Annals of Coloproctology

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Review

Translation/basic research

Extracellular vesicles in colorectal cancer: Young Il Kim, Chungyeop Lee, Hakho Lee, In Ja Park; Ann Coloproctol. 2025;41(5):379-392. Published online October 16, 2025; DOI: https://doi.org/10.3393/ac.2025.00745.0106

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Abstract PDF: Colorectal cancer (CRC) remains a major global health issue, with challenges including early detection and recurrence monitoring. While colonoscopy and fecal-based tests are standard screening tools, their limitations have driven interest in less invasive alternatives. Extracellular vesicles (EVs) present in patient liquid biopsy samples have emerged as potential biomarkers and therapeutic tools in CRC. EVs carry molecular cargo, including nucleic acids and proteins, that reflect the status of their cells of origin and can be readily accessed through minimally invasive liquid biopsy. This review outlines the role of EVs in the initiation and progression of CRC, summarizes recent advances in EV isolation techniques, and highlights candidate EV-derived biomarkers for diagnosis, prognosis, and treatment monitoring. By providing an updated synthesis of current research, this review aims to inform future studies and support clinical translation of EV-based approaches in CRC.

Original Articles

Minimally invasive surgery

Comparative perioperative outcomes of articulated versus conventional straight devices in laparoscopic low anterior resection: a propensity score–matched analysis: Hayoung Lee, Yong Sik Yoon, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim; Ann Coloproctol. 2025;41(5):434-442. Published online October 16, 2025; DOI: https://doi.org/10.3393/ac.2025.00227.0032

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Abstract PDF Supplementary Material: Purpose
Laparoscopic low anterior resection for rectal cancer is technically challenging due to the precision required for mesorectal excision. Articulated instruments were developed to improve precision and oncological safety over conventional instruments. This study compares their perioperative outcomes.
Methods
A retrospective cohort study of 432 patients with colorectal cancer who underwent low anterior resection between August 2022 and February 2024 applied propensity score matching to minimize selection bias. Primary endpoints were circumferential resection margin (CRM), distal resection margin (DRM), and harvested lymph nodes count. Secondary outcomes included postoperative complications.
Results
Following propensity score matching, 84 matched pairs were analyzed. Most patients achieved CRM negativity (>1 mm), with CRM ≥10 mm in 67.9% of the articulated group and 59.5% of the conventional group (P=0.613). Median (interquartile range, IQR) lymph nodes harvests were comparable (20 [14–26] vs. 18 [14–22], P=0.147). The articulated group had a significantly longer DRM (30.0 mm [IQR, 18.0–40.0 mm] vs. 24.0 mm [IQR, 12.0–34.2 mm], P=0.008) and the median operation time (111.0 minutes [IQR, 95.8–125.2 minutes] vs. 99.5 minutes [IQR, 72.0–119.8 minutes], P=0.009). Estimated blood loss, open conversion rates, and postoperative complications, including leakage (7.1% vs. 8.3%, P>0.999) and surgical site infections, (15.5% vs. 9.5%, P=0.383), showed no significant differences.
Conclusion
Articulated laparoscopic instruments demonstrated comparable safety and feasibility to conventional instruments but offered no significant clinical or oncological benefits beyond a longer DRM. Larger studies are needed to evaluate their value in laparoscopic rectal surgery.

Colorectal cancer

Effects of clinical information on the treatment decisions for good responders to neoadjuvant chemoradiotherapy among rectal cancer patients: Eon Bin Kim, In Ja Park, Hwa Jung Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu; Ann Coloproctol. 2025;41(5):473-482. Published online July 10, 2025; DOI: https://doi.org/10.3393/ac.2024.00276.0039

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Abstract PDF Supplementary Material

Purpose
The decision for treatment after neoadjuvant chemoradiotherapy (nCRT) in rectal cancer is intricately linked to tumor response and clinical parameters. This study was designed to elucidate determinants influencing treatment decisions for good responders to nCRT, while concurrently evaluating the ramifications of modifications in magnetic resonance imaging (MRI) tumor response evaluation protocols.
Methods
A survey was constructed with 5 cases of good responder after nCRT based on the magnetic resonance–based tumor regression grade (mrTRG) criteria. A total of 35 colorectal surgeons in Korea participated in the survey via email, and they were introduced to 2 discrete MRI-based tumor response evaluation methodologies: the conventional mrTRG and an emergent complete response (CR)/non-CR classification system. Surgeons were directed to select between total mesorectal excision, local excision, or a watch and wait strategy.
Results
Treatment decisions varied significantly (P<0.01), as gradually more clinical information was provided with mrTRG. The paradigm shift from mrTRG to CR/non-CR evaluation criterion instigated the highest alteration in decision (P<0.01). Even comparing with other sets of information, decision change with different tumor response assessment (i.e., mrTRG vs. CR/non-CR) was statistically significant (P<0.01). Three particular cases consistently displayed a declining predilection for total mesorectal excision, favoring a more pronounced inclination towards watch and wait strategy or local excision. Nonetheless, the magnitude of these decisional shifts oscillated depending on the specific endoscopic imagery present.
Conclusion
Our current findings underscore the significant role of tumor response assessment methods in shaping treatment decisions for rectal cancer patients who respond well to nCRT. This highlights the need for clear and accurate tools to interpret MRI results.

