Annals of Coloproctology

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Review

Colorectal cancer

Essential knowledge and technical tips for total mesorectal excision and related procedures for rectal cancer: Min Soo Cho, Hyeon Woo Bae, Nam Kyu Kim; Ann Coloproctol. 2024;40(4):384-411. Published online August 30, 2024; DOI: https://doi.org/10.3393/ac.2024.00388.0055

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Total mesorectal excision (TME) has greatly improved rectal cancer surgery outcomes by reducing local recurrence and enhancing patient survival. This review outlines essential knowledge and techniques for performing TME. TME emphasizes the complete resection of the mesorectum along embryologic planes to minimize recurrence. Key anatomical insights include understanding the rectal proper fascia, Denonvilliers fascia, rectosacral fascia, and the pelvic autonomic nerves. Technical tips cover a step-by-step approach to pelvic dissection, the Gate approach, and tailored excision of Denonvilliers fascia, focusing on preserving pelvic autonomic nerves and ensuring negative circumferential resection margins. In Korea, TME has led to significant improvements in local recurrence rates and survival with well-adopted multidisciplinary approaches. Surgical techniques of TME have been optimized and standardized over several decades in Korea, and minimally invasive surgery for TME has been rapidly and successfully adopted. The review emphasizes the need for continuous research on tumor biology and precise surgical techniques to further improve rectal cancer management. The ultimate goal of TME is to achieve curative resection and function preservation, thereby enhancing the patient’s quality of life. Accurate TME, multidisciplinary-based neoadjuvant therapy, refined sphincter-preserving techniques, and ongoing tumor research are essential for optimal treatment outcomes.

Citations

Citations to this article as recorded by

Robotic-assisted colorectal surgery in colorectal cancer management: a narrative review of clinical efficacy and multidisciplinary integration
Engeng Chen, Li Chen, Wei Zhang
Frontiers in Oncology.2025;[Epub] CrossRef
Golden vision: The potential of yellow enhancement in laparoscopic abdominal surgeries and surgical education
Harpreet Singh, Frederick Hong Xiang Koh
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Comparing robot-assisted vs. laparoscopic proctectomy for rectal cancer surgical and oncological outcomes
Wenpeng Wang, Jia Liu, Jiefu Wang, Jinghao Huang, Junfeng Wang
Frontiers in Surgery.2025;[Epub] CrossRef
Early Complication Differences Between Laparoscopic and Open Abdominoperineal Resection
Sarkhail A Sayar, Rehan Ahmed, Syed Shafqatullah, Muhammad Asad, Muhammad Osama Iqbal, Resham Ali, Raja Jawad, Mukkaram Khan, Amna Fareed, Uroosa Shadani
Cureus.2025;[Epub] CrossRef
Robotic Versus Laparoscopic Low Anterior Resection: Comparison of Peri-Operative Outcomes at United Lincolnshire Teaching Hospitals NHS Trust
Nadeem Ahmad Bhat, Rajalakshmi Venkateswaran, Nuha Amri, Trisha Kanani, Athula Tennakoon, Amit Shukla, Sridhar Dharmavaram
Cureus.2025;[Epub] CrossRef
Comparing the Surgical Outcomes of Intersphincteric Resection (ISR) and Transanal Total Mesorectal Excision (TATME) in Rectal Cancer: A Meta-Analysis
Mohsin Farid Sulehri, Mengchuan Wang, Wulikaixi Yagufu, Zhengqi Peng, Yiteng Chen
Cureus.2025;[Epub] CrossRef
From the Editor: Uniting expertise, a new era of global collaboration in coloproctology
In Ja Park
Annals of Coloproctology.2024; 40(4): 285. CrossRef
Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-Center Retrospective Analysis
Jae Seung Kim, Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
Cancers.2024; 16(24): 4280. CrossRef

Original Article

Colorectal cancer

Long-term bowel functional outcomes following anal sphincter-preserving surgery for upper and middle rectal cancer: a single-center longitudinal study: Ahmad Sakr, Seung Yoon Yang, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim; Ann Coloproctol. 2024;40(1):27-35. Published online February 28, 2024; DOI: https://doi.org/10.3393/ac.2022.01067.0152

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Abstract PDF

Purpose
Despite advances in neoadjuvant chemoradiotherapy and anal sphincter-preserving surgery for rectal cancer, bowel dysfunction is still unavoidable and negatively affects patients’ quality of life. In this longitudinal study, we aimed to investigate the changes in bowel function with follow-up time and the effect of neoadjuvant chemoradiotherapy on bowel function following low anterior resection for rectal cancer.
Methods
In this study, 171 patients with upper or middle rectal cancer who underwent low anterior resection between 2012 and 2018 were included. Bowel function was assessed longitudinally with Memorial Sloan Kettering Cancer Center Bowel Function Instrument and Wexner scores every 6 months after restoration of bowel continuity. Patients with at least 2 follow-up visits were included.
Results
Overall, 100 patients received neoadjuvant chemoradiotherapy. Urgency, soilage, and fecal incontinence were noted within 24 months in the patients treated with neoadjuvant chemoradiotherapy. After 2 years of follow-up, significant bowel dysfunction and fecal incontinence were observed in the neoadjuvant chemoradiotherapy group. Low tumor level and neoadjuvant chemoradiotherapy were associated with delayed bowel dysfunction.
Conclusion
Neoadjuvant chemoradiotherapy in combination with low tumor level was significantly associated with delayed bowel dysfunction even after 2 years of follow-up. Therefore, careful selection and discussion with patients are paramount.

Citations

Citations to this article as recorded by

Funktionelle Folgen von Radiotherapie, Chemotherapie und Operation bei der Behandlung des Rektumkarzinoms
Philipp Rhode, Matthias Mehdorn, Undine Gabriele Lange, Sebastian Murad Rabe, Johannes Quart, Robert Nowotny, Patrick Sven Plum, Stefan Niebisch, Sigmar Stelzner
Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie.2025; 150(04): 353. CrossRef
Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-Center Retrospective Analysis
Jae Seung Kim, Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
Cancers.2024; 16(24): 4280. CrossRef
Beyond survival: a comprehensive review of quality of life in rectal cancer patients
Won Beom Jung
Annals of Coloproctology.2024; 40(6): 527. CrossRef

Technical Notes

Benign GI diease,Surgical technique

Double-layered hand-sewn anastomosis: a valuable resource for the colorectal surgeon: Cristopher Varela, Manar Nassr, Azharuddin Razak, Nam Kyu Kim; Ann Coloproctol. 2022;38(3):271-275. Published online March 17, 2022; DOI: https://doi.org/10.3393/ac.2021.00990.0141

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3 Citations

Abstract PDF Supplementary Material

Hand-sewn anastomosis is an essential and fundamental skill for surgeons dealing with any gastrointestinal anastomosis. Despite the advances in minimally invasive surgery and stapling devices, there are still complex surgical circumstances when the surgeon’s surgical know-how are necessary. Therefore, a safe hand-sewn technique for bowel anastomosis is required to establish a tension-free, well-perfused, and sealed anastomosis that allows gastrointestinal continuity with no unexpected complications. We describe a step-by-step procedure for hand-sewn double-layered anastomosis that reflects these principles and is practical for small and large bowel anastomosis.

Citations

Citations to this article as recorded by

Grampeadores mecânicos versus sutura manual em Anastomoses intestinais: uma revisão sistemática
Letícia Meneses Teixeira, Yuri Fleury de Melo Prudente Guimarães, Leonardo de Oliveira Leite Coelho, Leo Ferreira Mattos De Miranda
RCMOS - Revista Científica Multidisciplinar O Saber.2025;[Epub] CrossRef
Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef

Review

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

Surgical Treatment of Low-Lying Rectal Cancer: Updates: Cristopher Varela, Nam Kyu Kim; Ann Coloproctol. 2021;37(6):395-424. Published online December 22, 2021; DOI: https://doi.org/10.3393/ac.2021.00927.0132

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429 Download
53 Web of Science
57 Citations

Abstract PDF

Despite innovative advancements, distally located rectal cancer remains a critical disease of challenging management. The crucial location of the tumor predisposes it to a circumferential resection margin (CRM) that tends to involve the anal sphincter complex and surrounding organs, with a high incidence of delayed anastomotic complications and the risk of the pelvic sidewall or rarely inguinal lymph node metastases. In this regard, colorectal surgeons should be aware of other issues beyond total mesorectal excision (TME) performance. For decades, the concept of extralevator abdominoperineal resection to avoid compromised CRM has been introduced. However, the complexity of deep pelvic dissection with poor visualization in low-lying rectal cancer has led to transanal TME. In contrast, neoadjuvant chemoradiotherapy (NCRT) has allowed for the execution of more sphincter-saving procedures without oncologic compromise. Significant tumor regression after NCRT and complete pathologic response also permit applying the watch-and-wait protocol in some cases, now with more solid evidence. This review article will introduce the current surgical treatment options, their indication and technical details, and recent oncologic and functional outcomes. Lastly, the novel characteristics of distal rectal cancer, such as pelvic sidewall and inguinal lymph node metastases, will be discussed along with its tailored and individualized treatment approach.

