Annals of Coloproctology

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Benign GI diease,Benign diesease & IBD,Complication,Biomarker & risk factor

A development study of drain fluid gastrografin as a biomarker of anastomotic leak: David A. Clark, Edward Yeoh, Aleksandra Edmundson, Craig Harris, Andrew Stevenson, Daniel Steffens, Michael Solomon; Ann Coloproctol. 2022;38(2):124-132. Published online January 11, 2021; DOI: https://doi.org/10.3393/ac.2020.12.24

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Purpose
Anastomotic leakage (AL) is the anathema of colorectal surgery. Its occurrence leads to increased morbidity and mortality and a prolonged hospital stay. Much work has gone into studying various biomarkers in drain fluid to facilitate early detection of AL. This stage 2a development study aims to assess the safety and feasibility of reliably detecting the iodine in Gastrografin (GG; Bayer Australia Ltd.) in drain fluid and stool samples by dual-energy computed tomography (DECT).
Methods
This is a prospective, observational, controlled, consecutive cohort study establishing the safety and feasibility of the detection of GG in surgical drain fluid and stool as a biomarker of AL when patients with a low pelvic colorectal anastomosis undergo luminal flushing of the rectal tube with GG.
Results
Ten consecutive patients were allocated to the saline flush group and the following 10 to the GG flush group. Three patients in the saline flush group developed an AL. One patient in the GG flush group developed an AL. An elevation in the drain fluid GG was detected using DECT on the day of clinical deterioration. None of the patients in the control group were found to have a positive result on DECT.
Conclusion
This study demonstrates the safety of a novel approach to the early detection of AL from extraperitoneal colorectal anastomoses. The technique requires validation in a larger cohort and a multicenter study is planned to investigate the efficacy of GG rectal tube flushes as an early biomarker of AL in low pelvic anastomoses.

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Drain fluid iodine as a biomarker of anastomotic leak after low anterior resection in patients undergoing Gastrografin rectal tube flushes and omission of a diverting ileostomy: The GUSH study
David A. Clark, Karen Dobeli, Darren Allen, Brett McWhinney, Michael Lonne, Aleksandra Edmundson
Colorectal Disease.2025;[Epub] CrossRef
Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef
Successful colorectal anastomotic leakage management: a two oncological centres' 12-year experience
Kiril G. KIROV, Tsvetomir M. IVANOV, Nadya S. IVANOVA
Chirurgia.2022;[Epub] CrossRef
Neoadjuvant chemoradiotherapy determines the prognostic impact of anastomotic leakage in advanced rectal cancer
Bo Young Oh, Yoon Ah Park, Jung Wook Huh, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee
Annals of Surgical Treatment and Research.2022; 103(4): 235. CrossRef
Does an ileostomy cover the surgeon or the anastomosis?
David A. Clark, Andrew Stevenson, John Lumley, Damien Petersen, Craig Harris, Daniel Steffens, Michael Solomon
ANZ Journal of Surgery.2022; 92(1-2): 19. CrossRef

Accuracy of Preoperative Local Staging of Primary Colorectal Cancer by Using Computed Tomography: Reappraisal Based on Data Collected at a Highly Organized Cancer Center: Jung Sub So, Chinock Cheong, Seung Yeop Oh, Jei Hee Lee, Young Bae Kim, Kwang Wook Suh; Ann Coloproctol. 2017;33(5):192-196. Published online October 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.5.192

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17 Citations

Abstract PDF

Purpose

In patients with colorectal cancer, preoperative staging using various imaging technologies is important for establishing the treatment plan and predicting the prognosis. Although computed tomography (CT) has been used most widely, the versatility of CT accuracy was primarily because of the lack of specialization. In this study, we aimed to identify whether any advancement in abdominal CT accuracy in the prediction of local staging has occurred.

Methods

Between December 2014 and November 2015, patients with colorectal cancer were retrospectively enrolled. All CT findings were retrospectively reported. A total of 285 patients were included, and their retrospectively collected data were retrospectively reviewed, focusing on a comparison between preoperative and postoperative staging.

Results

The overall prediction accuracy of the T stage was 55.1%, with overstaging occurring in 63 (22.1%) and understaging in 65 patients (22.8%). The sensitivity and specificity were 90.0% and 68.4%, respectively. The overall prediction accuracy of the N stage was 54.7%, with overstaging occurring in 89 (31.2%) and understaging in 40 patients (14.1%). The sensitivity and specificity were 71.9% and 63.2%, respectively. The CT accuracies by pathologic stage were 0%, 62.2%, 25.3%, and 81.2% for stages 0 (Tis N0), I, II, and III, respectively.

Conclusion

CT has good sensitivity for detecting colon cancers with tumor invasion beyond the bowel wall. However, detection of nodal involvement using CT is unreliable. In our opinion, abdominal CT alone has limitations in predicting the local staging of colorectal cancer, and additional technologies, such as CT plus positron emission tomography and/or colonography, will improve its accuracy.

