Annals of Coloproctology

The most viewed articles in the last three months among those published since 2022.

Original Article

Colorectal cancer

Public effect of the 2022 Colorectal Cancer Awareness Campaign delivered through a metaverse platform: Tae-Gyun Lee, Gil-Hyeon Song, Hong-min Ahn, Heung-Kwon Oh, Moonkyoung Byun, Eon Chul Han, Sohyun Kim, Chang Woo Kim, Hye Jin Kim, Samin Hong, Kee-Ho Song, Chan Wook Kim, Yong Beom Cho, on behalf of the Public Relations Committee of the Korean Society of Coloproctology (KSCP); Ann Coloproctol. 2024;40(2):145-153. Published online April 28, 2023; DOI: https://doi.org/10.3393/ac.2023.00122.0017

8,769 View
135 Download

Graphical Abstract Abstract PDF: Purpose
The Korean Society of Coloproctology has been conducting Colorectal Cancer Awareness Campaign, also known as the Gold Ribbon Campaign, every September since 2007. The 2022 campaign was held through a metaverse platform targeting the younger age group under the slogan of raising awareness of early-onset colorectal cancer (CRC). This study aimed to analyze the impact of the 2022 campaign on a metaverse platform.
Methods
Anonymized survey data were collected from participants in the metaverse campaign from September 1 to 15, 2022. The satisfaction score of the participants was evaluated by sex, age group, and previous campaign participation status.
Results
During the campaign, 2,770 people visited the metaverse. Among them, 455 people participated in the survey (response rate, 16.4%). Approximately 95% of the participants reported being satisfied with the information provided by the campaign, understood the necessity of undergoing screening for and prevention of early-onset CRC, and were familiar with the structure of the metaverse. The satisfaction score for campaign information tended to decrease as the participants’ age increased. When the participants’ overall level of satisfaction with the metaverse platform was assessed, teenagers scored particularly lower than the other age groups. The satisfaction scores for CRC information provided in the metaverse, as well as the scores for recognizing the seriousness and necessity of screening for early-onset CRC, indicated a high positive tendency (P<0.001).
Conclusion
Most of the 2022 Gold Ribbon Campaign participants were satisfied with the metaverse platform. Medical society should pay attention to increasing participation in and satisfaction with future public campaigns.

Video

Video clip

Cranial-first approach for laparoscopic extended right hemicolectomy: Kyong-Min Kang, Heung-Kwon Oh, Hong-Min Ahn, Tae-Gyun Lee, Hye-Rim Shin, Mi-Jeong Choi, Duck-Woo Kim, Sung-Bum Kang; Ann Coloproctol. 2024;40(3):282-284. Published online June 19, 2024; DOI: https://doi.org/10.3393/ac.2023.00661.0094

2,114 View
144 Download

Abstract PDF Supplementary Material: Complete mesocolic excision and central vascular ligation with D3 lymphadenectomy are important surgical principles for improving oncological outcomes in colon cancer. The cranial-first approach is a colonic mobilization–first approach to radical right hemicolectomy, which has several advantages, including early feasibility assessment, safe dissection from surrounding organs, preestablished inferior margin of lymph node dissection, and revelation of the tangible anatomy of the tributaries of the gastrocolic trunk. This video demonstrates the cranial-first approach to radical right hemicolectomy in a 66-year-old man with locally advanced cecal cancer.

Letter to the Editor

Local plus oral antibiotics and strict avoidance of constipation is effective and helps prevents surgery in most cases of anal fissure: Pankaj Garg, Vipul D. Yagnik, Kaushik Bhattacharya; Ann Coloproctol. 2023;39(2):188-189. Published online November 29, 2022; DOI: https://doi.org/10.3393/ac.2022.00731.0104

8,801 View
156 Download

PDF

Editorial

Multimodal analgesia for postoperative pain: pursuing liberation from pain, not redemption: Soo Yeun Park; Ann Coloproctol. 2024;40(3):189-190. Published online June 12, 2024; DOI: https://doi.org/10.3393/ac.2024.00304.0043

