Annals of Coloproctology

Original Articles

Anorectal physioloy

Risk factors associated with low anterior resection syndrome: a cross-sectional study: See Liang Lim, Wan Zainira Wan Zain, Zalina Zahari, Andee Dzulkarnaen Zakaria, Mohd Nizam Md Hashim, Michael Pak-Kai Wong, Zaidi Zakaria, Rosnelifaizur Ramely, Ahmad Shanwani Mohamed Sidek; Ann Coloproctol. 2023;39(5):427-434. Published online June 3, 2022; DOI: https://doi.org/10.3393/ac.2022.00227.0032

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Graphical Abstract Abstract PDF Supplementary Material

Purpose
Oncological outcomes following rectal cancer surgery have improved significantly over recent decades with lower recurrences and longer overall survival. However, many of the patients experienced low anterior resection syndrome (LARS). This study identified the prevalence and risk factors associated with the development of LARS.
Methods
This cross-sectional study involved patients who were diagnosed with rectal cancer and had undergone sphincter-preserving low anterior resection from January 2011 to December 2020. Upon clinic follow-up, patients were asked to complete an interviewed based questionnaire (LARS score) designed to assess bowel dysfunction after rectal cancer surgery.
Results
Out of 76 patients, 25 patients (32.9%) had major LARS, 10 patients (13.2%) had minor LARS, and 41 patients (53.9%) had no LARS. The height of tumor from anal verge showed an association with the development of major LARS (P=0.039). Those patients with less than 8 cm tumor from anal verge had an increased risk of LARS by 3 times compared to those with 8 cm and above (adjusted odds ratio, 3.11; 95% confidence interval, 1.06–9.13).
Conclusion
Results from our study show that low tumor height was a significant risk factor that has a negative impact on bowel function after surgery. The high prevalence of LARS emphasizes the need for study regarding risk factors and the importance of understanding the pathophysiology of LARS, in order for us to improve patient bowel function and quality of life after rectal cancer surgery.

Citations

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Score assessment and treatment in patients presenting with low anterior resection syndrome after sphincter-sparing rectal cancer surgery
R. Sguinzi, J. Fiechter, L. Bafumi, B. Gremaud, B. Geng, P. Janiak, L. Bühler, B. Egger
International Journal of Colorectal Disease.2025;[Epub] CrossRef
A randomized controlled trial of a digital lifestyle intervention involving postoperative patients with colorectal cancer
Young Il Kim, In Ja Park, Jun-Soo Ro, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Yura Lee, Yae Won Tak, Seockhoon Chung, Kyung Won Kim, Yousun Ko, Sung-Cheol Yun, Min-Woo Jo, Jong Won Lee
npj Digital Medicine.2025;[Epub] CrossRef
Comparative analysis of organ preservation attempt and radical surgery in clinical T2N0 mid to low rectal cancer
Hyeung-min Park, Jaram Lee, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
International Journal of Colorectal Disease.2024;[Epub] 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
Organ preservation for early rectal cancer using preoperative chemoradiotherapy
Gyung Mo Son
Annals of Coloproctology.2023; 39(3): 191. CrossRef
Low anterior resection syndrome: is it predictable?
Dong Hyun Kang
Annals of Coloproctology.2023; 39(5): 373. CrossRef

Benign diesease & IBD,Biomarker & risk factor,Minimally invasive surgery

Conversion rate and risk factors of conversion to open in laparoscopic appendicectomy: Nelson Rao Pushpanathan, Mohd Nizam Md Hashim, Zalina Zahari, Syed Hassan Syed Abd. Aziz, Wan Zainira Wan Zain, Rosnelifaizur Ramely, Michael Pak-Kai Wong, Ikhwan Sani Mohamad, Wan Mokhzani Wan Mokhter, Maya Mazuwin Yahya, Siti Rahmah Hashim Isa Merican, Zaidi Zakaria, Andee Dzulkarnaen Zakaria; Ann Coloproctol. 2022;38(6):409-414. Published online August 18, 2021; DOI: https://doi.org/10.3393/ac.2020.00437.0062

