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Editorial
Malignant disease,Colorectal cancer,Prognosis
- Elderly High-Risk Stage II Colorectal Cancer Patients: Candidates for Improving Outcome?
- Min Ki Kim
- Ann Coloproctol. 2021;37(5):267-268. Published online October 29, 2021
- DOI: https://doi.org/10.3393/ac.2021.00864.0123
- 4,784 View
- 61 Download
- 1 Citations
Original Article
Malignant disease, Rectal cancer
- Influence of the Enhanced Recovery After Surgery Protocol on Postoperative Inflammation and Short-term Postoperative Surgical Outcomes After Colorectal Cancer Surgery
- Heba Essam Jaloun, In Kyu Lee, Min Ki Kim, Na Young Sung, Suhail Abdullah Al Turkistani, Sun Min Park, Dae Youn Won, Sang Hyun Hong, Bong-Hyeon Kye, Yoon Suk Lee, Hae Myung Jeon
- Ann Coloproctol. 2020;36(4):264-272. Published online May 15, 2020
- DOI: https://doi.org/10.3393/ac.2020.03.25
- 13,474 View
- 204 Download
- 26 Web of Science
- 26 Citations
-
Abstract
PDF - Purpose
Many studies have shown that the enhanced recovery after surgery (ERAS) protocols improve postoperative surgical outcomes. The purpose of this study was to observe the effects on postoperative inflammatory markers and to explore the effects of a high degree of compliance and the use of epidural anesthesia on inflammation and surgical outcomes.
Methods
Four hundred patients underwent colorectal cancer surgery at 2 hospitals during 2 different periods, namely, from January 2006 to December 2009 and from January 2017 to July 2017. Data related to the patient’s clinicopathological features, inflammatory markers, percentage of compliance with elements of the ERAS protocol, and use of epidural anesthesia were collected from a prospectively maintained database.
Results
The complication rate and the length of hospital stay (LOS) were less in the ERAS group than in the conventional group (P = 0.005 and P ≤ 0.001, respectively). The postoperative white blood cell count and the duration required for leukocytes to normalize were reduced in patients following the ERAS protocol (P ≤ 0.001). Other inflammatory markers, such as lymphocyte count (P = 0.008), neutrophil/lymphocyte ratio (P = 0.032), and C-reactive protein level (P ≤ 0.001), were lower in the ERAS protocol group. High compliance ( ≥ 70%) was strongly associated with the complication rate and the LOS (P = 0.008 and P ≤ 0.001, respectively).
Conclusion
ERAS protocols decrease early postoperative inflammation and improves short-term postoperative recovery outcomes such as complication rate and the LOS. High compliance ( ≥ 70%) with the ERAS protocol elements accelerates the positive effects of ERAS on surgical outcomes; however, the effect on inflammation was very small. -
Citations
Citations to this article as recorded by
- Role and importance of quality control in improving compliance of enhanced recovery after surgery to overcome postoperative complications
In Kyeong Kim, Jung Hoon Bae, Soo Ji Park, Yoon Suk Lee, In Kyu Lee
BMC Surgery.2026;[Epub] CrossRef - Application of Enhanced Recovery After Surgery in high-risk patients undergoing colon cancer surgery: a retrospective cohort study
Reem Mohammed H. Alshiakh, In Kyeong Kim, Jung Hoon Bae, Yoon Suk Lee, In Kyu Lee
Annals of Surgical Treatment and Research.2026; 110(4): 205. CrossRef - The perioperative effect of ERAS protocol in patients with lung cancer: a randomized controlled study
Duan Xiao, Peng Deng, Zhihong Feng, Chi Yao, Bing Yuan
Journal of Cardiothoracic Surgery.2026;[Epub] CrossRef - Robotics versus open surgery: the impact on cytokine release and patient outcomes
Sidharth Misra, Zainab Yusufali Motiwala, Aditya Puniyani, Laaiba Shamsi, Fatima Nadeem, Danny Darlington Carbin
Journal of Robotic Surgery.2025;[Epub] CrossRef - Effect of ERAS pathway nursing on postoperative rehabilitation of patients undergoing gastrointestinal surgery: a meta-analysis
Fengying Dong, Yan Li, Wenxia Jin, Zhebing Qiu
BMC Surgery.2025;[Epub] CrossRef - Remimazolam-Based Anesthesia and Systemic Inflammatory Biomarkers in Relation to Postoperative Delirium in Elderly Patients: A Retrospective Cohort Study
Hayoung Lee, Keunyoung Kim, Cheol Lee
Medicina.2025; 61(6): 1023. CrossRef - Initial experience of pure robotic single incision TME with SST technique for middle-low rectal cancer using the da Vinci SP system
Choi Nim, Kuok Chi Ian
Intelligent Surgery.2025; 8: 70. CrossRef - Effects of early activity intervention on intestinal motility recovery in patients after colorectal cancer surgery
Xiu-Lian Zhang, Ai-Ping Lin, Tian-Sheng Lin, You-Qing Huang
