Annals of Coloproctology

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Case Report

Malignant disease,Rare disease & stoma

Outcomes of surgical management of buschke-lowenstein tumor in a Philippine tertiary hospital: Sofia Isabel T. Manlubatan, Mark Augustine S. Onglao, Mayou Martin T. Tampo, Marc Paul J. Lopez; Ann Coloproctol. 2022;38(1):82-87. Published online February 23, 2022; DOI: https://doi.org/10.3393/ac.2020.00731.0104

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Buschke-Lowenstein tumor (BLT) is a sexually transmitted infection (STI) caused by the human papillomavirus. This study investigated the profile, management, and outcomes of patients who underwent surgery for BLT from 2015 to 2019 at the Philippine General Hospital. Seven patients underwent surgery for BLT. All were male, with ages ranging from 21 to 41 years. Presenting symptoms were anal mass, foul-smelling discharge, pain, bleeding, and pruritus. All were positive for human immunodeficiency virus. All admitted to having engaged in both insertive and receptive anal intercourse, with multiple partners. All underwent excision with healing by secondary intention. Two had recurrence of warts. Four had an anal stricture. Of these, 3 underwent anal dilatation, while 1 had to undergo proximal bowel diversion. One had intraepithelial carcinoma without dermal invasion on histopathologic analysis. BLT is a rare STI characterized by local aggressiveness but with low malignant potential. Wide excision remains to be the mainstay of treatment.

Citations

Citations to this article as recorded by

Association of flap transfer versus excision with secondary healing on patient satisfaction in nasal mass surgery: A cohort study
Xinyu Li, Datao Li, Yiyuan Li, Feng Xu, Zhicheng Xu, Qun Zhang, Xia Chen, Ruhong Zhang
Journal of Plastic, Reconstructive & Aesthetic Surgery.2025; 100: 309. CrossRef
Sex Steroid Modulators and the Development of Buschke-Lowenstein Tumor: A Case Report of an Immunocompetent Patient
Paige Stratton , Vithal Vernenkar, Aeryn J Fulton, Varun Soti
Cureus.2023;[Epub] CrossRef

Original Article

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

Modifications to Treatment Plan of Rectal Cancer in Response to COVID-19 at the Philippine General Hospital: Sofia Isabel T. Manlubatan, Marc Paul J. Lopez, Mark Augustine S. Onglao, Hermogenes J. Monroy III; Ann Coloproctol. 2021;37(4):225-231. Published online August 6, 2021; DOI: https://doi.org/10.3393/ac.2021.00381.0054

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85 Download
6 Web of Science
6 Citations

Abstract PDF

Purpose
The coronavirus disease 2019 (COVID-19) pandemic has strained healthcare resources worldwide. Despite the high number of cases, cancer management should remain one of the priorities of healthcare, as any delay would potentially cause disease progression.
Methods
This was an observational study that included nonmetastatic rectal cancer patients managed at the Philippine General Hospital from March 16 to May 31, 2020, coinciding with the lockdown. The treatment received and their outcomes were investigated.
Results
Of the 52 patients included, the majority were female (57.7%), belonging to the age group of 50 to 69 years (53.8%), and residing outside the capital (59.6%). On follow-up, 23.1% had no disease progression, 17.3% had local progression, 28.8% had metastatic progression, 19.2% have died, and 11.5% were lost to follow up. The initial plan for 47.6% patients was changed. Of the 21 patients with nonmetastatic disease, 2 underwent outright resection. The remaining 19 required neoadjuvant therapy. Eight have completed their neoadjuvant treatment, 8 are undergoing treatment, 2 had their treatment interrupted, and 1 has yet to begin treatment. Among the 9 patients who completed neoadjuvant therapy, only 1 was able to undergo resection on time. The rest were delayed, with a median time of 4 months. One has repeatedly failed to arrive for her surgery due to public transport limitations. There was 1 adjuvant chemotherapy-related mortality.
Conclusion
Delays in cancer management resulted in disease progression in several patients. Alternative neoadjuvant treatment options should be considered while taking into account oncologic outcomes, acceptable toxicity, and limitation of potential COVID-19 exposure.