Citations

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Optimal extent of lymph node dissection in clinical early-stage right colon cancer: a retrospective analysis
Hyeung-min Park, Jaram Lee, Soo Young Lee, Suk Hee Heo, Yong Yeon Jeong, Hyeong Rok Kim, Chang Hyun Kim
Annals of Surgical Treatment and Research.2025; 108(1): 49. CrossRef
A 14‐Gene Panel for Predicting Colorectal Cancer Recurrence Using Circulating Tumor DNA in Different Testing Conditions
Yuichi Hisamatsu, Koji Ando, Kensuke Kudo, Ryota Nakanishi, Tetsuro Kawazoe, Yoko Zaitsu, Tetsuya Kusumoto, Taishi Hata, Yoshinori Kagawa, Tomoharu Yoshizumi, Naoko Ashida, Hayato Niiro, Takashi Hirose, Eiji Oki
Cancer Science.2025; 116(9): 2499. CrossRef
Stenting as bridge to surgery versus upfront emergency resection for non-metastatic left sided obstructing colorectal cancer: risk of peritoneal recurrence and long-term outcomes
Wenjie Lin, Aik Yong Chok, Isaac Seow-En, Emile Kwong-Wei Tan
Surgical Endoscopy.2024; 38(5): 2632. CrossRef
The impact of myosteatosis on outcomes following surgery for gastrointestinal malignancy: a meta-analysis
A MacCormick, A Streeter, M Puckett, S Aroori
The Annals of The Royal College of Surgeons of England.2023; 105(3): 203. CrossRef
Intelligent diagnosis value of preoperative T staging of colorectal cancer based on MR medical imaging
Junqing Wang, Bingqian Chen, Jing Zhu, Junfeng Zhang, Rui Jiang
Frontiers in Genetics.2023;[Epub] CrossRef
Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
Ji-Hyun Seo, In-Ja Park
Cancers.2023; 15(21): 5211. CrossRef
Imaging of Colorectal Liver Metastasis
Azarakhsh Baghdadi, Sahar Mirpour, Maryam Ghadimi, Mina Motaghi, Bita Hazhirkarzar, Timothy M. Pawlik, Ihab R. Kamel
Journal of Gastrointestinal Surgery.2022; 26(1): 245. CrossRef
The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

Colorectal Disease.2022; 24(6): 708. CrossRef
The Mesentery in Complete Mesocolic Excision
Jordan Fletcher, Danilo Miskovic
Clinics in Colon and Rectal Surgery.2022; 35(04): 288. CrossRef
Long-term outcomes of D2 vs. D3 lymph node dissection for cT2N0M0 colorectal cancer: a multi‑institutional retrospective analysis
Tadahiro Kojima, Hitoshi Hino, Akio Shiomi, Hiroyasu Kagawa, Yusuke Yamaoka, Shoichi Manabe, Kai Chen, Kenji Nanishi, Shinichi Yamauchi, Kenichi Sugihara
International Journal of Clinical Oncology.2022; 27(11): 1717. CrossRef
Colon cancer CT staging according to mismatch repair status: Comparison and suggestion of imaging features for high-risk colon cancer
Eun Kyoung Hong, Myriam Chalabi, Federica Landolfi, Francesca Castagnoli, Sae Jin Park, Karolina Sikorska, Arend Aalbers, Jose van den Berg, Monique van Leerdam, Jeong Min Lee, Regina Beets-Tan
European Journal of Cancer.2022; 174: 165. CrossRef
Accuracy of preoperative staging with multidetector computed tomography in colon cancer
Anna Sofie Friis Olsen, Anders Kierkegaard Gundestrup, Jakob Kleif, Tara Thanon, Claus Anders Bertelsen
Colorectal Disease.2021; 23(3): 680. CrossRef
Clinical TNM staging for esophageal, gastric, and colorectal cancers in the era of neoadjuvant therapy: A systematic review of the literature
Hideaki Shimada, Takeo Fukagawa, Yoshio Haga, Shin‐ichi Okazumi, Koji Oba
Annals of Gastroenterological Surgery.2021; 5(4): 404. CrossRef
Impact of D3 lymph node dissection on upstaging and short-term survival in clinical stage I right-sided colon cancer
Ji-Seon Kim, Se-Jin Baek, Jung-Myun Kwak, Jin Kim, Seon-Hahn Kim, Woong Bae Ji, Jung Sik Kim, Kwang Dae Hong, Jun Won Um, Sang Hee Kang, Sun Il Lee, Byung Wook Min
Asian Journal of Surgery.2021; 44(10): 1278. CrossRef
The risk of nodal disease in patients with pathological complete responses after neoadjuvant chemoradiation for rectal cancer: a systematic review, meta-analysis, and meta-regression
Ian Jun Yan Wee, Hai Man Cao, James Chi-Yong Ngu
International Journal of Colorectal Disease.2019; 34(8): 1349. CrossRef
Bildgebung vor kolorektaler Chirurgie aus Sicht des Chirurgen
I. Iesalnieks, A. Agha
Der Radiologe.2019; 59(9): 786. CrossRef
Over-diagnosis for preoperative T staging of colorectal cancer - A case series
Yugo Hirata, Hiroaki Nozawa, Koji Murono, Kazushige Kawai, Keisuke Hata, Toshiaki Tanaka, Takeshi Nishikawa, Kensuke Otani, Kazuhito Sasaki, Manabu Kaneko
Annals of Medicine and Surgery.2018; 32: 10. CrossRef

