Annals of Coloproctology

Volume 38(5); October 2022

Editorial

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

Can the cross-sectional area of the psoas muscle be a predictor of anastomotic failure in male rectal cancer patients?: Myong Hoon Ihn; Ann Coloproctol. 2022;38(5):333-334. Published online October 28, 2022; DOI: https://doi.org/10.3393/ac.2022.00794.0113

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Citations to this article as recorded by

Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Unraveling the role of computed tomography derived body composition metrics on anastomotic leakages rates in rectal cancer surgery: A protocol for a systematic review and meta-analysis
Mark Broekman, Charlotte M. S. Genders, Ritchie T. J. Geitenbeek, Klaas Havenga, Schelto Kruijff, Joost M. Klaase, Alain R. Viddeleer, Esther C. J. Consten, Ozlem Boybeyi-Turer
PLOS ONE.2024; 19(7): e0307606. CrossRef

Review

Benign diesease & IBD,Rare disease & stoma

Prolapse of intestinal stoma: Kotaro Maeda; Ann Coloproctol. 2022;38(5):335-342. Published online October 28, 2022; DOI: https://doi.org/10.3393/ac.2022.00465.0066

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Abstract PDF

Stoma prolapse can usually be managed conservatively by stoma care nurses. However, surgical management is considered when complications make traditional care difficult and/or stoma prolapse affects normal bowel function and induces incarceration. If the stoma functions as a fecal diversion, the prolapse is resolved by stoma reversal. Loop stoma prolapse reportedly occurs when increased intraabdominal pressure induces stoma prolapse by pushing the stoma up between the abdominal wall and the intestine, particularly in cases of redundant or mobile colon. Therefore, stoma prolapse repair aims to prevent or eliminate the space between the abdominal wall and the intestine, as well as the redundant or mobile intestine. Accordingly, surgical repair methods for stoma prolapse are classified into 3 types: methods to fix the intestine, methods to shorten the intestine, and methods to eliminate the space between the stoma and the abdominal wall around the stoma orifice. Additionally, the following surgical techniques at the time of stoma creation are reported to be effective in preventing stoma prolapse: an avoidance of excessive fascia incision, fixation of the stoma to the abdominal wall, an appropriate selection of the intestinal site for the stoma orifice to minimize the redundant intestine, and the use of an extraperitoneal route for stoma creation.

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Management of the Difficult Stoma
Clay Merritt, Paola Maldonado
Surgical Clinics of North America.2024; 104(3): 579. CrossRef
Ileostomy: Early and Late Complications
Francisco Duarte Cerqueira Gomes Girão Santos, Laura Elisabete Ribeiro Barbosa, João Paulo Meireles de Araújo Teixeira
Journal of Coloproctology.2024; 44(01): e80. CrossRef
Risk factors for stoma prolapse after laparoscopic loop colostomy
Yusuke Takashima, Hitoshi Hino, Akio Shiomi, Hiroyasu Kagawa, Shoichi Manabe, Yusuke Yamaoka, Chikara Maeda, Shunsuke Kasai, Yusuke Tanaka
Surgical Endoscopy.2024; 38(5): 2834. CrossRef
Linear stapler refashioning technique for irreducible stomal prolapse—A video vignette
Rajesh S. Shinde, Deep Mashru, Murali V
Colorectal Disease.2024; 26(7): 1483. CrossRef
Stomal Prolapse Due to Sidedness of Transverse Loop Colostomy: A Retrospective Cohort Study
Takuya Yano, Masanori Yoshimitsu, Chiyomi Ishibashi, Atsuko Nishibara, Kanyu Nakano, Hitoshi Idani, Masazumi Okajima
Journal of the Anus, Rectum and Colon.2023; 7(4): 258. CrossRef
Stoma Complications
Aaron J. Dawes, John V. Gahagan
Clinics in Colon and Rectal Surgery.2023;[Epub] CrossRef
Intestinal Stomas—Current Practice and Challenges: An Institutional Review
Isam Mazin Juma, Tabarak Qassim, Mirza Faraz Saeed, Aya Qassim, Sana Al-Rawi, Sabrina Al-Salmi, Mustafa Thaer Salman, Ibrahim Al-Saadi, Abdulaziz Almutawea, Eman Aljahmi, Mohamed Khalid Fadhul
Euroasian journal of hepato-gastroenterology.2023; 13(2): 115. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef

