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Original Articles
Minimally invasive surgery
Interim analysis of short-term outcomes between robotic and laparoscopic surgery for colon cancer: results from the ESSIMIC trial
Marco Milone, Sara Vertaldi, Pietro Anoldo, Simona Borin, Graziano Ceccarelli, Anna D’Amore, Maurizio Degiuli, Paolo Delrio, Uberto Romario Fumagalli, Mario Guerrieri, Michele Manigrasso, Monica Ortenzi, Ugo Pace, Felice Pirozzi, Lucia Puca, Wanda Petz, Rossella Reddavid, Daniela Rega, Fabio Rondelli, Antonio Sciuto, Giovanni Domenico De Palma
Ann Coloproctol. 2026;42(1):86-93.   Published online February 23, 2026
DOI: https://doi.org/10.3393/ac.2025.00339.0048
  • 302 View
  • 17 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Purpose
This study aimed to determine whether the benefits of robotic surgery can be applied to the treatment of colon cancer by evaluating short-term outcomes of robotic versus laparoscopic colonic resection.
Methods
This interim analysis of an interventional multicenter randomized trial was conducted to compare outcomes of robotic and laparoscopic colorectal surgery performed between January 2017 and December 2019. The study specifically assessed short-term outcomes in patients undergoing laparoscopic or robotic right or left colectomy for cancer. In addition, all short-term outcomes were evaluated in separate subgroups of right and left colonic resections through prespecified subgroup analyses.
Results
A total of 323 patients were analyzed, of whom 142 underwent robotic-assisted surgery and 181 underwent laparoscopic surgery. Overall, 109 complications (33.7%) occurred in the short-term period, 41 (28.9%) in the robotic group and 68 (37.6%) in the laparoscopic group, with no differences between groups in intraoperative or postoperative complications. However, grade III complications were significantly more frequent in the laparoscopic group, with 17 cases (9.4%) compared to 5 cases (3.5%) in the robotic group. Oncological radicality was similar between groups. Functional recovery after surgery was superior in the robotic group, as reflected by a shorter time to mobilization (17.5±10.2 hours vs. 21.1±11.5 hours). In the right colectomy subgroup, rates of grade III complications (1.9% vs. 11.7%) and lymph nodes retrieved (20.3±10.3 vs. 20.2±6.4) favored robotic surgery. In the left colon cancer subgroup, functional recovery was also improved with robotic surgery (44.3±22.2 hours vs. 61.1±31.1 hours, as measured by the composite recovery outcome).
Conclusion
Robotic surgery is associated with fewer severe complications and improved postoperative recovery following colonic resections. Trial registration: ClinicalTrials.gov identifier: NCT02871960
Colorectal cancer
Palliative resection versus palliative stenting for intestinal obstruction in patients with metastatic left-sided colonic cancer: a propensity score–matched analysis
Ruby Siu Ting Lau, Sophie Sok Fei Hon, Man Fung Ho, Simon Chu, Dennis CK Ng, Simon SM Ng
Ann Coloproctol. 2025;41(6):528-536.   Published online December 29, 2025
DOI: https://doi.org/10.3393/ac.2025.00535.0076
  • 690 View
  • 43 Download
AbstractAbstract PDF
Purpose
Palliative resection and palliative stenting are established options for managing obstruction in patients with metastatic left-sided colonic cancer. This retrospective study investigated the long-term outcomes and survival associated with each treatment modality.
Methods
Patients with left-sided colon cancer complicated by intestinal obstruction and unresectable metastatic lesions were included. Propensity score matching was conducted to balance demographic characteristics. The primary outcome was long-term survival. Secondary outcomes included short-term morbidity, length of hospital stay, clinical success rate, stoma formation rate, and number of readmissions due to tumor-related complications.
Results
Initially, 131 patients who underwent palliative resection or stenting between 2015 and 2022 were included. After propensity score matching, 98 patients remained (49 in each group). Survival was significantly better among patients receiving palliative resection compared to stenting (median, 19.6 months vs. 9.6 months; P=0.003). However, subgroup analysis for patients older than 70 years demonstrated no statistically significant survival benefit (median, 11.5 months vs. 10.2 months; P=0.240). The resection group experienced significantly higher rates of stoma formation and longer postoperative hospital stays. Readmission rates were similar. Cox regression analysis identified low carcinoembryonic antigen levels, tumor resection, chemotherapy, and targeted therapy as independent predictors of longer survival.
Conclusion
For metastatic colon cancer patients presenting with intestinal obstruction, palliative resection may offer a survival advantage. However, this benefit diminishes in patients over 70 years of age. Additionally, resection is associated with a higher rate of stoma formation. Therefore, individualized treatment decisions are warranted when choosing between palliative resection and palliative stenting in metastatic colonic cancer patients.
Translational/basic research
The effect of tumor resection on intestinal microbiota dysbiosis in patients with right-sided colon cancer
Aldhimas Marthsyal Pratikna, M. Iqbal Rivai, Rini Suswita, Andani Eka Putra, Irwan Abdul Rachman, Avit Suchitra
Ann Coloproctol. 2025;41(1):47-56.   Published online February 26, 2025
DOI: https://doi.org/10.3393/ac.2024.00346.0049
  • 3,341 View
  • 154 Download
  • 2 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Purpose
This study aimed to determine the effect of tumor resection on dysbiosis of the intestinal microbiota in patients with right-sided colon cancer.
Methods
This study utilized a longitudinal design to explore the outcomes of patients diagnosed with right-sided colon cancer who underwent surgical resection at Dr. M. Djamil General Hospital from July to December 2023. We excluded patients with a documented history of comorbidities, specifically those affecting the digestive system. To compare the microbiota (genus and phylum) between patients with right-sided colon cancer and the control group, we conducted bivariate analyses using the independent t-test or Mann-Whitney test. Furthermore, we employed the dependent t-test or Wilcoxon test to assess changes in the dysbiosis of the microbiota (genus and phylum) before and after resection. A P-value of <0.05 was considered statistically significant.
Results
This study included a total of 21 patients diagnosed with right-sided colon cancer. In the control group, Bacteroidetes constituted the highest proportion of intestinal microbiota, accounting for 56.34%. Prior to tumor resection, the intestinal microbiota of patients exhibited Proteobacteria as the predominant phylum, representing 52.97%. Following tumor resection, Bacteroidetes remained the most prevalent, comprising 50.9% of the intestinal microbiota. Significant variations in the levels of Proteobacteria, Verrucomicrobia, and Cyanobacteria/Chloroplast were observed in the intestinal microbiota of patients with right-sided colorectal cancer before and after tumor excision (all P=0.001).
Conclusion
The microbiome of patients with right-sided colorectal cancer differed significantly from that of the control group. However, following tumor resection, the microbiome composition of these patients became more similar to that observed in the control group.

Citations

Citations to this article as recorded by  
  • Dynamics of the microbiota in right-sided colon cancer patients: pre- and post-tumor resection
    Youn Young Park
    Annals of Coloproctology.2025; 41(1): 1.     CrossRef
  • 大腸癌周術期におけるONSのエビデンスと意義
    岳史 山田, 明久 松田, 圭 上原, 寛 吉田
    The Japanese Journal of SURGICAL METABOLISM and NUTRITION.2025; 59(4): 96.     CrossRef
Minimally invasive surgery
Robotic surgery may lead to reduced postoperative inflammatory stress in colon cancer: a propensity score–matched analysis
Eun Ji Park, Gyong Tae Noh, Yong Joon Lee, Min Young Park, Seung Yoon Yang, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Byung Soh Min
Ann Coloproctol. 2024;40(6):594-601.   Published online December 6, 2024
DOI: https://doi.org/10.3393/ac.2024.00171.0024
  • 3,676 View
  • 96 Download
  • 6 Web of Science
  • 7 Citations
AbstractAbstract PDFSupplementary Material
Purpose
Robot-assisted surgery is readily applied to every type of colorectal surgeries. However, studies showing the safety and feasibility of robotic surgery (RS) have dealt with rectal cancer more than colon cancer. This study aimed to investigate how technical advantages of RS can translate into actual clinical outcomes that represent postoperative systemic response.
Methods
This study retrospectively reviewed consecutive cases in a single tertiary medical center in Korea. Patients with primary colon cancer who underwent curative resection between 2006 and 2012 were included. Propensity score matching was done to adjust baseline patient characteristics (age, sex, body mass index, American Society of Anesthesiologists physical status, tumor profile, pathologic stage, operating surgeon, surgery extent) between open surgery (OS), laparoscopic surgery (LS), and RS groups.
Results
After propensity score matching, there were 66 patients in each group for analysis, and there was no significant differences in baseline patient characteristics. Maximal postoperative leukocyte count was lowest in the RS group and highest in the OS group (P=0.021). Similar results were observed for postoperative neutrophil count (P=0.024). Postoperative prognostic nutritional index was highest in the RS group and lowest in the OS group (P<0.001). The time taken to first flatus and soft diet resumption was longest in the OS group and shortest in the RS group (P=0.001 and P<0.001, respectively). Among all groups, other short-term postoperative outcomes such as hospital stay and complications did not show significant difference, and oncological survival results were similar.
Conclusion
Better postoperative inflammatory indices in the RS group may correlate with their faster recovery of bowel motility and diet resumption compared to LS and OS groups.

Citations

Citations to this article as recorded by  
  • Open, Laparoscopic, and robotic approaches in colorectal surgery: a comprehensive review with focus on colorectal cancer
    Farhad Shafiei, Fatemeh Kani, Nargess Porkar, Maede Mirzaee, Fatemeh Heidarzadeh, Mahdi Kolivand, Soheila Behdad, Amir Shokri
    Journal of Robotic Surgery.2026;[Epub]     CrossRef
  • Impact of Preoperative Neutrophil Percentage-to-Albumin Ratio (NPAR) on Short-Term Complications and Long-Term Prognosis in Patients Undergoing Robot-Assisted Laparoscopic Radical Surgery for Colorectal Cancer
    Jing Wang, Tao Hu, Nanhui Yu
    Journal of Inflammation Research.2026; Volume 19: 1.     CrossRef
  • Übergangsphase zur roboterassistierten Chirurgie beim kolorektalen Karzinom: eine vergleichende konsekutive Kohortenstudie
    U. A. Dietz, M. Kalisvaart, S. Maksimovic, R. Frey, M. Ramser, B. M. Erhart, U. Pfefferkorn
    Die Chirurgie.2025; 96(11): 942.     CrossRef
  • Comparative clinical efficacy of three surgical modalities for the treatment of malignant tumours of the left hemicolon
    Hao Chen, Dong-Ping Han, Jian-Yang Xiong, Zhen-Sheng Li, Teng-Cheng Hu, Zheng-Rong Li, Yi Cao
    World Journal of Gastrointestinal Surgery.2025;[Epub]     CrossRef
  • Comparison of the perioperative outcomes of robotic vs. open distal pancreatectomy: a meta-analysis of propensity-score-matched studies
    Junjie Wang, Yuanjun Liu, Yakun Wu
    Frontiers in Surgery.2025;[Epub]     CrossRef
  • Effectiveness of Guardix-SG in Preventing Postoperative Bowel Complications After Radical Cystectomy: A Single-Arm Prospective Observational Study
    Jiwoong Yu, Wan Song, Minyong Kang, Hyun Hwan Sung, Hwang Gyun Jeon, Seong Il Seo, Seong Soo Jeon, Byong Chang Jeong
    Journal of Urologic Oncology.2025; 23(3): 253.     CrossRef
  • Laparoscopic surgery should be a viable option for T4 colon cancer: evidence from a propensity score matching analysis
    Xiaomei Jiang, Hang Zhou, Zhaoyang Zheng, Xiaodong Wang, Zongguang Zhou, Lie Yang
    Updates in Surgery.2025;[Epub]     CrossRef
Complication
Early warning model to detect anastomotic leakage following colon surgery: a clinical observational study
Pooya Rajabaleyan, Ravish Jootun, Sören Möller, Ulrik Deding, Mark Bremholm Ellebæk, Issam al-Najami, Ian Lindsey
Ann Coloproctol. 2024;40(5):431-439.   Published online October 8, 2024
DOI: https://doi.org/10.3393/ac.2023.00745.0106
  • 14,835 View
  • 395 Download
  • 4 Web of Science
  • 5 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Purpose
We aimed to develop a predictive tool for anastomotic leakage (AL) following colon cancer surgery by combining a clinical early warning score (EWS) with the C-reactive protein (CRP) level.
Methods
The records of 1,855 patients who underwent colon cancer surgery at the Oxford University Hospitals NHS Foundation Trust between January 2013 and December 2018, with or without AL, were retrospectively reviewed. EWS and CRP levels were assessed daily from the first postoperative day until discharge. AL was defined as an anastomotic defect observed at reoperation, the presence of feculent fluid in a pelvic drain, or evidence of AL on computed tomography. The tool incorporated postoperative EWS and CRP levels for the accurate early detection of AL.
Results
From postoperative days 3 to 7, the mean CRP level exceeded 200 mg/L in patients with AL and was under 200 mg/L in those without AL (P<0.05). From postoperative days 1 to 5, the mean EWS among patients with leakage exceeded 2, while scores were below 2 among those without leakage (P<0.05). Receiver operating characteristic curve analysis identified postoperative day 3 as the most predictive of early leakage, with cutoff values of 2.4 for EWS and 180 mg/L for CRP; this yielded an area under the curve of 0.87 (sensitivity, 90%; specificity, 70%).
Conclusion
We propose using an EWS of 2.4 and a CRP level of 180 mg/L on postoperative day 3 following colon surgery with anastomosis as threshold values to prompt investigation and treatment of AL.

