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Original Articles
Inflammatory/benign bowel disease
Long-term risk factors of stoma construction after loose seton placement for Crohn disease–associated perianal fistulas
Eiichi Nakao, Kenji Tatsumi, Nao Obara, Koki Goto, Hirosuke Kuroki, Akira Sugita, Kazutaka Koganei
Ann Coloproctol. 2025;41(6):565-572.   Published online December 26, 2025
DOI: https://doi.org/10.3393/ac.2025.00766.0109
  • 273 View
  • 24 Download
AbstractAbstract PDFSupplementary Material
Purpose
To evaluate long-term outcomes and identify prognostic factors for stoma construction following loose seton placement in patients with Crohn disease (CD)-associated perianal fistulas.
Methods
This single-center, retrospective study included 136 patients who underwent initial loose seton placement for CD-associated perianal fistulas between 1999 and 2021, with at least 3 years of follow-up. Patient demographics, anorectal findings, and perioperative pharmacotherapy were assessed. Prognosis was defined as the cumulative incidence of stoma formation. Independent risk factors were identified using multivariate logistic regression. The association between postoperative molecular-targeted therapy and stoma-free survival was further analyzed in patients with severe anal ulceration and rectal stricture (high-risk features). Kaplan-Meier curves and log-rank tests were used for comparisons.
Results
During follow-up, 42 patients required stoma construction. Severe anal ulceration (odds ratio [OR], 2.37; 95% confidence interval [CI], 1.04–5.38; P=0.039), rectal stricture (OR, 2.84; 95% CI, 1.09–7.37; P=0.032), and absence of postoperative molecular-targeted therapy (OR, 0.36; 95% CI, 0.15–0.84; P=0.018) were independent risk factors. In patients with severe anal ulceration, the cumulative stoma construction rate was significantly lower with postoperative molecular-targeted therapy (P=0.018). No significant difference was observed in patients with rectal strictures (P=0.058).
Conclusion
Severe anal ulceration, rectal stricture, and absence of postoperative molecular-targeted therapy were independently associated with stoma construction. Postoperative molecular-targeted therapy improved stoma-free survival in patients with severe anal ulceration. Individualized treatment strategies, including early pharmacological intervention, may improve long-term outcomes and preserve anorectal function. Tailoring treatment according to lesion characteristics may reduce stoma formation and enhance quality of life in CD-associated perianal disease.
Anorectal benign disease
Cryotherapy reduces pain post-hemorrhoidectomy (CYPHER): a randomized, controlled, superiority trial of intra-anal ice after surgery for grade III hemorrhoids
Isaac Seow-En, Lionel Raphael Hui Chen, Yun Zhao, Yvonne Ying-Ru Ng, Emile Kwong-Wei Tan
Ann Coloproctol. 2025;41(6):537-544.   Published online December 24, 2025
DOI: https://doi.org/10.3393/ac.2025.00549.0078
  • 827 View
  • 48 Download
AbstractAbstract PDFSupplementary Material
Purpose
We aimed to determine whether intra-anal cryotherapy reduces postoperative pain in patients undergoing hemorrhoidectomy.
Methods
This randomized controlled trial was conducted from January 2023 to August 2024. Patients with symptomatic grade III hemorrhoids were randomized 1:1 to receive either 1 minute of intra-anal cryotherapy or standard postoperative care. Because cryotherapy was applied before reversal of general anesthesia, patients were blinded to treatment allocation. The primary outcome was pain at rest on postoperative day (POD) 1. Secondary outcomes included pain after defecation, time to return to work or non-work activities, 30-day complications, and compliance with analgesia. Pain was measured using the visual analog scale.
Results
A total of 50 patients were randomized (25 per group). All 50 were included in the analysis. Baseline clinicodemographic characteristics were comparable between groups. The primary outcome, POD 1 pain at rest, did not demonstrate superiority of cryotherapy compared with standard care (median 3.0 vs. 4.0, P=0.062). However, the POD 1 pain score after defecation was significantly lower with cryotherapy than without (3.0 vs. 4.0, P=0.046). On POD 2, median pain scores at rest and after defecation were both significantly lower in the cryotherapy cohort (at rest: 2.0 vs. 4.0, P=0.043; after defecation: 2.0 vs. 5.0, P=0.001).
Conclusion
Intra-anal cryotherapy significantly reduces pain after defecation in the early postoperative period following surgery for grade III hemorrhoids. Its therapeutic efficacy, ease of application, and safety support consideration for routine use. Trial registration ClinicalTrials.gov identifier: NCT06005727
Review
Minimally invasive surgery
Comparison of chyle leakage between laparoscopic and open colectomy in patients with colon cancer: a systematic review and meta-analysis
Tharin Thampongsa, Sitanun Saengsri, Pichet Wattanapreechanoni, Chairat Supsamutchai, Chumpon Wilasrusmee, Napaphat Poprom
Ann Coloproctol. 2025;41(4):262-270.   Published online August 27, 2025
DOI: https://doi.org/10.3393/ac.2025.00045.0006
  • 2,504 View
  • 403 Download
AbstractAbstract PDFSupplementary Material
Purpose
Laparoscopic complete mesocolon excision (LCME) for right colonic cancer improves oncological outcomes. This meta-analysis aimed to compare the rate of chylous leakage between laparoscopic and open right colectomy with CME for right-sided colonic cancers.
Methods
A literature search was performed up to February 2022. The primary outcome was the rate of chylous leakage. Secondary outcomes included related surgical and clinical parameters. A meta-analysis was performed to calculate risk ratios.
Results
Eleven studies were included. The rate of postoperative chylous leakage was lower in laparoscopic surgery compared to open surgery (risk ratio, 0.63; 95% confidence interval, 0.33–1.20), although this difference was not statistically significant. LCME showed superior outcomes to open CME (OCME) in secondary outcomes, such as reduced blood loss, increased harvested lymph node count, and decreased overall morbidity.
Conclusion
There was no significant difference between LCME and OCME regarding the rates of chylous leakage, anastomosis leakage, or operative time. However, LCME demonstrated superiority in blood loss reduction, harvested lymph node number, and overall morbidity in patients undergoing surgery for right colon cancer.
Original Article
ERAS
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
Ann Coloproctol. 2025;41(4):279-286.   Published online August 26, 2025
DOI: https://doi.org/10.3393/ac.2024.00857.0122
  • 2,972 View
  • 53 Download
AbstractAbstract PDFSupplementary Material
Purpose
Age and postoperative complications are known risk factors for venous thromboembolism (VTE). Minimally invasive surgery and Enhanced Recovery After Surgery (ERAS) protocol has been implemented to reduce these risks. The purpose of this study was to assess the short- and long-term effects of a VTE prophylaxis program using the Caprini score in elderly patients undergoing minimally invasive colorectal cancer surgery with the ERAS protocol.
Methods
This retrospective cross-sectional study included 1,043 colorectal cancer patients requiring surgery from January 2017 to December 2019, divided into a control group (≤75 years) and an elderly group (>75 years), with 827 and 216 patients, respectively. The primary outcome was the incidence of VTE; secondary outcome was the incidence of postoperative complications, particularly bleeding.
Results
The incidence of VTE was 1.5% in the control group and 3.7% in the elderly group (P=0.061). Five patients (0.5%) experienced symptomatic VTE, and the Caprini score for all VTE patients was ≤8 points; thus, only mechanical prophylaxis was used. In the multivariable logistic regression, the Caprini score (P=0.024) and cancer stage (P=0.004) were selected. The odds ratios (95% confidence interval) of the Caprini score and TNM staging were 1.758 (1.078–2.867) and 6.152 (2.045–26.510), respectively.
Conclusion
When the ERAS protocol was used for patients with colorectal cancer as perioperative care, the VTE risk was lower than that estimated by the Caprini score. Given that age is a recognized risk factor for major bleeding, criteria for the use of anticoagulation to prevent VTE, particularly in elderly patients, should be carefully evaluated, considering both the bleeding risks and the potential benefits of pharmacologic prophylaxis. Trial registration: Clinical Research Information Service (CRIS; cris.nih.go.kr) identifier: KCT0007804
Review Article
Others
Unraveling the enigma of sclerosing encapsulating peritonitis: a comprehensive review
Witcha Vipudhamorn, Tawan Juthasilaparut, Pawit Sutharat, Suwan Sanmee, Ekkarin Supatrakul, Sayanan Chowsilpa, Kraipop Wongwaiyut, Rujee Rattanasathien
Ann Coloproctol. 2025;41(3):175-189.   Published online June 18, 2025
DOI: https://doi.org/10.3393/ac.2024.00486.0069
  • 3,909 View
  • 126 Download
AbstractAbstract PDF
Sclerosing encapsulating peritonitis (SEP) is a rare but serious condition characterized by the progressive formation of a dense fibrous sheath encasing the small bowel within the peritoneal cavity. This review provides a comprehensive overview of the current understanding of SEP, focusing on its etiology, clinical presentation, diagnostic modalities, and management strategies. SEP can be classified into primary and secondary forms, each with distinct etiologies and treatment approaches. Primary SEP typically presents with acute or subacute bowel obstruction symptoms, necessitating surgical intervention to excise the fibrous sheath and relieve the obstruction. Secondary SEP often occurs in patients undergoing peritoneal dialysis, with cessation of dialysis being a key component of management. Medical treatments, including corticosteroids, immunosuppressive agents, and nutritional support, may complement surgical intervention, particularly in cases of secondary SEP. Advanced imaging techniques and personalized medicine approaches show promise in improving diagnostic accuracy and tailoring treatment strategies to individual patients. Future research directions include investigating targeted pharmacological therapies, exploring minimally invasive surgical techniques, and conducting long-term follow-up studies to evaluate treatment efficacy and disease recurrence. Multidisciplinary care teams play a crucial role in the comprehensive management of SEP, emphasizing collaboration among various specialties to optimize patient outcomes.
Review
Inflammatory/benign bowel disease
Clinical outcomes and optimal indications for nonoperative management of acute appendicitis in adult patients: a comprehensive literature review
Hyun Gu Lee, In Ja Park
Ann Coloproctol. 2025;41(2):107-118.   Published online April 16, 2025
DOI: https://doi.org/10.3393/ac.2023.00192.0027
  • 32,267 View
  • 464 Download
  • 1 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Appendectomy as the standard treatment for acute appendicitis has been challenged by accumulating evidence supporting nonoperative management with antibiotics as a potential primary treatment. This review aimed to summarize the clinical outcomes and the optimal indications for nonoperative management of acute appendicitis in adults. Current evidence suggests that uncomplicated and complicated appendicitis have different pathophysiologies and should be treated differently. Nonoperative management for uncomplicated appendicitis was not inferior to appendectomy in terms of complications and length of stay, with less than a 30% failure rate at 1 year. The risk of perforation and postoperative complications did not increase even if nonoperative management failed. Complicated appendicitis with localized abscess or phlegmon could also be treated conservatively, with a success rate of more than 80%. An interval appendectomy following successful nonoperative management is recommended only for patients over the age of 40 years to exclude appendiceal malignancy. The presence of appendicoliths increased the risk of treatment failure and complications; thus, it may be an indication for appendectomy. Nonoperative management is a safe and feasible option for both uncomplicated and complicated appendicitis. Patients should be informed that nonoperative management may be a safe alternative to surgery, with the possibility of treatment failure.

Citations

Citations to this article as recorded by  
  • Appendicolith in non-operative management of acute appendicitis: Implications for recurrence and future directions
    Ju Tian
    World Journal of Clinical Cases.2025;[Epub]     CrossRef
Original Articles
Anorectal benign disease
Antibiotic use during the first episode of acute perianal sepsis: a still-open question
Stanislas Blondin, David Lobo, Axel Egal, Saliha Ysmail-Dahlouk, Milad Taouk, Josée Bourguignon, David Blondeel, Isabelle Etienney
Ann Coloproctol. 2025;41(1):40-46.   Published online February 3, 2025
DOI: https://doi.org/10.3393/ac.2024.00472.0067
  • 13,381 View
  • 181 Download
  • 1 Citations
AbstractAbstract PDF
Purpose
The role of antibiotics in preventing fistula formation following an initial abscess remains a subject of debate. This study compared the incidence of fistula in ano in patients experiencing their first episode of acute perianal sepsis, with and without antibiotic therapy, and evaluated the prevalence of fistula in ano necessitating surgical intervention at 1 year.
Methods
This retrospective cohort study was conducted at a tertiary care hospital with a dedicated proctology department. All patients who presented to the emergency proctology unit with a first episode of acute perianal sepsis were eligible for inclusion.
Results
This study included 276 patients. At 1 year, fistula formation was identified in 65.6% of all patients, 54.0% of those who had received antibiotics, and 75.0% of those who had not (P<0.001). This finding remained significant after weighted propensity analysis (odds ratio, 0.53; 95% confidence interval, 0.31–0.92; P=0.025).
Conclusion
The rate of fistula formation was relatively high in this study. However, it was lower among patients with perianal sepsis who were treated with antibiotics, although a causal relationship could not be established. Prolonged follow-up is needed to clarify the role of antibiotic therapy in preventing or delaying fistula development in patients with acute perianal sepsis.

Citations

Citations to this article as recorded by  
  • Associations between adjuvant antibiotic therapy and fistula formation after incision and drainage of anorectal abscesses: results from a retrospective cohort study
    J. Alabbad, S. Almutairi, N. Alsabagha, H. Alhamly, F. Alnaqi
    Techniques in Coloproctology.2025;[Epub]     CrossRef
Anorectal benign disease
Lower pain, less itching, and faster healing after ultrasound scalpel-assisted hemorrhoidectomy using an intimate cleaner containing chlorhexidine, acid hyaluronic acid, and natural anti-inflammatories: a multicenter observational case-control study
Antonio Brillantino, Luigi Marano, Maurizio Grillo, Alessio Palumbo, Fabrizio Foroni, Luciano Vicenzo, Alessio Antropoli, Michele Lanza, Maria Laura Sandoval Sotelo, Nicola Sangiuliano, Mauro Maglio, Rosanna Filosa, Lucia Abbatiello, Maria Preziosa Romano, Luana Passariello, Pasquale Talento, Giovanna Ioia, Corrado Rispoli, Mariano Fortunato Armellino, Vincenzo Bottino, Adolfo Renzi, Carlo Bartone, Luigi Monaco, Paolino Mauro, Stefano Picardi, Maria Paola Menna, Elisa Palladino, Mario Massimo Mensorio, Vinicio Mosca, Claudio Gambardella, Luigi Brusciano, Ludovico Docimo
Ann Coloproctol. 2024;40(6):602-609.   Published online December 30, 2024
DOI: https://doi.org/10.3393/ac.2024.00570.0081
  • 6,698 View
  • 116 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDF
Purpose
Postoperative pain is a major concern for patients undergoing ultrasound scalpel-assisted hemorrhoidectomy, potentially exacerbated by delayed wound healing. This study aimed to evaluate the impact of an intimate cleansing gel containing chlorhexidine, hyaluronic acid, and other anti-inflammatory agents (Antroclean Fisioderm) on postoperative pain, itching, and wound healing in patients who had undergone this procedure.
Methods
This multicenter observational case-control study involved a cohort of consecutive adult patients who underwent hemorrhoidectomy using an ultrasound device. The study compared 2 different postoperative wound management strategies over 1 month after surgery: washing with warm water twice per day (control group) versus a 2-minute topical application of intimate cleansing gel (Antroclean Fisioderm) followed by a warm water wash (intervention group).
Results
The median postoperative pain score was significantly lower in the intervention group than in the control group at each follow-up point (P<0.01). The percentage of patients reporting anal itching was also significantly lower in the intervention group than in the control group at each follow-up point (P<0.01). All patients in the intervention group achieved complete wound healing 4 weeks after surgery, compared to 88 (82%) in the control group (P<0.01). No adverse events were reported.
Conclusion
The topical application of intimate cleansing gel (Antroclean Fisioderm) twice daily for 1 month following ultrasound scalpel-assisted hemorrhoidectomy appears to be associated with faster healing, reduced pain, decreased itching, and improved quality of life, without any adverse effects. Further larger and prospective randomized trials are recommended to confirm these findings.