Original Articles

Malignant disease,Epidemiology & etiology

Colorectal cancer mortality trends in the era of cancer survivorship in Korea: 2000–2020: Min Hyun Kim, Sanghee Park, Nari Yi, Bobae Kang, In Ja Park; Ann Coloproctol. 2022;38(5):343-352. Published online October 28, 2022; DOI: https://doi.org/10.3393/ac.2022.00535.0076

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Graphical Abstract Abstract PDF Supplementary Material

Purpose
Korea has implemented an early screening for colorectal cancer since 2004. However, it is not known whether this has translated into improved survival over the years.
Methods
We acquired colorectal cancer mortality data from the Cause of Death Statistics in Korea from 2000 to 2020. We characterized the data into year of death, cancer-specific loci, and age group. We analyzed age-standardized mortality rates (ASMR) according to year of death, age group, and primary location to find trends in colorectal cancer mortality over a 20-year period.
Results
The crude mortality rate of colorectal cancer increased from 8.78 per 100,000 in 2000 to 17.27 per 100,000 in 2020. The second decade was slower in increments compared to the first decade. ASMR showed a decrease over the second decade after an initial increase in the first decade. The decrease was primarily from the lowering of ASMR for rectosigmoid cancers. Age group analysis showed a lowering of ASMR mainly in the 45–59-year, 60–74-year, and ≥ 75-year age groups; however, 0–29-year and 30–44-year age groups showed generally unchanged ASMR over the total period.
Conclusion
After a brief incline of age-specific mortality of colorectal cancers during the early 2000s, colorectal cancer mortality has gradually been decreasing in the past decade. This was mainly due to decreased mortalities in rectosigmoid colon cancers especially in the age groups that were the target of early screening.

Citations

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Performance reporting design in artificial intelligence studies using image-based TNM staging and prognostic parameters in rectal cancer: a systematic review
Minsung Kim, Taeyong Park, Bo Young Oh, Min Jeong Kim, Bum-Joo Cho, Il Tae Son
Annals of Coloproctology.2024; 40(1): 13. CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
In-Hospital Mortality and Associated Factors among Colorectal Cancer Patients in Germany
Karel Kostev, Sarah Krieg, Andreas Krieg, Tom Luedde, Sven H. Loosen, Christoph Roderburg
Cancers.2024; 16(6): 1219. CrossRef
Clinical implication of tissue carcinoembryonic antigen expression in association with serum carcinoembryonic antigen in colorectal cancer
Abdulmohsin Fawzi Aldilaijan, Young Il Kim, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Jihun Kim, Jun-Soo Ro, Jin Cheon Kim
Scientific Reports.2023;[Epub] CrossRef
Development and validation of nomogram models to predict radiotherapy or chemotherapy benefit in stage III/IV gastric adenocarcinoma with surgery
Xiangqing Ren, Tian Huang, Xiaolong Tang, Qian Ma, Ya Zheng, Zenan Hu, Yuping Wang, Yongning Zhou
Frontiers in Oncology.2023;[Epub] CrossRef
Prognostic prediction of colorectal cancer using the C-reactive protein to albumin ratio: the importance of inflammatory biomarkers and their association with long-term outcomes
Chul Seung Lee
Annals of Coloproctology.2023; 39(4): 287. 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
National cancer screening program for colorectal cancer in Korea
Seung Min Baik, Ryung-Ah Lee
Annals of Surgical Treatment and Research.2023; 105(6): 333. CrossRef
Recurrence Patterns and Risk Factors after Curative Resection for Colorectal Cancer: Insights for Postoperative Surveillance Strategies
Hyo Seon Ryu, Jin Kim, Ye Ryung Park, Eun Hae Cho, Jeong Min Choo, Ji-Seon Kim, Se-Jin Baek, Jung-Myun Kwak
Cancers.2023; 15(24): 5791. CrossRef
Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer
In Ja Park
The Ewha Medical Journal.2023;[Epub] CrossRef
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han
The Ewha Medical Journal.2023;[Epub] 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
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef

