Annals of Coloproctology

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Editorial

The BANANA-Clip: an innovative solution for hemorrhoidal pile ligation?: Kyung Uk Jung; Ann Coloproctol. 2023;39(1):1-2. Published online February 28, 2023; DOI: https://doi.org/10.3393/ac.2023.00129.0018

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Latest Research Trends on the Management of Hemorrhoids
Sung Il Kang
Journal of the Anus, Rectum and Colon.2025; 9(2): 179. CrossRef

Original Articles

Colorectal cancer

Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer: Jung Tak Son, Yong Bog Kim, Hyung Ook Kim, Chungki Min, Yongjun Park, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim; Ann Coloproctol. 2023;39(3):260-266. Published online May 25, 2022; DOI: https://doi.org/10.3393/ac.2022.00101.0014

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Purpose
Surgical management of obstructive left colon cancer (OLCC) is still a matter of debate. The classic Hartmann procedure (HP) has a disadvantage that requires a second major operation. Subtotal colectomy/total abdominal colectomy (STC/TC) with ileosigmoid or ileorectal anastomosis is proposed as an alternative procedure to avoid stoma and anastomotic leakage. However, doubts about morbidity and functional outcome and lack of long-term outcomes have made surgeons hesitate to perform this procedure. Therefore, this trial was designed to provide data for morbidity, functional outcomes, and long-term outcomes of STC/TC.
Methods
This study retrospectively analyzed consecutive cases of OLCC that were treated by STC/TC between January 2000 and November 2020 at a single tertiary referral center. Perioperative outcomes and long-term outcomes of STC/TC were analyzed.
Results
Twenty-five descending colon cancer (45.5%) and 30 sigmoid colon cancer cases (54.5%) were enrolled in this study. Postoperative complications occurred in 12 patients. The majority complication was postoperative ileus (10 of 12). Anastomotic leakage and perioperative mortality were not observed. At 6 to 12 weeks after the surgery, the median frequency of defecation was twice per day (interquartile range, 1–3 times per day). Eight patients (14.5%) required medication during this period, but only 3 of 8 patients required medication after 1 year. The 3-year disease-free survival was 72.7% and 3-year overall survival was 86.7%.
Conclusion
The risk of anastomotic leakage is low after STC/TC. Functional and long-term outcomes are also acceptable. Therefore, STC/TC for OLCC is a safe, 1-stage procedure that does not require diverting stoma.

Citations

Citations to this article as recorded by

Controversial issues of colon stenting in case of tumor obstructive intestinal obstruction: surgical and oncological aspects
S.A. Aliyev, E.S. Aliyev, T.K. Aliyev
Endoscopic Surgery.2025; 31(2): 65. CrossRef
The Safety of Primary Anastomosis Without Protective Stoma in Emergency Left Colon Surgery: A Meta-Analysis
Zhiyan Wang, Wentao Sheng, Senjie Dai, Xuanzhou Li, Guojian Lin, Xiaohong Kang
Journal of Investigative Surgery.2025;[Epub] CrossRef
Ileus After Colectomy in the Modern Era: A Population-Based Analysis
Grace M. Crouch, Samantha Hendren, Kara K. Brockhaus, Wenjing Weng, Jami L. Boyd, Cheryl Rocker, Robert K. Cleary
Diseases of the Colon & Rectum.2025; 68(8): 1001. CrossRef
Influence of the type of anatomic resection on anastomotic leak after surgery for colon cancer
Suat Chin Ng, Andrew McCombie, Frank Frizelle, Tim Eglinton
ANZ Journal of Surgery.2024; 94(3): 424. CrossRef
Complete Obstruction, a Real Risk Factor: A Comprehensive Study on Obstruction in Stage IIA Colon Cancer With Propensity Score Matching Analysis
Soo Young Oh, Chan Wook Kim, Seonok Kim, Min Hyun Kim, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Clinical Colorectal Cancer.2024; 23(2): 135. CrossRef
Can we use colon stenting in accelerated recovery programs for surgical treatment colon cancer complicated by obstructive intestinal obstruction? A literature review
Saday A. Aliyev, Emil S. Aliyev
Russian Journal of Oncology.2024; 29(2): 130. CrossRef

