Annals of Coloproctology

Original Article

Colorectal cancer

Estimation of risk posed by malignant polyps amongst colorectal surgeons in Australia and New Zealand: Andrew P. Zammit, Ian Brown, John D. Hooper, David A. Clark, Andrew D. Riddell; Ann Coloproctol. 2024;40(2):114-120. Published online March 25, 2024; DOI: https://doi.org/10.3393/ac.2023.00178.0025

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Abstract PDF Supplementary Material: Purpose
The estimation of the risk posed by malignant polyps for residual or lymphatic disease plays a central role. This study investigated colorectal surgeons’ assessment of these risks associated with malignant polyps.
Methods
A cross-sectional questionnaire was electronically administered to colorectal surgeons in Australia and New Zealand in October 2022. The questionnaire contained 17 questions on demographics, when surgeons consider colorectal resection appropriate, and the risk assessment for 5 hypothetical malignant polyps.
Results
The mean risk of residual or lymphatic disease that would prompt surgeons to recommend colonic resection was 5%. However, this increased to a mean risk of 10% if the malignant polyp was located in the rectum, and the only resection option was abdominoperineal resection with end-colostomy. There was high concordance between the estimated risk of residual or lymphatic disease by colorectal surgeons and the Association of Coloproctology of Great Britain and Ireland (ACPGBI) guidelines for the 5 hypothetical malignant polyps, with the ACPGBI estimated risk lying within the 95% confidence interval for 4 of the 5 malignant polyps. Nonetheless, 96.6% of surgeons felt that an online risk calculator would improve clinical practice.
Conclusion
Colorectal surgeons in Australia and New Zealand accurately estimated the risk posed by malignant polyps. An online risk calculator may assist in better conveying risk to patients.

Review

AI colonoscopy

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

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

Original Articles

Clinical Significance of Preoperative Virtual Colonoscopy for Evaluation of the Proximal Colon in Patient With Obstructive Colorectal Cancer: Jae-Hyuk Heo, Chun-Geun Ryu, Eun-Joo Jung, Jin-Hee Paik, Dae-Yong Hwang; Ann Coloproctol. 2017;33(4):130-133. Published online August 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.4.130

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5 Citations

Abstract PDF

Purpose

Virtual colonoscopy is the most recently developed tool for detecting colorectal cancers and polyps, but its effectiveness is limited. In our study, we compared the result of preoperative virtual colonoscopy to result of preoperative and postoperative colonoscopy. We evaluated also the accuracy of preoperative virtual colonoscopy in patients who had obstructive colorectal cancer that did not allow passage of a colonoscope.

Methods

A total of 164 patients who had undergone preoperative virtual colonoscopy and curative surgery after the diagnosis of a colorectal adenocarcinoma between November 2008 and August 2013 were pooled. We compared the result of conventional colonoscopy with that of virtual colonoscopy in the nonobstructive group and the results of preoperative virtual colonoscopy with that of postoperative colonoscopy performed at 6 months after surgery in the obstructive group.

Results

Of the 164 patients, 108 were male and 56 were female patients. The mean age was 62.7 years. The average sensitivity, specificity, and accuracy of virtual colonoscopy for all patients were 31.0%, 67.2%, and 43.8%, respectively. In the nonobstructive group, the average sensitivity, specificity, and accuracy were 36.6%, 66.2%, and 48.0%, respectively, whereas in the obstructive group, they were 2%, 72.4%, and 25.4%. Synchronous cancer was detected via virtual colonoscopy in 4 of the 164 patients.

Conclusion

Virtual colonoscopy may not be an effective method for the detection of proximal colon polyps, but it can be helpful in determining the therapeutic plan when its results are correlated with the results of other studies.

Citations

Citations to this article as recorded by

Colon cancer: the 2023 Korean clinical practice guidelines for diagnosis and treatment
Hyo Seon Ryu, Hyun Jung Kim, Woong Bae Ji, Byung Chang Kim, Ji Hun Kim, Sung Kyung Moon, Sung Il Kang, Han Deok Kwak, Eun Sun Kim, Chang Hyun Kim, Tae Hyung Kim, Gyoung Tae Noh, Byung-Soo Park, Hyeung-Min Park, Jeong Mo Bae, Jung Hoon Bae, Ni Eun Seo, Cha
Annals of Coloproctology.2024; 40(2): 89. CrossRef
Application of Virtual Endoscopy in Microvascular Decompression of Trigeminal Neuralgia
Wenbin Wei, Zhiyang Liu, Weijie Zhang, Yiwen Wang, Minjie Chen
Journal of Craniofacial Surgery.2021; 32(5): 1696. CrossRef
Performance of CT Colonography in Diagnosis of Synchronous Colonic Lesions in Patients With Occlusive Colorectal Cancer
Nicola Flor, Andrea Pisani Ceretti, Carmelo Luigiano, Pietro Brambillasca, Anna Paola Savoldi, Clemente Verrusio, Daris Ferrari
American Journal of Roentgenology.2020; 214(2): 348. CrossRef
Synchronous colorectal cancer using CT colonography vs. other means: a systematic review and meta-analysis
Nicola Flor, Edoardo Zanchetta, Giovanni Di Leo, Miriam Mezzanzanica, Massimiliano Greco, Gianpaolo Carrafiello, Francesco Sardanelli
Abdominal Radiology.2018; 43(12): 3241. CrossRef
Correlation between microsatellite instability and RAS gene mutation and stage Ⅲ colorectal cancer
Wenbo Niu, Guiying Wang, Jun Feng, Zheng Li, Chenhui Li, Baoen Shan
Oncology Letters.2018;[Epub] CrossRef