Citations

Citations to this article as recorded by  
  • The Clinical Presentation of Anastomotic Leakage Compared Between CRS-HIPEC and Conventional Colorectal Surgery
    M. Cats, L. G. Magermans, E. C. E. Wassenaar, A. A. W. van Geloven, M. J. Wiezer, J. D. J. Plate, D. Boerma
    Annals of Surgical Oncology.2026; 33(2): 1706.     CrossRef
  • Anastomotic leak in colorectal surgery: Current evidence on risk, diagnosis, preventive measures and management
    Ali Akbar Shah, Gevorg Manoukian, Omar Yasin, Amy Jacob, Timothy M. Kopah, Jas Simran Gill, Ruthel Rose, Bashayer Khaled Alharbi, Sana Zafar
    Surgical Practice.2026;[Epub]     CrossRef
  • ‘Failure to rescue’ from anastomotic leak following colorectal cancer resection: An observational study from a binational registry
    Cameron I. Wells, Wal Baraza, Greg O'Grady, Ian P. Bissett
    Colorectal Disease.2025;[Epub]     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
  • Predictive Biomarkers for the Early Detection of Anastomotic Leaks in Colorectal Surgeries: A Systematic Review
    Wahidullah Dost, Mohammad Qaher Rasully , Mohammad Nazir Zaman, Wahida Dost, Wahida Ali, Sami A Ayobi, Raisa Dost, Jamaluddin Niazi, Kinza Bakht, Asma Iqbal, Syed Faqeer Hussain Bokhari
    Cureus.2024;[Epub]     CrossRef
ERAS
Impact of an Enhanced Recovery After Surgery (ERAS) program on the management of complications after laparoscopic or robotic colectomy for cancer
Victoria Weets, Hélène Meillat, Jacques Emmanuel Saadoun, Marie Dazza, Cécile de Chaisemartin, Bernard Lelong
Ann Coloproctol. 2024;40(5):440-450.   Published online September 20, 2024
DOI: https://doi.org/10.3393/ac.2023.00850.0121
  • 11,275 View
  • 249 Download
  • 6 Web of Science
  • 6 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Purpose
Enhanced Recovery After Surgery (ERAS) reduces postoperative complications (POCs) after colorectal surgery; however, its impact on the management of POCs remains unclear. This study compared the diagnosis and management of POCs before and after implementing our ERAS protocol after laparoscopic or robotic colectomy for cancer and examined the short- and mid-term oncologic impacts.
Methods
This single-center, retrospective study evaluated all consecutive patients who underwent laparoscopic or robotic colectomy for cancer between 2012 and 2021, focusing on the incidence of POCs within 90 days. We compared outcomes before (standard group) and after (ERAS group) the implementation of our ERAS protocol in January 2016.
Results
Significantly fewer patients in the ERAS group developed POCs (standard vs. ERAS, 136 of 380 patients [35.8%] vs.136 of 660 patients [20.6%]; P<0.01). The ERAS group had a significantly shorter mean total length of stay after POCs (13.1 days vs. 11.4 days, P=0.04), and the rates of life-threatening complications (6.7% vs. 0.7%) and 1-year mortality (7.4% vs. 1.5%) were significantly lower in the ERAS group than in the standard group. Among patients with anastomotic complications, laparoscopic reoperation was significantly more common in the ERAS group than in the standard group (8.3% vs. 75.0%, P<0.01). Among patients with postoperative ileus, the diagnosis and recovery times were significantly shorter in the ERAS group than in the standard group, resulting in a shorter total length of stay (13.5 days vs. 10 days, P<0.01).
Conclusion
The implementation of an ERAS protocol did not eliminate all POCs, but it did accelerate their diagnosis and management and improved patient outcomes.

Citations

Citations to this article as recorded by  
  • The ultrasonographic measure of postoperative day 2 gastric volume may be a useful tool to improve the management of colorectal surgery patients: results of an ancillary study
    Aurélien Venara, Anita Paisant, Julien Gillet, Lise Morgado, Emeline Rebmann, Jean-Francois Hamel
    International Journal of Colorectal Disease.2026;[Epub]     CrossRef
  • Perioperative impact of enhanced recovery after surgery (ERAS) for minimally invasive colorectal resection: a systematic review and meta-analysis
    Kaiming Wen, Haoyang Wu, Bo-Wen Wu
    Journal of Robotic Surgery.2026;[Epub]     CrossRef
  • Less is more: simplifying patient-centered cancer care
    In Ja Park
    Annals of Coloproctology.2025; 41(3): 173.     CrossRef
  • Research Progress on the Application of ERAS Concept in the Perioperative Period of Colorectal Cancer Patients
    梦云 孙
    Advances in Clinical Medicine.2025; 15(08): 1208.     CrossRef
  • Can Surgical Approach and Postoperative Factors Impact Survival in Rectal Cancer? Robotic Versus Laparoscopic Insights
    Ahmed Abdelsamad, Seyidali Mirzazada, Karsten Ridwelski, Mohamad Nour Nasif, Florian Gebauer
    Cancer Medicine.2025;[Epub]     CrossRef
  • Optimizing postoperative pain management in minimally invasive colorectal surgery
    Soo Young Lee
    Annals of Coloproctology.2024; 40(6): 525.     CrossRef
Colorectal cancer
Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer
Jung Tak Son, Yong Bog Kim, Hyung Ook Kim, Chungki Min, Yongjun Park, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim
Ann Coloproctol. 2023;39(3):260-266.   Published online May 25, 2022
DOI: https://doi.org/10.3393/ac.2022.00101.0014
  • 8,719 View
  • 194 Download
  • 4 Web of Science
  • 6 Citations
AbstractAbstract PDF
Purpose
Surgical management of obstructive left colon cancer (OLCC) is still a matter of debate. The classic Hartmann procedure (HP) has a disadvantage that requires a second major operation. Subtotal colectomy/total abdominal colectomy (STC/TC) with ileosigmoid or ileorectal anastomosis is proposed as an alternative procedure to avoid stoma and anastomotic leakage. However, doubts about morbidity and functional outcome and lack of long-term outcomes have made surgeons hesitate to perform this procedure. Therefore, this trial was designed to provide data for morbidity, functional outcomes, and long-term outcomes of STC/TC.
Methods
This study retrospectively analyzed consecutive cases of OLCC that were treated by STC/TC between January 2000 and November 2020 at a single tertiary referral center. Perioperative outcomes and long-term outcomes of STC/TC were analyzed.
Results
Twenty-five descending colon cancer (45.5%) and 30 sigmoid colon cancer cases (54.5%) were enrolled in this study. Postoperative complications occurred in 12 patients. The majority complication was postoperative ileus (10 of 12). Anastomotic leakage and perioperative mortality were not observed. At 6 to 12 weeks after the surgery, the median frequency of defecation was twice per day (interquartile range, 1–3 times per day). Eight patients (14.5%) required medication during this period, but only 3 of 8 patients required medication after 1 year. The 3-year disease-free survival was 72.7% and 3-year overall survival was 86.7%.
Conclusion
The risk of anastomotic leakage is low after STC/TC. Functional and long-term outcomes are also acceptable. Therefore, STC/TC for OLCC is a safe, 1-stage procedure that does not require diverting stoma.

Citations

Citations to this article as recorded by  
  • Controversial issues of colon stenting in case of tumor obstructive intestinal obstruction: surgical and oncological aspects
    S.A. Aliyev, E.S. Aliyev, T.K. Aliyev
    Endoscopic Surgery.2025; 31(2): 65.     CrossRef
  • The Safety of Primary Anastomosis Without Protective Stoma in Emergency Left Colon Surgery: A Meta-Analysis
    Zhiyan Wang, Wentao Sheng, Senjie Dai, Xuanzhou Li, Guojian Lin, Xiaohong Kang
    Journal of Investigative Surgery.2025;[Epub]     CrossRef
  • Ileus After Colectomy in the Modern Era: A Population-Based Analysis
    Grace M. Crouch, Samantha Hendren, Kara K. Brockhaus, Wenjing Weng, Jami L. Boyd, Cheryl Rocker, Robert K. Cleary
    Diseases of the Colon & Rectum.2025; 68(8): 1001.     CrossRef
  • Influence of the type of anatomic resection on anastomotic leak after surgery for colon cancer
    Suat Chin Ng, Andrew McCombie, Frank Frizelle, Tim Eglinton
    ANZ Journal of Surgery.2024; 94(3): 424.     CrossRef
  • Complete Obstruction, a Real Risk Factor: A Comprehensive Study on Obstruction in Stage IIA Colon Cancer With Propensity Score Matching Analysis
    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
  • Can we use colon stenting in accelerated recovery programs for surgical treatment colon cancer complicated by obstructive intestinal obstruction? A literature review
    Saday A. Aliyev, Emil S. Aliyev
    Russian Journal of Oncology.2024; 29(2): 130.     CrossRef
Comparison of long-term outcomes of colonic stenting as a “bridge to surgery” and emergency surgery in patients with left-sided malignant colonic obstruction
Supakij Khomvilai, Sukit Pattarajierapan
Ann Coloproctol. 2023;39(1):17-26.   Published online July 29, 2021
DOI: https://doi.org/10.3393/ac.2021.00227.0032
  • 9,573 View
  • 237 Download
  • 9 Web of Science
  • 9 Citations
AbstractAbstract PDF
Purpose
Long-term oncologic outcomes of colonic stenting as a “bridge to surgery” in patients with left-sided malignant colonic obstruction (LMCO) are unclear. This study was performed to compare long-term outcomes of self-expandable metal stent (SEMS) insertion as a bridge to surgery and emergency surgery in patients with acute LMCO.
Methods
This retrospective cohort study included patients with acute LMCO who underwent SEMS insertion as a bridge to surgery or emergency surgery. The primary outcomes were 5-year disease-free survival (DFS), overall survival (OS), and recurrence rate. Survival outcomes were determined using the Kaplan-Meier method and compared using log-rank tests.
Results
There was a trend of worsening 5-year OS rate in the SEMS group compared with emergency surgery group (45% vs. 57%, P=0.07). In stage-wise subgroup analyses, a trend of deteriorating 5-year OS rate in the SEMS group with stage III (43% vs. 59%, P=0.06) was observed. The 5-year DFS and recurrence rate were not different between groups. The overall median follow-up time was 58 months. On multivariate analysis, age of ≥65 years and American Joint Committee on Cancer stage of ≥III, and synchronous metastasis were significant poor prognostic factors for OS (hazard ratio [HR], 1.709; 95% confidence interval [CI], 1.007–2.900; P=0.05/HR, 1.988; 95% CI, 1.038–3.809; P=0.04/HR, 2.146; 95% CI, 1.191–3.866; P=0.01; respectively).
Conclusion
SEMS as a bridge to surgery may have adverse oncologic outcomes. Patients in the SEMS group had a trend of worsening 5-year OS rate without higher recurrence.