Benign proctology,Rare disease & stoma,Surgical technique

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; Ann Coloproctol. 2022;38(4):319-326. Published online March 7, 2022; DOI: https://doi.org/10.3393/ac.2021.00682.0097

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Graphical Abstract Abstract PDF

Purpose
Surgery to create a stoma for decompression might be required for unresectable stage IV cancer patients with complete colonic obstruction. The aim of this study was to compare the results of blowhole colostomy with those of loop ostomy.
Methods
Palliative ileostomy or colostomy procedures performed at a single center between January 2011 and October 2020, were analyzed retrospectively. Fifty-nine patients were identified during this period. The demographic characteristics and outcomes between the blowhole colostomy group (n=24) and the loop ostomy group (n=35) were compared.
Results
The median operative time tended to be shorter in the blowhole colostomy group (52.5 minutes; interquartile range [IQR], 43–65) than in the loop ostomy group (60 minutes; IQR, 40–107), but the difference did not reach statistical significance (P=0.162). The median length of hospital stay was significantly shorter with blowhole colostomy (blowhole, 13 days [IQR, 9–23]; loop, 21 days [IQR, 14–37]; P=0.013). Mean cecum diameter was significantly larger in the blowhole group than in the loop group (8.83±1.91 cm vs. 6.78±2.36 cm, P=0.001), and the emergency operation rate was higher in the blowhole group than in the loop group (22 of 24 [91.7%] vs. 23 of 35 [65.7%], P=0.021).
Conclusion
In surgical emergencies, diverting a blowhole colostomy can be safe and effective for palliative management of colonic obstruction in patients with end-stage cancer and might reduce the operative time in emergent situations.

Citations

Citations to this article as recorded by

A Last Resort: Dacron Vascular Graft Prosthesis for Management of a Blowhole Colostomy
Brittney A. Ehrlich, Maria C. Unuvar, Justin M. Orenich, Rebecca L. Hoffman
The American Surgeon™.2025; 91(2): 303. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef
Stoma-Related Complications: A Single-Center Experience and Literature Review
Zalán Benedek, Loránd Kocsis, Orsolya Bauer, Nicolae Suciu, Sorin Sorlea, Călin Crăciun, Rareș Georgescu, Marius Florin Coroș
Journal of Interdisciplinary Medicine.2022; 7(2): 31. CrossRef

Benign GI diease

Routine Intraoperative Bacterial Culture May Be Needed in Complicated Appendicitis: Jung Tack Son, Gue Chun Lee, Hyung Ook Kim, Taewoon Kim, Donghyoun Lee, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim, Ho-Kyung Chun; Ann Coloproctol. 2020;36(3):155-162. Published online June 30, 2020; DOI: https://doi.org/10.3393/ac.2019.11.04.1

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Abstract PDF

Purpose
Choosing the appropriate antibiotic is important for treatment of complicated appendicitis. However, increasing multidrug resistant bacteria have been a serious problem for successful treatment. This study was designed to identify bacteria isolated from patients with complicated appendicitis and reveal their susceptibilities for antibiotics and their relationship with patient clinical course.
Methods
This study included patients diagnosed with complicated appendicitis and examined the bacterial cultures and antimicrobial susceptibilities of the isolates. Data were retrospectively collected from medical records of Kangbuk Samsung Hospital from January 2008 to February 2018.
Results
The common bacterial species cultured in complicated appendicitis were as follows: Escherichia coli (n=113, 48.9%), Streptococcus spp. (n=29, 12.6%), Pseudomonas spp. (n=23, 10.0%), Bacteriodes spp. (n=22, 9.5%), Klebsiella (n=11, 4.8%), and Enterococcus spp. (n=8, 3.5%). In antibiotics susceptibility testing, the positive rate of extended-spectrum beta lactamase (ESBL) was 9.1% (21 of 231). The resistance rate to carbapenem was 1.7% (4 of 231), while that to vancomycin was 0.4% (1 of 231). E. coli was 16.8% ESBL positive (19 of 113) and had 22.1% and 19.5% resistance rates to cefotaxime and ceftazidime, respectively. Inappropriate empirical antibiotic treatment (IEAT) occurred in 55 cases (31.8%) and was significantly related with organ/space surgical site infection (SSI) (7 of 55, P=0.005).
Conclusion
The rate of antibiotic resistance organisms was high in community-acquired complicated appendicitis in Koreans. Additionally, IEAT in complicated appendicitis may lead to increased rates of SSI. Routine intraoperative culture in patients with complicated appendicitis may be an effective strategy for appropriate antibiotic regimen.