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef - Challenging issues of implementing enhanced recovery after surgery programs in South Korea
Soo-Hyuk Yoon, Ho-Jin Lee
Anesthesia and Pain Medicine.2024; 19(1): 24. CrossRef - Effect of different anesthetic modalities with multimodal analgesia on postoperative pain level in colorectal tumor patients
Ji-Chun Tang, Jia-Wei Ma, Jin-Jin Jian, Jie Shen, Liang-Liang Cao
World Journal of Gastrointestinal Oncology.2024; 16(2): 364. CrossRef - Dysregulation of systemic immunity in colorectal cancer and its clinical applications as biomarkers and therapeutics
Changqin Li, Jian Li
Critical Reviews in Oncology/Hematology.2024; 204: 104543. CrossRef - The role of robotic-assisted surgery in the management of rectal cancer: a systematic review and meta-analysis
Chenxiong Zhang, Hao Tan, Han Xu, Jiaming Ding
International Journal of Surgery.2024; 110(10): 6282. CrossRef - Enhancing recovery and reducing inflammation: the impact of enhanced recovery after surgery recommendations on inflammatory markers in laparoscopic surgery—a scoping review
Carlos Darcy Alves Bersot, Lucas Ferreira Gomes Pereira, Victor Gabriel Vieira Goncho, José Eduardo Guimarães Pereira, Luiz Fernando dos Reis Falcão
Frontiers in Surgery.2024;[Epub] CrossRef - Enhanced recovery pathway in open and minimally invasive colorectal cancer surgery: a prospective study on feasibility, compliance, and outcomes in a high-volume resource limited tertiary cancer center
Martin Thomas, Vandana Agarwal, Ashwin DeSouza, Riddhi Joshi, Minal Mali, Karuna Panhale, Omkar K. Salvi, Reshma Ambulkar, Shailesh Shrikhande, Avanish Saklani
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef - Initial experience of abdominal total mesorectal excision for rectal cancer using the da Vinci single port system
Wed Alshalawi, Chul Seung Lee, In Kyeong Kim, Yoon Suk Lee
Journal of Minimally Invasive Surgery.2023; 26(4): 208. CrossRef - Association between enrollment in an enhanced recovery program for colorectal cancer surgery and long‐term recurrence and survival
Andres Zorrilla‐Vaca, Javier Ripolles‐Melchor, Ane Abad‐Motos, Inés Rubiera Mingu, Nekane Moreno‐Jurado, Fátima Martínez‐Durán, Isabel Pérez‐Martínez, Alfredo Abad‐Gurumeta, María L. FuenMayor‐Varela, Gabriel E. Mena, Michael C. Grant
Journal of Surgical Oncology.2022; 125(8): 1269. CrossRef - Implementation and improvement of Enhanced Recovery After Surgery protocols for colorectal cancer surgery
Bo Yoon Choi, Jung Hoon Bae, Chul Seung Lee, Seung Rim Han, Yoon Suk Lee, In Kyu Lee
Annals of Surgical Treatment and Research.2022; 102(4): 223. CrossRef - Effect of Enhanced Recovery after Surgery with Integrated Traditional Chinese and Western Medicine on Postoperative Stress Response of Patients with Gastrointestinal Tumors
Haiping Zhao, Wenhui Sun, Tao Huang
Computational and Mathematical Methods in Medicine.2022; 2022: 1. CrossRef - Multidisciplinary treatment strategy for early colon cancer
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Korean Medical Association.2022; 65(9): 558. CrossRef - Robotic surgery for colorectal cancer
Sung Uk Bae
Journal of the Korean Medical Association.2022; 65(9): 577. CrossRef - Commentary: Preoperative neutrophil to lymphocyte ratio predicts complications after esophageal resection that can be used as inclusion criteria for enhanced recovery after surgery
Cheng Shen, Qiang Pu, Guowei Che
Frontiers in Surgery.2022;[Epub] CrossRef - Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 203. CrossRef - Current Status and Future of Robotic Surgery for Colorectal Cancer-An English Version
Sung Uk Bae
Journal of the Anus, Rectum and Colon.2022; 6(4): 221. CrossRef - A propensity score-matched analysis of advanced energy devices and conventional monopolar device for colorectal cancer surgery: comparison of clinical and oncologic outcomes
Woo Jin Song, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Annals of Surgical Treatment and Research.2022; 103(5): 290. CrossRef - Enhanced recovery after surgery: importance of compliance audits
Jung Hoon Bae
Journal of the Korean Medical Association.2021; 64(12): 820. CrossRef - Effect of the Enhanced Recovery After Surgery protocol After Colorectal Cancer Surgery
Dae Ro Lim
Annals of Coloproctology.2020; 36(4): 209. CrossRef
- Role and importance of quality control in improving compliance of enhanced recovery after surgery to overcome postoperative complications
Review
- Reconsideration of the Safety of Laparoscopic Rectal Surgery for Cancer
