Purpose This study aimed to demonstrate the safety of new double-stapling technique (nDST), without a crossing line and dog ears, by comparing with conventional DST (cDST) in laparoscopic low anterior resection (LAR).
Methods We retrospectively reviewed 98 consecutive patients who underwent laparoscopic LAR for rectal cancer from January 2018 to December 2020. The inclusion criterion was an anastomosis level below the peritoneal reflection and 4 cm above the anal verge. In the nDST group, the staple line of the linear cutter was sutured using barbed sutures to shorten the staple line before firing the circular stapler. Therefore, there were no crossing lines after firing the circular stapler. A 2:1 propensity score matching was performed between the cDST and nDST groups.
Results After propensity score matching, 39 patients were in the cDST group and 20 were in the nDST group. There were no significant differences in patient demographics between the 2 groups. There was no difference in the total operation time between the cDST and nDST groups (124.0±26.2 minutes vs. 125.2±20.3 minutes, P=0.853). Morbidity rates were similar between the 2 groups (9 cases [23.1%] vs. 5 cases [25.0%], P=0.855). There was no significant difference in leakage rate (4 cases [10.3%] vs. 1 case [5.0%], P=0.847) and anastomotic bleeding rate (1 case [2.6%] vs. 3 cases [15.0%], P=0.211).
Conclusion The nDST to eliminate the crossing line and dog ears in laparoscopic LAR is technically feasible and safe. However, more attention should be paid to anastomotic bleeding in such cases.
Citations
Citations to this article as recorded by
The robotic intracorporeal single-stapled anastomosis (RiSSA) technique in robotic left-sided colorectal resection: a technical note Chih-Chien Wu, Yung-Lin Tan, Chao-Wen Hsu, Hsin-Ping Tseng, Danilo Miskovic, Shih-Feng Huang Annals of Coloproctology.2025; 41(4): 357. CrossRef
Comparative perioperative outcomes of articulated versus conventional straight devices in laparoscopic low anterior resection: a propensity score–matched analysis Hayoung Lee, Yong Sik Yoon, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim Annals of Coloproctology.2025; 41(5): 434. CrossRef
Purpose Few studies have analyzed the effects of preoperative pain education on the postoperative decision to discharge. The purpose of this study was to determine the effects of pain education and management on the decision to discharge patients after single-incision laparoscopic appendectomy (SILA).
Methods We analyzed 135 patients who had undergone SILA for acute appendicitis between March 2017 and April 2018 in a single medical center. Of these, 72 patients (53.3%) had received preoperative pain education (group 1), and 63 (46.7%) had not (group 2). We compared perioperative outcomes and complications between the groups.
Results Baseline characteristics of sex, age, body mass index, American Society of Anesthesiologist score, and systemic inflammation factors (neutrophil-lymphocyte ratio, C-reactive protein level) did not differ significantly between the groups. There were no postoperative complications for patients in either group. Perioperative consequences and pathologic findings were not significantly different between the groups; however, length of hospital was significantly shorter in group 1.
Conclusion Preoperative pain education in relation to postoperative pain management influenced the decision to shorten the postoperative hospital length of stay after SILA.