Citations

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Clinical implications of radiologic criteria and prognostic factors for lateral lymph node metastasis in low rectal cancer
Gyung Mo Son
Annals of Coloproctology.2025; 41(6): 489. CrossRef

Editorial

Colorectal cancer

Less is more: simplifying patient-centered cancer care: In Ja Park; Ann Coloproctol. 2025;41(3):173-174. Published online June 30, 2025; DOI: https://doi.org/10.3393/ac.2025.00738.0105

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Review

Inflammatory/benign bowel disease

Clinical outcomes and optimal indications for nonoperative management of acute appendicitis in adult patients: a comprehensive literature review: Hyun Gu Lee, In Ja Park; Ann Coloproctol. 2025;41(2):107-118. Published online April 16, 2025; DOI: https://doi.org/10.3393/ac.2023.00192.0027

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Graphical Abstract Abstract PDF

Appendectomy as the standard treatment for acute appendicitis has been challenged by accumulating evidence supporting nonoperative management with antibiotics as a potential primary treatment. This review aimed to summarize the clinical outcomes and the optimal indications for nonoperative management of acute appendicitis in adults. Current evidence suggests that uncomplicated and complicated appendicitis have different pathophysiologies and should be treated differently. Nonoperative management for uncomplicated appendicitis was not inferior to appendectomy in terms of complications and length of stay, with less than a 30% failure rate at 1 year. The risk of perforation and postoperative complications did not increase even if nonoperative management failed. Complicated appendicitis with localized abscess or phlegmon could also be treated conservatively, with a success rate of more than 80%. An interval appendectomy following successful nonoperative management is recommended only for patients over the age of 40 years to exclude appendiceal malignancy. The presence of appendicoliths increased the risk of treatment failure and complications; thus, it may be an indication for appendectomy. Nonoperative management is a safe and feasible option for both uncomplicated and complicated appendicitis. Patients should be informed that nonoperative management may be a safe alternative to surgery, with the possibility of treatment failure.

Citations

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Appendicolith in non-operative management of acute appendicitis: Implications for recurrence and future directions
Ju Tian
World Journal of Clinical Cases.2025;[Epub] CrossRef

Editorial

From the Editor: Uniting expertise, a new era of global collaboration in coloproctology: In Ja Park; Ann Coloproctol. 2024;40(4):285-286. Published online August 30, 2024; DOI: https://doi.org/10.3393/ac.2024.00514.0073

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Original Articles

Colorectal cancer

Oncologic outcomes and associated factors of colon cancer patients aged 70 years and older: Byeo Lee Lim, In Ja Park, Jun-Soo Ro, Young Il Kim, Seok-Byung Lim, Chang Sik Yu; Ann Coloproctol. 2025;41(3):198-206. Published online August 5, 2024; DOI: https://doi.org/10.3393/ac.2023.00367.0052

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Abstract PDF Supplementary Material

Purpose
The aim of this study was to examine the prognosis and associated risk factors, including adjuvant chemotherapy (CTx), in elderly patients with colon cancer.
Methods
This retrospective study included patients who underwent radical resection for colon cancer between January 2010 and December 2014 at Asan Medical Center. The effects of stage, risk factors, and chemotherapy on overall survival (OS) and recurrence-free survival (RFS) were compared in patients aged ≥70 and <70 years.
Results
Of 3,313 patients, 933 (28.1%) was aged ≥70 years. Of the 1,921 patients indicated for adjuvant CTx, 1,294 of 1,395 patients (92.8%) aged <70 years and 369 of 526 patients (70.2%) aged ≥70 years received adjuvant CTx. Old age (≥70 years) was independently associated with RFS in overall cohort. Among patients aged ≥70 years indicated for adjuvant CTx, the 5-year OS (81.6% vs. 50.4%, P<0.001) and RFS (82.9% vs. 67.4%, P=0.025) rates were significantly higher in those who did than did not receive adjuvant CTx. Additionally, adjuvant CTx was confirmed as independent risk factor of both OS and RFS in patients aged ≥70 years indicated for adjuvant CTx.
Conclusion
Old age was associated with poor RFS and adjuvant CTx had benefits in OS as well as RFS in elderly patients eligible for adjuvant CTx.

Citations

Citations to this article as recorded by

Immunological changes and recovery-related factors in older patients with colon cancer: A pilot trial
Byeo Lee Lim, Young Il Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Yousun Ko, Kyung Won Kim, In Ja Park
Journal of Geriatric Oncology.2025; 16(3): 102200. CrossRef
Stage II-III colorectal cancer in geriatric patients: Clinicopathological features and chemotherapy utilization
Yakup Duzkopru, Özlem Doğan
Turkish Journal of Clinics and Laboratory.2025; 16(1): 118. CrossRef
Does Oxaliplatin-based Adjuvant Therapy Benefit Older Colorectal Cancer Patients?
Peter Hofland
Onco Zine - The International Oncology Network.2025;[Epub] CrossRef
Disease-Free Survival of Patients with Stage II Stroma-Rich Colorectal Adenocarcinomas with Microsatellite Stability
Ángel Romo-Navarro, Juan Ruiz Martín, Irene García-Camacha Gutiérrez, Mariano Amo-Salas, María Recuero Pradillo, César Sánchez-Muñoz, Cristina María Murillo Lázaro, Esperanza Carabias López, Raquel Sánchez Simón, Carlos Quimbayo-Arcila, Yasmina Hernández
International Journal of Molecular Sciences.2025; 26(24): 11795. CrossRef
Early detection of anastomotic leakage in colon cancer surgery: the role of early warning score and C-reactive protein
Gyung Mo Son
Annals of Coloproctology.2024; 40(5): 415. CrossRef
Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-Center Retrospective Analysis
Jae Seung Kim, Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
Cancers.2024; 16(24): 4280. 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,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

