Annals of Coloproctology

Original Articles

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

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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.

Citations

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#CRCandMe: results of a pre-post quasi-experimental study of a mass media campaign to increase early-onset colorectal cancer awareness in Utah and Wisconsin
Ami E Sedani
American Journal of Cancer Research.2024; 14(8): 3873. CrossRef
Metaverse in surgery — origins and future potential
Enrico Checcucci, Alessandro Veccia, Stefano Puliatti, Pieter De Backer, Pietro Piazza, Karl-Friedrich Kowalewski, Severin Rodler, Mark Taratkin, Ines Rivero Belenchon, Loic Baekelandt, Sabrina De Cillis, Alberto Piana, Ahmed Eissa, Juan Gomez Rivas, Giov
Nature Reviews Urology.2024;[Epub] CrossRef
Metaverso: perspectivas, possibilidades e limitações
Walter Rodrigues Marques, Maria Neuraildes Gomes Viana, Anderson Boás Viana, Luís Claúdio Azevedo Gomes, Francilene Silva Cruz, Bruna Monique Cunha Rodrigues, Andréa Luísa Frazão Silva, Regeanne Santos Guaianaz, Daiane Leite Chaves Bezerra, Diêgo Jorge Lo
Caderno Pedagógico.2024; 21(13): e12984. CrossRef

Colorectal cancer

Partial mesorectal excision can be a primary option for middle rectal cancer: a propensity score–matched retrospective analysis: Ee Jin Kim, Chan Wook Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2024;40(3):253-267. Published online March 31, 2023; DOI: https://doi.org/10.3393/ac.2022.00689.0098

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Abstract PDF

Purpose
Although partial mesorectal excision (PME) and total mesorectal excision (TME) is primarily indicated for the upper and lower rectal cancer, respectively, few studies have evaluated whether PME or TME is more optimal for middle rectal cancer.
Methods
This study included 671 patients with middle and upper rectal cancer who underwent robot-assisted PME or TME. The 2 groups were optimized by propensity score matching of sex, age, clinical stage, tumor location, and neoadjuvant treatment.
Results
Complete mesorectal excision was achieved in 617 of 671 patients (92.0%), without showing a difference between the PME and TME groups. Local recurrence rate (5.3% vs. 4.3%, P>0.999) and systemic recurrence rate (8.5% vs. 16.0%, P=0.181) also did not differ between the 2 groups, in patients with middle and upper rectal cancer. The 5-year disease-free survival (81.4% vs. 74.0%, P=0.537) and overall survival (88.0% vs. 81.1%, P=0.847) also did not differ between the PME and TME groups, confined to middle rectal cancer. Moreover, 5-year recurrence and survival rates were not affected by distal resection margins of 2 cm (P=0.112) to 4 cm (P>0.999), regardless of pathological stages. Postoperative complication rate was higher in the TME than in the PME group (21.4% vs. 14.5%, P=0.027). Incontinence was independently associated with TME (odds ratio [OR], 2.009; 95% confidence interval, 1.015–3.975; P=0.045), along with older age (OR, 4.366, P<0.001) and prolonged operation time (OR, 2.196; P=0.500).
Conclusion
PME can be primarily recommended for patients with middle rectal cancer with lower margin of >5 cm from the anal verge.

Citations

Citations to this article as recorded by

Review of definition and treatment of upper rectal cancer
Elias Karam, Fabien Fredon, Yassine Eid, Olivier Muller, Marie Besson, Nicolas Michot, Urs Giger-Pabst, Arnaud Alves, Mehdi Ouaissi
Surgical Oncology.2024; 57: 102145. CrossRef
Tumour-specific mesorectal excision for rectal cancer: Systematic review and meta-analysis of oncological and functional outcomes
Fabio Carbone, Wanda Petz, Simona Borin, Emilio Bertani, Stefano de Pascale, Maria Giulia Zampino, Uberto Fumagalli Romario
European Journal of Surgical Oncology.2023; 49(11): 107069. CrossRef

Malignant disease, Rectal cancer,Colorectal cancer,Epidemiology & etiology

Clinicopathological Characteristics and Surgical Outcomes of Crohn Disease-Associated Colorectal Malignancy: Yoo Na Lee, Jong Lyul Lee, Chang Sik Yu, Jong Beom Kim, Seok-Byung Lim, In Ja Park, Young Sik Yoon, Chan Wook Kim, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park, Jin Cheon Kim; Ann Coloproctol. 2021;37(2):101-108. Published online April 30, 2021; DOI: https://doi.org/10.3393/ac.2020.11.02

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Abstract PDF Supplementary Material

Purpose
Carcinoma arising from Crohn disease (CD) is rare, and there is no clear guidance on how to properly screen for at-risk patients and choose appropriate care. This study aimed to evaluate the clinicopathological characteristics, treatment, and oncologic outcomes of CD patients diagnosed with colorectal cancer (CRC).
Methods
Using medical records, we retrospectively enrolled a single-center cohort of 823 patients who underwent abdominal surgery for CD between January 2006 and December 2015. CD-associated CRC patients included those with adenocarcinoma, lymphoma, or neuroendocrine tumors of the colon and rectum.
Results
Nineteen patients (2.3%) underwent abdominal surgery to treat CD-associated CRC. The mean duration of CD in the CD-associated CRC group was significantly longer than that in the benign CD group (124.7 ± 77.7 months vs. 68.9 ± 60.2 months, P = 0.006). The CD-associated CRC group included a higher proportion of patients with a history of perianal disease (73.7% vs. 50.2%, P = 0.035) and colonic location (47.4% vs. 6.5%, P = 0.001). Among 19 CD-associated CRC patients, 17 (89.5%) were diagnosed with adenocarcinoma, and of the 17 cases, 15 (88.2%) were rectal adenocarcinoma. On multivariable analyses for developing CRC, only colonic location was a risk factor (relative risk, 7.735; 95% confidence interval, 2.862–20.903; P = 0.001).
Conclusion
Colorectal malignancy is rare among CD patients, even among patients who undergo abdominal surgery. Rectal adenocarcinoma accounted for most of the CRC, and colonic location was a risk factor for developing CRC.