Citations

Citations to this article as recorded by  
  • Transforming outcomes: the pivotal role of self-expanding metal stents in right- and left-sided malignant colorectal obstructions-bridge to surgery: a comprehensive review and meta-analysis
    Sheza Malik, Priyadarshini Loganathan, Hajra Khan, Abul Hasan Shadali, Pradeep Yarra, Saurabh Chandan, Babu P. Mohan, Douglas G. Adler, Shivangi Kothari
    Clinical Endoscopy.2025; 58(2): 240.     CrossRef
  • Controversial issues of colon stenting in case of tumor obstructive intestinal obstruction: surgical and oncological aspects
    S.A. Aliyev, E.S. Aliyev, T.K. Aliyev
    Endoscopic Surgery.2025; 31(2): 65.     CrossRef
  • Primary tumor resection vs. self-expandable metallic stent in unresectable obstructive stage IV colorectal cancer: a comparative outcome study
    Chang Hyun Kim, Jae Kyun Ju, Jaram Lee, Hyeung-min Park, Soo Young Lee, Hyeong Rok Kim, Young Eun Joo, Sung Bum Cho
    Annals of Surgical Treatment and Research.2025; 109(2): 89.     CrossRef
  • Safety and efficacy of fully-covered self-expandable metal stent placement for refractory stomal stenosis
    Ahamed A. Khalyfa, Navkiran K. Randhawa, Rahil Desai, Mahnoor Inam, Varshita Goduguchinta, Kamran Ayub
    Endoscopy International Open.2025;[Epub]     CrossRef
  • Complete Obstruction, a Real Risk Factor: A Comprehensive Study on Obstruction in Stage IIA Colon Cancer With Propensity Score Matching Analysis
    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
  • Can we use colon stenting in accelerated recovery programs for surgical treatment colon cancer complicated by obstructive intestinal obstruction? A literature review
    Saday A. Aliyev, Emil S. Aliyev
    Russian Journal of Oncology.2024; 29(2): 130.     CrossRef
  • Colonic stenting: is the bridge to surgery worth its cost? A cost-effectiveness analysis at a single Asian institution
    Michelle Shi Qing Khoo, Frederick H. Koh, Sharmini Su Sivarajah, Leonard Ming-Li Ho, Darius Kang-Lie Aw, Cheryl Xi-Zi Chong, Fung Joon Foo, Winson Jianhong Tan
    Annals of Coloproctology.2024; 40(6): 555.     CrossRef
  • Comparison of colonic stenting and stoma creation as palliative treatment for incurable malignant colonic obstruction
    Sukit Pattarajierapan, Chatiyaporn Manomayangoon, Panat Tipsuwannakul, Supakij Khomvilai
    JGH Open.2022; 6(9): 630.     CrossRef
  • Oncologic safety of colonic stenting as a bridge to surgery in left-sided malignant colonic obstruction: Current evidence and prospects
    Sukit Pattarajierapan, Nattapanee Sukphol, Karuna Junmitsakul, Supakij Khomvilai
    World Journal of Clinical Oncology.2022; 13(12): 943.     CrossRef
Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer
The Prognosis and Recurrence Pattern of Right- and Left-Sided Colon Cancer in Stage II, Stage III, and Liver Metastasis After Curative Resection
Yasuyuki Nakamura, Daisuke Hokuto, Fumikazu Koyama, Yasuko Matsuo, Takeo Nomi, Takahiro Yoshikawa, Naoki Kamitani, Tomomi Sadamitsu, Takeshi Takei, Yayoi Matsumoto, Yosuke Iwasa, Kohei Fukuoka, Shinsaku Obara, Takayuki Nakamoto, Hiroyuki Kuge, Masayuki Sho
Ann Coloproctol. 2021;37(5):326-336.   Published online September 18, 2020
DOI: https://doi.org/10.3393/ac.2020.09.14
  • 7,276 View
  • 248 Download
  • 32 Web of Science
  • 34 Citations
AbstractAbstract PDF
Purpose
Primary tumor location of colon cancer has been reported to affect the prognosis after curative resection. However, some reports suggested the impact was varied by tumor stage. This study analyzed the prognostic impact of the sidedness of colon cancer in stages II, III, and liver metastasis after curative resection using propensity-matched analysis.
Methods
Right-sided colon cancer was defined as a tumor located from cecum to splenic flexure, while any more distal colon cancer was defined as left-sided colon cancer. Patients who underwent curative resection at Nara Medical University hospital between 2000 and 2016 were analyzed.
Results
There were 110 patients with stage II, 100 patients with stage III, and 106 patients with liver metastasis. After propensity matching, 28 pairs with stage II and 32 pairs with stage III were identified. In the patients with stage II, overall survival (OS) and recurrence-free survival (RFS) were not significantly different for right- and left-sided colon cancers. In the patients with stage III, OS and RFS were significantly worse in right-sided colon cancer. In those with liver metastasis, OS of right-sided colon cancer was significantly worse than left-sided disease, while RFS was similar. Regarding metachronous liver metastasis, the difference was observed only in the patients whose primary colon cancer was stage III. In each stage, significantly higher rate of peritoneal recurrence was found in those with right-sided colon cancer.
Conclusion
Sidedness of colon cancer had a significant and varied prognostic impact in patients with stage II, III, and liver metastasis after curative resection.

Citations

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  • Risk factors for recurrence in stage I colorectal cancer after curative resection: a systematic review and meta-analysis
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Comparison of Short-term Outcomes of Laparoscopic-Assisted Colon Cancer Surgery Using a Joystick-Guided Endoscope Holder (Soloassist II) or a Human Assistant
Jun Sung Kim, Won Cheol Park, Joo Hyun Lee
Ann Coloproctol. 2019;35(4):181-186.   Published online August 31, 2019
DOI: https://doi.org/10.3393/ac.2018.10.18
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  • 10 Citations
AbstractAbstract PDF
Purpose
This study aimed to compare the short-term outcomes of laparoscopic-assisted colon cancer surgery in the Soloassist II-assisted (SA) group and in the human-assisted (HA) group.
Methods
A total of 76 patients with colon cancer who underwent laparoscopic-assisted right hemicolectomy and anterior resection performed by a single surgeon between January 2017 and May 2018 were recruited from the consecutively enrolled registry and retrospectively analyzed.
Results
Of 76 patients, 43 underwent surgery with human assistance and 33 underwent surgery using the Soloassist II system. The clinicopathologic characteristics were not statistically different between the 2 groups. In both HA and SA groups, no statistical difference was observed between operation time (220.23 ± 47.83 minutes vs. 218.03 ± 38.22 minutes, P = 0.829), total number of harvested lymph nodes (20.42 ± 10.86 vs. 20.24 ± 8.21, P = 0.938), and other parameters of short-term outcomes (length of hospital stay, blood loss, open conversion, time to flatus, time to soft diet, and complication events). Subgroup analyses did not show statistical differences.
Conclusion
Soloassist II can reduce the participation of a human assistant during surgery and is not inferior to human assistance in laparoscopic-assisted colon cancer surgery. Thus, it is a feasible instrument in laparoscopic-assisted colon cancer surgery that can provide positive short-term outcomes.

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Clinical Outcomes of Reduced-Port Laparoscopic Surgery for Patients With Sigmoid Colon Cancer: Surgery With 1 Surgeon and 1 Camera Operator
Jung Ryul Oh, Sung Chan Park, Sung Sil Park, Beonghoon Sohn, Hyoung Min Oh, Bun Kim, Min Jung Kim, Chang Won Hong, Kyung Su Han, Dae Kyung Sohn, Jae Hwan Oh
Ann Coloproctol. 2018;34(6):292-298.   Published online December 3, 2018
DOI: https://doi.org/10.3393/ac.2018.04.06
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  • 5 Citations
AbstractAbstract PDF
Purpose
This study compared the perioperative clinical outcomes of reduced-port laparoscopic surgery (RPLS) with those of conventional multiport laparoscopic surgery (MPLS) for patients with sigmoid colon cancer and investigated the safety and feasibility of RPLS performed by 1 surgeon and 1 camera operator.
Methods
From the beginning of 2010 until the end of 2014, 605 patients underwent a colectomy for sigmoid colon cancer. We compared the characteristics, postoperative outcomes, and pathologic results for the patients who underwent RPLS and for the patients who underwent MPLS. We also compared the clinical outcomes of single-incision laparoscopic surgery (SILS) and 3-port laparoscopic surgery.
Results
Of the 115 patients in the RPLS group, 59 underwent SILS and 56 underwent 3-port laparoscopic surgery. The MPLS group included 490 patients. The RPLS group had shorter operating time (137.4 ± 43.2 minutes vs. 155.5 ± 47.9 minutes, P < 0.001) and shorter incision length (5.3 ± 2.2 cm vs. 7.8 ± 1.2 cm, P < 0.001) than the MPLS group. In analyses of SILS and 3-port laparoscopic surgery, the SILS group showed younger age, longer operating time, and shorter incision length than the 3-port surgery group and exhibited a more advanced T stage, more lymphatic invasion, and larger tumor size.
Conclusion
RPLS performed by 1 surgeon and 1 camera operator appears to be a feasible and safe surgical option for the treatment of patients with sigmoid colon cancer, showing comparable clinical outcomes with shorter operation time and shorter incision length than MPLS. SILS can be applied to patients with favorable tumor characteristics.

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Complete Mesocolic Excision With Central Vascular Ligation in Comparison With Conventional Surgery for Patients With Colon Cancer – The Experiences at Two Centers
Mohamed Abdelkhalek, Ahmed Setit, Francesco Bianco, Andrea Belli, Adel Denewer, Tamer Fady Youssef, Armando Falato, Giovanni Maria Romano
Ann Coloproctol. 2018;34(4):180-186.   Published online August 31, 2018
DOI: https://doi.org/10.3393/ac.2017.08.05
  • 12,094 View
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  • 16 Web of Science
  • 15 Citations
AbstractAbstract PDF
Purpose
Revolutions have occurred over the last 3 decades in the management of patients with colorectal cancer. Most advances were in rectal cancer surgery, especially after the introduction of the total mesorectal excision (TME) by Heald. However, no parallel advances regarding colon cancer surgeries have occurred. In 2009, Hohenberger introduced a new concept trying to translate the survival advantages of TME to patients with colon cancer. This relatively new concept of a complete mesocolic excision (CME) with central vascular ligation (CVL) in the management of patients with colon cancer represents an evolution in operative technique. We performed a comparative study between CME with CVL and conventional surgery for patients with colon cancer at Italian and Egyptian cancer centers, considering surgical quality and clinical outcome.
Methods
Seventy-nine Egyptian patients underwent conventional surgery (non-CME group) while 52 Italian patients underwent CME with sharp dissection between the embryological planes and CVL of the supplying vessels (CME group).
Results
Significantly better results were observed in terms of lymph node yield (CME group: 22.5 vs. non-CME group: 12; P < 0.0001) and lymph node ratio (CME group: 0.03 vs. non-CME group: 0.22; P < 0.0001). Regarding surgical morbidity, no significant difference was noted (CME group: 2 vs. non-CME group: 5; P < 0.702).
Conclusion
CME appears to be a safe procedure when performed by experienced hands through proper embryological planes. It also provides a superior specimen, with a higher lymph node yield, which consequently affects the lymph node ratio. Eventually, CME with CVL should be increasingly adopted and studied more deeply.

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Case Report
Colon Cancer After Acute Diverticulitis Treatment
Kwang Hoon Oh, Koon Hee Han, Eun Jung Kim, Je Hoon Lee, Kyu Un Choi, Myung Sik Han, Jae Hong Ahn, Gab Jin Cheon
Ann Coloproctol. 2013;29(4):167-171.   Published online August 29, 2013
DOI: https://doi.org/10.3393/ac.2013.29.4.167
  • 15,753 View
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  • 3 Citations
AbstractAbstract PDF

Diverticulitis is the most common clinical complication of diverticular disease, affecting 10-25% of the patients with diverticula. The prevalences of diverticulitis and colon cancer tend to increase with age and are higher in industrialized countries. Consequently, diverticulitis and colon cancer have been reported to have similar epidemiological characteristics. However, the relationship between these diseases remains controversial, as is the performance of routine colonoscopy after an episode of diverticulitis to exclude colon cancer. Recently, we experienced three cases of colon cancer after treating acute diverticulitis, based on which we suggest the importance of follow-up colonoscopy after acute diverticulitis.

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    Liliane C. Meireles, Samuel R. Fernandes, Luis C. Ribeiro, José Velosa
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Original Articles
Feasibility of Hand-Assisted Laparoscopic Surgery as Compared to Open Surgery for Sigmoid Colon Cancer: A Case-Controlled Study
Sang Eun Nam, Eun-Joo Jung, Chun-Geun Ryu, Jin Hee Paik, Dae-Yong Hwang
Ann Coloproctol. 2013;29(1):17-21.   Published online February 28, 2013
DOI: https://doi.org/10.3393/ac.2013.29.1.17
  • 6,029 View
  • 18 Download
  • 5 Citations
AbstractAbstract PDF
Purpose

The aim of this study was to evaluate short-term clinical outcomes by comparing hand-assisted laparoscopic surgery (HALS) with open surgery for sigmoid colon cancer.

Methods

Twenty-six patients who underwent a hand-assisted laparoscopic anterior resection (HAL-AR group) and 52 patients who underwent a conventional open anterior resection during the same period were enrolled (open group) in this study with a case-controlled design.

Results

Pathologic parameters were similar between the two groups. The incidences of immediate postoperative leukocytosis were 38.5% in the HAL-AR group and 69.2% in the open group (P = 0.009). There were no significant differences between the two groups as to leukocyte count, hemoglobin, and hematocrits (P = 0.758, P = 0.383, and P = 0.285, respectively). Of the postoperative recovery indicators, first flatus, sips of water and soft diet started on postoperative days 3, 5, 7 in the HALS group and on days 4, 5, 6 in the open group showed statistical significance (P = 0.021, P = 0.259, and P = 0.174, respectively). Administration of additional pain killers was needed for 1.2 days in the HAL-AR group and 2.4 days in the open group (P = 0.002). No significant differences in the durations of hospital stay and the rates of postoperative complications were noted, and no postoperative mortality was encountered in either group.

Conclusion

The patients with sigmoid colon cancer who underwent a HAL-AR had a lower incidence of postoperative leukocytosis, less administration of pain killers, and faster first flatus than those who underwent open surgery. Clinical outcomes for patients' recovery and pathology status were similar between the two groups. Therefore, a HAL-AR for sigmoid colon cancer is feasible and has the same benefit as minimally invasive surgery.

Citations

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Effectiveness of Adjuvant Chemotherapy with 5-FU/Leucovorin and Prognosis in Stage II Colon Cancer
Sun Hee Jee, Sun Mi Moon, Ui Sup Shin, Hoe Min Yang, Dae-Yong Hwang
J Korean Soc Coloproctol. 2011;27(6):322-328.   Published online December 31, 2011
DOI: https://doi.org/10.3393/jksc.2011.27.6.322
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AbstractAbstract PDF
Purpose

The aims of this study were to investigate the survival results and the prognostic factors of adjuvant chemotherapy in stage II colon cancer in the sparsity of Korean data.

Methods

From 1993 to 2006, 363 curatively resected pathologic stage II colon cancer patients were enrolled. Six cycles of adjuvant chemotherapy was performed: intravenous bolus 5-fluorouracil (5-FU) 500 mg/m2 with leucovorin 20 mg/m2 for 2 hours daily for 5 days, followed by a 3-week resting period (n = 308). Fifty-five patients received only curative surgery. A high risk of recurrence was defined as the presence of one or more of the following factors: T4 tumor, lympho-vascular invasion, perineural invasion, perforation, obstruction, retrieved lymph node < 12, and poorly differention. The median follow-up period was 68 months (1 to 205 months).

