Annals of Coloproctology

Original Articles

Benign GI diease

Surgical Management of Sigmoid Volvulus: A Multicenter Observational Study: Keunchul Lee, Heung-Kwon Oh, Jung Rae Cho, Minhyun Kim, Duck-Woo Kim, Sung-Bum Kang, Hyung-Jin Kim, Hyoung-Chul Park, Rumi Shin, Seung Chul Heo, Seung-Bum Ryoo, Kyu Joo Park, Seoul Colorectal Research Group (SECOG); Ann Coloproctol. 2020;36(6):403-408. Published online December 31, 2020; DOI: https://doi.org/10.3393/ac.2020.03.23

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Purpose
This study aimed to evaluate real-world clinical outcomes from surgically treated patients for sigmoid volvulus.
Methods
Five tertiary centers participated in this retrospective study with data collected from October 2003 through September 2018, including demographic information, preoperative clinical data, and information on laparoscopic/open and elective/emergency procedures. Outcome measurements included operation time, postoperative hospitalization, and postoperative morbidity.
Results
Among 74 patients, sigmoidectomy was the most common procedure (n = 46), followed by Hartmann’s procedure (n = 23), and subtotal colectomy (n = 5). Emergency surgery was performed in 35 cases (47.3%). Of the 35 emergency patients, 34 cases (97.1%) underwent open surgery, and a stoma was established for 26 patients (74.3%). Elective surgery was performed in 39 cases (52.7%), including 21 open procedures (53.8%), and 18 laparoscopic surgeries (46.2%). Median laparoscopic operation time was 180 minutes, while median open surgery time was 130 minutes (P < 0.001). Median postoperative hospitalization was 11 days for laparoscopy and 12 days for open surgery. There were 20 postoperative complications (27.0%), and all were resolved with conservative management. Emergency surgery cases had a higher complication rate than elective surgery cases (40.0% vs. 15.4%, P = 0.034).
Conclusion
Relative to elective surgery, emergency surgery had a higher rate of postoperative complications, open surgery, and stoma formation. As such, elective laparoscopic surgery after successful sigmoidoscopic decompression may be the optimal clinical option.

