognostic value of NLR among patients with obstructing CRC who successfully underwent stenting before curative surgery.
Methods
We retrospectively reviewed patients who underwent stenting before surgery. Patient demographics, tumor characteristics, perioperative outcomes, recurrence-free survival (RFS), and overall survival (OS) were analyzed. NLR was calculated from the differential white blood cell counts at least 4 days after successful stenting, before elective surgery. Optimal cutoff to dichotomize NLR was obtained by maximizing log-rank test statistic with recursive partitioning of KaplanMeier RFS and OS curves. The optimal cutoff for high NLR was ≥ 5 at presentation before stenting, and ≥ 4 after stenting.
Results
Fifty-seven patients with localized obstructing CRC underwent successful endoscopic stenting before curative surgery. High NLR was associated with lymphovascular invasion (P = 0.006) and apical lymph node involvement (P = 0.034). Major perioperative complication(s) (hazard ratio [HR], 11.34; 95% confidence interval [CI], 2.49 to 51.56; P < 0.01) and high NLR (HR, 3.69; 95% CI, 1.46 to 9.35; P < 0.01) negatively impacted OS on univariate and multivariate analyses. High NLR negatively impacted RFS on univariate analysis (HR, 2.91; 95% CI, 1.29 to 6.60; P = 0.01).
Conclusion
NLR of ≥ 4 after stenting is an independent prognostic factor among patients with obstructing localized CRC who are successfully decompressed by endoscopic stenting before curative surgery.

Citations

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Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef
Inflammatory Response Markers as Predictors of Colorectal Cancer Prognosis
Minsung Kim, Il Tae Son, Bo Young Oh
The Ewha Medical Journal.2023;[Epub] CrossRef
Pretreatment inflammatory markers predicting treatment outcomes in colorectal cancer
Sanghyun An, Hongjin Shim, Kwangmin Kim, Bora Kim, Hui-Jae Bang, Hyejin Do, Hyang-Rae Lee, Youngwan Kim
Annals of Coloproctology.2022; 38(2): 97. CrossRef

Malignant disease,Colorectal cancer,Surgical technique

Comparison of Short-term Results after Laparoscopic Complete Mesocolic Excision and Standard Colectomy for Right-Sided Colon Cancer: Analysis of a Western Center Cohort: Cristian Conti, Corrado Pedrazzani, Giulia Turri, Eduardo Fernandes, Enrico Lazzarini, Raffaele De Luca, Alessandro Valdegamberi, Andrea Ruzzenente, Alfredo Guglielmi; Ann Coloproctol. 2021;37(3):166-173. Published online April 22, 2021; DOI: https://doi.org/10.3393/ac.2020.05.18

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Abstract PDF

Purpose
Laparoscopic complete mesocolic excision (CME) right colectomy is a technically demanding procedure infrequently employed in Western centers. This retrospective cohort study aims to analyze the safety of laparoscopic CME colectomy compared to standard colectomy for right-sided colon cancer in a Western series.
Methods
Prospectively collected data from 60 patients who underwent laparoscopic CME right colectomy were compared to the ones of 55 patients who underwent laparoscopic standard right colectomy.
Results
No differences in clinical characteristics were observed between the CME and standard right colectomy groups. No differences were demonstrated in terms of blood loss (P = 0.060), intraoperative complications (P = 1), conversion rate (P = 0.102), and operative time (P = 0.473). No deaths were observed in either group, while complication rate was 40.0% in the CME and 49.1% in the standard group (P = 0.353). Severe complications occurred in 10.0% vs. 9.1% (P = 0.842), redo surgery in 5.0% vs. 7.3% (P = 0.708), and unplanned readmission in 5.0% vs. 5.5% (P = 1) after CME and standard colectomy, respectively. A significant difference in favor of CME was observed in the total length of specimen (P < 0.001), proximal (P = 0.018), and distal margins (P = 0.037). The number of lymph nodes harvested was significantly higher in the CME group (27 vs. 22, P = 0.037).
Conclusion
In Western series, where patients have less favorable clinical characteristics, laparoscopic CME allows to obtain better quality surgical specimens and comparable short-term outcomes compared to standard right colectomy.

Citations

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Retrocaecal, supracolic and medial dissection (the RESUME approach) as an optimal surgical procedure for right‐sided colon cancer—A Video Vignette
Hong‐min Ahn, Min Hyeong Jo, Mi Jeong Choi, Heung‐Kwon Oh, Duck‐Woo Kim, Sung‐Bum Kang
Colorectal Disease.2024; 26(7): 1480. CrossRef
Complete mesocolic excision (CME) impacts survival only for Stage III right-sided colon cancer: a systematic review and meta-analysis
Kengo Hayashi, Roberto Passera, Chiara Meroni, Rebecca Dallorto, Chiara Marafante, Carlo Alberto Ammirati, Alberto Arezzo
Minimally Invasive Therapy & Allied Technologies.2024; : 1. CrossRef
Robot-assisted versus laparoscopic short- and long-term outcomes in complete mesocolic excision for right-sided colonic cancer: a systematic review and meta-analysis
Pedja Cuk, Mohamad Jawhara, Issam Al-Najami, Per Helligsø, Andreas Kristian Pedersen, Mark Bremholm Ellebæk
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Nadir Adnan Hacım, Ahmet Akbaş, Yigit Ulgen, Talar Vartanoglu Aktokmakyan, Serhat Meric, Merve Tokocin, Onder Karabay, Yuksel Altinel
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Marlou F. M. Sterk, Rogier M. P. H. Crolla, Mareille Verseveld, Jan Willem T. Dekker, George P. van der Schelling, Cornelis Verhoef, Pim B. Olthof
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Ji-Hyun Seo, In-Ja Park
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In Ja Park
Journal of the Korean Medical Association.2022; 65(9): 540. CrossRef
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Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Korean Medical Association.2022; 65(9): 558. CrossRef
Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
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Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] CrossRef

Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer

Feasibility and Outcomes of Multivisceral Resection in Locally Advanced Colorectal Cancer: Experience of a Tertiary Cancer Center in North-East India: Joydeep Purkayastha, Pritesh Rajeev Singh, Abhijit Talukdar, Gaurav Das, Jitin Yadav, Srinivas Bannoth; Ann Coloproctol. 2021;37(3):174-178. Published online July 3, 2020; DOI: https://doi.org/10.3393/ac.2020.06.03

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5 Citations

Abstract PDF

Purpose
Locally advanced colorectal cancer may require an en bloc resection of surrounding organs or structures to achieve complete tumor removal. This decision must weigh the risk of complications of multivisceral resection against the potential survival benefit. The purpose of this study is to review a single-center experience of feasibility of en bloc multivisceral resections for locally advanced colorectal carcinoma and to examine the effect of surgical experience on immediate outcome and rate of R0 resections.
Methods
This is a study of 27 patients who underwent multivisceral resection for locally advanced colorectal carcinoma which was performed at our institute from January 2016 to December 2019. Among the 27 patients aged between 21 and 76 years (mean age, 48.67±7.3 years), 13 were males and 14 were females. Overall 18 patients had primary colon carcinoma and 9 had primary rectal carcinoma. All rectal cancer patients received neoadjuvant chemoradiation. All patients underwent surgery with curative intent. All patients underwent open surgery of which 66.7% underwent colectomy, 14.8% underwent anterior resection, 11.1% underwent Miles procedure, and 7.4% underwent pelvic exenteration.
Results
The mean operative time was 268.14±72.2 minutes and the median amount of blood units transfused was 2.07 units. The mean hospital stay was 13.67±3.4 days. Histologically, 44.4% of patients had well-differentiated adenocarcinoma and 55.6% had moderately differentiated adenocarcinoma. The final histopathological examinatio n revealed malignant infiltration of the adjacent organs in 19/27 patients (70.4%). Pathological complete response was seen in 2 patients. R0 resection rate achieved was 96.3%. Lymph node metastasis was seen in 66.7% of patients with colon cancer and 11.1% with rectal cancer with overall mean number of harvested lymph nodes being 12.44±3.01. Postoperative complications were identified in 7 patients (25.9%), while mortality was seen in 2 (7.4%).
Conclusion
Multivisceral resection for advanced colorectal cancer invading into the adjacent organ may be performed with acceptable morbidity and mortality.

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Comparison of short- and long-term outcomes between laparoscopic and open multivisceral resection for clinical T4b colorectal cancer: A multicentre retrospective cohort study in China
Jinzhu Zhang, Jinfeng Sun, Junguang Liu, Shiwen Mei, Jichuan Quan, Gang Hu, Bo Li, Meng Zhuang, Xishan Wang, Jianqiang Tang
European Journal of Surgical Oncology.2024; 50(1): 107316. CrossRef
Analysis of Patient Outcomes following Curative R0 Multiorgan Resections for Locally Advanced Gastric Cancer: A Systematic Review and Meta-Analysis
Viorel Dejeu, Paula Dejeu, Anita Muresan, Paula Bradea, Danut Dejeu
Journal of Clinical Medicine.2024; 13(10): 3010. CrossRef
Prognostic stratification of patients with pT4bN0M0 colorectal cancer following multivisceral resection: a multi-institutional case series analysis
Jichuan Quan, Kai Zuo, Guoli Li, Junguang Liu, Shiwen Mei, Gang Hu, Wenlong Qiu, Meng Zhuang, Ling Meng, Xishan Wang, Hu Chang, Jianqiang Tang
International Journal of Surgery.2024; 110(9): 5323. CrossRef
Advances in the Treatment of Colorectal Cancer with Peritoneal Metastases: A Focus on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Youngbae Jeon, Eun Jung Park
The Ewha Medical Journal.2023;[Epub] CrossRef
Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and Current Management
Seung Mi Yeo, Gyung Mo Son
The Ewha Medical Journal.2022;[Epub] CrossRef