Citations

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Optimizing Antibiotic Management for Adult Patients Presenting with Acute Perforated Appendicitis: A Quality Improvement Study
Carlos Gallego-Navarro, Jason Beckermann, Maria E. Linnaus, Hayden J. Swartz, Shelby Stewart, Justin M. York, Ryan R. Gassner, Christopher A. Kasal, Annaliese G. Seidel, Corey J. Wachter, Kirstin J. Kooda, Jennifer R. Rich, Mark D. Sawyer
Surgical Infections.2025; 26(3): 143. CrossRef
A Prospective Analysis of the Burden of Multi-Drug-Resistant Pathogens in Acute Appendicitis and Their Implication for Clinical Management
Faruk Koca, Sara Fatima Faqar-Uz-Zaman, Claudia Reinheimer, Michael Hogardt, Volkhard A. J. Kempf, Paul Ziegler, Andreas A. Schnitzbauer, Armin Wiegering, Wolf Otto Bechstein, Patrizia Malkomes
Antibiotics.2025; 14(4): 378. CrossRef
Bacteriological Profile and Antimicrobial Resistance in Intraoperative Purulent Samples From Acute Appendicitis: A 3‐Year Retrospective Analysis
Quanwei Wang, Xiao Xu, Weiwei Ma, Chengcheng Huang, Liqing Cao, Yaru Zhang
ANZ Journal of Surgery.2025;[Epub] CrossRef
Culture-based bacterial evaluation of the appendix lumen and antibiotic susceptibility of acute appendicitis in Japan: A single-center retrospective analysis
Hiroe Kitahara, Yonfan Park, Kai Seharada, Masaki Yoshimura, Akira Horiuchi, Yukihiko Karasawa
Medicine.2024; 103(29): e39037. CrossRef
Do Cultures From Percutaneously Drained Intra-abdominal Abscesses Change Treatment? A Retrospective Review
Andrew C. Esposito, Yuqi Zhang, Nupur Nagarkatti, William D. Laird, Nathan A. Coppersmith, Vikram Reddy, Ira Leeds, Anne Mongiu, Walter Longo, Ritche M. Hao, Haddon Pantel
Diseases of the Colon & Rectum.2023; 66(3): 451. CrossRef
Bacterial pathogens in pediatric appendicitis: a comprehensive retrospective study
Julia Felber, Benedikt Gross, Arend Rahrisch, Eric Waltersbacher, Evelyn Trips, Percy Schröttner, Guido Fitze, Jurek Schultz
Frontiers in Cellular and Infection Microbiology.2023;[Epub] CrossRef
An Update on Acute Appendicitis in Lebanon: Insights From a Single-Center Retrospective Study
Nagham Bazzi, Samer Dbouk, Ahmad Rached, Sadek Jaber, Hala Bazzi, Manal Jrad, Mariam Bazzi
Cureus.2023;[Epub] CrossRef
Bacterial peritonitis in paediatric appendicitis; microbial epidemiology and antimicrobial management
Keir Bhaskar, Simon Clarke, Luke S. P. Moore, Stephen Hughes
Annals of Clinical Microbiology and Antimicrobials.2023;[Epub] CrossRef
Aerobic Intraoperative Abdominal Cavity Culture Modifies Antibiotic Therapy and Reduces the Risk of Surgical Site Infection in Complicated Appendicitis with Peritonitis
Víctor Manuel Quintero-Riaza, Romario Chancí-Drago, Natalia Guzmán-Arango, Pablo Posada-Moreno, Tatiana López-Sandoval, Isabel Cristina Ramírez-Sánchez, Johanna Marcela Vanegas-Munera
Journal of Gastrointestinal Surgery.2023; 27(11): 2563. CrossRef
Does the Covid-19 pandemic have an effect on wound culture in patients undergoing appendectomy? A Case Control Study
Hacı BOLAT, Tuğba AVAN MUTLU
Journal of Contemporary Medicine.2022; 12(2): 332. CrossRef
Are We Hitting the Target?
Julia Elrod, Fatima Yarmal, Christoph Mohr, Martin Dennebaum, Michael Boettcher, Deirdre Vincent, Konrad Reinshagen, Ingo Koenigs
Pediatric Infectious Disease Journal.2022; 41(6): 460. CrossRef
Is Routine Intra-operative Gram Stain, Culture, and Sensitivity during an Appendectomy is Effective in Decreasing the Rate of Post-operative Infective Complications?
Muqdad Fuad, Ahmed Modher, Mohammed Habash
Open Access Macedonian Journal of Medical Sciences.2022; 10(B): 868. CrossRef
Die Bedeutung mikrobiologischer Ergebnisse für die Therapie der komplizierten Appendizitis – eine monozentrische Fall-Kontroll-Studie
F-X. Anzinger, K. Rothe, S. Reischl, C. Stöss, A. Novotny, D. Wilhelm, H. Friess, P-A. Neumann
Die Chirurgie.2022; 93(10): 986. CrossRef
Implications of bacteriological study in complicated and uncomplicated acute appendicitis
Sorin Cimpean, Alberto Gonzalez Barranquero, Ion Surdeanu, Benjamin Cadiere, Guy-Bernard Cadiere
Annals of Coloproctology.2022;[Epub] CrossRef