Management of Colonic Diverticulitis Tailored to Location and Severity: Comparison of the Right and the Left Colon: Byeoung Hoon Chung, Gi Won Ha, Min Ro Lee, Jong Hun Kim; Ann Coloproctol. 2016;32(6):228-233. Published online December 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.6.228

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Abstract PDF

Purpose

This study assessed optimal management of colonic diverticulitis as functions of disease location and severity and factors associated with complicated diverticulitis.

Methods

This retrospective review analyzed 202 patients diagnosed between 2007 and 2014 at Chonbuk National University Hospital, South Korea, with colonic diverticulitis by using abdominopelvic computed tomography. Diverticulitis location was determined, and disease severity was categorized using the modified Hinchey classification.

Results

Patients included 108 males (53.5%) and 94 females (46.5%); of these, 167 patients (82.7%) were diagnosed with right-sided and 35 (17.3%) with left-sided colonic diverticulitis. Of the 167 patients with right-sided colonic diverticulitis, 12 (7.2%) had complicated and 155 (92.8%) had uncomplicated diverticulitis; of these, 157 patients (94.0%) were successfully managed conservatively. Of the 35 patients with left-sided colonic diverticulitis, 23 (65.7%) had complicated and 12 (34.3%) had uncomplicated diverticulitis; of these, 23 patients (65.7%) were managed surgically. Among patients with right-sided diverticulitis, those with complicated disease were significantly older (54.3 ± 12.7 years vs. 42.5 ± 13.4 years, P = 0.004) and more likely to be smokers (66.7% vs. 32.9%, P = 0.027) than those with uncomplicated disease. However, among patients with left-sided diverticulitis, those with complicated disease had significantly lower body mass index (BMI; 21.9 ± 4.7 kg/m² vs. 25.8 ± 4.3 kg/m², P = 0.021) than those with uncomplicated disease.

Conclusion

Conservative management may be effective in patients with right-sided diverticulitis and patients with uncomplicated left-sided colonic diverticulitis. Surgical management may be required for patients with complicated left-sided diverticulitis. Factors associated with complicated diverticulitis include older age, smoking and lower BMI.