Results

The five-year overall survival (OS) rate was 90.1%, and the five-year disease-free survival (DFS) rate was 84.7%. Among high-risk patients, the OS and the DFS rates of the treatment group were significantly higher than those of the non-treatment group (OS: 90.6% vs. 69.1%, P < 0.0001; DFS: 85.9% vs. 54.1%, P < 0.0001). Among low-risk patients, the survival results of the treatment group were also significantly superior (OS: 97.7% vs. 88.2%, P < 0.0001; DFS: 93.0% vs. 80.0%, P = 0.001). In the multivariate analysis, adjuvant chemotherapy was a significantly favorable prognostic factor for overall survival (hazard ratio, 0.41; 95% confidence interval, 0.22 to 0.75; P = 0.004).

Conclusion

In our population, adjuvant chemotherapy showed superior survival to curative surgery alone and significantly reduced the risk of death. A nationwide multicenter randomized trial is needed.

Citations

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Short-term Outcomes of a Laparoscopic Left Hemicolectomy for Descending Colon Cancer: Retrospective Comparison with an Open Left Hemicolectomy
Kil-Su Han, Gyu-Seog Choi, Jun-Seok Park, Hye Jin Kim, Soo Yeon Park, Soo-Han Jun
J Korean Soc Coloproctol. 2010;26(5):347-353.   Published online October 31, 2010
DOI: https://doi.org/10.3393/jksc.2010.26.5.347
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AbstractAbstract PDF
Purpose

Many randomized clinical trials have been performed to treat a colorectal neoplasm with the exclusion of descending colon cancer. The aim of the present study was to investigate the difference in surgical outcomes between a laparoscopic left hemicolectomy and a conventional open left hemicolectomy for descending colon cancer.

Methods

A retrospective study of ninety patients with descending colon cancer, who underwent a laparoscopic (LAP) or open left hemicolectomy (OS) between May 1998 and December 2009 at Kyungpook National University Hospital, was performed. Clinicopathological and surgical outcomes were compared between the LAP and the OS for descending colon cancer.

Results

The baseline characteristics, including age, gender, body mass index, history of prior abdominal surgical history and tumor location, were similar between the two groups. The mean operation time was 156.2 minutes for the LAP group and 223.2 minutes for the OS group (P < 0.001). Intraoperative blood loss was significantly greater in the OS group (37.5 mL vs. 80.4 mL; P = 0.039). The postoperative recovery in the LAP group was faster, as reflected by the shorter time to pass gas and the shorter hospital stay. Pathological examinations showed the surgery to be equally radical in the two groups. The median follow-up was 21 months and there were 3 distant metastases (8.5%) during follow-up in the LAP group, but no port-site or local recurrence.

Conclusion

A laparoscopic left hemicolectomy is a technically safe and feasible procedure for treating descending colon cancer. Prospective multi-center trials are necessary to establish the LAP as the standard treatment for descending colon cancer.

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Oncologic Outcome after Cessation or Dose Reduction of Capecitabine in Patients with Colon Cancer
Jung-A Yun, Hee Cheol Kim, Hyun-Sook Son, Hyoung Ran Kim, Hae Ran Yun, Yong Beom Cho, Seong Hyeon Yun, Woo Yong Lee, Ho-Kyung Chun
J Korean Soc Coloproctol. 2010;26(4):287-292.   Published online August 31, 2010
DOI: https://doi.org/10.3393/jksc.2010.26.4.287
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AbstractAbstract PDF
Purpose

Oral capecitabine has been used as adjuvant therapy for colorectal cancer patients since the 1990s. Patient-initiated cessation or reduced use of capecitabine occurs widely for various reasons, yet the consequences of these actions are unclear. The present study sought to clarify treatment outcomes in such patients.

Methods

The study included 173 patients who had been diagnosed with stage II or III colon cancer according to the pathologic report after radical surgery at Samsung Medical Center from May 2005 to June 2007 and who had received capecitabine as adjuvant therapy. The patients were divided into groups according to whether the dose was reduced (I, dose maintenance; II, dose reduction) or stopped (A, cycle completion; B, cycle cessation). Recurrence and disease-free survival rates between the two groups each were analyzed.

Results

Of the 173 patients, 128 (74.6%) experienced complications, most frequently hand-foot syndrome (n = 114). Reduction (n = 35) or cessation (n = 18) of medication was most commonly due to complications. Concerning reduced dosage, both groups displayed no statistically significant differences in recurrence rate and 3-year disease-free survival rate. Concerning discontinued medication use, the cycle completion group showed an improved recurrence rate (P = 0.048) and 3-year disease-free survival rate (P = 0.028).

Conclusion

The results demonstrate that maintaining compliance with capecitabine as an adjuvant treatment for colon cancer to preventing complications positively affects patient prognosis.

Citations

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Anticancer Effects of IP6 in a Human Colon Carcinoma Cell Line in Nude Mice Xenografts.
Kim, Chan Dong , Lee, Jeong Eun , Lee, Ryung Ah , Kim, Kwang Ho
J Korean Soc Coloproctol. 2010;26(2):93-97.
DOI: https://doi.org/10.3393/jksc.2010.26.2.93
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AbstractAbstract PDF
PURPOSE
Inositol hexaphosphate (IP6) is a naturally occurring polyphosphorylated carbohydrate that has been shown to suppress the growth of epithelial cancer. Because IP6 is a dietary phytochemical present in cereals, soy, legumens, and fiber-rich foods, we evaluated the efficacy of IP6 against colon cancer formation.
METHODS
HT-29 cells were injected into nude mice. The animals were fed a normal diet (group 1), a low IP6 diet (group 2), and a high IP6 diet (group 3) for 4 wk. Body weight, tumor volume, tumor growth rate, growth inhibition rate, and therapeutic ratio were monitored after injection of HT-29 cells.
RESULTS
HT-29-cell human-colon-carcinoma xenograft mice treated with IP6 showed a significant reduction in tumor growth rate, irrespective of the IP6 dose compared to normal diet group. Compared with the control group, group 3 showed a significant reduction (45%) in tumor volume. In the therapeutic ratio gain profiles, IP6 diet groups showed a significant alteration of therapeutic ratio when compared with the normal diet group (0% vs. 11%, P=0.014). In the body weight gain profiles, group 3 showed a significant reduction of body weight compared with the other two groups (20.25 g vs. 21.6 g, 21.7 g, P=0.009). Groups 1 and 2 showed similar changes in body weight. Tumor xenografts from IP6-fed mice showed significantly decreased cancer formation and growth, but increased toxicity was noted for high doses of IP6.
CONCLUSION
These results indicate that in the future, IP6 could be an effective chemopreventive or chemotherapeutic agent for use in the treatment of colon cancer.

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  • Facile synthesis of template-free 3D-connected hierarchically porous CaCu3Ti4O12 monolith by a green aqueous sol-gel method
    Pascal Nbelayim, Xuanming Lu, Pierre Kalenga Mubiayi, George Hasegawa, Nosipho Moloto, Kazuki Nakanishi
    Journal of Porous Materials.2025; 32(4): 1505.     CrossRef
Expression of LDH-5 in Colorectal Carcinomas: Correlation with Prognosis and Tumor Angiogenesis.
Ahn, Tae Sung , Kim, Chang Jin , Jung, Dong Jun , Park, Dong Guk , Cho, Sung Woo , Kim, Sung Young , Lee, Moon Soo , Kim, Chang Ho , Cho, Moo Sik , Baek, Moo Jun
J Korean Soc Coloproctol. 2010;26(1):62-68.
DOI: https://doi.org/10.3393/jksc.2010.26.1.62
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  • 13 Download
AbstractAbstract PDF
PURPOSE
Lactate dehydrogenase-5 (LDH-5) is one of five isoenzymes and is the most important for anaerobic glycolysis. LDH-5 is transcriptionally regulated by hypoxia-inducible factor (HIF). HIF plays a role in the response to hypoxia by activating genes involved in vascular remodeling, cell proliferation, and erythropoiesis. In this study, we investigated the clinicopathologic significance and angiogenesis of LDH-5 expression in colorectal cancer.
METHODS
We retrospectively reviewed the medical records of 83 patients with colorectal cancer who underwent a surgical resection at Soonchunhyang Cheonan Hospital from January 2001 to December 2003. LDH-5 and HIF-1alpha protein expressions were evaluated in 83 human colorectal cancer specimens. These factors were related to TNM stage, lymph node metastasis, vascular, neural, and lymphatic invasion, and prognosis.
RESULTS
LDH-5 was positive in 66% (55 patients) of the tumors, and HIF-1alpha was positive in 66% (55 patients) of the tumors. LDH-5 expression was significantly associated with HIF-1alpha protein expression (P<0.001). Also, LDH-5 expression was significantly associated with TNM stage and lymph node metastasis (P<0.001) while HIF-1alpha expression was significantly associated with TNM stage (P<0.001), lymph node metastasis (P<0.001), vascular invasion (P=0.011), and lymphatic invasion (P=0.005). The survival of the patients with high LDH-5 expression was worse than that of patients with low LDH-5 expression (P=0.032).
CONCLUSION
Our study shows a high expression of LDH-5 in colorectal cancer. The up-regulation of LDH-5 parallels an increase in HIF-1alpha expression. The immunohistochemical assessment of tissue LDH-5 and HIF-1alpha provides important prognostic information for colorectal carcinomas.
Short-Term Outcome of Curative One-Stage Laparoscopic Resection for Obstructive Left-Sided Colon Cancers Followed by Stent Insertion: Comparative Study with Non-Obstructive Left-Sided Colon Cancers.
Kim, Hyun Sil , Kim, Sung Geun , Ahn, Chang Hyuk , Kang, Won Kyung , Lee, Yun Seok , Lee, In Kyu , Kim, Hyung Jin , Lee, Sang Cheol , Cho, Hyeon Min , Park, Jong Kyung , Oh, Seong Taek , Kim, Jun Gi
J Korean Soc Coloproctol. 2009;25(6):417-422.
DOI: https://doi.org/10.3393/jksc.2009.25.6.417
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AbstractAbstract PDF
PURPOSE
Laparoscopic surgery has been considered to be contraindicated for treating malignant colorectal obstruction. Stent insertion for obstructive colorectal cancer has recently allowed laparoscopic surgery to be performed by means of preoperative bowel decompression and bowel preparation. The aim of this study is to evaluate the safety and the feasibility of a one-stage laparoscopic resection for obstructive left-sided colon cancer after stent insertion by comparing the results to those for non-obstructive left-sided colon cancer. METHODS: Between May 2006 and January 2009, a laparoscopic colorectal operation was performed on 18 consecutive patients with obstructive left-sided colon cancer after placement of a self-expandable stent by one colorectal surgeon, and the results were compared retrospectively to those for 43 patients with non-obstructive left-sided colon cancer who had undergone a laparoscopic procedure with the same surgeon. The collected data were the clinicopathologic characteristics, the perioperative complications, the oncologic outcomes, the postoperative recovery results, and the survival rate. RESULTS: The obstructive left-sided colon cancer group had significant benefits in retrieved lymph nodes (18.8+/-5.3 vs. 14.0+/-8.7, P=0.036), and distal resection margin (5.5+/-3.0 cm vs. 3.6+/-2.4 cm, P=0.011). There were no significant differences in other clinicopathological characteristics and oncologic outcomes, including the overall 3-yr survival rate, between the two groups. CONCLUSION: Preoperative stent decompression followed by a laparoscopic colorectal resection is a safe and feasible option for treating obstructive left-sided colon cancer. A further large-scale prospective study should be performed to evaluate the long-term outcome of a one-stage laparoscopic resection using stent insertion in cases of obstructive left-sided colon cancer.
The Influence of Age on Survival and Recurrence after a Curative Surgical Resection for Colon Cancer Patients.
Lee, Cho Rok , Kim, Young Wan , Kim, Nam Kyu , Hur, Hyuk , Min, Byung Soh , Lee, Kang Young , Sohn, Seung Kook , Cho, Chang Hwan
J Korean Soc Coloproctol. 2009;25(6):401-409.
DOI: https://doi.org/10.3393/jksc.2009.25.6.401
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AbstractAbstract PDF
PURPOSE
This study was performed to evaluate whether age was a factor associated with oncological outcome for colon cancer patients who underwent a curative surgical resection.
METHODS
A retrospective study of 2,125 colon cancer patients who underwent surgery between January 1989 to December 2004 was conducted. RESULTS: Of the 2,125 patients, 1,724 patients underwent a curative resection (R0). The patients with R0 were classified into three groups: group I (n=142) under 40 yr of age, group II (n=1,462) between 40 and 75 yr of age, and group III (n=120) over 75 yr of age. There were no significant differences in gender, tumor diameter, or postoperative complications among the groups. A history of hereditary colon cancer, advanced TNM stage (III, IV), and poorly- differentiated histology were more commonly found in group I. Adjuvant chemotherapy was administered less frequently in group III. In the survival analysis, the cancer-specific survival (CSS) and the disease-free survival (DFS) rates were not different between groups I and II. The CSS and the DFS rates of group III were significantly unfavorable compared with those of groups I and II. On the multivariate analysis, old age (group III), TNM stage, and preoperative CEA level were independent risk factors for CSS and DFS. CONCLUSION: In colon cancer patients, tailored approaches according to age, such as early screening in young adults with family history and proper patients selection for adjuvant treatment in old patients, could be needed.