Citations

Citations to this article as recorded by

Patience is key: Association of surgical timing with clinical outcomes in elderly patients with sigmoid volvulus
Suzanne C. Arnold, Wardah Rafaqat, May Abiad, Emanuele Lagazzi, Anne H. Hoekman, Vahe S. Panossian, Ikemsinachi C. Nzenwa, Charudutt N. Paranjape, George C. Velmahos, Haytham M.A. Kaafarani, John O. Hwabejire
The American Journal of Surgery.2024; 232: 81. CrossRef
Epidemiology and age-related trends in surgical outcomes for sigmoid volvulus: a 17-year analysis
Lukas Schabl, Stefan D. Holubar, Kamil Erozkan, Ali Alipouriani, Himani Sancheti, Scott R. Steele, Hermann Kessler
Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
Unveiling a Coalescing Catastrophe: Pre-pyloric Perforation Co-existing With Sigmoid Volvulus in a Middle-Aged Patient
Mihir Patil, Pankaj Gharde
Cureus.2024;[Epub] CrossRef
Navigating Abdominal Volvulus: A Comprehensive Review of Management Strategies
Simran Chauhan, Raju K Shinde, Yashraj Jain
Cureus.2024;[Epub] CrossRef
Laparoscopic redo surgery for sigmoid volvulus following laparoscopic sigmoidectomy
Hideyuki Masui, Kenji Kawada, Susumu Inamoto, Toshiaki Wada, Yoshiharu Sakai, Kazutaka Obama
Surgical Case Reports.2024;[Epub] CrossRef
Sigmoid volvulus as a rare cause of intestinal obstruction in the pediatric population: case series and literature review
Isabel C. Brito Rojas, Mayra A. Hernández Peñuela, Vanessa Medina Gaviria, Martin La Rotta, John M. Escobar Echeverri
International Journal of Surgery Open.2024; 62(2): 149. CrossRef
Metachronous volvulus of the descending colon after resection of the sigmoid volvulus; a case report
Molla Asnake Kebede, Sisay Mengistu Mohammed, Yilkal Teshome Numaro, Yohanes Yoseph Mesfine, Adugnaw Bogale Worku, Anteneh Messele Birhanu
International Journal of Surgery Case Reports.2024; 123: 110212. CrossRef
Mesopexy instead of colectomy successfully treated an elderly patient with sigmoid volvulus, a case report
Jin Qian, Shu-Qing Hua
Asian Journal of Surgery.2024;[Epub] CrossRef
Outcomes for sigmoid volvulus managed with and without early definitive surgery: 20‐year experience in a tertiary referral centre
Shriranshini Satheakeerthy, Priscilla Leow, Benjamin Hall, Damien Ah Yen, Jesse Fischer
ANZ Journal of Surgery.2023;[Epub] CrossRef
Bowel Preparation Before Nonelective Sigmoidectomy for Sigmoid Volvulus: Highly Beneficial but Vastly Underused
Natalie Schudrowitz, C Patrick Shahan, Tovah Moss, John E Scarborough
Journal of the American College of Surgeons.2023; 236(4): 649. CrossRef
Perioperative Adverse Outcome and Its Predictors After Emergency Laparotomy Among Sigmoid Volvulus Patients: Retrospective Follow-Up Study
Tilahun Deresse, Esubalew Tesfahun, Zenebe Gebreegziabher, Mandante Bogale, Dawit Alemayehu, Megbar Dessalegn, Tewodros Kifleyohans, George Eskandar
Open Access Emergency Medicine.2023; Volume 15: 383. CrossRef
Colonic pseudo-obstruction in a patient with dyssynergic defecation: A case report
Yejun Jeong, Yongjae Kim, Wonhyun Kim, Seoyeon Park, Su-Jin Shin, Eun Jung Park
International Journal of Surgery Case Reports.2022; 98: 107524. CrossRef
Comments on “Surgical Management of Sigmoid Volvulus: A Multicenter Observational Study”
Sabri Selcuk Atamanalp
Annals of Coloproctology.2021; 37(2): 73. CrossRef

Unexpected Appendiceal Pathologies and Their Changes With the Expanding Use of Preoperative Imaging Studies: Hong Yeol Yoo, Jaewoo Choi, Jongjin Kim, Young Jun Chai, Rumi Shin, Hye Seong Ahn, Chang-Sup Lim, Hae Won Lee, Ki-Tae Hwang, In Mok Jung, Jung Kee Chung, Seung Chul Heo; Ann Coloproctol. 2017;33(3):99-105. Published online June 30, 2017; DOI: https://doi.org/10.3393/ac.2017.33.3.99

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Abstract PDF

Purpose

The preoperative diagnosis of acute appendicitis is often challenging. Sometimes, pathologic results of the appendix embarrass or confuse surgeons. Therefore, more and more imaging studies are being performed to increase the accuracy of appendicitis diagnoses preoperatively. However, data on the effect of this increase in preoperative imaging studies on diagnostic accuracy are limited. We performed this study to explore unexpected appendiceal pathologies and to delineate the role of preoperative imaging studies in the diagnosis of acute appendicitis.

Methods

The medical records of 4,673 patients who underwent an appendectomy for assumed appendicitis between 1997 and 2012 were reviewed retrospectively. Pathological results and preoperative imaging studies were surveyed, and the frequencies of pathological results and preoperative imaging studies were investigated.

Results

The overall rate of pathology compatible with acute appendicitis was 84.4%. Unexpected pathological findings, such as normal histology, specific inflammations other than acute appendicitis, neoplastic lesions, and other pathologies, comprised 9.6%, 3.3%, 1.2%, and 1.5%, respectively. The rate of unexpected pathological results was significantly reduced because of the increase in preoperative imaging studies. The decrease in normal appendices contributed the most to the reduction while other unexpected pathologies did not change significantly despite the increased use of imaging studies. This decrease in normal appendices was significant in both male and female patients under the age of 60 years, but the differences in females were more prominent.

