Annals of Coloproctology

Original Article

Analysis of adenoma detection rate of colonoscopy among trainees: Young Min Song, Kyung Su Han, Byung Chang Kim, Chang Won Hong, Bun Kim, Min Chul Kim, Myeong Jae Jin, Dae Kyung Sohn; Received March 10, 2023 Accepted July 20, 2023 Published online August 28, 2024; DOI: https://doi.org/10.3393/ac.2023.00199.0028 [Epub ahead of print]

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Abstract PDF Supplementary Material: Purpose
To analyze adenoma detection rate (ADR) and related quality indicators of colonoscopy among trainees and make recommendations for appropriate colonoscopy training.
Methods
ADR and related indicators of colonoscopies performed by 3 trainees and 5 colonoscopy experts between March and November 2022 were analyzed. These indicators were analyzed in both the entire patients and the screening/surveillance group. In addition, the training period of the 3 trainees was divided into 3 sections, and the changes in these indicators were examined.
Results
The mean ADR of the 3 trainees was 50.6%. In the screening/surveillance group, the mean ADR of the 3 trainees was 51.8%, showing no significant difference from the experts' ADR (53.4%). When the training period was divided into 3 sections and analyzed in the screening/surveillance group, the mean ADR of the trainees gradually increased to 49.4%, 52.6%, and 53.6%, respectively; however, the difference was insignificant. Analyzing each trainee’s ADR, there was a significant difference among the 3 trainees (58.5% vs. 44.7% vs. 50.2%, P=0.008). However, in the third section of the training period, the 3 trainees’ ADRs were 53.0%, 49.2%, and 57.3%, respectively, showing no significant difference (P=0.606).
Conclusion
In the early stages of training, the ADR was higher than recommended; however, there were variances in ADR between individuals. As the training period passed, the ADR became similar at the expert level, whereas the difference in ADR between trainees decreased. Therefore, efforts to increase ADR should be made actively from the beginning of training and continued during the training period.

Reviews

AI colonoscopy

The imitation game: a review of the use of artificial intelligence in colonoscopy, and endoscopists’ perceptions thereof: Sarah Tham, Frederick H. Koh, Jasmine Ladlad, Koy-Min Chue, SKH Endoscopy Centre, Cui-Li Lin, Eng-Kiong Teo, Fung-Joon Foo; Ann Coloproctol. 2023;39(5):385-394. Published online March 10, 2023; DOI: https://doi.org/10.3393/ac.2022.00878.0125

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Abstract PDF: The development of deep learning systems in artificial intelligence (AI) has enabled advances in endoscopy, and AI-aided colonoscopy has recently been ushered into clinical practice as a clinical decision-support tool. This has enabled real-time AI-aided detection of polyps with a higher sensitivity than the average endoscopist, and evidence to support its use has been promising thus far. This review article provides a summary of currently published data relating to AI-aided colonoscopy, discusses current clinical applications, and introduces ongoing research directions. We also explore endoscopists’ perceptions and attitudes toward the use of this technology, and discuss factors influencing its uptake in clinical practice.

Malignant disease,Colorectal cancer,Biomarker & risk factor

Genotypic and Phenotypic Characteristics of Hereditary Colorectal Cancer: Jin Cheon Kim, Walter F. Bodmer; Ann Coloproctol. 2021;37(6):368-381. Published online December 22, 2021; DOI: https://doi.org/10.3393/ac.2021.00878.0125

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Abstract PDF

The genomic causes and clinical manifestations of hereditary colorectal cancer (HCRC) might be stratified into 2 groups, namely, familial (FCRC) and a limited sense of HCRC, respectively. Otherwise, FCRC is canonically classified into 2 major categories; Lynch syndrome (LS) or associated spectra and inherited polyposis syndrome. By contrast, despite an increasing body of genotypic and phenotypic traits, some FCRC cannot be clearly differentiated as definitively single type, and the situation has become more complex as additional causative genes have been discovered. This review provides an overview of HCRC, including 6 LS or associated spectra and 8 inherited polyposis syndromes, according to molecular pathogenesis. Variants and newly-identified FCRC are particularly emphasized, including MUTYH (or MYH)-associated polyposis, Muir-Torre syndrome, constitutional mismatch repair deficiency, EPCAM-associated LS, polymerase proofreading-associated polyposis, RNF43- or NTHL1-associated serrated polyposis syndrome, PTEN hamartoma tumor syndrome, and hereditary mixed polyposis syndrome. We also comment on the clinical utility of multigene panel tests, focusing on comprehensive cancer panels that include HCRC. Finally, HCRC surveillance strategies are recommended, based on revised or notable concepts underpinned by competent validation and clinical implications, and favoring major guidelines. As hereditary syndromes are mainly attributable to genomic constitutions of distinctive ancestral groups, an integrative national HCRC registry and guideline is an urgent priority.