Citations to this article as recorded by

Immunological changes and recovery-related factors in older patients with colon cancer: A pilot trial
Byeo Lee Lim, Young Il Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Yousun Ko, Kyung Won Kim, In Ja Park
Journal of Geriatric Oncology.2025; 16(3): 102200. CrossRef
Oncologic outcomes of surgically treated colorectal cancer in octogenarians: a comparative study using inverse probability of treatment weighting (IPTW)
Soo Young Oh, Jung Yun Park, Kwan Mo Yang, Seong-A Jeong, Yong Jae Kwon, Yun Tae Jung, Chung Hyeun Ma, Keong Won Yun, Kwang Hyun Yoon, Jae Young Kwak, Chang Sik Yu
BMC Gastroenterology.2025;[Epub] CrossRef
Oncologic outcomes and associated factors of colon cancer patients aged 70 years and older
Byeo Lee Lim, In Ja Park, Jun-Soo Ro, Young Il Kim, Seok-Byung Lim, Chang Sik Yu
Annals of Coloproctology.2025; 41(3): 198. CrossRef
Older Age Threshold for Oxaliplatin Benefit in Stage II to III Colorectal Cancer
Jun Woo Bong, Hwamin Lee, Seogsong Jeong, Sanghee Kang
JAMA Network Open.2025; 8(8): e2525660. CrossRef
Primary tumor resection vs. self-expandable metallic stent in unresectable obstructive stage IV colorectal cancer: a comparative outcome study
Chang Hyun Kim, Jae Kyun Ju, Jaram Lee, Hyeung-min Park, Soo Young Lee, Hyeong Rok Kim, Young Eun Joo, Sung Bum Cho
Annals of Surgical Treatment and Research.2025; 109(2): 89. CrossRef
Evaluation of the utility of a nomogram for predicting lymph node metastasis in T1 colorectal cancer in shared decision-making in clinical practice: a survey-based study
Hyeon Seung Kim, Kyung Su Han, Min Wan Lee, Dae Kyung Sohn, Chang Won Hong, Dong Woon Lee, Kiho You, Sung Chan Park, Byung Chang Kim, Bun Kim, Jae Hwan Oh
Annals of Coloproctology.2025; 41(4): 303. CrossRef
Oncologic outcomes of multivisceral resection for locally advanced colorectal cancer: a single-center retrospective cohort study
Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
BMC Surgery.2025;[Epub] CrossRef
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
Effect of Fluorescence Lymph Node Mapping on Improving Diagnostic Values of CT D3 Lymph Node Staging for Right-Sided Colon Cancer
Gyung Mo Son, Tae Un Kim, Mi Sook Yun, ChangYeop Kim, In Young Lee, Su Bum Park, Dong-Hoon Shin, Gi Won Ha
Cancers.2024; 16(20): 3496. CrossRef
Gochujang suppresses cell survival and changes reactive oxygen species metabolism in colorectal cancer cells
Eun-Bi Seo, So-Min Oh, Anna Han
Food & Nutrition Research.2024;[Epub] CrossRef
Optimal Indocyanine Green Dosage for Repetitive Angiography for Laparoscopic Colorectal Surgery
Gyung Mo Son, Sang-Ho Park, Nam Su Kim, Mi Sook Yun, In Young Lee, Myeong-Sook Kwon, Tae Kyun Kim, Eun Hwa Lee, Eun Jung Hwang, Kwang-Ryul Baek
Medicina.2024; 60(12): 1966. CrossRef
Beyond survival: a comprehensive review of quality of life in rectal cancer patients
Won Beom Jung
Annals of Coloproctology.2024; 40(6): 527. 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

Editorial

Malignant disease,Rectal cancer

Precision medicine for primary rectal cancer will become a reality: In Ja Park; Ann Coloproctol. 2022;38(4):281-282. Published online August 29, 2022; DOI: https://doi.org/10.3393/ac.2022.00500.0071

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PDF

Citations

Citations to this article as recorded by

Was there any change in surgical treatment for colorectal cancer during the COVID-19 pandemic?
Yeajin Moon, Seung Hun Lee, Seung Hyun Lee
Kosin Medical Journal.2025; 40(3): 207. CrossRef
Effects of clinical information on the treatment decisions for good responders to neoadjuvant chemoradiotherapy among rectal cancer patients
Eon Bin Kim, In Ja Park, Hwa Jung Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu
Annals of Coloproctology.2025; 41(5): 473. CrossRef
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
Beyond survival: a comprehensive review of quality of life in rectal cancer patients
Won Beom Jung
Annals of Coloproctology.2024; 40(6): 527. 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
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] 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

Original Articles

Colorecal cancer

Prognostic significance of lymph node yield on oncologic outcomes according to tumor response after preoperative chemoradiotherapy in rectal cancer patients: Hyo Seon Ryu, In Ja Park, Bo Kyung Ahn, Min Young Park, Min Sung Kim, Young Il Kim, Seok-Byung Lim, Jin Cheon Kim; Ann Coloproctol. 2023;39(5):410-420. Published online April 28, 2022; DOI: https://doi.org/10.3393/ac.2022.00143.0020

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Graphical Abstract Abstract PDF

