Annals of Coloproctology

Original Article

Minimally invasive surgery

Learning curve for single-port robot-assisted colectomy: Moon Suk Choi, Seong Hyeon Yun, Sung Chul Lee, Jung Kyong Shin, Yoon Ah Park, Jungwook Huh, Yong Beom Cho, Hee Cheol Kim, Woo Yong Lee; Ann Coloproctol. 2024;40(1):44-51. Published online December 20, 2022; DOI: https://doi.org/10.3393/ac.2022.00745.0106

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Purpose
Since the introduction of robotic surgery, robots for colorectal cancer have replaced laparoscopic surgery, and a single-port robot (SPR) platform has been launched and is being used to treat patients. We analyzed the learning curve and initial complications of using an SPR platform in colorectal cancer surgery.
Methods
We reviewed 39 patients who underwent SPR colectomy from April to October 2019. All surgeries were performed by the same surgeon using an SPR device. A learning curve was generated using the cumulative sum methodology to assess changes in total operation time, docking time, and surgeon console time. We grouped the patients into 3 groups according to the time period: the first 11 were phase 1, the next 11 were phase 2, and the last 17 were phase 3.
Results
The mean age of the patients was 61.28±13.03 years, and they had a mean body mass index of 23.79±2.86 kg/m2. Among the patients, 23 (59.0%) were male, and 16 (41.0%) were female. The average operation time was 186.59±51.30 minutes, the average surgeon console time was 95.49±35.33 minutes, and the average docking time (time from skin incision to robot docking) was 14.87±10.38 minutes. The surgeon console time differed significantly among the different phases (P<0.001). Complications occurred in 8 patients: 2 ileus, 2 postoperation hemoglobin changes, 3 urinary retentions, and 1 complicated fluid collection.
Conclusion
In our experience, the learning curve for SPR colectomy was achieved after the 18th case.

Citations

Citations to this article as recorded by

Da Vinci single-port robotic system current application and future perspective in general surgery: A scoping review
Francesco Celotto, Niccolò Ramacciotti, Alberto Mangano, Giacomo Danieli, Federico Pinto, Paula Lopez, Alvaro Ducas, Jessica Cassiani, Luca Morelli, Gaya Spolverato, Francesco Maria Bianco
Surgical Endoscopy.2024; 38(9): 4814. CrossRef
Wristed articulated instrumentation for single‐incision plus one‐port laparoscopic surgery for obstructed sigmoid colon cancer—A video vignette
Sung Uk Bae
Colorectal Disease.2024; 26(9): 1782. CrossRef
Evaluation of the da Vinci single-port system in colorectal cancer surgery: a scoping review
Arcangelo Picciariello, Alfredo Annicchiarico, Gaetano Gallo, Agnese Dezi, Ugo Grossi
Updates in Surgery.2024; 76(7): 2515. CrossRef

Technical Note

Malignant disease, Rectal cancer,Minimally invasive surgery

Single-port robot-assisted abdominoperineal resection: a case review of the first four experiences: Moon Suk Choi, Seong Hyeon Yun, Jung Kyong Shin, Yoon Ah Park, Jung Wook Huh, Yong Beom Cho, Hee Cheol Kim, Woo Yong Lee; Ann Coloproctol. 2022;38(1):88-92. Published online October 18, 2021; DOI: https://doi.org/10.3393/ac.2021.00395.0056

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Abstract PDF

Recently, abdominoperineal resection (APR) using a robot has been demonstrated in other studies. However, there has been no report on APR for rectal cancer using the single-port robot (SPR) platform. In response to this research gap, we described the clinical experience of APR using a SPR. From April 2019 to March 2020, APR using a SPR platform was performed in a total of 4 patients. Three patients had a transumbilical approach, and 1 patient had a transstoma site approach. The average operation time was 307 minutes, and the patient docking time to the SPR platform was 133.5 minutes. There were no complications during the operation, and no laparoscopy or open conversion. No reoperation occurred within 30 days. Mild postoperative complications occurred in 2 patients. We found that APR has safety and feasibility in surgery using an SPR platform. There was no intraoperative event and severe postoperative complications.

