Annals of Coloproctology

Original Articles

Minimally invasive surgery

Impact of single-port laparoscopic approach on scar assessment by patients and observers: a multicenter retrospective study: Sung Uk Bae, Kyeong Eui Kim, Chang-Woo Kim, Ji-Hoon Kim, Woon Kyung Jeong, Yoon-Suk Lee, Seong Kyu Baek, Suk-Hwan Lee, Jun-Gi Kim; Ann Coloproctol. 2025;41(2):154-161. Published online April 29, 2025; DOI: https://doi.org/10.3393/ac.2024.00563.0080

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Purpose
This study aimed to compare the wound cosmesis of a single-incision approach on scar assessment after laparoscopic surgery for colon cancer.
Methods
This study included 32 patients undergoing single-port laparoscopic surgery (SPLS) and 61 patients undergoing multiport laparoscopic surgery (MPLS) for colon cancer at 3 tertiary referral hospitals between September 2011 and December 2019. We modified and applied the Korean version of the Patient and Observer Scar Assessment Scale (POSAS) to assess cosmetic outcomes. To assess the interobserver reliability using intraclass correlation coefficient values for the Observer Scar Assessment Scale (OSAS), the surgeons evaluated 5 images of postoperative scars.
Results
No significant differences were observed in the time before the return of normal bowel function, time to sips of water and soft diet initiation, length of in-hospital stay, and postoperative complication rate. The SPLS group had a shorter total incision length than the MPLS group. The POSAS favored the SPLS approach, revealing significant differences in the Patient Scar Assessment Scale (PSAS), OSAS, and overall scores. The SPLS approach was an independent factor influencing the POSAS, PSAS, and OSAS scores. Eleven colorectal surgeons had a significantly substantial intraclass coefficient.
Conclusion
The cosmetic outcomes of SPLS as assessed by the patients and surgeons were superior to those of MPLS in colon cancer. Reducing the number of ports is an independent factor affecting scar assessment by patients and observers.

Citations

Citations to this article as recorded by

Investigating the Efficacy of Layered Moderate Tension Reduction Suturing in Facial Aesthetic Surgery
Gui H Wang, Jin Y Gang, Yan Li
Cureus.2025;[Epub] CrossRef

Minimally invasive surgery

New double-stapling technique without staple-crossing line in laparoscopic low anterior resection: effort to reduce anastomotic leakage: Nam Seok Kim, Ji Hoon Kim, Yoon Suk Lee, In Kyu Lee, Won Kyung Kang; Ann Coloproctol. 2024;40(6):573-579. Published online November 22, 2024; DOI: https://doi.org/10.3393/ac.2022.00409.0058

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Graphical Abstract Abstract PDF: Purpose
This study aimed to demonstrate the safety of new double-stapling technique (nDST), without a crossing line and dog ears, by comparing with conventional DST (cDST) in laparoscopic low anterior resection (LAR).
Methods
We retrospectively reviewed 98 consecutive patients who underwent laparoscopic LAR for rectal cancer from January 2018 to December 2020. The inclusion criterion was an anastomosis level below the peritoneal reflection and 4 cm above the anal verge. In the nDST group, the staple line of the linear cutter was sutured using barbed sutures to shorten the staple line before firing the circular stapler. Therefore, there were no crossing lines after firing the circular stapler. A 2:1 propensity score matching was performed between the cDST and nDST groups.
Results
After propensity score matching, 39 patients were in the cDST group and 20 were in the nDST group. There were no significant differences in patient demographics between the 2 groups. There was no difference in the total operation time between the cDST and nDST groups (124.0±26.2 minutes vs. 125.2±20.3 minutes, P=0.853). Morbidity rates were similar between the 2 groups (9 cases [23.1%] vs. 5 cases [25.0%], P=0.855). There was no significant difference in leakage rate (4 cases [10.3%] vs. 1 case [5.0%], P=0.847) and anastomotic bleeding rate (1 case [2.6%] vs. 3 cases [15.0%], P=0.211).
Conclusion
The nDST to eliminate the crossing line and dog ears in laparoscopic LAR is technically feasible and safe. However, more attention should be paid to anastomotic bleeding in such cases.

Impact of Patient’s Pain and Fatigue on Decision of Discharge After Laparoscopic Surgery for Colorectal Cancer: Gyeora Lee, Jun-Suh Lee, Ji Hoon Kim, Duk Yeon Hwang, Yoon-Suk Lee; Ann Coloproctol. 2019;35(4):209-215. Published online August 31, 2019; DOI: https://doi.org/10.3393/ac.2018.11.29

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6 Web of Science
5 Citations