Citations

Citations to this article as recorded by  
  • Enhancing Proctological Outcomes: The Role of Hyaluronic Acid in Hemorrhoid Care – An Innovative Adjunct to Surgery
    Riddhi Upadhyay, Akshat Vadaliya, Haryax V. Pathak, Soham Upadhyay
    Journal of Coloproctology.2025; 45(03): 001.     CrossRef
ERAS
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
Ann Coloproctol. 2024;40(6):564-572.   Published online November 22, 2024
DOI: https://doi.org/10.3393/ac.2023.00143.0020
  • 4,598 View
  • 131 Download
  • 1 Web of Science
  • 1 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Purpose
Continuous wound infiltration (CWI) has been introduced as a component of multimodal analgesia to counteract the adverse effects of the most frequently used opioids. Advantages of reduced-port laparoscopic surgery (RPLS) include cosmetic benefits and decreased postoperative pain. We aimed to investigate the effect of CWI in patients using intravenous (IV) patient-controlled analgesia (PCA) for pain management after RPLS for colorectal cancer.
Methods
This retrospective study included 25 patients who received both CWI (0.5% ropivacaine infused over 72 hours) and IV PCA (fentanyl citrate) and 52 patients who received IV PCA alone. The primary endpoint was pain scores on postoperative days (PODs) 0, 1, and 2. Univariate and multivariate analyses were conducted to determine the factors affecting the pain score on POD 0.
Results
On POD 0, the mean numeric rating scale score was significantly lower in the CWI group than in the control group (3.2±0.8 vs. 3.7±0.9, P=0.042). However, the scores were comparable between the groups during the rest of the period. Within 24 hours of surgery, the CWI group consumed fewer opioids (0.7±0.9 vs. 1.3±1.1, P=0.018) and more nonsteroidal anti-inflammatory drugs (2.0±1.4 vs. 1.3±1.4, P=0.046) than the control group. Time to removal of IV PCA was significantly longer in the CWI group than in the control group (4.4±1.6 days vs. 3.4±1.0 days, P=0.016).
Conclusion
CWI with ropivacaine and IV PCA was more effective than IV PCA alone in controlling postoperative pain within 24 hours of surgery, and opioid use could be reduced further.

Citations

Citations to this article as recorded by  
  • Optimizing postoperative pain management in minimally invasive colorectal surgery
    Soo Young Lee
    Annals of Coloproctology.2024; 40(6): 525.     CrossRef
Minimally invasive surgery
New double-stapling technique without staple-crossing line in laparoscopic low anterior resection: effort to reduce anastomotic leakage
Nam Seok Kim, Ji Hoon Kim, Yoon Suk Lee, In Kyu Lee, Won Kyung Kang
Ann Coloproctol. 2024;40(6):573-579.   Published online November 22, 2024
DOI: https://doi.org/10.3393/ac.2022.00409.0058
  • 4,922 View
  • 174 Download
  • 2 Web of Science
  • 2 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
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
Colorectal cancer
Oncologic outcomes and associated factors of colon cancer patients aged 70 years and older
Byeo Lee Lim, In Ja Park, Jun-Soo Ro, Young Il Kim, Seok-Byung Lim, Chang Sik Yu
Ann Coloproctol. 2025;41(3):198-206.   Published online August 5, 2024
DOI: https://doi.org/10.3393/ac.2023.00367.0052
  • 7,537 View
  • 90 Download
  • 4 Web of Science
  • 6 Citations
AbstractAbstract PDFSupplementary Material
Purpose
The aim of this study was to examine the prognosis and associated risk factors, including adjuvant chemotherapy (CTx), in elderly patients with colon cancer.
Methods
This retrospective study included patients who underwent radical resection for colon cancer between January 2010 and December 2014 at Asan Medical Center. The effects of stage, risk factors, and chemotherapy on overall survival (OS) and recurrence-free survival (RFS) were compared in patients aged ≥70 and <70 years.
Results
Of 3,313 patients, 933 (28.1%) was aged ≥70 years. Of the 1,921 patients indicated for adjuvant CTx, 1,294 of 1,395 patients (92.8%) aged <70 years and 369 of 526 patients (70.2%) aged ≥70 years received adjuvant CTx. Old age (≥70 years) was independently associated with RFS in overall cohort. Among patients aged ≥70 years indicated for adjuvant CTx, the 5-year OS (81.6% vs. 50.4%, P<0.001) and RFS (82.9% vs. 67.4%, P=0.025) rates were significantly higher in those who did than did not receive adjuvant CTx. Additionally, adjuvant CTx was confirmed as independent risk factor of both OS and RFS in patients aged ≥70 years indicated for adjuvant CTx.
Conclusion
Old age was associated with poor RFS and adjuvant CTx had benefits in OS as well as RFS in elderly patients eligible for adjuvant CTx.

Citations

Citations to this article as recorded by  
  • Immunological changes and recovery-related factors in older patients with colon cancer: A pilot trial
    Byeo Lee Lim, Young Il Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Yousun Ko, Kyung Won Kim, In Ja Park
    Journal of Geriatric Oncology.2025; 16(3): 102200.     CrossRef
  • Stage II-III colorectal cancer in geriatric patients: Clinicopathological features and chemotherapy utilization
    Yakup Duzkopru, Özlem Doğan
    Turkish Journal of Clinics and Laboratory.2025; 16(1): 118.     CrossRef
  • Does Oxaliplatin-based Adjuvant Therapy Benefit Older Colorectal Cancer Patients?
    Peter Hofland
    Onco Zine - The International Oncology Network.2025;[Epub]     CrossRef
  • Disease-Free Survival of Patients with Stage II Stroma-Rich Colorectal Adenocarcinomas with Microsatellite Stability
    Ángel Romo-Navarro, Juan Ruiz Martín, Irene García-Camacha Gutiérrez, Mariano Amo-Salas, María Recuero Pradillo, César Sánchez-Muñoz, Cristina María Murillo Lázaro, Esperanza Carabias López, Raquel Sánchez Simón, Carlos Quimbayo-Arcila, Yasmina Hernández
    International Journal of Molecular Sciences.2025; 26(24): 11795.     CrossRef
  • Early detection of anastomotic leakage in colon cancer surgery: the role of early warning score and C-reactive protein
    Gyung Mo Son
    Annals of Coloproctology.2024; 40(5): 415.     CrossRef
  • Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-Center Retrospective Analysis
    Jae Seung Kim, Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
    Cancers.2024; 16(24): 4280.     CrossRef
ERAS
Clinical impact of a multimodal pain management protocol for loop ileostomy reversal
Jeong Sub Kim, Chul Seung Lee, Jung Hoon Bae, Seung Rim Han, Do Sang Lee, In Kyu Lee, Yoon Suk Lee, In Kyeong Kim
Ann Coloproctol. 2024;40(3):210-216.   Published online June 19, 2024
DOI: https://doi.org/10.3393/ac.2022.01137.0162
  • 6,236 View
  • 242 Download
  • 3 Web of Science
  • 4 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Purpose
As introduced, multimodal pain management bundle for ileostomy reversal may be considered to reduce postoperative pain and hospital stay. The aim of this study was to evaluate clinical efficacy of perioperative multimodal pain bundle for ileostomy.
Methods
Medical records of patients who underwent ileostomy reversal after rectal cancer surgery from April 2017 to March 2020 were analyzed. Sixty-seven patients received multimodal pain bundle protocol with ileostomy reversal (group A) and 41 patients underwent closure of ileostomy with conventional pain management (group B).
Results
Baseline characteristics, including age, sex, body mass index, American Society of Anesthesiologists classification, diabetes mellitus, and smoking history, were not significantly different between the groups. The pain score on postoperative day 1 was significant lower in group A (visual analog scale, 2.6 ± 1.3 vs. 3.2 ± 1.2; P = 0.013). Overall consumption of opioid in group A was significant less than group B (9.7 ± 9.5 vs. 21.2 ± 8.8, P < 0.001). Hospital stay was significantly shorter in group A (2.3 ± 1.5 days vs. 4.1 ± 1.5 days, P < 0.001). There were no significant differences between the groups in postoperative complication rate.
Conclusion
Multimodal pain protocol for ileostomy reversal could reduce postoperative pain, usage of opioid and hospital stay compared to conventional pain management.

Citations

Citations to this article as recorded by  
  • Immunological changes and recovery-related factors in older patients with colon cancer: A pilot trial
    Byeo Lee Lim, Young Il Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Yousun Ko, Kyung Won Kim, In Ja Park
    Journal of Geriatric Oncology.2025; 16(3): 102200.     CrossRef
  • Multimodal analgesia for postoperative pain: pursuing liberation from pain, not redemption
    Soo Yeun Park
    Annals of Coloproctology.2024; 40(3): 189.     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
  • Optimizing postoperative pain management in minimally invasive colorectal surgery
    Soo Young Lee
    Annals of Coloproctology.2024; 40(6): 525.     CrossRef
Case Report
Anorectal benign disease
Chronic fistula in ano associated with adenocarcinoma: a case report with a review of the literature
Nalini Kanta Ghosh, Ashok Kumar
Ann Coloproctol. 2024;40(Suppl 1):S1-S5.   Published online May 16, 2024
DOI: https://doi.org/10.3393/ac.2022.00752.0107
  • 4,609 View
  • 133 Download
AbstractAbstract PDF
The malignant transformation of chronic fistula in ano is rare, accounting for 3% to 11% of all anal canal malignancies. It results from long-standing inflammation and chronic irritation. No guidelines are available for the management of these cases. We herein present a case report of a 55-year-old man who presented with a history of constipation, perianal pain, and discharging fistula in ano of 4-year duration and underwent fistula surgery with recurrence. Biopsy of the fistulous tract revealed adenocarcinoma. He received neoadjuvant chemoradiotherapy, followed by abdominoperineal excision including excision of the fistulous tract. After 18 months of follow-up, he is free of recurrence. We present this case with a review of the literature, highlighting the management strategies.
Technical Note
Technical tips
Introduction of extraperitoneal tunneling method: a way to secure the drain tube in the pelvic cavity after proctectomy
Sung Il Kang, Sohyun Kim, Jae Hwang Kim
Ann Coloproctol. 2024;40(2):182-185.   Published online March 25, 2024
DOI: https://doi.org/10.3393/ac.2023.00073.0010
  • 3,629 View
  • 124 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDF
The effectiveness of closed drainage tube insertion after low anterior resection has been controversial. We believe that drain tube displacement, which occurs up to 35% in real clinical practice, reduces the effectiveness of the drain tube. We report in this video a simple way to secure the drain tube in the pelvic cavity after low anterior resection and introduce a case that used the drain fixation method and treated anastomotic leakage without interventional procedure.

Citations

Citations to this article as recorded by  
  • Comparison of drain displacement and complications between conventional drain insertion and extraperitoneal tunneling drain insertion following anterior or low anterior resection: a retrospective comparative cohort study
    Sung Il Kang, Sohyun Kim
    Annals of Surgical Treatment and Research.2025; 109(1): 7.     CrossRef
Original Article
Colorectal cancer
Long-term clinical outcomes after high and low ligations with lymph node dissection around the root of the inferior mesenteric artery in patients with rectal cancer
Min Wan Lee, Sung Sil Park, Kiho You, Dong Eun Lee, Dong Woon Lee, Sung Chan Park, Kyung Su Han, Dae Kyung Sohn, Chang Won Hong, Bun Kim, Byung Chang Kim, Hee Jin Chang, Dae Yong Kim, Jae Hwan Oh
Ann Coloproctol. 2024;40(1):62-73.   Published online February 26, 2024
DOI: https://doi.org/10.3393/ac.2023.00094.0013
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Graphical AbstractGraphical Abstract AbstractAbstract PDF
Purpose
This study aimed to evaluate the long-term clinical outcomes based on the ligation level of the inferior mesenteric artery (IMA) in patients with rectal cancer.
Methods
This was a retrospective analysis of a prospectively collected database that included all patients who underwent elective low anterior resection for rectal cancer between January 2013 and December 2019. The clinical outcomes included oncological outcomes, postoperative complications, and functional outcomes. The oncological outcomes included overall survival (OS) and relapse-free survival (RFS). The functional outcomes, including defecatory and urogenital functions, were analyzed using the Fecal Incontinence Severity Index, International Prostate Symptom Score, and International Index of Erectile Function questionnaires.
Results
In total, 545 patients were included in the analysis. Of these, 244 patients underwent high ligation (HL), whereas 301 underwent low ligation (LL). The tumor size was larger in the HL group than in the LL group. The number of harvested lymph nodes (LNs) was higher in the HL group than in the LL group. There were no significant differences in complication rates and recurrence patterns between the groups. There were no significant differences in 5-year RFS and OS between the groups. Cox regression analysis revealed that the ligation level (HL vs. LL) was not a significant risk factor for oncological outcomes. Regarding functional outcomes, the LL group showed a significant recovery in defecatory function 1 year postoperatively compared with the HL group.
Conclusion
LL with LNs dissection around the root of the IMA might not affect the oncologic outcomes comparing to HL; however, it has minimal benefit for defecatory function.

Citations

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  • Meeting report on the 8th Asian Science Editors’ Conference and Workshop 2024
    Eun Jung Park
    Science Editing.2025; 12(1): 66.     CrossRef
  • Early detection of anastomotic leakage in colon cancer surgery: the role of early warning score and C-reactive protein
    Gyung Mo Son
    Annals of Coloproctology.2024; 40(5): 415.     CrossRef
Review
Colorectal cancer
Survival outcomes of salvage surgery in the watch-and-wait approach for rectal cancer with clinical complete response after neoadjuvant chemoradiotherapy: a systematic review and meta-analysis
Wenjie Lin, Ian Jun Yan Wee, Isaac Seow-En, Aik Yong Chok, Emile Kwong-Wei Tan
Ann Coloproctol. 2023;39(6):447-456.   Published online December 28, 2023
DOI: https://doi.org/10.3393/ac.2022.01221.0174
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  • 8 Web of Science
  • 11 Citations
AbstractAbstract PDFSupplementary Material
Purpose
This systematic review and meta-analysis compared the outcomes of the watch-and-wait (WW) approach versus radical surgery (RS) in rectal cancers with clinical complete response (cCR) after neoadjuvant chemoradiotherapy.
Methods
This study followed the PRISMA guidelines. Major databases were searched to identify relevant articles. WW and RS were compared through meta-analyses of pooled proportions. Primary outcomes included overall survival (OS), disease-free survival (DFS), local recurrence, and distant metastasis rates. Pooled salvage surgery rates and outcomes were also collected. The Newcastle-Ottawa scale was employed to assess the risk of bias.
Results
Eleven studies including 1,112 rectal cancer patients showing cCR after neoadjuvant chemoradiation were included. Of these patients, 378 were treated nonoperatively with WW, 663 underwent RS, and 71 underwent local excision. The 2-year OS (risk ratio [RR], 0.95; P = 0.94), 5-year OS (RR, 2.59; P = 0.25), and distant metastasis rates (RR, 1.05; P = 0.80) showed no significant differences between WW and RS. Local recurrence was more frequent in the WW group (RR, 6.93; P < 0.001), and 78.4% of patients later underwent salvage surgery (R0 resection rate, 97.5%). The 2-year DFS (RR, 1.58; P = 0.05) and 5-year DFS (RR, 2.07; P = 0.02) were higher among RS cases. However, after adjustment for R0 salvage surgery, DFS showed no significant between-group difference (RR, 0.82; P = 0.41).
Conclusion
Local recurrence rates are higher for WW than RS, but complete salvage surgery is often possible with similar long-term outcomes. WW is a viable strategy for rectal cancer with cCR after neoadjuvant chemoradiation, but further research is required to improve patient selection.