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Seyed Mohsen Mirabdolhosseini, Leili Rejali, Mohammad Yaghoob Taleghani, Hossein Sadeghi, Seyed Mohammad Hossein Kashfi, Faeghe Behboudi Farahbakhsh, Mina Golmohammadi, Pegah Larki, Nayeralsadat Fatemi, Pardis Ketabi Moghadam, Ehsan Nazemalhosseini Mojara
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Case Report

Hidradenoma Papilliferum of the Anus: A Report of 2 Cases and Review of the Literature: Guh Jung Seo, Ju Heon Seo, Kyung Jin Cho, Hyung-Suk Cho; Ann Coloproctol. 2019;35(6):361-363. Published online December 31, 2019; DOI: https://doi.org/10.3393/ac.2018.08.03

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Abstract PDF

Hidradenoma papilliferum is a rare benign cystic tumor that originates from apocrine glands or anogenital mammary glands. Here, we describe 2 cases of hidradenoma papilliferum of the anus. Two female patients aged 39 and 35 presented with perianal masses with hemorrhoids. The patients underwent hemorrhoidectomy and excision of the lesion. Histopathology confirmed the masses as hidradenoma papilliferum. The postoperative course was uneventful for both patients, and there were no recurrences after 18 and 12 months of follow-up, respectively. Proctologists should consider hidradenoma papilliferum in their differential diagnosis of benign anal tumors. Surgical excision is necessary for diagnosis and treatment of hidradenoma papilliferum.

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Original Articles

Correlation Between Bowel Preparation and the Adenoma Detection Rate in Screening Colonoscopy: Jung Hun Park, Sang Jin Kim, Jong Hee Hyun, Kyung Su Han, Byung Chang Kim, Chang Won Hong, Sang-Jeon Lee, Dae Kyung Sohn; Ann Coloproctol. 2017;33(3):93-98. Published online June 30, 2017; DOI: https://doi.org/10.3393/ac.2017.33.3.93

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Abstract PDF

Purpose

The adenoma detection rate is commonly used as a measure of the quality of colonoscopy. This study assessed both the association between the adenoma detection rate and the quality of bowel preparation and the risk factors associated with the adenoma detection rate in screening colonoscopy.

Methods

This retrospective analysis involved 1,079 individuals who underwent screening colonoscopy at the National Cancer Center between December 2012 and April 2014. Bowel preparation was classified by using the Aronchick scale. Individuals with inadequate bowel preparations (n = 47, 4.4%) were excluded because additional bowel preparation was needed. The results of 1,032 colonoscopies were included in the analysis.

Results

The subjects' mean age was 53.1 years, and 657 subjects (63.7%) were men. The mean cecal intubation time was 6.7 minutes, and the mean withdrawal time was 8.7 minutes. The adenoma and polyp detection rates were 28.1% and 41.8%, respectively. The polyp, adenoma, and advanced adenoma detection rates did not correlate with the quality of bowel preparation. The multivariate analysis showed age ≥ 60 years (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.02–1.97; P = 0.040), body mass index ≥ 25 kg/m² (HR, 1.56; 95% CI, 1.17–2.08; P = 0.002) and current smoking (HR, 1.44; 95% CI, 1.01–2.06; P = 0.014) to be independent risk factors for adenoma detection.

Conclusion

The adenoma detection rate was unrelated to the quality of bowel preparation for screening colonoscopy. Older age, obesity, and smoking were independent risk factors for adenoma detection.

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Transanal Endoscopic Microsurgery for Patients With Rectal Tumors: A Single Institution's Experience: Audrius Dulskas, Alfredas Kilius, Kestutis Petrulis, Narimantas E. Samalavicius; Ann Coloproctol. 2017;33(1):23-27. Published online February 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.1.23

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Abstract PDF

Purpose

The purpose of this study was to look at our complication rates and recurrence rates, as well as the need for further radical surgery, in treating patients with benign and early malignant rectal tumors by using transanal endoscopic microsurgery (TEM).

Methods

Our study included 130 patients who had undergone TEM for rectal adenomas and early rectal cancer from December 2009 to December 2015 at the Department of Surgical Oncology, National Cancer Institute, Lithuania. Patients underwent digital and endoscopic evaluation with multiple biopsies. For preoperative staging, pelvic magnetic resonance imaging or endorectal ultrasound was performed. We recorded the demographics, operative details, final pathologies, postoperative lengths of hospital stay, postoperative complications, and recurrences.

Results

The average tumor size was 2.8 ± 1.5 cm (range, 0.5–8.3 cm). 102 benign (78.5%) and 28 malignant tumors (21.5%) were removed. Of the latter, 23 (82.1%) were pT1 cancers and 5 (17.9%) pT2 cancers. Of the 5 patients with pT2 cancer, 2 underwent adjuvant chemoradiotherapy, 1 underwent an abdominoperineal resection, 1 refused further treatment and 1 was lost to follow up. No intraoperative complications occurred. In 7 patients (5.4%), postoperative complications were observed: urinary retention (4 patients, 3.1%), postoperative hemorrhage (2 patients, 1.5%), and wound dehiscence (1 patient, 0.8%). All complications were treated conservatively. The mean postoperative hospital stay was 2.3 days.