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

Cross-sectional area of psoas muscle as a predictive marker of anastomotic failure in male rectal cancer patients: Japanese single institutional retrospective observational study: Yusuke Mizuuchi, Yoshitaka Tanabe, Masafumi Sada, Koji Tamura, Kinuko Nagayoshi, Shuntaro Nagai, Yusuke Watanabe, Sadafumi Tamiya, Kohei Nakata, Kenoki Ohuchida, Toru Nakano, Masafumi Nakamura; Ann Coloproctol. 2022;38(5):353-361. Published online April 12, 2022; DOI: https://doi.org/10.3393/ac.2022.00122.0017

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Graphical Abstract Abstract PDF Supplementary Material

Purpose
Preoperative sarcopenia worsens postoperative outcomes in various cancer types including colorectal cancer. However, we often experienced postoperative anastomotic leakage in muscular male patients such as Judo players, especially in rectal cancer surgery with lower anastomosis. It is controversial whether the whole skeletal muscle mass impacts the potential for anastomotic failure in male rectal cancer patients. Thus, the purpose of this study was to clarify whether skeletal muscle mass impacts anastomotic leakage in rectal cancer in men.
Methods
We reviewed the medical charts of male patients suffering from rectal cancer who underwent colo-procto anastomosis below the peritoneal reflection without a protective diverting stoma. We measured the psoas muscle area and calculated the psoas muscle index.
Results
One hundred ninety-seven male rectal cancer patients were enrolled in this study. The psoas muscle index was significantly higher in patients with anastomotic leakage (P<0.001). Receiver operating characteristic curve determined the optimal cut-off value of the psoas muscle index for predicting anastomotic leakage as 812.67 cm²/m² (sensitivity of 60% and specificity of 74.3%). Multivariate analysis revealed that high psoas muscle index (risk ratio [RR], 3.933; P<0.001; 95% confidence interval [CI], 1.917–8.070) and super low anastomosis (RR, 2.792; P=0.015; 95% CI, 1.221–6.384) were independent predictive factors of anastomotic leakage.
Conclusion
This study showed that male rectal cancer patients with a large psoas muscle mass who underwent lower anastomosis had a higher rate of postoperative anastomotic leakage.

Citations

Citations to this article as recorded by

Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Unraveling the role of computed tomography derived body composition metrics on anastomotic leakages rates in rectal cancer surgery: A protocol for a systematic review and meta-analysis
Mark Broekman, Charlotte M. S. Genders, Ritchie T. J. Geitenbeek, Klaas Havenga, Schelto Kruijff, Joost M. Klaase, Alain R. Viddeleer, Esther C. J. Consten, Ozlem Boybeyi-Turer
PLOS ONE.2024; 19(7): e0307606. CrossRef
Association of computed tomography‐derived body composition and complications after colorectal cancer surgery: A systematic review and meta‐analysis
Claire P.M. van Helsdingen, Job G.A. van Wijlick, Ralph de Vries, Nicole D. Bouvy, Mariska M.G. Leeflang, Robert Hemke, Joep P.M. Derikx
Journal of Cachexia, Sarcopenia and Muscle.2024;[Epub] CrossRef
Prognostic Value of Artificial Intelligence-Driven, Computed Tomography-Based, Volumetric Assessment of the Volume and Density of Muscle in Patients With Colon Cancer
Minsung Kim, Sang Min Lee, Il Tae Son, Taeyong Park, Bo Young Oh
Korean Journal of Radiology.2023; 24(9): 849. CrossRef
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
Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef
Can the cross-sectional area of the psoas muscle be a predictor of anastomotic failure in male rectal cancer patients?
Myong Hoon Ihn
Annals of Coloproctology.2022; 38(5): 333. CrossRef
Psoas Muscle Index – Could It Be an Indicator of Postoperative Complications in Colorectal Cancer? Case Presentation and Review of the Literature
Georgiana Alexandra Scurtu, Zsolt Zoltán Fülöp, Botond Kiss, Patricia Simu, Diana Burlacu, Tivadar Bara
Journal of Interdisciplinary Medicine.2022; 7(4): 100. CrossRef