Citations

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  • Watch‐and‐Wait Approach Following Neoadjuvant Chemo‐Radiotherapy for Locally Advanced Rectal Cancer: A Retrospective Single‐Center Cohort Study
    Georgi Kalev, Sylvia Buettner, Tianzuo Zhan, Ralf‐Dieter Hofheinz, Judit Boda‐Heggemann, Christoph Reissfelder, Steffen Seyfried, Georgi Vassilev, Julia Hardt
    Journal of Surgical Oncology.2025; 131(4): 658.     CrossRef
  • Phase 2, Multicenter, Open-label, Nonrandomized Study of Neoadjuvant Chemotherapy Liposomal Irinotecan With 5-Fluorouracil, Leucovorin, and Oxaliplatin, Followed by Chemoradiotherapy in Patients With Rectal Cancer in a Watch-and-Wait Program
    César Muñoz, María-C. Riesco Martinez, Lisardo Ugidos, Pilar García-Alfonso, Rafael Alvarez-Gallego, Paloma Peinado, Carmen Toledano, Luka Mihic-Góngora, Justo Gabriel Ortega Anselmi, Enrique Sanz Garcia, Emilio Vicente, Yolanda Quijano, Hipólito J. Durán
    American Journal of Clinical Oncology.2025; 48(3): 142.     CrossRef
  • Therapeutic Management of Locally Advanced Rectal Cancer: Existing and Prospective Approaches
    Horia-Dan Lișcu, Nicolae Verga, Dimitrie-Ionuț Atasiei, Andreea-Teodora Ilie, Maria Vrabie, Laura Roșu, Alexandra Poștaru, Stefania Glăvan, Adriana Lucaș, Maria Dinulescu, Andreea Delea, Andreea-Iuliana Ionescu
    Journal of Clinical Medicine.2025; 14(3): 912.     CrossRef
  • A management of patients achieving clinical complete response after neoadjuvant therapy and perspectives: on locally advanced rectal cancer
    Yu-Xin Liu, Xin-Rong Yang, Lan-Qing Peng, Zhuo-Hong Li
    Frontiers in Oncology.2025;[Epub]     CrossRef
  • ACCORD study: a national multi‐centre study of the watch and wait approach in patients with rectal cancer in Aotearoa New Zealand

    ANZ Journal of Surgery.2025; 95(3): 440.     CrossRef
  • Watch and wait in early onset rectal cancer patients: A review of the literature
    Melissa K Drezdzon, Carrie Y Peterson
    Seminars in Colon and Rectal Surgery.2025; : 101117.     CrossRef
  • Non-operative management of locally advanced rectal cancer with an emphasis on outcomes and quality of life: a narrative review
    In Ja Park
    Ewha Medical Journal.2025; 48(3): e40.     CrossRef
  • Non-Operative Management (NOM) in Rectal Cancer: Current Evidence and Future Directions
    Vincenzo Schiavone, Gabriella Teresa Capolupo, Gianluca Mascianà, Filippo Carannante, Gianluca Costa, Valentina Miacci, Marco Caricato
    Encyclopedia.2025; 5(4): 165.     CrossRef
  • Advancing Personalized Medicine in the Treatment of Locally Advanced Rectal Cancer
    Francesco Giulio Sullo, Alessandro Passardi, Chiara Gallio, Chiara Molinari, Giorgia Marisi, Eleonora Pozzi, Leonardo Solaini, Alessandro Bittoni
    Journal of Clinical Medicine.2024; 13(9): 2562.     CrossRef
  • Tailoring rectal cancer surgery: Surgical approaches and anatomical insights during deep pelvic dissection for optimal outcomes in low‐lying rectal cancer
    Youn Young Park, Nam Kyu Kim
    Annals of Gastroenterological Surgery.2024; 8(5): 761.     CrossRef
  • Combined Transanal and Laparoscopic Approach for Full-Thickness Local Excision of Locally Advanced Rectal Cancer Following Near-Complete Response after Chemotherapy
    Joshua S. H. Lim, Si-Lin Koo, Iain Beehuat Tan, Isaac Seow-En
    World Journal of Colorectal Surgery.2024; 13(3): 95.     CrossRef
Original Article
Translational/basic research
Exfoliate cancer cell analysis in rectal cancer surgery: comparison of laparoscopic and transanal total mesorectal excision, a pilot study
Kiho You, Jung-Ah Hwang, Dae Kyung Sohn, Dong Woon Lee, Sung Sil Park, Kyung Su Han, Chang Won Hong, Bun Kim, Byung Chang Kim, Sung Chan Park, Jae Hwan Oh
Ann Coloproctol. 2023;39(6):502-512.   Published online December 26, 2023
DOI: https://doi.org/10.3393/ac.2023.00479.0068
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Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Purpose
Minimally invasive surgery (MIS) is currently the standard treatment for rectal cancer. However, its limitations include complications and incomplete total mesorectal resection (TME) due to anatomical features and technical difficulties. Transanal TME (TaTME) has been practiced since 2010 to improve this, but there is a risk of local recurrence and intra-abdominal contamination. We aimed to analyze samples obtained through lavage to compare laparoscopic TME (LapTME) and TaTME.
Methods
From June 2020 to January 2021, 20 patients with rectal cancer undergoing MIS were consecutively and prospectively recruited. Samples were collected at the start of surgery, immediately after TME, and after irrigation. The samples were analyzed for carcinoembryonic antigen (CEA) and cytokeratin 20 (CK20) through a quantitative real-time polymerase chain reaction. The primary outcome was to compare the detected amounts of CEA and CK20 immediately after TME between the surgical methods.
Results
Among the 20 patients, 13 underwent LapTME and 7 underwent TaTME. Tumor location was lower in TaTME (7.3 cm vs. 4.6 cm, P=0.012), and negative mesorectal fascia (MRF) was more in LapTME (76.9% vs. 28.6%, P=0.044). CEA and CK20 levels were high in 3 patients (42.9%) only in TaTME. There was 1 case of T4 with incomplete purse-string suture and 1 case of positive MRF with dissection failure. All patients were followed up for an average of 32.5 months without local recurrence.
Conclusion
CEA and CK20 levels were high only in TaTME and were related to tumor factors or intraoperative events. However, whether the detection amount is clinically related to local recurrence remains unclear.
Technical Note
Clinical outcomes with of the Contix Faecal Incontinence Management System: preliminary results
Moris Venturero, Reuma Yehuda-Margalit, Carla Maradey-Romero, Yael Corcos, Dan Carter, Marc Beer-Gabel
Ann Coloproctol. 2023;39(1):89-93.   Published online December 6, 2022
DOI: https://doi.org/10.3393/ac.2022.00563.0080
  • 5,346 View
  • 150 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDF
Fecal incontinence (FI) has a significant long-term impact on patient quality of life for which there is a range of medical and surgical management alternatives. We report the preliminary outcome using the ForConti Contix Faecal Incontinence Management System (FIMS) in FI patients who had failed conservative therapy and who were recruited at 2 tertiary institutions between September 2018 and September 2020. Comparative assessments were made before and after 2 week periods of treatment using bowel diaries and subjective Wexner and Faecal Incontinence Quality of Life scores. Of 17 patients enrolled, 11 completed an 8-week assessment with a significant fall in the average percentage of FI days reported from 84% before treatment to 16.8% at the first posttreatment assessment and down to 13.2% by the second assessment period. This finding correlated with a similar reduction in the total weekly number of episodes of frank FI, minor soiling, and fecal urgency reported by patients along with concomitant improvements in the Wexner scores. For those using the device, there was less concern about accidental bowel leakage, high rates of satisfaction, and minimal problems with the device. Initial results are encouraging warranting further study.

Citations

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  • Novel Nonablative Radiofrequency Approach for the Treatment of Anal Incontinence: A Phase 1 Clinical Trial
    Patrícia Lordêlo, Juliana Barros, Claudia Liony, Cristiane Maria Carvalho C Dias, Janine Ferreira, Priscila G Januário, Luana N Matos, Camila O Muniz, Laizza S Silva, Cristina Brasil
    Cureus.2023;[Epub]     CrossRef
Original Articles
Benign bowel disease
Implications of bacteriological study in complicated and uncomplicated acute appendicitis
Sorin Cimpean, Alberto Gonzalez Barranquero, Ion Surdeanu, Benjamin Cadiere, Guy-Bernard Cadiere
Received February 28, 2022  Accepted July 7, 2022  Published online November 10, 2022  
DOI: https://doi.org/10.3393/ac.2022.00157.0022    [Epub ahead of print]
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  • 4 Citations
AbstractAbstract PDF
Purpose
Bacteriological sample in the presence of intra-abdominal free fluid is necessary to adapt the antibiotherapy and to prevent the development of resistance. The aim was to evaluate the differences between uncomplicated acute appendicitis (UAA) and complicated acute appendicitis (CAA) in terms of bacterial culture results and antibiotic resistance, and to evaluate the factors linked with CAA.
Methods
We performed a single-center, retrospective observational study of all consecutive patients who presented with appendicular peritonitis and underwent emergent surgery in a tertiary referral hospital in Brussels, Belgium, between January 2013 and December 2020. The medical history, parameters at admission, bacterial culture, antibiotic resistance, and postoperative outcomes of 268 patients were analyzed. UAA was considered catarrhal or phlegmonous inflammation of the appendix. CAA was considered gangrenous or perforated appendicitis.
Results
Positive microbiological cultures were significantly higher in the CAA group (68.2% vs. 53.4%). The most frequently isolated bacteria in UAA and CAA cultures were Escherichia coli (37.9% and 48.6%, respectively). Most observed resistances were against ampicillin (28.9% and 21.7%) and amoxicillin/clavulanic acid (16.4% and 10.5%) in UAA and CAA, respectively. A higher Charlson Comorbidity Index, an elevated white blood cell count, an open procedure, and the need for drainage were linked to CAA. Culture results, group of bacterial isolation, and most common isolated bacteria were not related to CAA.
Conclusion
CAA presented a higher rate of positive cultures with increased identification of gram-negative bacteria. Bacterial culture from the peritoneal liquid does not reveal relevant differences in terms of antibiotic resistance.

Citations

Citations to this article as recorded by  
  • Optimizing Antibiotic Management for Adult Patients Presenting with Acute Perforated Appendicitis: A Quality Improvement Study
    Carlos Gallego-Navarro, Jason Beckermann, Maria E. Linnaus, Hayden J. Swartz, Shelby Stewart, Justin M. York, Ryan R. Gassner, Christopher A. Kasal, Annaliese G. Seidel, Corey J. Wachter, Kirstin J. Kooda, Jennifer R. Rich, Mark D. Sawyer
    Surgical Infections.2025; 26(3): 143.     CrossRef
  • The functional landscape of the appendix microbiome under conditions of health and disease
    Md Shahjalal Sagor, Tarequl Islam, Noshin Tabassum Tamanna, Md. Kamrul Islam Bappy, Danishuddin, Md Azizul Haque, Maximilian Lackner
    Gut Pathogens.2025;[Epub]     CrossRef
  • Causative microbes and antibiotic susceptibility of acute appendicitis in adults and children
    Chia-Hsiang Yu, Chia-Ning Chang, Chih-Chien Wang
    Pediatrics & Neonatology.2024; 65(2): 159.     CrossRef
  • The role of intraoperative swab during appendectomy in patients with uncomplicated and complicated appendicitis
    Bruno Leonardo Bancke Laverde, Matthias Maak, Melanie Langheinrich, Stephan Kersting, Axel Denz, Christian Krautz, Georg F. Weber, Robert Grützmann, Maximilian Brunner
    International Journal of Colorectal Disease.2023;[Epub]     CrossRef
Colorectal cancer
Outcomes of side-to-end versus end-to-end colorectal anastomosis in nonemergent sigmoid and rectal cancers: a randomized controlled clinical trial
Tamer A.A.M. Habeeb, Hatem Mohammad, Tamer Wasefy, Mohamed Ibrahim Mansour
Ann Coloproctol. 2023;39(3):231-241.   Published online March 11, 2022
DOI: https://doi.org/10.3393/ac.2021.00906.0129
  • 9,733 View
  • 201 Download
  • 6 Web of Science
  • 7 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Purpose
The outcomes of open colorectal anastomosis of side-to-end versus end-to-end in nonemergent sigmoid and rectal cancer surgery in adults were compared.
Methods
A randomized controlled trial on individuals with sigmoid and rectal cancers was conducted between September 2016 and September 2018.
Results
The mean age was 62.58±12.3 years in the side-to-end anastomotic (SEA) group and 61.03±13.98 years in the end-to-end anastomotic (EEA) group. Except for the operative time, intraoperative data revealed no significant differences between the studied groups, and the SEA group revealed that the mean anastomotic time was significantly shorter. Perioperative blood loss, length of stay, reoperation, inpatient death, infection, and bleeding were significantly associated with leakage. There is a statistically significant change regarding the range of bowel frequency in the EEA group only (P=0.04). There is a statistically significant difference regarding incontinence for flatus in the SEA group only (P≤0.001). A statistically significant change in both groups regards incontinence for liquid stools (P≤0.001) and clustering of stools (P≤0.001 and P=0.043). The quality of life in the SEA group significantly dropped at 6 months and then returned to baseline as regards to physical well-being (PWB), functional well-being (FWB), and colorectal cancer symptoms (CCS) with no difference as regards SWB and EWB, while in the EEA group, the exact change happened only as regard PWB and FWB, but SWB and CCS percentage did not return to baseline.
Conclusion
The SEA group offers a safe alternative approach to the EEA group.

Citations

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  • Short-term Outcomes of Linear vs. Circular Stapling for Esophagojejunostomy in Gastric Cancer: an Inverse Probability of Treatment Weighting Analysis
    Yeojin Boo, Ho-Jung Shin, Jeong Ho Song, Sang-Yong Son, Hoon Hur, Sang-Uk Han
    Journal of Gastric Cancer.2025; 25(3): 509.     CrossRef
  • Risk Factors for Sigmoid Colonic Anastomosis: A Comparative and Cross-Sectional Analysis
    Tutkun Talih, Gokhan Sonmez, Erdogan Sozuer, Sevket Tombul, Mahmut Kulturoglu, Dogan Islam, Hızır Akyıldız, Abdullah Demirtas, Mustafa Karaagac, Fatih Dal
    Therapeutics and Clinical Risk Management.2025; Volume 21: 1219.     CrossRef
  • Updates in surgery for colorectal cancer: incidence and risk factors for acute anastomotic leak—a retrospective study
    Tamer A. A. M. Habeeb, Abdulzahra Hussain, Massimo Chiaretti, Igor A. Kryvoruchko, Aristotelis Kechagias, Abd Al-Kareem Elias, Abdelmonem A. M. Adsam, Mohamed A. Gadallah, Saad Mohamed Ali Ahmed, Ahmed khyrallh, Mohammed H. Alsayed, Esmail Tharwat Kamel A
    Updates in Surgery.2025;[Epub]     CrossRef
  • Minimally invasive left colectomy with total intracorporeal anastomosis versus extracorporeal anastomosis. A single center cohort study. Stage 2b IDEAL framework for evaluating surgical innovation
    Xavier Serra-Aracil, Irene Gómez-Torres, Andrea Torrecilla-Portoles, Anna Serracant-Barrera, Albert García-Nalda, Anna Pallisera-Lloveras
    Langenbeck's Archives of Surgery.2024;[Epub]     CrossRef
  • The impact of powered circular staplers on anastomotic leak in left-sided colorectal cancer surgeries
    Hayoung Lee, Yong Sik Yoon, Young Il Kim, Eun Jung Park, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim
    Surgical Endoscopy.2024; 38(10): 6111.     CrossRef
  • Is end-to-end or side-to-end anastomotic configuration associated with risk of positive intraoperative air leak test in left-sided colon and rectal resections for colon and rectal cancers?
    Sami Alahmadi, David L. Berger, Christy E. Cauley, Robert N. Goldstone, William V. Kastrinakis, Marc Rubin, Hiroko Kunitake, Rocco Ricciardi, Grace C. Lee
    Journal of Gastrointestinal Surgery.2024; : 101899.     CrossRef
  • Operative time and surgical efficiency in end-to-end versus side-to-end colorectal anastomosis for rectal cancer
    Asif Almas Haque, Mir Rasekh Alam Ovi, Mohammad Tanvir Jalal
    International Surgery Journal.2024; 12(1): 42.     CrossRef
The importance of topical metronidazole in the treatment of acute anal fissure: a double-blind study controlled for prospective randomization
Tuba Mert
Ann Coloproctol. 2023;39(2):131-138.   Published online January 18, 2022
DOI: https://doi.org/10.3393/ac.2021.00675.0096
  • 8,508 View
  • 310 Download
  • 6 Web of Science
  • 9 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Purpose
Acute anal fissure, a disease characterized by severe pain in the anorectal area, reduces quality of life and becomes chronic absent appropriate treatment. More recently, anaerobic infections have been noted as contributive to etiopathogenesis. This study investigates topical metronidazole’s effect in the treatment of acute anal fissure.
Methods
Our prospective randomized controlled double-blind study included 2 groups of 100 patients older than 18 years from our General Surgery Clinic with anal fissure complaints for less than 8 weeks. Topical diltiazem treatment was started in group 1, and topical diltiazem and metronidazole treatment in group 2. Pain levels were evaluated by the visual analogue scale (VAS) score, and recovery status was evaluated by physical examination findings ab initio and at the 1st, 4th, and 6th weeks. VAS score levels, demographic, clinical, and recovery status were then compared.
Results
There was no difference between the groups as to age, sex, pain on defecation, bleeding, constipation, and duration of pain, bleeding and constipation (P>0.05). From week 1, fissure epithelialization and healing rates were higher in group 2 (P<0.001); group 2 VAS score levels were lower than in group 1 (P<0.001) and achieved by group 1 only in week 4 (P=0.073).
Conclusion
Adding topical metronidazole to treatment reduces the duration and severity of pain, shortens healing time, and increases the healing rate.