Citations

Citations to this article as recorded by

Single-incision laparoscopic total extraperitoneal inguinal-hernia repair using the new articulating instruments: A video vignette
Chul Seung Lee, Gwan Chul Lee, Choon Sik Chung, Dong Keun Lee
Asian Journal of Surgery.2024; 47(8): 3586. CrossRef
Evaluation of the da Vinci single-port system in colorectal cancer surgery: a scoping review
Arcangelo Picciariello, Alfredo Annicchiarico, Gaetano Gallo, Agnese Dezi, Ugo Grossi
Updates in Surgery.2024; 76(7): 2515. CrossRef
Single-incision robotic colorectal surgery with the da Vinci SP® surgical system: initial results of 50 cases
H. S. Kim, B.-Y. Oh, C. Cheong, M. H. Park, S. S. Chung, R.-A. Lee, K. H. Kim, G. T. Noh
Techniques in Coloproctology.2023; 27(7): 589. CrossRef
Short-term outcomes of single-incision robotic colectomy versus conventional multiport laparoscopic colectomy for colon cancer
Ho Seung Kim, Bo-Young Oh, Soon Sup Chung, Ryung-Ah Lee, Gyoung Tae Noh
Journal of Robotic Surgery.2023; 17(5): 2351. CrossRef
Short-term outcomes of da Vinci SP versus Xi for colon cancer surgery: a propensity-score matching analysis of multicenter cohorts
Jin-Min Jung, Young Il Kim, Yong Sik Yoon, Songsoo Yang, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Journal of Robotic Surgery.2023; 17(6): 2911. CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef

Original Articles

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

Has the COVID-19 Pandemic Caused Upshifting in Colorectal Cancer Stage?: Ji Ha Lim, Woo Yong Lee, Seong Hyeon Yun, Hee Cheol Kim, Yong Beom Cho, Jung Wook Huh, Yoon Ah Park, Jung Kyong Shin; Ann Coloproctol. 2021;37(4):253-258. Published online August 9, 2021; DOI: https://doi.org/10.3393/ac.2021.00269.0038

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97 Download
19 Web of Science
21 Citations

Abstract PDF

Purpose
Coronavirus disease 2019 (COVID-19) has affected many parts of daily life and healthcare, including cancer screening and diagnosis. The purpose of this study was to determine whether there was an upshift in the colorectal cancer stage at diagnosis due to delays related to the COVID-19 outbreak.
Methods
From January to June of each year from 2017 to 2020, a total of 3,229 patients who were first diagnosed with colorectal cancer were retrospectively reviewed. Those enrolled from 2017 to 2019 were classified as the ‘pre-COVID’ group, and those enrolled in 2020 were classified as the ‘COVID’ group. The primary outcome was the rate of stage IV disease at the time of diagnosis.
Results
There was no statistically significant difference in the proportion of stage IV patients between the pre-COVID and COVID groups (P=0.19). The median preoperative carcinoembryonic antigen level in the COVID group was higher than in the pre-COVID group in all stages (all P<0.05). In stage I, II patients who underwent radical surgery, the lymphatic invasion was more presented in COVID patients (P=0.009).
Conclusion
We did not find significant stage upshifting in colorectal cancer during the COVID-19 outbreak. However, there were more initially unresectable stage IV colorectal cancer patients with a low conversion rate to resectable status, and more patients had factors related to poor prognosis. These results may become more apparent over time, so it is vital not to neglect cancer screening to not delay the diagnosis during the COVID-19 epidemic.