Conclusion

Unexpected appendiceal pathologies comprised 15.6% of the cases. Preoperative imaging studies reduced them by decreasing the negative appendectomy rate of patients with normal appendices.

Citations

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The appendix: An unexpected band obstruction
Rowan Klein Nulend, Rakesh Quinn, Kar Yin Fok, Nimalan Pathmanathan
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Marian Constantin, Livia Petrescu, Cristina Mătanie, Corneliu Ovidiu Vrancianu, Adelina-Gabriela Niculescu, Octavian Andronic, Alexandra Bolocan
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Rising incidence of appendiceal neoplasms over time: Does pathological handling of appendectomy specimens play a role?
Hisham F. Bahmad, Abed Alhalim Aljamal, Juan Carlos Alvarez Moreno, Ali Salami, Philip Bao, Sarah Alghamdi, Robert J. Poppiti
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The Impact of Pathological Criteria on Pediatric Negative Appendectomy Rate
Caroline Maloney, Morris C. Edelman, Alexandra C. Bolognese, Aaron M. Lipskar, Barrie S. Rich
Journal of Pediatric Surgery.2019; 54(9): 1794. CrossRef
Communication and management of incidental pathology in 1,214 consecutive appendicectomies; a cohort study
Ned Kinnear, Bridget Heijkoop, Eliza Bramwell, Alannah Frazzetto, Amy Noll, Prajay Patel, Derek Hennessey, Greg Otto, Christopher Dobbins, Tarik Sammour, James Moore
International Journal of Surgery.2019; 72: 185. CrossRef
Unexpected Appendiceal Pathologies and Preoperative Imaging Studies on Patients With Acute Appendicitis
Byung Chun Kim
Annals of Coloproctology.2017; 33(3): 82. CrossRef

Predictors of Morbidity and Mortality After Surgery for Intestinal Perforation: Rumi Shin, Sang Mok Lee, Beonghoon Sohn, Dong Woon Lee, Inho Song, Young Jun Chai, Hae Won Lee, Hye Seong Ahn, In Mok Jung, Jung Kee Chung, Seung Chul Heo; Ann Coloproctol. 2016;32(6):221-227. Published online December 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.6.221

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33 Citations

Abstract PDF

Purpose

An intestinal perforation is a rare condition, but has a high mortality rate, even after immediate surgical intervention. The clinical predictors of postoperative morbidity and mortality are still not well established, so this study attempted to identify risk factors for postoperative morbidity and mortality after surgery for an intestinal perforation.

Methods

We retrospectively analyzed the cases of 117 patients who underwent surgery for an intestinal perforation at a single institution in Korea from November 2008 to June 2014. Factors related with postoperative mortality at 1 month and other postoperative complications were investigated.

Results

The mean age of enrolled patients was 66.0 ± 15.8 years and 66% of the patients were male. Fifteen patients (13%) died within 1 month after surgical treatment. Univariate analysis indicated that patient-related factors associated with mortality were low systolic and diastolic blood pressure, low serum albumin, low serum protein, low total cholesterol, and high blood urea nitrogen; the surgery-related factor associated with mortality was feculent ascites. Multivariate analysis using a logistic regression indicated that low systolic blood pressure and feculent ascites independently increased the risk for mortality; postoperative complications were more likely in both females and those with low estimated glomerular filtration rates and elevated serum C-reactive protein levels.

Conclusion

Various factors were associated with postoperative clinical outcomes of patients with an intestinal perforation. Morbidity and mortality following an intestinal perforation were greater in patients with unstable initial vital signs, poor nutritional status, and feculent ascites.