Conclusion

TEM in our experience demonstrated low complication and recurrence rates. This technique is recommended for treating patients with a rectal adenoma and early rectal cancer and has good prognosis.

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The Outcome of Local Excision of Rectal Adenomas with High-Grade Dysplasia by Transanal Endoscopic Microsurgery: A Single-Center Experience
Muhammad Khalifa, Rachel Gingold-Belfer, Nidal Issa
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Transanal endoscopic rectal resection: immediate and long-term results
A.A. Maslov, Yu.A. Gevorkyan, N.V. Soldatkina, A.V. Dashkov, S.I. Poluektov, V.E. Kolesnikov, D.O. Kaymakchi, A.V. Snezhko
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Complex Procedures in Transanal Endoscopic Microsurgery: Intraperitoneal Entry, Ultra Large Rectal Tumors, High Lesions, and Resection in the Anal Canal
Xavier Serra-Aracil, Victoria Lucas-Guerrero, Laura Mora-López
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Multidisciplinary treatment strategy for early rectal cancer
Gyung Mo Son, In Young Lee, Sung Hwan Cho, Byung-Soo Park, Hyun Sung Kim, Su Bum Park, Hyung Wook Kim, Sang Bo Oh, Tae Un Kim, Dong Hoon Shin
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N. E. Samalavicius, P. Kavaliauskas, A. Dulskas
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Sheng Wang, Siyu Sun, Xiang Liu, Nan Ge, Guoxin Wang, Jintao Guo, Wen Liu, Jinlong Hu
Scandinavian Journal of Gastroenterology.2020; 55(3): 330. CrossRef
Is Previous Transanal Endoscopic Microsurgery for Early Rectal Cancer a Risk Factor of Worse Outcome following Salvage Surgery A Case-Matched Analysis
Audrius Dulskas, Aivaras Atkociunas, Alfredas Kilius, Kestutis Petrulis, Narimantas E. Samalavicius
Visceral Medicine.2019; 35(3): 151. CrossRef
Transanal endoscopic microsurgery for rectal lesions in a specialist regional early rectal cancer centre: the Mersey experience
M. Ondhia, P. Tamvakeras, P. O'Toole, A. Montazerri, T. Andrews, C. Farrell, S. Ahmed, S. Slawik, S. Ahmed
Colorectal Disease.2019; 21(10): 1164. CrossRef
Transanal Endoscopic Microsurgery for Patients with Rare Rectal Tumors
Xin Wu, Guole Lin, Huizhong Qiu, Jiaolin Zhou
Journal of Laparoendoscopic & Advanced Surgical Techniques.2018; 28(5): 546. CrossRef
Modern management of T1 rectal cancer by transanal endoscopic microsurgery: a 10‐year single‐centre experience
H. J. S. Jones, R. Hompes, N. Mortensen, C. Cunningham
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Transanal endoscopic microsurgery as day surgery – a single‐centre experience with 500 patients
C. J. Brown, J. Q. Gentles, T. P. Phang, A. A. Karimuddin, M. J. Raval
Colorectal Disease.2018;[Epub] CrossRef
Transanal Endoscopic Microsurgery
Byung Chun Kim
Annals of Coloproctology.2017; 33(1): 5. CrossRef
Transanal endoscopic microsurgery for giant benign rectal tumours: is large size a contraindication?
Audrius Dulskas, Alfredas Kilius, Kestutis Petrulis, Narimantas E. Samalavicius
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Association Between Exposure to Environmental Tobacco Smoke at the Workplace and Risk for Developing a Colorectal Adenoma: A Cross-Sectional Study: Seung-Hwa Lee, Ji-Yeon Hong, Jung-Un Lee, Dong Ryul Lee; Ann Coloproctol. 2016;32(2):51-57. Published online April 30, 2016; DOI: https://doi.org/10.3393/ac.2016.32.2.51

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Abstract PDF

Purpose

A colorectal adenoma (CRA) is a well-defined precursor to colorectal cancer (CRC). Additionally, smoking is a potent risk factor for developing a CRA, as well as CRC. However, the association between exposure to environmental tobacco smoke (ETS) and the risk for developing a CRA has not yet been fully evaluated in epidemiologic studies. We performed a cross-sectional analysis on the association between exposure to ETS at the workplace and the risk for developing a CRA.

Methods

The study was conducted on subjects who had undergone a colonoscopy at a health promotion center from January 2012 to December 2012. After descriptive analyses, overall and subgroup analyses by smoking status were performed by using a multivariate logistic regression.

Results

Among the 1,129 participants, 300 (26.6%) were diagnosed as having CRAs. Exposure to ETS was found to be associated with CRAs in all subjects (fully adjusted odds ratio [OR], 1.95; 95% confidence interval [CI], 1.08–2.44; P = 0.001). In the subgroup analysis, exposure to ETS in former smokers increased the risk for developing a CRA (fully adjusted OR, 4.44; 95% CI, 2.07–9.51; P < 0.001).