Citations

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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
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
Surgical safety in the COVID-19 era: present and future considerations
Young Il Kim, In Ja Park
Annals of Surgical Treatment and Research.2022; 102(6): 295. CrossRef
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
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

Case Report

Benign GI diease,Rare disease & stoma

McKittrick-Wheelock Syndrome: A Case Series: Maureen Elvira P. Villanueva, Mark Augustine S. Onglao, Mayou Martin T. Tampo, Marc Paul J. Lopez; Ann Coloproctol. 2022;38(3):266-270. Published online July 13, 2021; DOI: https://doi.org/10.3393/ac.2020.00745.0106

5,117 View
205 Download
5 Web of Science
7 Citations

Abstract PDF

McKittrick-Wheelock syndrome is a rare and life-threatening disease characterized by the triad of (1) chronic mucous diarrhea, (2) renal function impairment with hydroelectrolyte imbalance, and (3) a giant colorectal tumor. Often, the tumor is a rectal adenoma. With the mortality being certain, if left untreated, it is important to raise awareness on the presentation, diagnosis, and management of this disease entity. Here, we presented 3 cases of McKittrick-Wheelock syndrome that were successfully managed with surgical resection at the Philippine General Hospital from August 2018 to May 2019. Resolution of their symptoms, reversal of their renal impairment, and correction of their electrolyte depletion were noted after removal of the tumor with a sphincter-saving operation.

Citations

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Renal failure due to rectal neoplastic polyp: McKittrick–Wheelock syndrome—a case report
Ivan Valentinov Dimitrov, Theophil Angelov Sedloev, Ivan Petrov Vasilev, Slavyana Slavcheva Usheva, Yavor Asenov Nikolov, Nikolay Metodiev Penkov, Plamen Ivanov Penchev, Maria-Elena Boyadzhieva, Georgi Chavdarov Jelev
Journal of Medical Case Reports.2025;[Epub] CrossRef
A New Perspective on the Management of Giant Rectal Polyps Presenting With McKittrick-Wheelock Syndrome: A Case Report on Treatment With Transanal Excision and Delorme’s Plication
Andrew C Ekwesianya, Abraham V Jesudoss, Manoj Jacob, Mohamad F Badr, Bandipalyam V Praveen
Cureus.2025;[Epub] CrossRef
Mckittrick-Wheelock syndrome as a rare manifestation of villous adenoma of the rectum
V.E. Khoronenko, V.S. Trifanov, N.V. Chebotareva, M.Yu. Meshcheryakova, M.V. Kosogolov
Pirogov Russian Journal of Surgery.2024; (3): 76. CrossRef
McKittrick–Wheelock Syndrome: A Case Report
Kristina Marcinkevičiūtė, Marius Kryžauskas, Tomas Poškus
Medicina.2023; 59(3): 633. CrossRef
Rapid Malignant Transformation of Tubulovillous Adenoma, Initially Presenting as McKittrick-Wheelock Syndrome: A Case Report
Ibnu Purwanto, Benedreky Leo, Bambang Purwanto Utomo, Imam Sofii, Ery Kus Dwianingsih, Neneng Ratnasari
Case Reports in Oncology.2023; 16(1): 818. CrossRef
Giant Villous Adenoma of the Rectum With Prolapse: Case Report
Iurii Munteanu, Munteanu Mihaela, Silvia Popescu, Iulian M Slavu, Anca Oprescu Macovei, Daniel Cochior
Cureus.2023;[Epub] CrossRef
Chronic Kidney Disease, Hypokalemia, and Appendicular Mucocele in a 66-Year-Old Man
Sanda Mrabet, Yosr Chaabouni, Mohamed Ben Hmida
American Journal of Men's Health.2022;[Epub] CrossRef