Citations

Citations to this article as recorded by  
  • A comparative study between combination of topical metronidazole and diltiazem vs diltiazem alone in treatment of acute anal fissure
    Abhishek Jain, Rafat Khan, Nitin Garg
    International Surgery Journal.2025; 12(3): 350.     CrossRef
  • Search for bacterial biofilms in the chronic anal fissure (descriptive study with in-depth visualization)
    M. A. Ignatenko, A. A. Ponomarenko, M. V. Zhurina, N. A. Kostrikina, E. E. Zharkov, Yu. A. Nikolaev, A. R. Melkumyan
    Koloproktologia.2025; 24(3): 95.     CrossRef
  • Efficacy of local metronidazole with glyceryl trinitrate versus topical glyceryl trinitrate alone in the treatment of acute anal fissure: a randomized clinical trial
    Hesham M. Elgendy, Ahmed AbdelMawla, Ahmed F. Hussein
    The Egyptian Journal of Surgery.2024; 43(1): 304.     CrossRef
  • Belgian consensus guideline on the management of anal fissures
    P Roelandt, G Bislenghi, G Coremans, D De Looze, M.A. Denis, H De Schepper, P Dewint, J Geldof, I Gijsen, N Komen, H Ruymbeke, J Stijns, M Surmont, D Van de Putte, S Van den Broeck, B Van Geluwe, J Wyndaele
    Acta Gastro Enterologica Belgica.2024; 87(2): 304.     CrossRef
  • Avances terapéuticos en el abordaje de las fisuras anales: explorando la sinergia entre Farmacología y Nanotecnología
    Carlos Ostwaldo Pazmiño-Chiluiza, María Luisa González Rodríguez
    Ars Pharmaceutica (Internet).2024; 65(4): 409.     CrossRef
  • Local plus oral antibiotics and strict avoidance of constipation is effective and helps prevents surgery in most cases of anal fissure
    Pankaj Garg, Vipul D. Yagnik, Kaushik Bhattacharya
    Annals of Coloproctology.2023; 39(2): 188.     CrossRef
  • COMPARATIVE STUDY ON THE EFFICACY OF TOPICAL METRONIDAZOLE, TOPICAL NITROGLYCERINE, AND TOPICAL DILTIAZEM IN THE MANAGEMENT OF CHRONIC ANAL FISSURE
    PURSHOTAM DASS GUPTA, FAHAD TAUHEED, ANURAG SARASWAT, Karthik P
    Asian Journal of Pharmaceutical and Clinical Research.2023; : 141.     CrossRef
  • The Italian Unitary Society of Colon-proctology (SIUCP: Società Italiana Unitaria di Colonproctologia) guidelines for the management of anal fissure
    Antonio Brillantino, Adolfo Renzi, Pasquale Talento, Francesca Iacobellis, Luigi Brusciano, Luigi Monaco, Domenico Izzo, Alfredo Giordano, Michele Pinto, Corrado Fantini, Marcello Gasparrini, Michele Schiano Di Visconte, Francesca Milazzo, Giovanni Ferrer
    BMC Surgery.2023;[Epub]     CrossRef
  • Comparative Efficacy of Topical Metronidazole and Glyceryl Trinitrate Versus Topical Glyceryl Trinitrate Alone in the Treatment of Acute Anal Fissure: A Randomized Clinical Trial
    M Hasaan Shahid, Sidra Javed, Saryia Javed, Anwar Zeb Khan, Adeel Kaiser, Reda H Mithany
    Cureus.2022;[Epub]     CrossRef
Benign GI diease,Benign diesease & IBD,Complication,Surgical technique
Efficacy and Safety of Endoscopic Clipping for Acute Anastomotic Bleeding After Colorectal Surgery
Ryun Kyong Ha, Kyung Su Han, Sung Sil Park, Dae Kyung Sohn, Chang Won Hong, Byung Chang Kim, Bun Kim
Ann Coloproctol. 2022;38(3):262-265.   Published online October 26, 2021
DOI: https://doi.org/10.3393/ac.2021.00297.0042
  • 6,689 View
  • 182 Download
  • 3 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
Anastomotic bleeding after colorectal surgery is a rare, mostly self-limiting, postoperative complication that could lead to a life-threatening condition. Therefore, prompt management is required. This study aimed to evaluate the efficacy and safety of endoscopic clipping for acute anastomotic bleeding after colorectal surgery.
Methods
We retrospectively reviewed the data of patients pathologically diagnosed with colorectal cancer at National Cancer Center, Korea from January 2018 to November 2020, which presented with anastomotic bleeding within the first postoperative week and were endoscopically managed with clips.
Results
Nine patients had anastomotic bleeding, underwent endoscopic management, and, therefore, were included in this study. All patients underwent laparoscopic (low/ultralow) anterior resection with mechanical double-stapled anastomosis. Anastomotic bleeding was successfully managed through a colonoscopy with clips on the first trial in all patients. Hypovolemic shock occurred in one patient, following anastomotic breakdown.
Conclusion
Endoscopic clipping seems to be an effective and safe treatment for anastomotic bleeding with minimal physiologic stress, easy accessibility, and scarce postoperative complications. However, a surgical backup should always be considered for massive bleeding.

Citations

Citations to this article as recorded by  
  • Post-Surgical Imaging Assessment in Rectal Cancer: Normal Findings and Complications
    Federica De Muzio, Roberta Fusco, Carmen Cutolo, Giuliana Giacobbe, Federico Bruno, Pierpaolo Palumbo, Ginevra Danti, Giulia Grazzini, Federica Flammia, Alessandra Borgheresi, Andrea Agostini, Francesca Grassi, Andrea Giovagnoni, Vittorio Miele, Antonio B
    Journal of Clinical Medicine.2023; 12(4): 1489.     CrossRef
  • Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
    Hyun Gu Lee
    The Ewha Medical Journal.2023;[Epub]     CrossRef
Benign diesease & IBD,Surgical technique
Transanal rectopexy for external rectal prolapse
Shantikumar Dhondiram Chivate, Meghana Vinay Chougule, Rahul Shantikumar Chivate, Palak Harshuk Thakrar
Ann Coloproctol. 2022;38(6):415-422.   Published online October 21, 2021
DOI: https://doi.org/10.3393/ac.2021.00262.0037
  • 7,459 View
  • 201 Download
  • 2 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
The surgical management of patients with full-thickness rectal prolapse (FTRP) continues to remain a challenge in the laparoscopic era. This study retrospectively assesses a cohort of patients undergoing a transanal suture sacro rectopexy supported by sclerosant injection into the presacral space under ultrasound guidance.
Methods
Patients with FTRP underwent a sutured transrectal presacral fixation of 2/3 of the circumference of the rectum from the third sacral vertebra to the sacrococcygeal junction through a side-viewing operating proctoscope. The procedure was supplemented by ultrasound-guided injection into the retrorectal space of a 2 mL solution of sodium tetradecyl sulfate/polidocanol mixed with air. Patients were functionally assessed before and 6 months after surgery with the Agachan constipation score and the Pescatori incontinence score.
Results
There were 36 adult patients (26 males; the range of age, 23–92 years). The mean operative time was 27 minutes (range, 23–50 minutes) with no recorded perioperative morbidity. The median follow-up was 66 months (range, 48–84 months) with 1 (2.8%) recurrence presenting 18 months after surgery. There were 19 patients (52.8%) who presented with incontinence before surgery with 17 out of 19 (89.5%) reporting improvement in their Pescatori score (P<0.001). No patient had worsening incontinence and there were no de novo incontinence cases. Constipation scores improved in 23 out of 36 patients (63.9%) with a mean score reduction difference of 7.91 (P=0.001).
Conclusion
Transanal sutured sacral rectopexy with supplemental presacral sclerosant injection is safe and effective in the management of FTRP with sustained improvement in bowel function.

Citations

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  • Systematic literature review and meta-analysis of surgical treatment of complete rectal prolapse in male patients
    S. H. Emile, A. Wignakumar, N. Horesh, Z. Garoufalia, V. Strassmann, M. Boutros, S. D. Wexner
    Techniques in Coloproctology.2024;[Epub]     CrossRef
  • External rectal prolapse: more than meets the eye
    M. Yiasemidou, C. Yates, E. Cooper, R. Goldacre, I. Lindsey
    Techniques in Coloproctology.2023; 27(10): 783.     CrossRef
Incidence of anal fistula after pyogenic perianal abscess drainage in Kingdom of Bahrain
Zahra Abdulla Isa Yusuf Hasan, Bayan Mohamed, Rawaa AlSayegh, Raed AlMarzooq
Ann Coloproctol. 2023;39(1):27-31.   Published online August 9, 2021
DOI: https://doi.org/10.3393/ac.2020.00962.0137
  • 11,364 View
  • 200 Download
  • 4 Web of Science
  • 5 Citations
AbstractAbstract PDF
Purpose
Perianal fistula is one of the most common anorectal diseases in adult patients, especially men. A relationship between pyogenic perianal abscess and fistula formation is established in multiple domains. This is the first exploration of such association among patients in the country as no related study has been published in Bahrain. We expect this study to be a foundation for future protocols and evidence-based practice.
Methods
A retrospective study was conducted in Salmaniya Medical Complex of Bahrain. A total of 109 patients with a diagnosis of anal abscess were included between 2015 and 2018. Data were collected from the electronic files database used in Salmaniya Medical Complex (iSeha) as well as phone calls to the patients. Collected data were analyzed using statistical software.
Results
The most predominant presentation of perianal abscess was pain. Over 50% of abscesses were classified as perianal (56.9%) and among those, left-sided abscesses were more common, followed by right-, posterior-, and anterior-sited, respectively. No recurrence of abscess was recorded among 80% of patients. A fistula developed following abscess drainage in 33.9% of patients. Most fistulas (37.8%) were diagnosed within 6 months or less from abscess drainage. Posterior fistulas were the most common, followed by anterior and left-sided fistulas.
Conclusion
The incidence of anal fistula in Bahrain after perianal abscess was 33.9%. Most of the patients who developed a fistula following pyogenic abscess drainage were males and above the age of 40 years. The most common site for fistula was posterior.

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  • Risk factors for perianal abscess recurrence after incision and drainage: a review of the literature
    Kheira Gabsi
    International Surgery Journal.2025; 12(2): 255.     CrossRef
  • A Review of the Anatomy of Anal Glands Relevant to Cryptoglandular Fistulas; Are We on the Right Track?
    James Church
    ANZ Journal of Surgery.2025; 95(11): 2355.     CrossRef
  • Anal Cryptoglandular Suppuration
    Oladapo Akinmoladun, Quinton M. Hatch
    Surgical Clinics of North America.2024; 104(3): 491.     CrossRef
  • Proposal for a new classification of anorectal abscesses based on clinical characteristics and postoperative recurrence
    Shan-Zhong Chen, Kui-Jun Sun, Yi-Fan Gu, Hong-Yuan Zhao, Dong Wang, Yun-Fang Shi, Ren-Jie Shi
    World Journal of Gastrointestinal Surgery.2024; 16(11): 3425.     CrossRef
  • Research Progress on Diagnosis and Surgical Treatment of Perianal Deep Space Abscess
    永罡 秦
    Advances in Clinical Medicine.2023; 13(01): 180.     CrossRef
Case Report
Benign proctology,Complication,Biomarker & risk factor
Recurrent bleeding after posthemorrhoidectomy caused by factor V deficiency: a case report and review of the literature
Jun Seong Chung, Han Deok Kwak, Jae Kyun Ju
Ann Coloproctol. 2022;38(6):449-452.   Published online July 27, 2021
DOI: https://doi.org/10.3393/ac.2021.00185.0026
  • 5,259 View
  • 152 Download
  • 1 Web of Science
  • 2 Citations
AbstractAbstract PDF
Congenital factor V (FV) deficiency is a rare hemorrhagic disorder that can cause excessive bleeding during and after surgery in the affected patient. This report is the case of a patient who had FV deficiency with recurrent posthemorrhoidectomy bleeding treated with the hemostatic procedure and fresh frozen plasma (FFP) transfusions. A 45-year-old male patient had previously undergone hemorrhoidectomy for multiple hemorrhoids at a local hospital. Hemorrhoidectomy was successful; however, he was transferred to our hospital for evaluation of the origin of the recurrent posthemorrhoidectomy bleeding and underwent a hemostatic procedure. This bleeding was treated with coagulation using electrocautery, multiple sutures, and FFP transfusion (1,600 mL/day) for 7 consecutive days. The patient’s plasma FV activity was 23%. Early detection of clotting factor deficiency in patients with hemorrhagic events after surgical treatments may prevent unnecessary procedures such as reoperations and minimize the cost of replacement therapy such as large-volume FFP transfusion.

Citations

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  • Rare Inherited Coagulation Deficiencies: A Single-center Study
    Özlem Terzi, Sadik Sami Hatipoğlu
    Journal of Pediatric Hematology/Oncology.2025; 47(2): e90.     CrossRef
  • Plasma/tranexamic-acid/vitamin-k

    Reactions Weekly.2023; 1954(1): 383.     CrossRef
Original Articles
Benign proctology,Complication,Biomarker & risk factor
Frequency and risk factors of severe postoperative bleeding after proctological surgery: a retrospective case-control study
Sarah Taieb, Patrick Atienza, Jean-David Zeitoun, Milad Taouk, Josée Bourguignon, Christian Thomas, Nabila Rabahi, Saliha Dahlouk, Anne-Carole Lesage, David Lobo, Isabelle Etienney
Ann Coloproctol. 2022;38(5):370-375.   Published online July 27, 2021
DOI: https://doi.org/10.3393/ac.2021.00122.0017
  • 6,867 View
  • 170 Download
  • 4 Web of Science
  • 4 Citations
AbstractAbstract PDF
Purpose
The aim of this study was to assess frequency and risk factors of severe bleeding after proctological surgery requiring hemostatic surgery observed after publication of the French guidelines for anticoagulant and platelet-inhibitor treatment.
Methods
All patients who underwent proctological surgery between January 2012 and March 2017 in a referral center were included. Delay, severity of bleeding, and need for blood transfusion were recorded. Patients with severe postoperative bleeding were matched to controls at a 2:1 ratio adjusted on the operator, and the type of surgery.
Results
Among the 8,890 operated patients, 65 (0.7%) needed a postoperative hemostatic procedure in an operating room. The risk of a hemostatic surgery was significantly increased after hemorrhoidal surgery compared with other procedures (1.9% vs. 0.5%, P<10–4) and was most frequent after Milligan-Morgan hemorrhoidectomy (2.5%). Mean bleeding time was 6.2 days and no bleeding occurred after day 15. Blood transfusion rate was 0.1%. Treatment with anticoagulants and platelet inhibitors were managed according to recommendations and did not increase the severity of bleeding. The risk of severe bleeding was significantly lower in active smokers vs. non-smokers in univariate (16.9% vs. 36.2%, P=0.007) and multivariate (odds ratio, 0.31; 95% confidence interval, 0.14–0.65) analysis whereas sex, age, and body mass were not significantly associated with bleeding.
Conclusion
Severe postoperative bleeding occurs in 0.7% of patients, but varies with type of procedure and is not affected by anticoagulant or antiplatelet treatment. These treatments given in accordance with the new guidelines do not increase the severity of postoperative bleeding.