Conclusion

Exposure to occupational ETS at the workplace, independent of the other factors, was associated with increased risk for developing a CRA in all subjects and in former smokers. Further retrospective studies with large sample sizes may be necessary to clarify the causal effect of this relationship.

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Kiki Lukman, Arrayyan Muhammad, Mohammad Ghozali, Prapanca Nugraha, Yunia Sribudiani, Bistamy Muhammad Nursabur
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Metformin therapy and the risk of colorectal adenoma in patients with type 2 diabetes: A meta-analysis
Yi-Chao Hou, Qiang Hu, Jiao Huang, Jing-Yuan Fang, Hua Xiong
Oncotarget.2017; 8(5): 8843. CrossRef
Exposure to Cigarette Smoke Contributes to the Risk of Developing a Colorectal Adenoma, Doesn't It? Are Repeated Exposures to Such Smoke Dangerous?
Bong Hwa Lee, Min Jung Kim, Hyoung Chul Park
Annals of Coloproctology.2016; 32(2): 43. CrossRef

Case Report

Primary Retroperitoneal Mucinous Cystadenoma: Seok Youn Lee, Weon Cheol Han; Ann Coloproctol. 2016;32(1):33-37. Published online February 29, 2016; DOI: https://doi.org/10.3393/ac.2016.32.1.33

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Abstract PDF

Mucinous cystadenomas and cystadenocarcinomas of the ovary are clinically and histopathologically well-established common tumors. However, primary retroperitoneal mucinous cystic tumors are extremely rare, and although their histopathogenesis is still uncertain, several theories have been proposed. Most authors suggest that they develop through mucinous metaplasia in a preexisting mesothelium-lined cyst. An accurate preoperative diagnosis of these tumors is difficult because no effective diagnostic measures have been established. Delay in diagnosis and treatment of this tumor may be fatal for the patient because of complications such as rupture, infection, and malignant transformation. We describe the case of a 31-year-old woman with abdominal pain and a palpable mass. Computed tomography of the abdomen revealed a retroperitoneal cystic mass, which was resected successfully through laparoscopy. Histopathological examination of the resected mass confirmed the diagnosis of a primary retroperitoneal mucinous cystadenoma. The patient was discharged on postoperative day 5 without any complications.

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International Journal of Surgery Case Reports.2019; 61: 242. CrossRef
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Filippo Pesapane, Sofie Van Renterghem, Francesca Patella, Pieter De Visschere, Geert Villeirs
Future Oncology.2018; 14(28): 2923. CrossRef
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Original Article

Distribution of the Colonoscopic Adenoma Detection Rate According to Age: Is Recommending Colonoscopy Screening for Koreans Over the Age of 50 Safe?: Taeseok Bae, Yunhyung Ha, Changkyun Kim, Jihyun Lee, Kwangil Ha, Sanghyun Shin, Youngcheol Lee, Yoonsik Kang; Ann Coloproctol. 2015;31(2):46-51. Published online April 30, 2015; DOI: https://doi.org/10.3393/ac.2015.31.2.46

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Abstract PDF

Purpose

This study was conducted to determine the distributions of the polyp detection rate (PDR) and the adenoma detection rate (ADR) according to age by analyzing the polypectomy results.

Methods

A total of 10,098 patients who underwent a colonoscopy in 2013 were included in this study. Chi-square and logistic regression statistical analyses were performed using SPSS ver. 19.

Results

The mean age of the patients was 52.7 years old (median, 54 ± 12.52 years; range, 14 to 92 years). A total of 6,459 adenomatous polyps (61.7%) from a total of 10,462 polyps were eliminated. The PDR was 50.9% (5,136/10,098), and the. ADR was 35.4% (3,579/10,098). The male-to-female ratio was 51.3%:48.7%, with a male-to-female ADR ratio of 42.8% : 27.7% (P < 0.001). In the age distribution, the values of the ADR were 0% for patients in their 10's, 6.3% for those in their 20's, 14.0% for those in their 30's, 28.7% for those in their 40's, 38.4% for those in their 50's, 46.2% for those in their 60's, 55.8% for those in their 70's, 56.1% for those in their 80's, and 33.3% for those in their 90's. In males, the values of the ADR were 0%, 9.1%, 17.1%, 37.8%, 48.2%, 53.6%, 61.7%, 59.1%, and 33.3% for the same age distribution, and a steep increase was found between patients in their 30's and patients in their 40's. Significant (P < 0.001) factors influencing the ADR included sex, previous colonoscopy experience, polypectomy method, and age of more than 40 years.

Conclusion

In considering the adenoma carcinoma sequence, 28.7% of people, especially 37.8% of males in their 40's showed adenomatous polyps. Whether an earlier first-time colonoscopy will have better results in preventing colorectal cancer should be investigated and discussed.