Citations

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The outcomes of right and left complicated colonic diverticulitis
Anh Tuan Nguyen, Quang Tien Pham, Hoi Van Tran, Hoang Viet Truong, Loc Huynh Tran
Surgery Open Science.2025; 27: 31. CrossRef
Right‐sided acute diverticulitis in a North African country: Presentation and management in one surgical center
Laila Jedidi, Aymen Mabrouk, Hela Ghali, Anis Ben Dhaou, Senda Ben Lahouel, Sami Daldoul, Houyem Said Latiri, Mounir Ben Moussa
World Journal of Surgery.2024; 48(6): 1509. CrossRef
Current diagnosis and management of acute colonic diverticulitis: What you need to know
Lisa M. Kodadek, Kimberly A. Davis
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E. Karam, C. Sabbagh, L. Beyer-Bergeot, P. Zerbib, V. Bridoux, G. Manceau, Y. Panis, E. Buscail, A. Venara, I. Khaoudy, M. Gaillard, M. Viennet, A. Thobie, B. Menahem, C. Eveno, C. Bonnel, J.-Y. Mabrut, B. Badic, C. Godet, Y. Eid, E. Duchalais, Z. Lakkis,
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Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines
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Diagnosis and management of acute colonic diverticulitis: results of a survey among Korean gastroenterologists
Jae Gon Lee, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Shin Hee Lee, Myung-Won You, Seong-Eun Kim
The Korean Journal of Internal Medicine.2023; 38(5): 672. CrossRef
Right-sided diverticulitis in a Western population
Adi Rov, Anat Ben-Ari, Eyal Barlev, David Pelcman, Sergio Susmalian, Haim Paran
International Journal of Colorectal Disease.2022; 37(6): 1251. CrossRef
Emergency surgery comparison of right versus left acute colonic diverticulitis: A 10-year outcome analysis
JS Tsang, Chi Chung Foo, Jeremy Yip, Hok Kwok Choi, Wai Lun Law, Oswens Siu Hung Lo
The Surgeon.2021; 19(3): 150. CrossRef
Elective surgical management of diverticulitis
Jordan M. Rook, Jill Q. Dworsky, Thomas Curran, Sudeep Banerjee, Mary R. Kwaan
Current Problems in Surgery.2021; 58(5): 100876. CrossRef
Special Situations in the Management of Diverticular Disease
Elizabeth H. Wood, Michael M. Sigman, Dana M. Hayden
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Routine colonoscopy may be needed for uncomplicated acute right colonic diverticulitis
Kil-yong Lee, Jaeim Lee, Youn Young Park, Seong Taek Oh
BMC Gastroenterology.2021;[Epub] CrossRef
WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections
Massimo Sartelli, Federico Coccolini, Yoram Kluger, Ervis Agastra, Fikri M. Abu-Zidan, Ashraf El Sayed Abbas, Luca Ansaloni, Abdulrashid Kayode Adesunkanmi, Boyko Atanasov, Goran Augustin, Miklosh Bala, Oussama Baraket, Suman Baral, Walter L. Biffl, Marja
World Journal of Emergency Surgery.2021;[Epub] CrossRef
Right sided diverticulitis in western countries: A review
Angelo Gabriele Epifani, Diletta Cassini, Roberto Cirocchi, Caterina Accardo, Francesca Di Candido, Massimiliano Ardu, Gianandrea Baldazzi
World Journal of Gastrointestinal Surgery.2021; 13(12): 1721. CrossRef
Difference in Clinical Features between Right- and Left-Sided Acute Colonic Diverticulitis
Kil-yong Lee, Jaeim Lee, Youn Young Park, Younglim Kim, Seong Taek Oh
Scientific Reports.2020;[Epub] CrossRef
2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting
Massimo Sartelli, Dieter G. Weber, Yoram Kluger, Luca Ansaloni, Federico Coccolini, Fikri Abu-Zidan, Goran Augustin, Offir Ben-Ishay, Walter L. Biffl, Konstantinos Bouliaris, Rodolfo Catena, Marco Ceresoli, Osvaldo Chiara, Massimo Chiarugi, Raul Coimbra,
World Journal of Emergency Surgery.2020;[Epub] CrossRef
Clinical Characteristics of Right Colonic Diverticulitis: A Comparison of Ileocecal Diverticulitis and Hepatic Flexure Diverticulitis
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Nippon Daicho Komonbyo Gakkai Zasshi.2020; 73(6): 244. CrossRef
Meta‐analysis of the demographic and prognostic significance of right‐sided versus left‐sided acute diverticulitis
S. Hajibandeh, S. Hajibandeh, N. J. Smart, A. Maw
Colorectal Disease.2020; 22(12): 1908. CrossRef
Long-term outcome and management of right colonic diverticulitis in western countries: Multicentric Retrospective Study
L. Courtot, V. Bridoux, Z. Lakkis, G. Piessen, G. Manceau, A. Mulliri, G. Meurette, A. Bouayed, A. Vénara, B. Blanc, N. Tabchouri, E. Salamé, M. Ouaïssi
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L. Courtot, V. Bridoux, Z. Lakkis, G. Piessen, G. Manceau, A. Mulliri, G. Meurette, A. Bouayed, A. Vénara, B. Blanc, N. Tabchouri, E. Salamé, M. Ouaïssi
Journal de Chirurgie Viscérale.2019; 156(4): 322. CrossRef
Prospective randomized clinical trial of uncomplicated right-sided colonic diverticulitis: antibiotics versus no antibiotics
Jeong Yeon Kim, Sung Gil Park, Hee Joon Kang, Young Ah Lim, Kyung Ho Pak, Tae Yoo, Won Tae Cho, Dong Woo Shin, Jong Wan Kim
International Journal of Colorectal Disease.2019; 34(8): 1413. CrossRef
Predictive Factors Affecting the Clinical Course of Patients With Diverticulitis: Who Needs Hospital Management?
Taeyoung Yoo, Keun Ho Yang, Jungbin Kim, Inseok Park, Hyunjin Cho, Geumhee Gwak, Byung Noe Bae, Ki Hwan Kim
Annals of Coloproctology.2018; 34(1): 23. CrossRef
Perforated diverticulitis: is the right and left difference present here too?
Nicholas Yock Teck Soh, Nan Zun Teo, Carrie Jen Hsi Tan, Shivani Rajaraman, Marianne Tsang, Calvin Jian Ming Ong, Ramesh Wijaya
International Journal of Colorectal Disease.2018; 33(5): 525. CrossRef
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Pill Sun Paik, Jung-A Yun
Annals of Coloproctology.2017; 33(5): 178. CrossRef
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Positron Emission Tomography/Computed Tomography in the Staging of Colon Cancer: Jae Hyung Lee, Min Ro Lee; Ann Coloproctol. 2014;30(1):23-27. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.23