Malignant disease,Colorectal cancer,Epidemiology & etiology

Clinicopathologic characteristics of early-onset colorectal cancer: Kui Seon Park, Young Ki Hong, Yoon Jung Choi, Jung Gu Kang; Ann Coloproctol. 2022;38(5):362-369. Published online March 11, 2022; DOI: https://doi.org/10.3393/ac.2021.00976.0139

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Abstract PDF

Purpose
The aim of this study was to analysis of the clinicopathological characteristics and prognosis of colorectal cancer (CRC) under the age of 50 years.
Methods
Between January 2009 and December 2018, 1,126 primary CRC patients were included from National Health Insurance Service Ilsan Hospital. The patients were divided into group 1 (n=111, ≤50 years) and group 2 (n=1,015, >50 years). The clinicopathologic features and prognostic outcomes were compared. In addition, to analyze whether there were any differences of those characteristics in 3 groups, patients aged under 50 years were divided into their 20s, 30s, and 40s.
Results
Group 1 had a slightly higher distribution in the left colon and rectum, lower T stage I and higher T stage IV rate, and a significantly higher distribution in stage N2 than group 2 (30.6%:16.3%, P<0.001). Poor histological differentiation of tumors was significantly high in group 1 (P=0.003). The 5-year survival rate for those in their 30s (69.2%) and 40s (91.6%) was higher than those in their 20s who died immediately after surgery (P<0.001). The 5-year disease-free survival rate was also confirmed to be meaningful for each age group, with 0% in their 20s, 53.8% in their 30s, 79.2% in their 40s (P<0.001).
Conclusion
Although the age was not an independent prognostic factor for overall survival in this study, the early onset group of CRCs is more advanced at the time of diagnosis and has a more aggressive histologic type.