Citations

Citations to this article as recorded by

Perianal Fistulizing Crohn’s Disease–Associated Anorectal and Fistula Cancers: Systematic Review and Expert Consensus
Serre-Yu Wong, Cathy Rowan, Elvira Diaz Brockmans, Cindy C.Y. Law, Elisabeth Giselbrecht, Celina Ang, Sergey Khaitov, David Sachar, Alexandros D. Polydorides, Leon Shin-han Winata, Bram Verstockt, Antonino Spinelli, David T. Rubin, Parakkal Deepak, Dermot
Clinical Gastroenterology and Hepatology.2024;[Epub] CrossRef
Reduced expression of alanyl aminopeptidase is a robust biomarker of non‐familial adenomatous polyposis and non‐hereditary nonpolyposis colorectal cancer syndrome early‐onset colorectal cancer
Ye Jin Ha, Yun Jae Shin, Ka Hee Tak, Jong Lyul Park, Jeong Hwan Kim, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seon Young Kim, Jin Cheon Kim
Cancer Medicine.2023; 12(8): 10091. 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
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, Rectal cancer,Prognosis and adjuvant therapy

Beware of Early Relapse in Rectal Cancer Patients Treated With Preoperative Chemoradiotherapy: Seul Gi Oh, In Ja Park, Ji-hyun Seo, Young Il Kim, Seok-Byung Lim, Chan Wook Kim, Yong Sik Yoon, Jong Lyul Lee, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2020;36(6):382-389. Published online June 17, 2020; DOI: https://doi.org/10.3393/ac.2020.06.11

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Abstract PDF

Purpose
Recurrence patterns in rectal cancer patients treated with preoperative chemoradiotherapy (PCRT) are needed to evaluate for establishing tailored surveillance protocol.
Methods
This study included 2,215 patients with locally-advanced mid and low rectal cancer treated with radical resection between January 2005 and December 2012. Recurrence was evaluated according to receipt of PCRT; PCRT group (n = 1,258) and no-PCRT group (n = 957). Early recurrence occurred within 1 year of surgery and late recurrence after 3 years. The median follow-up duration was 65.7 ± 29 months.
Results
The overall recurrence rate was similar between the PCRT and no-PCRT group (25.8% vs. 24.9%, P = 0.622). The most common initial recurrence site was the lungs in both groups (50.6% vs. 49.6%, P = 0.864), followed by the liver, which was more common in the no-PCRT group (22.5% vs. 33.6%, P = 0.004). Most of the recurrence occurred within 3 years after surgery in both groups (85.3% vs. 85.8%, P = 0.862). Early recurrence was more common in the PCRT group than in the no-PCRT group (43.1% vs. 32.4%, P = 0.020). Recurrence within the first 6 months after surgery was significantly higher in the PCRT group than in the no-PCRT group (18.8% vs. 7.6%, P = 0.003). Lung (n = 27, 44.3%) and liver (n = 22, 36.1%) were the frequent the first relapsed site within 6 months after surgery in PCRT group.
Conclusion
Early recurrence within the first 1 year after surgery was more common in patients treated with PCRT. This difference would be considered for surveillance protocols and need to be evaluated in further studies.

Citations

Citations to this article as recorded by

Watch and wait strategies for rectal cancer: A systematic review
In Ja Park
Precision and Future Medicine.2022; 6(2): 91. CrossRef
Update on Diagnosis and Treatment of Colorectal Cancer
Chan Wook Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
The watch-and-wait strategy versus radical resection for rectal cancer patients with a good response (≤ycT2) after neoadjuvant chemoradiotherapy
Chungyeop Lee, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Annals of Surgical Treatment and Research.2022; 103(6): 350. CrossRef
Optimal Postoperative Surveillance Strategies for Colorectal Cancer: A Retrospective Observational Study
Min-Young Park, In-Ja Park, Hyo-Seon Ryu, Jay Jung, Min-Sung Kim, Seok-Byung Lim, Chang-Sik Yu, Jin-Cheon Kim
Cancers.2021; 13(14): 3502. CrossRef
Comparison between Local Excision and Radical Resection for the Treatment of Rectal Cancer in ypT0-1 Patients: An Analysis of the Clinicopathological Factors and Survival Rates
Soo Young Oh, In Ja Park, Young IL Kim, Jong-Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Cancers.2021; 13(19): 4823. CrossRef
Shifting Treatment Strategies to Prevent Early Relapse of Locally Advanced Rectal Cancer After Preoperative Chemoradiotherapy
Eun Jung Park
Annals of Coloproctology.2020; 36(6): 357. CrossRef

Benign GI diease, Inflammatory bowel disease

Clinical Characteristics and Postoperative Outcomes of Patients Presenting With Upper Gastrointestinal Tract Crohn Disease: Joon Suk Moon, Jong Lyul Lee, Chang Sik Yu, Seok-Byung Lim, In Ja Park, Yong Sik Yoon, Chan Wook Kim, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park, Hassan Abdullah Alsaleem, Jin Cheon Kim; Ann Coloproctol. 2020;36(4):243-248. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.10.16.1

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Abstract PDF

Purpose
Upper gastrointestinal (GI) tract involvement in Crohn disease (CD) is rare and effectiveness of surgical treatment is limited. The aim of this study was to evaluate characteristics and surgical outcomes of upper GI CD.
Methods
Medical records of 811 patients who underwent intestinal surgery for CD between January 2006 and December 2015 at a single institution were reviewed. Upper GI CD was defined by involvement of the stomach to the fourth portion of duodenum, with or without concomitant small/large bowel CD involvement according to a modification of the Montreal classification.
Results
We identified 24 patients (21 males, 3 females) who underwent surgery for upper GI CD. The mean age at diagnosis was 27 ± 12 years, the mean age at surgery was 33 ± 11 years, and the mean duration of CD was 73.6 ± 56.6 months. Fifteen patients (62.5%) had history of previous perianal surgery. Ten patients (41.7%) had duodenal or gastric stricture and 14 patients (58.3%) had penetrating fistula; patients with fistula were significantly more likely to develop complications (57.1% vs. 20.0%, P = 0.035). One patient with stricture had surgical recurrence. In seven patients with fistula, fistula was related to previous anastomosis. Patients with fistula had significantly longer hospital stays than those with stricture (16 days vs. 11 days, P = 0.01).
Conclusion
Upper GI CD is rare among CD types (2.96%). In patients with upper GI CD, penetrating fistula was associated with longer hospital stay and more complications.