1,758 View
146 Download

PDF

Original Article

Anorectal benign disease

Laser hemorrhoidoplasty in the treatment of symptomatic hemorrhoids: a pilot Australian study: Anshini Jain, Chen Lew, Gamze Aksakal, Richard Hiscock, Naseem Mirbagheri; Ann Coloproctol. 2024;40(1):52-61. Published online May 19, 2022; DOI: https://doi.org/10.3393/ac.2022.00164.0023

10,754 View
447 Download
6 Web of Science
8 Citations

Graphical Abstract Abstract PDF

Purpose
Traditional therapeutic approaches to the surgical management of hemorrhoid disease such as hemorrhoidectomies are plagued with severe postoperative pain and protracted recovery. Our pilot study aims to the laser hemorrhoidoplasty (LH) patients with symptomatic hemorrhoid disease that have failed conservative management for the first time in an Australian population.
Methods
Thirty patients were prospectively enrolled to undergo LH. Postoperative pain, time to return to function, and quality of life (QoL) were determined through the Hemorrhoid Disease Symptom Score and Short Health Scale adapted for hemorrhoidal disease and compared to a historical group of 43 patients who underwent a Milligan-Morgan hemorrhoidectomy by the same surgeon at 3, 6, and 12 months.
Results
The LH group had significantly lower mean predicted pain scores on days 1 and 2 and lower defecation pain scores and lower opioid analgesia use on days 1, 2, 3, and 4. The median time to return to normal function was significantly lower in the LH group (2 days vs. 9 days, P<0.001). Similarly, the median days to return to the workplace was significantly lower in the LH group (6 days vs. 13 days, P=0.007). During long-term follow-up (12 months), hemorrhoid symptoms and all QoL measures were significantly improved, especially among those with grade II to III disease.
Conclusion
This pilot study demonstrates low pain scores with this revivified procedure in an Australian population, indicating possible expansion of the therapeutic options available for this common condition. Further head-to-head studies comparing LH to other hemorrhoid therapies are required to further determine the most efficacious therapeutic approach.

Citations

Citations to this article as recorded by

Laser hemorrhoidoplasty versus LigaSure™ hemorrhoidectomy versus diathermy hemorrhoidectomy in treatment of grade III and IV Hemorrhoids: A non-randomized prospective trial
Mohammad Ashour Khadr, Walid Galal El Shazly, Mohamed Mazloum Zakria, Ahmed Mohamed Moaz
Surgery Open Digestive Advance.2024; 13: 100129. CrossRef
Global International Society of University Colon and Rectal Surgeons in collaboration with European Society of Coloproctology audit on office‐based and surgical treatment of haemorrhoidal disease: Study protocol
Audrius Dulskas, Dovile Cerkauskaite, Joseph Nunoo‐Mensah, Richard Fortunato, Gaetano Gallo, Alaa El Hussuna, Varut Lohsiriwat, Tomas Aukstikalnis, Narimantas E. Samalavicius
Colorectal Disease.2024; 26(6): 1266. CrossRef
The efficacy of laser haemorrhoidoplasty (LHP) in the treatment of symptomatic haemorrhoidal disease: An observational cohort study
Nadim H. P. Boerhave, Rutger J. Klicks, Kemal Dogan
Colorectal Disease.2023; 25(6): 1202. CrossRef
Comparing outcomes of laser hemorrhoidoplasty and LigaSure hemorrhoidectomy in grade II–III hemorrhoidal disease: a retrospective analysis
Haluk Tümer, Mevlüt Harun Ağca
ANZ Journal of Surgery.2023; 93(7-8): 1885. CrossRef
Comparison of the efficacy of LigaSure and laser for grade 2-3 hemorrhoids
Ali Kemal Taşkin, Bülent Özçetin
Journal of Clinical Medicine of Kazakhstan.2023; 20(4): 33. CrossRef
Laser hemorrhoidoplasty combined with blind hemorrhoidal artery ligation compared to Milligan–Morgan hemorrhoidectomy in patients with second and third degree piles; a prospective randomized study
Amir F. Abdelhamid, Mohamed M. Elsheikh, Osama H. Abdraboh
The Egyptian Journal of Surgery.2023; 42(3): 669. CrossRef
Comparison of Laser Hemorrhoidoplasty and Milligan-Morgan Hemorrhoidectomy Techniques in the Treatment of Grade 2 and 3 Hemorrhoidal Disease
Adas Cemil, Kesici Ugur, Genc M. Salih, Karadag Merve, Duman M. Guray, Boluk S. Emine
The American Surgeon™.2023;[Epub] CrossRef
Laser hemorrhoidoplasty for hemorrhoidal disease: a systematic review and meta-analysis
Hendry Lie, Evelyn Franca Caesarini, Antonius Agung Purnama, Andry Irawan, Taufik Sudirman, Wifanto Saditya Jeo, Bernardus Parish Budiono, Erik Prabowo, M. Iqbal Rivai, Ryanto Karobuana Sitepu
Lasers in Medical Science.2022; 37(9): 3621. CrossRef