Original Articles

Malignant disease, Functional outcomes,Postoperative outcome & ERAS

Improved outcomes with implementation of an Enhanced Recovery After Surgery pathway for patients undergoing elective colorectal surgery in the Philippines: Mayou Martin T. Tampo, Mark Augustine S. Onglao, Marc Paul J. Lopez, Marie Dione P. Sacdalan, Ma. Concepcion L. Cruz, Rosielyn T. Apellido, Hermogenes J. Monroy III; Ann Coloproctol. 2022;38(2):109-116. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.09.02

5,824 View
297 Download
8 Web of Science
8 Citations

Abstract PDF Supplementary Material

Purpose
This study aims to evaluate surgical outcomes (i.e. length of stay [LOS], 30-day morbidity, mortality, reoperation, and readmission rates) with the use of the Enhanced Recovery After Surgery (ERAS) pathway, and determine its association with the rate of compliance to the different ERAS components.
Methods
This was a prospective cohort of patients, who underwent the following elective procedures: stoma reversal (SR), colon resection (CR), and rectal resection (RR). The primary endpoint was to determine the association of compliance to an ERAS pathway and surgical outcomes. These were then retrospectively compared to outcomes prior to the implementation of ERAS.
Results
A total of 267 patients were included in the study. The overall compliance to the ERAS component was 92.0% (SR, 91.8%; CR, 93.1%; RR, 90.7%). There was an associated decrease in morbidity rates across all types of surgery, as compliance to ERAS increased. The average total LOS decreased in all groups but was only found to have statistical significance in SR (12.1±6.7 days vs. 10.0±5.4 days, P=0.002) and RR (19.9±11.4 days vs. 16.9±10.5 days, P=0.04) groups. Decreased postoperative LOS was noted in all groups. Morbidity rates were significantly higher after ERAS implementation, but reoperation and mortality rates were found to be similar.
Conclusion
Increased compliance to ERAS protocol is associated with a decrease in morbidity across all surgery types. The implementation of an ERAS protocol significantly decreased mean hospital LOS, without any increase in major surgical complications. Having your own hospital ERAS pathway improves documentation and accuracy of reporting surgical complications.

Citations

Citations to this article as recorded by

Enhanced recovery after surgery (ERAS) in stoma reversal surgery: a systematic review and meta-analysis
Túlio Pimentel, Dante L. S. Souza, Ivonne Zuniga, Maria Clara Faveri, Julia Canfild, Paula Motta Pauperio, Hamza Guend
Updates in Surgery.2025; 77(2): 297. CrossRef
Surgical Enhanced Recovery: Where Are We Now?
Anika Tahmeed, Juan P. Cata, Tong J. Gan
International Anesthesiology Clinics.2025; 63(2): 62. CrossRef
Lessons following implementation of a colorectal enhanced recovery after surgery (ERAS) protocol in a rural hospital setting
Stephen Tolmay, Jamie‐Lee Rahiri, Kim Snoep, Gillian Fewster, Rachel Kee, Yukai Lim, Bridget Watson, Konrad Klaus Richter
ANZ Journal of Surgery.2024; 94(5): 910. 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
Influence of additional prophylactic oral antibiotics during mechanical bowel preparation on surgical site infection in patients receiving colorectal surgery
Hayoung Lee, Jong Lyul Lee, Ji Sung Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok‐Byung Lim
World Journal of Surgery.2024; 48(6): 1534. CrossRef
Clinical outcomes and future directions of enhanced recovery after surgery in colorectal surgery: a narrative review
Ji Hyeong Song, Minsung Kim
The Ewha Medical Journal.2024;[Epub] CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
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

Benign proctology

Initial Experience With Video-Assisted Anal Fistula Treatment in the Philippines: Marc Paul J. Lopez, Mark Augustine S. Onglao, Hermogenes J. Monroy III; Ann Coloproctol. 2020;36(2):112-118. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2020.02.28