Citations

Citations to this article as recorded by  
  • Efficacy of Endoscopic Evaluation and Hemostatic Intervention for Post-hemorrhoidectomy Bleeding
    Katsuhisa Ohashi, Katsuhide Ohashi, Akinori Sasaki, Kazuyoshi Ota, Kazutomo Kitagawa
    Journal of the Anus, Rectum and Colon.2025; 9(1): 162.     CrossRef
  • Evaluation of Clinical Manifestations of Hemorrhoidal Disease, Carried Out Surgeries and Prolapsed Anorectal Tissues: Associations with ABO Blood Groups of Patients
    Inese Fišere, Valērija Groma, Šimons Svirskis, Estere Strautmane, Andris Gardovskis
    Journal of Clinical Medicine.2023; 12(15): 5119.     CrossRef
  • Sclerobanding in the treatment of second and third degree hemorrhoidal disease in high risk patients on antiplatelet/anticoagulant therapy without suspension: a pilot study
    Francesco Pata, Luigi M. Bracchitta, Bruno Nardo, Gaetano Gallo, Giancarlo D’Ambrosio, Salvatore Bracchitta
    Frontiers in Surgery.2023;[Epub]     CrossRef
  • Principles of minimize bleeding and the transfusion of blood and its components in operated patients – surgical aspects
    Tomasz Banasiewicz, Waldemar Machała, Maciej Borejsza Wysocki, Maciej Lesiak, Sebastian Krych, Małgorzata Lange, Piotr Hogendorf, Adam Durczyński, Jarosław Cwaliński, Tomasz Bartkowiak, Adam Dziki, Wojciech Kielan, Stanisław Kłęk, Łukasz Krokowicz, Krzysz
    Polish Journal of Surgery.2023; 95(5): 14.     CrossRef
Complication,Biomarker & risk factor
Intraoperative fluorescence angiography as an independent factor of anastomotic leakage and a nomogram for predicting leak for colorectal anastomoses
Mikhail Alekseev, Evgeny Rybakov, Evgeniy Khomyakov, Irina Zarodnyuk, Yuri Shelygin
Ann Coloproctol. 2022;38(5):380-386.   Published online July 22, 2021
DOI: https://doi.org/10.3393/ac.2021.00171.0024
  • 6,386 View
  • 180 Download
  • 13 Web of Science
  • 18 Citations
AbstractAbstract PDF
Purpose
Colorectal anastomotic leakage (AL) is a life-threatening complication, which increases morbidity, hospital stay and cost of treatment. The aim of this study is to identify risk factors, including intraoperative indocyanine green fluorescence angiography (ICG FA), associated with the leak of stapled colorectal anastomosis.
Methods
Four hundred twenty-nine consecutive patients underwent surgery between 2017 and 2019 for benign (n=10, 2.3%) or malignant (n=419, 97.7%) and rectal (n=349, 81.4%) or distal sigmoid (n=80, 18.6%) lesions with double-stapling technique reconstruction were included into retrospective study. Univariate analysis and multivariate logistic regression of the tumor-, patient- and treatment-related risk factors of AL was performed.
Results
An AL developed in 52 patients (12.1%). In multivariate analysis following variables were independently associated with AL; male sex (odds ratio [OR], 3.8; 95% confidence interval [CI], 1.9−7.7; P<0.01), anastomosis at ≤6.5 cm from anal verge (OR, 3.1; 95% CI, 1.3−7.5; P=0.01), and age of ≤62.5 years (OR, 2.1; 95% CI, 1.1−4.1; P=0.03). ICG FA was found as independent factor reducing colorectal AL rate (OR, 0.4; 95% CI, 0.2−0.8; P=0.02). A nomogram with high discriminative ability (concordance index, 0.81) was created.
Conclusion
ICG FA is a modifiable surgery-related risk factor associated with a decrease of colorectal AL rate. A suggested nomogram, which takes into consideration ICG FA, might be helpful to identify the individual risk of AL.

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  • Multiple robotic stapler firings to transect the rectum are not associated with anastomotic leakage
    Stefano Cardelli, Luca Stocchi, Amit Merchea, Dorin T. Colibaseanu, Michelle F. DeLeon, Nitin Mishra, Kevin J. Hancock, David W. Larson
    Colorectal Disease.2025;[Epub]     CrossRef
  • Prospective analysis of factors influencing the change of the section line based on fluorescence angiography with ICG for colorectal anastomosis
    J. R. Gómez-López, A. Balla, E. Licardie, S. Morales-Conde
    Techniques in Coloproctology.2025;[Epub]     CrossRef
  • Perfil epidemiológico de pacientes submetidos a cirurgias colorretais e análise da incidência de fístulas anastomóticas em hospital secundário - de 2019 a 2024
    Davidson Anthony Aragão Freire, Carla Camila Bezerra Rocha, Matthaus Rabelo da Costa, Bruno Gadelha Bezerra, Cid Gerardo Paracampos Liberato, Neto Lorena Cavalcante de Lemos
    Revista Científica do Hospital e Maternidade José Martiniano Alencar.2025; 4(2): 20.     CrossRef
  • Risk factors for anastomotic fistula after total mesorectal excision: A monocentric retrospective study of 78 patients
    Amine Majdoubi, Anass El Aachi, Mohammed El Hammouti, Haïtam Aabalou, Ayoub Kharkhach, Tariq Bouhout, Badr Serji
    Clinical Surgical Oncology.2025; 4(3): 100096.     CrossRef
  • SAGES 2025 systematic review and meta-analysis for fluorescence image-guided gastrointestinal surgery using indocyanine green
    Panagiotis Kapsampelis, Elisa C. Calabrese, Sunjay S. Kumar, Dena Shehata, Varun Bansal, Katie Carsky, Austin Eason, Himsikhar Khataniar, Stefan Scholz, María Rita Rodríguez-Luna, Nisha Narula, Jeffrey Chiu, Subhashini Ayloo, Farah Husain, Ahmed Abou-Sett
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  • Multicentre prospective non-interventional study protocol for evaluating surgical strategies for Colorectal Resections and Postoperative Quality of Life in Retroperitoneal Sarcoma Patients Across German-Speaking Sarcoma Centres (COLOSARC-Q)
    Madelaine Hettler, Katrin R Scharpf, Anna Eich, Markus Albertsmeier, Anna Duprée, Svetlana Hetjens, Melissa Harbrücker, Franka Menge, Alexander Betzler, Peter Hohenberger, Jens Jakob
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  • 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
  • RISK FACTORS AND PREVENTIVE MEASURES OF SURGICAL COMPLICATIONS IN THE TREATMENT OF RECTAL CANCER
    Світлана Віталіївна Маліборська, Y.D. Partykevych, A.E. Kryzhanivska
    Art of Medicine.2024; : 282.     CrossRef
  • The impact of powered circular staplers on anastomotic leak in left-sided colorectal cancer surgeries
    Hayoung Lee, Yong Sik Yoon, Young Il Kim, Eun Jung Park, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim
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    Gyung Mo Son, Sang-Ho Park, Nam Su Kim, Mi Sook Yun, In Young Lee, Myeong-Sook Kwon, Tae Kyun Kim, Eun Hwa Lee, Eun Jung Hwang, Kwang-Ryul Baek
    Medicina.2024; 60(12): 1966.     CrossRef
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    Christos Tsalikidis, Athanasia Mitsala, Vasileios I. Mentonis, Konstantinos Romanidis, George Pappas-Gogos, Alexandra K. Tsaroucha, Michail Pitiakoudis
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    S. N. Lukmonov, Ya. V. Belenkaya, M. S. Lebedko, S. S. Gordeev, Z. Z. Mammadli
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  • The Safe Values of Quantitative Perfusion Parameters of ICG Angiography Based on Tissue Oxygenation of Hyperspectral Imaging for Laparoscopic Colorectal Surgery: A Prospective Observational Study
    Gyung Son, Armaan Nazir, Mi Yun, In Lee, Sun Im, Jae Kwak, Sang-Ho Park, Kwang-Ryul Baek, Ines Gockel
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    Xue-Cong Zheng, Jin-Bo Su, Jin-Jie Zheng
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    Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
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    Hyun Gu Lee
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    Eugenia Claudia Zarnescu, Narcis Octavian Zarnescu, Radu Costea
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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
  • 6,873 View
  • 201 Download
  • 14 Web of Science
  • 17 Citations
AbstractAbstract PDFSupplementary Material
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

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  • 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
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    Chungyeop Lee, In Ja Park
    The World Journal of Men's Health.2024; 42(2): 304.     CrossRef
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    Kuanxuan You, He Han
    Medicine.2024; 103(22): e38409.     CrossRef
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    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
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    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
Malignant disease,Rectal cancer, Prognosis and adjuvant therapy,Colorectal cancer
Effect of Adjuvant Chemotherapy on Elderly Stage II High-Risk Colorectal Cancer Patients
Yujin Lee, Inseok Park, Hyunjin Cho, Geumhee Gwak, Keunho Yang, Byung-Noe Bae
Ann Coloproctol. 2021;37(5):298-305.   Published online July 6, 2021
DOI: https://doi.org/10.3393/ac.2020.00829.0118
  • 6,293 View
  • 100 Download
  • 16 Web of Science
  • 20 Citations
AbstractAbstract PDF
Purpose
Adjuvant chemotherapy (AC) is recommended for patients with stage II colorectal cancer with adverse features. However, the effect of adjuvant treatment in elderly patients with high-risk stage II colorectal cancer remains controversial. This study aimed to investigate the oncologic outcomes in elderly high-risk stage II colorectal cancer patients who underwent curative resection with or without AC.
Methods
Patients aged over 70 years having stage II colorectal adenocarcinoma with at least 1 adverse feature who underwent radical surgery between 2008 and 2017 at a single center were included. We compared recurrence-free survival (RFS) and overall survival (OS) between patients who received more than 80% of the planned AC cycle (the AC+ group) and those who did not receive it (the AC− group).
Results
The AC+ and AC– group contained 46 patients and 50 patients, respectively. The log-rank test revealed no significant intergroup differences in RFS (P = 0.083) and OS (P = 0.122). In the subgroup of 27 patients with more than 2 adverse features, the AC+ group (n = 16) showed better RFS (P = 0.006) and OS (P = 0.025) than the AC− group. In this subgroup, AC was the only significant factor affecting RFS in the multivariate analysis (P = 0.023). AC was significantly associated with OS (P = 0.033) in the univariate analysis, but not in the multivariate analysis (P = 0.332).
Conclusion
Among elderly patients with stage II high-risk colorectal cancer, the AC+ group did not show better RFS or OS than the AC− group. However, selected patients with more than 2 adverse features might benefit from AC.

Citations

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  • Tumor aggression-defense index–a novel indicator to predicts recurrence and survival in stage II-III colorectal cancer
    Tong Wu, Lin Fang, Yuli Ruan, Mengde Shi, Dan Su, Yue Ma, Ming Ma, Bojun Wang, Yuanyu Liao, Shuling Han, Xiaolin Lu, Chunhui Zhang, Chao Liu, Yanqiao Zhang
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  • 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
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    Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
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    Jian Li, Yu zhou Yang, Peng Xu, Cheng Zhang
    Journal of Gastrointestinal Cancer.2024; 55(3): 1111.     CrossRef
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    Soo Young Oh, Chan Wook Kim, Seonok Kim, Min Hyun Kim, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu
    Clinical Colorectal Cancer.2024; 23(2): 135.     CrossRef
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    Abdulmohsin Fawzi Aldilaijan, Young Il Kim, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Jihun Kim, Jun-Soo Ro, Jin Cheon Kim
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    Youngbae Jeon, Eun Jung Park
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    Tomohito Tanaka, Suguru Yamashita, Haruo Kuroboshi, Junya Kamibayashi, Atsushi Sugiura, Kaori Yoriki, Taisuke Mori, Kazuharu Tanaka, Aiko Nagashima, Michihide Maeda, Shoji Kamiura, Yukako Mizuno, Noriko Ohtake, Tomoyuki Ichimura, Taiki Kikuchi, Yuri Nobut
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    Jianbing Chen, Chengda Zhang, Yajuan Wu
    Expert Review of Gastroenterology & Hepatology.2022; 16(4): 383.     CrossRef
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    Cancers.2022; 14(12): 2833.     CrossRef
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    Gyung Mo Son
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    Chang Hyun Kim
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    Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
    Journal of the Korean Medical Association.2022; 65(9): 549.     CrossRef
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    Chang Hyun Kim
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    Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
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    International Journal of Colorectal Disease.2022; 37(12): 2481.     CrossRef
  • Elderly High-Risk Stage II Colorectal Cancer Patients: Candidates for Improving Outcome?
    Min Ki Kim
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Malignant disease, Rectal cancer, Functional outcomes
Introduction of a handmade vacuum-assisted sponge drain for the treatment of anastomotic leakage after low anterior rectal resection
Amir Keshvari, Abolfazl Badripour, Mohammad Reza Keramati, Alireza Kazemeini, Behnam Behboudi, Mohammad Sadegh Fazeli, Ehsan Rahimpour, Parisa Ghaffari, Seyed Mohsen Ahmadi Tafti
Ann Coloproctol. 2022;38(3):230-234.   Published online June 10, 2021
DOI: https://doi.org/10.3393/ac.2021.00059.0008
  • 8,548 View
  • 232 Download
  • 5 Web of Science
  • 6 Citations
AbstractAbstract PDF
Purpose
Anastomotic leakage, a known major postoperative complication, potentially leads to readmission, reoperation, and increased mortality rates in patients, such as rectal cancer patients following a low anterior resection (LAR). Currently, vacuum-assisted closure, as featured by B-Braun (B-Braun Medical B.V.), is already being used for the treatment of gastrointestinal leakages and fistulas. The main aim of this study was to introduce a novel method for creating a vacuum-assisted drain for the treatment of anastomotic leakage after LAR.
Methods
All 10 patients, who underwent LAR surgery from 2018 to 2019, were diagnosed with anastomotic leakage and had received neoadjuvant chemotherapy prior to surgery. Therefore, patients were treated with a handmade vacuum-assisted drain and were revisited every 5 to 7 days for further evaluations and drain replacement until leakage resolution. Physical features of cavity, time of diagnose, and duration of treatment were analyzed correspondingly. The handmade vacuum-assisted sponge drain was prepared for each patient in each session of follow-up.
Results
Eight out of 10 patients experienced complete closure of the defect. The mean delay time from the day of operation to the diagnosis of anastomotic leakage was 61.0±80.4 days while the mean time for leakage closure was 117.6±68.3 days. Eventually, 7 cases underwent ileostomy reversal with no complications during a 3-month follow-up.
Conclusion
In this study, we evaluated the healing process of anastomotic leakage after the usage of a handmade vacuum-assisted sponge drain in a case series method. In our trial, we provided an innovative cost-benefit method easily applicable in the operating room.

Citations

Citations to this article as recorded by  
  • Ghost Ileostomy Versus Protective Ileostomy in Rectal Cancer Followed by Low Anterior Resection: A Randomized Feasibility Trial
    Seyed Mostafa Meshkati Yazd, Mohammad Reza Keramati, Marzieh Ghanbari Ghalerudkhani, Reza Shahriarirad, Amir Parsa, Amir Keshvari
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    Gyung Mo Son, Sang-Ho Park, Nam Su Kim, Mi Sook Yun, In Young Lee, Myeong-Sook Kwon, Tae Kyun Kim, Eun Hwa Lee, Eun Jung Hwang, Kwang-Ryul Baek
    Medicina.2024; 60(12): 1966.     CrossRef
  • Assessment of the efficacy of Handmade Vacuum-Assisted Sponge Drain for Treatment of Anastomotic leakage after Low Anterior Rectal Resection
    Amir Keshvari, Leila mollamohammadi, Mohammad Reza Keramati, Behnam Behboudi, Mohammad Sadegh Fazeli, Alireza Kazemeini, Amirhossein Naseri, Elnaz Shahmohammadi, Laleh Foroutani, Aryan Ayati, Amirhossein Tayebi, Zahra Sajjadian, Alireza Hadizadeh, Seyed-M
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    F. Borja de Lacy, Kevin Talboom, Sapho X. Roodbeen, Robin Blok, Anna Curell, Pieter J. Tanis, Wilhelmus A. Bemelman, Roel Hompes
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    Jairo Enrique Mendoza Saavedra, Cesar Andrés Torres Carrillo, Gloria Liliana Mendoza Valbuena
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  • Neoadjuvant chemoradiotherapy determines the prognostic impact of anastomotic leakage in advanced rectal cancer
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Malignant disease, Rectal cancer, Functional outcomes,Colorectal cancer
The Effect of Anastomotic Leakage on the Incidence and Severity of Low Anterior Resection Syndrome in Patients Undergoing Proctectomy: A Propensity Score Matching Analysis
Sungjin Kim, Sung Il Kang, So Hyun Kim, Jae-Hwang Kim
Ann Coloproctol. 2021;37(5):281-290.   Published online June 7, 2021
DOI: https://doi.org/10.3393/ac.2021.03.15
  • 6,422 View
  • 73 Download
  • 23 Web of Science
  • 23 Citations
AbstractAbstract PDF
Purpose
Proctectomy for the treatment of rectal cancer results in inevitable changes to bowel habits. Symptoms such as fecal incontinence, constipation, and tenesmus are collectively referred to as low anterior resection syndrome (LARS). Among the several risk factors that cause LARS, anastomotic leakage (AL) is a strong risk factor for permanent stoma formation. Therefore, the purpose of this study was to investigate the relationship between the severity of LARS and AL in patients with rectal cancer based on the LARS score and the Memorial Sloan Kettering Cancer Center (MSKCC) defecation symptom questionnaires.
Methods
We retrospectively analyzed patients who underwent low anterior resection for rectal cancer since January 2010. Patients who completed the questionnaire were classified into the AL group and control group based on medical and imaging records. Major LARS and MSKCC scores were analyzed as primary endpoints.
Results
Among the 179 patients included in this study, 37 were classified into the AL group. After propensity score matching, there were significant differences in the ratio of major LARS and MSKCC scores of the control group and AL group (ratio of major LARS: 11.1% and 37.8%, P<0.001; MSKCC score: 67.29±10.4 and 56.49±7.2, respectively, P<0.001). Univariate and multivariate analyses revealed that AL was an independent factor for major LARS occurrence and MSKCC score.
Conclusion
This study showed that AL was a significant factor in the occurrence of major LARS and defecation symptoms after proctectomy.