Purpose
This study aimed to evaluate the predictive value of lymph node yield (LNY) for survival outcomes according to tumor response after preoperative chemoradiotherapy (PCRT) in patients with rectal cancer.
Methods
This study was a retrospective study conducted in a tertiary center. A total of 1,240 patients with clinical stage II or III rectal cancer who underwent curative resection after PCRT between 2007 and 2016 were included. Patients were categorized into the good response group (tumor regression grade [TRG], 0–1) or poor response group (TRG, 2–3). Propensity score matching was performed for age, sex, and pathologic stage between LNY of ≥12 and LNY of <12 within tumor response group. The primary outcome was 5-year disease-free survival (DFS) and overall survival (OS).
Results
LNY and positive lymph nodes were inversely correlated with TRG. In good responders, 5-year DFS and 5-year OS of patients with LNY of <12 were better than those with LNY of ≥12, but there was no statistical significance. In poor responders, the LNY of <12 group had worse survival outcomes than the LNY of ≥12 group, but there was also no statistical significance. LNY of ≥12 was not associated with DFS and OS in multivariate analysis.
Conclusion
LNY of <12 showed contrasting outcomes between the good and poor responders in 5-year DFS and OS. LNY of 12 may not imply adequate oncologic surgery or proper staging in rectal cancer patients treated by PCRT. Furthermore, a decrease in LNY should be comprehended differently according to tumor response.

Citations

Citations to this article as recorded by

Breaking Myths: Comparable Outcomes in Lymph Node Analysis Across Surgical Methods
Salvatore Pezzino, Tonia Luca, Mariacarla Castorina, Giulia Fuccio Sanzà, Gaetano Magro, Stefano Puleo, Ornella Coco, Sergio Castorina
Cancers.2025; 17(8): 1312. CrossRef
A predictive nomogram for assessing the likelihood of retrieving 12 lymph nodes after rectal cancer surgery: a single-center study
Jian Ma, Runyang Hao, Shuai Jiao, Qingmin Chen, Baohong Yang, Xu Guan, Jiale Li, Xinxuan Zhao, Yu Huo, Qingxia Xu, Haiyi Liu, Wen Su, Xishan Wang
Frontiers in Oncology.2025;[Epub] 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
Artificial Intelligence-Driven Volumetric Analysis of Muscle Mass as a Predictor of Tumor Response to Neoadjuvant Chemoradiotherapy in Patients with Rectal Cancer
Minsung Kim, Sang Min Lee, Il Tae Son, Jaewoong Kang, Gyoung Tae Noh, Bo Young Oh
Journal of Clinical Medicine.2024; 13(23): 7018. CrossRef
Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 203. CrossRef

Colorectal cancer

Efficacy of preoperative chemoradiotherapy in patients with cT2N0 distal rectal cancer: Min Young Park, Chang Sik Yu, Tae Won Kim, Jong Hoon Kim, Jin-hong Park, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Jin Cheon Kim; Ann Coloproctol. 2023;39(3):250-259. Published online April 4, 2022; DOI: https://doi.org/10.3393/ac.2022.00066.0009

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Graphical Abstract Abstract PDF Supplementary Material

Purpose
This study was designed to determine the feasibility of preoperative chemoradiotherapy (PCRT) in patients with clinical T2N0 distal rectal cancer.
Methods
Patients who underwent surgery for clinical T2N0 distal rectal cancer between January 2008 and December 2016 were included. Patients were divided into PCRT and non-PCRT groups. Non-PCRT patients underwent radical resection or local excision (LE) according to the surgeon’s decision, and PCRT patients underwent surgery according to the response to PCRT. Patients received 50.0 to 50.4 gray of preoperative radiotherapy with concurrent chemotherapy.
Results
Of 127 patients enrolled, 46 underwent PCRT and 81 did not. The mean distance of lesions from the anal verge was lower in the PCRT group (P=0.004). The most frequent operation was transanal excision and ultralow anterior resection in the PCRT and non-PCRT groups, respectively. Of the 46 patients who underwent PCRT, 21 (45.7%) achieved pathologic complete response, including 15 of the 24 (62.5%) who underwent LE. Rectal sparing rate was significantly higher in the PCRT group (11.1% vs. 52.2%, P<0.001). There were no significant differences in 3- and 5-year overall survival and recurrence-free survival regardless of PCRT or surgical procedures.
Conclusion
PCRT in clinical T2N0 distal rectal cancer patients increased the rectal sparing rate via LE and showed acceptable oncologic outcomes. PCRT may be a feasible therapeutic option to avoid abdominoperineal resection in clinical T2N0 distal rectal cancer.

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Is there a role for total neoadjuvant treatment in early-stage rectal cancer?
Kamil Erozkan, Metincan Erkaya, Jacob A. Miller, Ali Alipouriani, David Liska, Hermann Kessler, Scott R. Steele, Emre Gorgun
Langenbeck's Archives of Surgery.2025;[Epub] CrossRef
Effects of clinical information on the treatment decisions for good responders to neoadjuvant chemoradiotherapy among rectal cancer patients
Eon Bin Kim, In Ja Park, Hwa Jung Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu
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Organ preservation for early rectal cancer using preoperative chemoradiotherapy
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Editorial

Malignant disease,Postoperative outcome & ERAS,Functional outcome

Future direction of Enhanced Recovery After Surgery (ERAS) program in colorectal surgery: In Ja Park; Ann Coloproctol. 2022;38(1):1-2. Published online February 23, 2022; DOI: https://doi.org/10.3393/ac.2022.00094.0013

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Comment from Editor-in-Chief: Master Class 2021

It Is a Pleasure to Announce the Issue Titled “Master Class 2021” in Annals of Coloproctology: In Ja Park; Ann Coloproctol. 2021;37(6):349-350. Published online December 22, 2021; DOI: https://doi.org/10.3393/ac.2021.00997.0142

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Original Article

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.