Abstract PDF

Purpose
Hospital stays after laparoscopic surgery for colorectal cancer tend to be much shorter than those after conventional open surgery. Many factors, including surgical outcomes and complications, are associated with patient discharge planning. However, few studies have analyzed the impact of patient subjective discomfort (including pain and fatigue) on the decision to discharge after surgery. Therefore, the purpose of this study was to determine how patient pain and fatigue play a role in the decision to discharge after laparoscopic surgery for colorectal cancer.
Methods
Between March 2014 and February 2015, we conducted a questionnaire survey of 91 patients who underwent laparoscopic surgery for colorectal cancer to estimate the expectation criteria for discharge and patient subjective discomfort at that time. Patients were divided into the following 2 groups: group A, those who complied with the medical professional’s decision to discharge; and group B, those who refused discharge despite the medical professional’s decision. The participants’ subjective factors were analyzed.
Results
Preoperatively, 78 of 91 patients (85.7%) identified activity level, amount of food (tolerance), and bowel movements as important factors that should be considered in the decision to discharge a patient postoperatively. Postoperatively, 17 patients (18.7%) refused discharge despite a discharge recommendation. Subjective pain and fatigue were significantly different in linear-by-linear association between the group of patients who agreed to be discharge and those who disagreed. Despite this difference, there was no significant difference in mean length of hospital stay between the 2 groups.
Conclusion
A patient’s subjective feelings of pain and fatigue can impact their decision regarding hospital discharge.

Citations

Citations to this article as recorded by

Effect of continuous wound infiltration on patients using intravenous patient-controlled analgesia for pain management after reduced-port laparoscopic colorectal surgery
Hyeon Deok Choi, Sung Uk Bae
Annals of Coloproctology.2024; 40(6): 564. CrossRef
The Impact of an Enhanced Recovery Protocol in a High-Risk Population Undergoing Colon Cancer Surgery
Denise L. Wong, Alexis Holland, Mehmet Kocak, Mace Coday, Caroline Brown, Justin J. Monroe, Nathan M. Hinkle, Jeremiah L. Deneve, Evan S. Glazer, David Shibata
The American Surgeon™.2023; 89(11): 4485. CrossRef
Effectiveness of Aromatherapy on Ameliorating Fatigue in Adults: A Meta-Analysis
Qiuting Wang, Lin Wei, Yueming Luo, Lijun Lin, Chong Deng, Ping Hu, Lijia Zhu, Yangchen Liu, Meizhen Lin, Azizah Ugusman
Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1. CrossRef
Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge
Thaís T. T. Tweed, Carmen Woortman, Stan Tummers, Maikel J. A. M. Bakens, James van Bastelaar, Jan H. M. B. Stoot
International Journal of Colorectal Disease.2021; 36(7): 1535. CrossRef
The Impact of Patient’s Pain and Fatigue on the Discharge Decision After Laparoscopic Surgery for Colorectal Cancer
Won Beom Jung
Annals of Coloproctology.2019; 35(4): 158. CrossRef

Effect of Gum Chewing on the Recovery From Laparoscopic Colorectal Cancer Surgery: Duk Yeon Hwang, Ho Young Kim, Ji Hoon Kim, In Gyu Lee, Jun Ki Kim, Seung Taek Oh, Yoon Suk Lee; Ann Coloproctol. 2013;29(6):248-251. Published online December 31, 2013; DOI: https://doi.org/10.3393/ac.2013.29.6.248

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40 Download
5 Citations

Abstract PDF

Purpose

We aimed to examine the effect of gum chewing after laparoscopic colorectal cancer surgery.

Methods

We reviewed the medical records of patients who underwent laparoscopic colorectal cancer surgery in Incheon St. Mary's Hospital, The Catholic University of Korea School of Medicine. We divided the patients into 2 groups: group A consisted of 67 patients who did not chew gum; group B consisted of 65 patients who chewed gum. We analyzed the short-term clinical outcomes between the two groups to evaluate the effect of gum chewing.

Results

The first passage of gas was slightly earlier in group B, but the difference was not significant. However, the length of hospital stay was 6.7 days in group B, which was significantly shorter than that in group A (7.3 days, P = 0.018).

Conclusion

This study showed that length of postoperative hospital stay was shorter in the gum-chewing group. In future studies, we expect to elucidate the effect of gum chewing on the postoperative recovery more clearly.

Citations

Citations to this article as recorded by

Postoperative Ileus and Nonpharmacological Nursing Interventions for Colorectal Surgery: A Systematic Review
Hande Nur Arslan, Sevilay Şenol Çelik, Gamze Bozkul
Journal of PeriAnesthesia Nursing.2025; 40(1): 181. CrossRef
https://medcraveonline.com/IJCAM/IJCAM-14-00535.pdf
Nahima Miah, Sanjay Noonan, Emma Copeland, Eastern Road, Elaine Macaninch
International Journal of Complementary & Alternative Medicine.2021; 14(2): 69. CrossRef
Chewing Gum for Intestinal Function Recovery after Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis
Binbin Mei, Wenting Wang, Feifei Cui, Zunjia Wen, Meifen Shen
Gastroenterology Research and Practice.2017; 2017: 1. CrossRef
Chewing gum for postoperative recovery of gastrointestinal function
Vaneesha Short, Georgia Herbert, Rachel Perry, Charlotte Atkinson, Andrew R Ness, Christopher Penfold, Steven Thomas, Henning Keinke Andersen, Stephen J Lewis
Cochrane Database of Systematic Reviews.2015;[Epub] CrossRef
Sham Feeding? Same Feeding?
Hungdai Kim
Annals of Coloproctology.2013; 29(6): 224. CrossRef

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