Annals of Coloproctology

Original Articles

Long-term Outcomes and Risk Factors for Reoperation After Surgical Treatment for Gastrointestinal Crohn Disease According to Anti-tumor Necrosis Factor-α Antibody Use: 35 Years of Experience at a Single Institute in Korea: Sang Mok Lee, Eon Chul Han, Seung-Bum Ryoo, Heung-Kwon Oh, Eun Kyung Choe, Sang Hui Moon, Joo Sung Kim, Hyun Chae Jung, Kyu Joo Park; Ann Coloproctol. 2015;31(4):144-152. Published online August 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.4.144

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Purpose

Crohn disease is characterized by high rates of recurrence and reoperations. However, few studies have investigated long-term surgical outcomes in Asian populations. We investigated risk factors for reoperation, particularly those associated with anti-tumor necrosis factor-α (anti-TNF-α) antibody use, and long-term follow-up results.

Methods

We reviewed the records of 148 patients (100 males and 48 females) who underwent surgery for gastrointestinal Crohn disease and retrospectively analyzed long-term outcomes and risk factors.

Results

The mean age at diagnosis was 28.8 years. Thirty-eight patients (25.7%) received monoclonal antibody treatment before reoperation. A small bowel and colon resection was most commonly performed (83 patients, 56.1%). The median follow-up was 149 months, during which 47 patients underwent reoperation. The median interval between the primary and the secondary surgeries was 65 months, with accumulated reoperation rates of 16.5%, 31.8%, and 57.2% after 5, 10, and 15 years, respectively. Obstruction was the most common indication for reoperation (37 patients, 25.0%). In a multivariable analysis, age <17 years at diagnosis (A1) (odds ratio [OR], 2.20; P = 0.023), penetrating behavior (B3) (OR, 4.39; P < 0.001), and no azathioprine use (OR, 2.87; P = 0.003) were associated with reoperation. Anti-TNF-α antibody use did not affect the reoperation rate (P = 0.767).

Conclusion

We showed a high reoperation rate regardless of treatment with anti-TNF-α antibody, which indicates that recurrent surgery is still needed to cure patients with gastrointestinal Crohn diseases. Younger age at primary operation, penetrating behavior, and no azathioprine use were significant factors associated with reoperation for gastrointestinal Crohn disease.

Citations

Citations to this article as recorded by

Inflammatory Bowel Disease Reoperation Rate Has Decreased Over Time If Corrected by Prevalence
Mafalda Santiago, Fernando Magro, Luís Correia, Francisco Portela, Paula Ministro, Paula Lago, Eunice Trindade, Cláudia Camila Dias
Clinical and Translational Gastroenterology.2020; 11(9): e00227. CrossRef
Effect of Thiopurine on Potential Surgical Intervention in Crohn’s Disease in Korea: Results from the CONNECT Study
Hee Man Kim, Jin Woo Kim, Hyun-Soo Kim, Joo Sung Kim, You Sun Kim, Jae Hee Cheon, Won Ho Kim, Byong Duk Ye, Won Moon, Sung Hee Jung, Young-Ho Kim, Dong Soo Han
Journal of Clinical Medicine.2020; 10(1): 25. CrossRef
Risk factors for postoperative surgical site infections in patients with Crohn’s disease receiving definitive bowel resection
Song Liu, Ji Miao, Gefei Wang, Meng Wang, Xiuwen Wu, Kun Guo, Min Feng, Wenxian Guan, Jianan Ren
Scientific Reports.2017;[Epub] CrossRef
Advanced age impacts surgical characteristics and postoperative course in patients with Crohn's disease
Stanislaus Argeny, Anton Stift, Martina Mittlböck, Amy C. Lord, Svenja Maschke, Mathias Schneeweiß, Stefan Riss
International Journal of Surgery.2016; 33: 182. CrossRef
Effect of Tripterygium Wilfordii Polyglycoside on Experimental Prostatitis Caused by Ureaplasma Urealyticum in Rats
Pingnan Shan, Zhiyong Lu, Lihong Ye, Yaqin Fang, Suhong Tan, Guohong Xuan, Jincheng Ru, Liming Mao
Medical Science Monitor.2016; 22: 3722. CrossRef
Endoscopy-based management decreases the risk of postoperative recurrences in Crohn’s disease
Anne-Laure Boucher, Bruno Pereira, Stéphanie Decousus, Marion Goutte, Felix Goutorbe, Anne Dubois, Johan Gagniere, Corinne Borderon, Juliette Joubert, Denis Pezet, Michel Dapoigny, Pierre J Déchelotte, Gilles Bommelaer, Anthony Buisson
World Journal of Gastroenterology.2016; 22(21): 5068. CrossRef
Anti-tumor Necrosis Factor Therapy for Crohn Disease: Friend or Foe to the Surgeon?
Hungdai Kim
Annals of Coloproctology.2015; 31(4): 121. CrossRef