Citations

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  • Repeated Treatments for Chronic Colorectal and Coloanal Anastomotic Leaks are Associated With a Higher Chance of a Permanent Stoma
    Justin Dourado, Sameh Hany Emile, Anjelli Wignakumar, Brett Weiss, Nir Horesh, Victoria DeTrolio, Rachel Gefen, Zoe Garoufalia, Peter Rogers, Victor Strassmann, Steven D. Wexner
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  • Adenoma and carcinoma in the anal transitional zone following hand-sewn versus stapled ileal pouch-anal anastomosis in familial adenomatous polyposis
    Jun Yong Han, Min Jung Kim, Sang Hui Moon, Young Jin Kim, Hyun Tae Lim, Jesung Park, Jae Hyun Park, Hyo Jun Kim, Ji Won Park, Seung-Bum Ryoo, Kyu Joo Park, Seung-Yong Jeong
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    Surgical Endoscopy.2024; 38(4): 1912.     CrossRef
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    Chungyeop Lee, In Ja Park
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    Balázs Bánky, András Fülöp, Viktória Bencze, Lóránd Lakatos, Petra Rozman, Attila Szijártó
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    Gyung Mo Son
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    Dong Hyun Kang
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    Kelly C.L.R. Buzatti, Andy Petroianu, Søren Laurberg, Rodrigo G. Silva, Beatriz D.S. Rodrigues, Peter Christensen, Antonio Lacerda-Filho, Therese Juul
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Case Report
Benign diesease & IBD,Rare disease & stoma
Calcium polystyrene sulfonate associated colonic mucosal injury—innocent bystander or pathogenic culprit?: a case report and literature review
Setthachai Piwchan, Ekawee Sripariwuth, Peerayut Sitthichaiyakul
Ann Coloproctol. 2022;38(6):453-456.   Published online May 28, 2021
DOI: https://doi.org/10.3393/ac.2021.03.19
  • 12,562 View
  • 218 Download
  • 7 Web of Science
  • 7 Citations
AbstractAbstract PDF
Colonic mucosal injury is rare, but may severely fatal, complications following the administration of calcium polystyrene sulfonate resins. The incidence rate is about 0.57%, administered without sorbitol, and increases to 1.8% when it is concomitant with sorbitol, especially in postoperative patients. In this case report, we demonstrated the case of a 77-year-old female with stage 3b chronic kidney disease presented with in-hospital hematochezia after 3 weeks of calcium polystyrene sulfonate administration. The colonoscopic findings showed several serpiginous ulcers with some oozing at descending and sigmoid colon. The histological findings revealed some focal inflammation and ulcerations with crystal-like materials, compatible with cation exchange resins. The recent in vitro study, explaining the pathogenesis of cation exchange resin-associated colonic mucosal injury, was also reviewed.

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    Shinnosuke Fukushima, Hideharu Hagiya, Hiroyuki Honda, Tomoharu Ishida, Ryohei Shoji, Kou Hasegawa, Fumio Otsuka
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    Benjamin Thorpe, Salustiano Gonzalez Vinagre, Daniel Santos, Javier Caneiro Gomez, Manuel Bustamante Montalvo
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Review
Malignant disease,Prognosis and adjuvant therapy
Survival and Operative Outcomes After Salvage Surgery for Recurrent or Persistent Anal Cancer
In Ja Park, George Chang
Ann Coloproctol. 2020;36(6):361-373.   Published online December 31, 2020
DOI: https://doi.org/10.3393/ac.2020.12.29
  • 9,553 View
  • 160 Download
  • 20 Web of Science
  • 21 Citations
AbstractAbstract PDF
Anal squamous cell carcinoma (SCC) is a relatively rare cancer comprising less than 2.5% of all gastrointestinal malignancies. The standard treatment for anal SCC is primary chemoradiation therapy which can result in complete regression. After successful treatment, the 5-year survival is approximately 80%. However, up to 30% of patients experience recurrent persistent or recurrent disease. The role of surgery in the treatment of anal cancer, therefore, is limited to the management of recurrent or persistent disease with abdominoperineal resection and/or en bloc adjacent organ excision. Salvage surgery after irradiated anal cancer can be technically demanding in terms of acquisition of oncologically safe surgical margins and minimization of postoperative morbidity. In addition, 5-year survival outcomes after salvage resection have been reported to vary from 23% to 69%. Positive resection margins are generally regarded as the important risk factor associated with poor survival outcome. Perineal wound complications are the most common major postoperative morbidity. Because of the challenges of primary wound closure after salvage abdominoperineal resection, myocutaneous flap reconstruction has been performed to reduce the severity of perianal would complications. We, therefore, descriptively reviewed contemporary published evidence describing the treatment and outcomes after salvage surgery for persistent or recurrent anal SCC.

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Original Articles
Benign GI diease,Benign proctology,Surgical technique
Pilonidal Sinus Management; Bascom Flap Versus Pilonidal Pits Excision: A Single-Center Experience
Ashraf Imam, Harbi Khalayleh, Guy Pines, Deeb Khoury, Eli Mavor, Arie Pelta
Ann Coloproctol. 2021;37(2):109-114.   Published online November 6, 2020
DOI: https://doi.org/10.3393/ac.2019.11.19.2
  • 16,147 View
  • 265 Download
  • 6 Web of Science
  • 7 Citations
AbstractAbstract PDF
Purpose
This study aimed to evaluate the outcomes of the Bascom cleft lift (flap) and the pilonidal pits excision (Gips procedure).
Methods
The records of all the patients who underwent pilonidal sinus excision between November 2013 and August 2017 were reviewed. Inclusion criteria included either pilonidal pits excision or the Bascom cleft lift procedure. All procedures were performed by a single surgeon. Perioperative complications and recurrence rates were reviewed.
Results
Fifty-three patients met the inclusion criteria. Male/female ratio was 36/17, with a mean age of 23.4 ± 7 years. In this study, 21 patients underwent the Bascom cleft lift (skin flap) procedure and 32 underwent the Gips-style operation. The mean follow-up was 3.5 months. Twenty-eight patients (52.8%) underwent prior drainage of pilonidal abscess. Eleven patients had a previous wide local excision with recurrent disease. A higher rate of recurrence was observed among patients who underwent pits picking following failure of a previous wide local excision (80% vs. 0%, P = 0.02). Minor wound dehiscence developed in 8 patients; all of which were in the Bascom flap group (40% vs. 0%, P < 0.005). All of these wounds healed completely between 3 and 6 weeks.
Conclusion
The Gips procedure is the recommended treatment for simple pilonidal disease. For recurrent pilonidal disease, the Bascom cleft lift (flap) procedure is an excellent option since it demonstrates a short wound healing time and a good success rate. This calls into question the continued use of the wide excision technique used by most surgeons in this country and abroad.

Citations

Citations to this article as recorded by  
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    Walid G. Elshazly, Ahmed Radwan, Mohmed A. Elhalim, Ahmed Moaz
    The Egyptian Journal of Surgery.2024; 43(2): 548.     CrossRef
  • ЭФФЕКТИВНОСТЬ КОЛЛАГЕНОВОЙ ГУБКИ ПРОПИТАННОЙ ДОКСИЦИКЛИНОМ ПРИ ХИРУРГИЧЕСКОМ ЛЕЧЕНИИ ПИЛОНИДАЛЬНОГО СИНУСА
    G.A. Kosayeva
    Azerbaijan Medical Journal.2024; (2): 16.     CrossRef
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    Yu. Yu. Koinov, Yu. V. Chikinev, P. V. Trushin, A. I. Shevela, V. V. Sytkov, A. I. Khavkin
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    Yaoyao Song, Yu Zang, Zequn Chen, Jianjun Li, Minhui Zhu, Hongjuan Zhu, Wanli Chu, Gang Liu, Chuan'an Shen
    International Wound Journal.2023; 20(6): 2241.     CrossRef
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    Marta Amorim, José Estevão-Costa, Cristina Santos, Sara Fernandes, Ana Catarina Fragoso
    Surgery.2023; 174(3): 480.     CrossRef
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    Peiliang Wu, Yingyi Zhang, Yewei Zhang, Shuang Wang, Zhe Fan
    International Journal of Surgery.2023; 109(8): 2388.     CrossRef
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    Sara Fernandes, Carolina Soares‐Aquino, Inês Teixeira, Joana Mafalda Monteiro, Miguel Campos
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Malignant disease
Colorectal Cancer in Octogenarian and Nonagenarian Patients: Clinicopathological Features and Survivals
Soo Min Lee, Jun Sang Shin
Ann Coloproctol. 2020;36(5):323-329.   Published online October 31, 2020
DOI: https://doi.org/10.3393/ac.2020.01.19.2
  • 6,487 View
  • 85 Download
  • 18 Web of Science
  • 20 Citations
AbstractAbstract PDF
Purpose
Elderly population will comprise a substantial proportion of colorectal cancer (CRC) patients. We examined patients older than 80 years according to their clinical and pathological characteristics to fully understand the elderly patients.
Methods
CRC patients, 60 years or older at diagnosis, admitted between 2009 and 2014 at our hospital were enrolled. The patients were divided into 2 groups: elderly (aged > 80 years, n = 133), and controls (aged 60 to 79 years, n = 596). Patient’s demographics, risk factors for prognosis of CRC, Clinicopathological parameters, treatment, and survival rates were compared.
Results
The mean ages were 83.9 and 64.8 years, respectively. Male-to-female ratio and tumor sidedness were comparable in both groups. Prognostic factors found in univariate analysis; differentiation, stage, lymphovascular invasion, and carcinoembryonic antigen showed no statistical difference. The microsatellite instability status and number of retrieved lymph nodes were also similar (17.2 vs 21.6, P = 0.505). A significant difference was found in the treatment approach for chemotherapy as the elderly patients with stage III and IV tend to have omitted adjuvant (43.6% vs. 92.8%, P < 0.001) or palliative (35.8% vs. 89.4%, P = 0.016) chemotherapy. Except in stage I, elderly patients showed significantly lower overall survival rates.
Conclusion
Current study shows far-elderly patients with CRC were less likely to receive standard treatments, which might have resulted in an inferior outcome. As the number of elderly patients with CRC increase, our results provide a basis for further clinical and molecular investigations of elderly CRC patients.

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    Ioannis A. Voutsadakis
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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
  • 7,908 View
  • 118 Download
  • 15 Web of Science
  • 21 Citations
AbstractAbstract 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

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Review
Benign proctology, Functional outcomes
Still a Case of “No Pain, No Gain”? An Updated and Critical Review of the Pathogenesis, Diagnosis, and Management Options for Hemorrhoids in 2020
Kheng-Seong Ng, Melanie Holzgang, Christopher Young
Ann Coloproctol. 2020;36(3):133-147.   Published online June 30, 2020
DOI: https://doi.org/10.3393/ac.2020.05.04
  • 30,150 View
  • 592 Download
  • 26 Web of Science
  • 39 Citations
AbstractAbstract PDF
The treatment of haemorrhoids remains challenging: multiple treatment options supported by heterogeneous evidence are available, but patients rightly demand a tailored approach. Evidence for newer surgical techniques that promise to be less painful has been conflicting. We review the current evidence for management options in patients who present with varying haemorrhoidal grades. A review of the English literature was performed utilizing MEDLINE/PubMed, Embase, and Cochrane databases (31 May 2019). The search terms (haemorrhoid OR haemorrhoid OR haemorrhoids OR haemorrhoids OR “Hemorrhoid”[Mesh]) were used. First- and second-degree haemorrhoids continue to be managed conservatively. The easily repeatable and cost-efficient rubber band ligation is the preferred method to address minor haemorrhoids; long-term outcomes following injection sclerotherapy remain poor. Conventional haemorrhoidectomies (Ferguson/Milligan-Morgan/Ligasure haemorrhoidectomy) still have their role in third- and fourth-degree haemorrhoids, being associated with lowest recurrence; nevertheless, posthaemorrhoidectomy pain is problematic. Stapled haemorrhoidopexy allows quicker recovery, albeit at the costs of higher recurrence rates and potentially serious complications. Transanal Haemorrhoidal Dearterialization has been promoted as nonexcisional and less invasive, but the recent HubBLe trial has questioned its overall place in haemorrhoid management. Novel “walk-in-walk-out” techniques such as radiofrequency ablations or laser treatments will need further evaluation to define their role in modern-day haemorrhoid management. There are numerous treatment options for haemorrhoids, each with their own evidence-base. Newer techniques promise to be less painful, but recurrence rates remain an issue. The balance continues to be sought between long-term efficacy, minimisation of postoperative pain, and preservation of anorectal function.

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    椰 刘
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    Ian Peate
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    Hyo Seon Ryu
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Case Reports
Malignant disease, Benign GI diease,Colorectal cancer,Complication
An Unusual Case of Colon Perforation With Multiple Transmural Ulcers After Use of Polmacoxib and Everolimus in a Metastatic Breast Cancer Patient
In-Gyu Song, Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Ho-Kyung Chun
Ann Coloproctol. 2021;37(2):120-124.   Published online March 16, 2020
DOI: https://doi.org/10.3393/ac.2019.08.17
  • 6,050 View
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  • 2 Web of Science
  • 3 Citations
AbstractAbstract PDF
Everolimus (Afinitor) is an inhibitor of mammalian target of rapamycin. Polmacoxib (Acelex) is a nonsteroidal anti-inflammatory drug that belongs to the cyclooxygenase-2 (COX-2) inhibitor family and is mainly used for treatment of arthritis. Intestinal perforation has not been reported previously as a complication of everolimus, and perforation of the lower intestinal tract caused by a selective COX-2 inhibitor is extremely rare. We present here a case of colon perforation that occurred after use of polmacoxib in a metastatic breast cancer patient who had been treated with everolimus for the preceding six months.

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    Xinyue Zhang, Xueqing Li, Wuda Huoshen, Shiting Li
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  • Everolimus/polmacoxib

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Benign proctology,Rare disease & stoma
Extraperitoneal Spread of Anorectal Abscess: A Case Report and Literature Review
Papadopoulos S. Konstantinos, Dimopoulos Andreas, Kordeni Kleoniki, Filis Dimitrios
Ann Coloproctol. 2021;37(Suppl 1):S11-S14.   Published online January 31, 2020
DOI: https://doi.org/10.3393/ac.2020.01.20
  • 6,414 View
  • 152 Download
  • 5 Web of Science
  • 7 Citations
AbstractAbstract PDF
Supralevator abscess is a rare form of anorectal disease responsible for very rare but morbid manifestations, one of which is superior spread through fascial planes. We present a rare case of a spreading anorectal abscess in a patient who presented with only diffuse abdominal pain, and we review similar cases in the literature according to anatomical considerations, presentation, diagnostic procedures, and treatment options. We identified 7 previously reported cases of spreading anorectal abscesses. Most abscesses had a horseshoe morphology, and all patients presented or developed abdominal pain. All patients had perianal swelling and pain. Five out of 7 patients were previously mistreated. Only 2 abscesses spread through both the pre- and retroperitoneal planes. Abdominal pain is a dominant feature of extraperitoneal inflammation originating from anorectal abscesses. The absence of perianal signs is rare, and proper inspection of the patient along with the medical history can lead to quicker diagnosis and decisive treatment.