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Victor Castañeda-Marquez, Yeisson Rivero-Moreno, Enrique Avila-Liendo, Gabriel Gonzalez-Quinde, Wilson Garcia-Cazorla, Georcimar Mendez-Meneses, Yoalkris E Salcedo, Tamara Rodriguez-Rugel, Jackner Antigua-Herrera, Miguel Rivas-Perez, Silvia Agudelo-Mendoz
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Kyowon Gu, Tae Wook Kang, Seungchul Han, Dong Ik Cha, Kyoung Doo Song, Min Woo Lee, Hyunchul Rhim, Go Eun Park
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Saikrishna Eswaravaka, Chirantan Suhrid, Bhavya Rao, Sundaresh Prabhakar, Jayashri Pandya
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M. Forooghi, R. Shahrokhi, Sh. Yousufzai
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Xue Gao, Ying Guo, Xiaoting Zhu, Chunlei Du, Beibei Ma, Yinghua Cui, Shuai Wang
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Abdominal emergency surgery in patients with hematological malignancies: a retrospective single-center analysis
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Dauda Bawa, Yasser Mohammad Khalifa, Saleem Khan, Waddah Norah, Nibras Noman
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Individualized Cutoff Value of the Preoperative Carcinoembryonic Antigen Level is Necessary for Optimal Use as a Prognostic Marker: Byeong Geon Jeon, Rumi Shin, Jung Kee Chung, In Mok Jung, Seung Chul Heo; Ann Coloproctol. 2013;29(3):106-114. Published online June 30, 2013; DOI: https://doi.org/10.3393/ac.2013.29.3.106

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Abstract PDF

Purpose

Carcinoembryonic antigen (CEA) is an important prognostic marker in colorectal cancer (CRC). However, in some stages, it does not work. We performed this study to find a way in which preoperative CEA could be used as a constant prognostic marker in harmony with the TNM staging system.

Methods

Preoperative CEA levels and recurrences in CRC were surveyed. The distribution of CEA levels and the recurrences in each TNM stage of CRC were analyzed. An optimal cutoff value for each TNM stage was calculated and tested for validity as a prognostic marker within the TNM staging system.

Results

The conventional cutoff value of CEA (5 ng/mL) was an independent prognostic factor on the whole. However, when evaluated in subgroups, it was not a prognostic factor in stage I or stage III of N2. A subgroup analysis according to TNM stage revealed different CEA distributions and recurrence rates corresponding to different CEA ranges. The mean CEA levels were higher in advanced stages. In addition, the recurrence rates of corresponding CEA ranges were higher in advanced stages. Optimal cutoff values from the receiver operating characteristic curves were 7.4, 5.5, and 4.5 ng/mL for TNM stage I, II, and III, respectively. Those for N0, N1, and N2 stages were 5.5, 4.8, and 3.5 ng/mL, respectively. The 5-year disease-free survivals were significantly different according to these cutoff values for each TNM and N stage. The multivariate analysis confirmed the new cutoff values to be more efficient in discriminating the prognosis in the subgroups of the TNM stages.

Conclusion

Individualized cutoff values of the preoperative CEA level are a more practical prognostic marker following and in harmony with the TNM staging system.

Citations

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Case Report

Rectal Perforation Caused by Anal Stricture After Hemorrhoid Treatment: Yong Joon Suh, Heon-Kyun Ha, Heung-Kwon Oh, Rumi Shin, Seung-Yong Jeong, Kyu Joo Park; Ann Coloproctol. 2013;29(1):28-30. Published online February 28, 2013; DOI: https://doi.org/10.3393/ac.2013.29.1.28

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Abstract PDF

Inappropriate therapies for hemorrhoids can lead to various complications including anorectal stricture. We report a patient presenting with catastrophic rectal perforation due to severe anal stricture after inappropriate hemorrhoid treatment. A 67-years old man with perianal pain visited the emergency room. The hemorrhoids accompanied by constipation, had tortured him since his youth. Thus he had undergone injection sclerotherapy several times by an unlicensed therapist and hemorrhoidectomy twice at the clinics of private practitioners. His body temperature was as high as 38.5℃. The computed tomographic scan showed a focal perforation of posterior rectal wall. The emergency operation was performed. The fibrotic tissues of the anal canal were excised. And then a sigmoid loop colostomy was constructed. The patient was discharged four days following the operation. This report calls attention to the enormous risk of unlicensed injection sclerotherapy and overzealous hemorrhoidectomy resulting in scarring, progressive stricture, and eventual rectal perforation.