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Abstract PDF

Purpose
Laparoscopic appendicectomy (LA) has several advantages over conventional open appendicectomy (OA). However, about 5% to 10% of LA patients still need to be converted to open surgery. Identifying risk factors that contribute to conversion to OA allows for early identification of patients who may benefit from primary OA. This study aimed to determine the conversion rate of LA to OA and to identify its associated risk factors among patients with acute or perforated appendicitis.
Methods
A retrospective review of medical records was performed among patients with acute or perforated appendicitis who underwent LA between December 2015 and January 2017. With the use of multivariable logistic regression analyses, the predictors of conversion from laparoscopic to OA were investigated.
Results
Out of 120 patients, 33 cases were converted to OA which gives a conversion rate of 27.5%. Among 33 patients who were converted to OA, 27 patients (81.8%) had perforated appendix, while in the LA group, perforated appendix cases consisted of 34.5% (P<0.001). Histopathology of the appendix was the predictor of conversion from LA to OA (adjusted odds ratio, 8.82; 95% confidence interval, 3.13–24.91; P<0.001).
Conclusion
The result from our study shows that the overall conversion rate for the study period was high. Patients with perforated appendicitis had a higher risk of conversion to OA. Therefore, preoperative diagnosis of perforated appendicitis may be paramount in predicting conversion to OA.

Citations

Citations to this article as recorded by

Post-colonoscopy appendicitis: A systematic review
Kostas Tepelenis, Christos K. Stefanou, Stefanos K. Stefanou, Evangelos Sitos, Frideriki Steliou, Konstantinos Mpakas, Dimitra Lepida, Theocharis Chatzoglou, Thomas Iraklis Smyris, Maria Alexandra Kefala
Asian Journal of Surgery.2025; 48(1): 62. CrossRef
Laparoscopic appendectomy as the gold standard: What role remains for open surgery, conversion, and disease severity?
Claus Schildberg, Ulrike Weber, Volker König, Marius Linnartz, Sophie Heisler, Jennifer Hafkesbrink, Marcia Fricke, René Mantke
World Journal of Emergency Surgery.2025;[Epub] CrossRef
Controversies and Future Directions in Management of Acute Appendicitis: An Updated Comprehensive Review
Dushyant Singh Dahiya, Hamzah Akram, Aman Goyal, Abdul Moiz Khan, Syeda Shahnoor, Khawaja M. Hassan, Manesh Kumar Gangwani, Hassam Ali, Bhanu Siva Mohan Pinnam, Saqr Alsakarneh, Andrew Canakis, Abu Baker Sheikh, Saurabh Chandan, Amir Humza Sohail
Journal of Clinical Medicine.2024; 13(11): 3034. CrossRef
Comparison of Clinical, Pathological, and Procedural Characteristics of Adult and Pediatric Acute Appendicitis before and during the COVID-19 Pandemic
Goran Augustin, Jurica Žedelj, Karmen Jeričević, Nora Knez
Children.2024; 11(6): 641. CrossRef
Risk Factors for Conversion from Laparoscopic to Open Appendectomy
Bruno Leonardo Bancke Laverde, Matthias Maak, Melanie Langheinrich, Stephan Kersting, Axel Denz, Christian Krautz, Georg F. Weber, Robert Grützmann, Maximilian Brunner
Journal of Clinical Medicine.2023; 12(13): 4299. CrossRef
Risk of Conversion from Laparoscopic Appendectomy to Open Surgery: The Role of Clinical and Radiological Factors in Prediction
Nihan Turhan, Cengiz Duran, Taha Yusuf Kuzan, Beyza Nur Kuzan, Elbrus Zarbaliyev
Journal of Laparoendoscopic & Advanced Surgical Techniques.2023; 33(12): 1176. CrossRef
Conversion from Laparoscopic to Open Appendectomy: Trends, Risk Factors and Outcomes. A 15-Year Single-Center Analysis of 2193 Adult Patients
Manuela Monrabal Lezama, María A. Casas, Cristian A. Angeramo, Camila Bras Harriott, Francisco Schlottmann
World Journal of Surgery.2022; 46(11): 2642. CrossRef