Review

Anorectal benign disease

Recent advances in the diagnosis and treatment of complex anal fistula: Pankaj Garg, Kaushik Bhattacharya, Vipul D. Yagnik, G. Mahak; Ann Coloproctol. 2024;40(4):321-335. Published online August 30, 2024; DOI: https://doi.org/10.3393/ac.2024.00325.0046

1,364 View
283 Download

Abstract PDF: Anal fistula can be a challenging condition to manage, with complex fistulas presenting even greater difficulties. The primary concerns in treating this condition are a risk of damage to the anal sphincters, which can compromise fecal continence, and refractoriness to treatment, as evidenced by a high recurrence rate. Furthermore, the treatment of complex anal fistula involves several additional challenges. Satisfactory solutions to many of these obstacles remain elusive, and no consensus has been established regarding the available treatment options. In summary, complex anal fistula has no established gold-standard treatment, and the quest for effective therapies continues. This review discusses and highlights groundbreaking advances in the management of complex anal fistula over the past decade.

Guideline

Anorectal benign disease

The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease: Antonio Brillantino, Adolfo Renzi, Pasquale Talento, Luigi Brusciano, Luigi Marano, Maurizio Grillo, Mauro Natale Maglio, Fabrizio Foroni, Alessio Palumbo, Maria Laura Sandoval Sotelo, Luciano Vicenzo, Michele Lanza, Giovanna Frezza, Massimo Antropoli, Claudio Gambardella, Luigi Monaco, Ilaria Ferrante, Domenico Izzo, Alfredo Giordano, Michele Pinto, Corrado Fantini, Marcello Gasparrini, Michele Schiano Di Visconte, Francesca Milazzo, Giovanni Ferreri, Andrea Braini, Umberto Cocozza, Massimo Pezzatini, Valeria Gianfreda, Alberto Di Leo, Vincenzo Landolfi, Umberto Favetta, Sergio Agradi, Giovanni Marino, Massimiliano Varriale, Massimo Mongardini, Claudio Eduardo Fernando Antonio Pagano, Riccardo Brachet Contul, Nando Gallese, Giampiero Ucchino, Michele D’Ambra, Roberto Rizzato, Giacomo Sarzo, Bruno Masci, Francesca Da Pozzo, Simona Ascanelli, Patrizia Liguori, Angela Pezzolla, Francesca Iacobellis, Erika Boriani, Eugenio Cudazzo, Francesca Babic, Carmelo Geremia, Alessandro Bussotti, Mario Cicconi, Antonia Di Sarno, Federico Maria Mongardini, Antonio Brescia, Leonardo Lenisa, Massimiliano Mistrangelo, Matteo Zuin, Marta Mozzon, Alessandro Paolo Chiriatti, Vincenzo Bottino, Antonio Ferronetti, Corrado Rispoli, Ludovico Carbone, Giuseppe Calabrò, Antonino Tirrò, Domenico de Vito, Giovanna Ioia, Giovanni Luca Lamanna, Lorenzo Asciore, Ettore Greco, Pierluigi Bianchi, Giuseppe D’Oriano, Alessandro Stazi, Nicola Antonacci, Raffaella Marina Di Renzo, Gianmario Edoardo Poto, Giuseppe Paolo Ferulano, Antonio Longo, Ludovico Docimo; Ann Coloproctol. 2024;40(4):287-320. Published online August 30, 2024; DOI: https://doi.org/10.3393/ac.2023.00871.0124