Citations

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Update S2k-Guideline Helicobacter pylori and gastroduodenal ulcer disease of the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS)
Wolfgang Fischbach, Jan Bornschein, Jörg C. Hoffmann, Sibylle Koletzko, Alexander Link, Lukas Macke, Peter Malfertheiner, Kerstin Schütte, Dieter-Michael Selgrad, Sebastian Suerbaum, Christian Schulz
Zeitschrift für Gastroenterologie.2024; 62(02): 261. CrossRef
Aktualisierte S2k-Leitlinie Helicobacter pylori und gastroduodenale Ulkuskrankheit der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – Juli 2022 – AWMF-Registernummer: 021–001

Zeitschrift für Gastroenterologie.2023; 61(05): 544. CrossRef
A systematic review and meta‐analysis of prevalence and clinical features of upper gastrointestinal (UGI) tract Crohn's disease in adults compared to non‐UGI types
Babak Tamizifar, Peyman Adibi, Maryam Hadipour, Vahid Mohamadi
JGH Open.2023; 7(5): 325. CrossRef
Upper gastrointestinal tract involvement of Crohn disease: clinical implications in children and adolescents
Eun Sil Kim, Mi Jin Kim
Clinical and Experimental Pediatrics.2022; 65(1): 21. CrossRef
Profiling non-coding RNA levels with clinical classifiers in pediatric Crohn’s disease
Ranjit Pelia, Suresh Venkateswaran, Jason D. Matthews, Yael Haberman, David J. Cutler, Jeffrey S. Hyams, Lee A. Denson, Subra Kugathasan
BMC Medical Genomics.2021;[Epub] CrossRef
Surgical Treatment of Upper Gastrointestinal Tract Crohn Disease: A Long Way to Go to Identify the Optimal Method
Soo Yeun Park
Annals of Coloproctology.2020; 36(4): 207. CrossRef

Benign GI diease, Inflammatory bowel disease

Short-term Outcomes of Elective 2-Stage Restorative Proctocolectomy for Ulcerative Colitis in Korea: Does Laparoscopy Have Benefits?: Jun Woo Bong, Yong Sik Yoon, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2020;36(1):41-47. Published online February 29, 2020; DOI: https://doi.org/10.3393/ac.2019.03.29

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Abstract PDF

Purpose
This study aimed to compare the short-term outcomes of the open and laparoscopic approaches to 2-stage restorative proctocolectomy (RPC) for Korean patients with ulcerative colitis (UC).
Methods
We retrospectively analyzed the medical records of 73 patients with UC who underwent elective RPC between 2009 and 2016. Patient characteristics, operative details, and postoperative complications within 30 days were compared between the open and laparoscopic groups.
Results
There were 26 cases (36%) in the laparoscopic group, which had a lower mean body mass index (P = 0.025), faster mean time to recovery of bowel function (P = 0.004), less intraoperative blood loss (P = 0.004), and less pain on the first and seventh postoperative days (P = 0.029 and P = 0.027, respectively) compared to open group. There were no deaths, and the overall complication rate was 43.8%. There was no between-group difference in the overall complication rate; however, postoperative ileus was more frequent in the open group (27.7% vs. 7.7%, P = 0.043). Current smoking (odds ratio [OR], 44.4; P = 0.003) and open surgery (OR, 5.4; P = 0.014) were the independent risk factors for postoperative complications after RPC.
Conclusion
Laparoscopic RPC was associated with acceptable morbidity and faster recovery than the open approach. The laparoscopic approach is a feasible and safe option for surgical treatment for UC in selective cases.

Citations

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Patient-reported Outcome Measures in Ileoanal Pouch Surgery: a Systematic Review
Zakary Ismail Warsop, Carlo Alberto Manzo, Natalie Yu, Bilal Yusuf, Christos Kontovounisios, Valerio Celentano
Journal of Crohn's and Colitis.2024; 18(3): 479. CrossRef
Creation of an institutional preoperative checklist to support clinical risk assessment in patients with ulcerative colitis (UC) considering ileoanal pouch surgery
Bruno Augusto Alves Martins, Amira Shamsiddinova, Manal Mubarak Alquaimi, Guy Worley, Phil Tozer, Kapil Sahnan, Zarah Perry-Woodford, Ailsa Hart, Naila Arebi, Manmeet Matharoo, Janindra Warusavitarne, Omar Faiz
Frontline Gastroenterology.2024; 15(3): 203. CrossRef
Benefits of Elective Laparoscopic 2-Stage Restorative Proctocolectomy for Ulcerative Colitis in Korea
Sun Min Park, Won-Kyung Kang
Annals of Coloproctology.2020; 36(1): 3. CrossRef

Original article

Defunctioning Protective Stoma Can Reduce the Rate of Anastomotic Leakage after Low Anterior Resection in Rectal Cancer Patients: Byoung Chul Lee, Seok-Byung Lim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Chang Sik Yu, Jin Cheon Kim; Received October 22, 2019 Accepted November 19, 2019 Published online January 16, 2020; DOI: https://doi.org/10.3393/ac.2019.11.19.1

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Abstract PDF

PURPOSE
This study aimed to identify risk factors for anastomotic leakage and to evaluate the impact of protective stoma on the rate of anastomotic leakage and subsequent management.
METHODS
This retrospective study analyzed data from 4,282 patients who underwent low anterior resection between 2007 and 2014. Among these, 1,367 (31.9%) underwent surgery to create protective diverting stoma and 232 (5.4%) experienced anastomotic leakage. At 6-month timepoints, data were evaluated to identify any correlation between the presence of diverting stoma and the incidence of anastomotic leakage. In addition, clinicopathological parameters were investigated to identify risk factors for anastomotic leakage.
RESULTS
Diverting stomas significantly reduced the rate of anastomotic leakage [HR 0.334, 95% CI 0.212