Detection of Polyps After Resection of Colorectal Cancer: Jin-Hee Paik, Eun-Joo Jung, Chun-Geun Ryu, Dae-Yong Hwang; Ann Coloproctol. 2015;31(5):182-186. Published online October 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.5.182

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6 Web of Science
8 Citations

Abstract PDF

Purpose

Because colonoscopy after colorectal cancer surgery is important for detecting synchronous or metachronous colorectal neoplasms, we designed this study to investigate, by using postoperative colonoscopy, the miss rate for and the location of polyps remaining after colorectal cancer surgery.

Methods

In a prospectively-collected patient database, 264 patients were shown to have undergone a colorectal cancer resection between May 2012 and June 2013. Of these, 116 who had received a complete colonoscopy preoperatively and postoperatively were included in this study.

Results

Of these 116 patients, 68 were males and 48 were females; their mean age was 63 years. The mean time after surgery at which postoperative colonoscopy was performed was 7.1 months (range, 3-15 months). On postoperative colonoscopy, a total of 125 polyps were detected. Of these, there were no cancerous lesions; 46 (36.8%) were neoplastic polyps, and 79 (63.2%) were nonneoplastic polyps. Fifty-nine polyps (47.2%) and 15 polyps (12%) were located in the proximal and the distal parts of the anastomosis, respectively. The miss rates for the total numbers of polyps and of neoplastic polyps remaining after surgery were 37.4% and 24.2%, respectively. The incidence of neoplastic polyps increased during postoperative colonoscopy as it had during preoperative colonoscopy (r = 0.164, P = 0.048).

Conclusion

Colonoscopic surveillance after colorectal cancer resection results in the detection of pathologic polyps in one-fourth of the cases. During postoperative colonoscopy, careful examination of the proximal colon is necessary. Patients in whom multiple neoplastic polyps had been detected during preoperative colonoscopy require careful and thorough follow-up.

Citations

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Bile acids as carcinogens in the colon and at other sites in the gastrointestinal system
Harris Bernstein, Carol Bernstein
Experimental Biology and Medicine.2023; 248(1): 79. CrossRef
Current status of water-assisted colonoscopy
Jun-Quan Shen
World Chinese Journal of Digestology.2020; 28(22): 1162. CrossRef
Resting heart rate is an independent predictor of advanced colorectal adenoma recurrence
Jihye Park, Jae Hyun Kim, Yehyun Park, Soo Jung Park, Jae Hee Cheon, Won Ho Kim, Ji Soo Park, Justin Y. Jeon, Tae Il Kim, John Green
PLOS ONE.2018; 13(3): e0193753. CrossRef
A Study of Metachronous Colorectal Neoplasms after Colorectal Cancer Resection Detected by Surveillance Colonoscopy
Seiji Kimura, Masanori Tanaka, Shinsaku Fukuda
Nippon Daicho Komonbyo Gakkai Zasshi.2017; 70(3): 149. CrossRef
Kolon polipleri sayı ve büyüklüğü malignite göstergesi olabilir mi?
Abdurahman ŞAHİN, Nurettin TUNÇ, Salih KILIÇ, Gökhan ARTAŞ, Ulvi DEMİREL, Orhan K. POYRAZOĞLU, İbrahim H. BAHÇECİOĞLU, Mehmet YALNIZ
Endoskopi Gastrointestinal.2017; : 14. CrossRef
The Effects of Physical Activity and Body Fat Mass on Colorectal Polyp Recurrence in Patients with Previous Colorectal Cancer
Jihye Park, Jae Hyun Kim, Hyun Jung Lee, Soo Jung Park, Sung Pil Hong, Jae Hee Cheon, Won Ho Kim, Ji Soo Park, Justin Y. Jeon, Tae Il Kim
Cancer Prevention Research.2017; 10(8): 478. CrossRef
Frequency of colonic adenomatous polyps in a tertiary hospital in Mumbai
Anjali D. Amarapurkar, Prachi Nichat, Nitin Narawane, Deepak Amarapurkar
Indian Journal of Gastroenterology.2016; 35(4): 299. CrossRef
Surveillance Colonoscopy After a Resection of Colorectal Cancer
Byung Chun Kim
Annals of Coloproctology.2015; 31(5): 170. CrossRef