Citations

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Adenoma Detection Rate in Average-Risk Population: An Observational Consecutive Retrospective Study
Xiaoyan He, Xiangyin Lv, Binbin Zhang, Xiaoxuan Ying, Chiyu Hu, Xiaoying Zhou, Jianwen Hu
Cancer Control.2023;[Epub] CrossRef
Adenoma Detection Rates in 45-49 Year Old Persons Undergoing Screening Colonoscopy: Analysis from the GIQuIC Registry
Mohammad Bilal, Jennifer Holub, David Greenwald, Mark B. Pochapin, Douglas K. Rex, Aasma Shaukat
American Journal of Gastroenterology.2022;[Epub] CrossRef
Adenoma Detection Rate in Colonoscopic Screening with Ketamine-based Sedation: A Prospective Observational Study
Mirza KOVACEVIC, Nermina RIZVANOVIC, Adisa SABANOVIC ADILOVIC, Nedim BARUCIJA, Anida ABAZOVIC
Medeniyet Medical Journal.2022; 37(1): 79. CrossRef
Gastrointestinal Disease in Patients with Common Variable Immunodeficiency: A Retrospective Observational Study
Rishad Khan, Mohamad Habbal, Michael A Scaffidi, Abbas A Bukhari, Amir Rumman, Sarah Al Ghamdi, Stephen D Betschel, Samir C Grover
Journal of the Canadian Association of Gastroenterology.2020; 3(4): 162. CrossRef
Global patterns and trends in colorectal cancer incidence in young adults
Rebecca L Siegel, Lindsey A Torre, Isabelle Soerjomataram, Richard B Hayes, Freddie Bray, Thomas K Weber, Ahmedin Jemal
Gut.2019; 68(12): 2179. CrossRef
Anatomical distribution and detection rate of colorectal neoplasms according to age in the colonoscopic screening of a Korean population
Suk-young Lee, Wan Hee Song, Sang Cheul Oh, Byung-Wook Min, Sun Il Lee
Annals of Surgical Treatment and Research.2018; 94(1): 36. CrossRef
An Adjusted Level of Adenoma Detection Rate is Necessary for Adults Below 50 Years Old
Jin Young Yoon, Jae Myung Cha, Jeong Eun Shin, Kyeong Ok Kim, Hyo-Joon Yang, Hyun Gun Kim, Young-Seok Cho, Sun-Jin Boo, Jun Lee, Yunho Jung, Hyun Jung Lee, Hoon Sup Koo, Young-Eun Joo
Journal of Clinical Gastroenterology.2018; 52(8): 703. CrossRef
Adenoma Detection before and after the age of 50: a retrospective analysis of Lebanese outpatients
Mohammed Hussein Kamareddine, Youssef Ghosn, Karam Karam, Anwar Andrew Nader, Ahmad El-Mahmoud, Naseem Bou-Ayash, Mansour El-Khoury, Said Farhat
BMJ Open Gastroenterology.2018; 5(1): e000253. CrossRef
LINE-1 is preferentially hypomethylated within adenomatous polyps in the presence of synchronous colorectal cancer
Alice Chu Jiang, Lela Buckingham, William Barbanera, Amoah Yeboah Korang, Faraz Bishesari, Joshua Melson
Clinical Epigenetics.2017;[Epub] CrossRef
Risks of colorectal advanced neoplasia in young adults versus those of screening colonoscopy in patients aged 50 to 54 years
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The Korean Journal of Gastroenterology.2016; 67(2): 87. CrossRef
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Adenoma Detection Rate in Patients Younger Than 50 Years of Age: Relationship of the Adenoma Detection Rate to Interval Cancer
In Ja Park
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Case Report

Regression of Colonic Adenomas After Treatment With Sulindac in Familial Adenomatous Polyposis: A Case With a 2-Year Follow-up Without a Prophylactic Colectomy: Kyu Young Kim, Seong Woo Jeon, Jung Gil Park, Chung Hoon Yu, Se Young Jang, Jae Kwang Lee, Hee Young Hwang; Ann Coloproctol. 2014;30(4):201-204. Published online August 26, 2014; DOI: https://doi.org/10.3393/ac.2014.30.4.201

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6 Citations

Abstract PDF

Familial adenomatous polyposis (FAP) is an autosomal dominant disorder characterized by hundreds of colorectal adenomatous polyps that progress to colorectal cancer. Management of patients with FAP is with a total colectomy. Chemopreventive strategies have been studied in FAP patients in an effort to delay the development of adenomas in the upper and the lower gastrointestinal tract and to prevent recurrence of adenomas in the retained rectum of patients after prophylactic surgery. Sulindac, a nonsteroidal anti-inflammatory drug, causes regression of colorectal adenomas in the retained rectal segment of FAP patients. However, evidence regarding long-term use of this therapy and its effect on the intact colon has been insufficient. We report a case in which the long-term use of sulindac was effective in reducing the size and the number of colonic polyps in patients with FAP without a prophylactic colectomy and polypectomy; we also present a review of the literature.