Citations
Citations to this article as recorded by
Perioperative outcomes of laparoscopic low anterior resection using ArtiSential® versus robotic approach in patients with rectal cancer: a propensity score matching analysis I. K. Kim, C. S. Lee, J. H. Bae, S. R. Han, W. Alshalawi, B. C. Kim, I. K. Lee, D. S. Lee, Y. S. Lee Techniques in Coloproctology.2024;[Epub] CrossRef
Effect of continuous wound infiltration on patients using intravenous patient-controlled analgesia for pain management after reduced-port laparoscopic colorectal surgery Hyeon Deok Choi, Sung Uk Bae Annals of Coloproctology.2024; 40(6): 564. CrossRef
Relationship Between Appendectomy Incidence and Computed Tomography Scans Based on Korean Nationwide Data, 2003–2017 Ki Bum Park, Jinwook Hong, Jong Youn Moon, Jaehun Jung, Ho Seok Seo Journal of Korean Medical Science.2022;[Epub] CrossRef
Wound Irrigation Using Wet Gauze May Reduce Surgical Site Infection Following Laparoscopic Appendectomy Abdullah Al-Sawat, Ji Yeon Mun, Sung Hoon Yoon, Chul Seung Lee Frontiers in Surgery.2022;[Epub] CrossRef
Surgical rectus sheath block combined with multimodal pain management reduces postoperative pain and analgesic requirement after single-incision laparoscopic appendectomy: a retrospective study Won Jong Kim, Ji Yeon Mun, Hee Ju Kim, Sung-Hoon Yoon, Seung-Rim Han, Jung Hoon Bae, In Kyu Lee, Yoon Suk Lee, Do Sang Lee, Chul Seung Lee International Journal of Colorectal Disease.2021; 36(1): 75. CrossRef
Clinical effect of multimodal perioperative pain management protocol for minimally invasive colorectal cancer surgery: Propensity score matching study Chul Seung Lee, Soo Ji Park, Sang Hyun Hong, Jung-Woo Shim, Min Suk Chae, Seung-Rim Han, Jung Hoon Bae, In Kyu Lee, Dosang Lee, Yoon Suk Lee, Seong Taek Oh Asian Journal of Surgery.2021; 44(2): 471. CrossRef
Comparing the Postoperative Outcomes of Single-Incision Laparoscopic Appendectomy and Three Port Appendectomy With Enhanced Recovery After Surgery Protocol for Acute Appendicitis: A Propensity Score Matching Analysis Won Jong Kim, Hyeong Yong Jin, Hyojin Lee, Jung Hoon Bae, Wooree Koh, Ji Yeon Mun, Hee Ju Kim, In Kyu Lee, Yoon Suk Lee, Chul Seung Lee Annals of Coloproctology.2021; 37(4): 232. CrossRef
A laparoscopic colectomy in colorectal-cancer patients is usually associated with a high risk of postoperative nausea and vomiting (PONV). The purpose of this study is to evaluate the efficacy of injection of long-acting 5-hydroxytryptamine type 3 (5-HT3) receptor antagonist for the reduction of PONV in patients with colorectal cancer.
Methods
A total of 48 patients scheduled to undergo a laparoscopic colectomy for colorectal cancer were randomized in a double-blinded fashion. Patients were randomly allocated to 1 of 2 groups and assigned to receive either 0.3 mg of ramosetron intravenously (group A, n = 25) or 2 mL of normal saline (placebo) (group B, n = 22) immediately after the operation. The incidence of PONV, the nausea severity scale score, the visual analogue scale (VAS) score for pain, the total amount of patient-controlled analgesia used, the recovery of bowel function, and morbidities were assessed at 1 hour and at 24, 48, and 72 hours after surgery.
Results
The baseline and the operative characteristics were similar between the groups (P > 0.05). The number of cases without PONV (complete response) was higher for group A (ramosetron) than group B (normal saline): 24 hours after surgery, 92.0% (23 of 25) for group A versus 54.5% (12 of 22) for group B; 48 hours after surgery, 92% (23 of 25) for group A versus 81.8% (18 of 22) for group B (both P < 0.05). No serious adverse events occurred.
Conclusion
Postoperative ramosetron injection is effective for the prevention of PONV after a laparoscopic colectomy in colorectal-cancer patients.