1,208 View
200 Download

Abstract PDF: The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colon-Proctologia, SIUCP) on the diagnosis and management of hemorrhoidal disease, with the goal of guiding physicians in the choice of the best treatment option. A panel of experts was charged by the Board of the SIUCP to develop key questions on the main topics related to the management of hemorrhoidal disease and to perform an accurate and comprehensive literature search on each topic, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in multiple rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to PICO (patients, intervention, comparison, and outcomes) criteria, and the statements were developed adopting the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology. In cases of grade 1 hemorrhoidal prolapse, outpatient procedures including hemorrhoidal laser procedure and sclerotherapy may be considered the preferred surgical options. For grade 2 prolapse, nonexcisional procedures including outpatient treatments, hemorrhoidal artery ligation and mucopexy, laser hemorrhoidoplasty, the Rafaelo procedure, and stapled hemorrhoidopexy may represent the first-line treatment options, whereas excisional surgery may be considered in selected cases. In cases of grades 3 and 4, stapled hemorrhoidopexy and hemorrhoidectomy may represent the most effective procedures, even if, in the expert panel opinion, stapled hemorrhoidopexy represents the gold-standard treatment for grade 3 hemorrhoidal prolapse.

Review

Colorectal cancer

Postoperative outcomes after prehabilitation for colorectal cancer patients undergoing surgery: a systematic review and meta-analysis of randomized and nonrandomized studies: Ian Jun Yan Wee, Isaac Seow-En, Aik Yong Chok, Eileen Sim, Chee Hoe Koo, Wenjie Lin, Chang Meihuan, Emile Kwong-Wei Tan; Ann Coloproctol. 2024;40(3):191-199. Published online May 16, 2024; DOI: https://doi.org/10.3393/ac.2022.01095.0156

1,662 View
186 Download

Abstract PDF: Purpose
Prehabilitation (PH) is purported to improve patients’ preoperative functional status. This systematic review and meta-analysis sought to compare short-term postoperative outcomes between patients who underwent a protocolized PH program and the existing standard of care among colorectal cancer patients awaiting surgery.
Methods
A search in MEDLINE/PubMed, the Cochrane Library, Embase, Scopus, and CINAHL was conducted to identify relevant articles. Repetitive and exhaustive combinations of MeSH search terms (“prehabilitation,” “colorectal cancer,” “colon cancer,” and “rectal cancer”) were used to identify randomized and nonrandomized studies comparing PH versus standard of care for colorectal cancer patients awaiting surgery. The primary outcomes included postoperative morbidity, length of hospital stay, and readmission rates.
Results
Seven studies including 1,042 colorectal cancer patients (PH, 382) were included. No significant differences were found in intraoperative outcomes. The postoperative complication rates were comparable between groups (Clavien-Dindo grades I and II: risk ratio, 0.82; 95% confidence interval, 0.62–1.07; P=0.15; Clavien-Dindo grades ≥III: risk ratio, 1.02; 95% confidence interval, 0.72–1.44; P=0.92). There were also no significant differences in length of hospital stay (P=0.21) or the risk of 30-day readmission (P=0.68).
Conclusion
Although PH does not appear to improve short-term postoperative outcomes following colorectal cancer surgery, the quality of evidence is impaired by the limited trials and heterogeneity. Thus, further large-scale trials are warranted to draw definitive conclusions and establish the long-term effects of PH.