Case Report

Malignant disease, Benign GI diease,Colorectal cancer,Complication

An Unusual Case of Colon Perforation With Multiple Transmural Ulcers After Use of Polmacoxib and Everolimus in a Metastatic Breast Cancer Patient: In-Gyu Song, Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Ho-Kyung Chun; Ann Coloproctol. 2021;37(2):120-124. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.08.17

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Abstract PDF

Everolimus (Afinitor) is an inhibitor of mammalian target of rapamycin. Polmacoxib (Acelex) is a nonsteroidal anti-inflammatory drug that belongs to the cyclooxygenase-2 (COX-2) inhibitor family and is mainly used for treatment of arthritis. Intestinal perforation has not been reported previously as a complication of everolimus, and perforation of the lower intestinal tract caused by a selective COX-2 inhibitor is extremely rare. We present here a case of colon perforation that occurred after use of polmacoxib in a metastatic breast cancer patient who had been treated with everolimus for the preceding six months.

Citations

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Identification of Drugs Associated With Oral Ulcers Based on Pharmacovigilance
Xinyue Zhang, Xueqing Li, Wuda Huoshen, Shiting Li
International Dental Journal.2025; 75(6): 103957. CrossRef
Multiple ulcers and perforation of small intestine with everolimus use in a patient with rectal neuroendocrine tumor: A case report
Kentaro Abe, Shigenobu Emoto, Kazuhito Sasaki, Hiroaki Nozawa, Yoichi Yasunaga, Soichiro Ishihara
International Journal of Surgery Case Reports.2023; 106: 108094. CrossRef
Everolimus/polmacoxib

Reactions Weekly.2021; 1869(1): 157. CrossRef

Original Articles

Malignant disease

Increased Risk of Neoplasms in Adult Patients Undergoing Interval Appendectomy: Jungtak Son, Yong Jun Park, Sung Ryol Lee, Hyung Ook Kim, Kyung Uk Jung; Ann Coloproctol. 2020;36(5):311-315. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2019.10.15.1

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Abstract PDF

Purpose
The low rate of recurrent appendicitis after initial nonsurgical management of complicated appendicitis supports the recently implemented strategy of omitting routine interval appendectomy. However, several reports have suggested an increased incidence rate of neoplasms in these patients. We aimed to identify the risk of neoplasms in the population undergoing interval appendectomy.
Methods
This study retrospectively analyzed consecutive cases of appendicitis that were treated surgically between January 2014 and December 2018 at a single tertiary referral center. Patients were divided into 2 groups depending on whether they underwent immediate or interval appendectomy. Demographics and perioperative clinical and pathologic parameters were analyzed.
Results
All 2,013 adults included in the study underwent surgical treatment because of an initial diagnosis of acute appendicitis. Of these, 5.5% (111 of 2,013) underwent interval appendectomy. Appendiceal neoplasm was identified on pathologic analysis in 36 cases (1.8%). The incidence of neoplasm in the interval group was 12.6% (14 of 111), which was significantly higher than that of the immediate group (1.2% [22 of 1,902], P < 0.001). Conclusion: The incidence rate of neoplasms was significantly higher in patients undergoing interval appendectomy. These findings should be considered when choosing treatment options after successful nonsurgical management of complicated appendicitis.