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Multiethnic Trends in Early Onset Colorectal Cancer
Michelle Nagata, Kohei Miyagi, Brenda Y. Hernandez, Scott K. Kuwada
Cancers.2024; 16(2): 398. CrossRef
Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus R0 resection for resectable colorectal cancer with peritoneal metastases and low peritoneal cancer index scores: a collaborative observational study from Korea and Japan
Daichi Kitaguchi, Eun Jung Park, Seung Hyuk Baik, Shoma Sasaki, Yuichiro Tsukada, Masaaki Ito
International Journal of Surgery.2024; 110(1): 45. CrossRef
Surgical and survival outcomes of early‐onset colorectal cancer patients: a single‐centre descriptive Australian study
Celine Garrett, Daniel Steffens, Michael Solomon, Cherry Koh
ANZ Journal of Surgery.2024; 94(9): 1584. CrossRef
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Pojsakorn Danpanichkul, Thanida Auttapracha, Siwanart Kongarin, Ben Ponvilawan, Daniel M. Simadibrata, Kwanjit Duangsonk, Supitchaya Jaruvattanadilok, Sakditad Saowapa, Kanokphong Suparan, Rashid N. Lui, Suthat Liangpunsakul, Michael B. Wallace, Karn Wija
Journal of Gastroenterology and Hepatology.2024; 39(9): 1856. CrossRef
Early onset metastatic colorectal cancer in Australia
A. Jalali, S. Smith, G. Kim, H. Wong, M. Lee, J. Yeung, M. Loft, R. Wong, J.D. Shapiro, S. Kosmider, J. Tie, S. Ananda, B. Ma, M. Burge, R. Jennens, B. Lee, J. Johns, L. Lim, A. Dean, L. Nott, P. Gibbs
Cancer Treatment and Research Communications.2024; 40: 100827. CrossRef
The prognostic significance of clinicopathological characteristics in early-onset versus late-onset colorectal cancer liver metastases
Yi-Tong Li, Xiang-Yu Wang, Bo Zhang, Bao-Rui Tao, Zhen-Mei Chen, Xiao-Chen Ma, Jia-Hao Han, Chong Zhang, Rui Zhang, Jin-Hong Chen
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Clinical implication of tissue carcinoembryonic antigen expression in association with serum carcinoembryonic antigen in colorectal cancer
Abdulmohsin Fawzi Aldilaijan, Young Il Kim, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Jihun Kim, Jun-Soo Ro, Jin Cheon Kim
Scientific Reports.2023;[Epub] CrossRef
Patients younger than 40 years with colorectal cancer have a similar prognosis to older patients
Tomoki Abe, Takeru Matsuda, Ryuichiro Sawada, Hiroshi Hasegawa, Kimihiro Yamashita, Takashi Kato, Hitoshi Harada, Naoki Urakawa, Hironobu Goto, Shingo Kanaji, Taro Oshikiri, Yoshihiro Kakeji
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Clinical and pathological characteristics of early-onset colorectal cancer in South Korea
Su Bee Park, Jin Young Yoon, Min Seob Kwak, Jae Myung Cha
Saudi Journal of Gastroenterology.2023; 29(6): 358. CrossRef
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
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef
Is the oncological impact of vascular invasion more important in right colon cancer?
Gyung Mo Son
Journal of Minimally Invasive Surgery.2022; 25(2): 49. CrossRef
Different Oncologic Outcomes in Early-Onset and Late-Onset Sporadic Colorectal Cancer: A Regression Analysis on 2073 Patients
Caterina Foppa, Annalisa Maroli, Sara Lauricella, Antonio Luberto, Carlotta La Raja, Francesca Bunino, Michele Carvello, Matteo Sacchi, Francesca De Lucia, Giuseppe Clerico, Marco Montorsi, Antonino Spinelli
Cancers.2022; 14(24): 6239. CrossRef

Benign proctology,Complication,Biomarker & risk factor

Frequency and risk factors of severe postoperative bleeding after proctological surgery: a retrospective case-control study: Sarah Taieb, Patrick Atienza, Jean-David Zeitoun, Milad Taouk, Josée Bourguignon, Christian Thomas, Nabila Rabahi, Saliha Dahlouk, Anne-Carole Lesage, David Lobo, Isabelle Etienney; Ann Coloproctol. 2022;38(5):370-375. Published online July 27, 2021; DOI: https://doi.org/10.3393/ac.2021.00122.0017

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Abstract PDF

Purpose
The aim of this study was to assess frequency and risk factors of severe bleeding after proctological surgery requiring hemostatic surgery observed after publication of the French guidelines for anticoagulant and platelet-inhibitor treatment.
Methods
All patients who underwent proctological surgery between January 2012 and March 2017 in a referral center were included. Delay, severity of bleeding, and need for blood transfusion were recorded. Patients with severe postoperative bleeding were matched to controls at a 2:1 ratio adjusted on the operator, and the type of surgery.
Results
Among the 8,890 operated patients, 65 (0.7%) needed a postoperative hemostatic procedure in an operating room. The risk of a hemostatic surgery was significantly increased after hemorrhoidal surgery compared with other procedures (1.9% vs. 0.5%, P<10^–4) and was most frequent after Milligan-Morgan hemorrhoidectomy (2.5%). Mean bleeding time was 6.2 days and no bleeding occurred after day 15. Blood transfusion rate was 0.1%. Treatment with anticoagulants and platelet inhibitors were managed according to recommendations and did not increase the severity of bleeding. The risk of severe bleeding was significantly lower in active smokers vs. non-smokers in univariate (16.9% vs. 36.2%, P=0.007) and multivariate (odds ratio, 0.31; 95% confidence interval, 0.14–0.65) analysis whereas sex, age, and body mass were not significantly associated with bleeding.
Conclusion
Severe postoperative bleeding occurs in 0.7% of patients, but varies with type of procedure and is not affected by anticoagulant or antiplatelet treatment. These treatments given in accordance with the new guidelines do not increase the severity of postoperative bleeding.