Original Articles

Minimally invasive surgery

Preoperative localization of potentially invisible colonic lesions on the laparoscopic operation field: using autologous blood tattooing: Ji Yeon Mun, Hyunjoon An, Ri Na Yoo, Hyeon-Min Cho, Bong-Hyeon Kye; Ann Coloproctol. 2024;40(3):225-233. Published online June 19, 2024; DOI: https://doi.org/10.3393/ac.2023.00059.0008

1,293 View
144 Download

Graphical Abstract Abstract PDF: Purpose
Preoperative colonoscopic (POC) localization is recommended for patients scheduled for elective laparoscopic colectomy for early colon cancer. Among the various localization method, POC tattooing localization has been widely used. Several dyes have been used for tattooing, but dye has disadvantages, including foreign body reactions. For this reason, we have used autologous blood tattooing for POC localization. This study aimed to evaluate the safety and efficacy of the autologous blood tattooing method.
Methods
This study included patients who required POC localization of the colonic neoplasm among the patients who were scheduled for elective colon resection. The indication for localization was early colon cancer (clinically T1 or T2) or colonic neoplasms that could not be resected endoscopically. POC autologous blood tattooing was performed after saline injection, and 2 hemoclips were applied.
Results
A total of 45 patients who underwent autologous blood tattooing and laparoscopic colectomy were included in this study. All POC localization sites were visible in the laparoscopic view. POC localization sites showed almost perfect agreement with intraoperative surgical findings. There were no complications like bowel perforation, peritonitis, hemoperitoneum, and mesenteric hematoma.
Conclusion
Autologous blood is a safe and effective agent for localizing materials that can replace previous dyes. However, a large prospective case-control study is required for the routine application of this procedure in early colon cancer or colonic neoplasms.

ERAS

Clinical impact of a multimodal pain management protocol for loop ileostomy reversal: Jeong Sub Kim, Chul Seung Lee, Jung Hoon Bae, Seung Rim Han, Do Sang Lee, In Kyu Lee, Yoon Suk Lee, In Kyeong Kim; Ann Coloproctol. 2024;40(3):210-216. Published online June 19, 2024; DOI: https://doi.org/10.3393/ac.2022.01137.0162

1,278 View
169 Download
1 Citations

Graphical Abstract Abstract PDF

Purpose
As introduced, multimodal pain management bundle for ileostomy reversal may be considered to reduce postoperative pain and hospital stay. The aim of this study was to evaluate clinical efficacy of perioperative multimodal pain bundle for ileostomy.
Methods
Medical records of patients who underwent ileostomy reversal after rectal cancer surgery from April 2017 to March 2020 were analyzed. Sixty-seven patients received multimodal pain bundle protocol with ileostomy reversal (group A) and 41 patients underwent closure of ileostomy with conventional pain management (group B).
Results
Baseline characteristics, including age, sex, body mass index, American Society of Anesthesiologists classification, diabetes mellitus, and smoking history, were not significantly different between the groups. The pain score on postoperative day 1 was significant lower in group A (visual analog scale, 2.6 ± 1.3 vs. 3.2 ± 1.2; P = 0.013). Overall consumption of opioid in group A was significant less than group B (9.7 ± 9.5 vs. 21.2 ± 8.8, P < 0.001). Hospital stay was significantly shorter in group A (2.3 ± 1.5 days vs. 4.1 ± 1.5 days, P < 0.001). There were no significant differences between the groups in postoperative complication rate.
Conclusion
Multimodal pain protocol for ileostomy reversal could reduce postoperative pain, usage of opioid and hospital stay compared to conventional pain management.

Citations

Citations to this article as recorded by

Multimodal analgesia for postoperative pain: pursuing liberation from pain, not redemption
Soo Yeun Park
Annals of Coloproctology.2024; 40(3): 189. CrossRef

Anorectal benign disease

Long-term outcomes of sacral neuromodulation for low anterior resection syndrome after rectal cancer surgery: Mario J. de Miguel Valencia, Gabriel Marin, Ana Acevedo, Ana Hernando, Alfonso Álvarez, Fabiola Oteiza, Mario J. de Miguel Velasco; Ann Coloproctol. 2024;40(3):234-244. Published online June 25, 2024; DOI: https://doi.org/10.3393/ac.2023.00542.0077

