Annals of Coloproctology

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Anorectal benign disease

Pharmacotherapy for fecal incontinence: potential treatment with a traditional Japanese medicine Kampo: Kotaro Maeda, Toshinobu Sasaki, Tomohisa Hattori; Ann Coloproctol. 2025;41(5):369-378. Published online October 23, 2025; DOI: https://doi.org/10.3393/ac.2025.00283.0040

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Abstract PDF: Fecal incontinence (FI) significantly impairs patient quality of life and creates substantial distress not only for affected individuals but also for nurses and caregivers. The prevalence of FI among older adults is estimated at up to 20%, although the sensitive nature of the condition often prevents active reporting by patients. This article reviews risk factors and pharmacotherapies for FI, emphasizing the therapeutic potential of Daikenchuto (DKT). The etiology of FI is multifactorial and lacks a singular definition. Currently, no prescription drugs specifically approved for FI are available, leaving treatment options limited. Nonetheless, major clinical guidelines have identified several viable pharmacological approaches. Strongly recommended treatments include the antidiarrheal agent loperamide and stool bulking or solidifying agents, such as dietary fiber and polycarbophil. Other therapeutic options include ramosetron, a 5-HT3 receptor antagonist; amitriptyline, a tricyclic antidepressant; and sodium valproate and diazepam, which are GABAergic neuromodulators. Recently, research has explored the efficacy and mechanism of action of DKT, a traditional Japanese medicine Kampo. Historically used for abdominal symptoms like bloating and known for promoting intestinal motility, emerging evidence suggests DKT may also effectively manage FI.

Benign diesease & IBD,Rare disease & stoma

Prolapse of intestinal stoma: Kotaro Maeda; Ann Coloproctol. 2022;38(5):335-342. Published online October 28, 2022; DOI: https://doi.org/10.3393/ac.2022.00465.0066

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8 Web of Science
11 Citations

Abstract PDF

Stoma prolapse can usually be managed conservatively by stoma care nurses. However, surgical management is considered when complications make traditional care difficult and/or stoma prolapse affects normal bowel function and induces incarceration. If the stoma functions as a fecal diversion, the prolapse is resolved by stoma reversal. Loop stoma prolapse reportedly occurs when increased intraabdominal pressure induces stoma prolapse by pushing the stoma up between the abdominal wall and the intestine, particularly in cases of redundant or mobile colon. Therefore, stoma prolapse repair aims to prevent or eliminate the space between the abdominal wall and the intestine, as well as the redundant or mobile intestine. Accordingly, surgical repair methods for stoma prolapse are classified into 3 types: methods to fix the intestine, methods to shorten the intestine, and methods to eliminate the space between the stoma and the abdominal wall around the stoma orifice. Additionally, the following surgical techniques at the time of stoma creation are reported to be effective in preventing stoma prolapse: an avoidance of excessive fascia incision, fixation of the stoma to the abdominal wall, an appropriate selection of the intestinal site for the stoma orifice to minimize the redundant intestine, and the use of an extraperitoneal route for stoma creation.

Citations

Citations to this article as recorded by

Comprehensive nursing management for an older patient with diarrhoea and risk of dehydration
Tiago Horta Reis da Silva
Gastrointestinal Nursing.2025; 23(2): 89. CrossRef
Incarcerated trans-stomal herniation resembling a stomal prolapse – a case report
N Shaikh, RV Blanco, M Vente, R Ebrahim
South African Journal of Surgery.2025; 63(1): 31. CrossRef
Non-Operative Considerations in Relation to Parastomal Hernia
Z. Malaibari, M. W. Christoffersen, M. Krogsgaard, N. A. Henriksen, K. Andresen, F. Helgstrand, R. Aldemyati, J. Rosenberg
Journal of Abdominal Wall Surgery.2025;[Epub] CrossRef
Stoma Complications
Aaron J. Dawes, John V. Gahagan
Clinics in Colon and Rectal Surgery.2024; 37(06): 387. CrossRef
Management of the Difficult Stoma
Clay Merritt, Paola Maldonado
Surgical Clinics of North America.2024; 104(3): 579. CrossRef
Ileostomy: Early and Late Complications
Francisco Duarte Cerqueira Gomes Girão Santos, Laura Elisabete Ribeiro Barbosa, João Paulo Meireles de Araújo Teixeira
Journal of Coloproctology.2024; 44(01): e80. CrossRef
Risk factors for stoma prolapse after laparoscopic loop colostomy
Yusuke Takashima, Hitoshi Hino, Akio Shiomi, Hiroyasu Kagawa, Shoichi Manabe, Yusuke Yamaoka, Chikara Maeda, Shunsuke Kasai, Yusuke Tanaka
Surgical Endoscopy.2024; 38(5): 2834. CrossRef
Linear stapler refashioning technique for irreducible stomal prolapse—A video vignette
Rajesh S. Shinde, Deep Mashru, Murali V
Colorectal Disease.2024; 26(7): 1483. CrossRef
Stomal Prolapse Due to Sidedness of Transverse Loop Colostomy: A Retrospective Cohort Study
Takuya Yano, Masanori Yoshimitsu, Chiyomi Ishibashi, Atsuko Nishibara, Kanyu Nakano, Hitoshi Idani, Masazumi Okajima
Journal of the Anus, Rectum and Colon.2023; 7(4): 258. CrossRef
Intestinal Stomas—Current Practice and Challenges: An Institutional Review
Isam Mazin Juma, Tabarak Qassim, Mirza Faraz Saeed, Aya Qassim, Sana Al-Rawi, Sabrina Al-Salmi, Mustafa Thaer Salman, Ibrahim Al-Saadi, Abdulaziz Almutawea, Eman Aljahmi, Mohamed Khalid Fadhul
Euroasian journal of hepato-gastroenterology.2023; 13(2): 115. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef

Co-Chief-Editor’s Address

Special issue

Annals of Coloproctology to be an Official Journal of APFCP: Kotaro Maeda; Ann Coloproctol. 2020;36(2):64-64. Published online April 30, 2020; DOI: https://doi.org/10.3393/ac.2020.02.10

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Current Practice in Asia-Pacific Region

Malignant disease, Rectal cancer

Current Status of “Watch-and-Wait” Rectal Cancer Treatment in Asia-Pacific Countries: Jung Wook Huh, Kotaro Maeda, Zheng Liu, Xishan Wang, April Camilla Roslani, Woo Yong Lee; Ann Coloproctol. 2020;36(2):70-77. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2020.01.19

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188 Download
17 Web of Science
15 Citations

Abstract PDF

Purpose
Current acceptance of the watch-and-wait (W&W) approach by surgeons in Asia-Pacific countries is unknown. An international survey was performed to determine status of the W&W approach on behalf of the Asia-Pacific Federation of Coloproctology (APFCP).
Methods
Surgeons in the APFCP completed an Institutional Review Board-approved anonymous e-survey and/or printed letters (for China) containing 19 questions regarding nonsurgical close observation in patients who achieved clinical complete response (cCR) to neoadjuvant chemoradiotherapy (nCRT).
Results
Of the 417 responses, 80.8% (n = 337) supported the W&W approach and 65.5% (n = 273) treated patients who achieved cCR after nCRT. Importantly, 78% of participants (n = 326) preferred a selective W&W approach in patients with old age and medical comorbidities who achieved cCR. In regard to restaging methods after nCRT, the majority of respondents based their decision to use W&W on a combination of magnetic resonance imaging results (94.5%, n = 394) with other test results. For interval between nCRT completion and tumor response assessment, most participants used 8 weeks (n = 154, 36.9%), followed by 6 weeks (n = 127, 30.5%) and 4 weeks (n = 102, 24.5%). In response to the question of how often responders followed-up after W&W, the predominant period was every 3 months (209 participants, 50.1%) followed by every 2 months (75 participants, 18.0%). If local regrowth was found during follow-up, most participants (79.9%, n = 333) recommended radical surgery as an initial management.
Conclusion
The W&W approach is supported by 80% of Asia-Pacific surgeons and is practiced at 65%, although heterogeneous hospital or society protocols are also observed. These results inform oncologists of future clinical study participation.

Citations

Citations to this article as recorded by

Patient and multidisciplinary team perspectives on watch and wait in rectal cancer
Helen Mohan, Mohammed Rabie, Ciaran Walsh, Deena Harji, Paul Sutton, Ian Geh, Ian Jackson, Emma Helbren, Martyn Evans, John T. Jenkins
Colorectal Disease.2023; 25(7): 1489. CrossRef
Organ preservation for early rectal cancer using preoperative chemoradiotherapy
Gyung Mo Son
Annals of Coloproctology.2023; 39(3): 191. CrossRef
International Society of University Colon and Rectal Surgeons survey of surgeons’ preference on rectal cancer treatment
Audrius Dulskas, Philip F. Caushaj, Domas Grigoravicius, Liu Zheng, Richard Fortunato, Joseph W. Nunoo-Mensah, Narimantas E. Samalavicius
Annals of Coloproctology.2023; 39(4): 307. CrossRef
Clinical Implication of Lateral Pelvic Lymph Node Metastasis in Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy
In Ja Park
The Ewha Medical Journal.2022; 45(1): 3. 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
Surgical treatment for metastatic colorectal cancer
Eun Jung Park, Seung Hyuk Baik
Journal of the Korean Medical Association.2022; 65(9): 568. CrossRef
Correlation between T stage and lymph node metastasis in rectal cancer treated with preoperative chemoradiotherapy
Seijong Kim, Jung Wook Huh, Woo Yong Lee, Seong Hyeon Yun, Hee Cheol Kim, Yong Beom Cho, Yoonah Park, Jung Kyong Shin
Therapeutic Advances in Medical Oncology.2022;[Epub] CrossRef
Recent Advance in the Surgical Treatment of Metastatic Colorectal Cancer-An English Version
Eun Jung Park, Seung Hyuk Baik
Journal of the Anus, Rectum and Colon.2022; 6(4): 213. CrossRef
Update on Diagnosis and Treatment of Colorectal Cancer
Chan Wook Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
The watch-and-wait strategy versus radical resection for rectal cancer patients with a good response (≤ycT2) after neoadjuvant chemoradiotherapy
Chungyeop Lee, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Annals of Surgical Treatment and Research.2022; 103(6): 350. CrossRef
Contemporary snapshot of tumor regression grade (TRG) distribution in locally advanced rectal cancer: a cross sectional multicentric experience
Paola Germani, Francesca Di Candido, Daniel Léonard, Dajana Cuicchi, Ugo Elmore, Marco Ettore Allaix, Vittoria Pia Barbieri, Laura D’Allens, Seraina Faes, Marika Milani, Damiano Caputo, Carmen Martinez, Jan Grosek, Valerio Caracino, Niki Christou, Sapho X
Updates in Surgery.2021; 73(5): 1795. CrossRef
Non-operative Management (NOM) of Rectal Cancer: Literature Review and Translation of Evidence into Practice
Christopher J. Anker, Dmitriy Akselrod, Steven Ades, Nancy A. Bianchi, Nataniel H. Lester-Coll, Peter A. Cataldo
Current Colorectal Cancer Reports.2021; 17(2): 23. 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
Widening role of multidisciplinary treatment for rectal cancer: toward diversity of cancer care
Yong Beom Cho
Precision and Future Medicine.2021; 5(4): 149. CrossRef

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