- Gyung Mo Son, Bong-Hyeon Kye, Min Ki Kim, Jun-Gi Kim
- Ann Coloproctol. 2019;35(5):229-237. Published online October 31, 2019
- DOI: https://doi.org/10.3393/ac.2019.10.16
- 7,493 View
- 118 Download
- 8 Web of Science
- 8 Citations
-
Abstract
PDF
- The oncological outcomes of laparoscopic rectal cancer surgery were evaluated in recent multicenter randomized clinical trials (RCTs). The MRC-CLASSIC, COLOR II, and COREAN trials found no differences in local recurrence or diseasefree survival rate between laparoscopic and open surgery. However, the noninferiority of laparoscopic surgery with respect to open surgery for rectal cancer was not established on statistical analysis in the ACOSOG Z6051 and the ALaCaRT trials. Quality of total mesorectal excision (TME) is one of the most important prognostic factors. Incomplete TME had unfavorable oncologic outcomes compared to complete TME. Although TME quality can be clearly identified on pathologic evaluation, there is controversy regarding the acceptable range of oncologically safe TME for laparoscopic surgery. It is not certain whether near-complete TME has an unfavorable oncologic impact and whether laparoscopic surgery with near-complete TME is an oncological threat. Therefore, the surgical community will be interested in the long-term outcomes and meta-analyses of ongoing large-scale RCTs. Laparoscopic rectal cancer surgery has been steadily improving its safety for oncology surgery, which has been reported consistently in various multicenter RCTs. To improve surgical quality, colorectal surgeons should choose the most appropriate surgical technique, including laparoscopic surgery.
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Citations
Citations to this article as recorded by- Four clinical dilemmas in surgical decision making for low rectal cancer
Amine Souadka, Urs Giger-Pabst, Mehdi Ouaissi
Discover Oncology.2026;[Epub] CrossRef - Beyond sphincter preservation in low rectal cancer: Context-Adapted reconstruction in France and Morocco – A bicentric retrospective cohort study
Rayan Aribi, Rémy Sindayigaya, Mohammed Anass Majbar, Nicolas Michot, Oumayma Lahnaoui, Zakaria El Mouatassim, Thierry Lecomte, Hind Mrabti, Driffa Moussata, Hanane El Kacemi, Raouf Mohsine, Sofia Bakkar, Jean Pierre Barbieux, Ephrem Salamé, Urs Giger-Pab
Surgical Oncology.2026; 69: 102557. CrossRef - Why did we encounter a pCRM-positive specimen whose preoperative MRI indicates negative mesorectal fascia involvement in middle to low rectal cancer?
F. Sumiyama, M. Hamada, T. Kobayashi, Y. Matsumi, R. Inada, H. Kurokawa, Y. Uemura
Techniques in Coloproctology.2025;[Epub] CrossRef - Efficacy of laparoscopic radical resection of colorectal cancer in older patients and its effects on inflammatory factors
Zhen-Yu Min, Jie Zhou, Zhong-Wei Zhu, Zhen-Zhong Fa
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef - Operative and Survival Outcomes of Robotic-Assisted Surgery for Colorectal Cancer in Elderly and Very Elderly Patients: A Study in a Tertiary Hospital in South Korea
Hugo Cuellar-Gomez, Siti Mayuha Rusli, María Esther Ocharan-Hernández, Tae-Hoon Lee, Guglielmo Niccolò Piozzi, Seon-Hahn Kim, Cruz Vargas-De-León, Yazhou He
Journal of Oncology.2022; 2022: 1. CrossRef - Evidenz in der minimal-invasiven onkologischen Chirurgie des Kolons und des Rektums
Carolin Kastner, Joachim Reibetanz, Christoph-Thomas Germer, Armin Wiegering
Der Chirurg.2021; 92(4): 334. CrossRef - The Safety and Feasibility of Laparoscopic Surgery for Very Low Rectal Cancer: A Retrospective Analysis Based on a Single Center’s Experience
Hyuk-Jun Chung, Jun-Gi Kim, Hyung-Jin Kim, Hyeon-Min Cho, Bong-Hyeon Kye
Biomedicines.2021; 9(11): 1720. CrossRef - Reoperative laparoscopic rectal surgery: Another potential tool for the expert’s toolbox
Marc D. Basson
The American Journal of Surgery.2020; 219(6): 894. CrossRef
- Four clinical dilemmas in surgical decision making for low rectal cancer
Original Articles
- Indication for and Effect of Adjuvant Chemotherapy for Stage IIa (T3N0M0) Colon Cancer
- Chul-Hyo Jeon, Min Ki Kim, In Kyu Lee
- Ann Coloproctol. 2019;35(5):254-261. Published online October 31, 2019
- DOI: https://doi.org/10.3393/ac.2018.12.04
- 11,621 View
- 96 Download
- 2 Web of Science
- 2 Citations
-
Abstract
PDF
- Purpose
The efficacy of adjuvant chemotherapy (AC) in stage IIa colon cancer is controversial. This study aimed to investigate the factors influencing survival in patients with stage IIa colon cancer, the role of AC, and the indications for AC utilization by surgical oncologists.