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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
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Review

Malignant disease,Prognosis and adjuvant therapy

Survival and Operative Outcomes After Salvage Surgery for Recurrent or Persistent Anal Cancer: In Ja Park, George Chang; Ann Coloproctol. 2020;36(6):361-373. Published online December 31, 2020; DOI: https://doi.org/10.3393/ac.2020.12.29

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Abstract PDF

Anal squamous cell carcinoma (SCC) is a relatively rare cancer comprising less than 2.5% of all gastrointestinal malignancies. The standard treatment for anal SCC is primary chemoradiation therapy which can result in complete regression. After successful treatment, the 5-year survival is approximately 80%. However, up to 30% of patients experience recurrent persistent or recurrent disease. The role of surgery in the treatment of anal cancer, therefore, is limited to the management of recurrent or persistent disease with abdominoperineal resection and/or en bloc adjacent organ excision. Salvage surgery after irradiated anal cancer can be technically demanding in terms of acquisition of oncologically safe surgical margins and minimization of postoperative morbidity. In addition, 5-year survival outcomes after salvage resection have been reported to vary from 23% to 69%. Positive resection margins are generally regarded as the important risk factor associated with poor survival outcome. Perineal wound complications are the most common major postoperative morbidity. Because of the challenges of primary wound closure after salvage abdominoperineal resection, myocutaneous flap reconstruction has been performed to reduce the severity of perianal would complications. We, therefore, descriptively reviewed contemporary published evidence describing the treatment and outcomes after salvage surgery for persistent or recurrent anal SCC.

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Original Articles

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.

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Efficacies of radiotherapy in rectal cancer patients treated with total mesorectal excision or other types of surgery: an updated meta-analysis
Wenshu Wang, Runyuan Zhao, Xi Liang, Manjun Liu, Haiyan Bai, Jianli Ge, Binxi Yao, Zheng Zhi, Jianming He
Oncology Reviews.2025;[Epub] CrossRef
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In Ja Park
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Chan Wook Kim
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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
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.

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Definitions, diagnosis, management, and outcomes of upper gastrointestinal Crohn's disease: an international, expert RAND/UCLA appropriateness study
Nathaniel A Cohen, Dominik Bettenworth, Neta Sror, Raneem Khedraki, Qijun Yang, Maria T Abreu, Raja Atreya, Badr Al-Bawardy, Susan J Connor, Geert D'Haens, Iris Dotan, Axel Dignass, Sara El Ouali, Brian Feagan, Roger Feakins, Richard Gearry, Ilyssa O Gord
The Lancet Gastroenterology & Hepatology.2026;[Epub] CrossRef
Diagnosis and Management of Upper Gastrointestinal Involvement in Adult Patients With Crohn’s Disease: A Systematic Review
Nathaniel A. Cohen, Neta Sror, Maliha Naseer, Dominik Bettenworth, Cathy Lu, Raneem Khedraki, Maria T. Abreu, Raja Atreya, Badr Al-Bawardy, Susan J. Connor, Geert d’Haens, Iris Dotan, Axel Dignass, Sara El Ouali, Brian Feagan, Roger Feakins, Richard Gearr
Clinical Gastroenterology and Hepatology.2025;[Epub] CrossRef
Upper Gastrointestinal Crohn’s Disease: Shedding Light on the Obscure L4 Classification Meaning
Francesca Lusetti, Cristina Bezzio, Alice De Bernardi, Michele Puricelli, Gianpiero Manes, Simone Saibeni
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Upper gastrointestinal tract involvement of Crohn disease: clinical implications in children and adolescents
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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
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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.

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Zakary Ismail Warsop, Carlo Alberto Manzo, Natalie Yu, Bilal Yusuf, Christos Kontovounisios, Valerio Celentano
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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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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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Predicting the effectiveness of neoadjuvant therapy in rectal cancer patients: Model construction based on radiomics and carcinoembryonic antigens
Biyao Liu, Jinyue Feng, Yiguang Hu, Ruisi Tang, Yutong Zhang, Yidian Wang, Yong Wang, Liya Wang, Hang Qiu, Xiaodong Wang
Intelligent Oncology.2026; 2(1): 100035. CrossRef
Pathologic complete response in rectal cancer: advocating for local excision
Daniel Gonzalez-Nunez, Luis Torres, Mauricio Gonzalez-Dorado, Juan C. Reyes
Annals of Coloproctology.2025; 41(6): 592. 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
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
A Nine-Gene Signature for Predicting the Response to Preoperative Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer
In Ja Park, Yun Suk Yu, Bilal Mustafa, Jin Young Park, Yong Bae Seo, Gun-Do Kim, Jinpyo Kim, Chang Min Kim, Hyun Deok Noh, Seung-Mo Hong, Yeon Wook Kim, Mi-Ju Kim, Adnan Ahmad Ansari, Luigi Buonaguro, Sung-Min Ahn, Chang-Sik Yu
Cancers.2020; 12(4): 800. CrossRef

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.