Citations
Citations to this article as recorded by
Postoperative ileus after digestive surgery: Network meta‐analysis of pharmacological intervention Etienne Buscail, Thibault Planchamp, Guillaume Le Cosquer, Manon Bouchet, Julie Thevenin, Nicolas Carrere, Fabrice Muscari, Olivier Abbo, Charlotte Maulat, Ariane Weyl, Jean Pierre Duffas, Antoine Philis, Laurent Ghouti, Cindy Canivet, Jean Paul Motta, Na British Journal of Clinical Pharmacology.2024; 90(1): 107. CrossRef
Cost-effectiveness of prophylactic ramosetron in the prevention of postoperative nausea and vomiting David Suh, Dong-Won Kim, Seung-Mi Lee, Yu-Seon Jung, Sun-Young Jung, Chul-Min Kim, Kuo-Cherh Huang PLOS ONE.2024; 19(10): e0309592. CrossRef
A Clinical Risk Analysis of Postoperative Nausea and Vomiting After Colorectal Cancer Surgery Masatsugu Hiraki, Toshiya Tanaka, Mika Koga, Daisuke Miura, Eiji Sadashima, Hirofumi Sato, Shinji Mitsumizo, Kenji Kitahara Journal of Coloproctology.2022; 42(03): 203. CrossRef
Comparing the effects of continuous infusion of esmolol and ramosetron alone and in combination on nausea and vomiting after laparoscopic cholecystectomy: A prospective, randomized, double-blind study Jae Young Ji, Nan Seol Kim, Yong Han Seo, Ho Soon Jung, Hea Rim Chun, Jin Soo Park, Jeong Soo Choi, Jae Min Ahn, Woo Jong Kim Medicine.2022; 101(35): e30105. CrossRef
Levosulpiride and Ramosetron for the Prevention of Postoperative Nausea and Vomiting in Laparoscopic Surgery R. T. Ranjithkumar, Imran Sholapur, Ravi Bhat, C. Chandan Kumar Anesthesia Essays & Researches.2022; 16(3): 307. CrossRef
Reducing ileus after colorectal surgery: A network meta-analysis of therapeutic interventions James Ashcroft, Aminder Anthony Singh, Bhavna Ramachandran, Amir Habeeb, Victoria Hudson, Jeremy Meyer, Constantinos Simillis, Richard Justin Davies Clinical Nutrition.2021; 40(7): 4772. CrossRef
Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review Ofelia Loani Elvir-Lazo, Paul F. White, Roya Yumul, Hillenn Cruz Eng F1000Research.2020; 9: 983. CrossRef
Drugs for preventing postoperative nausea and vomiting in adults after general anaesthesia: a network meta-analysis Stephanie Weibel, Gerta Rücker, Leopold HJ Eberhart, Nathan L Pace, Hannah M Hartl, Olivia L Jordan, Debora Mayer, Manuel Riemer, Maximilian S Schaefer, Diana Raj, Insa Backhaus, Antonia Helf, Tobias Schlesinger, Peter Kienbaum, Peter Kranke Cochrane Database of Systematic Reviews.2020;[Epub] CrossRef
Postoperative nausea and vomiting in patients undergoing colorectal surgery within an institutional enhanced recovery after surgery protocol: comparison of two prophylactic antiemetic regimens Jennifer Holder-Murray, Stephen A Esper, Michael L Boisen, Julie Gealey, Katie Meister, David S Medich, Kathirvel Subramaniam Korean Journal of Anesthesiology.2019; 72(4): 344. CrossRef
The Niti CAR 27 (ColonRing) uses compression to create an anastomosis. This study aimed to investigate the safety and the effectiveness of the anastomosis created with the Niti CAR 27 in a laparoscopic anterior resection for sigmoid colon cancer.
Methods
In a single-center study, 157 consecutive patients who received an operation between March 2010 and December 2011 were retrospectively assessed. The Niti CAR 27 (CAR group, 63 patients) colorectal anastomoses were compared with the conventional double-stapled (CDS group, 94 patients) colorectal anastomoses. Intraoperative, immediate postoperative and 6-month follow-up data were recorded.
Results
There were no statistically significant differences between the two groups in terms of age, gender, tumor location and other clinical characteristics. One patient (1.6%) in the CAR group and 2 patients (2.1%) in the CDS group experienced complications of anastomotic leakage (P = 0.647). These three patients underwent a diverting loop ileostomy. There were 2 cases (2.1%) of bleeding at the anastomosis site in the CDS group. All patients underwent a follow-up colonoscopy (median, 6 months). One patient in the CAR group experienced anastomotic stricture (1.6% vs. 0%; P = 0.401). This complication was solved by using balloon dilatation.
Conclusion
Anastomosis using the Niti CAR 27 device in a laparoscopic anterior resection for sigmoid colon cancer is safe and feasible. Its use is equivalent to that of the conventional double-stapler.