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Risk factors influencing sphincter preservation in laparoscopic radical rectal cancer surgery
Jia-Rui Liu, Jin Zhang, Xiang-Long Duan
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Machine learning model for prediction of permanent stoma after anterior resection of rectal cancer: A multicenter study
Yang Su, Yanqi Li, Heng Zhang, Wangshuo Yang, Mengdie Liu, Xuelai Luo, Lu Liu
European Journal of Surgical Oncology.2024; 50(7): 108386. CrossRef
A nomogram of anastomotic stricture after rectal cancer: a retrospective cohort analysis
Yifan Cheng, Zhen Tian, Shuyang Gao, Shuai Zhao, Ruiqi Li, Jiajie Zhou, Qiannan Sun, Daorong Wang
Surgical Endoscopy.2024; 38(7): 3661. CrossRef
Factors associated with leakage after reversal of protective stoma in patients with locally advanced rectal cancer following curative resection and anastomosis
Miao-Ling Tsai, Ji-Shiang Hung, John Huang, Been-Ren Lin
European Journal of Surgical Oncology.2024; : 108698. CrossRef
Impact of diversion ileostomy on postoperative complications and recovery in the treatment of locally advanced upper-half rectal cancer
Yangyang Wang, Xiaojie Wang, Shenghui Huang, Heyuan Zhu, Ying Huang
Scientific Reports.2024;[Epub] CrossRef
The role of transanal drainage tube in preventing the anastomotic leakage in rectal cancer surgery without a defunctioning stoma: A meta-analysis
Yue-Xin Zhang, Tao Jin, Kun Yang
The Surgeon.2023; 21(4): e164. CrossRef
Sarcopenic Obesity Is a Risk Factor for Worse Oncological Long-Term Outcome in Locally Advanced Rectal Cancer Patients: A Retrospective Single-Center Cohort Study
Peter Tschann, Markus P. Weigl, Patrick Clemens, Philipp Szeverinski, Christian Attenberger, Matthias Kowatsch, Tarkan Jäger, Klaus Emmanuel, Thomas Brock, Ingmar Königsrainer
Nutrients.2023; 15(11): 2632. CrossRef
One Decade of Declining Use of Defunctioning Stomas After Rectal Cancer Surgery in the Netherlands: Are We on the Right Track?
Erik W. Ingwersen, Paulien J.K. van der Beek, Jan Willem T. Dekker, Susan van Dieren, Freek Daams
Diseases of the Colon & Rectum.2023; 66(7): 1003. CrossRef
Effects of Neoadjuvant Radiotherapy on Postoperative Complications in Rectal Cancer: A Meta-Analysis
Jianguo Yang, Yajun Luo, Tingting Tian, Peng Dong, Zhongxue Fu, Irena Ilic
Journal of Oncology.2022; 2022: 1. CrossRef
Tailored Management with Highly-Selective Diversion for Low Colorectal Anastomosis: Biochemical Postoperative Follow-Up and Long-Term Results from a Single-Institution Cohort
Philippe Rouanet, Marie Selvy, Marta Jarlier, Caroline Bugnon, Guillaume Carrier, Anne Mourregot, Pierre-Emmanuel Colombo, Christophe Taoum
Annals of Surgical Oncology.2022; 29(4): 2514. CrossRef
Are risk factors for anastomotic leakage influencing long-term oncological outcomes after low anterior resection of locally advanced rectal cancer with neoadjuvant therapy? A single-centre cohort study
Peter Tschann, Markus P. Weigl, Philipp Szeverinski, Daniel Lechner, Thomas Brock, Stephanie Rauch, Jana Rossner, Helmut Eiter, Paolo N. C. Girotti, Tarkan Jäger, Jaroslav Presl, Klaus Emmanuel, Alexander De Vries, Ingmar Königsrainer, Patrick Clemens
Langenbeck's Archives of Surgery.2022; 407(7): 2945. CrossRef
Analysis of Risk Factors for Anastomotic Leakage After Laparoscopic Anterior Resection of Rectal Cancer and Construction of a Nomogram Prediction Model
Keli Wang, Meijiao Li, Rui Liu, Yang Ji, Jin Yan
Cancer Management and Research.2022; Volume 14: 2243. CrossRef
Preoperative risk factors associated with anastomotic leakage after colectomy for colorectal cancer: a systematic review and meta-analysis
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Revista do Colégio Brasileiro de Cirurgiões.2022;[Epub] CrossRef
Risk Factors of Anastomotic Leakage After Anterior Resection for Rectal Cancer Patients
Xiang-nan Yu, Lu-ming Xu, Ya-wen Bin, Ye Yuan, Shao-bo Tian, Bo Cai, Kai-xiong Tao, Lin Wang, Guo-bin Wang, Zheng Wang
Current Medical Science.2022; 42(6): 1256. CrossRef
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Ho Yung Lee, Sung Il Kang, So Hyun Kim, Jae-Hwang Kim
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Preoperative chemoradiotherapy versus surgery alone for advanced low rectal cancer: a large multicenter cohort study in Japan
Tomonori Akagi, Masafumi Inomata, Hajime Fujishima, Meiki Fukuda, Tsuyoshi Konishi, Shunsuke Tsukamoto, Fuminori Teraishi, Heita Ozawa, Keitaro Tanaka, Koya Hida, Yoshiharu Sakai, Masahiko Watanabe
Surgery Today.2020; 50(11): 1507. CrossRef

Original Articles

Sensitivity of Various Evaluating Modalities for Predicting a Pathologic Complete Response After Preoperative Chemoradiation Therapy for Locally Advanced Rectal Cancer: Sungwoo Jung, Anuj Parajuli, Chang Sik Yu, Seong Ho Park, Jong Seok Lee, Ah Young Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Jin Cheon Kim; Ann Coloproctol. 2019;35(5):275-281. Published online October 31, 2019; DOI: https://doi.org/10.3393/ac.2019.01.07

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Abstract PDF

Purpose
We investigated the sensitivity of various evaluating modalities in predicting a pathologic complete response (pCR) after preoperative chemoradiation therapy (PCRT) for locally advanced rectal cancer (LARC).
Methods
From a population of 2,247 LARC patients who underwent PCRT followed by surgery at Asan Medical Center, Seoul, Korea from January 2007 to June 2016, we retrospectively analyzed 313 patients (14.1%) who showed a pCR after surgery. Transrectal ultrasound (TRUS), high-resolution magnetic resonance imaging (MRI), abdominopelvic computed tomography (AP-CT), and endoscopy were performed within 2 weeks prior to surgery.
Results
Of the 313 patients analyzed, 256 (81.8%) had a pCR after radical surgery and 57 (18.2%) showed total regression after local excision. Preoperative TRUS, MRI, and AP-CT were performed in 283, 305, and 139 patients, respectively. Among these 3 groups, a prediction of a pCR of the primary tumor was made in 41 (14.5%), 51 (16.7%), and 27 patients (19.4%), respectively, before surgery. A prediction of a clinical N0 stage was made in 204 patients (88.3%) using TRUS, 130 (52.2%) using MRI, and 78 (65.5%) using AP-CT. Of the 211 patients who underwent endoscopy, 87 (41.2%) had a mention of clinical CR in their records. A prediction of a pathologic CR was made for 124 patients (39.6%) through at least one diagnostic modality.
Conclusion
The various evaluation methods for predicting a pCR after PCRT show a predictive sensitivity of 0.15–0.41 for primary tumors and 0.52–0.88 for lymph nodes. Endoscopy is a relatively superior modality for predicting the pCR of the primary tumor of LARC patients.