Citations

Citations to this article as recorded by

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Current Problems in Surgery.2025; 63: 101694. CrossRef
Comparative efficacy analysis of laparoscopic-assisted transanal total mesorectal excision vs laparoscopic transanal mesorectal excision for low-lying rectal cancer
Feng Lu, Shu-Guang Tan, Juan Zuo, Hai-Hua Jiang, Jian-Hua Wang, Yu-Ping Jiang
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Risk factors influencing sphincter preservation in laparoscopic radical rectal cancer surgery
Jia-Rui Liu, Jin Zhang, Xiang-Long Duan
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Clinical using of innovative biodegradable stent with extension sleeve in Ta_tme for low rectal cancer with high risk of anastomotic leakage
Rongrong Hao, Wensheng Wang, Yuanhang Ma, Jianghong Chen, Yunbo Li, Yang Yang, Dan Ma, Zhicao Zhang
Scientific Reports.2025;[Epub] CrossRef
Robotic-assisted colorectal surgery in colorectal cancer management: a narrative review of clinical efficacy and multidisciplinary integration
Engeng Chen, Li Chen, Wei Zhang
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Radiomic Features of Mesorectal Fat as Indicators of Response in Rectal Cancer Patients Undergoing Neoadjuvant Therapy
Francesca Treballi, Ginevra Danti, Sofia Boccioli, Sebastiano Paolucci, Simone Busoni, Linda Calistri, Vittorio Miele
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Rui Sang, Sheri Nixdorf, Tzongtyng Hung, Carl Power, Fei Deng, Thuy Anh Bui, Alexander Engel, Ewa M. Goldys, Wei Deng
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Jingjing Liu, Wei Sun, Shujie Zhang, Gengyun Miao, Lamei Deng, Mengsu Zeng, Liheng Liu
Academic Radiology.2025; 32(10): 5887. CrossRef
Personalized Treatment Modalities for Rectal Cancer: Advances in Neoadjuvant Treatment
Nussara Pakvisal, Leontios Pappas, Bennett A. Caughey, Rocco Ricciardi, Aparna Parikh
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Sphincter-preserving surgical techniques in low rectal cancer management: A systematic review of contemporary evidence
Song Wang, A-Jian Li, Hui-Hong Jiang, Yin Lin, Hai-Bo Ding
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Incidence, Risk Factors, and Prediction Model of Parastomal Hernia After Abdominoperineal Resection for Rectal Cancer
Jiyun Li, Jichuan Quan, Zixing Zhu, Dedi Jiang, Zhixun Zhao, Mingguang Zhang, Jianjun Bi, Qiang Feng, Zheng Wang, Haitao Zhou, Wei Pei, Qian Liu, Zhaoxu Zheng, Minjie Wang, Jianwei Liang
World Journal of Surgery.2025; 49(10): 2680. CrossRef
A Predictive Model for Anastomotic Complications After Sphincter-Preserving Surgery for Rectal Cancer: Integrating Clinical and Anatomical Risk Factors
Chih-Yu Kuo, Chen-Yin Lee, Ching-Huei Kung, James Chi-Yong Ngu, Li-Jen Kuo
Diseases of the Colon & Rectum.2025; 68(11): 1296. CrossRef
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Saeed Derakhshani, Milad Karimian Ghadim, Sara Ashtari
BMC Surgery.2025;[Epub] CrossRef
Effects of clinical information on the treatment decisions for good responders to neoadjuvant chemoradiotherapy among rectal cancer patients
Eon Bin Kim, In Ja Park, Hwa Jung Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu
Annals of Coloproctology.2025; 41(5): 473. CrossRef
POSTOPERASİON YOĞUN BAĞIRSAQ FİSTULU OLAN PASİYENTLƏRDƏ ŞÜA DİAQNOSTİKASI METODLARININ EFFEKTİVLİYİNİN MÜQAYİSƏLİ TƏHLİLİ
A.N. Mustafayev, Z.Ə. Hacıyev
Azerbaijan Medical Journal.2025; (3): 44. CrossRef
Elderly Rectal Cancer: An Updated Review
Chih-Kai Huang, Chi-Hsiu Shih, Yung-Shuo Kao
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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
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Jasper Max Gebhardt, Neno Werner, Andrea Stroux, Frank Förster, Ioannis Pozios, Claudia Seifarth, Christian Schineis, Benjamin Weixler, Katharina Beyer, Johannes Christian Lauscher
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Cureus.2024;[Epub] CrossRef
Tailoring rectal cancer surgery: Surgical approaches and anatomical insights during deep pelvic dissection for optimal outcomes in low‐lying rectal cancer
Youn Young Park, Nam Kyu Kim
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Personalized Decisional Algorithms for Soft Tissue Defect Reconstruction after Abdominoperineal Resection for Low-Lying Rectal Cancers
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Comparative analysis of organ preservation attempt and radical surgery in clinical T2N0 mid to low rectal cancer
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Essential knowledge and technical tips for total mesorectal excision and related procedures for rectal cancer
Min Soo Cho, Hyeon Woo Bae, Nam Kyu Kim
Annals of Coloproctology.2024; 40(4): 384. CrossRef
The role of robotic-assisted surgery in the management of rectal cancer: a systematic review and meta-analysis
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Hyeon Woo Bae, Nam Kyu Kim
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Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
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Youngbae Jeon, Eun Jung Park
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How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han
The Ewha Medical Journal.2023;[Epub] CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
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
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Epidemiologie, Diagnostik und Therapie des Rektumkarzinoms
Maurice Vuattoux, Soleen Stocker-Ghafoor, Hatice Bunea, Christoph Kettelhack, Andreas Wicki, Frank B. Zimmermann
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Hyo Seon Ryu, Jin Kim
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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
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In Ja Park
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Robotic surgery for colorectal cancer
Sung Uk Bae
Journal of the Korean Medical Association.2022; 65(9): 577. CrossRef
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Sung Uk Bae
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Seung Mi Yeo, Gyung Mo Son
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Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] 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
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In Ja Park
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Case Reports

Malignant disease, Rectal cancer,Colorectal cancer,Complication

Neorectal Mucosal Prolapse After Intersphincteric Resection for Low-Lying Rectal Cancer: A Case Report: Mohammed Alessa, Hyeon Woo Bae, Homoud Alawfi, Ahmad Sakr, Fozan Sauri, Nam Kyu Kim; Ann Coloproctol. 2021;37(Suppl 1):S15-S17. Published online April 22, 2021; DOI: https://doi.org/10.3393/ac.2020.02.22

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92 Download
6 Web of Science
7 Citations

Abstract PDF

Radical resection for low rectal cancer is the mainstay among the treatment modalities. Intersphincteric resection (ISR) is considered a relatively new but effective surgical treatment for low-lying rectal tumor. As the sphincter preserving techniques get popularized, we notice uncommon complication associated with it in the form of rectal mucosal prolapse. We presented 2 rare cases that developed neorectal mucosa prolapse after ISR a complication following low rectal cancer surgery. Although ISR is a safe and effective surgical technique for low rectal cancer, it should be considered to correct modifiable possible risk factors. Also, Delorme procedure is good option for management of neorectal mucosal prolapse.

Citations

Citations to this article as recorded by

Tailoring rectal cancer surgery: Surgical approaches and anatomical insights during deep pelvic dissection for optimal outcomes in low‐lying rectal cancer
Youn Young Park, Nam Kyu Kim
Annals of Gastroenterological Surgery.2024; 8(5): 761. CrossRef
Treatment of side limb full-thickness prolapse of the side-to-end coloanal anastomosis following intersphincteric resection: a case report and review of literature
Guglielmo Niccolò Piozzi, Krunal Khobragade, Seon Hui Shin, Jeong Min Choo, Seon Hahn Kim
Annals of Coloproctology.2024; 40(Suppl 1): S38. CrossRef
Surgical Treatment for Mucosal Prolapse after Intersphincteric Resection
Rina Takahashi, Makoto Takahashi, Yuki Ii, Megumi Kawaguchi, Hirotaka Momose, Shunsuke Motegi, Ryoichi Tsukamoto, Yu Okazawa, Masaya Kawai, Kiichi Sugimoto, Yutaka Kojima, Kazuhiro Sakamoto
Nippon Daicho Komonbyo Gakkai Zasshi.2023; 76(3): 299. CrossRef
Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
Annals of Surgical Treatment and Research.2023; 105(6): 341. CrossRef
Clinical outcome of the Gant-Miwa-Thiersch procedure for colonic mucosal prolapse after intersphincteric resection—a single-center report from Japan
Toshikatsu Nitta, Masatsugu Ishii, Jun Kataoka, Sedakatsu Senpuku, Yasuhiko Ueda, Ryo Iida, Ayumi Matsutani, Takashi Ishibashi
Annals of Medicine and Surgery.2021; 72: 103005. CrossRef
Robotic Intersphincteric Resection for Low Rectal Cancer: Technical Controversies and a Systematic Review on the Perioperative, Oncological, and Functional Outcomes
Guglielmo Niccolò Piozzi, Seon Hahn Kim
Annals of Coloproctology.2021; 37(6): 351. CrossRef
Surgical Treatment of Low-Lying Rectal Cancer: Updates
Cristopher Varela, Nam Kyu Kim
Annals of Coloproctology.2021; 37(6): 395. CrossRef

Malignant disease,Rare disease & stoma

Malignant Melanoma of Anorectum: Two Case Reports: Binh Van Pham, Jae Hyun Kang, Huynh Huu Phan, Min Soo Cho, Nam Kyu Kim; Ann Coloproctol. 2021;37(1):65-70. Published online February 28, 2021; DOI: https://doi.org/10.3393/ac.2020.01.07.1

12,295 View
159 Download
18 Web of Science
14 Citations

Abstract PDF

Malignant melanoma of the anorectum is a rare disorder. Patients often present with local symptoms similar to benign diseases. The prognosis is very poor, and almost all patients die because of metastases. We report 2 female patients with unremarkable histories. Both of them received previous operations before visiting our center after they were diagnosed with anorectal malignant melanoma. One case underwent abdominoperineal resection and postoperative chemotherapy. The other had been treated with ultralow anterior resection followed by immunotherapy.

Citations

Citations to this article as recorded by

Case Report: Surgical management and prognostic factors in primary anorectal melanoma: a retrospective analysis of nine cases
Xiangxiang Ren, Xiaoshi Jin, Tianhao Xie, Litao Liu, Qiang Wang, Xingli Sun, Meng Zhang
Frontiers in Medicine.2025;[Epub] CrossRef
Malignant melanoma of the anal canal: a case report
Shubu Parajuli, Shruti Sah, Narendra Pandit
Journal of Surgical Case Reports.2025;[Epub] CrossRef
A Rare Entity: Primary Malignant Melanoma of the Anorectum
Jeongmin Choi, Jong Whan Kim
Journal of Digestive Cancer Research.2024; 12(1): 44. CrossRef
Anorectal Malignant Melanoma Post- Hemorrhoidectomy
Ramazan Kozan, Ozkan Akpinar, Meral Toker
Acta Médica Portuguesa.2024; 37(7-8): 556. CrossRef
Immunotherapy for anorectal melanoma: A case report
Nicholas L. Vitagliano, Muhammad B. Darwish, Roger W. Hsiung
Current Problems in Cancer: Case Reports.2024; 15: 100302. CrossRef
Amelanotic Malignant Melanoma With Atypical Divergent Neuroendocrine Differentiation: A Report of an Unusual and Rare Case of Anorectal Bleeding
Shamiliprabha MG, Anand CD, Supriya Verma, Nivethitha S, Jaison J John
Cureus.2024;[Epub] CrossRef
Anorectal melanoma: systematic review of the current literature of an aggressive type of melanoma
Giovanni Paolino, Antonio Podo Brunetti, Carolina De Rosa, Carmen Cantisani, Franco Rongioletti, Andrea Carugno, Nicola Zerbinati, Mario Valenti, Domenico Mascagni, Giulio Tosti, Santo Raffaele Mercuri, Riccardo Pampena
Melanoma Research.2024; 34(6): 487. CrossRef
A rare account of incidentally discovered anal melanoma
Nawal Khan, Dondre Irving, Lynn O’Connor
Journal of Surgical Case Reports.2024;[Epub] CrossRef
Prolapsed anorectal malignant melanoma presenting as hemorrhoids
Busara Songtanin, Kenneth Nugent, Sameer Islam
Baylor University Medical Center Proceedings.2023; 36(1): 89. CrossRef
Long recurrence-free survival of localized rectal melanoma after abdominoperineal resection in comparison to partial excision and highlighting the place of immunotherapy: A case report
Othmane Bourouail, Noureddine Njoumi, Youssef Elmahdaouy, Mohamed Fahssi, Mbarek Yaka, Abderrahmane Hejjouji, Abdelmounaim Ait Ali
JRSM Open.2023;[Epub] CrossRef
Challenges in managing anorectal melanoma, a rare malignancy
Jyotirmoy Biswas, Lakshmi Deepak Bethineedi, Arkadeep Dhali, Jamal Miah, Sukanta Ray, Gopal Krishna Dhali
International Journal of Surgery Case Reports.2023; 105: 108093. CrossRef
Organ preservation in anorectal melanoma: A tempting challenge—a case report
Mohamed Mehdi Trabelsi, Neirouz Kammoun, Marwa Inoubli, Mohamed Ali Chaouch, Haifa Ben Romdhane, Wafa Koubaa, Hichem Jerraya
SAGE Open Medical Case Reports.2023;[Epub] CrossRef
Primary anorectal amelanotic melanoma with liver, lungs and lymph nodal metastases
James R Marak, Gaurav Raj, Shivam Dwivedi, Ariba Zaidi
BMJ Case Reports.2023; 16(11): e257510. CrossRef
Treatment of Hemorrhoid in Unusual Condition-Pregnancy
Hyo Seon Ryu
The Ewha Medical Journal.2022;[Epub] CrossRef