1,256 View
168 Download

Abstract PDF: Purpose
This study assessed the long-term outcomes and quality of life in patients who underwent sacral neuromodulation (SNM) due to low anterior resection syndrome (LARS).
Methods
This single-center retrospective study, conducted from 2005 to 2021, included 30 patients (21 men; median age, 70 years) who had undergone total mesorectal excision with stoma closure and had no recurrence at inclusion. All patients were diagnosed with LARS refractory to conservative treatment. We evaluated clinical and quality-of-life outcomes after SNM through a stool diary, Wexner score, LARS score, the Fecal Incontinence Quality of Life (FIQL) questionnaire, and EuroQol-5D (EQ-5D) questionnaire.
Results
Peripheral nerve stimulation was successful in all but one patient. Of the 29 patients who underwent percutaneous nerve evaluation, 17 (58.62%) responded well to SNM and received permanent implants. The median follow-up period was 48 months (range, 18–153 months). The number of days per week with fecal incontinence episodes decreased from a median of 7 (range, 2–7) to 0.38 (range, 0–1). The median number of bowel movements recorded in patient diaries fell from 5 (range, 4–12) to 2 (range, 1–6). The median Wexner score decreased from 18 (range, 13–20) to 6 (range, 0–16), while the LARS score declined from 38.5 (range, 37–42) to 19 (range, 4–28). The FIQL and EQ-5D questionnaires demonstrated enhanced quality of life.
Conclusion
SNM may benefit patients diagnosed with LARS following rectal cancer surgery when conservative options have failed, and the treatment outcomes may possess long-term sustainability.

Anorectal benign disease

Immediate sphincter repair following fistulotomy for anal fistula: does it impact the healing rate and septic complications?: Maher A. Abbas, Anna T. Tsay, Mohammad Abbass; Ann Coloproctol. 2024;40(3):217-224. Published online June 28, 2024; DOI: https://doi.org/10.3393/ac.2022.01144.0163

1,189 View
178 Download

Abstract PDF: Purpose
Fistulotomy is considered the most effective treatment for anal fistula; however, it carries a risk of incontinence. Sphincteroplasty in the setting of fistulotomy is not standard practice due to concerns regarding healing and potential infectious complications. We aimed to compare the outcomes of patients who underwent fistulotomy with primary sphincteroplasty to those who did not undergo repair.
Methods
This was a retrospective review of consecutive patients who underwent fistulotomy for cryptoglandular anal fistula. All operations were performed by one colorectal surgeon. Sphincteroplasty was performed for patients perceived to be at higher risk for continence disturbance. The main outcome measures were the healing rate and postoperative septic complications.
Results
In total, 152 patients were analyzed. Group A (fistulotomy with sphincteroplasty) consisted of 45 patients and group B (fistulotomy alone) included 107 patients. Both groups were similar in age (P=0.16) and sex (P=0.20). Group A had higher proportions of multiple fistulas (26.7% vs. 6.5%, P<0.01) and complex fistulas (mid to high transsphincteric, 37.8% vs. 10.3%; P<0.01) than group B. The median follow-up time was 8 weeks. The overall healing rate was similar in both groups (93.3% vs. 90.6%, P=0.76). No significant difference between the 2 groups was noted in septic complications (6.7% vs. 3.7%, P=0.42).
Conclusion
Fistulotomy with primary sphincter repair demonstrated a comparable healing rate to fistulotomy alone, without an increased risk of postoperative septic complications. Further prospective randomized studies are needed to confirm these findings and to explore the functional outcomes of patients who undergo sphincteroplasty.

Review

Colorectal cancer

The role of lateral pelvic lymph node dissection in advanced rectal cancer: a review of current evidence and outcomes: Gyu-Seog Choi, Hye Jin Kim; Ann Coloproctol. 2024;40(4):363-374. Published online August 30, 2024; DOI: https://doi.org/10.3393/ac.2024.00521.0074