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Abstract PDF

Purpose
Accurate preoperative staging of colon cancer is essential for providing the optimal treatment strategy and evaluating the expected prognosis. The aim of this study is to assess the value of positron emission tomography/computed tomography (PET/CT) over conventional studies in the staging of colon cancer.
Methods
A total of 266 colon cancer patients diagnosed between January 2008 and December 2010 were assessed with both PET/CT and conventional studies. Discordance with PET/CT and conventional studies were evaluated, and changes in the management strategy were assessed for each stage. Discordant findings were verified by using intraoperative examination, pathology reports, and follow-up imaging studies.
Results
Multidetector computed tomography (MDCT) and PET/CT showed similar accuracy in detecting lymph node metastasis in patients with clinical stage III (36.2% vs. 42%, P = 0.822) and stage IV (60.3% vs. 63.5%, P = 0.509) disease. PET/CT led to a change in management strategy for 1 of 40 patients (2.5%) with clinical stage I, 0 of 25 patients (0%) with stage II, 9 of 138 patients (6.5%) with stage III, and 8 of 63 patients (12.7%) with stage IV disease.
Conclusion
PET/CT changed the management plan in 6.5% of patients with clinical stage III and 12.7% of patients with clinical stage IV colon cancer. Our findings suggest that PET/CT may be considered as a routine staging tool for clinical stage III and IV colon cancers.

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Bezoar-induced Small Bowel Obstruction: Se Heon Oh, Hwan Namgung, Mi Hyun Park, Dong-Guk Park; J Korean Soc Coloproctol. 2012;28(2):89-93. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.89

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Abstract PDF

Purpose

The aim of this study was to observe the clinical features of a bezoar-induced small bowel obstruction and to investigate the role of abdominal computed tomography (CT) in establishing the diagnosis.

Methods

We retrospectively reviewed 20 cases of bezoar-induced small bowel obstruction in our hospital from 1996 to 2010.

Results

Thirteen patients (65%) had a history of abdominal surgery. Nine patients (45%) were diagnosed with a bezoar before surgery, seven patients were diagnosed by using abdominal CT, and two patients were diagnosed with a small bowel series. Abdominal CT was performed in 15 patients, and the diagnostic accuracy was 47% (7/15). Surgery revealed ten bezoars in the jejunum and 11 in the ileum. Two patients had bezoars found concurrently in the stomach. Spontaneous removal took place in two patients. An enterotomy and bezoar extraction was performed in 15 patients. Fragmentation and milking, a small bowel resection, and a Meckel's diverticulectomy were performed in one patient each. Early operative treatment was possible (P = 0.036) once the bezoar had been diagnosed by using abdominal CT. There tended to be fewer postoperative complications in patients who were diagnosed with a bezoar by using abdominal CT, but the result was not statistically significant (P = 0.712).

Conclusion

A preoperative diagnosis of bezoar-induced small bowel obstruction by using clinical features was difficult. Increased use of abdominal CT led to a more accurate diagnosis and to earlier surgery for bezoar-induced small bowel obstructions, thereby reducing the rate of complications.

Citations

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Small bowel obstruction due to a meat bolus bezoar: the second case report in literature
Ammar Albostani, Fadi Kfelati, Wafaa Alsaadi, Rufaida Ahmad Faraman, Aasem Farman
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A Rare Case of Gastric Phytobezoar (Diospyrobezoar) in a Healthy Adult
Ahmed M Odeh, Ahmed A Alkhalifa, Mohammed A AlHajji, Alwayah J Alahmed, Jawad H Alsalman, Abdulrahman M AlMulhem, Mohammed S AlGhadeer, Ezzeddin Kurdi, Fatima S Albader, Abdulmohsen Alsuwaigh, Mohammad A Khan
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Significance of Follow-up in Detection of Pulmonary Metastasis of Colorectal Cancer: Jae Won Shin, Sun Il Lee, Hong Young Moon; J Korean Soc Coloproctol. 2010;26(4):293-297. Published online August 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.4.293

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Abstract PDF

Purpose

This study was performed to evaluate the effectiveness of conventional chest radiography, carcinoembrionic antigen (CEA) level and abdominal computed tomography (CT) or chest CT for early detection of pulmonary metastasis after a curative resection of colorectal cancer.

Methods

We retrospectively reviewed 84 cases of pulmonary metastasis from a group of colorectal cancer patients who had a curative surgical resection from 2000 to 2006 at the Korea University Medical Center.

Results

Stage I tumors were detected in 4 patients, stage II tumors in 18, stage III tumors in 43 and stage IV tumors in 19. The detection rates for pulmonary metastasis were 28.5% by conventional chest radiography, 40.5% by increased CEA level and 28.5% by abdominal CT or chest CT. Among them, fourteen patients underwent a radical pneumonectomy. After detection of pulmonary metastasis, the survival outcome for the patients who underwent a resection of the lung was superior to the survival outcome of the patients who did not undergo a resection of the lung (43.7 months vs. 17.4 months, P = 0.001). For patients who underwent resections of the lung, pulmonary metastasis was detected by conventional chest radiography in 2 (14%) patients, by elevated CEA level in 6 (42%) patients, and by abdominal CT or chest CT in 6 (42%) patients.