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Surgical Decision-Making in Familial Adenomatous Polyposis
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Cancer-preventive Properties of an Anthocyanin-enriched Sweet Potato in the APCMIN Mouse Model
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Endogenous conversion of ω-6 to ω-3 polyunsaturated fatty acids infat-1 mice attenuated intestinal polyposis by either inhibiting COX-2/β-catenin signaling or activating 15-PGDH/IL-18
Young-Min Han, Jong-Min Park, Ji-Young Cha, Migyeong Jeong, Eun-Jin Go, Ki Baik Hahm
International Journal of Cancer.2016; 138(9): 2247. CrossRef
NOSH-sulindac (AVT-18A) is a novel nitric oxide- and hydrogen sulfide-releasing hybrid that is gastrointestinal safe and has potent anti-inflammatory, analgesic, antipyretic, anti-platelet, and anti-cancer properties
Khosrow Kashfi, Mitali Chattopadhyay, Ravinder Kodela
Redox Biology.2015; 6: 287. CrossRef
Sulindac

Reactions Weekly.2015; 1570(1): 198. CrossRef

Original Articles

Importance of Early Follow-up Colonoscopy in Patients at High Risk for Colorectal Polyps: Sung Taek Jung, Dae Kyung Sohn, Chang Won Hong, Byung Chang Kim, Ji Won Park, Kyung Su Han, Hee Jin Chang, Hyo Sung Choi, Jae Hwan Oh; Ann Coloproctol. 2013;29(6):243-247. Published online December 31, 2013; DOI: https://doi.org/10.3393/ac.2013.29.6.243

3,468 View
27 Download
5 Citations

Abstract PDF

Purpose

Minimizing the polyp miss rate during colonoscopy is important for patients at high risk for colorectal polyps. We investigated the polyp miss rate and the factors associated with it in high-risk patients.

Methods

The medical records of 163 patients who underwent follow-up colonoscopy between January 2001 and April 2010, which was within 9 months after a polypectomy, because the index colonoscopy had shown multiple (more than 3) adenomas or advanced adenoma were retrospectively reviewed. Miss rates were calculated for all polyps, for neoplastic polyps and for advanced adenomas. Factors associated with the miss rates in these patients, such as the location, shape and size of the polyp, were analyzed.

Results

The miss rates for polyps, adenomas, adenomas <5 mm, adenomas ≥5 mm and advanced adenomas were 32.6%, 20.9%, 17.7%, 3.2%, and 0.9%, respectively. No carcinoma, except for one small carcinoid tumor, was missed. Flat shape and small size (<5 mm) were significantly associated with adenoma miss rate. The miss rate was significantly higher for flat-type advanced adenomas than for protruded-type advanced adenomas (27.7% vs 4.1%).

Conclusion

The polyp miss rate in patients at high risk for colorectal polyps was higher than expected. Efforts are needed to reduce miss rates and improve the quality of colonoscopy. Also, early follow-up colonoscopy is mandatory, especially in patients at high risk.

Citations

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Removal of GIT lesions and the role of impedance of the injection solution—an innovative approach to known methods
Martina Lösle, K. E. Grund, B. Duckworth-Mothes
Journal of Molecular Medicine.2024; 102(8): 1009. CrossRef
An eco-friendly synthesis of Enterococcus sp.–mediated gold nanoparticle induces cytotoxicity in human colorectal cancer cells
Mathivadani Vairavel, Ezhilarasan Devaraj, Rajeshkumar Shanmugam
Environmental Science and Pollution Research.2020; 27(8): 8166. CrossRef
Evaluating the Cost-Effective Use of Follow-Up Colonoscopy Based on Screening Findings and Age
Grace N. Joseph, Farid Heidarnejad, Eric A. Sherer
Computational and Mathematical Methods in Medicine.2019; 2019: 1. CrossRef
Impact of a new distal attachment on colonoscopy performance in an academic screening center
Zacharias P. Tsiamoulos, Ravi Misra, Rajaratanam Rameshshanker, Timothy R. Elliott, Iosif Beintaris, Siwan Thomas-Gibson, Adam Haycock, Noriko Suzuki, Colin Rees, Brian P. Saunders
Gastrointestinal Endoscopy.2018; 87(1): 280. CrossRef
What Matters in Colonoscopy?
Hyun Shig Kim
Annals of Coloproctology.2013; 29(6): 223. CrossRef

Incidence and Multiplicities of Adenomatous Polyps in TNM Stage I Colorectal Cancer in Korea: Young-Sang Hong, Eun-Joo Jung, Chun-Geun Ryu, Gang-Mi Kim, Su-Ran Kim, Sung-Noh Hong, Dae-Yong Hwang; J Korean Soc Coloproctol. 2012;28(4):213-218. Published online August 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.4.213

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1 Citations

Abstract PDF

Purpose

In recent years, the incidence of early-stage colorectal cancer (CRC) has markedly increased in the population within the Republic of Korea. The aim of this study was to evaluate the clinicopathologic features of adenomatous polyps in TNM stage I CRC patients and in the general population.

