Annals of Coloproctology

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Original Articles

Malignant disease,Prognosis and adjuvant therapy,Functional outcomes,Colorectal cancer,Postoperative outcome & ERAS

Clinical validation of implementing Enhanced Recovery After Surgery protocol in elderly colorectal cancer patients: Wooree Koh, Chul Seung Lee, Jung Hoon Bae, Abdullah Al-Sawat, In Kyu Lee, Hyeong Yong Jin; Ann Coloproctol. 2022;38(1):47-52. Published online July 21, 2021; DOI: https://doi.org/10.3393/ac.2021.00283.0040

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17 Web of Science
20 Citations

Purpose
The aim of this study was to evaluate the safety and feasibility of applying enhanced recovery after surgery (ERAS) protocol in elderly colorectal cancer patients.
Methods
The medical records of patients who underwent elective colorectal cancer surgery at our institution, from January 2017 to December 2017, were reviewed. Patients were divided into 2 groups: the young group (YG, patients aged 70 and under 70 years) and the old group (OG, patients over 70 years old). Perioperative outcomes and length of hospital stay were compared between both groups.
Results
In total, 335 patients were enrolled; 237 were YG and 98 were OG. Despite the poorer baseline characteristics of OG, the perioperative outcomes were similar. Length of hospital stay was not different between the groups (YG, 5 days vs. OG, 5 days; P=0.320). When comparing the postoperative complications using the comprehensive complication index (CCI), there was no significant difference (YG, 8.0±13.2 vs. OG, 11.7±23.0; P=0.130). In regression analysis, old age (>70 years) was not a risk factor for high CCI in all patients. In multivariate analysis, C-reactive protein (CRP) level on postoperative day (POD) 3 to 4 was the only strong predictive factor for high CCI in elderly patients.
Conclusion
Implementing the ERAS protocol in patients aged >70 years is safe and feasible. High CRP (≥6.47 mg/dL) on POD 3 to 4 can be used as a safety index to postpone discharge in elderly patients.