10,810 View
141 Download
6 Web of Science
7 Citations

Abstract PDF

Purpose
We determined the outcomes of patients undergoing video-assisted anal fistula treatment (VAAFT) for fistulain-ano at the Philippine General Hospital.
Methods
Twenty consecutive adult patients who underwent the VAAFT procedure from 2016–2018 were included in this investigation. Information detailing baseline demographic and clinical data, fistula type and classification, and previous surgeries were retrieved from in-hospital and operative records. Operative time, identification of the internal opening, method of internal opening closure, and occurrence of immediate postoperative complications were determined. The status of the fistula was assessed at one month, 3 months, and 6 months postoperatively based on outpatient follow-up records. The primary outcomes were healing rate and recurrence rate. Secondary outcomes were 30-day morbidity, postoperative complications, and incontinence using the Wexner score.
Results
Eighteen patients (90%) had a preoperative diagnosis of complex fistula, and 13 patients (65%) had undergone a previous fistula surgery. Primary healing rate was 55% at 1 month, 63.16% at 3 months, and 78.95% at 6 months postoperatively. Eighteen patients (94.74%) maintained continence (Wexner score = 0) at 6 months.
Conclusion
Our study results suggest that VAAFT is a safe, minimally invasive technique for treatment of anal fistula and can preserve anal sphincter function. The technique has an acceptable healing rate with minimal complications.

Citations

Citations to this article as recorded by

A technical note of flex video-assisted anal fistula treatment procedure: Utilizing modified flexible fistuloscope in video-assisted approach for anal fistula laser treatment
Okkian Wijaya Kotamto, Tery Nehemia Nugraha Joseph, Clement Dewanto, Natalia Maria Christina, Nadiska Patricia Artha, Marsja Ruthfanny Hutapea, Jeremiah H. Wijaya
Surgery Open Science.2025; 24: 80. CrossRef
Failure rates and complications of four sphincter-sparing techniques for the treatment of fistula-in-ano: a systematic review and network meta-analysis
G. Fuschillo, F. Pata, M. D’Ambrosio, L. Selvaggi, M. Pescatori, F. Selvaggi, G. Pellino
Techniques in Coloproctology.2025;[Epub] CrossRef
Efficacy and safety of video-assisted anal fistula treatment in anorectal fistula: a meta-analysis
Chunqiang WANG, Tianye HUANG, Xuebing WANG
Minerva Gastroenterology.2024;[Epub] CrossRef
Long term efficacy of Video‐Assisted Anal Fistula Treatment (VAAFT) for complex fistula‐in‐ano: a single‐centre Australian experience
Mat Hinksman, Sanjeev Naidu, Kenneth Loon, Joshua Grundy
ANZ Journal of Surgery.2022; 92(5): 1132. CrossRef
Advancing standard techniques for treatment of perianal fistula; when tissue engineering meets seton
Hojjatollah Nazari, Zahra Ebrahim Soltani, Reza Akbari Asbagh, Amirsina Sharifi, Abolfazl Badripour, Asieh Heirani Tabasi, Majid Ebrahimi Warkiani, Mohammad Reza Keramati, Behnam Behboodi, Mohammad Sadegh Fazeli, Amir Keshvari, Mojgan Rahimi, Seyed Mohsen
Health Sciences Review.2022; 3: 100026. CrossRef
Is It a Refractory Disease?- Fecal Incontinence; beyond Medication
Chungyeop Lee, Jong Lyul Lee
The Ewha Medical Journal.2022;[Epub] CrossRef
VAAFT for complex anal fistula: a useful tool, however, cure is unlikely
T. J. G. Chase, A. Quddus, D. Selvakumar, P. Cunha, T. Cuming
Techniques in Coloproctology.2021; 25(10): 1115. CrossRef

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