Citations
Citations to this article as recorded by
New alternative colorectal anastomotic devices: A systematic review and meta-analysis T. Shakir, T. Pampiglione, M. Hassouna, P. Rogers, J. Dourado, S. Emile, R. Kokelaar, S. Wexner The American Journal of Surgery.2025; 240: 116128. CrossRef
Systematic Review and Meta-Analysis on Colorectal Anastomotic Techniques Jana Steger, Alissa Jell, Stefanie Ficht, Daniel Ostler, Markus Eblenkamp, Petra Mela, Dirk Wilhelm Therapeutics and Clinical Risk Management.2022; Volume 18: 523. CrossRef
A systematic analysis of controlled clinical trials using the NiTi CAR™ compression ring in colorectal anastomoses R. Tabola, R. Cirocchi, A. Fingerhut, A. Arezzo, J. Randolph, V. Grassi, G. A. Binda, V. D’Andrea, I. Abraha, G. Popivanov, S. Di Saverio, A. Zbar Techniques in Coloproctology.2017; 21(3): 177. CrossRef
Can a nickel–titanium memory-shape device serve as a substitute for the stapler in gastrointestinal anastomosis? A systematic review and meta-analysis Ning-Ning Li, Wen-Tao Zhao, Xiao-Ting Wu Journal of Surgical Research.2016; 201(1): 82. CrossRef
Efficacy and safety of a NiTi CAR 27 compression ring for end-to-end anastomosis compared with conventional staplers: A real-world analysis in Chinese colorectal cancer patients Zhenhai Lu, Jianhong Peng, Cong Li, Fulong Wang, Wu Jiang, Wenhua Fan, Junzhong Lin, Xiaojun Wu, Desen Wan, Zhizhong Pan Clinics.2016; 71(5): 264. CrossRef
The New Stapler Device Is Good, But Needs More Evaluation Young Wan Kim, Ik Yong Kim Annals of Coloproctology.2014; 30(2): 59. CrossRef
Recent literature has shown that lymph node ratio is superior to the absolute number of metastatic lymph nodes in predicting the prognosis in several malignances other than colorectal cancer. The aim of this study was to evaluate the prognostic significance of the lymph node ratio (LNR) in patients with stage III colorectal cancer.
Methods
We included 186 stage III colorectal cancer patients who underwent a curative resection over a 10-year period in one hospital. The cutoff point of LNR was chosen as 0.07 because there was significant survival difference at that LNR. The Kaplan-Meier and the Cox proportional hazard models were used to evaluate the prognostic effect according to LNR.
Results
There was statistically significant longer overall survival in the group of LNR > 0.07 than in the group of LNR ≤ 7 (P = 0.008). Especially, there was a survival difference for the N1 patients group (LN < 4) according to LNR (5-year survival of N1 patients was lower in the group of LNR > 0.07, P = 0.025), but there was no survival difference for the N2 group (4 ≥ LN) according to LNR. The multivariate analysis showed that the LNR is an independent prognostic factor.
Conclusions
LNR can be considered as a more accurate and potent modality for prognostic stratifications in patients with stage III colorectal cancer.
Citations
Citations to this article as recorded by
The prognostic performance of the log odds of positive lymph nodes in patients with esophageal squamous cell carcinoma: A population study of the US SEER database and a Chinese single‐institution cohort Hongdian Zhang, Wanyi Xiao, Peng Ren, Kai Zhu, Ran Jia, Yueyang Yang, Lei Gong, Zhentao Yu, Peng Tang Cancer Medicine.2021; 10(17): 6149. CrossRef
Lymph Node Ratio and Liver Metachronous Metastases in Colorectal Cancer Giovanni Li Destri, Giuseppe Privitera, Gaetano La Greca, Roberto Scilletta, Antonio Pesce, Teresa Rosanna Portale, Erminia Conti, Stefano Puleo International Surgery.2021; 105(1-3): 122. CrossRef
Rectal cancers with microscopic circumferential resection margin involvement (R1 resections): Survivals, patterns of recurrence, and prognostic factors Gianpiero Gravante, David Hemingway, James Andrew Stephenson, David Sharpe, Ahmed Osman, Melissa Haines, Vafa Pirjamali, Roberto Sorge, Justin Ming Yeung, Michael Norwood, Andrew Miller, Kirsten Boyle Journal of Surgical Oncology.2016; 114(5): 642. CrossRef
Prognostic Impact of the Metastatic Lymph Node Ratio on Survival in Rectal Cancer Wafi Attaallah, Omer Gunal, Manuk Manukyan, Gulden Ozden, Cumhur Yegen Annals of Coloproctology.2013; 29(3): 100. CrossRef
Prognostic Value of Total Lymph Node Identified and Ratio of Lymph Nodes in Resected Colorectal Cancer Leila Ghahramani, Leila Moaddabshoar, Samira Razzaghi, Sayed Hasan Hamedi, Saeedeh Pourahmad, Mohammad Mohammadianpanah Annals of Colorectal Research.2013; 1(3): 81. CrossRef