Citations

Citations to this article as recorded by

Practical Application of ERAS Protocols in Older Adults with Hepatocellular Carcinoma Undergoing Hepatectomy: A Propensity Score Matching Study
Hang Deng, Xiao-Qin Tong, Zi-Ang Jiang, Wan-Li Wu, Yan Dai, Jian Xu, Yu Zhang, Yao Zhou, Jun Gong, Xiang-Yu Lu, Wen-Jun Mi, Hao Zhang
Clinical Interventions in Aging.2026; Volume 21: 1. CrossRef
Impact of Enhanced Recovery After Surgery on factors affecting postoperative recovery in colorectal cancer: a multicenter propensity score–matched analysis
Yong Ki Jeong, In Kyeong Kim, Jung Hoon Bae, Hyeon-Min Cho, Yoon Suk Lee, Kil-Yong Lee, Ji Hoon Kim, Bong-Hyeon Kye, Won Kyung Kang, In Kyu Lee
Journal of Gastrointestinal Surgery.2026; 30(6): 102408. CrossRef
Application of Enhanced Recovery After Surgery in high-risk patients undergoing colon cancer surgery: a retrospective cohort study
Reem Mohammed H. Alshiakh, In Kyeong Kim, Jung Hoon Bae, Yoon Suk Lee, In Kyu Lee
Annals of Surgical Treatment and Research.2026; 110(4): 205. CrossRef
Correlation between inflammatory markers and enhanced recovery after surgery (ERAS) failure in laparoscopic colectomy
Ji Hyeong Song, Yoonsoo Shin, Kyung Ha Lee, Ji Yeon Kim, Jin Soo Kim
Surgery Today.2025; 55(10): 1353. CrossRef
Predicting venous thromboembolism and determining appropriate prophylaxis in elderly patients undergoing colorectal cancer surgery with Enhanced Recovery After Surgery (ERAS) using the adjusted Caprini score
Young Sun Choi, Hyung Jin Cho, Chul Seung Lee, Dong Geun Lee, Choon Sik Chung, Gwan Cheol Lee, Dong Woo Kang, Jeong Sub Kim, Tae Gyu Kim
Annals of Coloproctology.2025; 41(4): 279. CrossRef
Enhanced Recovery After Surgery (ERAS®) Protocol in Colorectal Resections: A Prospective Observational Study of Implementation and Outcomes at a Tertiary Referral Center
Nadeem Ahmad, Kanchan Sone Lal Baitha, Shashi S Pawar, Farhan Mohsin, Prem Prakash, Rishika Raj, Saptarshi Mondal
Cureus.2025;[Epub] CrossRef
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
Challenging issues of implementing enhanced recovery after surgery programs in South Korea
Soo-Hyuk Yoon, Ho-Jin Lee
Anesthesia and Pain Medicine.2024; 19(1): 24. CrossRef
Effects of the enhanced recovery after surgery (ERAS) protocol on the postoperative stress state and short‐term complications in elderly patients with colorectal cancer
He Han, Rong Wan, Jixiang Chen, Xin Fan, LiWen Zhang
Cancer Reports.2024;[Epub] CrossRef
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
Application of ERAS in older patients with gastric cancer
Kuanxuan You, He Han
Medicine.2024; 103(22): e38409. CrossRef
Clinical outcomes and future directions of enhanced recovery after surgery in colorectal surgery: a narrative review
Ji Hyeong Song, Minsung Kim
The Ewha Medical Journal.2024;[Epub] CrossRef
Beyond the Operating Room: A Narrative Review of Enhanced Recovery Strategies in Colorectal Surgery
Hamed Ibrahim Hamed Albalawi, Rawshan Khalid A Alyoubi, Nawaf Mohsen Mubarak Alsuhaymi, Farha Abdullah K Aldossary, Alkathiry Abdulrahman Mohammed G, Fayez Mubarak Albishi, Jumana Aljeddawi, Fedaa Ahmed Omar Najm, Neda Ahmed Najem, Mohamed Mirza Ali Alma