Citations

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The impact of extended invitation intervals on stage distribution of screen‐detected and interval cancer within the Dutch colorectal cancer screening program
Maria‐Alexandra Katsara, Danica van den Berg, Manon C. W. Spaander, Adriana J. van Vuuren, Evelien Dekker, Folkert J. van Kemenade, Iris D. Nagtegaal, Monique E. van Leerdam, Iris Lansdorp‐Vogelaar, Esther Toes‐Zoutendijk
International Journal of Cancer.2025;[Epub] CrossRef
The COVID-19 pandemic and clinical characteristics of colorectal cancer: a multicenter retrospective study
Yoon Dae Han, Sung Uk Bae, Woo Ram Kim, Dae Ro Lim, Chang Woo Kim
Scientific Reports.2025;[Epub] CrossRef
The impact of COVID-19 on patients diagnosed with melanoma, breast, and colorectal cancer
Danielle Hanuschak, Mallori DePiero, Melissa DeMoraes, Shamoore Bailly, Muni Rubens, Paul Lindeman, Michael Zinner, Geoffrey Young
The American Journal of Surgery.2024; 229: 36. CrossRef
The global pandemic's second deadly hit: cancer care
Emma Bradley, Magge Deepa
The American Journal of Surgery.2024; 229: 34. CrossRef
Trends in the Stage Distribution of Colorectal Cancer During the COVID-19 Pandemic in Japan: A Nationwide Hospital-claims Data Analysis
Masato Ota, Kohei Taniguchi, Mitsuhiro Asakuma, Sang-Woong Lee, Yuri Ito
Journal of Epidemiology.2024; 34(7): 356. CrossRef
Inadvertent laparoscopic lavage of perforated colon cancer: a systematic review
Mahir Gachabayov, Agon Kajmolli, Luis Quintero, Daniel M. Felsenreich, Dorin E. Popa, Dejan Ignjatovic, Roberto Bergamaschi
Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
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Simon Marty, Guillaume Lamé, Etienne Guével, Sonia Priou, Gilles Chatellier, Christophe Tournigand, Emmanuelle Kempf
BMC Cancer.2024;[Epub] CrossRef
Measuring the impact of COVID-19 on cancer survival using an interrupted time series analysis
Pascal Lambert, Katie Galloway, Allison Feely, Oliver Bucher, Piotr Czaykowski, Pamela Hebbard, Julian O Kim, Marshall Pitz, Harminder Singh, Maclean Thiessen, Kathleen M Decker
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Tadataka Takagi, Fumikazu Koyama, Hiroyuki Kuge, Yosuke Iwasa, Takeshi Takei, Tomomi Sadamitsu, Kosuke Fujimoto, Suzuka Harada, Takashi Tamura, Goki Ejiri, Chihiro Yoshikawa, Masayuki Sho
Journal of the Anus, Rectum and Colon.2024; 8(3): 188. CrossRef
Impact of COVID-19 Pandemic on the Clinical and Pathologic Characteristics of Colorectal Cancer: A Retrospective Multicenter Study in South Korea
Jae Hyun Kang, Il Tae Son, Sang Nam Yoon, Jin Soo Ihm, Byung Mo Kang, Jong Kim
Cancer Management and Research.2024; Volume 16: 1131. CrossRef
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Byeong Jin Kang, Kyung Hwan Kim, Hong Koo Ha
Kosin Medical Journal.2023; 38(3): 193. CrossRef
Measuring the impact of the COVID‐19 pandemic on colorectal cancer presentation: a retrospective comparative study
Kirsten Fullard, Daniel Steffens, Michael Solomon, Joo‐Shik Shin, Cherry Koh
ANZ Journal of Surgery.2023; 93(12): 2951. 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
Colorectal Surgery in the COVID-19 Era: A Systematic Review and Meta-Analysis
Nikolaos Pararas, Anastasia Pikouli, Dimitrios Papaconstantinou, Georgios Bagias, Constantinos Nastos, Andreas Pikoulis, Dionysios Dellaportas, Panagis Lykoudis, Emmanouil Pikoulis
Cancers.2022; 14(5): 1229. CrossRef
Short-Term Impact of Temporary Shutdown of a University-Affiliated Hospital on Patients With Colorectal Cancer During the Coronavirus Disease 2019 Pandemic
Youn Young Park, Jaeim Lee, Kil-yong Lee, Seong Taek Oh
Journal of Korean Medical Science.2022;[Epub] CrossRef
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Young Il Kim, In Ja Park
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The effect of the COVID-19 pandemic on the outcomes of surgically treated colorectal diseases: a retrospective cohort study
Gülten Çiçek Okuyan, Melih Yıldırım
Annals of Surgical Treatment and Research.2022; 103(2): 104. CrossRef
Clinical presentation, management, screening and surveillance for colorectal cancer during the COVID-19 pandemic
Sami Akbulut, Abdirahman Sakulen Hargura, Ibrahim Umar Garzali, Ali Aloun, Cemil Colak
World Journal of Clinical Cases.2022; 10(26): 9228. CrossRef
Epidemiology, risk factors, and prevention of colorectal cancer
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
Journal of the Korean Medical Association.2022; 65(9): 549. CrossRef
Epidemiology, Risk Factors, and Prevention of Colorectal Cancer-An English Version
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 231. CrossRef
No evidence of delay in colorectal cancer diagnosis during the COVID-19 pandemic in Gwangju and Jeonnam, Korea
Hye-Yeon Kim, Min-Gyeong Kim, Mi-Ran Kang, Jeong-Ho Yang, Min-Ho Shin, Sun-Seog Kweon
Epidemiology and Health.2022; 44: e2022092. CrossRef