Rectourethral Fistula: Systemic Review of and Experiences With Various Surgical Treatment Methods: Ji Hye Choi, Byeong Geon Jeon, Sang-Gi Choi, Eon Chul Han, Heon-Kyun Ha, Heung-Kwon Oh, Eun Kyung Choe, Sang Hui Moon, Seung-Bum Ryoo, Kyu Joo Park; Ann Coloproctol. 2014;30(1):35-41. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.35

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47 Web of Science
46 Citations

Abstract PDF

Purpose

A rectourethral fistula (RUF) is an uncommon complication resulting from surgery, radiation or trauma. Although various surgical procedures for the treatment of an RUF have been described, none has gained acceptance as the procedure of choice. The aim of this study was to review our experience with surgical management of RUF.

Methods

The outcomes of 6 male patients (mean age, 51 years) with an RUF who were operated on by a single surgeon between May 2005 and July 2012 were assessed.

Results

The causes of the RUF were iatrogenic in four cases (two after radiation therapy for rectal cancer, one after brachytherapy for prostate cancer, and one after surgery for a bladder stone) and traumatic in two cases. Fecal diversion was the initial treatment in five patients. In one patient, fecal diversion was performed simultaneously with definitive repair. Four patients underwent staged repair after a mean of 12 months. Rectal advancement flaps were done for simple, small fistula (n = 2), and flap interpositions (gracilis muscle flap, n = 2; omental flap, n = 1) were done for complex or recurrent fistulae. Urinary strictures and incontinence were observed in patients after gracilis muscle flap interposition, but they were resolved with simple treatments. The mean follow-up period was 28 months, and closure of the fistula was achieved in all five patients (100%) who underwent definitive repairs. The fistula persisted in one patient who refused further definitive surgery after receiving only a fecal diversion.

Conclusion

Depending on the severity and the recurrence status of RUF, a relatively simple rectal advancement flap repair or a more complex gracilis muscle or omental flap interposition can be used to achieve closure of the fistula.