Cureus.2024;[Epub] CrossRef
Impact of Early Oral Feeding on Postoperative Outcomes after Elective Colorectal Surgery: A Systematic Review and Meta-Analysis
Soo Young Lee, Eon Chul Han
Digestive Surgery.2024; : 1. CrossRef
Enhanced recovery after colorectal surgery is a safe and effective pathway for older patients: a pooling up analysis
Xu-Rui Liu, Xiao-Yu Liu, Bin Zhang, Fei Liu, Zi-Wei Li, Chao Yuan, Zheng-Qiang Wei, Dong Peng
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Effects of preoperative bicarbonate and lactate levels on short-term outcomes and prognosis in elderly patients with colorectal cancer
Xiao-Yu Liu, Zi-Wei Li, Bin Zhang, Fei Liu, Wei Zhang, Dong Peng
BMC Surgery.2023;[Epub] CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
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
The Ewha Medical Journal.2023;[Epub] CrossRef
Future direction of Enhanced Recovery After Surgery (ERAS) program in colorectal surgery
In Ja Park
Annals of Coloproctology.2022; 38(1): 1. CrossRef
Implementation and improvement of Enhanced Recovery After Surgery protocols for colorectal cancer surgery
Bo Yoon Choi, Jung Hoon Bae, Chul Seung Lee, Seung Rim Han, Yoon Suk Lee, In Kyu Lee
Annals of Surgical Treatment and Research.2022; 102(4): 223. CrossRef

Benign GI diease,Benign diesease & IBD,Postoperative outcome & ERAS,Minimally invasive surgery

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; Ann Coloproctol. 2021;37(4):232-238. Published online September 30, 2020; DOI: https://doi.org/10.3393/ac.2020.09.15

9,025 View
122 Download
16 Web of Science
24 Citations

Abstract PDF

Purpose
The objective of this study was to compare the perioperative outcomes between single-incision laparoscopic appendectomy (SILA) and 3-port conventional laparoscopic appendectomy (CLA) in enhanced recovery after surgery (ERAS) protocol.
Methods
Of 101 laparoscopic appendectomy with ERAS protocol cases for appendicitis from March 2019 to April 2020, 54 patients underwent SILA with multimodal analgesic approach (group 1) while 47 patients received CLA with multimodal analgesic approach (group 2). SILA and CLA were compared with the single institution’s ERAS protocol. To adjust for baseline differences and selection bias, operative outcomes and complications were compared after propensity score matching (PSM).
Results
After 1:1 PSM, well-matched 35 patients in each group were evaluated. Postoperative hospital stays for patients in group 1 (1.2 ± 0.8 vs. 1.6 ± 0.8 days, P = 0.037) were significantly lesser than those for patients in group 2. However, opioid consumption (2.0 mg vs. 1.4 mg, P=0.1) and the postoperative scores of visual analogue scale for pain at 6 hours (2.4±1.9 vs. 2.8 ± 1.4, P = 0.260) and 12 hours (2.4 ± 2.0 vs. 2.9 ± 1.5, P = 0.257) did not show significant difference between the 2 groups.
Conclusion
SILA resulted in shortening the length of hospitalization without increase in complications or readmission rates compared to CLA with ERAS protocol.