Citations

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Incidental appendiceal neoplasms in a multicenter registry of appendicitis management
Aksel D. Laudon, Brendin R. Beaulieu-Jones, Swetha Duraiswamy, Frank F. Yang, Elizabeth Chen, Dave R. Flum, Kasey Lerner, Heather L. Evans, Lauren Thompson, Faris K. Azar, Alex Charboneau, Vlad V. Simianu, Victoria Valdes, Chaitan Narsule, Sabrina E. Sanc
Surgery.2026; 190: 109879. CrossRef
Appendiceal Tumor Prevalence in Patients With Periappendicular Abscess
Roosa Salminen, Jenny Alajääski, Tero Rautio, Saija Hurme, Pia Nordström, Elisa Mäkäräinen, Elina Lietzén, Tarja Pinta, Marie Grönroos-Korhonen, Tuomo Rantanen, Jan Andersén, Anne Mattila, Jyrki Kössi, Antti Riikola, Hannu Paajanen, Markku Matikainen, Ves
JAMA Surgery.2025; 160(5): 526. CrossRef
Acellular mucin in neoplastic and non-neoplastic conditions of the lower gastrointestinal tract
Noureldien Darwish, Lynn Guo, Eundong Park, Hwajeong Lee
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Is it Possible to Manage Appendicular Mass Without Surgery?
Muhammad Albahadili, Saif Mundher Ismael, Monaf Faik Al-Samarraee
Al-Rafidain Journal of Medical Sciences ( ISSN 2789-3219 ).2025; 9(2): 46. CrossRef
Can Appendiceal Neoplasms Be Predicted in Patients with Presumed Acute Appendicitis?
Şevki Pedük
European Journal of Therapeutics.2024; 30(2): 145. CrossRef
Beyond acute appendicitis: a single-institution experience of unexpected pathology findings after 989 consecutive emergency appendectomy
Pietro Fransvea, Caterina Puccioni, Gaia Altieri, Luca D’Agostino, Gianluca Costa, Giuseppe Tropeano, Antonio La Greca, Giuseppe Brisinda, Gabriele Sganga
Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
Exploring the mysterious mucinous appendiceal neoplasm
Erika Hissong
Seminars in Diagnostic Pathology.2024; 41(5): 222. CrossRef
High Incidence of Appendiceal Neoplasms in the Elderly: A Critical Concern for Non-Surgical Treatment
Gizem Issin, Fatih Demir, Irem Guvendir Bakkaloglu, Diren Vuslat Cagatay, Hasan Aktug Simsek, Ismail Yilmaz, Ebru Zemheri
Medical Principles and Practice.2023; 32(6): 358. CrossRef
Benign multicystic mesothelioma of appendiceal origin treated by hyperthermic intraperitoneal chemotherapy: A case report
Suk Jun Lee, Ji Hae Nahm, Jeonghyun Kang, Seung Hyuk Baik, Eun Jung Park
International Journal of Surgery Case Reports.2022; 99: 107665. CrossRef
Risk of appendiceal neoplasm after interval appendectomy for complicated appendicitis: A systematic review and meta-analysis
Roberto Peltrini, Valeria Cantoni, Roberta Green, Ruggero Lionetti, Michele D'Ambra, Carolina Bartolini, Marcello De Luca, Umberto Bracale, Alberto Cuocolo, Francesco Corcione
The Surgeon.2021; 19(6): e549. CrossRef
Interval appendicectomy for complicated appendicitis: do not let your guard down!
R Peltrini, M Podda, S Di Saverio, U Bracale, F Corcione
British Journal of Surgery.2021; 108(9): e288. CrossRef
Modern Management of the Appendix
CPT Samuel Grasso, LTC Avery Walker
Surgical Clinics of North America.2021; 101(6): 1023. CrossRef