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  • Overweight is Associated with a Favorable Survival in Patients with Colorectal Cancer: A Prospective Cohort Study in an Asian Population
    Yang Won Min, Su-A Kim, Jun Hee Lee, Jin Young Kim, Dong Kyung Chang, Poong-Lyul Rhee, Jae J. Kim, Jong Chul Rhee, Young-Ho Kim
    Annals of Surgical Oncology.2012; 19(11): 3460.     CrossRef
  • Analysis of the Prognostic Effectiveness of a Multivisceral Resection for Locally Advanced Colorectal Cancer
    Sejin Park, Yun Sik Lee
    Journal of the Korean Society of Coloproctology.2011; 27(1): 21.     CrossRef
Expression of Alpha-catenin/E-cadherin and Clinical Significance of Metastatic Factors in Stage III Advanced Colon Cancer.
Chae, Seung Hun , Kim, Han Sun , Kim, Jae Man , Lee, Sang Hee , Jo, Sung Ook , Lee, Mi Keung , Jung, Wan Jo , Lee, Ho Jun
J Korean Soc Coloproctol. 2009;25(5):334-339.
DOI: https://doi.org/10.3393/jksc.2009.25.5.334
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AbstractAbstract PDF
PURPOSE
Among the cell adhesion molecules, alpha-catenin and E-cadherin play an important part in maintaining normal cell structure. The change in expression of cell adhesion molecules affects the invasion and metastasis of a tumor and the prognosis for patients. In this study, we evaluated the relationship between the expression of cell adhesion molecules and the histopathologic characteristics of stage III colon cancer.
METHODS
The relationship between the immunohistochemical expression of cell adhesion molecules and tumor progression were statistically analyzed in 40 patients with stage III colon cancer.
RESULTS
There were no statistically significant correlations between loss of membranous alpha-catenin and E-cadherin expressions and such variables as histologic differentiation and lymph node disease based on the criteria of the American Joint Committee on Cancer (AJCC). A significant correlation, however, existed between depth of mural invasion and loss of expressions of both alpha-catenin and E-cadherin (P=0.001 and P=0.002, respectively). Expressions of both alpha-catenin and E-cadherin were also significantly decreased in patients showing liver metastases during follow-up (P=0.019 and P=0.015, respectively).
CONCLUSION
Immunohistochemical analyses of alpha-catenin and E-cadherin expressions may be available as predictors for distant metastasis, especially in stage III colon cancer. Such analyses may also help to identify appropriate therapeutic strategies and the need for intensive follow-up in patients with stage III colon cancer.
Mucinous Histology as a Predictive Marker of 5-Fluorouracil-based Adjuvant Chemotherapy for Colon Cancer.
Kang, Jeonghyun , Min, Byung Soh , Park, Yoon Ah , Kim, Nam Kyu , Sohn, Seung Kook , Cho, Chang Hwan , Lee, Kang Young
J Korean Soc Coloproctol. 2009;25(4):241-247.
DOI: https://doi.org/10.3393/jksc.2009.25.4.241
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AbstractAbstract PDF
PURPOSE
The aim of this study was to evaluate the value of mucinous histology as a predictive marker of 5-Fluorouracil (FU)-based adjuvant chemotherapy in stage II, III colon cancer. METHODS: Between January 1995 and December 2004, 987 patients who underwent curative resections for stage II, III sporadic colon cancer were classified into two groups, a mucinous carcinoma (MC) group and a non-mucinous carcinoma (NMC) group, based on the histology of the primary tumor. The differences in their clinicopathological characteristics and the prognostic impact of 5-FU-based adjuvant chemotherapy for various tumor histologies were analyzed.
RESULTS
Of the 987 patients, MCs accounted for 6.8% (68 patients). MCs were more frequently located in the Rt. Colon (P<0.001) and were more frequently seen in young patients (less than 40 yr old) (P=0.028). The 5-yr survival rates between MC and NMC did not show any statistically significant difference. Patients, including both MC and NMC patients, who received 5-FU-based chemotherapy, revealed a better overall survival rate than patients with no adjuvant chemotherapy. In the multivariate analysis for the prognosis in NMC patients, 5-FU-based adjuvant chemotherapy, initial negative nodal status, and preoperative CEA <5 ng/mL were statistically significant prognostic factors (P values: <0.001, <0.001, and <0.001, respectively). In contrast, there was no statistically independent significance of 5-FU-based adjuvant chemotherapy in MC patients. CONCLUSION: In stage II and stage III sporadic colon cancer patients, response to 5-FU-based adjuvant chemotherapy in MC patients might be poor than it is in NMC patients.

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  • Early recurrence in patients undergoing curative surgery for colorectal cancer: is it a predictor for poor overall survival?
    Jung Wook Huh, Chang Hyun Kim, Sang Woo Lim, Hyeong Rok Kim, Young Jin Kim
    International Journal of Colorectal Disease.2013; 28(8): 1143.     CrossRef
Prognosis and Recurrent Patterns of Sporadic Primary Colon Cancers According to Location.
Park, Jin Seok , Yu, Chang Sik , Kim, Chan Wook , Jeong, Kwang Yong , Shin, Ui Sup , Yoon, Sang Nam , Lim, Seok Byung , Kim, Jin Cheon
J Korean Soc Coloproctol. 2009;25(4):221-226.
DOI: https://doi.org/10.3393/jksc.2009.25.4.221
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AbstractAbstract PDF
PURPOSE
We aimed to compare the prognosis and the recurrence patterns of sporadic primary colon cancers according to the location of the cancer. METHODS: One thousand four-hundred eighty-three (1,483) stage II, III colon cancer patients who had undergone a consecutive curative resection between January 1989 and December 2003 were analyzed. Hereditary, synchronous, metachronous, and recurrent colon cancers were excluded. The right colon was defined as being from the cecum to the transverse colon, and the left colon was defined as being from the splenic flexure colon to the rectosigmoid colon. The median follow-up time was 63 (3-228) mo. RESULTS: Poorly differentiated and mucinous cell type tumors were more frequent in the right colon. T3 tumors were more frequent in the right colon. Lymph-node-positive tumors were more frequent in the left colon. The recurrence rate was higher in the left colon, but the patterns of recurrence were not different according to the tumor's location. By univariate analysis, age, preoperative serum CEA level, T-stage, N-stage, lymphovascular invasion, postoperative chemotherapy, and tumor location were significant prognostic factors associated with recurrence. By multivariate analysis, sex, preoperative serum CEA level, T-stage, N-stage, postoperative chemotherapy, and tumor location were significant prognostic factors associated with recurrence. The 5-yr disease-free survival rates were 84.0% for right colon cancer and 77.1% for left colon cancer (P=0.005). The recurrence rates for cancers in the sigmoid colon and the rectosigmoid colon were higher than those for cancers in the cecum and the ascending colon. CONCLUSION: The tumor's location was an independent prognostic factor for recurrence, but the pattern of recurrence did not vary with the tumor's location.

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  • Survival analysis for colon subsite and rectal cancers: Experience from a single surgeon
    Inhwa Lee, Seung-Hyun Baek, Hyunsung Kim, Hong-Jae Jo, Nahm-Gun Oh, Sanghwa Ko
    Korean Journal of Clinical Oncology.2015; 11(2): 114.     CrossRef
Concomitant Adjacent Organ Resection in Locally Advanced Colon Cancer.
Cho, Sung Wook , Lee, Ryung Ah , Chung, Soon Sup , Kim, Kwang Ho
J Korean Soc Coloproctol. 2009;25(2):94-99.
DOI: https://doi.org/10.3393/jksc.2009.25.2.94
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AbstractAbstract PDF
PURPOSE
In locally advanced adherent colon cancer surgery, a mutivisceral resection is known to reduce local recurrence and improve survival. Practically, the benefit of using this procedure may outweigh the risk of associated morbidity, but the procedure may not be performed uniformly. We reviewed the results of multivisceral resections for locally advanced colon cancer. METHODS: From 2003 January to 2008 January, 476 colon cancer patients underwent surgery for locally advanced colon cancer in our hospital. Out of the 476 patients, 36 patients with pT3-pT4 who underwent any kind of adjacent organ resection other than a resection of the colon were reviewed retrospectively. RESULTS: Out of the 36 patients, 22 were male and 14 were female, and the mean age was 63.44+/-13.26 yr. The sigmoid colon was the most common location for the primary lesion, followed by the ascending colon, the transverse colon, and the cecum. Invaded organs were the abdominal or pelvic wall in 5 patients, the visceral organs in 26 patients, the retroperitoneum in 2 patients. All patients received an en-bloc resection of the invaded organs. Ten patients were stage II, 14 patients were stage III, and 12 patients were stage IV. Fifteen patients were disease free at the end of this study, local recurrence had occurred in 1 patient, 6 patients had an intraabdominal recurrence, and 2 patients had developed a distant metastasis. The overall complication rate was 28%. The 5-yr survival rate of each stage according to the surgical approach did not show any meaningful difference. CONCLUSION: A multivisceral en-bloc resection has been recommended for locally advanced adherent colon cancer patients. To improve the outcome, we suggest progressive surgical treatment in such patients.

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  • Analysis of the Prognostic Effectiveness of a Multivisceral Resection for Locally Advanced Colorectal Cancer
    Sejin Park, Yun Sik Lee
    Journal of the Korean Society of Coloproctology.2011; 27(1): 21.     CrossRef
Treatment of Multiple Colorectal Cancers.
Paek, Ok Joo , Oh, Seung Yeop , Suh, Kwang Wook
J Korean Soc Coloproctol. 2009;25(1):34-40.
DOI: https://doi.org/10.3393/jksc.2009.25.1.34
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AbstractAbstract PDF
PURPOSE
The detection of synchronous and metachronous colon cancer is important for the surgical treatment. The aim of this study is to review the clinicopathological characteristics of multiple colon cancers.
METHODS
A retrospective analysis was performed with 43 patients with multiple colon cancers who underwent surgical treatment from June 1996 to May 2008. Patients with familial adenomatous polyposis and cancer from inflammatory bowel disease were excluded.
RESULTS
There were 43 cases of multiple colon cancers. Synchronous colon cancers were present in 30 patients and metachronous colon cancers were present in 18 patients. The mean age was 61.33+/-11.44, and the male-to-female ratio was 23:20. The index cancer and the second cancers in synchronous colon cancers, as well as the first colon cancer in metachronous colon cancers showed, significantly more distal tumor locations. However, the second cancers in metachronous colon cancers showed no significant differences in tumor location. As for stage, a more advanced stage was noted in the index cancer than in the second cancers in synchronous cancer. However, an early stage was noted for the first colon cancer in metachronous cancers. Seventeen patients with synchronous cancer and 14 patients with metachronous colon cancer underwent a total or a subtotal colectomy.
CONCLUSION
Detection of synchronous colon cancer was important for deciding the extent of surgical resection. Patients with colon cancer should be considered for frequent colonoscopy follow-up for early detection of metachronous colon cancer.
IMA-origin Lymph Node Metastasis in Left Colon Cancer.
Lee, Jae Hoon , Jung, Sang Hun , Kim, Hyun Jin , Hwang, Jong Sung , Kim, Jae Hwang , Shim, Min Chul
J Korean Soc Coloproctol. 2008;24(5):380-385.
DOI: https://doi.org/10.3393/jksc.2008.24.5.380
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AbstractAbstract PDF
PURPOSE
Although an extended colon resection with high ligation of the inferior mesenteric artery (IMA) generally has been recommended as curative surgery for advanced left colon cancer (LCC), it shows little or no survival advantage over segmental resection with low ligation of IMA. The present study is to determine the risk factors associated with IMA-origin lymph-node (LN) metastasis and to clarify the implication of IMA-origin LN metastasis.
METHODS
We examined the clinicopathological results of 200 cases of LCC. LN dissection was performed as follows: D2 en-bloc resection of the primary tumor, IMA-origin LN dissection, and paraaortic LN dissection.
RESULTS
The incidence of IMA-origin LN metastasis of LCC was 4.5% (9 cases), and all cases involved sigmoid colon cancer. The independent risk factors of IMA-origin LN metastasis were four or more regional LN metastases (hazard ratio: 16.51, 95% confidence interval: 1.60~164.12) and a preoperative CEA level of greater than 6 ng/ml of (hazards ratio: 6.63, 95% confidence interval: 1.06~41.32). The incidence of IMA-origin LN metastasis among stage IIIC patients was 26.7%. Five of the 9 (55.6%) cases of IMA-origin LN metastasis had a concomitant paraaortic LN metastasis.
CONCLUSIONS
The incidence of IMA-origin LN metastasis among patients with LCC was low; however, IMA-origin LN metastasis should be considered as a systemic metastasis.
Association of Methylenetetrahydrofolate Reductase C677T, A1298C, and G1793A Polymorphism and the Risk of Colon Cancer.
Kang, Dong Baek , Rhee, Jeong Kyun , Park, Won Cheol
J Korean Soc Coloproctol. 2008;24(4):239-245.
DOI: https://doi.org/10.3393/jksc.2008.24.4.239
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AbstractAbstract PDF
PURPOSE
Methylenetetrahydrofolate reductase (MTHFR) is a critical enzyme regulating folate level, which affects DNA synthesis and methylation. MTHFR is highly polymorphic, and its variant genotypes result in decreased MTHFR enzyme activity and lower plasma folate level. Generally, a low folate level is known to be associated with a gastrointestinal neoplasm. Three common single nucleotide polymorphisms (SNPs) resulting in amino-acid changes (C677T, A1298C and G1793A) have been reported in MTHFR. We studied the relationship of MTHFR C677T, A1298C and G1793A polymorphisms between from colon cancer group and control group of Korean people.
METHODS
We performed a case- control study to examine the relationship between MTHFR C677, A1298C, and G1793A polymorphisms and the risk of colon cancer. Two hundred seven (207) individuals with colon cancer and 288 healthy persons were analyzed. Blood sampling of each group was performed, and (PCR-RFLP) was analyzed; as a result, MTHFR polymorphism genotypes were obtained.
RESULTS
The genotype frequencies of MTHFR C677T polymorphisms were 27.1% (CC), 48.3% (CT), 24.6% (TT), and 72.9% (CT+TT) in the patient group and 39.2% (CC), 36.8% (CT), 24.0% (TT), and 60.8% (CT+TT) in the control group. The genotype frequencies of MTHFR A1298C polymorphisms were 58% (AA), 35.7% (AC), 6.3% (CC), and 42% (AC+CC) in the patient group and 55.6% (AA), 40.3% (AC), 4.2% (CC), and 44.4% (AC+CC) in control group. The genotype frequencies of MTHFR G1793A polymorphisms were 83% (GG), 15.9% (GA), 1% (AA), and 16.9% (GA+AA) in the patient group and 85.8% (GG), 11.8% (GA), 2.4% (AA), and 14.2% (GA+AA) in the control group. The 677CT genotype was associated with a significantly increased risk for colon cancer (adjusted OR=1.90, 95% confidence interval: 1.25~2.90 in CT) than the 677CC genotype. The 1298CC, 1298AC, 1793AA, and 1793GA genotypes were not associated with a significantly increased risk for colon cancer.
CONCLUSIONS
The MTHFR C677T polymorphism may influence colon cancer, but the MTHFR A1298C and G1793A polymorphisms need to be studied further for careful interpretation and confirmation in larger studies.