Citations

Citations to this article as recorded by

Evolving Paradigms in Minimal Access Surgery: A Comprehensive Review of Single-Incision Laparoscopic Appendicectomy
Divyakant H Barot, Minesh Sindhal, Priyanka Aanandaka, Nidhi D Gheewala, Parmar Bhargav
Cureus.2026;[Epub] CrossRef
Meta-analysis of single-incision versus three-port laparoscopic appendectomy comparing operation time and postoperative pain
Kyung-Goo Lee, Min Ki Kim, Jong Seob Park, Areum Han, Seokyung Hahn
International Journal of Surgery.2026; 112(1): 1737. CrossRef
DaVinci SP robotic TEP hernia repair of a long-standing bilateral inguinal hernia using the "Hansol-roll" self-gripping mesh technique
Young Sun Choi, Gwan Chul Lee, Choon Sik Chung, Chul Seung Lee
Asian Journal of Surgery.2026;[Epub] CrossRef
Swedish national guidelines for diagnosis and management of acute appendicitis in adults and children
Martin Salö, Catarina Tiselius, Anders Rosemar, Elin Öst, Sara Sohlberg, Roland E Andersson
BJS Open.2025;[Epub] CrossRef
Single-incision versus conventional multi-incision laparoscopic appendicectomy for suspected uncomplicated appendicitis
Ahmer Irfan, Ahsan Rao, Irfan Ahmed
Cochrane Database of Systematic Reviews.2025;[Epub] CrossRef
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
Challenging issues of implementing enhanced recovery after surgery programs in South Korea
Soo-Hyuk Yoon, Ho-Jin Lee
Anesthesia and Pain Medicine.2024; 19(1): 24. CrossRef
A Single Site Approach to Appendicitis: A Review of a Single Center
Yoshito Tsuji, Yujiro Nishizawa, Yuki Ozato, Akira Inoue, Yoshinori Kagawa
Nippon Daicho Komonbyo Gakkai Zasshi.2024; 77(3): 161. CrossRef
The “Hansol-roll” folding method for placement of self-gripping (ProGrip™) mesh in single-port inguinal hernia repair using ArtiSential®
Gwan Chul Lee, Dong Woo Kang, Choon Sik Chung, Chul Seung Lee
Asian Journal of Surgery.2024; 47(7): 3272. CrossRef
Comparison between liquid skin adhesive and wound closure strip for skin closure after subcuticular suturing in single-port laparoscopic appendectomy: a single-center retrospective study in Korea
Kyeong Eui Kim, Yu Ra Jeon, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Journal of Minimally Invasive Surgery.2024; 27(1): 14. CrossRef
Progress in Clinical Treatment of Uncomplicated Acute Appendicitis in Children
珊白
Advances in Clinical Medicine.2024; 14(04): 471. CrossRef
Single-incision laparoscopic total extraperitoneal inguinal-hernia repair using the new articulating instruments: A video vignette
Chul Seung Lee, Gwan Chul Lee, Choon Sik Chung, Dong Keun Lee
Asian Journal of Surgery.2024; 47(8): 3586. CrossRef
Single-incision versus conventional multi-incision laparoscopic appendicectomy for suspected uncomplicated appendicitis
Ahmer Irfan, Ahsan Rao, Irfan Ahmed
Cochrane Database of Systematic Reviews.2024;[Epub] CrossRef
Clinical Outcomes of Single-incision Laparoscopic Appendectomy Versus Conventional Laparoscopic Appendectomy in Adult Acute Appendicitis
SHINTARO KOHAMA, KUNIHIKO NAGAKARI, MASAKAZU OHUCHI, KAZUHIRO TAKEHARA, KUMPEI HONJO, SHUN ISHIYAMA, KIICHI SUGIMOTO, SHINICHI OKA, JIRO YOSHIMOTO, MASAKI FUKUNAGA, YOICHI ISHIZAKI, KAZUHIRO SAKAMOTO
Juntendo Medical Journal.2024; 70(6): 436. CrossRef
Risk factors for prolonged hospitalization and delayed treatment completion after laparoscopic appendectomy in patients with uncomplicated acute appendicitis
Jiyoung Shin, Myong Hoon Ihn, Kyung Sik Kim, Sang Hyun Kim, Jihyoun Lee, Sangchul Yun, Sung Woo Cho
Annals of Coloproctology.2023; 39(1): 50. CrossRef
A prospective randomized controlled study comparing patient-reported scar evaluation of single-port versus multiport laparoscopic appendectomy for acute appendicitis
Kyeong Eui Kim, In Soo Cho, Sung Uk Bae, Woon Kyung Jeong, Hyung Jin Kim, Seong Kyu Baek
Journal of Minimally Invasive Surgery.2023; 26(2): 55. CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Analyzing the conversion factors associated with switching from a single-incision, one-puncture procedure to a two-site, three-port procedure in pediatric laparoscopic appendectomy
Keisuke Yano, Mitsuru Muto, Toshio Harumatsu, Taichiro Nagai, Masakazu Murakami, Chihiro Kedoin, Ayaka Nagano, Mayu Matsui, Koshiro Sugita, Shun Onishi, Koji Yamada, Waka Yamada, Makoto Matsukubo, Tatsuru Kaji, Satoshi Ieiri
Journal of Pediatric Endoscopic Surgery.2022; 4(2): 49. CrossRef
Laparoscopic Appendectomy Using the Surgical-Glove Port Through an Umbilical Incision: A Single-Center Retrospective Study
Tran Que Son, Tran Hieu Hoc, Vu Duc Long, Tran Thanh Tung, Nguyen Minh Tuan, Bui Minh Hue, Nguyen Van Minh, Nguyen Toan Thang
Cureus.2022;[Epub] CrossRef
Single-port robotic totally extraperitoneal(TEP) inguinal hernia repair using the da Vinci SP platform: A video vignette
Dongjun Kim, Chul Seung Lee
Asian Journal of Surgery.2022; 45(10): 2062. CrossRef
Single-incision compared with conventional laparoscopy for appendectomy in acute appendicitis: a systematic review and meta-analysis
Changjia Li, Yukun Liu, Yumin Jiang, Yongjing Xu, Zhiwei Wang
International Journal of Colorectal Disease.2022; 37(9): 1925. CrossRef
Enhanced recovery after surgery pathways for patients undergoing laparoscopic appendectomy
Abhijit Nair, Hamed Humayid Mohammed Al-Aamri, Osama Azmy Ishaq, Parwez Waseemul Haque
Journal of Acute Disease.2022; 11(5): 173. CrossRef
Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
Enhanced recovery after surgery: importance of compliance audits
Jung Hoon Bae
Journal of the Korean Medical Association.2021; 64(12): 820. CrossRef