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Laser hemorrhoidoplasty for hemorrhoidal disease: a systematic review and meta-analysis
Hendry Lie, Evelyn Franca Caesarini, Antonius Agung Purnama, Andry Irawan, Taufik Sudirman, Wifanto Saditya Jeo, Bernardus Parish Budiono, Erik Prabowo, M. Iqbal Rivai, Ryanto Karobuana Sitepu
Lasers in Medical Science.2022; 37(9): 3621. CrossRef

Original Articles

Does T3 Subdivision Correlate with Nodal or Distant Metastasis in Colorectal Cancer?: Hong Yeol Yoo, Rumi Shin, Heon-Kyun Ha, Heung-Kwon Oh, Seung-Yong Jeong, Kyu Joo Park, Gyeong Hoon Kang, Woo Ho Kim, Jae-Gahb Park; J Korean Soc Coloproctol. 2012;28(3):160-164. Published online June 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.3.160

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10 Citations

Abstract PDF

Purpose

We analyzed the clinical data of T3 colorectal cancer patients to assess whether T3 subdivision correlates with node (N) or metastasis (M) staging and stage-independent factors.

Methods

Five hundred fifty-five patients who underwent surgery for primary colorectal cancer from January 2003 to December 2009 were analyzed for T3 subdivision. T3 subdivision was determined by the depth of invasion beyond the outer border of the proper muscle (T3a, <1 mm; T3b, 1 to 5 mm; T3c, >5 to 15 mm; T3d, >15 mm). We investigated the correlation between T3 subdivision and N, M staging and stage-independent prognostic factors including angiolymphatic invasion (ALI), venous invasion (VI) and perineural invasion (PNI).

Results

The tumors of the 555 patients were subclassified as T3a in 86 patients (15.5%), T3b in 209 patients (37.7%), T3c in 210 patients (37.8%) and T3d in 50 patients (9.0%). The nodal metastasis rates were 39.5% for T3a, 56.5% for T3b, 75.7% for T3c and 74.0% for T3d. The distant metastasis rates were 7.0% for T3a 9.1% for T3b, 27.1% for T3c and 40.0% for T3d. Both N and M staging correlated with T3 subdivision (Spearman's rho = 0.288, 0.276, respectively; P < 0.001). Other stage-independent prognostic factors correlated well with T3 subdivision (Spearman's rho = 0.250, P < 0.001 for ALI; rho = 0.146, P < 0.001 for VI; rho = 0.271, P < 0.001 for PNI).

Conclusion

Subdivision of T3 colorectal cancer correlates with nodal and metastasis staging. Moreover, it correlates with other prognostic factors for colorectal cancer.