Malignant disease,Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer

Clinical Outcomes of Neoadjuvant Chemotherapy in Colorectal Cancer Patients With Synchronous Resectable Liver Metastasis: A Propensity Score Matching Analysis: Sung Hae Park, Jung Kyong Shin, Woo Yong Lee, Seong Hyeon Yun, Yong Beom Cho, Jung Wook Huh, Yoon Ah Park, Jin Seok Heo, Gyu Seong Choi, Seung Tae Kim, Young Suk Park, Hee Cheol Kim; Ann Coloproctol. 2021;37(4):244-252. Published online June 29, 2021; DOI: https://doi.org/10.3393/ac.2020.00710.0101

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Abstract PDF

Purpose
The survival benefit of neoadjuvant chemotherapy (NAC) prior to surgical resection in colorectal cancer with liver metastases (CRCLM) patients remains controversial. The aim of this study was to compare overall outcome of CRCLM patients who underwent NAC followed by surgical resection versus surgical treatment first.
Methods
We retrospectively analyzed 429 patients with stage IV colorectal cancer with synchronous liver metastases who underwent simultaneous liver resection between January 2008 and December 2016. Using propensity score matching, overall outcome between 60 patients who underwent NAC before surgical treatment and 60 patients who underwent surgical treatment first was compared.
Results
Before propensity score matching, metastatic cancer tended to involve a larger number of liver segments and the primary tumor size was bigger in the NAC group than in the primary resection group, so that a larger percentage of patients in the NAC group underwent major hepatectomy (P<0.001). After propensity score matching, demographic features and pathologic outcomes showed no significant differences between the 2 groups. In addition, there was no significant difference in short-term recovery outcomes such as postoperative morbidity (P=0.603) and oncologic outcome, including 3-year overall survival rate (P=0.285) and disease-free survival rate (P=0.730), between the 2 groups.
Conclusion
NAC prior to surgical treatment in CRCLM is considered a safe treatment that does not increase postoperative morbidity, and its impact on oncologic outcome was not inferior.