Citations

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Comparison between Local Excision and Radical Resection for the Treatment of Rectal Cancer in ypT0-1 Patients: An Analysis of the Clinicopathological Factors and Survival Rates
Soo Young Oh, In Ja Park, Young IL Kim, Jong-Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Cancers.2021; 13(19): 4823. CrossRef
Predicting Neoadjuvant Chemoradiotherapy Response in Locally Advanced Rectal Cancer Using Tumor-Infiltrating Lymphocytes Density
Yao Xu, Xiaoying Lou, Yanting Liang, Shenyan Zhang, Shangqing Yang, Qicong Chen, Zeyan Xu, Minning Zhao, Zhenhui Li, Ke Zhao, Zaiyi Liu
Journal of Inflammation Research.2021; Volume 14: 5891. CrossRef
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Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection: Yunghuyn Hwang, Yong Sik Yoon, Jun Woo Bong, Hye Yun Choi, In Ho Song, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2019;35(4):194-201. Published online August 31, 2019; DOI: https://doi.org/10.3393/ac.2018.10.18.2

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Abstract PDF

Purpose
Transanal excision (TAE) is an alternative surgical procedure for early rectal cancer. This study compared long-term TAE outcomes, in terms of survival and local recurrence (LR), with total mesorectal excision (TME) in patients with pathologically confirmed T1 rectal cancer.
Methods
T1 rectal adenocarcinoma patients who underwent surgery from 1990 to 2011 were retrospectively reviewed. Patients that were suspected to have preoperative lymph node metastasis were excluded. Demographics, recurrence, and survival were analyzed based on TAE and TME surgery.
Results
Of 268 individuals, 61 patients (26%) underwent TAE, which was characterized by proximity to the anus, submucosal invasion depth, and lesion infiltration, compared with TME patients (P < 0.001–0.033). During a median follow-up of 10.4 years, 12 patients had systemic and/or LR. Ten-year cancer-specific survival in the TAE and TME groups was not significantly different (98% vs. 100%). However, the 10-year LR rate in the TAE group was greater than that of TME group (10% vs. 0%, P < 0.001). Although 5 of the 6 TAE patients with LR underwent salvage surgery, one of the patients eventually died. The TAE surgical procedure (hazard ratio, 19.066; P = 0.007) was the only independent risk factor for LR.
Conclusion
Although long-term survival after TAE was comparable to that after TME, TAE had a greater recurrence risk than TME. Thus, TAE should only be considered as an alternative surgical option for early rectal cancer in selected patients.

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Jesus Badia-Closa, Juan Pablo Campana, Gustavo Leandro Rossi, Xavier Serra-Aracil
Cirugía Española (English Edition).2025;[Epub] CrossRef
Short- and long-term outcomes of local excision with adjuvant radiotherapy in high-risk T1 rectal cancer patients
Abdullah Al-Sawat, Jung Hoon Bae, Hyun Ho Kim, Chul Seung Lee, Seung Rim Han, Yoon Suk Lee, Hyeon-Min Cho, Hong Seok Jang, In Kyu Lee
Annals of Surgical Treatment and Research.2022; 102(1): 36. CrossRef
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Natalie F. Berger, Patricia Sylla
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Multidisciplinary treatment strategy for early rectal cancer
Gyung Mo Son, In Young Lee, Sung Hwan Cho, Byung-Soo Park, Hyun Sung Kim, Su Bum Park, Hyung Wook Kim, Sang Bo Oh, Tae Un Kim, Dong Hoon Shin
Precision and Future Medicine.2022; 6(1): 32. CrossRef
Watch and wait strategies for rectal cancer: A systematic review
In Ja Park
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Early-rectal Cancer Treatment: A Decision-tree Making Based on Systematic Review and Meta-analysis
Ignacio Aguirre-Allende, Jose Maria Enriquez-Navascues, Garazi Elorza-Echaniz, Ane Etxart-Lopetegui, Nerea Borda-Arrizabalaga, Yolanda Saralegui Ansorena, Carlos Placer-Galan
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Kang Xu, Yulin Liu, Peng Yu, Wei Shang, Yongbo Zhang, Mingwen Jiao, Zhonghui Cui, Lijian Xia, Jingbo Chen
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Ignacio Aguirre-Allende, Jose Maria Enriquez-Navascues, Garazi Elorza-Echaniz, Ane Etxart-Lopetegui, Nerea Borda-Arrizabalaga, Yolanda Saralegui Ansorena, Carlos Placer-Galan
Cirugía Española (English Edition).2021; 99(2): 89. CrossRef
The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Surveillance and Survivorship Care of Patients After Curative Treatment of Colon and Rectal Cancer
Karin M. Hardiman, Seth I. Felder, Garrett Friedman, John Migaly, Ian M. Paquette, Daniel L. Feingold
Diseases of the Colon & Rectum.2021; 64(5): 517. CrossRef
The risk factors of local recurrence and distant metastasis on pT1/T2N0 mid-low rectal cancer after total mesorectal excision
I-Li Lai, Jeng-Fu You, Yih-Jong Chern, Wen-Sy Tsai, Jy-Ming Chiang, Pao-Shiu Hsieh, Hsin-Yuan Hung, Yu-Jen Hsu
World Journal of Surgical Oncology.2021;[Epub] CrossRef
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Moon Suk Choi, Jung Wook Huh, Jung Kyong Shin, Yoon Ah Park, Yong Beom Cho, Hee Cheol Kim, Seong Hyeon Yun, Woo Yong Lee
Yonsei Medical Journal.2021; 62(12): 1107. CrossRef
New morphological risk factors for metastasis to regional lymph nodes in rectal cancer with invasion into the submucosa
O. A. Maynovskaya, E. G. Rybakov, S. V. Chernyshov, Yu. A. Shelygin, S. I. Achkasov
Koloproktologia.2021; 20(4): 22. CrossRef
Surgical Treatment of Low-Lying Rectal Cancer: Updates
Cristopher Varela, Nam Kyu Kim
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Comparison of the transanal surgical techniques for local excision of rectal tumors: a network meta-analysis
Konstantinos Perivoliotis, Ioannis Baloyiannis, Chamaidi Sarakatsianou, George Tzovaras
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What Should Be Considered for Local Excision in Early Rectal Cancer?
Taesung Ahn
Annals of Coloproctology.2019; 35(4): 155. CrossRef
Survival analysis of local excision vs total mesorectal excision for middle and low rectal cancer in pT1/pT2 stage and intermediate pathological risk
I-Li Lai, Jeng-Fu You, Yih-Jong Chern, Wen-Sy Tsai, Jy-Ming Chiang, Pao-Shiu Hsieh, Hsin-Yuan Hung, Chien-Yuh Yeh, Sum-Fu Chiang, Cheng-Chou Lai, Rei-Ping Tang, Jinn-Shiun Chen, Yu-Jen Hsu
World Journal of Surgical Oncology.2019;[Epub] CrossRef