Citations

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Local resection in rectal cancer: When, who and how?
Jesus Badia-Closa, Juan Pablo Campana, Gustavo Leandro Rossi, Xavier Serra-Aracil
Cirugía Española (English Edition).2025; 103(4): 244. CrossRef
Resección local en cáncer de recto: ¿cuándo, a quién y cómo?
Jesus Badia-Closa, Juan Pablo Campana, Gustavo Leandro Rossi, Xavier Serra-Aracil
Cirugía Española.2025; 103(4): 244. CrossRef
Transanal excision in early rectal cancer
Marija Nikolić, Nemanja Trifunović, Damir Jašarović, Tanja Abazović, Milica Radivojević, Nebojša Mitrović
Medicinski glasnik Specijalne bolnice za bolesti štitaste žlezde i bolesti metabolizma.2025; 30(97): 28. 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
The Role of Transanal Endoscopic Surgery for Early Rectal Cancer
Natalie F. Berger, Patricia Sylla
Clinics in Colon and Rectal Surgery.2022; 35(02): 113. 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
Watch and wait strategies for rectal cancer: A systematic review
In Ja Park
Precision and Future Medicine.2022; 6(2): 91. CrossRef
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
Cirugía Española.2021; 99(2): 89. CrossRef
Oncological Outcomes of Transanal Endoscopic Microsurgery Plus Adjuvant Chemoradiotherapy for Patients with High-Risk T1 and T2 Rectal Cancer
Kang Xu, Yulin Liu, Peng Yu, Wei Shang, Yongbo Zhang, Mingwen Jiao, Zhonghui Cui, Lijian Xia, Jingbo Chen
Journal of Laparoendoscopic & Advanced Surgical Techniques.2021; 31(9): 1006. CrossRef
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
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
Prognostic Factors and Treatment of Recurrence after Local Excision of Rectal Cancer
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
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Cristopher Varela, Nam Kyu Kim
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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.

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Dynamic variation in a combined inflammation–tumor marker index during neoadjuvant chemotherapy and its value for organ-preservation decisions in gastric cancer
Ke Liu, Haiquan Qian, Shensi Chen, Shengjun Zhang, Wei Zhao
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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
Diseases of the Colon & Rectum.2025; 68(3): 287. CrossRef
Rectal cancer approach strategies after neoadjuvant treatment – a systematic review and network meta-analysis
Cong Meng, Wenlong Shu, Liting Sun, Si Wu, Pengyu Wei, Jiale Gao, Jinyao Shi, Yang Li, Zhengyang Yang, Hongwei Yao, Zhongtao Zhang
International Journal of Surgery.2025; 111(4): 3078. CrossRef
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
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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
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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
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Watch and wait strategies for rectal cancer: A systematic review
In Ja Park
Precision and Future Medicine.2022; 6(2): 91. 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
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
Cancers.2021; 13(14): 3480. 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
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Eun Jung Park, Seung Hyuk Baik
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Joanna Socha, Lucyna Kępka, Wojciech Michalski, Karol Paciorek, Krzysztof Bujko
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From Total Mesorectal Excision to Organ Preservation for the Treatment of Rectal Cancer
Seong Kyu Baek
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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

8,524 View
124 Download
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13 Citations

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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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
Abdominal Radiology.2021; 46(3): 867. CrossRef
Robotic Intersphincteric Resection for Low Rectal Cancer: Technical Controversies and a Systematic Review on the Perioperative, Oncological, and Functional Outcomes
Guglielmo Niccolò Piozzi, Seon Hahn Kim
Annals of Coloproctology.2021; 37(6): 351. CrossRef

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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Review

Intersphincteric Resection for Patients With Low-Lying Rectal Cancer: Oncological and Functional Outcomes: In Ja Park, Jin Cheon Kim; Ann Coloproctol. 2018;34(4):167-174. Published online August 31, 2018; DOI: https://doi.org/10.3393/ac.2018.08.02

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Abstract PDF

The aim of this review is to evaluate the outcomes after an intersphincteric resection (ISR) for patients with low-lying rectal cancer. Reports published in the literature regarding surgical, oncological, and functional outcomes of an ISR were reviewed. The morbidity after an ISR was 7.7%–32%, and anastomotic leakage was the most common adverse event. Local recurrence rates ranged from 0% to 12%, 5-year overall survival rates ranged from 62% to 92%, and rates of major incontinence ranged from 0% to 25.8% after an ISR. An ISR is a safe procedure for sphincter-saving rectal surgery in patients with very low rectal cancer; it does not compromise the oncological outcomes of the resection and is a valuable alternative to an abdominoperineal resection. While the functional outcomes after an ISR were found to be acceptable, the long-term functional outcome and quality of life still require careful investigation. ISRs have been performed with surgical and oncologic safety on patients with low-lying rectal cancer. However, patients must be selected very carefully for an ISR, considering the associated functional derangement and the limited extent of the resection.