Citations

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Original Articles
Benign GI diease
The Management of Retained Rectal Foreign Body
Ju Hun Kim, Eunhae Um, Sung Min Jung, Yong Chan Shin, Sung-Won Jung, Jae Il Kim, Tae Gil Heo, Myung Soo Lee, Heungman Jun, Pyong Wha Choi
Ann Coloproctol. 2020;36(5):335-343.   Published online January 31, 2020
DOI: https://doi.org/10.3393/ac.2019.10.03.1
  • 16,334 View
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  • 5 Web of Science
  • 7 Citations
AbstractAbstract PDF
Purpose
Because insertion of a foreign body (FB) into the anus is considered a taboo practice, patients with a retained rectal FB may hesitate to obtain medical care, and attending surgeons may lack experience with removing these FBs. We performed this study to evaluate the clinical characteristics of Korean patients with a retained rectal FB and propose management guideline for such cases based on our experience.
Methods
We retrospectively investigated 14 patients between January 2006 and December 2018. We assessed demographic features, mechanism of FB insertion, clinical course between diagnosis and management, and outcomes.
Results
All patients were male (mean age, 43 years) and presented with low abdominal pain (n = 2), anal bleeding (n = 2), or concern about a retained rectal FB without symptoms (n = 10). FB insertion was most commonly associated with sexual gratification or anal eroticism (n = 11, 78.6%). All patients underwent general anesthesia for anal sphincter relaxation with the exception of 2 who underwent FB removal in the emergency department. FBs were retrieved transanally using a clamp (n = 2), myoma screw (n = 1), clamp application following abdominal wall compression (n = 2), or laparotomy followed by rectosigmoid colon milking (n = 2). Colotomy and primary repair were performed in four patients, and Hartmann operation was performed in one patient with fecal peritonitis. No morbidity or mortality was reported. All patients refused postextraction anorectal functional and anatomical evaluation and psychological counseling.
Conclusion
Retained rectal FB is rare; however, colorectal surgeons should be aware of the various methods that can be used for FB retrieval and the therapeutic algorithm applicable in such cases.

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Malignant disease, Rectal cancer,Prognosis and adjuvant therapy
Effect of Age on Laparoscopic Surgery and Postoperative Chemotherapy in Elderly Patients With Colorectal Cancer
Hyun Hee Kim, Myong Hoon Ihn, Yun Hee Lee, Jihyoun Lee, Sangchul Yun, Sung Woo Cho
Ann Coloproctol. 2020;36(4):229-242.   Published online January 31, 2020
DOI: https://doi.org/10.3393/ac.2019.10.03
  • 6,072 View
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  • 11 Web of Science
  • 12 Citations
AbstractAbstract PDFSupplementary Material
Purpose
We aimed to evaluate the postoperative complications of laparoscopic colorectal cancer (CRC) surgery and the adverse events of postoperative chemotherapy in elderly patients compared to younger patients and to identify the factors influencing the termination of postoperative chemotherapy.
Methods
Between June 2015 and May 2018, 188 patients with CRC underwent laparoscopic surgery with curative intent. Patients aged ≥ 70 were defined as elderly. Postoperative complications and adverse events of chemotherapy were assessed by using the Clavien-Dindo classification and the Common Terminology Criteria for Adverse Events, respectively. The clinicopathological factors were analyzed retrospectively.
Results
Seventy-eight patients were considered elderly with a mean age of 77.5 ± 5.5 years. Overall postoperative complications occurred in 68 patients (36.2%). Age and primary tumor location were independent predictors of overall postoperative complications. Smoking history was the only independent predictor of major postoperative complications. Of 113 patients who were recommended postoperative chemotherapy, 90 patients (79.6%) received postoperative chemotherapy. Overall adverse events occurred in 40 patients (44.4%). The American Society of Anesthesiologists physical status classification and chemotherapy regimen were significantly associated with overall adverse events. The chemotherapy regimen was the only factor significantly associated with severe adverse events. Of 90 patients, postoperative chemotherapy could not be completed in 11 (12.2%). Age was the only factor significantly associated with stopping postoperative chemotherapy (P = 0.003).
Conclusion
This study shows that laparoscopic CRC surgery and postoperative chemotherapy were feasible in elderly patients. Further efforts are needed to ensure that elderly patients have the opportunity to make informed decisions regarding postoperative chemotherapy.

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    Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
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Original article
Defunctioning Protective Stoma Can Reduce the Rate of Anastomotic Leakage after Low Anterior Resection in Rectal Cancer Patients
Byoung Chul Lee, Seok-Byung Lim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Chang Sik Yu, Jin Cheon Kim
Received October 22, 2019  Accepted November 19, 2019  Published online January 16, 2020  
DOI: https://doi.org/10.3393/ac.2019.11.19.1
  • 6,660 View
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  • 19 Citations
AbstractAbstract PDF
PURPOSE
This study aimed to identify risk factors for anastomotic leakage and to evaluate the impact of protective stoma on the rate of anastomotic leakage and subsequent management.
METHODS
This retrospective study analyzed data from 4,282 patients who underwent low anterior resection between 2007 and 2014. Among these, 1,367 (31.9%) underwent surgery to create protective diverting stoma and 232 (5.4%) experienced anastomotic leakage. At 6-month timepoints, data were evaluated to identify any correlation between the presence of diverting stoma and the incidence of anastomotic leakage. In addition, clinicopathological parameters were investigated to identify risk factors for anastomotic leakage.
RESULTS
Diverting stomas significantly reduced the rate of anastomotic leakage [HR 0.334, 95% CI 0.212

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Original Articles
Short-term Outcomes After Upfront Chemotherapy Followed by Curative Surgery in Metastatic Colon Cancer: A Comparison With Upfront Surgery Patients
Myung Hyun Han, Youn Young Park, Shiva Pratap, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim
Ann Coloproctol. 2019;35(6):327-334.   Published online December 31, 2019
DOI: https://doi.org/10.3393/ac.2019.03.04.1
  • 4,878 View
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  • 2 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
Upfront systemic chemotherapy with target agents has been recommended for patients with stage IV colon cancer. Some with partial response are considered for curative resection. There is high risk of developing postoperative complications following upfront systemic chemotherapy. We aimed to evaluate short-term perioperative outcomes of curative surgery after upfront chemotherapy in comparison with upfront surgery in patients with metastatic colon cancer.
Methods
Between January 2010 and October 2015, 146 patients (80 in the surgery first group, 66 in the upfront chemotherapy group) who underwent surgical resection before or after systemic chemotherapy for metastatic colon cancer were included in the present study. All decisions for treatment were made through a multidisciplinary team. Postoperative clinical outcomes and complications were analyzed to compare the groups.
Results
There was no difference between the 2 groups in terms of postoperative clinical outcomes. Overall complication rates were not different between the groups (surgery first group: 46.3% vs. upfront chemotherapy group: 60.6%; P = 0.084). When classified according to the Clavien-Dindo method, there was no difference between the 2 groups in terms of major complications (grade 3 or more) (surgery first group: 18.9% vs. upfront chemotherapy group: 27.5%; P = 0.374).
Conclusion
There was no significant increase in major postoperative complications in metastatic colon cancer patients who received upfront chemotherapy followed by curative surgery. Careful patient selection and treatment planning are important.

Citations

Citations to this article as recorded by  
  • Impact of preoperative chemotherapy on perioperative morbidity in combined resection of colon cancer and liver metastases
    Joy Z. Done, Angelos Papanikolaou, Miloslawa Stem, Shannon N. Radomski, Sophia Y. Chen, Chady Atallah, Jonathan E. Efron, Bashar Safar
    Journal of Gastrointestinal Surgery.2023; 27(11): 2380.     CrossRef
  • Treatment for Peritoneal Metastasis of Patients With Colorectal Cancer
    Young Jin Kim, Chang Hyun Kim
    Annals of Coloproctology.2021; 37(6): 425.     CrossRef
Effectiveness of Autologous Fat Graft in Treating Fecal Incontinence
Hyeonseok Jeong, Sung Hwan Hwang, Hyoung Rae Kim, Kil O Ryu, Jiyong Lim, Hye Mi Yu, Jihoon Yoon, Chee Young Kim, Kwang-Yong Jeong, Young Jae Jung, In Seob Jeong, Young Gil Choi
Ann Coloproctol. 2019;35(3):144-151.   Published online June 30, 2019
DOI: https://doi.org/10.3393/ac.2018.09.15
  • 7,995 View
  • 105 Download
  • 5 Web of Science
  • 5 Citations
AbstractAbstract PDF
Purpose
The most common risk factor for fecal incontinence (FI) is obstetric injury. FI affects 1.4%–18% of adults. Most patients are unaware when they are young, when symptoms appear suddenly and worsen with aging. Autologous fat graft is widely used in cosmetic surgical field and may substitute for injectable bulky agents in treating FI. Authors have done fat graft for past several years. This article reports the effectiveness of the fat graft in treating FI and discusses satisfaction with the procedure.
Methods
Fat was harvested from both lateral thighs using 10-mL Luer-loc syringe. Pure fat was extracted from harvests and mixed with fat, oil, and tumescent through refinement. Fats were injected into upper border of posterior ano-rectal ring, submucosa of anal canal and intersphincteric space. Thirty-five patients with FI were treated with this method from July 2016 to February 2017 in Busan Hangun Hospital. They were 13 male (mean age, 60.8 years) and 22 female patients (mean age, 63.3 years). The Wexner score was checked before procedure. We evaluated outcome in outpatients by asking the patients. For 19 patients we checked the Wexner score after procedure.
Results
Symptom improved in 29 (82.9%), and not improved in 6 (17.1%). In 2 of 6 patients, they felt better than before procedure, although not satisfied. No improvement in 4. Mean Wexner score was 9.7 before procedure. There were no serious complications such as inflammation or fat embolism.
Conclusion
Autologous fat graft can be an effective alternative treatment for FI. It is safe and easy to perform, and cost effective.

Citations

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  • Cell-assisted lipotransfer in treating uncontrollable sepsis associated perianal fistula: a pilot study
    In Seob Jeong, Sung Hwan Hwang, Hye Mi Yu, Hyeonseok Jeong
    Annals of Coloproctology.2024; 40(2): 169.     CrossRef
  • Efficacy of injection of autologous adipose tissue in the treatment of patients with complex and recurrent fistula-in-ano of cryptoglandular origin
    S. Guillaumes, N. J. Hidalgo, I. Bachero, R. Pena, S. T. Nogueira, J. Ardid, M. Pera
    Techniques in Coloproctology.2024;[Epub]     CrossRef
  • Role of Autologous Fat Grafting in the Conservative Treatment of Fecal Incontinence in Children
    Valentina Pinto, Marco Pignatti, Giovanni Parente, Neil Di Salvo, Luca Contu, Mario Lima
    Journal of Clinical Medicine.2023; 12(4): 1258.     CrossRef
  • Clinical and physiological efficacy of the application of autologous fat with platelet rich plasma in treating faecal incontinence
    Elvis Vargas Castillo, Ingrid Melo Amaral, Arisel Domínguez, Sthephfania López, Daniel Chiantera, Mariangela Pérez Paz, Jenils Daniela Coacuto, Andrés Eloy Soto
    Journal of Coloproctology.2020; 40(03): 227.     CrossRef
  • Preliminary Study on the Echo-Assisted Intersphincteric Autologous Microfragmented Adipose Tissue Injection to Control Fecal Incontinence in Children Operated for Anorectal Malformations
    Giovanni Parente, Valentina Pinto, Neil Di Salvo, Simone D’Antonio, Michele Libri, Tommaso Gargano, Vincenzo Davide Catania, Giovanni Ruggeri, Mario Lima
    Children.2020; 7(10): 181.     CrossRef
Anastomotic Sinus That Developed From Leakage After a Rectal Cancer Resection: Should We Wait for Closure of the Stoma Until the Complete Resolution of the Sinus?
Chris Tae-Young Chung, Se-Jin Baek, Jung-Myun Kwak, Jin Kim, Seon-Hahn Kim
Ann Coloproctol. 2019;35(1):30-35.   Published online January 25, 2019
DOI: https://doi.org/10.3393/ac.2018.08.13
  • 7,908 View
  • 157 Download
  • 5 Web of Science
  • 5 Citations
AbstractAbstract PDF
Purpose
The aims of this study were to identify the clinical characteristics of an anastomotic sinus and to assess the validity of delaying stoma closure in patients until the complete resolution of an anastomotic sinus.
Methods
The subject patients are those who had undergone a resection of rectal cancer from 2011 to 2017, who had a diversion ileostomy protectively or therapeutically and who developed a sinus as a sequelae of anastomotic leakage. The primary outcomes that were measured were the incidence, management and outcomes of an anastomotic sinus.
Results
Of the 876 patients who had undergone a low anterior resection, 14 (1.6%) were found to have had an anastomotic sinus on sigmoidoscopy or a gastrografin enema before their ileostomy closure. In the 14 patients with a sinus, 7 underwent ileostomy closure as scheduled, with a mean closure time of 4.1 months. The remaining 7 patients underwent ileostomy repair, but it was delayed until after the follow-up for the widening of the sinus opening by using digital dilation, with a mean closure time of 6.9 months. Four of those remaining seven patients underwent stoma closure even though their sinus condition had not yet been completely resolved. No pelvic septic complications occurred after closure in any of the 14 patients with an anastomotic sinus, but 2 of the 14 needed a rediversion due to a severe anastomotic stricture.
Conclusion
Patients with an anastomotic sinus who had been carefully selected underwent successful ileostomy closure without delay.

Citations

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  • Management of Low-Rectal Anastomotic Sinus With Transanal Minimally Invasive Septotomy
    Nirvana B. Saraswat, Scott A. Brill, William E. Wise
    The American Surgeon™.2023; 89(2): 322.     CrossRef
  • The management of asymptomatic radiological anastomotic leakage following anterior resection
    Mohamed Rabie, Laura Parry, Iannish Sadien, Sandeep Kapur, Adam Stearns, Irshad Shaikh
    ANZ Journal of Surgery.2022; 92(4): 801.     CrossRef
  • Chronische Anastomoseninsuffizienz nach tiefer Rektumresektion – ein ungelöstes Problem?
    Peter Kienle, Jörn Richard Magdeburg
    Der Chirurg.2021; 92(7): 605.     CrossRef
  • Response to Dioscoridi et al.
    G. I. Popivanov, V. M. Mutafchiyski, R. Cirocchi, S. D. Chipeva, V. V. Vasilev, K. T. Kjossev, M. S. Tabakov
    Colorectal Disease.2020; 22(7): 841.     CrossRef
  • Anastomotic Sinus Developed From Leakage in Rectal Cancer Resection: When Can We Reverse the Defunctioning Stoma?
    Chang Hyun Kim
    Annals of Coloproctology.2019; 35(1): 1.     CrossRef
Transanal Tube Drainage as a Conservative Treatment for Anastomotic Leakage Following a Rectal Resection
Mostafa Shalaby, Waleed Thabet, Oreste Buonomo, Nicola Di Lorenzo, Mosaad Morshed, Giuseppe Petrella, Mohamed Farid, Pierpaolo Sileri
Ann Coloproctol. 2018;34(6):317-321.   Published online December 20, 2018
DOI: https://doi.org/10.3393/ac.2017.10.18
  • 8,004 View
  • 184 Download
  • 12 Web of Science
  • 15 Citations
AbstractAbstract PDF
Purpose
We evaluate the role of transanal tube drainage (TD) as a conservative treatment for patients with anastomotic leakage (AL).
Methods
Patients treated for AL who had undergone a low or an ultralow anterior resection with colorectal or coloanal anastomosis for the treatment of rectal cancer between January 2013 and January 2017 were enrolled in this study. The data were collected prospectively and analyzed retrospectively. The primary outcomes were the diagnosis and the management of AL.
Results
Two hundred thirteen consecutive patients, 122 males and 91 females, were included. The mean age was 66.91 ± 11.15 years, and the median body mass index was 24 kg/m2 (range, 20–35 kg/m2 ). The median tumor distance from the anal verge was 8 cm (range, 4–12 cm). Ninety-three patients (44%) received neoadjuvant therapy for nodal disease and/or locally advanced rectal cancer. Only 13 patients (6%) developed AL. Six patients developed subclinical AL as they had a defunctioning ileostomy at the time of the initial procedure. They were treated conservatively with TD under endoscopic guidance in the endoscopy unit and received intravenous antibiotics. Six weeks after discharge, these 6 patients underwent follow-up flexible sigmoidoscopy which showed a completely healed anastomotic defect with no residual stenosis. Seven patients developed a clinically significant AL and required reoperation with pelvic abscess drainage and Hartmann colostomy formation.
Conclusion
These results suggest that TD for management of patients with AL is safe, cheap, and effective. Salvaging the anastomosis will help decrease the need for Hartmann colostomy formation. Proper patient selection is important.