Prognostic Value of Lymph Node Ratios in Node Positive Rectal Cancer Treated with Preoperative Chemoradiation Jamal Jafari Nadoshan, Ramesh Omranipour, Omid Beiki, Kazem Zendedel, Abbas Alibakhshi, Habibollah Mahmoodzadeh Asian Pacific Journal of Cancer Prevention.2013; 14(6): 3769. CrossRef
Proposal of a New Classification for Stage III Colorectal Cancer Based on the Number and Ratio of Metastatic Lymph Nodes Li‐Ping Wang, Hong‐Yan Wang, Rui Cao, Cong Zhu, Xiong‐Zhi Wu World Journal of Surgery.2013; 37(5): 1094. CrossRef
An appraisal of lymph node ratio in colon and rectal cancer: not one size fits all M. Medani, Niall Kelly, George Samaha, G. Duff, Vourneen Healy, Elizabeth Mulcahy, Eoghan Condon, David Waldron, Jean Saunders, J. Calvin Coffey International Journal of Colorectal Disease.2013; 28(10): 1377. CrossRef
The lung is the second most common site of metastasis from colorectal cancer. Of all patients who undergo a curative resection for colorectal cancer, 10% to 15% will develop lung metastasis. As a hepatic resection of colorectal liver metastases results in improved survival, many reports have suggested that a pulmonary resection of a colorectal lung metastasis would also improve survival. The aim of this study was to analyze the postoperative outcomes of and the prognostic factors for a surgical resection of a lung metastasis.
Methods
Between August 1997 and March 2006, 27 patients underwent surgical resections for colorectal lung metastases at Seoul St. Mary's hospital. A retrospective review of patients' characteristics and various tumor factors was performed.
Results
The mean interval between colorectal resection and lung metastasis was 24.0 ± 15.1 months. The overall 3- and 5-year survival rates were 76.5% and 22.2%, respectively. The mean follow-up after pulmonary resection was 39.5 ± 21.6 months (range, 3.3 to 115 months). Except for the existence of hilar-lymph-node metastasis (P < 0.001), no risk factors that we studied were statistically significant. Two patients had hilar-lymph-node metastasis. They survived for only for 3.3- and 11.6-months, respectively.
Conclusion
In our study, we found that a pulmonary resection for metastases from colorectal cancer may improve survival in selected patients.
Citations
Citations to this article as recorded by
Prognostic factors of para-aortic lymph node metastasis from colorectal cancer in highly selected patients undergoing para-aortic lymph node dissection Shin Emoto, Yosuke Fukunaga, Manabu Takamatsu, Hiroshi Kawachi, Shuhei Sano, Tetsuro Tominaga, Toshiki Mukai, Tomohiro Yamaguchi, Toshiya Nagasaki, Takashi Akiyoshi, Tsuyoshi Konishi, Satoshi Nagayama, Masashi Ueno Surgery Today.2024; 54(4): 356. CrossRef
The Determinants of Long-Term Outcomes After Colorectal Cancer Surgery: A Literature Review Olorungbami K Anifalaje, Charles Ojo, Oluwaseyi T Balogun, Fikayo A Ayodele, Abeeb Azeez, Shirley Gabriels Cureus.2024;[Epub] CrossRef
Distant Lung Recurrence of Rectal Cancer 20 Years After Primary Surgery Sreekanthan Gobishangar, Sivakumaran Gobinath, Antony J Thanenthiran, Subramaniyam Bakeerathan Cureus.2023;[Epub] CrossRef
Pulmonary metastasectomy with lymphadenectomy for colorectal pulmonary metastases: A systematic review Martijn van Dorp, Jelle Egbert Bousema, Bart Torensma, Christian Dickhoff, Frank Jozef Christiaan van den Broek, Wilhelmina Hendrika Schreurs, Michel Gonzalez, Geert Kazemier, David Jonathan Heineman European Journal of Surgical Oncology.2022; 48(1): 253. CrossRef
Safety and efficacy of combined resection of colorectal peritoneal and liver metastases Stephanie Downs-Canner, Yongli Shuai, Lekshmi Ramalingam, James F. Pingpank, Matthew P. Holtzman, Herbert J. Zeh, David L. Bartlett, Haroon A. Choudry Journal of Surgical Research.2017; 219: 194. CrossRef
CT-guided percutaneous laser ablation of metastatic lung cancer: three cases report and literature review Qiyu Zhao, Guo Tian, Fen Chen, Liyun Zhong, Tian’an Jiang Oncotarget.2017; 8(2): 2187. CrossRef
Simultaneous Laparoscopic Resection for Synchronous Pulmonary Metastases of Colorectal Cancers Byung-Kwon Ahn Gastroenterology & Hepatology: Open Access.2016;[Epub] CrossRef
Tumors of the small bowel are rare, accounting for about 3-6% of all gastrointestinal neoplasms, though they cover more than 90% of the intestinal surface. However, diagnosis and treatment are difficult and present an ongoing challenge for both gastrointestinal surgeons and gastroenterologists. The aim of this study was to investigate the clinical features of small bowel tumors.