1,081 View
208 Download

Abstract PDF: Metastatic lateral pelvic lymph nodes (LPNs) in rectal cancer significantly impact the prognosis and treatment strategies. Western practices emphasize neoadjuvant chemoradiotherapy (CRT), whereas Eastern approaches often rely on LPN dissection (LPND). This review examines the evolving role of LPND in the context of modern treatments, including total neoadjuvant therapy (TNT), and the impact of CRT on the management of clinically suspicious LPNs. We comprehensively reviewed the key literature comparing the outcomes of LPND versus preoperative CRT for rectal cancer, focusing on recent advancements and ongoing debates. Key studies, including the JCOG0212 trial and recent multicenter trials, were analyzed to assess the efficacy of LPND, particularly in conjunction with preoperative CRT or TNT. Current evidence indicates that LPND can reduce local recurrence rates compared to total mesorectal excision alone in patients not receiving radiation therapy. However, the benefit of LPND in the context of neoadjuvant CRT is influenced by the size and pretreatment characteristics of LPNs. While CRT can effectively control smaller metastatic LPNs, larger or clinically suspicious LPNs may require LPND for optimal outcomes. Advances in surgical techniques, such as robotic-assisted LPND, offer potential benefits but also present challenges and complications. The role of TNT in controlling metastatic LPNs and improving patient outcomes is emerging but remains underexplored. The decision to perform LPND should be individualized based on patient-specific factors, including LPN size, response to neoadjuvant treatment, and surgeon expertise. Future research should focus on optimizing treatment protocols and further evaluating the role of TNT in managing metastatic LPNs.

Technical Note

Technical tips

Transvaginal removal of rectal stromal tumor with Martius flap interposition: a feasible option for a large tumor at the anterior wall of the rectum: Weerapat Suwanthanma, Ploybutsara Kittiwetsakun, Samart Phuwapraisirisan, Pitichote Hiranyatheb; Ann Coloproctol. 2024;40(3):276-281. Published online June 26, 2024; DOI: https://doi.org/10.3393/ac.2023.00556.0079

1,073 View
146 Download

Abstract PDF: Neoadjuvant imatinib treatment, followed by complete transvaginal removal, presents a feasible option for large rectal gastrointestinal tumors located on the anterior wall of the rectum and protruding into the vagina. The use of Martius flap interposition is convenient and can be employed to prevent rectovaginal fistula.

Case Report

A rare presentation of low-grade appendiceal mucinous neoplasm within an amyand’s hernia: a case report: Hani Atiqah Saim, Ian Chik, Fahrol Fahmy Jaafar, Zamri Zuhdi, Razman Jarmin, Azlanudin Azman; Ann Coloproctol. 2023;39(2):183-187. Published online October 18, 2021; DOI: https://doi.org/10.3393/ac.2021.00430.0061

6,950 View
118 Download
3 Web of Science
1 Citations

Abstract PDF

An Amyand’s hernia is characterised as the presence of the appendix in an inguinal hernial sac. During laparoscopic cholecystectomy for gallbladder polyps, an incidental Amyand’s hernia was discovered in a 75-year-old female patient. On examination, the hernia contained an appendiceal mucocele but no evidence of perforation. An open appendicectomy with tension-free mesh repair was performed for the hernia. The histopathological report of the appendix was a low-grade appendiceal mucinous neoplasm (LAMN), an entity that is just as rare as an Amyand’s hernia. The patient had the right inguinal swelling for over 10 years but it was thought to be an inguinal intramuscular cyst as reported on a previous abdominal ultrasound. Mucocele of the appendix may have a benign or malignant appendiceal progress, leading to individualised diagnosis and treatment. We review an Amyand’s hernia with LAMN and discuss the asymptomatic tendency yet malignant potential of appendiceal mucoceles along with treatment strategies.

Citations

Citations to this article as recorded by

Complicated Appendicitis Associated With Appendiceal Mucinous Neoplasm Within Amyand’s Hernia in a Patient With Previous Hernia Repair: A Case Report and Literature Review
Carlos A Navarro-Castañeda, Luis A Pérez-Silva, Rubén A Sandoval-Barba, Nubia A Ramírez-Buensuceso-Conde, Jorge Farell-Rivas
Cureus.2024;[Epub] CrossRef

First
Prev
Page of 14
Next
Last

Most viewed articles