Conclusion

Conventional chest radiography is no more useful in detecting early pulmonary metastasis after a curative colorectal surgery than a routine chest CT. Thus, we propose the use of routine chest CT for screening for lung metastasis.

Citations

Citations to this article as recorded by

Differentiating second primary lung cancer from pulmonary metastasis in patients of single solitary pulmonary lesion with extrapulmonary tumor using multiparametric analysis of FDG PET/CT
Honghong Liu, Xiaolin Meng, Guanyun Wang, Shulin Yao, Yanmei Wang, Ruimin Wang, Tao Wang
Annals of Nuclear Medicine.2025; 39(6): 567. CrossRef
A novel diagnostic model for differentiation of lung metastasis from primary lung cancer in patients with colorectal cancer
Rui Guo, Shi Yan, Fei Wang, Hua Su, Qing Xie, Wei Zhao, Zhi Yang, Nan Li, Jiangyuan Yu
Frontiers in Oncology.2022;[Epub] CrossRef
Simultaneous laparoscopic colorectal resection and pulmonary resection by minithoracotomy: Report of four cases
Tetsuo Tsukahara, Seiichiro Yamamoto, Taihei Oshiro, Shin Fujita, Hiroyuki Sakurai, Shun‐ichi Watanabe
Asian Journal of Endoscopic Surgery.2014; 7(2): 160. CrossRef
Clinical Characteristics of Patients With Solitary Pulmonary Mass After Radical Treatment for Primary Cancers: Pulmonary Metastasis or Second Primary Lung Cancer?
Jun Ge, Hong-Feng Gou, Ye Chen, Ke Cheng, Long-Hao Li, Hang Dong, Feng Gao, Feng Zhao, Hai-Tao Men, Qiu Li, Meng Qiu, Jing-Mei Su, Feng Xu, Feng Bi, Ji-Yan Liu
Cancer Investigation.2013; 31(6): 397. CrossRef

Diagnostic Usefulness of Routinely Performed Preoperative Chest Computed Tomography for Colorectal Cancer.: Hwang, Mi Jin , Jung, Sang Hun , Kim, Jae Hwang , Shim, Min Chul; J Korean Soc Coloproctol. 2010;26(3):211-216.; DOI: https://doi.org/10.3393/jksc.2010.26.3.211

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6 Citations

Abstract PDF

PURPOSE
The most common site of metastases in colorectal cancer (CRC) is the liver, and the second common site is the lung (10-20%). Preoperative staging for CRC is very important. The aim of this study was to assess the usefulness of chest computed tomography (CT) for preoperative staging in CRC.
METHODS
From January 2006 to December 2007, a total of 597 patients with colorectal cancer underwent surgery at our hospital. One hundred fifty of those patients had received chest CT preoperatively. We analyzed the chest radiologic findings from chest x-ray (CXR), abdominal CT, and chest CT.
RESULTS
The detection rate of abnormal lung findings was higher in chest CT than in the other chest radiologic findings (chest PA: 10 [6.6%]; abdominal CT: 19 [12.7%]; chest CT: 48 [32.0%]). On the chest CT, 19 of the 150 (12.7%) patients that had received a chest CT preoperatively were initially suspected of having malignant lesions. Besides two primary lung malignancies (solitary nodules), metastatic lesions were revealed in 5 (3.3%), 11 (7.3%), and 17 (11.3%) patients on CXR, abdominal CT, and chest CT, respectively. Eleven (64.7%) of the patients having metastatic chest CT lesions were also identified on lower lung fields by abdominal CT. Seven also had other metastatic foci (liver and paraaortic LN). Initially, stage IV was identified in 37 (24.7%) and 40 (26.7%) patients in abdominal CT and chest CT, respectively. After one year, 11 of the 150 (7.3%) patients who had received a chest CT had been diagnosed with pulmonary metastasis.
CONCLUSION
Chest computed tomography is the most sensitive method for the diagnosis of pulmonary metastases. However, if the interpretations of abdominal CT and individualized diagnostic methods are accurate, the demand for unnecessary preoperative work-up may be reduced.