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  • APOE, MTHFR, LDLR and ACE Polymorphisms Among Angami and Lotha Naga Populations of Nagaland, India
    Benrithung Murry, Neikethono Vakha, Nongthombam Achoubi, M. P. Sachdeva, K. N. Saraswathy
    Journal of Community Health.2011; 36(6): 975.     CrossRef
Case Report
Colon Obstruction due to Colonic Metastasis of a Breast Carcinoma.
Kim, Do Hyoung , Lee, In Kyu , Oh, Chang Hyun , Lee, Yoon Suk , Park, Jong Kyung , Park, Woo Chan , Jeon, Hae Myung , Byun, Jae Ho , Park, Gyeoung Sin , Chang, Suk Kyun
J Korean Soc Coloproctol. 2008;24(2):144-147.
DOI: https://doi.org/10.3393/jksc.2008.24.2.144
  • 2,047 View
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AbstractAbstract PDF
Breast cancer is a common malignancy in women and metastasizes to the liver, the lung, the brain, and the bone, but metastasis to the colon is rare. We describe a 58-year-old woman with colon metastasis of breast cancer. She was diagnosed with right colon cancer, and during investigation for colon cancer, we found a breast cancer. She received a palliative right hemicolectomy due to obstruction before chemotherapy. The histology of the tissue taken from the right colon was shown to be the same as that of the left breast mass. This is a case of colonic metastasis from breast cancer and we report this case with a review of literature.
Original Articles
Short-term Clinico-pathological Outcomes of a Laparoscopic Transverse Colectomy for Transverse Colon Cancer.
Lee, Yoon Suk , Lee, In Kyu , Kim, Hyung Jin , Kang, Won Kyoung , Park, Jong Kyuong , Oh, Seung Teak , Kim, Jun Gi , Kim, Young Ha
J Korean Soc Coloproctol. 2008;24(2):107-112.
DOI: https://doi.org/10.3393/jksc.2008.24.2.107
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  • 1 Citations
AbstractAbstract PDF
PURPOSE
The COST study trial has demonstrated oncological safety by using laparoscopy for colon cancer. However, in a prior trial, the transverse colon was excluded. Therefore, it has not been determined whether laparoscopy can be used in the setting of transverse colon cancer. Moreover, a transverse colectomy for transverse colon cancer is controversial. This study evaluated the peri-operative and short-term oncological outcomes of a laparoscopic transverse colectomy. METHODS: A retrospective review of patients with colorectal cancer treated using laparoscopy from August 2004 to August 2007 was conducted. Peri-operative and short-term oncological outcomes were compared between an extended right or left colectomy and a transverse colectomy. RESULTS: Of 234 patients, 26 patients underwent laparoscopic surgery for transverse colon cancer. Extended right & left colectom were performed in 20 cases, and a transverse colectomy was performed in 6 cases. There were no significant differences between the two groups in terms of age, gender, BMI, blood loss, time to pass flatus, start of diet, hospital stay, tumor size, number of lymph nodes, and radial margin. The distal and the proximal resection margins of an extended Rt. or Lt. colectomy were longer than those of a transverse colectomy. One transverse colectomy was converted to open surgery because of a T4 lesion of transverse colon cancer. There were no differences between the two groups in terms of morbidity and mortality. CONCLUSIONS: The results of this study show that a laparoscopic transverse colectomy has acceptable peri-operative and short-term oncological outcomes compared to an extended right and left colectomy. However, further investigations are needed to establish the long-term oncological safety of laparoscopic surgery, including transverse colectomy, for transverse colon cancer.

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  • Lymph Node Metastasis Patterns in Right-Sided Colon Cancers: Is Segmental Resection of These Tumors Oncologically Safe?
    In Ja Park, Gyu-Seog Choi, Byung Mo Kang, Kyoung Hoon Lim, Soo Han Jun
    Annals of Surgical Oncology.2009; 16(6): 1501.     CrossRef
PRL-3 Expression in Primary Colorectal Cancer.
Lee, Hee Jae , Chu, Chong Woo , Baek, Moo Jun , Shin, Eung Jin , Kim, Hyung Chul , Cho, Gyu Seok , Song, Ok Pyung , Kim, Hee Kyung , Park, Hyo Jin
J Korean Soc Coloproctol. 2007;23(6):497-502.
DOI: https://doi.org/10.3393/jksc.2007.23.6.497
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AbstractAbstract PDF
PURPOSE
Overexpression of the protein tyrosine phosphatase (PRL-3) is elevated in liver metastases derived from colorectal cancer. We examined PRL-3 expression in the primary lesion of colorectal cancer patients and investigated its relation to clinicopathological features.
METHODS
A total of 63 randomly selected patients who underwent surgical resection for colorectal cancer between May 2001 and June 2005 at our hospital were investigated. Formalin-fixed and paraffin-embedded specimens from colorectal cancer patients who underwent surgical resections for primary tumors were collected. The expression of PRL-3 was detected by immunohistochemistry and the relation with age, sex, primary tumor size, tumor cell differentiation, depth of invasion, microscopic lymph node metastases, vascular invasion, numbers of lymph node metastases, postoperative stage, and postoperative survival time were analyzed.
RESULTS
A total of 16 of the 63 colorectal cancer patients were detected with liver metastases during the follow-up periods. Liver resection was performed for those liver metastases patients. Five patients developed lung metastases after liver resection. PRL-3 expression was detected in 46 colorectal cancer patients. Fourteen patients with lymphatic invasion had positive expression of PRL-3 that was significant (P=0.042). The incidence of PRL-3 expression in the T stage was significant (P=0.019). Moreover, PRL-3 expression was closely associated with liver metastases (P=0.048).
CONCLUSIONS
These results indicate that an investigation of PRL-3 expression in primary colorectal cancer lesions may contribute to the detection of occult liver metastases and to a differentiation between postoperative management strategies.

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  • Correlation between Liver Metastases and the Level of PRL-3 mRNA Expression in Patients with Primary Colorectal Cancer
    Nam Won Kim, Chong Woo Chu, Tae Sung Ahn, Chang Jin Kim, Dong Jun Jung, Myoung Won Son, Sang Ho Bae, Moon Soo Lee, Chang Ho Kim, Moo Jun Baek
    Journal of the Korean Society of Coloproctology.2011; 27(5): 231.     CrossRef
  • Krukenberg Tumor Confirmed by Surgery during the Follow-up after a Primary Resection of Colorectal Cancer
    Won-Ho Choi, Si-Youl Jun
    Journal of the Korean Society of Coloproctology.2008; 24(4): 273.     CrossRef
Case Reports
Sigmoid Colon Cancer with Metastasis to the Right Spermatic Cord.
Kim, Hyung Jin , Moon, Eun Jung , Kang, Won Kyung , Hong, Seong Hu , Jung, Chan Kwon , Oh, Seong Taek
J Korean Soc Coloproctol. 2007;23(3):203-205.
DOI: https://doi.org/10.3393/jksc.2007.23.3.203
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  • 2 Citations
AbstractAbstract PDF
Metastatic tumors involving the spermatic cord are very rare, and the prognosis for such patients is poor. The primary tumors that are frequently metastatic to the spermatic cord are gastric and colon carcinomas. We report a case of a 35-year-old male with a metastatic spermatic cord tumor following a palliative anterior resection for sigmoid colon cancer with peritoneal seeding. The patient complained of a tender mass in a right inguinal lesion. A right orchiectomy was performed, and the pathologic finding was a poorly differentiated adenocarcinoma similar to that of the sigmoid colon cancer.