Video

Malignant disease, Rectal cancer

Robotic Partial Excision of Levator-Ani Muscle for Locally Advanced Low Rectal Cancer Invading Ipsilateral Pelvic Floor: Seung Yoon Yang, Nam Kyu Kim; Ann Coloproctol. 2020;36(6):415-416. Published online December 31, 2020; DOI: https://doi.org/10.3393/ac.2020.06.29

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Abstract PDF Supplementary Material

Tumors at the level of the anorectal junction had required abdominoperineal resection (APR) to achieve an adequate resection margin. However, in the cases of tumor invading ipsilateral levator-ani muscle (LAM), en-bloc resection of the rectum with LAM including tumor would be possible. This video is to show the critical anatomic steps of this procedure. A video was produced from the robotic right partial excision of LAM (PELM) performed in a 57-year-old female patient with rectal cancer at 3 cm from the anal verge, invading the ipsilateral anorectal ring, who had received neoadjuvant chemoradiotherapy. The patient discharged at postoperative day 8 without complication. The pathology of the surgical specimen revealed ypT3N1bM0. The secure resection margin from the tumor was achieved. Robotic PELM is the sphincter-preserving technique that can be an alternative treatment option for low rectal cancer invading the ipsilateral LAM, which has been an indication for APR or extralevator APR.

Citations

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Tailoring rectal cancer surgery: Surgical approaches and anatomical insights during deep pelvic dissection for optimal outcomes in low‐lying rectal cancer
Youn Young Park, Nam Kyu Kim
Annals of Gastroenterological Surgery.2024; 8(5): 761. CrossRef
Recent advances in functional bismuth chalcogenide nanomaterials: Cancer theranostics, antibacterial and biosensing
Qian Wang, Jun Du, Ruizhuo Ouyang, Baolin Liu, Yuqing Miao, Yuhao Li
Coordination Chemistry Reviews.2023; 492: 215281. CrossRef
Robotic APR with en bloc TAH/BSO and posterior vaginectomy
M. S. Meece, L. P. Horner, S. J. Danker, A. K. Sinno, N. Paluvoi
Techniques in Coloproctology.2023; 27(12): 1381. CrossRef
Current status and role of robotic approach in patients with low-lying rectal cancer
Hyo Seon Ryu, Jin Kim
Annals of Surgical Treatment and Research.2022; 103(1): 1. CrossRef
Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
Outcomes of robotic partial excision of the levator ani muscle for locally advanced low rectal cancer invading the ipsilateral pelvic floor at the anorectal ring level
Seung Yoon Yang, Min Soo Cho, Nam Kyu Kim
The International Journal of Medical Robotics and Computer Assisted Surgery.2021;[Epub] CrossRef

Original Article

Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer,Epidemiology & etiology

Characteristics of Patients Presented With Metastases During or After Completion of Chemoradiation Therapy for Locally Advanced Rectal Cancer: A Case Series: Radwan Torky, Mohammed Alessa, Ho Seung Kim, Ahmed Sakr, Eman Zakarneh, Fozan Sauri, Heejin Bae, Nam Kyu Kim; Ann Coloproctol. 2021;37(3):186-191. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.08.10.1

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Abstract PDF

Purpose
Locally advanced rectal cancer (LARC) is managed by chemoradiotherapy (CRT), followed by surgery. Herein we reported patients with metastases during or after CRT.
Methods
Data of patients with LARC who received CRT from 2008 to 2017 were reviewed. Patients with metastases after CRT were included. Those with metastatic tumors at the initial diagnosis were excluded.
Results
Fourteen patients (1.3%) of 1,092 who received CRT presented with metastases. Magnetic resonance circumferential resection margin (mrCRM) and mesorectal lymph nodes (LNs) were positive in 12 patients (85.7%). Meanwhile, magnetic resonance extramural vascular invasion (mrEMVI) was positive in 10 patients (71.4%). Magnetic resonance tumor regression grade (mrTRG) 4 and mrTRG5 was detected in 5 and 1 patient respectively. Ten patients (71.4%) underwent combined surgery and 3 (21.4%) received palliative chemotherapy.
Conclusion
Patients with metastases after CRT showed a higher rate of positive mrCRM, mrEMVI, mesorectal LNs, and poor tumor response. Further studies with a large number of patients are necessary for better survival outcomes in LARC.

Citations

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Clinical implications of radiologic criteria and prognostic factors for lateral lymph node metastasis in low rectal cancer
Gyung Mo Son
Annals of Coloproctology.2025; 41(6): 489. CrossRef
Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
Annals of Surgical Treatment and Research.2023; 105(6): 341. CrossRef
Advances in the Treatment of Colorectal Cancer with Peritoneal Metastases: A Focus on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Youngbae Jeon, Eun Jung Park
The Ewha Medical Journal.2023;[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

Case Report

Benign GI diease,Benign diesease & IBD,Complication

Clostridium difficile Infection After Ileostomy Reversal: Ho Seung Kim, Jae Hyun Kang, Han-gil Kim, Young Hun Kim, Hyeonwoo Bae, Nam Kyu Kim; Ann Coloproctol. 2021;37(Suppl 1):S4-S6. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.09.24

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129 Download
2 Web of Science
2 Citations

Abstract PDF

Clostridium difficile infection (CDI) after ileostomy reversal is rare, with few reports available in the available literature describing this condition. The diagnosis of CDI after ileostomy reversal is challenging because symptoms such as diarrhea observed in these patients can occur frequently after surgery. However, CDI can be fatal, so early diagnosis and prompt treatment are important. We discuss 2 patients with positive C. difficile toxin assay results on stool cultures performed after ileostomy reversal. Clinical progression differed between these patients: one patient who presented with severe CDI and shock was successfully treated following a prolonged intensive care unit stay for the management of vital signs and underwent hemodialysis, while another patient showed symptoms of mild colitis but we could not confirm whether diarrhea was associated with CDI or with the usual postoperative state. To our knowledge, these represent 2 of just a few cases reported in the literature describing CDI after ileostomy reversal.

Citations

Citations to this article as recorded by

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
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef

Original Articles

Malignant disease

Long-term Oncologic Outcome and Its Relevant Factors in Anal Cancer in Korea: A Nationwide Data Analysis: Hyuk Hur, Kyu-Won Jung, Byung-Woo Kim, Chang-Mo Oh, Young-Joo Won, Jae Hwan Oh, Nam Kyu Kim; Ann Coloproctol. 2020;36(1):35-40. Published online February 29, 2020; DOI: https://doi.org/10.3393/ac.2019.07.17

6,537 View
100 Download
3 Web of Science
3 Citations

Abstract PDF Supplementary Material

Purpose
Anal cancer is a rare disease in Korea, and thus survival analyses are limited by small sample sizes. This study used the Korea Central Cancer Registry (KCCR) for a survival analysis and for assessing characteristics of anal cancer in a large sample of Koreans.
Methods
From the KCCR, data on 3,615 patients who were diagnosed and treated for anal cancer from 1993 to 2015 were retrieved. Clinicopathologic variables including age, sex, histological type, and Surveillance Epidemiology and End Results (SEER) stage were reviewed, and a survival analysis was performed according to these variables.
Results
The 5-year relative survival rate improved from 39.7% in 1993–1995 to 66.5% in 2011–2015. Squamous cell carcinoma was the most common and showed the highest survival rate. Males and older patients (≥40 years and ≥70 years) showed poor prognoses.
Conclusion
The survival rate for anal cancer in Korea has improved steadily over time. The characteristics related to survival were the histological type, sex, and age. These statistics will be fundamental for future Korean anal cancer research.

Citations

Citations to this article as recorded by

Risk of Anorectal Cancer Associated with Benign Anal Inflammatory Diseases: A Retrospective Matched Cohort Study
Wonjeong Chae, Seung Yeon Kang, Sung-In Jang, Yoon Dae Han
International Journal of Environmental Research and Public Health.2022; 19(12): 7467. CrossRef
Immune Checkpoint Blockade in Lower Gastrointestinal Cancers: A Systematic Review
K. C. Wilson, M. P. Flood, D. Oh, N. Calvin, M. Michael, R. G. Ramsay, A. G. Heriot
Annals of Surgical Oncology.2021; 28(12): 7463. CrossRef
Acknowledging the Unsung Role of the Cancer Registry in Rare Cancers
Jung-Myun Kwak
Annals of Coloproctology.2020; 36(1): 1. CrossRef

Impact of Adjuvant Chemotherapy Completion on Oncologic Outcomes in ypTNMstage 2 Rectal Cancer Patients: Youn Young Park, Kang Young Lee, Nam Kyu Kim, Sat Byol Lee, Ga Ram Kim, Byung Soh Min, Seong-Taek Oh; Ann Coloproctol. 2019;35(6):335-341. Published online December 31, 2019; DOI: https://doi.org/10.3393/ac.2019.03.10

4,948 View
64 Download
3 Web of Science
3 Citations

Abstract PDF

Purpose
Adjuvant chemotherapy (aCT) in rectal cancer patients who have undergone curative resection after neoadjuvant chemoradiation (nCRT) is controversial. We aimed to investigate the benefits of using aCT and the clinical impact of completing aCT in ypstage 2 rectal cancer patients.
Methods
We retrospectively reviewed clinicopathological data from patients who had undergone radical resection after nCRT between January 2006 and December 2012. In total, 152 patients with ypT3/4N0M0 rectal cancer were included. Of these patients, 139 initiated aCT, while 13 did not receive aCT (no-aCT). Among those who received aCT, 132 patients completed their planned cycles (aCT-completion) whereas 7 did not (aCT-incompletion). All patients received longcourse chemoradiation; a 5-fluorouracil-based regimen was used for nCRT in most patients. The prognostic factors affecting disease-free survival (DFS) and overall survival (OS) were analyzed.
Results
The median follow-up duration was 41 months. Demographic data did not differ significantly among the 3 groups. In multivariate analysis, open surgery, a tumor size >2 cm, retrieval of <12 lymph nodes, circumferential resection margin (CRM) positivity and aCT incompletion were independent prognostic factors for poor DFS. Old age (≥60 years), open surgery, CRM positivity, aCT incompletion, and lack of aCT initiation compared to aCT completion were independent prognostic factors for poor OS.
Conclusion
In ypstage 2 rectal cancer patients, aCT after nCRT and total mesorectal excision affected both DFS and OS; however, only patients who completed planned aCT exhibited survival benefits. Therefore, improving patients’ compliance with the completion of aCT is desirable.