Citations

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Complex case of granulomatosis with polyangiitis involving the urethra and prostate causing outflow obstruction and ano-urethral fistula
Mustafa Rashid, Adam Cox
Journal of Clinical Urology.2024; 17(1): 89. CrossRef
A rare case of fatal rectal perforation and sepsis following traumatic urinary catheterization
Darshan Sitharthan, Paul Sved
Urology Case Reports.2024; 54: 102706. CrossRef
Gracilis muscle interposition for complex perineal fistulas: A systematic review and meta‐analysis of the literature
Zoe Garoufalia, Rachel Gefen, Sameh Hany Emile, Emanuela Silva‐Alvarenga, Nir Horesh, Michael R. Freund, Steven D. Wexner
Colorectal Disease.2023; 25(4): 549. CrossRef
Outcomes of gracilis muscle interposition for rectourethral fistulas caused by treatment of prostate cancer
S. H. Emile, N. Horesh, V. Strassmann, Z. Garoufalia, R. Gefen, P. Zhou, E. Ray-Offor, G. Dasilva, S. D. Wexner
Techniques in Coloproctology.2023; 27(10): 937. CrossRef
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Sapphire Melody Ho, Kishore Rajaguru, Jing Yu Ng, Choon Sheong Seow
International Journal of Surgery Case Reports.2023; 105: 108009. CrossRef
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Christian Mouawad, Elie El Helou, Houssam Dahboul, Rhea Akel, Bilal Chamaa, Rany Aoun, Serge Kassar, Michael Osseis, Roger Noun, Ghassan Chakhtoura
Asian Journal of Endoscopic Surgery.2023; 16(4): 814. CrossRef
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Nikolas Moring, Seamus Barrett, Andrew C. Peterson, Brian M. Inouye
Cancers.2023; 15(17): 4238. CrossRef
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Kyeong Ri Yu, Lucas Keller-Biehl, Leon Smith-Harrison, Sarah Z. Hazell, William R. Timmerman, Jeannie F. Rivers, Thomas A. Miller
Surgery in Practice and Science.2023; 15: 100216. CrossRef
Gracilis muscle flap combined with a laparoscopic transabdominal approach is effective in the treatment of post-prostatectomy rectourethral fistula: A case report
Tomohiro Takeda, Tatsuya Shonaka, Chikayoshi Tani, Toshihiko Hayashi, Hidehiro Kakizaki, Yasuo Sumi
International Journal of Surgery Case Reports.2022; 92: 106856. CrossRef
Effectiveness of York-Mason Procedure for a Refractory Rectourethral Fistula that Relapsed after Repair by a Perineal Approach:A Case Report
Masatsugu Kojima, Toru Miyake, Tomoyuki Ueki, Tomoharu Shimizu, Masaji Tani
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Alex J. Xu, Kirtishri Mishra, Yeonsoo S. Lee, Lee Cheng Zhao
Urologic Clinics of North America.2022; 49(3): 507. CrossRef
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Bernardo Rocco, Gaia Giorgia, Assumma Simone, Calcagnile Tommaso, Sangalli Mattia, Terzoni Stefano, Eissa Ahmed, Bozzini Giorgio, Bernardino De Concilio, Antonio Celia, Micali Salvatore, Maria Chiara Sighinolfi
European Urology Open Science.2022; 44: 54. CrossRef
Preventing Rectourethral Fistula Recurrence With Gracilis Flap
Keon Min Park, Yenny Y. Rosli, Allen Simms, Rachel Lentz, Deepak R. Bharadia, Benjamin Breyer, William Y. Hoffman
Annals of Plastic Surgery.2022; 88(4): S316. CrossRef
Validating the Martini Staging System for Rectourethral Fistula: A Meta-Analysis of Postoperative Outcomes
Kirtishri Mishra, Amr Mahran, Bissan Abboud, Laura Bukavina, Ahmed Elshafei, Al Ray, Austin Fernstrum, Rayan Abboud, Mohammed Elgammal, Lee C. Zhao, Shubham Gupta
Urology.2021; 147: 299. CrossRef
Rectourethral Fistula Repair With Endorectal Advancement Flap and Implantation of Biologic Mesh
Tae David Kim, Gerald Gantt, Kunal Kochar, Slawomir Marecik, John J. Park
Diseases of the Colon & Rectum.2021; 64(1): e1. CrossRef
Clinical outcome and quality of life after gracilis muscle transposition for fistula closure over a 10-year period
M. Grott, A. Rickert, S. Hetjens, P. Kienle
International Journal of Colorectal Disease.2021; 36(3): 569. CrossRef
Urorectal fistula repair using different approaches: operative results and quality of life issues
Javier C. Angulo, Ignacio Arance, Yannick Apesteguy, João Felicio, Natália Martins, Francisco E. Martins
International braz j urol.2021; 47(2): 399. CrossRef
Robotic transanal rectourethral fistula repair—a video vignette
Thomas Surya Suhardja, Belinda Errington, Amirala Khalessi, Kim‐Chi Phan‐Thien
Colorectal Disease.2021; 23(5): 1275. CrossRef
Tratamiento de las fístulas uretrorrectales tras prostatectomía radical mediante la interposición de material biológico vía perineal
J.U. Juan Escudero, F. Villalba Ferrer, M. Ramos de Campos, M. Fabuel Deltoro, M.J. García Coret, F. Sánchez Ballester, I. Povo Martín, Y. Pallas Costa, P. Pardo Duarte, J. García Ibañez, A. Monzó Cataluña, K. Rechi Sierra, C. Juliá Romero, E. López Alcin
Actas Urológicas Españolas.2021; 45(5): 398. CrossRef
Treatment for rectourethral fistulas after radical prostatectomy with biological material interposition through a perineal access
J.U. Juan Escudero, F. Villaba Ferrer, M. Ramos de Campos, M. Fabuel Deltoro, M.J. Garcia Coret, F. Sanchez Ballester, I. Povo Martín, Y. Pallas Costa, P. Pardo Duarte, J. García Ibañez, A. Monzó Cataluña, K. Rechi Sierra, C. Juliá Romero, E. Lopez Alcina
Actas Urológicas Españolas (English Edition).2021; 45(5): 398. CrossRef