Citations

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Colon cancer: the 2023 Korean clinical practice guidelines for diagnosis and treatment
Hyo Seon Ryu, Hyun Jung Kim, Woong Bae Ji, Byung Chang Kim, Ji Hun Kim, Sung Kyung Moon, Sung Il Kang, Han Deok Kwak, Eun Sun Kim, Chang Hyun Kim, Tae Hyung Kim, Gyoung Tae Noh, Byung-Soo Park, Hyeung-Min Park, Jeong Mo Bae, Jung Hoon Bae, Ni Eun Seo, Cha
Annals of Coloproctology.2024; 40(2): 89. CrossRef
Survival of patients with colorectal liver metastases treated with and without preoperative chemotherapy: Nationwide propensity score-matched study
Michelle.R. de Graaff, Joost M. Klaase, Ronald M. van Dam, Koert F.D. Kuhlmann, Geert Kazemier, Rutger-Jan Swijnenburg, Arthur K.E. Elfrink, Cees Verhoef, J.Sven Mieog, Peter B. van den Boezem, Paul Gobardhan, Arjen M. Rijken, Daan J. Lips, Wouter G.K. Le
European Journal of Surgical Oncology.2023; 49(9): 106932. CrossRef
Laparoscopic right hemicolectomy with aortocaval lymphadenectomy, and pelvic peritoneum partial resection for ascending colon cancer
Hannah Kim, An Na Seo, Soo Yeun Park
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Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
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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
Surgical safety in the COVID-19 era: present and future considerations
Young Il Kim, In Ja Park
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Yu-Juan Jiang, Si-Cheng Zhou, Jing-Hua Chen, Jian-Wei Liang
Frontiers in Oncology.2022;[Epub] CrossRef
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Chang Hyun Kim
Journal of the Korean Medical Association.2022; 65(9): 586. CrossRef
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Eun Jung Park, Seung Hyuk Baik
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Chan Wook Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
Direction of diagnosis and treatment improvement in colorectal cancer
In Ja Park
Journal of the Korean Medical Association.2022; 65(9): 540. CrossRef
Molecular Analyses in Peritoneal Metastasis from Colorectal Cancer: A Review-An English Version
Chang Hyun Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 197. CrossRef
Surgical treatment for metastatic colorectal cancer
Eun Jung Park, Seung Hyuk Baik
Journal of the Korean Medical Association.2022; 65(9): 568. CrossRef
Applications of propensity score matching: a case series of articles published in Annals of Coloproctology
Hwa Jung Kim
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Malignant disease, Prognosis and adjuvant therapy

Long-term Oncologic Outcome of Postoperative Complications After Colorectal Cancer Surgery: Chang Kyu Oh, Jung Wook Huh, You Jin Lee, Moon Suk Choi, Dae Hee Pyo, Sung Chul Lee, Seong Mun Park, Jung Kyong Shin, Yoon Ah Park, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee; Ann Coloproctol. 2020;36(4):273-280. Published online November 13, 2019; DOI: https://doi.org/10.3393/ac.2019.10.15

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Abstract PDF

Purpose
The impact of postoperative complications on long-term oncologic outcome after radical colorectal cancer surgery is controversial. The aim of this study was to examine the risk factors and oncologic outcomes of surgery-related postoperative complication groups.
Methods
From January 2010 to December 2010, 310 patients experienced surgery-related postoperative complications after radical colorectal cancer surgery. These stage I–III patients were classified into 2 subgroups, minor (grades I, II) and major (grades III, IV) complication groups, according to extended Clavien-Dindo classification system criteria. Clinicopathologic differences between the 2 groups were analyzed to identify risk factors for major complications. The diseasefree survival rates of surgery-related postoperative complication groups were also compared.
Results
Minor and major complication groups were stratified with 194 patients (62.6%) and 116 patients (37.4%), respectively. The risk factors influencing the major complication group were pathologic N category and operative method. The prognostic factors associated with disease-free survival were preoperative perforation, perineural invasion, tumor budding, and receiving neoadjuvant therapy. With a median follow-up period of 72.2 months, the 5-year disease-free survival rates were 84.4% in the minor group and 78.5% in the major group, but there was no statistical significance between the minor and major groups (P = 0.392).
Conclusion
Advanced cancer and open surgery were identified as risk factors for increased surgery-related major complications after radical colorectal cancer surgery. However, severity of postoperative complications did not affect disease-free survival from colorectal cancer.

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