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  • Metastatic Spermatic Cord Tumor From Colorectal Cancer
    Ji Geon Jang, Hye Yun Jeong, Ki Soo Kim, Mi Jung Park, Jin Sook Lee, Sang Su Kim, Ho Young Kim
    Annals of Coloproctology.2015; 31(5): 202.     CrossRef
  • Skeletal Muscle Metastasis from Colorectal Cancer: Report of a Case
    Pyong Wha Choi, Chul Nam Kim, Han Seong Kim, Jung Min Lee, Tae Gil Heo, Je Hoon Park, Myung Soo Lee, Surk Hyo Chang
    Journal of the Korean Society of Coloproctology.2008; 24(6): 492.     CrossRef
A Case of Colon Cancer Associated with Colonic Tuberculosis.
Yun, Sang Chul , Shin, Eung Jin , Song, Ok Pyung , Kim, Hyung Chul , Lim, Cheol Wan , Cho, Gyu Seok , Chu, Chong Woo , Lee, Hyo Won
J Korean Soc Coloproctol. 2007;23(3):194-198.
DOI: https://doi.org/10.3393/jksc.2007.23.3.194
  • 2,885 View
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AbstractAbstract PDF
Inflammatory bowel disease, such as ulcerative colitis and Crohn's disease, has a potential risk of developing into colorectal cancer. However, there is little relationship between intestinal tuberculosis and colon cancer because intestinal tuberculosis is a curable disease and has a relatively short disease course. Nevertheless, there have been a few case reports of intestinal tuberculosis associated with colon cancer. There was a case report in which the carcinoma facilitated entry of tubercle bacilli with development of a secondary infection, and ulcerative lesions of tuberculosis may be precursors of carcinomas. We experienced a 77-year-old woman who had intestinal tuberculosis combined with ascending colon cancer. She visited our hospital because of abdominal pain and constipation. Colonoscopy showed a luminal obstruction mass in the ascending colon. Histologic examination revealed an adenocarcinoma. After surgery, the surgical specimen disclosed an adenocarcinoma in the cecum and ascending colon and intestinal tuberculosis around the cancer site of the cecum. Herein, we report a rare case of colon cancer co-existing with colonic tuberculosis with a review of the literature.
Original Article
Laparoscopic Surgery for Splenic Flexure Colon Cancer.
Lee, Yoon Suk , Heo, Yoon Jung , Lee, In Kyu , Cho, Hyun Min , Kang, Won Kyung , Park, Jong Kyung , Ahn, Chang Hyuk , Lee, Do Sang , Oh, Seung Teak , Kim, Jun Gi , Kim, Young Ha
J Korean Soc Coloproctol. 2007;23(3):167-171.
DOI: https://doi.org/10.3393/jksc.2007.23.3.167
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AbstractAbstract PDF
Purpose
While a carcinoma of the splenic flexure is uncommon, is associated with a high risk of obstruction, and has a dual lymphatic drainage system, A COST study excluded transverse colon cancer, including splenic flexure colon cancer. This study reviews our experience with splenic flexure colon cancer treated laparoscopically and discusses a appropriate, safe laparoscopic surgical procedure.
Methods
The authors reviewed the medical records of patients who underwent laparoscopic surgery for splenic flexure colon cancer from January 1995 to June 2006. The splenic flexure colon was defined as 5 cm from the splenic flexure proximally and distally by using radiologic studies. Curative surgery for splenic flexure colon cancer was defined as: primary cancer removal, a safe resected margin, no metastasis, and a complete lymphadenectomy including high ligation of left colic artery and of the left branch of the middle colic artery. Results: A total of 407 patients underwent laparoscopic surgery for colon cancer; among them, 15 patients underwent a laparoscopic left colectomy for splenic flexure colon cancer. The mean age of the patients was 63.8 years, and the male-to-female ratio was 9:6. The mean operation time was 325.3+/-95.1 minutes, and the average hospital stay was 15.8+/-4.9 days. The average number of harvested lymph nodes was 12.3+/-9.7, the average distal resection margin was 15.3+/-7.6 cm, and the average proximal margin was 10.7+/-3.2 cm. One case of chyle discharge and one case of ileus developed, but were treated conservatively. There was no surgical mortality.
Conclusions
A laparoscopic left colectomy for splenic flexure colon cancer is a technically feasible and safe procedure with acceptable short-term outcomes in experienced hands.
Case Report
Sigmoid Colon Cancer with Isolated Metastasis to the Left Kidney.
Kim, Hyung Jin , Choi, Ho Joong , Kang, Won Kyung , Oh, Soon Nam , Jung, Chan Kwon , Oh, Seong Taek
J Korean Soc Coloproctol. 2006;22(5):346-349.
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AbstractAbstract PDF
We report the case of a 63-year-old female with sigmoid colon cancer and isolated metastasis to the left kidney at the time of initial diagnosis. An anterior resection of the sigmoid colon and a left nephrectomy were performed. Three cycles of adjuvant chemotherapy consisting of oxaliplatin, 5-fluorouracil, and leucovorin were given, but two months after the surgery, multiple metastases of the liver were detected on a CT scan. The patient refused further treatment and died 5 months after the discovery of an isolated metastasis. An isolated metastasis to the kidney is very rare in clinical practice. A nephrectomy for kidney metastasis has no effect on survival and quality of life, and a nephrectomy may also compromise the choice of chemotherapy agents that require renal clearance; thus, a careful evaluation of renal function is necessary before a nephrectomy. At present, kidney metastasis should be regarded as an advanced metastatic disease, and aggressive chemotherapy, including target therapy, should prolong survival and improve the quality of life. However, when a synchronous or a metachronous renal tumor is suspected, a nephrectomy should be performed for accurate diagnosis and treatment.
Original Articles
Clinical Significance of Lateral Resection Margin Involvement for Colon Cancer.
Lee, Nan Joo , Ha, Tae Geun , Shin, Jin Yong , Jeong, Su Jin , Hong, Kwan Hee
J Korean Soc Coloproctol. 2006;22(5):322-329.
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AbstractAbstract PDF
PURPOSE
The clinical significance of the lateral resection margin for rectal cancer has been widely investigated. The ascending and the descending colon do not have a peritoneal covering posteriorly. Therefore, colon cancers located on their posterior side can penetrate the entire bowel wall, which is similar to mesorectal invasion in rectal cancer. However, the prognostic significance of the retroperitoneal resection margin involvement is unknown. The aim of this study is to evaluate the prognostic significance of the lateral resection margin in ascending and descending colon cancer.
METHODS
A retrospective study was performed and involved 92 patients who had undergone a curative resection for right or left colon cancer with TNM stage II and III. The patients were assigned to either a lateral margin negative group (LMNG, n=73) or a lateral margin positive group (LMPG, n=19) according to the presence of a tumor or a metastatic lymph node within 1 mm of the lateral resection margin. The oncological outcomes of the LMPG were compared with those of the LMNG.
RESULTS
The LMPG was younger and had higher incidences of tumors positive vascular or neural invasion and advanced T and N stages. The overall recurrence rate of the LMPG was higher than that of the LMNG (36.8% versus 16.4%) and the cumulative survival rate of the LMPG was significantly lower than that of the LMNG (35.0% versus 76.2%). High preoperative CEA, lymphatic invasion, lateral margin involvement of the tumor, N2 in nodal status were significant factors in the univariate analysis for evaluation of the prognosis, but lateral margin involvement was not a significant factor in the multivariate analysis. In the lymph-node-positive group and the CEA non-elevation group, lateral margin involvement of the tumor was revealed as a prognostic factor.
CONCLUSIONS
Lateral margin involvement of ascending and descending colon cancer affects tumor recurrence and overall survival, but it is not a significant prognostic factor.
Cytosolic Glutathione S-Transferase Change after Deoxycholate Exposure in Colon Cancer Cell Lines.
Park, Dong Kook , Shin, Ji Hyun , Park, Seok Gun , Cheung, Sun Young
J Korean Soc Coloproctol. 1998;14(4):701-708.
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AbstractAbstract PDF
PURPOSE
Bile acids (especially deoxycholate) was known to be toxic and mutagenic on colon epithelium. They proposed at least four mechanisms for the bile acid toxicity. It is the one of these mechanisms that bile acid inhibits the xenobiotic metabolizing enzyme activity (esp glutathione S-transferase, GST). So we measured the cytosolic GST level of colon carcinoma cell lines after deoxycholate exposure whether or not the deoxycholate lowered the cytosolic GST activity.
METHODS
Three colon cancer cell lines (LoVo, SW480, HT29) were used for this study. We calculated the cellular toxicity by MTS method. And cytosolic GST activity was measured according to the method as Habig described. For total GST activity, 2.5 mM 1-chloro-2,4-dinitrobenzene was used for substrate, and measured as absorbance in 340 nm.
RESULTS
Basal cytosolic GST level for LoVo, SW480, HT29 cell line was 514.59+/-27.01, 291.63+/-38.44 and 344.58+/-47.92 nmol/min/mg cytosol protein. GST level did not changed significantly after 5 days culture without DCA. But GST level was decreased significantly to 128.63+/-21.35, 134.33+/-41.76 and 163.10+/-22.73 nmol/min/mg cytosol protein each cell line after 5 days deoxycholate exposure (p<0.005).
CONCLUSION
Cytosolic GST level was lowered significantly after deoxycholate exposure for 5 days. One of the mechanisms of bile acid toxicity for colon cancer cell is proposed to inhibit cytosolic GST activity.
Case Report
Double Primary Cancer Patient with Sigmoid Colon Adenocarcinoma and Anal Squamous Cell Carcinoma with Rectal Mucosal Metastasis A case report.
Rhyou, Jai Hyun , Shim, Kang Sup , Kim, Kwang Ho , Park, Eung Bum
J Korean Soc Coloproctol. 1998;14(3):629-634.
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AbstractAbstract PDF
Synchronous neoplams are uncommon condition but the incidence is now being increased. The situation is rare when these tumors comes from different origin. We experienced the case with synchronous sigmoid colon cancer and anal squamous cell carcinoma with rectal mucosal metastasis. The patient was 61 years old male. He complained of intermittent hematochezia since 3~4 months ago. The patient underwent anterior resection for colon cancer and wide excision for anal squamous cell carcinoma. After surgical operation, postoperative adjuvant chemotherapy (5-FU + Leucovorin) and radiotherapy were done. In this case, we could preserve the anal sphincter using combined therapy. We think that this type of management may be useful treatment in patients with colon cancer and anal squamous cell cancer simultaneously.
Original Article
The Economic Efficiency of the Single Stage Management of Left Colon Cancer Patient.
Kang, Shin Hwa , Shon, Dae Ho , Kwun, Woo Hyung , Kim, Sang Woon , Shim, Min Chul , Kim, Jae Hwang
J Korean Soc Coloproctol. 2002;18(4):251-256.
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AbstractAbstract PDF
PURPOSE
Two-stage management with Hartmann's procedure is the most common procedure used for the treatment of obstructive left colon cancer with or without perforation. However, single-stage procedures have gained popularity recently with reports that show little difference in safety compared to the conventional multi-stage procedures. To evaluate the economic advantage of single stage procedure compare with two stage procedure in emergent left colonic pathology.
METHODS
Eleven patients (SP; single stage procedure) without other accompanying diseases among 15 patients who entered the emergency room and treated by the single stage procedure using the intraoperative irrigation for the left colon obstructions with or without perforation during the period from July of 1999 to November of 2000, were compared in their costs retrospectively with 11 patients (MP; multiple stage procedure) without other accompanying diseases and had final reduction of stoma out of 28 patients treated by Hartman's procedures including the resections of lesions during the period from September 1996 to May 1999 with the same diagnosis. The costs were compared using Mann-Whitney U tests, with data on the costs of overall treatments, operations, anesthesia, admission room, medications, test/evaluations, and managements as well as days of hospital stay, all on the record of accounting department. The relationships of the factors to the total cost of treatment were evaluated using Multi-variant regression analysis, and the pre-operative physiologic status were compared using APACHE III scoring system. The total treatment cost did not include optional treatment costs, uninsured admission room costs, and the costs of colonic irrigator used in the operations for the SP.
RESULTS
There were no significant difference in the age and gender of the two groups as 67 +/-15 years with 6 males for the SP and 6+/-19 years with 7 males for the MP. The preoperative physiologic status of patients, in APACHE III scoring system, were 29.1+/-10.6 in the SP and 26.1+/-8.2 in the MP without any significant difference between the two groups. The average of hospital stay showed a significant difference between two groups as 17.1+/-6.2 (range: 13-25) days for the SP and 31.3 (range: 24-43) days for the MP (p<0.01). The average of total costs showed also a significant difference in two groups as 3,938 687 (range: 3,017-4,974) thousand won for the SP and 7,543 1,851 (range: 5,314-9925) thousand won for the MP (p<0.01). It showed that the SP had roughly 50, 53, 76, 79, and 72% reductions of costs over operations, anesthesia, admission room, medications, tests/evaluations, and managements. The analysis of the overall costs of treatments showed 3,540 thousand won reduction in SP.
CONCLUSIONS
Single stage procedure using intraoperative colonic irrigation technique showed no difference in safety but has an economical advantage over the conventional multiple stage in the management of emergent left colonic obstruction or perforation patients.
Case Report
A Case of Turcot's Syndrome Combined with Colon Cancer in a 15-year-old Girl.
Lee, Seok Ryeol , Lee, Kil Yeon , Lee, Kee Hyung , Leem, Won , Kim, Hyo Jong , Lee, Ju Hie
J Korean Soc Coloproctol. 2002;18(3):200-204.
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AbstractAbstract PDF
Turcot's syndrome is a rare hereditary disease marked by the association of central nervous system neuroepithelial tumor with colonic polyposis. Authors report herein a case of a 15-year-old girl diagnosed as having Turcot's syndrome, otherwise known as brain tumor-polyposis syndrome, combined with sigmoid colon cancer. The patient was carried out craniostomy and brain tumor removal. The tumor was confirmed histologically to be oligodendroglioma. The patient visited the department of internal medicine for bloody diarrhea during 6 months. Colonoscopy and biopsy was done. The patient was diagnosed as having Turcot's syndrome combined with sigmoid colon cancer, and was then transferred to the department of surgery for treatment of sigmoid colon cancer. Total proctocolectomy and IPAA (ileal pouch-anal anastomosis) was carried out. Multiple polyps were found in the colon, two large masses were confirmed histologically to be adenocarcinoma. The remaining polyps were adenomas. This case report describes the characteristic features of Turcot's syndrome presented by this patient.
Original Articles
Effect of Ionizing Radiation on Homotypic Cell Adhesion, Cell-Matrix Adhesion, Matrix Metalloproteinases Excretion of High Mucin Producing HM7 Colon Cancer Cells.
Kim, Hye Gyong , Kim, Tae Dong , Li, Ge , Yoon, Wan Hee
J Korean Soc Coloproctol. 2006;22(3):153-161.
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AbstractAbstract PDF
PURPOSE
To investigate the effect of ionizing radiation on high mucin-producing colon cancer cells, we evaluated homotypic cell adhesion, cell-matrix adhesion, and matrix metalloproteinases (MMPs) on HM7 cells.
METHODS
After an irradiation of 60 Gy for 48 hours on HM7 cells, we evaluated cellular proliferation, colony-forming ability, homotypic adhesion, cell-matrix binding, and integrin subunit expressions. Also, alterations of MMPs expression were analyzed by using zymography.
RESULTS
Cell proliferation of HM7 colon cancer cells was not remarkably affected even after high doses of radiation; however, clonogenic cell growth was significantly affected. Homotypic cell-cell adhesion and cell adhesion to ECM components and basement membrane protein matrigel were significantly increased after irradiation. Radiation induced expressions of cell surface integrin alpha2, alpha3, and beta1 subunits of HM7 cells. The activities of secreted MMPs (MMP-9 and MMP-2) were remarkably inhibited by radiation.