Citations

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Evaluation of Clinical Manifestations of Hemorrhoidal Disease, Carried Out Surgeries and Prolapsed Anorectal Tissues: Associations with ABO Blood Groups of Patients
Inese Fišere, Valērija Groma, Šimons Svirskis, Estere Strautmane, Andris Gardovskis
Journal of Clinical Medicine.2023; 12(15): 5119. CrossRef
Sclerobanding in the treatment of second and third degree hemorrhoidal disease in high risk patients on antiplatelet/anticoagulant therapy without suspension: a pilot study
Francesco Pata, Luigi M. Bracchitta, Bruno Nardo, Gaetano Gallo, Giancarlo D’Ambrosio, Salvatore Bracchitta
Frontiers in Surgery.2023;[Epub] CrossRef
Principles of minimize bleeding and the transfusion of blood and its components in operated patients – surgical aspects
Tomasz Banasiewicz, Waldemar Machała, Maciej Borejsza Wysocki, Maciej Lesiak, Sebastian Krych, Małgorzata Lange, Piotr Hogendorf, Adam Durczyński, Jarosław Cwaliński, Tomasz Bartkowiak, Adam Dziki, Wojciech Kielan, Stanisław Kłęk, Łukasz Krokowicz, Krzysz
Polish Journal of Surgery.2023; 95(5): 14. CrossRef

Benign proctology,Surgical technique

Transperineal rectocele repair is ideal for patients presenting with fecal incontinence: Marie Shella De Robles, Christopher J. Young; Ann Coloproctol. 2022;38(5):376-379. Published online October 19, 2021; DOI: https://doi.org/10.3393/ac.2021.00157.0022

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1 Citations

Abstract PDF

Purpose
Rectocele can be associated with both obstructed defecation and fecal incontinence. There exists a great variety of operative techniques to treat patients with rectocele. The purpose of this study was to evaluate the clinical outcome in a consecutive series of patients who underwent transperineal repair of rectocele when presenting with fecal incontinence as the predominant symptom.
Methods
Twenty-three consecutive patients from April 2000 to July 2015 with symptomatic rectocele underwent transperineal repair by a single surgeon.
Results
All patients had a history of vaginal delivery, with or without evidence of associated anal sphincter injury at the time. The median age of the cohort was 53 years (range, 21–90 years). None were fully continent preoperatively. However, continence improved to just rare mucus soiling or loss of flatus in all patients 6 months after their surgery. There was no operative mortality. Postoperative complications including urinary retention and wound dehiscence occurred in 3 patients.
Conclusion
Fecal incontinence associated with rectocele is multifactorial and may be caused by preexisting anal sphincteric damage and attenuation. Our experience suggests that transperineal repair provides excellent anatomic and physiologic results with minimal morbidity in selected patients presenting with combined rectocele and anal sphincter defect.

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The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Evaluation and Management of Chronic Constipation
Karim Alavi, Amy J. Thorsen, Sandy H. Fang, Pamela L. Burgess, Gino Trevisani, Amy L. Lightner, Daniel L. Feingold, Ian M. Paquette
Diseases of the Colon & Rectum.2024; 67(10): 1244. CrossRef

Complication,Biomarker & risk factor

Intraoperative fluorescence angiography as an independent factor of anastomotic leakage and a nomogram for predicting leak for colorectal anastomoses: Mikhail Alekseev, Evgeny Rybakov, Evgeniy Khomyakov, Irina Zarodnyuk, Yuri Shelygin; Ann Coloproctol. 2022;38(5):380-386. Published online July 22, 2021; DOI: https://doi.org/10.3393/ac.2021.00171.0024