Malignant disease,Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer

Prognostic Impact of Carcinoembryonic Antigen Levels in Rectal Cancer Patients Who Had Received Neoadjuvant Chemoradiotherapy: Jung Il Joo, Sang Woo Lim, Bo Young Oh; Ann Coloproctol. 2021;37(3):179-185. Published online May 11, 2021; DOI: https://doi.org/10.3393/ac.2020.11.27

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Abstract PDF Supplementary Material

Purpose
Carcinoembryonic antigen (CEA) is a useful marker for rectal cancer. The aim of this study was to investigate the prognostic impact of CEA level according to neoadjuvant chemoradiotherapy (nCRT) in rectal cancer patients who underwent radical surgery.
Methods
A total of 245 patients with rectal cancer who underwent radical surgery were retrospectively evaluated. Serum CEA level was measured preoperatively and postoperatively. We compared survival outcomes based on CEA level before and after surgery according to nCRT.
Results
Of the 245 patients, elevation of CEA level was observed preoperatively in 79 and postoperatively in 30, respectively. Eighty-seven (35.5%) patients received nCRT, and elevated CEA level was a significant prognostic factor both before and after surgery. In patients who had not received nCRT, an elevated CEA level was a significant prognostic factor before surgery but was not significant after surgery. In a multivariate analysis for prognostic factors, elevation of preoperative CEA level was an independent prognostic factor of disease-free survival (DFS) regardless of nCRT. Postoperative CEA level was an independent prognostic factor of DFS in patients who had received nCRT but was not a factor in patients who had not received nCRT.
Conclusion
Serum CEA level was an independent prognostic factor both preoperatively and postoperatively in rectal cancer patients who had received nCRT.

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Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef
Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
Annals of Surgical Treatment and Research.2023; 105(6): 341. CrossRef
Inflammatory Response Markers as Predictors of Colorectal Cancer Prognosis
Minsung Kim, Il Tae Son, Bo Young Oh
The Ewha Medical Journal.2023;[Epub] CrossRef
Prognostic Impact of An Integrative Landscape of Clinical, Immune, and Molecular Features in Non-Metastatic Rectal Cancer
Soledad Iseas, Juan M. Sendoya, Juan Robbio, Mariana Coraglio, Mirta Kujaruk, Vanesa Mikolaitis, Mariana Rizzolo, Ana Cabanne, Gonzalo Ruiz, Rubén Salanova, Ubaldo Gualdrini, Guillermo Méndez, Marina Antelo, Marcela Carballido, Cecilia Rotondaro, Julieta
Frontiers in Oncology.2022;[Epub] CrossRef
Carcinoembryonic Antigen, the Most Accessible Test for Predicting Colorectal Cancer Prognosis: Exploring Alternative Roles
Sanghee Kang
Annals of Coloproctology.2021; 37(3): 129. CrossRef

Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer,Epidemiology & etiology

Characteristics of Patients Presented With Metastases During or After Completion of Chemoradiation Therapy for Locally Advanced Rectal Cancer: A Case Series: Radwan Torky, Mohammed Alessa, Ho Seung Kim, Ahmed Sakr, Eman Zakarneh, Fozan Sauri, Heejin Bae, Nam Kyu Kim; Ann Coloproctol. 2021;37(3):186-191. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.08.10.1

2,980 View
96 Download
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4 Citations

Abstract PDF

Purpose
Locally advanced rectal cancer (LARC) is managed by chemoradiotherapy (CRT), followed by surgery. Herein we reported patients with metastases during or after CRT.
Methods
Data of patients with LARC who received CRT from 2008 to 2017 were reviewed. Patients with metastases after CRT were included. Those with metastatic tumors at the initial diagnosis were excluded.
Results
Fourteen patients (1.3%) of 1,092 who received CRT presented with metastases. Magnetic resonance circumferential resection margin (mrCRM) and mesorectal lymph nodes (LNs) were positive in 12 patients (85.7%). Meanwhile, magnetic resonance extramural vascular invasion (mrEMVI) was positive in 10 patients (71.4%). Magnetic resonance tumor regression grade (mrTRG) 4 and mrTRG5 was detected in 5 and 1 patient respectively. Ten patients (71.4%) underwent combined surgery and 3 (21.4%) received palliative chemotherapy.
Conclusion
Patients with metastases after CRT showed a higher rate of positive mrCRM, mrEMVI, mesorectal LNs, and poor tumor response. Further studies with a large number of patients are necessary for better survival outcomes in LARC.

Citations

Citations to this article as recorded by

Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
Annals of Surgical Treatment and Research.2023; 105(6): 341. CrossRef
Advances in the Treatment of Colorectal Cancer with Peritoneal Metastases: A Focus on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Youngbae Jeon, Eun Jung Park
The Ewha Medical Journal.2023;[Epub] CrossRef
Recent Advance in the Surgical Treatment of Metastatic Colorectal Cancer-An English Version
Eun Jung Park, Seung Hyuk Baik
Journal of the Anus, Rectum and Colon.2022; 6(4): 213. CrossRef
Update on Diagnosis and Treatment of Colorectal Cancer
Chan Wook Kim
The Ewha Medical Journal.2022;[Epub] CrossRef

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