Oncologic Outcomes of Organ Preserving Approaches in Patients With Rectal Cancer Treated With Preoperative Chemoradiotherapy: In Ja Park, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2019;35(2):65-71. Published online April 30, 2019; DOI: https://doi.org/10.3393/ac.2019.03.17

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Abstract PDF

Purpose
We evaluated the oncologic outcomes of organ-preserving strategies in patients with rectal cancer treated with preoperative chemoradiotherapy (PCRT).
Methods
Between January 2008 and January 2013, 74 patients who underwent wait-and-watch (WW) (n = 42) and local excision (LE) (n = 32) were enrolled. Organ-preserving strategies were determined based on a combination of magnetic resonance imaging, sigmoidoscopy, and physical examination 4–6 weeks after completion of PCRT. The rectum sparing rate, 5-year recurrence-free survival (RFS), and overall survival (OS) were evaluated.
Results
The rectum was more frequently spared in the LE (100% vs. 87.5%, P = 0.018) at last follow-up. Recurrence occurred in 9 (28.1%) WW and 7 (16.7%) LE (P = 0.169). In the WW, 7 patients had only luminal regrowth and 2 had combined lung metastasis. In the LE, 2 (4.8%) had local recurrence only, 4 patients had distant metastasis, and 1 patient had local and distant metastasis. Among 13 patients who indicated salvage surgery (WW, n = 7; LE, n = 11), all in the WW received but all of LE refused salvage surgery (P = 0.048). The 5-year OS and 5-year RFS in overall patients was 92.7% and 76.9%, respectively, and were not different between WW and LE (P = 0.725, P = 0.129).
Conclusion
WW and LE were comparable in terms of 5-year OS and RFS. In the LE group, salvage treatment was performed much less among indicated patients. Therefore, methods to improve the oncologic outcomes of patients indicated for salvage treatment should be considered before local excision.

Citations

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Effectiveness of Organ Preservation for Locally Advanced Rectal Cancer With Complete Clinical Response After Neoadjuvant Chemoradiotherapy: Bayesian Network Meta-analysis
Kaibo Ouyang, Zifeng Yang, Yuesheng Yang, Zejian Lyu, Junjiang Wang, Yong Li
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Rectal Sparing Approaches after Neoadjuvant Treatment for Rectal Cancer: A Systematic Review and Meta-Analysis Comparing Local Excision and Watch and Wait
Quoc Riccardo Bao, Stefania Ferrari, Giulia Capelli, Cesare Ruffolo, Marco Scarpa, Amedea Agnes, Giuditta Chiloiro, Elisa Palazzari, Emanuele Damiano Luca Urso, Salvatore Pucciarelli, Gaya Spolverato
Cancers.2023; 15(2): 465. CrossRef
Organ preservation for early rectal cancer using preoperative chemoradiotherapy
Gyung Mo Son
Annals of Coloproctology.2023; 39(3): 191. CrossRef
Can pretreatment platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios predict long-term oncologic outcomes after preoperative chemoradiation followed by surgery for locally advanced rectal cancer?
Sang Hyun An, Ik Yong Kim
Annals of Coloproctology.2022; 38(3): 253. CrossRef
Multidisciplinary treatment strategy for early rectal cancer
Gyung Mo Son, In Young Lee, Sung Hwan Cho, Byung-Soo Park, Hyun Sung Kim, Su Bum Park, Hyung Wook Kim, Sang Bo Oh, Tae Un Kim, Dong Hoon Shin
Precision and Future Medicine.2022; 6(1): 32. 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
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Watch and wait strategies for rectal cancer: A systematic review
In Ja Park
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The watch-and-wait strategy versus radical resection for rectal cancer patients with a good response (≤ycT2) after neoadjuvant chemoradiotherapy
Chungyeop Lee, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
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Improvement in the Assessment of Response to Preoperative Chemoradiotherapy for Rectal Cancer Using Magnetic Resonance Imaging and a Multigene Biomarker
Eunhae Cho, Sung Woo Jung, In Ja Park, Jong Keon Jang, Seong Ho Park, Seung-Mo Hong, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
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From Total Mesorectal Excision to Organ Preservation for the Treatment of Rectal Cancer
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Variation in the Height of Rectal Cancers According to the Diagnostic Modalities: Seung-Seop Yeom, In Ja Park, Dong-Hoon Yang, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seok-Byung Lim, Sung Ho Park, Hwa Jung Kim, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2019;35(1):24-29. Published online February 28, 2019; DOI: https://doi.org/10.3393/ac.2018.07.31

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Abstract PDF

Purpose
Although the height of a rectal tumor above the anal verge (tumor height) partly determines the treatment strategy, no practical standard exists for reporting this. We aimed to demonstrate the differences in tumor height according to the diagnostic modality used for its measurement.
Methods
We identified 100 patients with rectal cancers located within 15 cm of the anal verge who had recorded tumor heights measured by using magnetic resonance imaging (MRI), colonoscopy, and digital rectal examination (DRE). Tumor height measured by using MRI was compared with those measured by using DRE and colonoscopy to assess reporting inconsistencies. Factors associated with differences in tumor height among the modalities were also evaluated.
Results
The mean tumor heights were 77.8 ± 3.3, 52.9 ± 2.3, and 68.9 ± 3.1 mm when measured by using MRI, DRE, and colonoscopy, respectively (P < 0.001). Agreement among the 3 modalities in terms of tumor sublocation within the rectum was found in only 39% of the patients. In the univariate and the multivariate analyses, clinical stage showed a possible association with concordance among modalities, but age, sex, and luminal location of the tumor were not associated with differences among modalities.
Conclusion
The heights of rectal cancer differed according to the diagnostic modality. Tumor height has implications for rectal cancer’s surgical planning and for interpreting comparative studies. Hence, a consensus is needed for measuring and reporting tumor height.