Methods
Between January 2004 and December 2010, 736 patients with stage IIa colon cancer underwent curative resection in 1 of 6 participating hospitals. Factors related to survival were identified and analyzed according to whether AC was administered or not. After high- and low-risk groups were identified, their respective results were analyzed.
Results
The 5-year overall survival (OS) of stage IIa colon cancer was 90.3%. With the exception of poorly differentiated histology, indications for AC did not include typical high-risk factors. The indications for AC were significantly younger patients, higher body mass index (BMI), lower American Society of Anesthesiologists (ASA) physical status classification, and higher histologic grade. BMI, preoperative carcinoembryonic antigen, and harvested lymph node (LN) count were significant factors for disease-free survival, while BMI and ASA physical status classification were significant factors for OS in the chemotherapy group. In the high-risk group, AC was associated with increased OS in univariate analysis. BMI and harvested LN count were statistically significant in multivariate analysis.
Conclusion
Surgical oncologists consider the patient’s condition and postoperative course rather than high-risk factors to determine use of AC. Regardless of AC use, both the extent of surgery and the patient’s subsequent status affected the survival rate in the high-risk group. None of the factors identified influenced survival rate in the low-risk group. -
Citations
Citations to this article as recorded by- Use of ascitic CEA levels as a predictive value for distant metastasis in high-risk stage II and III colorectal cancer
Abdullah Al-Sawat, Jung Hoon Bea, Seung-Rim Han, Hyo Jin Lee, Mi Ran Yoon, Yoon Suk Lee, Do Sang Lee, Chul Seung Lee, In Kyu Lee
International Journal of Colorectal Disease.2022; 37(2): 365. CrossRef - Prognostic Factor and Survival Benefit of Adjuvant Chemotherapy in Stage IIA Colon Cancer
Mok-Won Lee, Jin-Su Kim, Ji-Yeon Kim, Kyung-ha Lee
Annals of Coloproctology.2021; 37(1): 35. CrossRef
- Use of ascitic CEA levels as a predictive value for distant metastasis in high-risk stage II and III colorectal cancer
- Efficacy and Safety of Ramosetron Injection for Nausea and Vomiting in Colorectal-Cancer Patients Undergoing a Laparoscopic Colectomy: A Randomized, Double-Blind, Comparative Study
- Han Eol Park, Min Ki Kim, Won-Kyung Kang
- Ann Coloproctol. 2018;34(1):36-41. Published online February 28, 2018
- DOI: https://doi.org/10.3393/ac.2018.34.1.36
- 7,903 View
- 77 Download
- 6 Web of Science
- 9 Citations
-
Abstract
PDF
Purpose A laparoscopic colectomy in colorectal-cancer patients is usually associated with a high risk of postoperative nausea and vomiting (PONV). The purpose of this study is to evaluate the efficacy of injection of long-acting 5-hydroxytryptamine type 3 (5-HT3) receptor antagonist for the reduction of PONV in patients with colorectal cancer.
Methods A total of 48 patients scheduled to undergo a laparoscopic colectomy for colorectal cancer were randomized in a double-blinded fashion. Patients were randomly allocated to 1 of 2 groups and assigned to receive either 0.3 mg of ramosetron intravenously (group A, n = 25) or 2 mL of normal saline (placebo) (group B, n = 22) immediately after the operation. The incidence of PONV, the nausea severity scale score, the visual analogue scale (VAS) score for pain, the total amount of patient-controlled analgesia used, the recovery of bowel function, and morbidities were assessed at 1 hour and at 24, 48, and 72 hours after surgery.