Methods

Between March 2003 and September 2009, 168 patients with stage I CRC were enrolled in this study. In addition, the records of 4,315 members of the general population without CRC, as determined by colonoscopy during a health check-up, were reviewed.

Results

Of the 168 patients with stage I CRC, 68 (40.5%) had coexisting colorectal adenomatous polyps and of the 4,315 members of the general population, 1,112 (26.0%) had coexisting adenomatous polyps (P = 0.006). The prevalences of adenomatous polyp multiplicity in early CRC and in the general population were 32% and 15%, respectively (P = 0.023). Patients with coexisting adenomatous polyps had a higher frequency of tubulovillous or villous adenomas than members of the general population with polyps (7.5% vs. 2.0%, P = 0.037). Furthermore, a subgroup analysis showed that the occurrence (44% vs. 34%, P = 0.006) and the multiplicity (32% vs. 15%, P = 0.023) of adenomatous polyps were greater for T2 than T1 cancer.

Conclusion

The prevalence and the multiplicity of adenomatous polyps in TNM stage I CRC is higher than it is in the general population. The findings of this study suggest that depth of invasion of early stage CRC affects the prevalence and the number of adenomatous polyps in the remaining colon and rectum.

Citations

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Risk factors of recurrence in TNM stage I colorectal cancer
Jin-Hee Paik, Chun-Geun Ryu, Dae-Yong Hwang
Annals of Surgical Treatment and Research.2023; 104(5): 281. CrossRef

Efficacy of Transparent Cap-attached Colonoscopy: Does It Improve the Quality of Colonoscopy?.: Choi, Dong Hyun , Shin, Hyeon Keun , Lee, Young Chan , Lim, Cheong Ho , Jeong, Seung Kyu , Lee, Suk Hwan , Yang, Hyung Kyu; J Korean Soc Coloproctol. 2010;26(2):116-122.; DOI: https://doi.org/10.3393/jksc.2010.26.2.116

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8 Citations

Abstract PDF

PURPOSE
Recently, the use of a transparent cap attached to the tip of the colonoscope has been revealed to be helpful in both detecting colorectal polyps and shortening the intubation time to the cecum. The aim of this study was to examine the usefulness of transparent cap-attached colonoscopy (CAC) as compared with conventional colonoscopy (CC) in terms of the technical ease and efficiency.
METHODS
Colonoscopies from a total of 228 patients between May and October 2008 were prospectively collected. All colonoscopies were performed by single colorectal surgeon whose experience exceeded 3,000 colonoscopies. Patients were assigned to the CAC group (n=114) or to the CC group (n=114). The cecal intubation rate and time, the polyp detection rate, the adenoma detection rate, the withdrawal time, and the visual analogue scale (VAS) of the patient's pain were compared.
RESULTS
There were no significant differences in the age, sex, body mass index, previous history of abdominal operation, diverticulosis, and the degree of bowel preparation between the two groups. The cecal intubation rate was 100% in both groups. The cecal intubation time was significantly shorter in the CAC group than in the CC group overall (5.3+/-4.0 min vs. 7.6+/-4.3 min, P<0.001), as well as for female (6.1+/-2.8 min vs. 9.1+/-4.7 min, P<0.001) patients. There were no statistically significant differences in the total colonoscopy time (13.1+/-6.3 min vs. 14.5+/-5.2 min, P=0.066), the polyp detection rate (38.6% vs. 33.3%, P=0.408), the adenoma detection rate (28.1% vs. 25.4%, P=0.654), and the VAS scale of pain (2.48 vs. 2.74, P=0.353) between the CAC and the CC groups.
CONCLUSION
The transparent cap is effective in shortening the cecal intubation time, especially in female patients.

Citations

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Cap-assisted endoscopy: Do we have enough evidence?
Thomas Frieling
Endoscopy International Open.2018; 06(10): E1224. CrossRef
Improving the utility of colonoscopy: Recent advances in practice
Crispin J Corte, Rupert W Leong
Journal of Gastroenterology and Hepatology.2016; 31(1): 32. CrossRef
The Effect of Indigocarmine on Improvement of the Polyp Detection Rate during Colonoscopic Examination with Hood Cap
Sang Chang Kwon, Sung Won Choi, Seong Ho Choi, Hee Seung Park, Seung Heon Lee, Bong Gun Kim, Eun Hee Seo, Mun Jang, Seung Min Ryu, Dong Hyun Kim, Young Hoon Kim, Jun Ouk Ha, Jae Seung Lee
Intestinal Research.2014; 12(1): 60. CrossRef
Image-enhanced, chromo, and cap-assisted colonoscopy for improving adenoma/neoplasia detection rate: a systematic review and meta-analysis
Fumio Omata, Sachiko Ohde, Gautam A. Deshpande, Daiki Kobayashi, Katsunori Masuda, Tsuguya Fukui
Scandinavian Journal of Gastroenterology.2014; 49(2): 222. CrossRef
Transparent cap colonoscopy versus standard colonoscopy: a systematic review and meta-analysis
Jenna L. Morgan, Kathryn Thomas, Sarah Braungart, Richard L. Nelson
Techniques in Coloproctology.2013; 17(4): 353. CrossRef
Can Cap-Assisted Colonoscopy Be a Savior for Right Side Interval Cancer?
Hyung Hun Kim
Digestive Diseases and Sciences.2013; 58(2): 289. CrossRef
Efficacy of Hood-cap Assisted Colonoscopy; Comparison with Conventional Colonoscopy
Sung Won Choi, Hee Seung Park, Jae Seung Lee, Sang Yon Hwang, Sung Dong Kwak, Seong Ho Choi
Intestinal Research.2012; 10(3): 280. CrossRef
Transparent Cap Colonoscopy versus Standard Colonoscopy to Improve Caecal Intubation
Jenna Morgan, Kathryn Thomas, Heather Lee-Robichaud, Richard L Nelson, Sarah Braungart
Cochrane Database of Systematic Reviews.2012;[Epub] CrossRef