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Long-term functional and prognostic outcomes of robotic intersphincteric resection for treating low rectal cancer: a single-center retrospective study
Yang Bo, Wang Yigao, Zheng Mingye, Jian Zhao, Yongxiang Li
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A randomized controlled trial of a digital lifestyle intervention involving postoperative patients with colorectal cancer
Young Il Kim, In Ja Park, Jun-Soo Ro, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Yura Lee, Yae Won Tak, Seockhoon Chung, Kyung Won Kim, Yousun Ko, Sung-Cheol Yun, Min-Woo Jo, Jong Won Lee
npj Digital Medicine.2025;[Epub] CrossRef
Comparison of quality of life between intersphincteric and abdominoperineal resection in patients with low rectal cancer
Adnan Abdulkadir Mohammed, Sara Shojaei-Zarghani, Zahra Ghanbarzadegan, Zahra Zabangirfard, Ahmed Mohammed Ali Hussein Alhurry, Khadije Gorgi, Seyed Vahid Hosseini
coloproctology.2025; 47(5): 360. CrossRef
Successful sphincter preservation and long-term survival in a patient with ultra-low locally advanced rectal cancer treated with photodynamic therapy combined with multimodal treatment: a case report and literature review
Dan Zou, Baohong Gu, Yifan Li, Ying Yan, Huanhuan Ma, Kai Wang, Weiyi Chen, Bofang Wang, Hao Chen
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Long-term efficacy and short-term outcomes of intersphincteric resection vs abdominoperineal resection in patients with ultra-low rectal cancer
Guan-Cong Wang, Jun-Xing Chen, Hong-Feng Pan, Kai Ye, Yin-Cong Guo, Ying Huang
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Qiang Du, Wenming Yang, Jianhao Zhang, Siyuan Qiu, Xueting Liu, Yong Wang, Lie Yang, Zongguang Zhou
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Does anastomotic leakage after intersphincteric resection for ultralow rectal cancer influence long-term outcomes? A retrospective observational study
Feifan Liu, Bin Zhang, Jianbin Xiang, Guangzuan Zhuo, Yujuan Zhao, Yiming Zhou, Jianhua Ding
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
Comparative study of functional outcomes between ultra‐low anterior resection and inter‐sphincteric resection: a propensity matched analysis
Jayesh Gori, Mufaddal Kazi, Barath Rajkumar, Prajesh Bhuta, Suman Kumar Ankathi, Ashwin Desouza, Avanish Saklani
ANZ Journal of Surgery.2022; 92(1-2): 151. CrossRef
Current status and role of robotic approach in patients with low-lying rectal cancer
Hyo Seon Ryu, Jin Kim
Annals of Surgical Treatment and Research.2022; 103(1): 1. CrossRef
Trans-Anastomotic Drainage Tube Placement After Hand-Sewn Anastomosis in Patients Undergoing Intersphincteric Resection for Low Rectal Cancer: An Alternative Drainage Method
Xinjian Zhong, Xiaoyu Xie, Hang Hu, Yi Li, Shunhua Tian, Qun Qian, Congqing Jiang, Xianghai Ren
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Functional outcomes of intersphincteric resection in low rectal tumors
Osman Bozbıyık, Cemil Çalışkan, Özgün Köse, Ozan Verendağ, Berk Göktepe, Tayfun Yoldaş, Erhan Akgün, Mustafa Ali Korkut
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Diwakar Pandey, Vivek Sukumar, Avanish Saklani
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Akihiro Kohata, Wataru Shimizu, Masatoshi Kochi, Yuji Takakura, Hideki Ohdan
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Oncologic and Functional Outcomes of Pelvic Perineal Reconstruction by Perineal Colostomy and Malone Procedure After Abdominoperineal Resection
Anthony Marinho, Nicolas Zalay, Léonor Chaltiel, Sylvain Kirzin, Antoine Philis, Jannick Selves, Nicolas Carrère, Etienne Buscail, Laurent Ghouti
Diseases of the Colon & Rectum.2021; 64(12): 1501. CrossRef
Functional outcomes after sphincter-preserving surgeries for low-lying rectal cancer: A review
Eun Jung Park, Seung Hyuk Baik
Precision and Future Medicine.2021; 5(4): 164. CrossRef
Robotic Intersphincteric Resection for Low Rectal Cancer: Technical Controversies and a Systematic Review on the Perioperative, Oncological, and Functional Outcomes
Guglielmo Niccolò Piozzi, Seon Hahn Kim
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Surgical Treatment of Low-Lying Rectal Cancer: Updates
Cristopher Varela, Nam Kyu Kim
Annals of Coloproctology.2021; 37(6): 395. CrossRef
Oncologic safety and bowel function after ultralow anterior resection with or without intersphincteric resection for low lying rectal cancer: Comparative cross sectional study
Ahmad Sakr, Seung Yoon Yang, Jae Hyun Kang, Min Soo Cho, Yoon Dae Han, Byung Soh Min, Waleed Thabet, Hosam Ghazy Elbanna, Mosaad Morshed, Nam Kyu Kim
Journal of Surgical Oncology.2020; 121(2): 365. CrossRef
Simplification or Accuracy: In Assessing Functional Outcomes After Intersphincteric Resection for Low Rectal Cancer
Kyung Jong Kim
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Avoidance of Overtreatment of Rectal Cancer by Selective Chemoradiotherapy: Results of the Optimized Surgery and MRI-Based Multimodal Therapy Trial
Reinhard Ruppert, Rainer Kube, Joachim Strassburg, Andreas Lewin, Joerg Baral, Christoph A. Maurer, Joerg Sauer, Theodor Junginger, Paul Hermanek, Susanne Merkel, Martin E. Kreis, Guenther Winde, Rena Thomasmeyer, Sigmar Stelzner, Cornelius Bambauer, Soen
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Editorial

Selection of Adjuvant Treatment Without Neoadjuvant Chemoradiotherapy for Patients With Rectal Cancer: Room for Further Investigation: In Ja Park; Ann Coloproctol. 2018;34(3):109-110. Published online June 30, 2018; DOI: https://doi.org/10.3393/ac.2018.05.27

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Citations

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Pleiotropic Role and Bidirectional Immunomodulation of Innate Lymphoid Cells in Cancer
Zhengwen An, Fabian Flores-Borja, Sheeba Irshad, Jinhai Deng, Tony Ng
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Original Articles

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.

Citations

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Non-operative management of gallstone sigmoid ileus in a patient with a prostatic cancer
Ahmed M AlMuhsin, Abdulaziz Bazuhair, Omar AlKhlaiwy, Rami O Abu Hajar, Thabit Alotaibi
Journal of Surgical Case Reports.2023;[Epub] CrossRef
Comparison of blowhole colostomy and loop ostomy for palliation of acute malignant colonic obstruction
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
Scientific Reports.2021;[Epub] CrossRef

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.