Citations

Citations to this article as recorded by

Facteurs pronostiques : degré d’invasion de la sous-séreuse, distance tumeur-séreuse et invasion de la limitante élastique de la sous-séreuse dans l’adénocarcinome colique
Arnaud Ronfaut, Christophe Attencourt, Jean-Rene Tesson, Charles Sabbagh, Jean-Marc Regimbeau, Denis Chatelain
Annales de Pathologie.2024;[Epub] CrossRef
Do treated rectal tumors appear differently on MRI after chemotherapy versus chemoradiotherapy?
Yu Shen, Yanqiong Wen, Liang Bi, Xuyang Yang, Xiaoling Gong, Xiangbing Deng, Wenjian Meng, Ziqiang Wang
Abdominal Radiology.2023; 49(3): 774. CrossRef
Pathology and Prognosis of Colonic Adenocarcinomas With Intermediate Primary Tumor Stage Between pT2 and pT3
John D. Paulsen, Alexandros D. Polydorides
Archives of Pathology & Laboratory Medicine.2022; 146(5): 591. CrossRef
Prognostic significance of additional histologic features for subclassification of pathological T3 colon cancer
Lorenzo Macchi, Quoc Riccardo Bao, Laura Albertoni, Matteo Fassan, Valentina Chiminazzo, Marco Scarpa, Gaya Spolverato, Salvatore Pucciarelli
International Journal of Clinical Oncology.2022; 27(9): 1428. CrossRef
The value of diffusion kurtosis imaging and intravoxel incoherent motion quantitative parameters in predicting synchronous distant metastasis of rectal cancer
Xue Ding, Danqi Sun, Qiuchen Guo, Yeting Li, Hao Chen, Xiaoxiao Dai, Guohua Fan, Yongyou Wu, Guangqiang Chen, Yonggang Li
BMC Cancer.2022;[Epub] CrossRef
The 2017 Assisi Think Tank Meeting on rectal cancer: A positioning paper
Vincenzo Valentini, Corrie Marijnen, Geerard Beets, Krzysztof Bujko, Berardino De Bari, Andres Cervantes, Giuditta Chiloiro, Claudio Coco, Maria Antonietta Gambacorta, Robert Glynne-Jones, Karin Haustermans, Elisa Meldolesi, Femke Peters, Claus Rödel, Har
Radiotherapy and Oncology.2020; 142: 6. CrossRef
Whole-lesion Apparent Diffusion Coefficient First- and Second-Order Texture Features for the Characterization of Rectal Cancer Pathological Factors
Weifeng Li, Zhuoran Jiang, Yue Guan, Ying Chen, Xiaolin Huang, Song Liu, Jian He, Zhengyang Zhou, Yun Ge
Journal of Computer Assisted Tomography.2018; 42(4): 642. CrossRef
A meta-analysis assessing the survival implications of subclassifying T3 rectal tumours
M.R.S. Siddiqui, C. Simillis, J. Bhoday, N.J. Battersby, J. Mok, S. Rasheed, P. Tekkis, A.M. Abulafi, G. Brown
European Journal of Cancer.2018; 104: 47. CrossRef
Extramural extension as indicator for postoperative adjuvant chemotherapy in Stage IIA (pT3N0) colon cancer
Yoshito Akagi, Kazuo Shirouzu, Tetsushi Kinugasa
Journal of Surgical Oncology.2013; 108(6): 358. CrossRef
T3 Subdivision Correlation with Nodal or Distant Metastasis in Colorectal Cancer; Is It Practically Useful?
Nam Kyu Kim
Journal of the Korean Society of Coloproctology.2012; 28(3): 119. CrossRef

Clinical Features of Colorectal Cancer Detected by the National Cancer Screening Program: Dae-Do Park, Rumi Shin, Ji-Sun Kim, Heung-Kwon Oh, Seung-Yong Jeong, Kyu Joo Park, Jae-Gahb Park; J Korean Soc Coloproctol. 2010;26(6):420-423. Published online December 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.6.420

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4 Citations

Abstract PDF

Purpose

Since 2004, the National Cancer Screening Program of Korea has included colorectal cancer screening based on primary screening with the fecal occult blood test (FOBT). We report on the clinical features of colorectal cancer detected by the National Cancer Screening Program.

Methods

We retrospectively analyzed 577 patients who underwent elective surgery for colorectal cancer at the Seoul National University Hospital between January 2008 and December 2009. We compared the clinical features of colorectal cancers detected by the National Cancer Screening Program (NCSP group) with those of the control group in terms of age, gender, preoperative symptom, location of the tumor, surgical technique and tumor-node-metastasis (TNM) stage.

Results

Age, gender, location of the tumor and operation types were not different between the two groups. The proportion of asymptomatic patients was significantly higher in the NCSP group than it was in the control group (86.5% vs. 20.0%; P < 0.001). The proportion of less invasive lesions (T1 or T2) was significantly higher in the NCSP group (46.3% vs. 27.7%; P = 0.002). The pathologic stages of the colorectal cancers in the NCSP group were I, 40.3%; II, 17.9%; III, 40.3% and IV, 1.5% whereas in the control group, they were I, 20.8%; II, 32.9%; III, 34.9% and IV, 11.4%. The proportion of stage I cancer was significantly higher in the NCSP group than in the control group (40.3% vs. 20.8%; P = 0.006).