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Abstract PDF

Purpose
Colorectal anastomotic leakage (AL) is a life-threatening complication, which increases morbidity, hospital stay and cost of treatment. The aim of this study is to identify risk factors, including intraoperative indocyanine green fluorescence angiography (ICG FA), associated with the leak of stapled colorectal anastomosis.
Methods
Four hundred twenty-nine consecutive patients underwent surgery between 2017 and 2019 for benign (n=10, 2.3%) or malignant (n=419, 97.7%) and rectal (n=349, 81.4%) or distal sigmoid (n=80, 18.6%) lesions with double-stapling technique reconstruction were included into retrospective study. Univariate analysis and multivariate logistic regression of the tumor-, patient- and treatment-related risk factors of AL was performed.
Results
An AL developed in 52 patients (12.1%). In multivariate analysis following variables were independently associated with AL; male sex (odds ratio [OR], 3.8; 95% confidence interval [CI], 1.9−7.7; P<0.01), anastomosis at ≤6.5 cm from anal verge (OR, 3.1; 95% CI, 1.3−7.5; P=0.01), and age of ≤62.5 years (OR, 2.1; 95% CI, 1.1−4.1; P=0.03). ICG FA was found as independent factor reducing colorectal AL rate (OR, 0.4; 95% CI, 0.2−0.8; P=0.02). A nomogram with high discriminative ability (concordance index, 0.81) was created.
Conclusion
ICG FA is a modifiable surgery-related risk factor associated with a decrease of colorectal AL rate. A suggested nomogram, which takes into consideration ICG FA, might be helpful to identify the individual risk of AL.

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Art of Medicine.2024; : 282. CrossRef
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Hayoung Lee, Yong Sik Yoon, Young Il Kim, Eun Jung Park, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim
Surgical Endoscopy.2024;[Epub] CrossRef
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Christos Tsalikidis, Athanasia Mitsala, Vasileios I. Mentonis, Konstantinos Romanidis, George Pappas-Gogos, Alexandra K. Tsaroucha, Michail Pitiakoudis
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S. N. Lukmonov, Ya. V. Belenkaya, M. S. Lebedko, S. S. Gordeev, Z. Z. Mammadli
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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
Risk assessment of rectal anastomotic leakage (RAREAL) after DIXON in non-emergency patients with rectal cancer
Xue-Cong Zheng, Jin-Bo Su, Jin-Jie Zheng
BMC Gastroenterology.2023;[Epub] CrossRef
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Case Report

Benign proctology,Complication,Surgical technique

Rectal perforation and perirectal abscess following stapled hemorrhoidectomy for prolapsed hemorrhoids successfully managed with Endo-SPONGE endoluminal vacuum-assisted wound closure system: Emanuele Rosati, Manuel Valeri, Luigina Graziosi, Lavinia Amato, Stefano Avenia, Annibale Donini; Ann Coloproctol. 2022;38(5):387-390. Published online June 9, 2021; DOI: https://doi.org/10.3393/ac.2021.02.07

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Abstract PDF

Active drains, which work by negative pressure, are commonly used to drain closed airtight wounds. Higher negative pressure is used in vacuum-assisted wound closure dressings. Gastrointestinal leaks may be difficult to treat by surgical approach because of their association with high morbidity and mortality. Recently, endoscopic approaches have been applied with several degrees of success. Most recently, endoluminal vacuum-assisted wound closure (EVAC) has been employed with high success rates in decreasing both morbidity and mortality. In the present paper, the authors describe the successful use of Endo-SPONGE (B. Braun Medical B.V.) EVAC system therapy to drain an open rectal wound, following a perforation occurred during stapled hemorrhoidectomy.

Citations

Citations to this article as recorded by

Endoluminal Vacuum Therapy (EVT) for the Treatment of Rectal Perforation Following Cleansing Enema Application
Alper Sozutek, Ekin Y Tas, Kemal Yener, Julia Ozcomert
Cureus.2023;[Epub] CrossRef

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