Citations

Citations to this article as recorded by

The Benefits of Adjuvant Chemotherapy for ypT3-4N0M0 Rectal Cancer Following Neoadjuvant Chemoradiation and Surgery
Chih-Hsien Chang, Hung-Hsin Lin, Shih-Ching Chang, Jeng-Kai Jiang, Huann-Sheng Wang, Yuan-Tzu Lan
Clinical Medicine Insights: Oncology.2025;[Epub] CrossRef
Adjuvant chemotherapy in locally advanced rectal cancer after neo-adjuvant concurrent chemoradiotherapy and surgery: A retrospective study in Vietnamese patients
Thang Tran, Huy Van Nguyen, Hoa Thi Nguyen, Hung Van Nguyen
Annals of Medicine & Surgery.2023; 85(9): 4234. CrossRef
Watch and wait strategies for rectal cancer: A systematic review
In Ja Park
Precision and Future Medicine.2022; 6(2): 91. CrossRef

Short-term Outcomes After Upfront Chemotherapy Followed by Curative Surgery in Metastatic Colon Cancer: A Comparison With Upfront Surgery Patients: Myung Hyun Han, Youn Young Park, Shiva Pratap, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim; Ann Coloproctol. 2019;35(6):327-334. Published online December 31, 2019; DOI: https://doi.org/10.3393/ac.2019.03.04.1

4,897 View
71 Download
2 Web of Science
2 Citations

Abstract PDF

Purpose
Upfront systemic chemotherapy with target agents has been recommended for patients with stage IV colon cancer. Some with partial response are considered for curative resection. There is high risk of developing postoperative complications following upfront systemic chemotherapy. We aimed to evaluate short-term perioperative outcomes of curative surgery after upfront chemotherapy in comparison with upfront surgery in patients with metastatic colon cancer.
Methods
Between January 2010 and October 2015, 146 patients (80 in the surgery first group, 66 in the upfront chemotherapy group) who underwent surgical resection before or after systemic chemotherapy for metastatic colon cancer were included in the present study. All decisions for treatment were made through a multidisciplinary team. Postoperative clinical outcomes and complications were analyzed to compare the groups.
Results
There was no difference between the 2 groups in terms of postoperative clinical outcomes. Overall complication rates were not different between the groups (surgery first group: 46.3% vs. upfront chemotherapy group: 60.6%; P = 0.084). When classified according to the Clavien-Dindo method, there was no difference between the 2 groups in terms of major complications (grade 3 or more) (surgery first group: 18.9% vs. upfront chemotherapy group: 27.5%; P = 0.374).
Conclusion
There was no significant increase in major postoperative complications in metastatic colon cancer patients who received upfront chemotherapy followed by curative surgery. Careful patient selection and treatment planning are important.

Citations

Citations to this article as recorded by

Impact of preoperative chemotherapy on perioperative morbidity in combined resection of colon cancer and liver metastases
Joy Z. Done, Angelos Papanikolaou, Miloslawa Stem, Shannon N. Radomski, Sophia Y. Chen, Chady Atallah, Jonathan E. Efron, Bashar Safar
Journal of Gastrointestinal Surgery.2023; 27(11): 2380. CrossRef
Treatment for Peritoneal Metastasis of Patients With Colorectal Cancer
Young Jin Kim, Chang Hyun Kim
Annals of Coloproctology.2021; 37(6): 425. CrossRef

Single-center Experience of 24 Cases of Tailgut Cyst: Ahmad Sakr, Ho Seung Kim, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim; Ann Coloproctol. 2019;35(5):268-274. Published online October 31, 2019; DOI: https://doi.org/10.3393/ac.2018.12.18

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323 Download
37 Web of Science
50 Citations

Abstract PDF

Purpose
Tailgut cysts are rare congenital or developmental lesions that arise from vestiges of the embryological hindgut. They are usually present in the presacral space. We report our single-center experience with managing tailgut cysts.
Methods
We conducted a retrospective analysis of 24 patients with tailgut cyst treated surgically at the Colorectal Surgery Department of Severance Hospital, Yonsei University, Seoul, South Korea, between 2007–2018.
Results
This study included 24 patients (18 females) with a median age of 51.5 years (range, 21–68 years). Ten cases were symptomatic and 14 were asymptomatic. Cysts were retrorectal in 21 patients. Cysts were below the coccyx level in 16 patients, opposite the coccyx in 6, and above the coccyx in 2. Cysts were supralevator in 5 patients, had a supra- and infralevator extension in 18 patients, and were infralevator in 1. Ten patients were managed using an anterior laparoscopic approach, 11 using a posterior approach, and 3 using a combined approach. Mean cyst size was 5.5 ± 2.7 cm. Postoperative complications were Clavien-Dindo (CD) classification grade II in 9 patients (37.5%) and CD grade III in 1 (4.2%). The posterior approach group showed the highest rate of complications (P = 0.021). Patients managed using a combined approach showed a larger cyst size (P < 0.001), longer operation times (P < 0.001), and a greater likelihood of tumor level above the coccyx (P = 0.002) compared to other approaches. The tumors of 2 male patients were malignant: 1 was a neuroendocrine tumor treated with radiotherapy, while the other was a closely followed adenocarcinoma. Median follow-up was 12 months (range, 1–66 months) with no recurrence.
Conclusion
Tailgut cysts are uncommon but can cause perineal or pelvic pain. Complete surgical excision via an appropriate approach according to tumor size, location, and correlation with adjacent pelvic floor muscles is the key treatment.

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Risk factors for rectal perforation during presacral cyst removal: a comparison between transabdominal, perineal, and combined surgical approaches
P. Tsarkov, S. Barkhatov, D. Shlyk, L. Safyanov, V. Balaban, M. He
Techniques in Coloproctology.2025;[Epub] CrossRef
Tailgut Cyst—Gynecologist’s Pitfall: Literature Review and Case Report
Andrei Mihai Malutan, Viorela-Elena Suciu, Florin Laurentiu Ignat, Doru Diculescu, Razvan Ciortea, Emil-Claudiu Boțan, Carmen Elena Bucuri, Maria Patricia Roman, Ionel Nati, Cristina Ormindean, Dan Mihu
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Laparoscopic Excision of a Tailgut Cyst With Refractory Pain: A Case Report
Masato Kitazawa, Seishu Karasawa, Satoshi Nakamura, Yuta Yamamoto, Yuji Soejima
Cureus.2025;[Epub] CrossRef
Diagnostic challenges of tailgut cysts: a case report on an occult perianal mass
Faraz Khalid, Haris Naveed, Masab Ali, Muhammad Saad Ansari, Muhammad Sajjad Shafiq, Muhammad Husnain Ahmad
Annals of Medicine & Surgery.2025; 87(1): 421. CrossRef
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Hussein Abdallah, Stefan Heinrich, Matthias Birth
coloproctology.2025; 47(3): 220. CrossRef
Partial Resection of a Tailgut Cyst Attached to the Rectum via a Transcoccygeal Approach: A Case Report With a Favorable Outcome
Eitaro Okumura, Motoo Kubota, Ouji Momosaki, Ryo Hashimoto, Kotaro Kohara
Cureus.2025;[Epub] CrossRef
Recurrent presacral tailgut cyst with mucinous adenocarcinoma and metastasis
Iyad Al Jada, Majd Oweidat, Mohammad Khaleel, Omar Harb, Ursula Abu Nahla, Rahaf Bleibel, Mai Arafeh, Ammar W.M. Hassouneh
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Awwab F. Hammad, Stefan D. Holubar, Imran Khan, Olga Lavryk, Michael Valente, David Liska, Scott R. Steele
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Mahmood Al‐Dhaheri, Ali Toffaha, Mooza Alhail, Ammar Aleter, Ejaz Latif, Amjad Parvaiz
Colorectal Disease.2025;[Epub] CrossRef
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Maliha Nusrat, Kenneth H. Yu, Laura Tang, Mohammad Ali El Amine, Brian McCarthy, Karuna Ganesh, Elisa de Stanchina, Emmanouil Pappou, Julio Garcia-Aguilar, Meredith Bartelstein, Christopher Crane, David Kelsen, Leonard Saltz, Carla Hajj
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Trans‐abdominal single‐incision robotic surgery with the da Vinci SP® surgical system for 8 cases of retrorectal tumour
Ho Seung Kim, Bo‐Young Oh, Soon Sup Chung, Ryung‐Ah Lee, Gyoung Tae Noh
The International Journal of Medical Robotics and Computer Assisted Surgery.2024;[Epub] CrossRef
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Kaori Tanaka, Toshiharu Mori, Hideki Yamada, Hideki Mori
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Shriya Haval, Divyansh Dwivedi, Prabhat Nichkaode
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Wei Guo, Ming Deng, Qiongrong Chen
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Ramendra Shukla, Jay Divyesh Patel, Sudhir B. Chandna, Urvish Parikh
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Jan Wojciechowski, Tomasz Skołozdrzy, Piotr Wojtasik, Maciej Romanowski
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K. Fechner, B. Bittorf, M. Langheinrich, K. Weber, M. Brunner, R. Grützmann, K. E. Matzel
Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
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Rosita Sortino, Sebastian Christen, Daniel Steinemann, Ida Füglistaler
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Jun Seong Chung, Han Deok Kwak, Jae Kyun Ju
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Characteristics and Survival of Korean Patients With Colorectal Cancer Based on Data From the Korea Central Cancer Registry Data: Hyuk Hur, Chang-Mo Oh, Young-Joo Won, Jae Hwan Oh, Nam Kyu Kim; Ann Coloproctol. 2018;34(4):212-221. Published online August 31, 2018; DOI: https://doi.org/10.3393/ac.2018.08.02.1

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Abstract PDF

Purpose
The incidence of colorectal cancer (CRC) in Korea has increased remarkably during the past few decades. The present study investigated the characteristics and survival of patients with CRC in Korea as a function of time, tumor distribution, stage, sex, and age.
Methods
We retrieved clinical data on 326,712 CRC patients diagnosed between 1996 and 2015 from the Korea Central Cancer Registry. The incidence and the 5-year relative survival rates were compared across time period, tumor distribution, stage, sex, and age group.
Results
The percentage of patients with colon cancer increased from 49.5% in 1996–2000 to 66.4% in 2011–2015 while the percentage of patients with rectal cancer decreased from 50.5% to 33.6%. The 5-year relative survival rates for all CRCs improved from 58.7% in 1996–2000 to 75.0% in 2011–2015. For 1996–2000, survival rates were highest for patients with left-sided colon cancers, followed by those with right-sided, transverse, rectal, rectosigmoid cancers. For 2011–2015, the survival rates for patients with left-sided cancers were highest, followed by those with rectosigmoid, rectal, transverse, and right-sided colon cancers. Patients with local and regional, but not distant, SEER (Surveillance, Epidemiology, and End Results) stage tumors experienced significantly increased survival rates for 2006–2010 and 2011–2015. The proportion of CRC patients by age decreased in the order ≥70, 60–69, 50–59, 40–49, ≤39 years whereas survival rates decreased in the order 50–59, 60–69, 40–49, ≤39, ≥70 years.
Conclusion
Korean CRC has some distinct characteristics and survival patterns in terms of tumor distribution, stage, sex, and age. With time, survival outcomes have improved for both local and regional, but not distant, stage tumors.