A Curious Case of Rectal Ejaculation
Frank L Ventura, Christopher M Nguyen, Alexander Dang, Michelle Baliss, Lindsay K Sonstein
Cureus.2021;[Epub] CrossRef
Adverse Features of Rectourethral Fistula Requiring Extirpative Surgery and Permanent Dual Diversion: Our Experience and Recommendations
Francisco E. Martins, João Felicio, Tiago Ribeiro Oliveira, Natália Martins, Vítor Oliveira, Artur Palmas
Journal of Clinical Medicine.2021; 10(17): 4014. CrossRef
Fistelchirurgie
C. M. Rosenbaum, M. W. Vetterlein, M. Fisch
Der Urologe.2020; 59(4): 489. CrossRef
Conservative treatment of rectovesical fistula after leakage following laparoscopic radical resection of rectal cancer
Shunli Yan, Huimin Sun, Zhaohui Li, Shuaifeng Liu, Baowei Han
Journal of International Medical Research.2020;[Epub] CrossRef
A rare case of tubercular recto-prostatic urethral fistula with tuberculous orchitis
Niramya Pathak, Mohan Keshavamurthy, Karthik Rao, Shakir Tabrez, Mohan Balaiah Ashwathaiya, Premakumar Krishnappa
Urology Case Reports.2020; 33: 101355. CrossRef
Minimally invasive perineal redo surgery for rectovesical and rectovaginal fistulae: A case series
A.A.J. Grüter, S.E. Van Oostendorp, L.J.H. Smits, M. Kusters, M. Özer, J.A. Nieuwenhuijzen, J.B. Tuynman
International Journal of Surgery Case Reports.2020; 77: 733. CrossRef
Iatrogenic bowel injury (early vs delayed)
Elyse Leevan, Joseph C. Carmichael
Seminars in Colon and Rectal Surgery.2019; 30(3): 100688. CrossRef
Management of acquired rectourethral fistulas in adults
Shulian Chen, Rang Gao, Hong Li, Kunjie Wang
Asian Journal of Urology.2018; 5(3): 149. CrossRef
The Place of Transanal Endoscopic Surgery in the Treatment of Rectourethral Fistula
Xavier Serra-Aracil, Meritxell Labró-Ciurans, Laura Mora-López, Jesús Muñoz-Rodríguez, Raúl Martos-Calvo, Joan Prats-López, Salvador Navarro-Soto
Urology.2018; 111: 139. CrossRef
A Case of Rectourethal Fistula Caused by a Urethral Foreign Body
Nobuyuki OKAMOTO, Norimitsu SHIMADA, Raita YANO, Yusuke WATADANI, Hiroki OHGE, Taijiro SUEDA
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2017; 78(8): 1900. CrossRef
Diagnosis and Treatments for Vesico-Enteric Fistulas: a 2017 Current Review
Justin W. Fincher, Ehab Eltahawy
Current Bladder Dysfunction Reports.2017; 12(3): 212. CrossRef
Management of radiation-induced rectovesical fistula in a woman using ileum
Qiqi Mao, Jindan Luo, Jiajie Fang, Hai Jiang
Medicine.2017; 96(46): e8553. CrossRef
Treatment Efficacy of Different Surgical Procedures for Postoperative Residual Rectourethral Fistula Following Anoplasty
Tingchong Zhang, Wei Chen, Wenbo Pang, Chunhui Peng, Yajun Chen, Jinzhe Zhang
International Surgery.2017; 102(11-12): 560. CrossRef
Rectourethral fistula reconstruction in elderly patients
Nirmish Singla, Allen F. Morey
Current Opinion in Urology.2016; 26(2): 171. CrossRef
Rectourethral fistula: A challenging management problem
Michael Stamatakos, K. Ntzeros, G. Christis, F. Anyfanti, S. Sotirianakos
Hellenic Journal of Surgery.2016; 88(4): 257. CrossRef
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Harcharan S. Gill
Surgical Clinics of North America.2016; 96(3): 583. CrossRef
Minimally invasive treatment of rectovesical fistula: A case report
Alba Manuel Vázquez, Francisco Javier Jiménez Miramón, José Luis Ramos Rodríguez, José María Jover Navalón
Revista Española de Enfermedades Digestivas.2016;[Epub] CrossRef
Abordaje perineal de fístulas rectouretrales tras prostatectomía radical laparoscópica
J. Guimerà-García, E. Pieras-Ayala, J.P. Burgués-Gasion, M. Ozonas-Moragues, V. Tubau-Vidaña, P. Piza-Reus
Actas Urológicas Españolas.2016; 40(2): 119. CrossRef
Unusual Case of Urethrorectal Fistula in Adolescence in a Patient with a History of Congenital Anorectal Malformation
Constantinos Nastos, Ira Sotirova, Athanasios Papatsoris, Andreas Skolarikos, Ioannis Papaconstantinou, Athanasios Dellis
Journal of Endourology Case Reports.2016; 2(1): 24. CrossRef
Perineal approach for rectourethral fistulae after radical laparoscopic prostatectomy
J. Guimerà García, E. Pieras Ayala, J.P. Burgués Gasion, M. Ozonas Moragues, V. Tubau Vidaña, P. Piza Reus
Actas Urológicas Españolas (English Edition).2016; 40(2): 119. CrossRef
Testicular Interposition Flap for Repair of Perineal Urinary Fistulae: A Novel Surgical Technique
Valary T. Raup, Jairam R. Eswara, Stephen D. Marshall, Steven B. Brandes
Case Reports in Urology.2015; 2015: 1. CrossRef
Fístulas recto-uretrales adquiridas: etiopatogenia, diagnóstico y opciones terapéuticas
Carlos Cerdán Santacruz, Javier Cerdán Miguel
Cirugía Española.2015; 93(3): 137. CrossRef
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M E Schutzer, P F Orio, M C Biagioli, D A Asher, H Lomas, D Moghanaki
Prostate Cancer and Prostatic Diseases.2015; 18(2): 96. CrossRef
Acquired Recto-Uretral Fistulas: Etiopathogenesis, Diagnosis and Therapeutic Options
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Cirugía Española (English Edition).2015; 93(3): 137. CrossRef
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Alessandro Crestani, Fabrizio Dal Mora
Urologia Journal.2015; 82(1): 30. CrossRef
Individualized Treatment for a Rectourethral Fistula: Rare Complications
In Ja Park
Annals of Coloproctology.2014; 30(1): 7. CrossRef