Patient-Controlled Nutrition After Abdominal Surgery: Novel Concept Contrary to Surgical Dogma: Hyung Ook Kim, Mingoo Kang, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim, Ho-Kyung Chun; Ann Coloproctol. 2018;34(5):253-258. Published online October 31, 2018; DOI: https://doi.org/10.3393/ac.2018.05.29

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Abstract PDF

Purpose
According to surgical dogma, patients who are recovering from general anesthesia after abdominal surgery should begin with a clear liquid diet, progress to a full liquid diet and then to a soft diet before taking regular meals. We propose patient-controlled nutrition (PCN), which is a novel concept in postoperative nutrition after abdominal surgery.
Methods
A retrospective pilot study was conducted to evaluate the feasibility and effects of PCN. This study was carried out with a total of 179 consecutive patients who underwent a laparoscopic appendectomy between August 2014 and July 2016. In the PCN group, diet was advanced depending on the choice of the patients themselves; in the traditional group, diet was progressively advanced to a full liquid or soft diet and then a regular diet as tolerated. The primary endpoints were time to tolerance of regular diet and postoperative hospital stay.
Results
Time to tolerance of a regular diet (P < 0.001) and postoperative hospital stay (P < 0.001) showed statistically significant differences between the groups. Multivariate analysis using linear regression showed that the traditional nutrition pattern was the only factor associated with postoperative hospital stay (P < 0.001). Multivariate analysis using logistic regression showed that traditional nutrition was the only risk factor associated with prolonged postoperative hospital stay (≥3 days).
Conclusion
After abdominal surgery, PCN may be a feasible and effective concept in postoperative nutrition. In our Early Recovery after Surgery program, our PCN concept may reduce the time to tolerance of a regular diet and shorten the postoperative hospital stay.

Citations

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Bilateral Exchange: Enteral Nutrition Clinical Decision Making in Pediatric Surgery Patients
Manisha B. Bhatia, Cassandra M. Anderson, Abdiwahab N. Hussein, Brian Opondo, Nereah Aruwa, Otieno Okumu, Sarah G. Fisher, Tasha Sparks Joplin, JoAnna L. Hunter-Squires, Brian W. Gray, Peter W. Saula
Journal of Surgical Research.2024; 295: 139. CrossRef
Clinical pharmacist intervention in Appendectomy - Dexmedetomidine as an adjunct therapy ‎
Bushra Abdel-Hadi, Sami Raid Abdel-Fattah
Journal Of Advanced Pharmacy Education And Research.2022; 12(2): 1. CrossRef
外科患者の栄養管理における給食の意義

The Japanese Journal of SURGICAL METABOLISM and NUTRITION.2021; 55(2): 57. CrossRef

Obstructive Left Colon Cancer Should Be Managed by Using a Subtotal Colectomy Instead of Colonic Stenting: Chung Ki Min, Hyung Ook Kim, Donghyoun Lee, Kyung Uk Jung, Sung Ryol Lee, Hungdai Kim, Ho-Kyung Chun; Ann Coloproctol. 2016;32(6):215-220. Published online December 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.6.215

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Abstract PDF

Purpose

This study compared a subtotal colectomy to self-expandable metallic stent (SEMS) insertion as a bridge to surgery for patients with left colon-cancer obstruction.

Methods

Ninety-four consecutive patients with left colon-cancer obstruction underwent an emergency subtotal colectomy or elective SEMS insertion between January 2007 and August 2014. Using prospectively collected data, we performed a retrospective comparative analysis on an intention-to-treat basis.

Results

A subtotal colectomy and SEMS insertion were attempted in 24 and 70 patients, respectively. SEMS insertion technically failed in 5 patients (7.1%). The mean age and rate of obstruction in the descending colon were higher in the subtotal colectomy group than the SEMS group. Sex, underlying disease, American Society of Anesthesiologists physical status, and pathological stage showed no statistical difference. Laparoscopic surgery was performed more frequently in patients in the SEMS group (62 of 70, 88.6%) than in patients in the subtotal colectomy group (4 of 24, 16.7%). The overall rate of postoperative morbidity was higher in the SEMS group. No Clavien-Dindo grade III or IV complications occurred in the subtotal colectomy group, but 2 patients (2.9%) died from septic complications in the SEMS group. One patient (4.2%) in the subtotal colectomy group had synchronous cancer. The total hospital stay was shorter in the subtotal colectomy group. The median number of bowel movements in the subtotal colectomy group was twice per day at postoperative 3–6 months.