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Review

Essential Anatomy of the Anorectum for Colorectal Surgeons Focused on the Gross Anatomy and Histologic Findings: Jong Min Lee, Nam Kyu Kim; Ann Coloproctol. 2018;34(2):59-71. Published online April 30, 2018; DOI: https://doi.org/10.3393/ac.2017.12.15

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Abstract PDF

The anorectum is a region with a very complex structure, and surgery for benign or malignant disease of the anorectum is impossible without accurate anatomical knowledge. The conjoined longitudinal muscle consists of smooth muscle from the longitudinal muscle of the rectum and the striate muscle from the levator ani and helps maintain continence; the rectourethralis muscle is connected directly to the conjoined longitudinal muscle at the top of the external anal sphincter. Preserving the rectourethralis muscle without damage to the carvernous nerve or veins passing through it when the abdominoperineal resection is implemented is important. The mesorectal fascia is a multi-layered membrane that surrounds the mesorectum. Because the autonomic nerves also pass between the mesorectal fascia and the parietal fascia, a sharp pelvic dissection must be made along the anatomic fascial plane. With the development of pelvic structure anatomy, we can understand better how we can remove the tumor and the surrounding metastatic lymph nodes without damaging the neural structure. However, because the anorectal anatomy is not yet fully understood, we hope that additional studies of anatomy will enable anorectal surgery to be performed based on complete anatomical knowledge.

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Original Articles

Single Center Experience With Hyperthermic Intraperitoneal Chemotherapy: Woo Ram Kim, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Kang Young Lee, Nam Kyu Kim; Ann Coloproctol. 2017;33(1):16-22. Published online February 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.1.16

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Abstract PDF

Purpose

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been proposed for controlling peritoneal seeding metastasis in some kinds of cancers, including those of colorectal origin, but their safety and oncological benefits are subjects of debate. We present our early experience with those procedures.

Methods

Data were retrospectively collected from all patients with peritoneal carcinomatosis (PC) and pseudomyxoma peritonei (PMP) treated using CRS and HIPEC at Yonsei Cancer Center between July 2014 and July 2015. Short-term outcomes and risk factors for postoperative complications were analyzed.

Results

Twenty-three patients with PC (n = 18) and PMP (n = 5) underwent CRS and HIPEC. Median follow-up and age were 2 months and 54 years, respectively. The median peritoneal carcinomatosis index score was 15, and CC0-1 was achieved in 78.3% of all patients. The median operation time and bleeding loss were 590 minutes and 570 mL, respectively. Grade-IIIa/grade-IIIb complications occurred in 4.3% (n = 1)/26.1% (n = 6) of the patients within 30 days postoperatively, and no 30-day mortalities were reported. Factors related to postoperative complications with CRS and HIPEC were number of organ resection (P = 0.013), longer operation time (P < 0.001), and amount of blood loss (P = 0.003). All patients treated with cetuximab for recurred colorectal cancer had grade-III postoperative complication.

Conclusion

Our initial experience with CRS and HIPEC presented about 30% grade-III postoperative complications. Therefore, expert surgeons need to perform those procedures with great caution in selected patients who might benefit from it.

Citations

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Multisocietal Consensus on the Use of Cytoreductive Surgery and HIPEC for the Treatment of Diffuse Malignant Peritoneal Mesothelioma: A GRADE Approach for Evidence Evaluation and Recommendation
Shigeki Kusamura, Michela Cinquini, David Morris, Pompiliu Piso, Hedy Kindler, Andreas Brandl, Edward Levine, Olivier Glehen, Vahan Kepenekian, Olivia Sgarbura, Paul H. Sugarbaker, Dario Baratti, Guaglio Marcello, Deraco Marcello
Journal of Surgical Oncology.2025; 131(5): 810. CrossRef
Pharmacologic Effects of Oxaliplatin Instability in Chloride-Containing Carrier Fluids on the Hyperthermic Intraperitoneal Chemotherapy to Treat Colorectal Cancer In Vitro and In Vivo
Eun Jung Park, Junhyun Ahn, Sharif Md Abuzar, Kyung Su Park, Sung-Joo Hwang, Seung Hyuk Baik
Annals of Surgical Oncology.2022; 29(13): 8583. CrossRef
Treatment for Peritoneal Metastasis of Patients With Colorectal Cancer
Young Jin Kim, Chang Hyun Kim
Annals of Coloproctology.2021; 37(6): 425. CrossRef
Is Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy a Safe and Effective Procedure for Treating Patients With a Peritoneal Surface Malignancy?
Dong-Guk Park
Annals of Coloproctology.2017; 33(1): 3. CrossRef

Prognostic Impact of Immunonutritional Status Changes During Preoperative Chemoradiation in Patients With Rectal Cancer: Yong Joon Lee, Woo Ram Kim, Jeonghee Han, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Nam Kyu Kim, Byung Soh Min; Ann Coloproctol. 2016;32(6):208-214. Published online December 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.6.208

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15 Citations

Abstract PDF

Purpose

Previous studies have demonstrated the prognostic impact of the prognostic nutritional index (PNI), a proposed indicator of immunonutritional statuses of surgical patients, on patients with various gastrointestinal cancers. Although the prognostic impact of the PNI on patients with colorectal cancer has been well established, its value has not been studied in patients treated with preoperative chemoradiation (pCRT). This study aimed to evaluate the prognostic impact of PNI on patients receiving pCRT for locally advanced rectal cancer (LARC).

Methods

Patients with LARC who underwent curative pCRT followed by surgical resection were enrolled. The PNI was measured in all patients before and after pCRT, and the difference in values was calculated as the PNI difference (dPNI). Patients were classified according to dPNI (<5, 5–10, and >10). Clinicopathologic parameters and long-term oncologic outcomes were assessed according to dPNI classification.

Results

No significant intergroup differences were observed in clinicopathologic parameters such as age, histologic grade, tumor location, tumor-node-metastasis stage, and postoperative complications. Approximately 53% of the patients had a mild dPNI (<5); only 15% had a high dPNI (>10). Univariate and multivariate analyses identified the dPNI as an independent prognostic factor for disease-free status (P < 0.01; hazard ratio [HR], 2.792; 95% confidence interval [CI], 1.577–4.942) and for cancer-specific survival (P = 0.012; HR, 2.469; 95%CI, 1.225–4.978).

Conclusion

The dPNI is predictive of long-term outcomes in pCRT-treated patients with LARC. Further prospective studies should investigate whether immune-nutritional status correction during pCRT would improve oncologic outcomes.

Citations

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Novel Index Based on Inflammatory Markers Correlates with Treatment Efficacy of Nivolumab for Recurrent/Metastatic Head and Neck Cancer
Hiroe Tada, Reika Kawabata-Iwakawa, Hideyuki Takahashi, Kazuaki Chikamatsu
Oncology.2024; 103(8): 714. CrossRef
Preoperative albumin-to-globulin ratio and prognostic nutritional index predict the prognosis of colorectal cancer: a retrospective study
JunHu Li, Na Zhu, Cheng Wang, LiuPing You, WenLong Guo, ZhiHan Yuan, Shuai Qi, HanZheng Zhao, JiaYong Yu, YueNan Huang
Scientific Reports.2023;[Epub] CrossRef
The modified Glasgow prognostic score is a reliable predictor of oncological outcomes in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy
Atsushi Shimada, Takeru Matsuda, Ryuichiro Sawada, Hiroshi Hasegawa, Kimihiro Yamashita, Hitoshi Harada, Naoki Urakawa, Hironobu Goto, Shingo Kanaji, Taro Oshikiri, Yoshihiro Kakeji
Scientific Reports.2023;[Epub] CrossRef
Prognostic Value of Postoperative Neutrophil and Albumin: Reassessment One Month After Gastric Cancer Surgery
Ali Guner, Minah Cho, Yoo-Min Kim, Jae-Ho Cheong, Woo Jin Hyung, Hyoung-Il Kim
Frontiers in Oncology.2021;[Epub] CrossRef
Pelvimetric and Nutritional Factors Predicting Surgical Difficulty in Laparoscopic Resection for Rectal Cancer Following Preoperative Chemoradiotherapy
Yanwu Sun, Jianhua Chen, Chengwei Ye, Huiming Lin, Xingrong Lu, Ying Huang, Pan Chi
World Journal of Surgery.2021; 45(7): 2261. CrossRef
Inflammation‐nutritional markers of peripheral blood could predict survival in advanced non‐small‐cell lung cancer patients treated with PD‐1 inhibitors
Dan Pu, Qian Xu, Lai‐Yan Zhou, Yu‐Wen Zhou, Ji‐Yan Liu, Xue‐Lei Ma
Thoracic Cancer.2021; 12(21): 2914. CrossRef
Preoperative change of modified Glasgow prognostic score after stenting predicts the long-term outcomes of obstructive colorectal cancer
Ryuichiro Sato, Masaya Oikawa, Tetsuya Kakita, Takaho Okada, Tomoya Abe, Takashi Yazawa, Haruyuki Tsuchiya, Naoya Akazawa, Masaki Sato, Tetsuya Ohira, Yoshihiro Harada, Haruka Okano, Kei Ito, Noriaki Ohuchi, Takashi Tsuchiya
Surgery Today.2020; 50(3): 232. CrossRef
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Yanwu Sun, Zhekun Huang, Huiming Lin, Pan Chi
Future Oncology.2020; 16(8): 339. CrossRef
Low Prognostic Nutritional Index Predicts Poor Clinical Outcomes in Patients with Stage IIIB Non-small-cell Lung Carcinoma Undergoing Chemoradiotherapy

Yurday Ozdemir, Erkan Topkan, Huseyin Mertsoylu, Ugur Selek
Cancer Management and Research.2020; Volume 12: 1959. CrossRef
Peripheral blood markers predictive of outcome and immune-related adverse events in advanced non-small cell lung cancer treated with PD-1 inhibitors
Lihong Peng, Yong Wang, Fen Liu, Xiaotong Qiu, Xinwei Zhang, Chen Fang, Xiaoyin Qian, Yong Li
Cancer Immunology, Immunotherapy.2020; 69(9): 1813. CrossRef
The prognostic value of the prognostic nutritional index and inflammation-based markers in obstructive colorectal cancer
Ryuichiro Sato, Masaya Oikawa, Tetsuya Kakita, Takaho Okada, Tomoya Abe, Takashi Yazawa, Haruyuki Tsuchiya, Naoya Akazawa, Masaki Sato, Tetsuya Ohira, Yoshihiro Harada, Haruka Okano, Kei Ito, Takashi Tsuchiya
Surgery Today.2020; 50(10): 1272. CrossRef
Preoperative Fibrinogen-Albumin Ratio Index (FARI) is a Reliable Prognosis and Chemoradiotherapy Sensitivity Predictor in Locally Advanced Rectal Cancer Patients Undergoing Radical Surgery Following Neoadjuvant Chemoradiotherapy

Siyi Lu, Zhenzhen Liu, Xin Zhou, Bingyan Wang, Fei Li, Yanpeng Ma, Wendong Wang, Junren Ma, Yuxia Wang, Hao Wang, Wei Fu
Cancer Management and Research.2020; Volume 12: 8555. CrossRef
Immunonutritional status and pulmonary cavitation in patients with tuberculosis: A revisit with an assessment of neutrophil/lymphocyte ratio
Makoto Nakao, Hideki Muramatsu, Sosuke Arakawa, Yusuke Sakai, Yuto Suzuki, Kohei Fujita, Hidefumi Sato
Respiratory Investigation.2019; 57(1): 60. CrossRef
Temporal changes in immune cell composition and cytokines in response to chemoradiation in rectal cancer
Yong Joon Lee, Sat Byol Lee, Suk Kyung Beak, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Nam Kyu Kim, Byung Soh Min
Scientific Reports.2018;[Epub] CrossRef
Impairment of Immunonutritional Status During Treatment is a Factor Associated With Oncologic Outcomes in Patients With Rectal Cancer Treated With Preoperative Chemoradiotherapy
In Ja Park
Annals of Coloproctology.2016; 32(6): 201. CrossRef

Case Report

Efficacy of Immunohistochemical Staining in Differentiating a Squamous Cell Carcinoma in Poorly Differentiated Rectal Cancer: Two Case Reports: Sairafi Rami, Yoon Dae Han, Mi Jang, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim; Ann Coloproctol. 2016;32(4):150-155. Published online August 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.4.150

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Abstract PDF

A rectal carcinoma, including primary an adenosquamous and a squamous cell carcinoma (SCC), is a very rare disease, accounting for 0.025% to 0.20% of all large-bowel malignant tumors. Because SCCs have a higher mortality than adenosquamous carcinomas, determining whether the primary rectal cancer exhibits an adenomatous component or a squamous component is important. While differentiating between these 2 components, especially in poorly differentiated rectal cancer, is difficult, specific immunohistochemical stains enable accurate diagnoses. Here, we report the use of immunohistochemical stains to distinguish between the adenomatous and the squamous components in 2 patients with low rectal cancer, a 58-year-old man and a 73-year-old woman, who were initially diagnosed using the histopathologic results for a poorly differentiated carcinoma. These data suggest that using these immunohistochemical stains will help to accurately diagnose the type of rectal cancer, especially for poorly differentiated carcinomas, and will provide important information to determine the proper treatment for the patient.