Case Report

Operative Treatment with a Laparotomy for Anorectal Problems Arising from a Self-Inserted Foreign Body: Seung-Bum Ryoo, Heung-Kwon Oh, Heon-Kyun Ha, Eun Kyung Choe, Sang Hui Moon, Kyu Joo Park; J Korean Soc Coloproctol. 2012;28(1):56-60. Published online February 29, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.1.56

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Abstract PDF

An anorectal foreign body can cause serious complications such as incontinence, rectal perforation, peritonitis, or pelvic abscess, so it should be managed immediately. We experienced two cases of operative treatment for a self-inserted anorectal foreign body. In one, the foreign body could not be removed as it was completely impacted in the anal canal. We failed to remove it through the anus. A laparotomy and removal of the foreign body was performed by using an incision on the rectum. Primary colsure and a sigmoid loop colostomy were done. A colostomy take-down was done after three months. The other was a rectal perforation from anal masturbation with a plastic device. We performed primary repair of the perforated rectosigmoid colon, and we didea sigmoid loop colostom. A colostomy take-down was done three months later. Immediate and proper treatment for a self-inserted anorectal foreign body is important to prevent severe complications, and we report successful surgical treatments for problems caused by anorectal foreign bodies.

Citations

Citations to this article as recorded by

Rectal foreign bodies. Diagnostic program and emergency care
M. A. Egorkin, E. E. Bolkvadze, V. K. Obukhov, I. N. Gorbunov, M. Ya. Evloeev
Koloproktologia.2024; 23(4): 124. CrossRef
Treatment of rectal foreign bodies
D. A. Khubezov, S. N. Trushin, K. V. Puchkov, D. K. Puchkov, A. Yu. Ogorel’tsev
Khirurgiya. Zhurnal im. N.I. Pirogova.2016; (9): 57. CrossRef
Rectal perforation caused by a sharp pig backbone in a middle-aged patient with mild depression
Hyeong Ju Sun, Jeonghun Lee, Dong Min Kim, Myeong-Su Chu, Kyoung Sun Park, Dong Jin Choi
Yeungnam University Journal of Medicine.2015; 32(1): 31. CrossRef

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