Conclusion

Our study demonstrates the FOBT in the NCSP is effective in early detection of colorectal cancer.

Citations

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Clinicopathological Characteristics of Colorectal Adenomas and Cancers Detected by FIT-positive Colonoscopy
Seiji Kimura, Shinichiro Yamagishi, Shinsaku Fukuda
Nippon Daicho Komonbyo Gakkai Zasshi.2020; 74(1): 6. CrossRef
Predictive Nomogram for Recurrence of Stage I Colorectal Cancer After Curative Resection
Chan Kim, Woo Ram Kim, Ki-Yeol Kim, Hong Jae Chon, Seung Hoon Beom, Hyojoong Kim, Minkyu Jung, Sang Joon Shin, Nam Kyu Kim, Joong Bae Ahn
Clinical Colorectal Cancer.2018; 17(3): e513. CrossRef
Early Colorectal Epithelial Neoplasm in Korea: A Multicenter Survey of Pathologic Diagnosis
Yun Kyung Kang, So-Young Jin, Mee Soo Chang, Jung Yeon Kim, Gyeong Hoon Kang, Hye Seung Lee, Jin Hee Sohn, Ho Sung Park, Kye Won Kwon, Mi Jin Gu, Young Hee Maeng, Jong Eun Joo, Haeng Ji Kang, Hee Kyung Kim, Kee-Taek Jang, Mi Ja Lee, Hee Kyung Chang, Joon
Korean Journal of Pathology.2013; 47(3): 245. CrossRef
Clinicopathologic Factors Affecting Recurrence after Curative Surgery for Stage I Colorectal Cancer
Min Ae Keum, Seok-Byung Lim, Sun A Kim, Yong Sik Yoon, Chan Wook Kim, Chang Sik Yu, Jin Cheon Kim
Journal of the Korean Society of Coloproctology.2012; 28(1): 49. CrossRef

Management of Appendicitis Presenting with Abscess or Mass: Jeong-Ki Kim, Seungbum Ryoo, Heung-Kwon Oh, Ji Sun Kim, Rumi Shin, Eun Kyung Choe, Seung-Yong Jeong, Kyu Joo Park; J Korean Soc Coloproctol. 2010;26(6):413-419. Published online December 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.6.413

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24 Citations

Abstract PDF

Purpose

Management strategy in acute appendicitis patients initially presenting with abscess or mass is surrounded with controversy. This study was performed to identify the outcomes of management for this condition.

Methods

We retrospectively analyzed prospectively registered 76 patients (male:female = 39:37; mean age, 50.8 years) with appendicitis presenting with abscess or mass over a 9-year period at the Seoul National University Hospital. Patients were divided into three groups (emergency operation group, delayed operation group, and follow-up group), and clinical characteristics and outcomes of treatment were investigated.

Results

Twenty-eight patients (36.8%) underwent an emergency operation. Of the remaining 48 patients, 20 (41.7%) were initially treated with conservative management through the use of antibiotics only; the other 28 (58.3%) with and additional ultrasound-guided percutaneous drainage of the abscess. Twenty-six (54.2%) patients underwent planned operations after conservative management, and 22 (45.8%) were followed without surgery (median duration, 37.8 month), of which 3 (13%) underwent an appendectomy due to recurrent appendicitis (mean of 56.7 days after initial attack). There were no statistical differences in types of operation performed (appendectomy or ileocecectomy), postoperative complications, and postoperative hospital stay among the patients who underwent emergency operations, delayed operations and operations for recurrence during follow-up.

Conclusion

Although the recurrence rate was relatively low after conservative management for appendicitis patients presenting with abscess or mass, there was no difference in surgical outcome between the emergent, elective, or recurrent groups. Our results indicate that proper management of appendicitis with abscess or mass can be selected according to surgeon's preference.

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Akinfemi A. Akingboye, Fahad Mahmood, Shafquat Zaman, Jenny Wright, Fatima Mannan, Ali Yasen Y. Mohamedahmed
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