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The efficacy of open transanal drainage tube against anastomotic leakage in left-sided colorectal cancer surgery: a propensity score matching study
Gen Tsujio, Tatsunari Fukuoka, Atsushi Sugimoto, Ken Yonemitsu, Yuki Seki, Hiroaki Kasashima, Yuichiro Miki, Mami Yoshii, Tatsuro Tamura, Masatsune Shibutani, Takahiro Toyokawa, Shigeru Lee, Kiyoshi Maeda
BMC Surgery.2025;[Epub] CrossRef
Defining the tumor location in rectal cancer – practice variations and impact on treatment decision making
Elisabeth P. Goedegebuure, Francesco M. Arico, Max J. Lahaye, Monique Maas, Geerard L. Beets, Femke P. Peters, Monique E. van Leerdam, Regina G.H. Beets-Tan, Doenja M.J. Lambregts
European Journal of Surgical Oncology.2025; : 109700. CrossRef
Effects of Adjuvant Chemotherapy on Oncologic Outcomes in Patients With Stage ⅡA Rectal Cancer Above the Peritoneal Reflection Who Did Not Undergo Preoperative Chemoradiotherapy
Hyo Seon Ryu, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Yong Sang Hong, Tae Won Kim, Chang Sik Yu
Clinical Colorectal Cancer.2024; 23(4): 392. CrossRef
Interrater Agreement of Height Assessment by Rigid Proctoscopy/Rectoscopy for Rectal Carcinoma
Matthias Kraemer, Sarkhan Nabiyev, Silvia Kraemer, Stephanie Schipmann
Diseases of the Colon & Rectum.2024; 67(8): 1018. CrossRef
Chinese national clinical practice guidelines on prevention, diagnosis and treatment of early colorectal cancer
Jingnan Li, Hongwei Yao, Yun Lu, Shutian Zhang, Zhongtao Zhang
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Elias Karam, Fabien Fredon, Yassine Eid, Olivier Muller, Marie Besson, Nicolas Michot, Urs Giger-Pabst, Arnaud Alves, Mehdi Ouaissi
Surgical Oncology.2024; 57: 102145. CrossRef
Comparison of flexible endoscopy and magnetic resonance imaging in determining the tumor height in rectal cancer
Mohammed H. Basendowah, Mohammed A. Ezzat, Aseel H. Khayyat, Eyad Saleh A. Alamri, Turki A. Madani, Anas H. Alzahrani, Rana Y. Bokhary, Arwa O. Badeeb, Hussam A. Hijazi
Cancer Reports.2023;[Epub] CrossRef
Measuring Rectal Cancer Tumor Height: Concordance Between Clinical Examination and MRI
Shannon M. Navarro, Shuai Chen, Linda M. Farkas
Diseases of the Colon & Rectum.2022; 65(4): 497. CrossRef
How do they measure up: Assessing the height of rectal cancer with digital rectal exam, endoscopy, and MRI,,
Jordan Wlodarczyk, Kshitij Gaur, Nicholas Serniak, Kevin Mertz, Jason Muri, Sarah Koller, Sang W. Lee, Kyle G. Cologne
Surgery in Practice and Science.2022; 10: 100096. CrossRef
Measurement of rectal tumor height from the anal verge on MRI: a comparison of internal versus external anal sphincter
David D. B. Bates, James L. Fuqua, Junting Zheng, Marinela Capanu, Jennifer S. Golia Pernicka, Sidra Javed-Tayyab, Viktoriya Paroder, Iva Petkovska, Marc J. Gollub
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Guglielmo Niccolò Piozzi, Seon Hahn Kim
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Does the Different Locations of Colon Cancer Affect the Oncologic Outcome? A Propensity-Score Matched Analysis: Kwan Mo Yang, In Ja Park, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seok-Byung Lim, Na Young Kim, Shinae Hong, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2019;35(1):15-23. Published online February 28, 2019; DOI: https://doi.org/10.3393/ac.2018.07.25

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Abstract PDF

Purpose
We evaluate the prognostic value of primary tumor location for oncologic outcomes in patients with colon cancer (CC).
Methods
CC patients treated with curative surgery between 2009 and 2012 were classified into 2 groups: right-sided colon cancer (RCC) and left-sided colon cancer (LCC). Recurrence-free survival (RFS) and overall survival (OS) were examined based on tumor stage. Propensity scores were created using eight variables (age, sex, T stage, N stage, histologic grade, presence of lymphovascular invasion/perineural invasion, and microsatellite instability status).
Results
Overall, 2,329 patients were identified. The 5-year RFSs for RCC and LCC patients were 89.7% and 88.4% (P = 0.328), respectively, and their 5-year OSs were 90.9% and 93.4% (P = 0.062). Multivariate survival analyses were carried out by using the Cox regression proportional hazard model. In the unadjusted analysis, a marginal increase in overall mortality was seen in RCC patients (hazard ratio [HR], 1.297; 95% confidence interval [CI], 0.987–1.704, P = 0.062); however, after multivariable adjustment, similar OSs were observed in those patients (HR, 1.219; 95% CI, 0.91–1.633; P = 0.183). After propensity-score matching with a total of 1,560 patients, no significant difference was identified (P = 0.183). A slightly worse OS was seen for stage III RCC patients (HR, 1.561; 95% CI, 0.967–2.522; P = 0.068) than for stage III LCC patients. The 5-year OSs for patients with stage III RCC and stage III LCC were 85.5% and 90.5%, respectively (P = 0.133).
Conclusion
Although the results are inconclusive, tumor location tended to be associated with OS in CC patients with lymph node metastasis, but it was not related to oncologic outcome.

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Prognostic value of primary tumor location in colorectal cancer: an updated meta-analysis
Hanieh Gholamalizadeh, Nima Zafari, Mahla Velayati, Hamid Fiuji, Mina Maftooh, Elnaz Ghorbani, Seyed Mahdi Hassanian, Majid Khazaei, Gordon A. Ferns, Elham Nazari, Amir Avan
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Liming Wang, Yasumitsu Hirano, Toshimasa Ishii, Hiroka Kondo, Kiyoka Hara, Nao Obara, Shigeki Yamaguchi
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Trephine Transverse Colostomy Is Effective for Patients Who Have Previously Undergone Rectal Surgery: Seung-Seop Yeom, Chan Wook Kim, Sung Woo Jung, Se Heon Oh, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2018;34(2):72-77. Published online April 30, 2018; DOI: https://doi.org/10.3393/ac.2017.09.29