Citations

Citations to this article as recorded by

Radiographic staging practices of newly diagnosed colorectal cancer vary according to medical specialty
Karen Ma, Sandeep Nayak, Hong Li, Kateri Evans, Amanda Francescatti, Marc I. Brand, Bruce Orkin, Marisa Hill, James Cameron, Sohrab Mobarhan, Joanne Favuzza, Joshua Melson
Gastrointestinal Endoscopy.2015; 82(3): 497. CrossRef
Should preoperative chest computed tomography be performed in all patients with colorectal cancer?
A. R. Lazzaron, M. V. Vieira, D. C. Damin
Colorectal Disease.2015;[Epub] CrossRef
The diagnostic yield of preoperative staging computed tomography of the thorax in colorectal cancer patients without hepatic metastases
Gabriella Yongue, Alexander Hotouras, Jamie Murphy, Hasan Mukhtar, Chetan Bhan, Christopher L. Chan
European Journal of Gastroenterology & Hepatology.2015; 27(4): 467. CrossRef
Should Preoperative Chest CT Be Recommended to All Colon Cancer Patients?
Hye Young Kim, Soon Jin Lee, Gilsun Lee, Limwha Song, Su-A Kim, Jin Yong Kim, Dong Kyung Chang, Poong-Lyul Rhee, Jae J. Kim, Jong Chul Rhee, Ho-Kyung Chun, Young-Ho Kim
Annals of Surgery.2014; 259(2): 323. CrossRef
Indeterminate Pulmonary Nodules at Colorectal Cancer Staging: A Systematic Review of Predictive Parameters for Malignancy
Andreas Nordholm-Carstensen, Peer A. Wille-Jørgensen, Lars N. Jorgensen, Henrik Harling
Annals of Surgical Oncology.2013; 20(12): 4022. CrossRef
Pulmonary staging in colorectal cancer: a review
C. N. Parnaby, W. Bailey, A. Balasingam, L. Beckert, T. Eglinton, J. Fife, F. A. Frizelle, M. Jeffery, A. J. M. Watson
Colorectal Disease.2012; 14(6): 660. CrossRef

Abdominal Computed Tomography in Patients with Right Lower Quadrant Pain.: Won, Chang Sik , Roh, Hye Rin , Park, Seung Bae , Kim, Yang Hei , Chae, Gi Bong; J Korean Soc Coloproctol. 2008;24(6):417-421.; DOI: https://doi.org/10.3393/jksc.2008.24.6.417

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Abstract PDF: PURPOSE
This study was performed to evaluate the usefulness of abdominal computed tomography (CT) for patients with right lower quadrant (RLQ) pain.
METHODS
Between January 2006 and July 2008, 191 consecutive patients with RLQ pain underwent abdominal CT (CT group). Forty-two patients who had undergone abdominal ultrasound (US group) and 52 patients without abdominal CT or abdominal ultrasound for RLQ pain (clinical Dx group) underwent emergent operations. Using the Alvarado scoring system, we scored all patients. The abdominal CT was performed in the abdominal and pelvic area with contrast.
RESULTS
One hundred twenty-one (63.4%) of the 191 patients in the CT group were preoperatively diagnosed as having acute appendicitis and underwent surgery. There were three cases of negative appendectomy (1.6%). In the US group and the clinical Dx group, the negative appendectomy rates were 4.8% and 3.8%, respectively. The sensitivity of the abdominal CT was 96.7%. In the CT group, in addition to acute appendicitis, colitis, nonspecific enteritis, diverticulitis, urinary stone, ovary, uterine, and diseases were indentified.
CONCLUSIONS
In this study, abdominal CT scans in patients with RLQ pain were useful for the diagnosis acute appendicitis and for the differential diagnosis of other diseases presenting with RLQ pain. The false positive rate was significantly lower in the CT group than in the other groups.

The Efficacy of the Alvarado Score in the Diagnosis of Acute Appendicitis.: Lee, Sung Min , Chang, In Taik , Kim, Beom Gyu , Cha, Sung Jae , Kim, Yong Seok , Pak, Jun Seok; J Korean Soc Coloproctol. 2008;24(1):1-6.; DOI: https://doi.org/10.3393/jksc.2008.24.1.1

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Abstract PDF

PURPOSE
Acute appendicitis is the most common cause of an acute abdomen that needs an emergency operation. However, the preoperative diagnosis is difficult. The purpose of this study is to assess the diagnostic efficacy of the Alvarado score by a comparison with CT and to determine the indication of CT evaluation. METHODS: From August 2006 to October 2006, 111 consecutive patients were admitted to Chung-Ang University hospital under the impression of acute appendicitis, and a CT scan was done. The Alvarado score, which consists of migration, anorexia, nausea-vomitig, tenderness, rebound tenderness, fever, leukocytosis, and left shift, was applied to the patients. RESULTS: Of the 111 patients, 85 patients underwent an operation, and 26 were discharged without an operation on the basis of the CT finding. The negative appendectomy rate were 4.7%. CT showed a sensitivity, of 0.90 a specificity of 0.97 and an accuracy rate of 0.92. Tenderness and leukocytosis were confirmed as the most important tests and showed accuracy rates of 0.73 and 0.70, respectively. The sensitivity was 0.90 at score 5 and 0.85 at score 7. Therefore, there was no single cut-off score that satisfied all diagnostic values. CONCLUSIONS: The Alvarado score alone is not a satisfactory diagnostic method acute appendicitis. Of the appendicitis patients, 90% might be included in the diagnosis for Alvarado scores above 5, and the negative appendectomy could be as high as 15% for Alvarado scores above 7, which is the score generally accepted for a diagnosis of appendicitis.