Case Report

Adult Sigmoido-recto-anal Intussusception by a Sigmoid Colon Adenoma.: Park, Young Jin; J Korean Soc Coloproctol. 2009;25(2):121-124.; DOI: https://doi.org/10.3393/jksc.2009.25.2.121

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Abstract PDF

Although rectal procidentia is not an uncommon disease, presentation of more proximal segments of the large bowel through the anus is extremely rare. A case with sigmoido-recto-anal prolapse secondary to a large adenoma of the sigmoid colon is reported herein. A 28-yr-old man with an anal prolapsing mass was admitted to our hospital. Preoperative CT scan showed a sigmoid-recto-anal prolapse. An emergency operation was decided upon because the prolapsed segment was irreducible and because its viability was questionable. After a manual reduction of the mass, an anterior resection was performed under general anesthesia. The pathologic diagnosis of the resected specimen was a large villo-tubular adenoma.

Citations

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Laparoscopic Treatment of Adult Sigmoidorectal Intussusception Caused by a Mucinous Adenocarcinoma of the Sigmoid Colon: A Case Report
Seok Youn Lee, Won Cheol Park, Jeong Kyun Lee, Dong Baek Kang, Young Kim, Ki Jung Yun
Journal of the Korean Society of Coloproctology.2011; 27(1): 44. CrossRef

Original Article

Desmoid Tumor in Familial Adenomatous Polyposis (FAP).: Kim, Dae Dong , Yu, Chang Sik , Hong, Dong Hyun , Jung, Sang Hun , Choi, Pyong Wha , Park, In Ja , Kim, Hee Cheol , Kim, Jin Cheon; J Korean Soc Coloproctol. 2008;24(1):20-26.; DOI: https://doi.org/10.3393/jksc.2008.24.1.20

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1 Citations

Abstract PDF

PURPOSE
This research was conducted to assess the incidence, clinical characteristics, and treatment outcomes for desmoid tumors in patients with familial adenomatous polyposis (FAP). METHODS: At Medical Center, we recruited 47 patients who had been diagnosed as having intraabdominal or abdominal wall desmoid tumor between Aug. 1995 and Dec. 2005. We compared FAP-associated desmoid tumors with non-FAP-associated desmoid tumors according to clinical characteristics and treatment outcomes. RESULTS: Desmoid tumors developed 12/46 (26.1%) in FAP, 1/14 (7.1%) in attenuated FAP and 34 in non-FAP associated. Unlike non-FAP-associated desmoid tumors, the occurrence of FAP-associated desmoid tumors in tended to be higher in the earlier age groups (< or =40 yrs, 92.3% vs 67.6%, P=0.082) and no sexual predominancy was observed (male:female ratio of 1.2:1 vs a tumor ratio 1:3.9, P=0.033). Intraabdominal-type desmoid tumors associated for the majority of FAP-associated desmoid tumors (92.3% vs 38.2%, P=0.002), and 70% of the desmoid tumors occurred within 3 years after total proctocolectomy. In the treatment of FAP-associated intraabdominal desmoid tumors, surgery was performed in 7 cases (58.3%), and complete resections were done in only 3 cases (25%), with one recurrence. In non-FAP-associated desmoid tumors, complete resection was possible in 10 cases (76.9%), and there was no recurrence (P=0.036). The medical treatment for unresectable or incompletely resectable cases in cases of non-FAP-associated desmoid tumor was good, but for FAP-associated desmoid tumors, the effectiveness was not good, and further investigation was needed. CONCLUSIONS: Intraabdominal desmoid tumors in FAP patients occurred frequently in the early (< or =3 yrs) postoperative period, and the treatment, outcome including surgery and medication, outcome was not good in patients with FAP-associated desmoid tumors.

Citations

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Clinical Characteristics and Adequate Treatment of Familial Adenomatous Polyposis Combined with Desmoid Tumors
Won Beom Jung, Chan Wook Kim, Jin Cheon Kim
Cancer Research and Treatment.2014; 46(4): 366. CrossRef

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