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Abstract PDF

Purpose
Colostomy creation is an essential procedure for colorectal surgeons, but the preferred method of colostomy varies by surgeon. We compared the outcomes of trephine colostomy creation with open those for the (laparotomy) and laparoscopic methods and evaluated appropriate indications for a trephine colostomy and the advantages of the technique.
Methods
We retrospectively evaluated 263 patients who had undergone colostomy creation by trephine, open and laparoscopic approaches between April 2006 and March 2016. We compared the clinical features and the operative and postoperative outcomes according to the approach used for stoma creation.
Results
One hundred sixty-three patients (62%) underwent colostomy surgery for obstructive causes and 100 (38%) for fistulous problems. The mean operative time was significantly shorter with the trephine approach (trephine, 46.0 ± 1.9 minutes; open, 78.7 ± 3.9 minutes; laparoscopic, 63.5 ± 5.0 minutes; P < 0.001), as was the time to flatus (1.8 ± 0.1 days, 2.1 ± 0.1 days, 2.2 ± 0.3 days, P = 0.025). Postoperative complications (<30 days) were not different among the 3 approaches (trephine, 4.3%; open, 1.2%; laparoscopic, 0%; P = 0.828). In patients who underwent rectal surgery, a trephine colostomy was feasible for a diversion colostomy (P < 0.001).
Conclusion
The trephine colostomy is safe and can be implemented quickly in various situations, and compared to other colostomy procedures, the patient’s recovery is faster. Previous laparotomy history was not a contraindication for a trephine colostomy, and a trephine transverse colostomy is feasible for patients who have undergone previous rectal surgery.

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Ahmed M AlMuhsin, Abdulaziz Bazuhair, Omar AlKhlaiwy, Rami O Abu Hajar, Thabit Alotaibi
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Yongjun Park, Dong Uk Choi, Hyung Ook Kim, Yong Bog Kim, Chungki Min, Jung Tack Son, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim
Annals of Coloproctology.2022; 38(4): 319. CrossRef
Minimally invasive colostomy with endoscopy as a novel technique for creation of a trephine stoma
Teppei Kamada, Hironori Ohdaira, Junji Takahashi, Wataru Kai, Keigo Nakashima, Yuichi Nakaseko, Norihiko Suzuki, Masashi Yoshida, Yutaka Suzuki
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Does Anastomosis Configuration Influence Long-term Outcomes in Patients With Crohn Disease?: Parajuli Anuj, Yong Sik Yoon, Chang Sik Yu, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Jin Cheon Kim; Ann Coloproctol. 2017;33(5):173-177. Published online October 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.5.173

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Abstract PDF

Purpose

In this study, we evaluated the role of various anastomoses in surgical recurrence for patients with Crohn disease (CD).

Methods

We analyzed data retrospectively from consecutive laparotomy cases involving complicated CD between 1991 and 2008. Clinical data were compared in terms of reoperation-free survival (RFS) according to the types of anastomoses, the materials used for the anastomoses, and the operating surgeon.

Results

Of 233 patients with entero-enteric or entero-colic anastomoses, 199 (85%), 11 (5%), and 23 (10%) experienced side-to-side (SS), side-to-end (SE), and end-to-end (EE) anastomoses, respectively. The SS group had the following characteristics: more extensive bowel involvement, frequent obstruction, and greater stapler use; the SS anastomoses were also frequently made by specialized surgeons (P < 0.001–0.004). EE anastomoses were frequently made by general surgeons using a hand-sewing technique (P < 0.001). No differences in RFS were noted among the 3 groups according to the type of anastomosis and the operating surgeon. However, the hand-sewn group showed better RFS than the stapler group (P = 0.04).

Conclusion

The roles of the anastomotic configuration, the material used, and the operating surgeon were not significantly correlated with reoperations or complications in our retrospective CD cohort, irrespective of the higher risk of anastomosis site stricture for EE anastomoses.

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Pauline Rivière, Gabriele Bislenghi, Nassim Hammoudi, Bram Verstockt, Steven Brown, Melissa Oliveira-Cunha, Willem Bemelman, Gianluca Pellino, Paulo Gustavo Kotze, Gabriele Dragoni, Mariangela Allocca, Nurulamin M Noor, Lieven Pouillon, Míriam Mañosa, Edo
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Benjamin Click, Amit Merchea, Dorin T Colibaseanu, Miguel Regueiro, Francis A Farraye, Luca Stocchi
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Shin Jeong Pak, Young Il Kim, Yong Sik Yoon, Jong Lyul Lee, Jung Bok Lee, Chang Sik Yu
World Journal of Gastroenterology.2021; 27(41): 7159. CrossRef
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Amy L. Lightner, Jon D. Vogel, Joseph C. Carmichael, Deborah S. Keller, Samir A. Shah, Uma Mahadevan, Sunanda V. Kane, Ian M. Paquette, Scott R. Steele, • Daniel L. Feingold
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Jin-Su Kim, Ji-Yeon Kim
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Prognostic Factors in Terms of the Number of Metastatic Nodules in Patients With Colorectal Cancer Liver Metastases: Ki Ung Jang, Chan Wook Kim, Ki-Hun Kim, Seok-Byung Lim, Chang Sik Yu, Tae Won Kim, Pyo Nyun Kim, Jong Hoon Kim, Jin Cheon Kim; Ann Coloproctol. 2016;32(3):92-100. Published online June 30, 2016; DOI: https://doi.org/10.3393/ac.2016.32.3.92

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Abstract PDF

Purpose

The hepatic resection is the gold-standard treatment for patients with colorectal-cancer liver metastases (CLM). This study aimed to identify prognostic factors in patients with synchronous CLM who underwent a surgical curative (R0) resection with respect to the number of metastatic nodules.

Methods

Of 1,261 CLM patients treated between January 1991 and December 2010, 339 who underwent a R0 resection for synchronous CLM were included in this retrospective analysis. Patients were grouped according to the number of CLM nodules: 1–2 CLM nodules, n = 272 (group 1) and 3–8 CLM nodules, n = 67 (group 2).

Results

The 5-year progression-free survival (PFS) rate in group 1was better than that in group 2 (P = 0.020). The multivariate analysis identified lymph-node metastasis (N2), lymphovascular invasion (LVI), and three or more CLM nodules as independent poor prognostic factors for PFS in all patients and lymph-node metastasis (N2) and LVI as independent poor prognostic factors for patients in group 1. No independent prognostic factors were identified for patients in group 2. CLM treatment method and neoadjuvant chemotherapy were not associated with survival.

Conclusion

Three or more metastatic nodules, lymph-node metastasis (N2), and LVI were independent poor prognostic factors for PFS in patients with synchronous CLM who underwent a R0 resection. The latter 2 factors were also independent prognostic factors for PFS in patients with less than 3 CLM nodules; however, in patients with three or more CLM nodules, the prognosis for PFS may be related only to liver metastasis.

Citations

Citations to this article as recorded by

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