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

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13 Web of Science
15 Citations

Abstract PDF

Purpose

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

Methods

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

Results

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

Conclusion

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

Citations

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Adenoma Detection Rate in Average-Risk Population: An Observational Consecutive Retrospective Study
Xiaoyan He, Xiangyin Lv, Binbin Zhang, Xiaoxuan Ying, Chiyu Hu, Xiaoying Zhou, Jianwen Hu
Cancer Control.2023;[Epub] CrossRef
Adenoma Detection Rates in 45-49 Year Old Persons Undergoing Screening Colonoscopy: Analysis from the GIQuIC Registry
Mohammad Bilal, Jennifer Holub, David Greenwald, Mark B. Pochapin, Douglas K. Rex, Aasma Shaukat
American Journal of Gastroenterology.2022;[Epub] CrossRef
Adenoma Detection Rate in Colonoscopic Screening with Ketamine-based Sedation: A Prospective Observational Study
Mirza KOVACEVIC, Nermina RIZVANOVIC, Adisa SABANOVIC ADILOVIC, Nedim BARUCIJA, Anida ABAZOVIC
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Gastrointestinal Disease in Patients with Common Variable Immunodeficiency: A Retrospective Observational Study
Rishad Khan, Mohamad Habbal, Michael A Scaffidi, Abbas A Bukhari, Amir Rumman, Sarah Al Ghamdi, Stephen D Betschel, Samir C Grover
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Rebecca L Siegel, Lindsey A Torre, Isabelle Soerjomataram, Richard B Hayes, Freddie Bray, Thomas K Weber, Ahmedin Jemal
Gut.2019; 68(12): 2179. CrossRef
Anatomical distribution and detection rate of colorectal neoplasms according to age in the colonoscopic screening of a Korean population
Suk-young Lee, Wan Hee Song, Sang Cheul Oh, Byung-Wook Min, Sun Il Lee
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An Adjusted Level of Adenoma Detection Rate is Necessary for Adults Below 50 Years Old
Jin Young Yoon, Jae Myung Cha, Jeong Eun Shin, Kyeong Ok Kim, Hyo-Joon Yang, Hyun Gun Kim, Young-Seok Cho, Sun-Jin Boo, Jun Lee, Yunho Jung, Hyun Jung Lee, Hoon Sup Koo, Young-Eun Joo
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Mohammed Hussein Kamareddine, Youssef Ghosn, Karam Karam, Anwar Andrew Nader, Ahmad El-Mahmoud, Naseem Bou-Ayash, Mansour El-Khoury, Said Farhat
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LINE-1 is preferentially hypomethylated within adenomatous polyps in the presence of synchronous colorectal cancer
Alice Chu Jiang, Lela Buckingham, William Barbanera, Amoah Yeboah Korang, Faraz Bishesari, Joshua Melson
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Risks of colorectal advanced neoplasia in young adults versus those of screening colonoscopy in patients aged 50 to 54 years
Kyeong Ok Kim, Hyo‐Joon Yang, Jae Myung Cha, Jeong Eun Shin, Hyun Gun Kim, Young‐Seok Cho, Sun‐Jin Boo, Jun Lee, Yunho Jung, Hyun Jung Lee, Kyu Chan Huh, Young‐Eun Joo, Jongha Park, Chang Mo Moon
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Endoscopic Improvement of the Adenoma Detection Rate during Colonoscopy - Where Do We Stand in 2015?
Martin Floer, Tobias Meister
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Clinical study of anesthetization by dezocine combined with propofol for indolent colonoscopy
Bin-Bin Xu, Xiao-Liang Zhao, Gui-Ping Xu
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Role of Colonoscopy in Patients with Hematochezia
Young Wook Kim, Hwang Choi, Gi Jun Kim, Seung Jee Ryu, Sung Min Park, Joon Sung Kim, Jeong-Seon Ji, Byung-Wook Kim, Bo-in Lee, Myung-Gyu Choi
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Bunchorn Siripongpreeda, Chulabhorn Mahidol, Navara Dusitanond, Tassanee Sriprayoon, Bunlung Muyphuag, Thaniya Sricharunrat, Narongchai Teerayatanakul, Watanya Chaiwong, Wipra Worasawate, Prassanee Sattayarungsee, Juthamas Sangthongdee, Jirapa Prarom, Gai
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Case Report