Citations

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Anastomosis after Bowel Resection for Crohn's Disease: State of the Art Review
Carla Newton, Alessandro Fichera
Clinics in Colon and Rectal Surgery.2025; 38(02): 104. CrossRef
Advances in endoscopy in IBD diagnostics and management
Joana Roseira, Maria Manuela Estevinho, Beatriz Gros, Irene Marafini, Virginia Solitano, Paula Sousa, Cristina Carretero, Winnie Zou, Nasim Parsa, Aline Charabaty, Lumir Kunovsky
Best Practice & Research Clinical Gastroenterology.2025; 78: 102055. CrossRef
New anti-mesenteric delta-shaped stapled anastomosis: Technical report with short-term postoperative outcomes in patients with Crohn’s disease
Jong Lyul Lee, Yong Sik Yoon, Hyun Gu Lee, Young Il Kim, Min Hyun Kim, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
World Journal of Gastrointestinal Surgery.2024; 16(8): 2592. CrossRef
Results of the Eighth Scientific Workshop of ECCO: Pathophysiology and Risk Factors of Postoperative Crohn’s Disease Recurrence after an Ileocolonic Resection
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
Journal of Crohn's and Colitis.2023; 17(10): 1557. CrossRef
Ileocolic Resection for Crohn Disease: The Influence of Different Surgical Techniques on Perioperative Outcomes, Recurrence Rates, and Endoscopic Surveillance
Benjamin Click, Amit Merchea, Dorin T Colibaseanu, Miguel Regueiro, Francis A Farraye, Luca Stocchi
Inflammatory Bowel Diseases.2022; 28(2): 289. CrossRef
Anastomotic Techniques for Abdominal Crohn's Disease: Tricks and Tips
Marco Bertucci Zoccali, Alessandro Fichera
Journal of Laparoendoscopic & Advanced Surgical Techniques.2021; 31(8): 861. CrossRef
Short-term and long-term outcomes of laparoscopic vs open ileocolic resection in patients with Crohn's disease: Propensity-score matching analysis
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
The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Surgical Management of Crohn’s Disease
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
Diseases of the Colon & Rectum.2020; 63(8): 1028. CrossRef
Correlation Between Anastomotic Configuration and Long-term Outcomes in Surgery for Crohn Disease
Jin-Su Kim, Ji-Yeon Kim
Annals of Coloproctology.2017; 33(5): 159. CrossRef

Editorials

The Need for Subdividing the Enhanced Recovery Program and Evaluation Criteria After Colorectal Surgery: In Ja Park; Ann Coloproctol. 2017;33(3):79-80. Published online June 30, 2017; DOI: https://doi.org/10.3393/ac.2017.33.3.79

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Efforts to Find Targets Involving Angiogenesis: Step to Improve the Efficacy of Target Therapy in the Era of Colorectal Cancer Treatment: In Ja Park; Ann Coloproctol. 2017;33(1):1-2. Published online February 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.1.1

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Obesity, blood rheology and angiogenesis
Maciej Wiewiora, Albert Krzak, Maciej Twardzik, Jerzy Piecuch
Clinical Hemorheology and Microcirculation.2018; 69(3): 339. CrossRef

Impairment of Immunonutritional Status During Treatment is a Factor Associated With Oncologic Outcomes in Patients With Rectal Cancer Treated With Preoperative Chemoradiotherapy: In Ja Park; Ann Coloproctol. 2016;32(6):201-202. Published online December 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.6.201

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Case Report

Multiple Glomus Tumors of the Omentum: Won Beom Jung, In Ja Park, Joon Seon Song, Kyung-Ja Cho, Jin Cheon Kim; Ann Coloproctol. 2015;31(4):153-156. Published online August 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.4.153

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Abstract PDF: A glomus tumor is a very rare neoplasm consisting of cells that resemble the modified smooth muscle cells of normal glomus bodies. Here, we report a case of a 39-year-old male with multiple omental glomus tumors. The patient underwent a complete resection of the glomus tumors. This is a rare case of omental glomus tumors, and to our knowledge, this patient is the first with multiple omental glomus tumors to be described.

Editorials

Adenoma Detection Rate in Patients Younger Than 50 Years of Age: Relationship of the Adenoma Detection Rate to Interval Cancer: In Ja Park; Ann Coloproctol. 2015;31(2):41-42. Published online April 30, 2015; DOI: https://doi.org/10.3393/ac.2015.31.2.41

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Changing trends in colorectal cancer in the Republic of Korea: contrast with Japan
Minjoo Yoon, Nicholas Kim, Byungho Nam, Jungnam Joo, Moran Ki
Epidemiology and Health.2015; 37: e2015038. CrossRef

Effect of a Purse-String Approximation Following Stoma Takedown on Wound Infection and Satisfaction: In Ja Park; Ann Coloproctol. 2015;31(1):7-8. Published online February 28, 2015; DOI: https://doi.org/10.3393/ac.2015.31.1.7

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Importance of Prompt Diagnosis in the Management of Colonoscopic Perforation: In Ja Park; Ann Coloproctol. 2014;30(5):208-209. Published online October 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.5.208

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Repair of a colonoscopic perforation of the rectum with transanal endoscopic microsurgery
R. Zhou, B. A. Orkin
Techniques in Coloproctology.2016; 20(10): 721. CrossRef

Individualized Treatment for a Rectourethral Fistula: Rare Complications: In Ja Park; Ann Coloproctol. 2014;30(1):7-8. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.7

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