Conclusion

A subtotal colectomy for patients with obstructive left-colon cancer is a clinically and oncologically safer, 1-stage, surgical strategy compared to SEMS insertion as a bridge to surgery.

Citations

Citations to this article as recorded by

Colonic stenting: is the bridge to surgery worth its cost? A cost-effectiveness analysis at a single Asian institution
Michelle Shi Qing Khoo, Frederick H. Koh, Sharmini Su Sivarajah, Leonard Ming-Li Ho, Darius Kang-Lie Aw, Cheryl Xi-Zi Chong, Fung Joon Foo, Winson Jianhong Tan
Annals of Coloproctology.2024; 40(6): 555. CrossRef
Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer
Jung Tak Son, Yong Bog Kim, Hyung Ook Kim, Chungki Min, Yongjun Park, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim
Annals of Coloproctology.2023; 39(3): 260. CrossRef
Outcomes After Colonic Self-Expanding Metal Stent Insertion Without Fluoroscopy: A Surgeon-Led 10-Year Experience
Tara M. Connelly, Jessica Ryan, Niamh M. Foley, Helen Earley, Shaheel M. Sahebally, Carl O'Brien, Peter McCullough, Peter Neary, Fiachra Cooke
Journal of Surgical Research.2023; 281: 275. CrossRef
Which treatment strategy is optimal for acute left-sided malignant colonic obstruction? A Bayesian meta-analysis
Kaibo Ouyang, Zifeng Yang, Yuesheng Yang, Junjiang Wang, Deqing Wu, Yong Li
International Journal of Colorectal Disease.2023;[Epub] CrossRef
New Challenges in Surgical Approaches for Colorectal Cancer during the COVID-19 Pandemic
Dragos Serban, Geta Vancea, Catalin Gabriel Smarandache, Simona Andreea Balasescu, Gabriel Andrei Gangura, Daniel Ovidiu Costea, Mihail Silviu Tudosie, Corneliu Tudor, Dan Dumitrescu, Ana Maria Dascalu, Ciprian Tanasescu, Laura Carina Tribus
Applied Sciences.2022; 12(11): 5337. CrossRef
Functional outcomes of surgery for colon cancer: A systematic review and meta-analysis
Sanne J. Verkuijl, Jara E. Jonker, Monika Trzpis, Johannes G.M. Burgerhof, Paul M.A. Broens, Edgar J.B. Furnée
European Journal of Surgical Oncology.2021; 47(5): 960. CrossRef
Short-term outcomes of stents in obstructive rectal cancer
Nora H. Trabulsi, Hajar M. Halawani, Esraa A. Alshahrani, Rawan M. Alamoudi, Sama K. Jambi, Nouf Y. Akeel, Ali H. Farsi, Mohammed O. Nassif, Ali A. Samkari, Abdulaziz M. Saleem, Nadim H. Malibary, Mohammad M. Abbas, Luca Gianotti, Antonietta Lamazza, Jin
Saudi Journal of Gastroenterology.2021; 27(3): 127. CrossRef
Fluoroscopic Stenting as a Bridge to Surgery versus Emergency Management for Malignant Obstruction of the Colon
Fan Xue, Feng Lin, Jun Zhou, Ning Feng, You-Gang Cui, Xu Zhang, Yu-Peng Yi, Wen-Zhi Liu
Emergency Medicine International.2020; 2020: 1. CrossRef
Safety of subtotal or total colectomy with primary anastomosis compared to Hartmann procedure for left-sided colon cancer obstruction or perforation
Eun-Do Kim, Jin-Kwon Lee, Jin-Kyu Cho, Jae-Myung Kim, Ji-Ho Park, Ju-Yeon Kim, Sang-Ho Jeong, Young-Tae Ju, Chi-Young Jeong, Eun-Jung Jung, Young-Joon Lee, Soon-Chan Hong, Seung-Jin Kwag
Korean Journal of Clinical Oncology.2019; 15(2): 106. CrossRef
Laparoscopic assisted insertion of a colonic self-expandable metallic stent
Y. M. Ho, V. Shenoy, J. Alberts, N. Ward
Techniques in Coloproctology.2018; 22(10): 809. CrossRef