Signet Ring Cell Carcinoma Arising from a Solitary Juvenile Polyp in the Colon: Hae Jung Kim, Min Kwan Kang, Hee Suk Lee, Do Sun Kim, Du Han Lee; J Korean Soc Coloproctol. 2010;26(5):365-367. Published online October 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.5.365

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6 Citations

Abstract PDF

Juvenile polyps are relatively common polyps that affect predominantly young patients and may occur in isolated, multiple, and/or familial forms. They have been considered to be benign lesions without neoplastic potential, but for patients with multiple juvenile polyposis, the cumulative malignant risk is greater than fifty percents. In patients with a solitary polyp, the risks are minimal, and only a few cases of malignant change from a solitary juvenile polyp have been reported. We describe the case of a twenty one year old female with one solitary juvenile polyp, which contained a signet ring cell carcinoma in the mucosal layer.

Citations

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Solitary juvenile polyp of the rectum with intramucosal adenocarcinoma
Kazuki Nagai, Uichiro Fuchizaki, Yoshimichi Ueda
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Cancer risk and mortality in patients with solitary juvenile polyps—A nationwide cohort study with matched controls
Anne Marie Jelsig, Laus Wullum, Tine Plato Kuhlmann, Lilian Bomme Ousager, Johan Burisch, John Gásdal Karstensen
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Characteristics and potential malignancy of colorectal juvenile polyps in adults: a single-center retrospective study in China
Jie Dong, Tian-Shi Ma, Yuan-Hong Xu, Peng Li, Wan-Yuan Chen, Jiang-Feng Tu, You-Wei Chen
BMC Gastroenterology.2022;[Epub] CrossRef
Can a Solitary Juvenile Polyp Be Regarded as a Nonmalignant Polyp?
Kumiko Fukami, Makoto Furihata, Shintaro Yano, Hiroki Okawa, Shinjiro Nishi, Yoichi Nakatsu, Yusuke Nomoto, Shingo Ogiwara, Tsuneo Kitamura, Shigeki Tomita, Taro Osada
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Ultrasonography with the colonic segment-approach for colonic polyps in children
Yu Wang, Xiao Man Wang, Li Qun Jia
Pediatric Radiology.2019; 49(13): 1735. CrossRef
Signet ring cell carcinoma in a juvenile polyp
Carmen Villar Lucas, Mercedes Hernando Martín, Begoña Álvarez-Cuenllas
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Original Article

Clinicopathologic Features and Clinical Significance of Small and Diminutive Colorectal Polyps.: Lee, Soong , Kim, Seong Ho , Lee, Doo Young , Sun, Jae Hyung , Park, Jin Seok , Park, Ju Sup , Yang, Dae Hyun , Na, Ho Young , Kim, Ky Tai; J Korean Soc Coloproctol. 2005;21(1):6-12.

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Abstract PDF: PURPOSE
Small (6 to 10 mm) and diminutive colon polyps (below 5 mm) are routinely removed at the time of colonoscopy for the prevention of colon cancer. Our aims in this study were to determine clinicopathologic features and frequency of significant synchronous neoplastic lesions of small colon polyps and diminutive colon polyps and to investigate development of colorectal carcinoma via surveillance colonoscopy.
METHODS
We evaluated medical reports of all patients undergoing total colonoscopic examination over a 12-month period. Three hundred thirty nine small colorectal polyps, removed during colonoscopy, have been analyzed. We investigated the result of surveillance colonoscopy, also. Using this database, all adenomas were categorized into two groups: Group I, < or =5 mm diameter (diminutive polyp), Group 2, 6 to 10 mm diameter (small polyp). Significant synchronous adenomas were defined as adenoma over 6 mm diameter, dysplasia or cancer.
RESULTS
The most common age group was the sixth decade. The male-to-female ratio was 2.1 : 1. Of the small colorectal polyps, 180 (53.1%) were adenomatous, 32 (10.0%) were hyperplastic, 119 (34.9%) were chronic nonspecific inflammation, 3 (0.9 %) were lymphoid hyperplasia, and 4 (1.1%) were cancerous. The most frequent sites of these lesions were rectum and sigmoid (60.2%). Recognizable endoscopic features of polyps were redness (35.8%) and nodule (26.3%). The prevalence of advanced proximal synchronous polyps was 20.7% among patients with distal small lesions. And we detected 2 cases (25%) had new small polyps in follow up colonoscopic examination. CONCLUSIONS: All polyps should be removed when encountered during colonoscopy due to the higher prevalence of adenoma among these lesions. Effort to find new polyps via surveillance colonoscopy is needed.

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