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  • A Review of Postoperative Complications in Colon Cancer Surgery: The Need for Patient-Centered Therapy
    Adrian Silaghi, Dragos Serban, Corneliu Tudor, Bogdan Mihai Cristea, Laura Carina Tribus, Irina Shevchenko, Alexandru Florin Motofei, Crenguta Sorina Serboiu, Vlad Denis Constantin
    Journal of Mind and Medical Sciences.2025; 12(1): 21.     CrossRef
  • Management of anastomotic leakage after low anterior resection with double-stapling anastomosis
    Kenji Kawada, Yoshiro Itatani, Kazutaka Obama
    Journal of Gastrointestinal Surgery.2025; 29(10): 102178.     CrossRef
  • Challenges in the interdisciplinary treatment of leakages after left-sided colorectal surgery: endoscopic negative pressure therapy, open-pore film drainage therapy and beyond
    Pasquale Scognamiglio, Anja Seeger, Matthias Reeh, Nathaniel Melling, Karl F Karstens, Thomas Rösch, Jakob R Izbicki, Marcus Kantowski, Michael Tachezy
    International Journal of Colorectal Disease.2023;[Epub]     CrossRef
  • Significance of information obtained during transanal drainage tube placement after anterior resection of colorectal cancer
    Yuki Okazaki, Masatsune Shibutani, Hisashi Nagahara, Tatsunari Fukuoka, Yasuhito Iseki, En Wang, Kiyoshi Maeda, Kosei Hirakawa, Masaichi Ohira, Zubing Mei
    PLOS ONE.2022; 17(8): e0271496.     CrossRef
  • The usefulness of transanal tube for reducing anastomotic leak in mid rectal cancer: compared to diverting stoma
    Seok Hyeon Cho, In Kyu Lee, Yoon Suk Lee, Min Ki Kim
    Annals of Surgical Treatment and Research.2021; 100(2): 100.     CrossRef
  • Treatment Modalities for Anastomotic Leakage in Rectal Cancer Surgery
    Deborah S. Keller, K. Talboom, C.P.M van Helsdingen, Roel Hompes
    Clinics in Colon and Rectal Surgery.2021; 34(06): 431.     CrossRef
  • Retrospective study of active drainage in the management of anastomotic leakage after anterior resection for rectal cancer
    Xiaojie Tan, Mei Zhang, Lai Li, He Wang, Xiaodong Liu, Haitao Jiang
    Journal of International Medical Research.2021;[Epub]     CrossRef
  • Improved colorectal anastomotic leakage healing by transanal rinsing treatment after endoscopic vacuum therapy using a novel patient-applied rinsing catheter
    Marcus Kantowski, Andreas Kunze, Eugen Bellon, Thomas Rösch, Utz Settmacher, Michael Tachezy
    International Journal of Colorectal Disease.2020; 35(1): 109.     CrossRef
  • Surgical complications in colorectal cancer patients
    Haleh Pak, Leila Haji Maghsoudi, Ali Soltanian, Farshid Gholami
    Annals of Medicine and Surgery.2020; 55: 13.     CrossRef
  • Effect comparison of three different types of transanal drainage tubes after anterior resection for rectal cancer
    Yun Luo, Chang-Kang Zhu, Ding-Quan Wu, Liang-Bi Zhou, Chong-Shu Wang
    BMC Surgery.2020;[Epub]     CrossRef
  • Percutaneous transesophageal gastro-tubing for the management of anastomotic leakage after upper GI surgery: a report of two clinical cases
    Yutaka Tamamori, Katsunobu Sakurai, Naoshi Kubo, Ken Yonemitsu, Yasuhiro Fukui, Junya Nishimura, Kiyoshi Maeda, Yukio Nishiguchi
    Surgical Case Reports.2020;[Epub]     CrossRef
  • Long-Term Results after Anastomotic Leakage following Rectal Cancer Surgery: A Comparison of Treatment with Endo-Sponge and Transanal Irrigation
    Alice Weréen, Martin Dahlberg, Göran Heinius, Emil Pieniowski, Deborah Saraste, Karolina Eklöv, Jonas Nygren, Klas Pekkari, Åsa H. Everhov
    Digestive Surgery.2020; 37(6): 456.     CrossRef
  • Preventive strategies for anastomotic leakage after colorectal resections: A review
    Mostafa Shalaby, Waleed Thabet, Mosaad Morshed, Mohamed Farid, Pierpaolo Sileri
    World Journal of Meta-Analysis.2019; 7(8): 389.     CrossRef
  • Transanal surgery: A tool in colorectal anastomotic leakage
    Pere Planellas Giné, Júlia Gil Garcia, Ramon Farrés Coll, Antoni Codina Cazador
    Cirugía Española (English Edition).2019; 97(10): 590.     CrossRef
  • La cirugía transanal como herramienta en la dehiscencia de la anastomosis colorrectal
    Pere Planellas Giné, Júlia Gil Garcia, Ramon Farrés Coll, Antoni Codina Cazador
    Cirugía Española.2019; 97(10): 590.     CrossRef
Discrepancy of Medical Terminology Regarding Colorectal Surgery Between South and North Korea
Dayoung Ko, Heung-Kwon Oh, Jangwhan Jo, Hyun Hui Yang, Min-Hyun Kim, Myung Jo Kim, Sung Il Kang, Duck-Woo Kim, Sung-Bum Kang
Ann Coloproctol. 2018;34(5):248-252.   Published online October 31, 2018
DOI: https://doi.org/10.3393/ac.2017.10.01
  • 5,325 View
  • 108 Download
  • 2 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
We aimed to investigate the extent of heterogeneity in medical terminology between South and North Korea by comparing medical terms related to the colorectal system.
Methods
North Korean medical terms were collected from the sections on diseases of the small intestine and colon in a surgery textbook from North Korea, and those terms were compared with their corresponding terms in a South Korean medical terminology textbook. The terms were categorized as either identical, similar, showing disparity, or not used in South Korea. In a subsection analysis, the terms were allocated to pathophysiology, diagnosis, symptoms and examination, drugs, testing, treatment, or others according to the categorization used in the textbook.
Results
We found 705 terms in the North Korean textbook, most of which were pathophysiological terms (206, 29.2%), followed by diagnostic terms (165, 23.4%) and symptom and examination terms (122, 17.3%). Treatment-, drug-, and testing-related terms constituted 15.5%, 5.8%, and 4.1% of the 705 terms, respectively. There were 331 identical terms (47.0%) and 146 similar terms (20.7%); 126 terms (17.9%) showed disparity. Another 102 terms (14.5%) were not used in South Korea. The pathophysiological terms were the least heterogeneous, with 61.2% being identical terms used in both countries. However, 26.8% of the terms in the drug category were not used in South Korea.
Conclusion
The present study showed that less than 50% of the terms for the colorectal system used in South and North Korea were identical. As the division between South and North Korea persists, the heterogeneity of medical terminology is expected to increase.

Citations

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  • Characteristics and Distribution of Surgical Diseases in North Korean Research Papers Published between 2006 and 2017
    Yo Han Lee, Namkee Oh, Hyerim Kim, Shin Ha
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
  • Assessing the pharmacy students’ knowledge of common medical terms after a curricular change in Saudi Arabia
    Yazed AlRuthia, Monira Alwhaibi, Haya Almalag, Hadeel Alkofide, Bander Balkhi, Amani Almejel, Fahad Alshammari, Fawaz Alharbi, Ibrahim Sales, Yousif Asiri
    Saudi Pharmaceutical Journal.2020; 28(6): 763.     CrossRef
The Impact of the Outcome of Treating a High Anal Fistula by Using a Cutting Seton and Staged Fistulotomy on Saudi Arabian Patients
Bader Hamza Shirah, Hamza Asaad Shirah
Ann Coloproctol. 2018;34(5):234-240.   Published online October 10, 2018
DOI: https://doi.org/10.3393/ac.2018.03.23
  • 15,064 View
  • 175 Download
  • 17 Web of Science
  • 15 Citations
AbstractAbstract PDF
Purpose
A cutting seton is used after a partial distal fistulotomy to treat patients with a high exrasphincteric fistula in ano to avoid fecal incontinence and recurrence. In Saudi Arabia, religious practices necessitate complete cleanness, which makes conditions affecting anal continence a major concern to patients affected by an anal fistula. Therefore, we aimed to evaluate the efficiency of the cutting seton in treating a high anal fistula among Saudi Arabians.
Methods
Between January 2005 and December 2014, a prospective study was done for 372 Saudi Arabian patients diagnosed as having a high anal fistula and treated with a cutting seton at Al-Ansar General Hospital, Medina, Saudi Arabia. 0-silk sutures were used. All patients underwent the same preoperative assessment, operative technique, and postoperative follow-up. Weekly, the seton was tightened in outpatient clinics.
Results
Two hundred ninety-eight patients (80.1%) were males and 74 (19.9%) females. The duration of symptoms varied from 3–21 months. The fistula healed completely in 363 patients (97.6%); 58 patients (15.6%) reported some degree of incontinence to flatus, but none to feces. In 9 patients (2.4%) the fistula recurred.
Conclusion
The utilization of the cutting seton method in the treatment of patients with a high anal fistula is highly efficient as it simultaneously drains the abscess, cuts the fistulous tract, and causes fibrosis along the tract. Treatment of a high anal fistula by using a staged fistulotomy with a cutting seton was very rewarding to Saudi Arabian patients who feared anal incontinence for religious reasons and was associated with low postoperative complication and recurrence rates.

Citations

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  • Ultrasound assessment of low type intersphincteric perianal fistulas in Yemen
    Sultan Abdulwadoud Alshoabi, Abdulkhaleq Ayedh Binnuhaid, Abdullgabbar M. Hamid, Fahad H. Alhazmi, Abdulaziz A. Qurashi, Awadia Gareeballah, Moawia Gameraddin, Osamah M. Abdulaal, Walaa Alsharif, Fathelrehman A. Elajab, Tareef S. Daqqaq, Khaled Mohammed A
    Scientific Reports.2025;[Epub]     CrossRef
  • Cutting seton for the treatment of cryptoglandular fistula-in-ano: a systematic review and meta-analysis
    J. Khamar, A. Sachdeva, T. McKechnie, Y. Lee, L. Tessier, D. Hong, C. Eskicioglu
    Techniques in Coloproctology.2024;[Epub]     CrossRef
  • Evaluation surgical strategies in perianal fistulas treatment: Efficacy draining seton compared to other surgical approaches; a case‐control study
    Amir Ghasemlouei, Amirhosein Naseri, Ali Ashjaei, Shahryar Sadeghi, Amir Keshvari
    Health Science Reports.2024;[Epub]     CrossRef
  • Assessing the suitability of video-assisted anal fistula treatment for obese patients compared to conventional surgery: a question worth investigating
    Xiao-Li Tang, Zi-Yang Xu, Jun Yang, Zhe Yang, Zhi-Gang Wang, Zheng-Yun Zhang, Jing Yao
    International Journal of Colorectal Disease.2024;[Epub]     CrossRef
  • Comparative Evaluation Between Cutting of the Intersphincteric Space vs Cutting Seton in High Anal Fistula: A Randomized Controlled Trial
    Jiawei Qin, Yanlan Wu, Xueping Zheng, Kunlan Wu, Gongjian Dai, Yanyan Tan, Xu Yang, Yuqing Sun
    Journal of the American College of Surgeons.2024; 239(6): 563.     CrossRef
  • Fistulectomy and primary sphincteroplasty in complex anal fistula treatment: a hospital-based long-term follow-up study
    Fakhrosadat Anaraki, Mohammad Reza Nikshoar, Arsh Haj Mohamad Ebrahim Ketabforoush, Rojin Chegini, Nasrin Borumandnia, Mehdi Tavallaei
    Techniques in Coloproctology.2023; 27(2): 145.     CrossRef
  • Exploring Health-Related Quality of Life in Patients with Anal Fistulas: A Comprehensive Study
    Tudor Mateescu, Lazar Fulger, Durganjali Tummala, Aditya Nelluri, Manaswini Kakarla, Lavinia Stelea, Catalin Dumitru, George Noditi, Amadeus Dobrescu, Cristian Paleru, Ana-Olivia Toma
    Life.2023; 13(10): 2008.     CrossRef
  • Surgical treatment of anal fistula
    A. Ya. Ilkanich, V. V. Darwin, E. A. Krasnov, F. Sh. Aliyev, K. Z. Zubailov
    Сибирский научный медицинский журнал.2023; 43(5): 74.     CrossRef
  • Evaluation of the Cutting Seton Technique in Treating High Anal Fistula
    Asim M Almughamsi, Mohamed Khaled S Zaky, Abdullatif M Alshanqiti, Ibrahim S Alsaedi, Hamed I Hamed, Tariq E Alharbi, Ali A Elian
    Cureus.2023;[Epub]     CrossRef
  • Comparison of loose combined cutting seton and traditional cutting seton for high anal fistula: a meta-analysis
    Yi SUN, Chunqiang WANG, Tianye HUANG, Xuebing WANG
    Gazzetta Medica Italiana Archivio per le Scienze Mediche.2023;[Epub]     CrossRef
  • Evaluating the Efficacy of Cutting Setons for the Treatment of Anal Fistulas
    Miguel E. Gomez, Koianka Trencheva, Matthew Symer, Kelly Garrett, Jeffrey W. Milsom, Parul J. Shukla
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    Hojjatollah Nazari, Zahra Ebrahim Soltani, Reza Akbari Asbagh, Amirsina Sharifi, Abolfazl Badripour, Asieh Heirani Tabasi, Majid Ebrahimi Warkiani, Mohammad Reza Keramati, Behnam Behboodi, Mohammad Sadegh Fazeli, Amir Keshvari, Mojgan Rahimi, Seyed Mohsen
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Case Reports
Abdominosacral Resection in the Management of Large-Size Retrorectal Tumors: A Report of 2 Rare Cases
Yuda Handaya, Sutamto Wibowo
Ann Coloproctol. 2018;34(5):271-276.   Published online October 10, 2018
DOI: https://doi.org/10.3393/ac.2017.12.01
  • 7,309 View
  • 139 Download
AbstractAbstract PDF
Management of large-size retrorectal gastrointestinal stromal tumors (GISTs) is complex and challenging from diagnosis to treatment. This may create technical difficulties in surgical access and complete resection of the tumor. The abdominosacral resection has the benefit of improved visualization via the anterior incision, with enhanced exposure of the midrectal area, which makes resecting the tumor completely via the posterior approach easier. We report 2 cases of patients with a retrorectal GIST and neurofibromatosis type 1, one in a 27-year-old woman with a defecation complaint and the other in a 58-year-old woman with a defecation and urination complaint. Based on the anatomical pathology, both patients were diagnosed with a GIST. The tumors were excised via an abdominosacral resection. Retrorectal GISTs are rare, and abdominosacral resection allows complete resection of a large-size retrorectal GIST with low morbidity and an absence of functional impairment. The abdominosacral resection should be considered in certain situations.
Endoscopic Band Ligation to Treat a Massive Hemorrhoidal Hemorrhage Following a Transrectal Ultrasound-Guided Prostate Biopsy
Nadim Mahmud, Kirk J. Wangensteen
Ann Coloproctol. 2018;34(1):47-51.   Published online February 28, 2018
DOI: https://doi.org/10.3393/ac.2018.34.1.47
  • 6,721 View
  • 92 Download
  • 2 Web of Science
  • 2 Citations
AbstractAbstract PDF

Prostate cancer is commonly diagnosed by using a transrectal ultrasound (TRUS)-guided biopsy. Although this procedure is usually well tolerated, rarely it may be complicated by massive rectal bleeding. We report a case of a 77-year-old male who underwent a TRUS biopsy and subsequently developed recurrent episodes of rectal bleeding with syncope and anemia requiring the transfusion of multiple units of blood. A sigmoidoscopy revealed the source of the bleeding: a large hemorrhoid on the anterior wall of the rectum with an overlying ulceration. We successfully applied a band to ligate the hemorrhoid, and the patient's condition improved. To our knowledge, this case represents the first report of a successful band ligation to treat massive bleeding from a hemorrhoid that had been punctured in the course of the TRUS biopsy procedure.

Citations

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  • A case report of urethral corpus cavernosum pseudoaneurysm formation after ultrasound-guided transperineal prostate biopsy
    Wang Zhize, Jiayidaer Dannier, Ma Nieying, Xiang Jianjian, Ying Shihong, Yu Jianjun
    BMC Urology.2025;[Epub]     CrossRef
  • Endoscopic Therapy in the Management of Patients With Severe Rectal Bleeding Following Transrectal Ultrasound-Guided Prostate Biopsy: A Case-Based Systematic Review
    Adnan Malik, Rizwan Ishtiaq, Muhammad Hassan Naeem Goraya, Faisal Inayat, Vinaya V. Gaduputi
    Journal of Investigative Medicine High Impact Case Reports.2021;[Epub]     CrossRef
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