Citations

Citations to this article as recorded by

Ultrasonography of Appendicitis
Dae Hyun Kim
Clinical Ultrasound.2016; 1(1): 19. CrossRef
Diagnostic Efficacy of the Alvarado Score according to Age in Acute Appendicitis
Bo-Young Oh, Kwang-Ho Kim, Ryung-Ah Lee, Soon Sup Chung
Journal of the Korean Surgical Society.2010; 78(2): 100. CrossRef

Intraoperative Detection of Liver Metastasis after Preoperative Radiotherapy in Rectal Cancer.: Lee, Seung Hyun , Ahn, Byung Kwon , Baek, Sung Uhn; J Korean Soc Coloproctol. 2002;18(6):415-418.

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Abstract PDF: PURPOSE
Preoperatvie radiotherapy has many theoretical advantages in contrast to postoperative one such as preventing dissemination of cancer cells during surgery and increasing resectability rate by down-staging, thus more feasibility of preserving anus and improving survival. But there are several adverse effects, too. Distant metastasis can be detected after preoperative radiotherapy. Postoperative complication rate is high. Pathologic stage is changed after preoperative radiationtherapy so that there is difficulty in prediction of prognosis. We reviewed distant metastasis after preoperative radiotherapy and evaluated detection rate of metastasis with computed tomography in rectal cancer.
METHODS
Fifty patients with histologically proven rectal cancer and locally advanced lesions, as determined by physical examination and with no distant metastasis on preoperative computed tomography, entered the trial from 1990 to 1999. Surgery followed 2 to 6 weeks after completion of hyperthermia-chemoradiotherapy (HTCRT). Preoperative stages were determined with computed tomography. Postoperatve stage were determined by pathologic study.
RESULTS
Thirty cases were male. Twenty cases were female. Distance from anal verge to tumor were under 7 cm of 36 cases, over of 14 cases. The median tumor size was 3.3 cm in diameter. The conservation rate of anal sphincter function were 48.0%. In preoperative staging with computed tomography, the number of stage I, II, and III were 4, 11 and 35 cases. none were stage IV. The overall resectability rate was 90.0% (45 of 50 patients). In postoperative staging with pathologic study, the number of stage 0, I, II, and III were 4, 5, 19, and 13 cases. stage IV were 9 cases. Anastomotic leakage were noticed in 2 cases. In stage IV cases, liver metastases were noticed in all cases.
CONCLUSIONS
The preoperative radiotherapy was applied to the 50 patients with rectal cancer. The liver metastases which were detected after preoperative radiotherapy were 9 cases. The false negative value of computed tomography for liver metastasis in rectal cancer was 18.0%. We need more sensitive study for detecting liver metastasis of rectal cancer, especially in scheduled preoperative radiotherapy.

The Role of Computed Tomography in the Diagnosis of Acute Appendicitis.: Choi, In Seok , Yea, Byung Kook , Han, Gun Taek , Sim, Mun Sup; J Korean Soc Coloproctol. 2002;18(3):178-183.

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Abstract PDF: PURPOSE
Appendicitis represents one of the most common surgical disorders. Typically, the diagnosis can be made from well established clinical criteria, with an acceptable negative appendectomy rate from 7~25%. However, when surgical intervention is performed in the patients suspected of having appendicitis but with equivocal clinical findings, the negative appendectomy rate approaches 50%. Routine contrast-enhanced computed tomography (CECT) has described as an accurate diagnostic imaging modality in patients with suspected appendicitis. We evaluated the role of intravenous CECT (iCECT) in patients suspected of having appendicitis but with equivocal clinical exams.
METHODS
Eighty seven consecutive patients who were thought to have appendicitis but with equivocal clinical findings and/or physical exams were imaged by iCECT over 18 months period. Intravenous contrast-enhanced, spiral abdominal and pelvic images were obtained using 7.5 mm cuts. iCECT images were interpreted by a board-certified radiologist. Main outcome measures included iCECT sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accurary and negative appendectomy rate in the diagnosis of acute appendicitis, and determining the impact iCECT on the clinical management of the patient population.
RESULTS
A group of 87 patients consisting of 36 males (41.4 %) and 51 females (58.6%) with median age of 32 years (range 12 to 75 years) were imaged with iCECT to evaluate suspected appendicitis. Of the 87 iCECTs performed, 8 false-positive and 2 false-negative readings were identified, resulting in a sensitivity of 93.5%, specificity of 85.7%, PPV of 78.4%, NPV of 96%, and an overall accuracy of 88.5%. With regard to clinical management, 100% (31/31) of patients with appendicitis, and 4% (2/50) of patients without appendicitis underwent appendectomy. Therefore, the overall negative appendectomy rate was 6.1% (2/33).
CONCLUSION
iCECT is a useful diagnostic imaging modality for patients suspected of having acute appendicitis but with equivocal clinical findings and/or physical exams. iCECT is particularly useful in excluding the diagnosis of appendicitis in those without disease.

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