Results The baseline and the operative characteristics were similar between the groups (P > 0.05). The number of cases without PONV (complete response) was higher for group A (ramosetron) than group B (normal saline): 24 hours after surgery, 92.0% (23 of 25) for group A versus 54.5% (12 of 22) for group B; 48 hours after surgery, 92% (23 of 25) for group A versus 81.8% (18 of 22) for group B (both P < 0.05). No serious adverse events occurred.
Conclusion Postoperative ramosetron injection is effective for the prevention of PONV after a laparoscopic colectomy in colorectal-cancer patients.
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Citations
Citations to this article as recorded by- Postoperative ileus after digestive surgery: Network meta‐analysis of pharmacological intervention
Etienne Buscail, Thibault Planchamp, Guillaume Le Cosquer, Manon Bouchet, Julie Thevenin, Nicolas Carrere, Fabrice Muscari, Olivier Abbo, Charlotte Maulat, Ariane Weyl, Jean Pierre Duffas, Antoine Philis, Laurent Ghouti, Cindy Canivet, Jean Paul Motta, Na
British Journal of Clinical Pharmacology.2024; 90(1): 107. CrossRef - Cost-effectiveness of prophylactic ramosetron in the prevention of postoperative nausea and vomiting
David Suh, Dong-Won Kim, Seung-Mi Lee, Yu-Seon Jung, Sun-Young Jung, Chul-Min Kim, Kuo-Cherh Huang
PLOS ONE.2024; 19(10): e0309592. CrossRef - A Clinical Risk Analysis of Postoperative Nausea and Vomiting After Colorectal Cancer Surgery
Masatsugu Hiraki, Toshiya Tanaka, Mika Koga, Daisuke Miura, Eiji Sadashima, Hirofumi Sato, Shinji Mitsumizo, Kenji Kitahara
Journal of Coloproctology.2022; 42(03): 203. CrossRef - Comparing the effects of continuous infusion of esmolol and ramosetron alone and in combination on nausea and vomiting after laparoscopic cholecystectomy: A prospective, randomized, double-blind study
Jae Young Ji, Nan Seol Kim, Yong Han Seo, Ho Soon Jung, Hea Rim Chun, Jin Soo Park, Jeong Soo Choi, Jae Min Ahn, Woo Jong Kim
Medicine.2022; 101(35): e30105. CrossRef - Levosulpiride and Ramosetron for the Prevention of Postoperative Nausea and Vomiting in Laparoscopic Surgery
R. T. Ranjithkumar, Imran Sholapur, Ravi Bhat, C. Chandan Kumar
Anesthesia Essays & Researches.2022; 16(3): 307. CrossRef - Reducing ileus after colorectal surgery: A network meta-analysis of therapeutic interventions
James Ashcroft, Aminder Anthony Singh, Bhavna Ramachandran, Amir Habeeb, Victoria Hudson, Jeremy Meyer, Constantinos Simillis, Richard Justin Davies
Clinical Nutrition.2021; 40(7): 4772. CrossRef - Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review
Ofelia Loani Elvir-Lazo, Paul F. White, Roya Yumul, Hillenn Cruz Eng
F1000Research.2020; 9: 983. CrossRef - Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis
Stephanie Weibel, Gerta Rücker, Leopold HJ Eberhart, Nathan L Pace, Hannah M Hartl, Olivia L Jordan, Debora Mayer, Manuel Riemer, Maximilian S Schaefer, Diana Raj, Insa Backhaus, Antonia Helf, Tobias Schlesinger, Peter Kienbaum, Peter Kranke
Cochrane Database of Systematic Reviews.2020;[Epub] CrossRef - Postoperative nausea and vomiting in patients undergoing colorectal surgery within an institutional enhanced recovery after surgery protocol: comparison of two prophylactic antiemetic regimens
Jennifer Holder-Murray, Stephen A Esper, Michael L Boisen, Julie Gealey, Katie Meister, David S Medich, Kathirvel Subramaniam
Korean Journal of Anesthesiology.2019; 72(4): 344. CrossRef
- Postoperative ileus after digestive surgery: Network meta‐analysis of pharmacological intervention
Editorial
- Effect of Laparoscopic Surgery on the Initiation and Completion of Chemotherapy in Patients With Colon Cancer
- Min-Ki Kim, Won-Kyung Kang
- Ann Coloproctol. 2014;30(6):250-250. Published online December 31, 2014
- DOI: https://doi.org/10.3393/ac.2014.30.6.250
- 3,959 View
- 26 Download
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