Citations

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Cerebral metastasis from anal squamous cell carcinoma: A case report and literature review
Elena Popa, Vanesa Tomatis, Esther Quick, Paul Mitchell, Chrisovalantis Tsimiklis, Annika Mascarenhas
Oncology Letters.2025; 30(1): 1. CrossRef

Editorial

Is A Mode of Presentation of Colorectal Cancer Different According to Each Individual's Social-economic Status?: Chinock Cheong, Nam Kyu Kim; Ann Coloproctol. 2016;32(4):123-123. Published online August 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.4.123

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PDF

Original Article

Short-term Outcomes of an Extralevator Abdominoperineal Resection in the Prone Position Compared With a Conventional Abdominoperineal Resection for Advanced Low Rectal Cancer: The Early Experience at a Single Institution: Seungwan Park, Hyuk Hur, Byung Soh Min, Nam Kyu Kim; Ann Coloproctol. 2016;32(1):12-19. Published online February 29, 2016; DOI: https://doi.org/10.3393/ac.2016.32.1.12

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10 Citations

Abstract PDF

Purpose

This study compared the perioperative and pathologic outcomes between an extralevator abdominoperineal resection (APR) in the prone position and a conventional APR.

Methods

Between September 2011 and March 2014, an extralevator APR in the prone position was performed on 13 patients with rectal cancer and a conventional APR on 26 such patients. Patients' demographics and perioperative and pathologic outcomes were obtained from the colorectal cancer database and electronic medical charts.

Results

Age and preoperative carcinoembryonic antigen (CEA) level were significantly different between the conventional and the extralevator APR in the prone position (median age, 65 years vs. 55 years [P = 0.001]; median preoperative CEA level, 4.94 ng/mL vs. 1.81 ng/mL [P = 0.011]). For perioperative outcomes, 1 (3.8%) intraoperative bowel perforation occurred in the conventional APR group and 2 (15.3%) in the extralevator APR group. In the conventional and extralevator APR groups, 12 (46.2%) and 6 patients (46.2%) had postoperative complications, and 8 (66.7%) and 2 patients (33.4%) had major complications (Clavien-Dindo III/IV), respectively. The circumferential resection margin involvement rate was higher in the extralevator APR group compared with the conventional APR group (3 of 13 [23.1%] vs. 3 of 26 [11.5%]).

Conclusion

The extralevator APR in the prone position for patients with advanced low rectal cancer has no advantages in perioperative and pathologic outcomes over a conventional APR for such patients. However, through early experience with a new surgical technique, we identified various reasons for the lack of favorable outcomes and expect sufficient experience to produce better peri- or postoperative outcomes.

Citations

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Abdominoperineal Resection in Prone Versus Supine Position: A Systematic Review and Meta-Analysis
Bernardo Fontel Pompeu, Eric Pasqualotto, Beatriz D'Andrea Pigossi, Matheus Reginato Araujo, Lucas Monteiro Delgado, Lucas Soares de Souza Pinto Guedes, Sergio Mazzola Poli de Figueiredo, Fernanda Bellotti Formiga
Journal of Laparoendoscopic & Advanced Surgical Techniques.2025; 35(3): 224. CrossRef
Management of left-sided malignant colorectal obstructions with curative intent: a network meta-analysis
Tyler McKechnie, Jeremy E. Springer, Zacharie Cloutier, Victoria Archer, Karim Alavi, Aristithes Doumouras, Dennis Hong, Cagla Eskicioglu
Surgical Endoscopy.2023; 37(6): 4159. CrossRef
Prone Versus Supine Position in Abdominoperineal Resection: Outcomes in the Laparoscopic Era
Cecilia Ferrari, Carmen Martinez Sanchez, Jesus Bollo, Pilar Hernandez, Lorena Cambeiro, Claudia Codina, Eduardo Targarona
Journal of Laparoendoscopic & Advanced Surgical Techniques.2021; 31(4): 382. CrossRef
Surgical Treatment of Low-Lying Rectal Cancer: Updates
Cristopher Varela, Nam Kyu Kim
Annals of Coloproctology.2021; 37(6): 395. CrossRef
Perioperative and oncological outcomes of abdominoperineal resection in the prone position vs the classic lithotomy position: A systematic review with meta‐analysis
Jose Wilson B. Mesquita‐Neto, Hassan Mouzaihem, Francisco Igor B. Macedo, Lance K. Heilbrun, Donald W. Weaver, Steve Kim
Journal of Surgical Oncology.2019; 119(7): 979. CrossRef
Prone Compared With Lithotomy for Abdominoperineal Resection: A Systematic Review and Meta-analysis
Tyler McKechnie, Yung Lee, Jeremy E. Springer, Aristithes G. Doumouras, Dennis Hong, Cagla Eskicioglu
Journal of Surgical Research.2019; 243: 469. CrossRef
Perineal Wound Complications After Extralevator Abdominoperineal Excision for Low Rectal Cancer
Jia Gang Han, Zhen Jun Wang, Zhi Gang Gao, Guang Hui Wei, Yong Yang, Zhi Wei Zhai, Bao Cheng Zhao, Bing Qiang Yi
Diseases of the Colon & Rectum.2019; 62(12): 1477. CrossRef
Critical and Challenging Issues in the Surgical Management of Low-Lying Rectal Cancer
Aeris Jane D. Nacion, Youn Young Park, Seung Yoon Yang, Nam Kyu Kim
Yonsei Medical Journal.2018; 59(6): 703. CrossRef
EXTRALEVATOR ABDOMINOPERINEAL EXCISION OF THE RECTUM: SHORT-TERM OUTCOMES IN COMPARISON WITH CONVENTIONAL SURGERY
R. A. Murashko, I. B. Uvarov, E. A. Ermakov, V. B. Kaushanskiy, R. V. Konkov, D. D. Sichinava, B. N. Sadikov
Koloproktologia.2017; (4): 34. CrossRef
Extralevator Abdominoperineal Resection in the Prone Position
Young Jin Kim
Annals of Coloproctology.2016; 32(1): 1. CrossRef

Case Report

Colon Stricture After Ischemia Following a Robot-Assisted Ultra-Low Anterior Resection With Coloanal Anastomosis: Dae Ro Lim, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Nam Kyu Kim; Ann Coloproctol. 2015;31(4):157-162. Published online August 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.4.157

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Abstract PDF

Four consecutive cases of a colonic stricture following a da Vinci robot-assisted ultra-low anterior resection (LAR) with coloanal anastomosis and diverting ileostomy for the treatment of rectal cancer are reported. The colonic strictures developed after early proximal colonic ischemia without anastomotic site leakage or disruption. All patients were treated with preoperative chemoradiation therapy. During the postoperative recovery period, patients developed colonic ischemia, presenting with a high, spiking fever, but without any symptoms of peritonitis. Patients were treated with conservative management (antibiotic therapy) and discharged after two weeks when in good condition. Several months after discharge, all four patients developed a long-segment colonic stricture from the anastomosis site to the distal colon. Management of the colon strictures, including the anastomotic site, involved colonic dilation with a Hegar dilator in an outpatient clinic for several months. The ileostomies in three patients could not be closed.

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Sofiya A. Myalina, Ksenia I. Paziuk, Tatiana P. Berezovskaya, Alexey A. Nevolskikh, Aleksandr L. Potapov, Sergey A. Ivanov
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Guglielmo Niccolò Piozzi, Seon Hahn Kim
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Peng Wang, Jian-Wei Liang, Hai-Tao Zhou, Zheng Wang, Zhi-Xiang Zhou
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A. Bressan, L. Marini, M. Michelotto, A. C. Frigo, G. Da Dalt, S. Merigliano, L. Polese
Colorectal Disease.2018; 20(10): 923. CrossRef
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Original Article

Reduced-Port Laparoscopic Surgery for a Tumor-Specific Mesorectal Excision in Patients With Colorectal Cancer: Initial Experience With 20 Consecutive Cases: Sung Uk Bae, Se Jin Baek, Byung Soh Min, Seung Hyuk Baik, Nam Kyu Kim, Hyuk Hur; Ann Coloproctol. 2015;31(1):16-22. Published online February 28, 2015; DOI: https://doi.org/10.3393/ac.2015.31.1.16

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Abstract PDF

Purpose

Single-port plus one-port, reduced-port laparoscopic surgery (RPLS) may decrease collisions between laparoscopic instruments and the camera in a narrow, bony, pelvic cavity while maintaining the cosmetic advantages of single-incision laparoscopic surgery. The aim of this study is to describe our initial experience with and to assess the feasibility and safety of RPLS for tumor-specific mesorectal excisions (TSMEs) in patients with colorectal cancer.

Methods

Between May 2010 and August 2012, RPLS for TSME was performed in 20 patients with colorectal cancer. A single port with four channels through an umbilical incision and an additional port in the right lower quadrant were used for RPLS.

Results

The median operation time was 231 minutes (range, 160-347 minutes), and the estimated blood loss was 100 mL (range, 50-500 mL). We transected the rectum with one laparoscopic stapler in 17 cases (85%). The median time to soft diet was 4 days (range, 3-6 days), and the length of hospital stay was 7 days (range, 5-45 days). The median total number of lymph nodes harvested was 16 (range, 7-36), and circumferential resection margin involvement was found in 1 case (5%). Seven patients (35%) developed postoperative complications, and no mortalities occurred within 30 days. During the median follow-up period of 20 months (range, 12-40 months), liver metastasis occurred in 1 patient 10 months after surgery, and local recurrence was nonexistent.

Conclusion

RPLS for TSME in patients with colorectal cancer is technically feasible and safe without compromising oncologic safety. However, further studies comparing RPLS with a conventional, laparoscopic low-anterior resection are needed to prove the advantages of the RPLS procedure.