Methods
Between November 1994 and November 2007, 81 patients underwent treatments for primary tumors in the jejuno-ileal region at the Department of Surgery, Kangnam St. Mary's Hospital, the Catholic University of Korea. A retrospective review of the patients' characteristics and variable tumor factors was performed.
Results
The mean age of the patients was 53.2 years with 48 men and 33 women. The most common symptom was abdominal pain (59.3%), followed by bleeding (22.2%) and an abdominal mass (6.2%). We found that the patients with ileal tumors complained mainly of abdominal pain (72.9%) whereas the patients with jejunal tumors presented with gastrointestinal bleeding (36.4%) (P = 0.048). Seventy-six of the 81 patients (93.8%) had malignant tumors, including 40 (49.4%) gastrointestinal stromal tumors, 26 (32.1%) lymphomas and 5 (6.2%) adenocarcinomas. No postoperative mortalities were observed. The overall 5-year survival rate of the patients with malignant small bowel tumors was 31.8%.
Conclusion
Because the clinical features of a primary tumor of the small bowel are obscure and its diagnosis is difficult, maintaining a high degree of suspicion and recognizing the possibility of a primary small bowel tumor are important.
Citations
Citations to this article as recorded by
Symptoms Contributing to the Diagnosis of Small Bowel Tumors Kozo Tsuruta, Hidetoshi Takedatsu, Shinichiro Yoshioka, Masahiro Yoshikai, Kensuke Tomiyasu, Masaru Morita, Kotaro Kuwaki, Keiichi Mitsuyama, Takumi Kawaguchi Digestion.2023; 104(6): 430. CrossRef
Clinicopathologic features, surgical treatments and outcomes of small bowel tumors Anh Doanh Nguyen, Tu Hoang Le Vietnam Journal of Endolaparoscopic Surgey.2022;[Epub] CrossRef
Clinicopathological Features of Small Bowel Tumors Diagnosed by Video Capsule Endoscopy and Balloon-Assisted Enteroscopy: A Single Center Experience Ah Young Yoo, Beom Jae Lee, Won Shik Kim, Seong Min Kim, Seung Han Kim, Moon Kyung Joo, Hyo Jung Kim, Jong-Jae Park Clinical Endoscopy.2021; 54(1): 85. CrossRef
Small Bowel Adenocarcinoma – Report of Two Cases and Review of Literature Philip Umman, Vineeth Adiyodi, Chanchal Narayan Indian Journal of Surgery.2013; 75(2): 123. CrossRef
Les tumeurs malignes primitives de l’intestin grêle : à propos de 11 cas A. Farouk, A. Diffaa, R. Hafidi, F. Hlili, K. Krati Journal Africain d'Hépato-Gastroentérologie.2012; 6(4): 284. CrossRef
A Gastrointestinal Stromal Tumor Presenting as an Emergency: a Case Report Konstantinos Bouliaris, Aikaterini Michopoulou, Konstantinos Spanos, Vassilios Simopoulos, Ioannis Bolanis, Stylianos Germanos Journal of Gastrointestinal Cancer.2012; 43(S1): 178. CrossRef