Malignant disease, Rectal cancer

The Use of M2-Pyruvate Kinase as a Stool Biomarker for Detection of Colorectal Cancer in Tertiary Teaching Hospital: A Comparative Study: Shahidah Che Alhadi, Wan Zainira Wan Zain, Zalina Zahari, Mohd Nizam Md Hashim, Syed Hassan Syed Abd. Aziz, Zaidi Zakaria, Michael Pak-Kai Wong, Andee Dzulkarnaen Zakaria; Ann Coloproctol. 2020;36(6):409-414. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.08.27

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9 Citations

Abstract PDF

Purpose
Guaiac fecal occult blood test (gFOBT) has been the standard for colorectal screening but it has low sensitivity and specificity. This study evaluated the use of fecal tumor M2-pyruvate kinase (M2-PK) for detection of colorectal cancer and to compare with the current surveillance tool; gFOBT in symptomatic adult subjects underwent colonoscopy.
Methods
Stool samples were collected prospectively from symptomatic adults who had elective colonoscopy from September 2014 to January 2016 and were analyzed with the ScheBo M2-PK Quick test and laboratory detection of fecal hemoglobin.
Results
The results were correlated to the colonoscopy findings and/or histopathology report. Eighty-five subjects (age of 56.8 ± 15.3 years [mean ± standard deviation]) were recruited with a total of 17 colorectal cancer (20.0%) and 10 colorectal adenoma patients (11.8%). The sensitivity of M2-PK test in colorectal cancer detection was higher than gFOBT (100% vs. 64.7%). M2-PK test had a lower specificity when compared to gFOBT (72.5% vs. 88.2%) in colorectal cancer detection. The positive and negative predictive values were 47.2% and 100% for M2-PK test and 57.9% and 90.9% for gFOBT.
Conclusion
Fecal M2-PK Quick test has a high sensitivity for detection of colorectal cancer when compared to gFOBT, making it the potential choice for colorectal tumor screening biomarker in the future.

Citations

Citations to this article as recorded by

The Importance of Evaluating Serum Levels of Tumor Markers M2-PK and Inhibin A in Patients Undergoing Colonoscopy
Mahmood Khosravi, Ali Arash Anoushirvani, Zahedin Kheiri, Ali Rahbari, Ali Jadidi
Technology in Cancer Research & Treatment.2023;[Epub] CrossRef
Noninvasive fecal testing for colorectal cancer
Jianhua Zou, Zhanshuo Xiao, Yu Wu, Jingyan Yang, Ning Cui
Clinica Chimica Acta.2022; 524: 123. CrossRef
Comparison of faecal protein biomarkers' diagnostic accuracy for colorectal advanced neoplasms: a systematic review and meta-analysis
Atefeh Nasir Kansestani, Mohammad Erfan Zare, Qingchao Tong, Jun Zhang
Scientific Reports.2022;[Epub] CrossRef
Direction of diagnosis and treatment improvement in colorectal cancer
In Ja Park
Journal of the Korean Medical Association.2022; 65(9): 540. CrossRef
Epidemiology, risk factors, and prevention of colorectal cancer
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
Journal of the Korean Medical Association.2022; 65(9): 549. CrossRef
Epidemiology, Risk Factors, and Prevention of Colorectal Cancer-An English Version
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 231. CrossRef
Update on Diagnosis and Treatment of Colorectal Cancer
Chan Wook Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
Towards Novel Non-Invasive Colorectal Cancer Screening Methods: A Comprehensive Review
Allegra Ferrari, Isabelle Neefs, Sarah Hoeck, Marc Peeters, Guido Van Hal
Cancers.2021; 13(8): 1820. CrossRef
Genotypic and Phenotypic Characteristics of Hereditary Colorectal Cancer
Jin Cheon Kim, Walter F. Bodmer
Annals of Coloproctology.2021; 37(6): 368. CrossRef

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