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Diseases of the Colon & Rectum.2016; 59(3): 245. CrossRef
Pfannenstiel laparoendoscopic reduced‐port radical nephrectomy
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Case Report

Perianal Paget's Disease: Chang Woo Kim, Yon Hee Kim, Min Soo Cho, Byung Soh Min, Seung Hyuk Baik, Nam Kyu Kim; Ann Coloproctol. 2014;30(5):241-244. Published online October 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.5.241

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Abstract PDF

The incidence of extramammary Paget's disease (EMPD) is very low. An 84-year-old Korean man was treated with topical and oral medications at a local dermatologic clinic for a year, but the symptoms did not improve. He visited Severance Hospital and underwent a perianal skin biopsy and was finally diagnosed with EMPD. The authors performed a wide local excision according to a 1-cm margin around the lesion. For the skin and the soft tissue defects, bilateral inferior gluteal artery perforator flap transpositions were performed. The size of the lesion was 14 cm² × 9 cm², and the lateral and the basal margins were all disease free.

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Beyond the Ordinary: A Surgical Approach to Perianal Paget Disease
Rita Ribeiro Dias, André Gonçalves, Joana Costa, Pedro Organista Machado, Eliane Jaconiano, Daniela Marinheiro Silva, Miguel Machado, Carolina Leal, Silvestre Carneiro
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Rectal Adenocarcinoma With Pagetoid Spread: A Novel Entity
Lefika Bathobakae, Pasha Shenasan, Aakash Trivedi, Ruhin Yuridullah, Sohail Qayyum, Abraham El-Sedfy, Hirotada Akiho
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Perianal paget’s disease: A case report
Hernández Pilar Navajas, Delgado Teresa Valdés, Aguado Jesús Machuca, González-Cámpora Ricardo, Arias Federico Argüelles
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Perianal Paget's disease
Pilar Navajas Hernández, Teresa Valdés Delgado , Jesús Machuca Aguado, Ricardo González-Cámpora, Federico Argüelles Arias
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Mireia Merichal Resina, Carlos Cerdan Santacruz, Enrique Sierra Grañón, Jordi Antoni Tarragona Foradada, Jorge Juan Olsina Kissler
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Perianal Paget Disease
Mireia Merichal Resina, Carlos Cerdan Santacruz, Enrique Sierra Grañón, Jordi Antoni Tarragona Foradada, Jorge Juan Olsina Kissler
Cirugía Española (English Edition).2019; 97(3): 179. CrossRef
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Editorial

Paradigm Shift in the Treatment of Elderly Patients With Unresectable Stage IV Colorectal Cancer: Nam Kyu Kim; Ann Coloproctol. 2014;30(4):155-156. Published online August 26, 2014; DOI: https://doi.org/10.3393/ac.2014.30.4.155

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Nomogram to Predict the Occurrence and Prognosis of Distant Metastasis in T1N0 Colon Cancer: A SEER Data-Based Study
Yunxiao Liu, Hao Zhang, Mingyu Zheng, Chunlin Wang, Zhiqiao Hu, Yang Wang, Huan Xiong, BoYang Fan, Yuliuming Wang, Hanqing Hu, Qingchao Tang, Guiyu Wang
International Journal of General Medicine.2021; Volume 14: 9131. CrossRef

Original Article

Feasibility and Safety of a Fold-Over Diverting Ileostomy Reversal After Rectal Cancer Surgery: Case-Matched Comparison to the Resection Technique: Jinock Cheong, Jeonghyun Kang, Im-Kyung Kim, Nam Kyu Kim, Seung-Kook Sohn, Kang Young Lee; Ann Coloproctol. 2014;30(3):118-121. Published online June 23, 2014; DOI: https://doi.org/10.3393/ac.2014.30.3.118

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Purpose

Compared to the stapling technique, the fold-over technique (FO) has the benefit of avoiding the sacrifice of the bowel segment. The aim of this study was to compare short-term outcomes between the FO and a conventional resection.

Methods

Between June 2008 and March 2012, a total of 242 patients who underwent a diverting ileostomy reversal after rectal cancer surgery were selected. Among them, 29 patients underwent the FO. Using propensity scores to adjust for body mass index, previous abdominal surgery history, rectal cancer surgery type (open vs. minimally invasive), and reason for ileostomy (protective aim vs. leakage management), we created a well-balanced cohort by matching each patient who underwent the FO, as the study group, with two patients who underwent a stapled or a hand-sewn technique with bowel resection (RE), as the control group (FO : RE = 1 : 2). Morbidity and perioperative recovery were compared between the two groups.

Results

Twenty-four and forty-eight patients were allocated to the FO and the RE groups, respectively. The mean operation time was 91 ± 26 minutes in the FO group and 97 ± 34 minutes in the RE group (P = 0.494). The overall morbidity rates were not different between the two groups (12.5% in FO vs. 14.6% in RE, P = 1.000). The rate of postoperative ileus was similar between the two groups (8.3% in FO vs. 12.5% in RE, P = 0.710). Although time to resumption of soft diet was shorter in the FO group than in the RE group, the lengths of hospital stay were not different.

Conclusion

The FO and the conventional resection have similar short-term clinical outcomes for diverting ileostomy reversal.

Citations

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Comparison of hand-sewn anterior repair, resection and hand-sewn anastomosis, resection and stapled anastomosis techniques for the reversal of diverting loop ileostomy after low anterior rectal resection: a randomized clinical trial
Seyed Mostafa Meshkati Yazd, Reza Shahriarirad, Mohammad Reza Keramati, Mehdi Fallahi, Soheila-sadat Nourmohammadi, Alireza Kazemeini, Mohammad Sadegh Fazeli, Amir Keshvari
Techniques in Coloproctology.2024;[Epub] CrossRef
Does the timing of protective ileostomy closure post-low anterior resection have an impact on the outcome? A retrospective study
Fozan Sauri, Ahmad Sakr, Ho Seung Kim, Mohammed Alessa, Radwan Torky, Eman Zakarneh, Seung Yoon Yang, Nam Kyu Kim
Asian Journal of Surgery.2021; 44(1): 374. CrossRef
Modified Colon Leakage Score to Predict Anastomotic Leakage in Patients Who Underwent Left-Sided Colorectal Surgery
Seung Up Yang, Eun Jung Park, Seung Hyuk Baik, Kang Young Lee, Jeonghyun Kang
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Factors affecting the morbidity and mortality of diverting stoma closure: retrospective cohort analysis of twelve-year period
Bojan Krebs, Arpad Ivanecz, Stojan Potrc, Matjaz Horvat
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Impact of prior abdominal surgery on postoperative prolonged ileus after ileostomy repair
Im-kyung Kim, Jeonghyun Kang, Seung Hyuk Baik, Kang Young Lee, Nam Kyu Kim, Seung-Kook Sohn
Asian Journal of Surgery.2018; 41(1): 86. CrossRef
Endless Arguments Over Diversion Stomas
Seung Chul Heo
Annals of Coloproctology.2014; 30(3): 103. CrossRef

Editorials

Is a Microsatellite Instability Still Useful for Tailored Treatment in Stage II and III Colon Cancer?: Nam Kyu Kim; Ann Coloproctol. 2014;30(1):5-6. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.5

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Assessment of the Circulating Tumor Cells and Microsatellite Instability in Colorectal Cancer Patients: Prognostic and Diagnostic Value
Aya Alsayed, Salem E Salem, Mostafa M El Serafi, Mona S Abdellateif, Abdel-Rahman N Zekri, Marwa Mohanad, Abeer A Bahnassy
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Anal Cancer Study Based on Korea Central Cancer Registry Data: One Step Forward in Clinical Research: Nam Kyu Kim; Ann Coloproctol. 2013;29(5):177-177. Published online October 31, 2013; DOI: https://doi.org/10.3393/ac.2013.29.5.177

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Commentary on "Characteristics and Survival of Korean Anal Cancer From the Korea Central Cancer Registry Data"
Mohammad Mohammadianpanah
Annals of Coloproctology.2014; 30(1): 54. CrossRef

Case Report

Intramural Recurrence Without Mucosal Lesions After an Endoscopic Mucosal Resection for Early Colorectal Cancer: Min Sung Kim, Nam Kyu Kim, Ji Hye Park; Ann Coloproctol. 2013;29(3):126-129. Published online June 30, 2013; DOI: https://doi.org/10.3393/ac.2013.29.3.126

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Abstract PDF

Advances in endoscopic instruments and techniques have enabled increased detection and removal of early colorectal cancer (ECC), which is defined as a tumor whose invasion is limited to the mucosa or submucosa. Some cases can be treated by endoscopic mucosal resection (EMR). However, local recurrence frequently occurs after an EMR for ECC. The recurrence pattern is usually intramural recurrence with a mucosal lesion at the EMR's site. We report the cases of two patients with intramural recurrence without mucosal lesions after an EMR for ECC. These cases indicate that a local recurrence after an EMR for ECC can appear as an intramural recurrence without mucosal lesions at a previous EMR site or another site, although this presentation is very unusual.

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Anti-Cancer Drugs.2014; 25(8): 857. CrossRef

Original Article

Safety and Feasibility of a Laparoscopic Colorectal Cancer Resection in Elderly Patients: Duck Hyoun Jeong, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Nam Kyu Kim; Ann Coloproctol. 2013;29(1):22-27. Published online February 28, 2013; DOI: https://doi.org/10.3393/ac.2013.29.1.22

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Abstract PDF

Purpose

The aim of this study is to assess the effects of age on the short-term outcomes of a laparoscopic resection of colorectal cancer in elderly (≥75 years old), as compared with younger (<75 years old), patients.

Methods

A retrospective analysis of patients who underwent laparoscopic surgery for colorectal cancer between January 2007 and December 2009 was performed. There were two groups: age <75 years old (group A) and age ≥75 years old (group B). The perioperative outcomes between group A and group B were compared.

Results

The study included 824 patients in group A and 92 patients in group B. The body mass index (BMI) and the American Society of Anesthesiologists (ASA) score were significantly different between group B and group A (BMI: 22.5 vs. 23.5, P = 0.002; ASA score: 1.88 vs. 1.48, P = 0.001). Mean operating times were similar between the groups (325.4 minutes vs. 351.6 minutes, P = 0.07). We observed a higher overall complication rate in group B than in group A (12.0% vs. 6.2%, P = 0.047), but the number of severe complications of Accordion Severity Classification ≥3 (those that required an invasive procedure) was not significantly different between the two groups (6.5% vs. 3.4%, P = 0.142). There was no significant difference in the length of hospital stay (13.0 days vs. 12.0 days, P = 0.053).

Conclusion

Although the elderly patients had a significantly higher overall postoperative complication rate, no significant difference was seen in either the number of severe complications of Accordion Severity Classification ≥3 or in the length of hospital stay. A laparoscopic colorectal cancer resection in elderly patients, especially those aged 75 years or older, is safe and feasible.