Age Over 80 is a Possible Risk Factor for Postoperative Morbidity After a Laparoscopic Resection of Colorectal Cancer: Taekhyun Kang, Hyung Ook Kim, Hungdai Kim, Ho-Kyung Chun, Won Kon Han, Kyung Uk Jung; Ann Coloproctol. 2015;31(6):228-234. Published online December 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.6.228

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Abstract PDF

Purpose

With extended life expectancy, the mean age of patients at the time of diagnosis of colorectal cancer and its treatment, including radical resection, is increasing gradually. We aimed to evaluate the impact of age on postoperative clinical outcomes after a laparoscopic resection of colorectal cancers.

Methods

This is a retrospective review of prospectively collected data. Patients with primary colorectal malignancies or premalignant lesions who underwent laparoscopic colectomies between January 2009 and April 2013 were identified. Patients were divided into 6 groups by age using 70, 75, and 80 years as cutoffs: younger than 70, 70 or older, younger than 75, 75 or older, younger than 80, and 80 or older. Demographics, pathological parameters, and postoperative clinical outcomes, including postoperative morbidity, were compared between the younger and the older age groups.

Results

All 578 patients underwent a laparoscopic colorectal resection. The overall postoperative complication rate was 21.1% (n = 122). There were 4 cases of operative mortality (0.7%). Postoperative complication rates were consistently higher in the older groups at all three cutoffs; however, only the comparison with a cutoff at 80 years showed a statistically significant difference between the younger and the older groups.

Conclusion

Age over 80 is a possible risk factor for postoperative morbidity after a laparoscopic resection of colorectal cancer.

Citations

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Transanal Endoscopic Microsurgery for the Treatment of Well-Differentiated Rectal Neuroendocrine Tumors: Hyoung Ran Kim, Woo Yong Lee, Kyung Uk Jung, Hyuk Jun Chung, Chul Joong Kim, Hae-Ran Yun, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Ho-Kyung Chun; J Korean Soc Coloproctol. 2012;28(4):201-204. Published online August 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.4.201

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Abstract PDF

Purpose

Recently, an increase in well-differentiated rectal neuroendocrine tumors (WRNETs) has been noted. We aimed to evaluate transanal endoscopic microsurgery (TEM) for the treatment of WRNETs.

Methods

Between December 1995 and August 2009, 109 patients with WRNETs underwent TEM. TEM was performed for patients with tumors sizes of up to 20 mm and without a lymphadenopathy. These patients had been referred from other clinics after having been diagnosed with WRNETs by using a colonoscopic biopsy; they had undergone a failed endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR) and exhibited an involved resection margin and remaining tumor after ESD or EMR, regardless of the distance from the anal verge. This study included 38 patients that had more than three years of follow-up.

Results

The mean age of the patients was 51.3 ± 11.9 years, the mean tumor size was 8.0 ± 3.9 mm, and no morbidity occurred. Thirty-five patients were asymptomatic. TEM was performed after a colonoscopic resection in 13 cases because of a positive resection margin, a residual tumor or a non-lifting lesion. Complete resections were performed in 37 patients; one patient with a positive margin was considered surgically complete. In one patient, liver metastasis and a recurrent mesorectal node occurred after five and 10 years, respectively.

Conclusion

TEM might provide an accessible and effective treatment either as an initial or as an adjunct after a colonoscopic resection for a WRNET.

Citations

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Kálmán Almási, Szabolcs Ábrahám, József Baracs, Attila Bursics, Zoltán Jánó, Tamás Sztipits, Áron Szűts, Dezső Tóth, Attila Zaránd, Balázs Bánky
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Lei He, Tao Deng, Hesheng Luo
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Current Issues Involving the Treatment of Small Rectal Carcinoid Tumors
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