CONCLUSIONS
These finding suggest the biologic characteristics of high-mucin-producing colorectal carcinomas. Even though the radiation-associated cellular alterations of HM7 cells with or without matrix proteins were not remarkably different from other cancer cell types studied, the radio-resistant behavior of high mucin producing HM7 cells may explain the aggressive characteristics of mucinous colorectal carcinomas.
A Comparative Study of Outcomes between Emergency and Elective Surgeries for Colon Cancer.
Yoo, Dae Hyung , Yon, Joon Moh , Lee, Mun Seob , Shin, Dong Jun , Ahn, Byeong Yul , Kim, Byung Wook
J Korean Soc Coloproctol. 2006;22(2):113-117.
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AbstractAbstract PDF
PURPOSE
The purpose of this study was to compare the efficacy of curative emergency surgery for complicated colon cancer in terms of tumor recurrence and survival compared with that of elective surgery.
METHODS
A total of 238 primary surgeries for colon cancer were performed. All patients were deemed to have undergone a curative resection. Patients were classified into an emergency surgery group for complicated colon cancers (n=40) and an elective surgery group for uncomplicated colon cancers (n=198).
RESULTS
Emergency colonic cancers present at a more advanced stage (P=0.002). The postoperative mortality rate in the emergency group was significantly higher than it was in the elective group (15.0% vs. 2.5%, P= 0.004). There were differences between the two groups in tumor recurrence (32.5% vs. 13.1%, P=0.003), overall survival (52.5% vs. 71.7%, P=0.017), and disease-free survival (50.0% vs. 69.7%, P=0.016). However, after the patients were stratified according to tumor stage, no statistical differences were observed.
CONCLUSIONS
When compared with uncomplicated colon cancers, complicated colon cancers present at a more advanced stage with a higher postoperative mortality and an overall worse prognosis. However, the difference decreases when patients are stratified according to the tumor stage. The negative prognostic efficacy of emergency surgery for complicated colon cancers appears to be confined to the perioperative period. Despite the more advanced stage of tumors in patients undergoing emergency surgery, the aim of the surgeon should be to offer a curative resection for better survival, if possible.
Distributions of MTHFR Gene Polymorphism according to the Location of Colon Cancer.
Kim, Jong Woo , Oh, Doyeun , Chong, So Young , Yim, Dong Jin , Kim, Jin Kyeoung , Kim, Nam Keun
J Korean Soc Coloproctol. 2006;22(2):69-74.
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AbstractAbstract PDF
PURPOSE
Colon carcinogenesis seems to vary according to the original location of tumor, especially theright and the left sides. Two common methylenetetrahydrofolate reductase (MTHFR) polymorphisms, 677C->T and 1298A->C, are now known. Especially, the TT type of the 677C->T mutation shows reduced catalytic activity at a rate 30% that of wild type. The aim of this study is to investigate the distributions of MTHFR polymorphisms of 677C->T and 1298A->C according to the location of the colon cancer.
METHODS
Blood samples were collected from 112 patients diagnosed in our hospital, as having colon cancer: 34 proximal and 78 distal cases to the splenic flexure and 448 healthy control subjects. In order to characterize MTHFR polymorphisms, we applied the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).
RESULTS
The distributions of MTHFR 677C->T polymorphisms as genotypes CC, CT, and TT were 32.4%, 53.1%, and 14.5% in the control group, and 34.8%, 58.0%, and 7.1% in the cancer group (P=0.056). In the 34 proximal cancers, the CC, CT, and TT distributions were 44.1%, 55.9%, and 0% (P<0.05), respectively. In the distal group, they were 30.8%, 59.0%, and 10.3%. The distributions of the MTHFR 1298 A->C polymorphism by genotypes, AA, AC, CC were 69.6%, 28.6%, and 1.8% in the control group, and 58.9%, 38.4%, and 2.7% in the cancer group. The proximal and the distal groups show genotype distributions of 44.1%, 53.0%, and 2.9% and 65.4%, 32.0%, and 2.6%, respectively, but the differences were not statistically significant.
CONCLUSIONS
There are no definite differences between control subjects and colon-cancer patients in the two polymorphisms 677C->T and 1298A->C. However, the TT genotype shows a lower frequency in the cancer group than in the control group with a marginal statistical value (P=0.056), which suggest a reduced risk of cancer incidence for this type, compared with a CC or a CT type.
Case Report
Neutropenic Enterocolitis after Chemotherapy for Colon Cancer.
Chun, Jung Woo , Hong, Seong Woo , Chang, Yeo Goo , Lee, Hye Kyoung , Lee, Hyucksang
J Korean Soc Coloproctol. 2006;22(1):62-65.
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AbstractAbstract PDF
Neutropenic enterocolitis is observed in approximately 10~46% of patients with acute leukemia, as well as in patients with other diseases, like acquired immunodeficiency syndrom (AIDS), that lead to profound neutropenia. Patients who become neutropenic after combined chemotherapy are at special risk of developing neutropenic enterocolitis. With the recently increasing numbers of patients with solid tumors treated with high-dose chemotherapy, the frequency of this disease is expected to increase. However, this disease has been rarely reported in patients with colon cancer treated with leucovorin and 5-fluorouracil for adjuvant chemotherapy. We report a case of neutropenic enterocolitis after a treatment of 5-fluorouracil and leucovorin for sigmoid colon cancer.
Original Article
Complete Single Stage Management of Left Colon Cancer Obstruction with a New Devices.
Kim, Jae Hwang , Shon, Dae Ho , Cahng, Byung Ik , Chung, Mun Kwan , Shim, Min Chul
J Korean Soc Coloproctol. 2002;18(1):30-36.
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AbstractAbstract PDF
Intraoperative antegrade colonic irrigation for single stage procedure in left colon cancer obstruction is a preferred technique recently however, synchronous pathology cannot be detected. A new device that enables easy intraoperative irrigation and colonoscopy before resection of tumor was devised. PURPOSE: To evaluate the efficacy of the new device for single stage procedure in left colon cancer obstruction.
METHODS
The new device (NICI; MITech co., Ltd, Seoul, Korea) consists of a Y-shaped teflon tube of maximum diameter 2.9, 3.5 and 4.1 cm, one proximal end is designed to connect with the dilated colon just proximal to the lesion. Two distal branches are for drainage of fecal matter and for retrograde insertion of irrigation catheter and subsequent colonoscope respectively.
RESULTS
There were 53 patients (27 male, median age 64, range; 28~82) who underwent this procedure. No extraintestinal leaks were encountered. The volume of saline used was 12 (range; 6 to 27) Liters over 14 (range; 9 to 22) minutes. Subsequent colonoscopic examination added 10 (range, 8 to 15) minutes to the entire operation in 28 patients. There were one anastomotic leakage and 2 wound infections, however, there was no operative mortality. On-table colonoscopy resulted in extended resection in 3 cases because of synchronous malignancy in frozen biopsy and found synchronous polyps in 13 of 28 cases.
CONCLUSIONS
The new device enabled safe, simple and time saving single stage surgical management of left colon cancer obstruction. The ability to perform on-table colonoscopy enabled treatment of synchronous bowel pathology.
Case Report
A Case Report of Colorectoanal Intussusception.
Lee, Sang Jeon , Park, Jin Woo
J Korean Soc Coloproctol. 1998;14(2):305-308.
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AbstractAbstract PDF
Colorectoanal intussusception is a rare and distinct entity that differs from the more common rectal prolapse. Typically the intussusception occurrs with tumor at the apex of the intussuscepted segment acting as lead point. Here we present a case and review the literature of colorectoanal intussusception. The case presented here is that of an elderly woman with a proximal sigmoid colon cancer at its apex. Anterior resection was electively performed after reduction of the intussusception. It is important to differentiate a colorectoanal intussusception from the more common rectal prolapse because treatment may differ. The anorectum remains in its normal anatomic position in colorectoanal intussusception, whereas the anal canal is effaced with the prolapsed segment of bowel in rectal prolapse. Identification of a tumor at the apex of the intussuscepted bowel should also arouse suspicion that the condition is not a rectal prolapse.
Original Articles
The Safety of Intraoperative Colonic Irrigation for Single Stage Procedure in Emergency Based Left Colonic Pathology.
Kim, Bum Ryul , Shon, Dae Ho , Jang, Byung Ik , Jung, Moon Kwan , Shim, Min Chul , Kim, Jae Hwang
J Korean Soc Coloproctol. 2001;17(6):309-315.
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AbstractAbstract PDF
Staged procedures are preferred to single stage procedures in emergency based left colonic obstruction or perforation because of the safety. PURPOSE: To evaluate whether the single stage procedure in emergency based left colonic pathology is not safe.
METHODS
We compared medical records of single stage procedure (SP, n=22 male; 10, mean age: 60+/-17, range: 26-82 Yrs) with Hartmanns procedure (HP, n=23 male; 13, mean age: 58+/-16, range: 18-90 Yrs) and diverting loop colostomy (DC, n=19, male; 12, mean age: 59+/-19, range: 19-80 Yrs) in these 4 years. All the patients were admitted via emergency room. Intraoperative colonic irrigation method with newly developed irrigation device (MITech co., Ltd, Seoul, Korea) was used for SP. APACHE III scoring system was applied to evaluate the physiologic status of the patients. Preoperative data were compared with the 1st and 3rd postoperative day (POD).
RESULTS
There were no statistically significant differences in patient demographics and preoperative APACHE III scores. The improvement of APACHE III score was significant in SP and DC on the 3rd POD from 29.6+/-20.9 to 22.9+/-10.2 and 25.7+/-13.3 to 21.4+/-14.8 (P<0.05). There was also a significant improvement in DC (25.7+/-13.3 to 21.9+/-12.9, P<0.05) on the 1st POD, however, there was only a tendency of improvement in SP (29.6+/-20.9 to 26.1+/-12.3) without statistical significance. The scores in HP showed no improvement on the 1st and 3rd POD. There were 3 operative mortalities in HP and one in DC.
CONCLUSIONS
Our results suggest that the safety of the single stage procedure with newly developed colonic irrigation device is comparable to palliative decompressive loop colostomy and better than Hartmanns procedure in emergency based left colonic pathology.
Case-Control Study for MTHFR and HFE Polymorphisms in Colorectal Cancer.
Lee, Ryung Ah
J Korean Soc Coloproctol. 2005;21(4):225-232.
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AbstractAbstract PDF
PURPOSE
A single nucleotide polymorphism is an important genetic variation in various pathologic situations. We examined MTHFR and HFE polymorphisms in a colorectal cancer group compared to those in a normal, healthy control group.
METHODS
Genomic DNA was isolated from whole blood of 99 colorectal cancer patients and 146 normal control patients and was subjected to MTHFR and HFE genotyping by using PCR-based restriction fragment length polymorphism analyses for the MTHFR C677T and A1298C sequences and for the HFE H63D and C282G sequences. Statistical analysis was done using SPSS 11.0.
RESULTS
The total allele frequencies of MTHFR C677T, A1298C, HFE H63D and C282Y were 0.398, 0.224, 0.014 and 0.022, respectively. The frequencies of homozygous mutants of MTHFR C677T and A1298C were 14.4% and 4.1% in the control group and 6.1% and 1.0% in the case group. There were no homozygous mutants of HFE in either group. Heterozygous mutants of H63D and C282Y were 2.1% and 4.1% in the control group and 4.0% and 5.1%, respectively in the case group. The odds ratio of a MTHFR C677T homozygous mutant was 0.604 (95% CI 0.375~0.973), and that of a MTHFR A1298C heterozygous and homozygous mutants were 0.513 (95% CI 0.298~0.883), but the difference was not statistically significant.
CONCLUSIONS
A homozygous mutant of MTHFR C677T and a homozygous and heterozygous mutant of A1298C showed a protective tendency against colorectal cancer. The HFE polymorphic mutant is quite rare in Korean population, which restricts the application of this polymorphism in a cancer epidemiologic study. The MTHFR C677T and A1298C variations should be useful predictive markers for colorectal cancer.
Safety of a One-stage Operation for an Obstructed Left Colon Carcinoma.
Oh, Soo Youn , Ahn, Eun Jung , Chung, Soon Sup , Lee, Ryung Ah , Kim, Kwang Ho , Park, Eung Bum
J Korean Soc Coloproctol. 2005;21(4):207-212.
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AbstractAbstract PDF
PURPOSE
For a left-sided colonic obstruction, the traditional method of a staged defunctioning colostomy and resection has been performed. Recently, there has been a trend towards a one-stage primary resection and anastomosis. The aim of this study was to assess the safety and the efficacy of a one-stage resection and anastomosis for obstructed left colon cancer.
METHODS
We retrospectively reviewed the records of 29 patients who had been diagnosed as having an obstructed left-sided colon cancer during the period from January 1995 to December 2003 at Ewha Womans University Hospital. We compared two techniques, a one-stage operation (10 cases) and a staged operation (13 cases).
RESULTS
The mean age of the one-stage group was 58.5+/-16.1, and that of the staged operation group was 65.0+/-13.4. Both groups had similar co-morbidities, TNM stages, and tumor locations. In the one-stage operation group, a subtotal colectomy (n=3), a resection and anastomosis with intraoperative lavage (n=5), and a resection and anastomosis following stent insertion (n=2) had been performed. Patients who had undergone a colostomy as the first operation, resection and anastomosis (n=3), and a resection and anastomosis following a defunctioning colostomy (n=10) were included in the staged operation group. The mean postoperative hospital stay showed no significant differences between the two groups. One patient who had undergone a one-stage operation presented with an intestinal partial obstruction five months later. There were no anastomotic leakages, intraabdominal absceses, and wound infections, nor were there any mortalities.
CONCLUSIONS
A one-stage resection and primary anastomosis for obstructed left-sided colon cancer can be done safely without significant morbidity.
Surgical Treatment for Obstructing Carcinomas of the Left Colon and Rectum.
Kim, Jung Soo , Park, Sang Su , Yoon, Jin , Kim, Il Myung , Yang, Dae Hyun , You, Byung Ook , Cho, Ik Hang
J Korean Soc Coloproctol. 2001;17(3):148-152.
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AbstractAbstract PDF
PURPOSE
There have been many different kinds of operations for obstructing left colon (distal to splenic flexure) cancer and rectal cancer because immediate resection and anastomosis was known to cause many complications. We performed this study to analyse operative cases and evaluate which procedure had the better result.
METHODS
Thirty-six cases of left colon cancer and rectal cancer with complete obstruction were analysed from April 1990 to January 2001 and those cases were divided into two groups, the group of staged procedure and the group of primary resection. 28 cases were curative operations and 8 cases were palliative operations.
RESULTS
The group of staged procedures had 17 cases of curative operations with 1st. stage-colostomy and 2nd. stage-cancer resection. And the group of primary resection had 11 cases of curative operations, 6 cases of Hartmann's procedures, 2 cases with intraoperative colonic lavage and resection and 3 cases with cancer resection, anastomosis and proximal colostomy. There were no differences in the distribution of age and cancer stage between two groups. In both groups, the sigmoid colon was the most prevalent obstruction site. The staged procedure group had higher operative mortality (25%) than the primary resection group (8%). And 5-year survival rate of the primary resection group was higher than that of the staged procedure group (45%: 33%), but there was no statistical significance.
CONCLUSIONS
We think that the primary resection is the better surgical procedure because of shorter hospital stay and fewer operations in the treatment of obstructing left colon and rectal cancer.
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