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Review

Update and Debate Issues in Surgical Treatment of Middle and Low Rectal Cancer: Nam Kyu Kim, Min Sung Kim, Sami F. AL-Asari; J Korean Soc Coloproctol. 2012;28(5):230-240. Published online October 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.5.230

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Abstract PDF

Based on a review of the literature, this paper provides an update on surgical treatment of middle and low rectal cancer and discusses issues of debate surrounding that treatment. The main goal of the surgical treatment of rectal cancer is radical resection of the tumor and surrounding lymphatic tissue. Local excision of early rectal cancer can be another treatment option, in which the patient can avoid possible complications related to radical surgery. Neoadjuvant chemoradiation therapy (CRT) has been recommended for patients with cT3-4N0 or any T N+ rectal cancer because CRT shows better local control and less toxicity than adjuvant CRT. However, recent clinical trials showed promising results for local excision after neoadjuvant CRT in selected patients with low rectal cancer. In addition, the "wait and see" concept is another modality that has been reported for the management of tumors that show complete clinical remission after neoadjuvant CRT. Although radical surgery for middle and low rectal cancer is the cornerstone therapy, an ultralow anterior resection with or without intersphincteric resection (ISR) has become an alternative standard surgical method for selected patients. Many studies have reported on the oncological safety of the ISR, but few of them have addressed the issue the functional outcome. Furthermore, an abdominoperineal resection (APR) has problems with high rates of tumor perforations and positive circumferential resection margins, and those factors have contributed to its having a high rate of local recurrence and a poor survival rate for rectal cancer compared with sphincter-saving procedures. Recently, great efforts have been made to reduce these problems, and the total levator excision or the extended APR concept has emerged. Surgical management for low rectal cancer should aim to radically excise the tumor and to preserve as much of the sphincter function as possible by using multidisciplinary approaches. However, further prospective clinical trials are needed for tailored treatment of rectal cancer patients.

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Editorial

T3 Subdivision Correlation with Nodal or Distant Metastasis in Colorectal Cancer; Is It Practically Useful?: Nam Kyu Kim; J Korean Soc Coloproctol. 2012;28(3):119-120. Published online June 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.3.119

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Matteo Zuin, Giulia Capelli, Nicola Gennaro, Cesare Ruffolo, Gaya Spolverato, Salvatore Pucciarelli, Laura Albertoni, Matteo Fassan
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European Journal of Cancer.2018; 104: 47. CrossRef

Original Article

Oncologic Outcomes of a Laparoscopic Right Hemicolectomy for Colon Cancer: Results of a 3-Year Follow-up: Jung Hoon Cho, Dae Ro Lim, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Kang Young Lee, Nam Kyu Kim; J Korean Soc Coloproctol. 2012;28(1):42-48. Published online February 29, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.1.42

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Abstract PDF

Purpose

The purpose of the study is to evaluate the oncologic outcomes of a laparoscopic-assisted right hemicolectomy for the treatment of colon cancer and compare the results with those of previous randomized trials.

Methods

From June 2006, to December 2008, 156 consecutive patients who underwent a laparoscopic right hemicolectomy with a curative intent for colon cancer were evaluated. The clinicopatholgic outcomes and the oncologic outcomes were evaluated retrospectively by using electronic medical records.

Results

There were 84 male patients and 72 female patients. The mean possible length of stay was 7.0 ± 1.5 days (range, 4 to 12 days). The conversion rate was 3.2%. The total number of complications was 30 (19.2%). Anastomotic leakage was not noted. There was no mortality within 30 days. The 3-year overall survival rate of all stages was 93.3%. The 3-year overall survival rates according to stages were 100% in stage I, 97.3% in stage II, and 84.8% in stage III. The 3-year disease-free survival rate of all stages was 86.1%. The 3-year disease-free survival rates according to stage were 96.2% in stage I, 90.3% in stage II, and 75.6% in stage III. The mean follow-up period was 36.3 (3 to 60) months.

Conclusion

A laparoscopic right hemicolectomy for the treatment of colon cancer is technically feasible and safe to perform in terms of oncologic outcomes. The present data support previously reported randomized trials.

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Journal of the Korean Surgical Society.2013; 85(6): 290. CrossRef
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Editorial

Robotic Colorectal Surgery: Is It Still on the Way to a Landmark?: Nam Kyu Kim; J Korean Soc Coloproctol. 2012;28(1):1-2. Published online February 29, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.1.1

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Citations

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Robot-Assisted Colectomy for Left-Sided Colon Cancer: Comparison of Reduced-Port and Conventional Multi-Port Robotic Surgery
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Case Report

Efficacy of Imatinib Mesylate Neoadjuvant Treatment for a Locally Advanced Rectal Gastrointestinal Stromal Tumor: Kyu Jong Yoon, Nam Kyu Kim, Kang Young Lee, Byung Soh Min, Hyuk Hur, Jeonghyun Kang, Sarah Lee; J Korean Soc Coloproctol. 2011;27(3):147-152. Published online June 30, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.3.147

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Abstract PDF

Surgery is the standard treatment for a primary gastrointestinal stromal tumor (GIST); however, surgical resection is often not curative, particularly for large GISTs. In the past decade, with imatinib mesylate (IM), management strategies for GISTs have evolved significantly, and now IM is the standard care for patients with locally advanced, recurrent or metastatic GISTs. Adjuvant therapy with imatinib was recently approved for use, and preoperative imatinib is an emerging treatment option for patients who require cytoreductive therapy. IM neoadjuvant therapy for primary GISTs has been reported, but there is no consensus on the dose of the drug, the duration of treatment and the optimal time of surgery. These are critical because drug resistance or tumor progression can develop with a prolonged treatment. This report describes two cases of large rectal malignant GISTs, for which a abdominoperineal resection was initially anticipated. The two patients received IM preoperative treatment; we followed-up with CT or magnetic resonance imaging to access the response. After 9 months of treatment, a multi-disciplinary consensus that maximal benefit from imatinib had been achieved was reached. We determined the best time for surgical intervention and successfully performed sphincter-preserving surgery before resistance to imatinib or tumor progression occurred. We believe that a multidisciplinary team approach, considerating the optimal duration of therapy and the timing of surgery, is required to optimize treatment outcome.

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Open transanal resection of low rectal stromal tumor following neoadjuvant therapy of imatinib mesylate: Report of 11 cases and review of literature
Qiang Sun, Ning Su, Xinxing Li, Zhiqian Hu, Weijun Wang
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Piotr Rutkowski, Daphne Hompes
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Samuel J. Ford, Alessandro Gronchi
European Journal of Cancer.2016; 63: 154. CrossRef
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M J Wilkinson, J E F Fitzgerald, D C Strauss, A J Hayes, J M Thomas, C Messiou, C Fisher, C Benson, P P Tekkis, I Judson
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Yousra Akasbi, Samia Arifi, Sami Aziz Brahmi, Fatima Zahra El Mrabet, Nawfel Mellas, Fatima Zahra Mernisi, Omar El Mesbahi
Journal of Gastrointestinal Cancer.2014; 45(S1): 71. CrossRef
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Piotr Rutkowski, Alessandro Gronchi, Peter Hohenberger, Sylvie Bonvalot, Patrick Schöffski, Sebastian Bauer, Elena Fumagalli, Pawel Nyckowski, Buu-Phuc Nguyen, Jan Martijn Kerst, Marco Fiore, Elzbieta Bylina, Mathias Hoiczyk, Annemieke Cats, Paolo G. Casa
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Original Article

Clinical Impact of Tumor Regression Grade after Preoperative Chemoradiation for Locally Advanced Rectal Cancer: Subset Analyses in Lymph Node Negative Patients: Byung Soh Min, Nam Kyu Kim, Ju Yeon Pyo, Hoguen Kim, Jinsil Seong, Ki Chang Keum, Seung Kook Sohn, Chang Hwan Cho; J Korean Soc Coloproctol. 2011;27(1):31-40. Published online February 28, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.1.31

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Abstract PDF

Background

We investigated the prognostic significance of tumor regression grade (TRG) after preoperative chemoradiation therapy (preop-CRT) for locally advanced rectal cancer especially in the patients without lymph node metastasis.

Methods

One-hundred seventy-eight patients who had cT3/4 tumors were given 5,040 cGy preoperative radiation with 5-fluorouracil/leucovorin chemotherapy. A total mesorectal excision was performed 4-6 weeks after preop-CRT. TRG was defined as follows: grade 1 as no cancer cells remaining; grade 2 as cancer cells outgrown by fibrosis; grade 3 as a minimal presence or absence of regression. The prognostic significance of TRG in comparison with histopathologic staging was analyzed.

Results

Seventeen patients (9.6%) showed TRG1. TRG was found to be significantly associated with cancer-specific survival (CSS; P = 0.001) and local recurrence (P = 0.039) in the univariate study, but not in the multivariate analysis. The ypN stage was the strongest prognostic factor in the multivariate analysis. Subgroup analysis revealed TRG to be an independent prognostic factor for the CSS of ypN0 patients (P = 0.031). TRG had a stronger impact on the CSS of ypN (-) patients (P = 0.002) than on that of ypN (+) patients (P = 0.521). In ypT2N0 and ypT3N0, CSS was better for TRG2 than for TRG3 (P = 0.041, P = 0.048), and in ypN (-) and TRG2 tumors, CSS was better for ypT1-2 than for ypT3-4 (P = 0.034).

Conclusion

TRG was found to be the strongest prognostic factor in patients without lymph node metastasis (ypN0), and different survival was observed according to TRG among patients with a specific histopathologic stage. Thus, TRG may provide an accurate prediction of prognosis and may be used for f tailoring treatment for patients without lymph node metastasis.

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Aoife Maguire
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K. I. Abdul‐Jalil, K. M. Sheehan, J. Kehoe, R. Cummins, A. O'Grady, D. A. McNamara, J. Deasy, O. Breathnach, L. Grogan, B. D. P. O'Neill, C. Faul, I. Parker, E. W. Kay, B. T. Hennessy, P. Gillen
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Review

Optimal Total Mesorectal Excision for Rectal Cancer: the Role of Robotic Surgery from an Expert's View: Nam-Kyu Kim, Jeonghyun Kang; J Korean Soc Coloproctol. 2010;26(6):377-387. Published online December 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.6.377

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Abstract PDF

Total mesorectal excision (TME) has gained worldwide acceptance as a standard surgical technique in the treatment of rectal cancer. Ever since laparoscopic surgery was first applied to TME for rectal cancer, with increasing penetration rates, especially in Asia, an unstable camera platform, the limited mobility of straight laparoscopic instruments, the two-dimensional imaging, and a poor ergonomic position for surgeons have been regarded as limitations. Robotic technology was developed in an attempt to reduce the limitations of laparoscopic surgery. The robotic system has many advantages, including a more ergonomic position, stable camera platform and stereoscopic view, as well as elimination of tremor and subsequent improved dexterity. Current comparison data between robotic and laparoscopic rectal cancer surgery show similar intraoperative results and morbidity, postoperative recovery, and short-term oncologic outcomes. Potential benefits of a robotic system include reduction of surgeon's fatigue during surgery, improved performance and safety for intracorporeal suture, reduction of postoperative complications, sharper and more meticulous dissection, and completion of autonomic nerve preservation techniques. However, the higher cost for a robotic system still remains an obstacle to wide application, and many socioeconomic issues remain to be solved in the future. In addition, we need more concrete evidence regarding the merits for both patients and surgeons, as well as the merits compared to conventional laparoscopic techniques. Therefore, we need large-scale prospective randomized clinical trials to prove the potential benefits of robot TME for the treatment of rectal cancer.

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