Video

Malignant disease, Rectal cancer,Minimally invasive surgery,Surgical technique

Standardized Step-by-step Technique Using Surgical Landmarks in Robotic Lateral Pelvic Lymph Node Dissection: Jung Hoon Bae, Wooree Koh, Hyun Ho Kim, Yoon Suk Lee; Ann Coloproctol. 2021;37(1):58-60. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.08.05

10,721 View
291 Download
12 Web of Science
13 Citations

Abstract PDF Supplementary Material

We aimed to show that a standardized step-by-step robotic approach using surgical landmarks could make lateral pelvic lymph node dissection (LPND) less complicated. We performed robot-assisted LPND consisting of 4 steps using surgical landmarks. The first step is a dissection of uretero-hypogastric fascia, which envelopes the ureter and the hypogastric nerve. The second step is a dissection of the medial side of the external iliac vein located at the lateral border of the obturator lymph nodes (LNs) group. The third step is a dissection of the vesico-hypogastric fascia, which is at the medial border of the obturator LNs group. The final step is a dissection of the internal iliac artery until the Alcock’s canal. Indocyanine green was injected just before surgery around the dentate line to identify the lateral pelvic LNs. Standardization using a robotic approach for LPND guided by surgical landmarks allows a safer and more effective surgery.

Citations

Citations to this article as recorded by

The first video comparison of lateral pelvic lymph node dissection in rectal cancer: Laparoscopic approach using articulating instruments (ArtiSential) versus robotic Xi platform—A video vignette
In Kyeong Kim, Jung Hoon Bae, In Kyu Lee, Yoon Suk Lee
Colorectal Disease.2025;[Epub] CrossRef
MRI-based scoring systems for selective lateral lymph node dissection in locally advanced low rectal cancer after neoadjuvant chemoradiotherapy
Min Jeong Cho, Kyunghwa Han, Hye Jung Shin, Woong Sub Koom, Kang Young Lee, Joo Hee Kim, Joon Seok Lim
European Radiology.2025; 35(8): 4967. CrossRef
Short- and long-term outcomes of robot-assisted versus laparoscopic lateral lymph node dissection for rectal cancer
Daichi Kitaguchi, Tsuyoshi Enomoto, Kinji Furuya, Shuntaro Tsukamoto, Tatsuya Oda
Langenbeck's Archives of Surgery.2025;[Epub] CrossRef
Is lateral pelvic lymph node dissection necessary for good responder to neoadjuvant chemoradiation in locally advanced rectal cancer?
Jung Hoon Bae, Jumyung Song, Ji Hoon Kim, Bong-Hyeon Kye, In Kyu Lee, Hyeon-Min Cho, Yoon Suk Lee
Surgical Oncology.2025; 61: 102249. CrossRef
Was there any change in surgical treatment for colorectal cancer during the COVID-19 pandemic?
Yeajin Moon, Seung Hun Lee, Seung Hyun Lee
Kosin Medical Journal.2025; 40(3): 207. CrossRef
The use of indocyanine green for lateral lymph node dissection in rectal cancer—preliminary data from an emerging procedure: a systematic review of the literature
D. Kehagias, C. Lampropoulos, A. Bellou, I. Kehagias
Techniques in Coloproctology.2024;[Epub] CrossRef
Japanese expert consensus on the standardization of robot‐assisted pelvic lymph node dissection in urological surgery: Extent of pelvic lymph node and surgical technique
Shuichi Morizane, Jun Miki, Masaki Shimbo, Toru Kanno, Noriyoshi Miura, Yuta Yamada, Takeshi Yamasaki, Takashi Saika, Atsushi Takenaka
International Journal of Urology.2024; 31(12): 1300. CrossRef
Simplified approach to the medial internal iliac region using a uretero‐hypogastric nerve fascia development procedure for extended pelvic lymph node dissection during robot‐assisted radical prostatectomy for high‐risk prostate cancer
Masaki Shimbo, Takehiro Ohyama, Fumiyasu Endo, Kenji Komatsu, Yoko Kyono, Masayuki Sano, Kazutaka Narimoto, Kazunori Hattori
International Journal of Urology.2023; 30(2): 190. CrossRef
Lateral Lymph Node Size and Tumor Distance From Anal Verge Accurately Predict Positive Lateral Pelvic Lymph Nodes in Rectal Cancer: A Multi-Institutional Retrospective Cohort Study
Jung Hoon Bae, Jumyung Song, Ji Hoon Kim, Bong-Hyeon Kye, In Kyu Lee, Hyeon-Min Cho, Yoon Suk Lee
Diseases of the Colon & Rectum.2023; 66(6): 785. CrossRef
Robotic Lateral Pelvic Lymph Node Dissection Could Harvest More Lateral Pelvic Lymph Nodes over Laparoscopic Approach for Mid-to-Low Rectal Cancer: A Multi-Institutional Retrospective Cohort Study
Jung Hoon Bae, Jumyung Song, Ri Na Yoo, Ji Hoon Kim, Bong-Hyeon Kye, In Kyu Lee, Hyeon-Min Cho, Yoon Suk Lee
Biomedicines.2023; 11(6): 1556. CrossRef
Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer
In Ja Park
The Ewha Medical Journal.2023;[Epub] CrossRef
Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
Enhanced recovery after surgery: importance of compliance audits
Jung Hoon Bae
Journal of the Korean Medical Association.2021; 64(12): 820. CrossRef

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