Annals of Coloproctology

Original Article

Complications

Bedside endoscopic inspection of colorectal anastomoses in the early postoperative period: a 2-center prospective feasibility study: David J. Nijssen, Roel Hompes, Jurriaan Tuynman, Jimme K. Wiggers, Willem A. Bemelman, Saidah Sahid, James Kinross, Wytze Laméris; Ann Coloproctol. 2025;41(2):127-135. Published online April 14, 2025; DOI: https://doi.org/10.3393/ac.2024.00584.0083

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Abstract PDF: Purpose
Early diagnosis of anastomotic leakage (AL) after colorectal surgery can reduce severe postoperative morbidity and ensure successful treatment. This study evaluated the feasibility of bedside endoscopic inspection of the anastomosis early postoperatively using a point-of-care digital rectoscope.
Methods
This prospective study was conducted at 2 tertiary centers. Patients who underwent minimally invasive or open sphincter-preserving surgery with creation of a colorectal or coloanal anastomosis were included. Data were collected from December 2022 to October 2023. Bedside anastomotic inspections were performed postoperative day (POD) 3 to 5 using a point-of-care digital rectoscope. The primary outcome was feasibility, defined as adequate clinical assessment of the anastomosis during bedside inspection. Secondary outcomes included patient tolerability, efficacy compared to other diagnostic methods, and clinical outcomes during 90 days of follow-up.
Results
In total, 35 patients were included. All bedside anastomotic inspections were carried out successfully. The examination showed complete visibility of the entire anastomosis in 30 patients (85.7%), with minimal discomfort reported by 3 (8.6%). No adverse events were recorded. AL occurred in 6 patients (17.1%), with 3 cases detected during bedside inspections between POD 3 and 5. Two leaks were detected without clinical or biochemical suspicion. Three patients with negative rectoscopy between POD 3 and 5 were later diagnosed with AL: 2 by a computed tomography scan and 1 by a bedside rectoscopy.
Conclusion
Bedside inspection of rectal anastomoses early postoperatively is feasible and tolerable for patients. Routine anastomotic inspections can detect early AL even without clear clinical or biochemical signs.

Review

Benign bowel disease

Colorectal screening following appendectomy in adult patients: a systematic review: Francesco Esposito, Marco Del Prete, Matilde Magri, Fanny Dufour, Alexandre Cortes; Ann Coloproctol. 2024;40(5):417-423. Published online August 1, 2024; DOI: https://doi.org/10.3393/ac.2023.00528.0075

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Abstract PDF: Purpose
Although the association between appendicitis and colorectal cancer in older patients has received attention, postoperative colorectal screening through endoscopy is not currently recommended. This study conducted a systematic review of the literature on colorectal screening following appendectomy in adult patients.
Methods
A literature search was performed using online databases. Studies reporting colorectal surveillance after appendectomy in adult patients were retrieved for assessment.
Results
Eight articles including a total of 3,995 patients were published between 2013 and 2023. An age of 40 years was the lower threshold in 6 of the 8 articles. Postoperative colorectal screening occurred in 771 patients (19.3%). Endoscopy was performed in 95.2% of cases and computed tomography–colonography in 4.8%. During endoscopic examinations, a lesion was discovered in 184 of 771 patients (24.0%), and an adenomatous polyp was found in 154 of 686 patients (22.5%). The overall cancer rate was 3.9% (30 of 771 patients). The tumor was located in the right-sided colon in 46.7% of the patients, in the cecum in 20.0%, in the rectum in 16.7%, in the left-sided colon in 10.0%, and in the sigmoid colon in 6.7%.
Conclusion
Performing post-appendectomy colorectal screening in patients >40 years of age could allow early detection of an underlying lesion.

Original Article

The albumin to globulin ratio is associated with clinical outcome in Japanese patients with ulcerative colitis: Sen Yagi, Shinya Furukawa, Kana Shiraishi, Teruki Miyake, Kazuhiro Tange, Yu Hashimoto, Shogo Kitahata, Tomoe Kawamura, Tomoyuki Ninomiya, Kenichirou Mori, Seiyuu Suzuki, Naozumi Shibata, Hidehiro Murakami, Katsuhisa Ohashi, Aki Hasebe, Hideomi Tomida, Yasunori Yamamoto, Eiji Takeshita, Yoshio Ikeda, Yoichi Hiasa; Ann Coloproctol. 2023;39(2):155-163. Published online March 30, 2022; DOI: https://doi.org/10.3393/ac.2021.01032.0147

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5 Web of Science
6 Citations

Abstract PDF

Purpose
The albumin to globulin ratio (AGR) is a recognized chronic inflammation marker. No evidence regarding the relationship between AGR level and ulcerative colitis (UC) exists. The aim of this study was to evaluate the association between AGR and clinical outcomes among Japanese subjects with UC.
Methods
The study subjects consisted of 273 Japanese individuals with UC. AGR was divided into 4 categories (low, moderate, high, and very high). The definition of complete mucosal healing (MH) was based on the Mayo endoscopic subscore of 0. Clinical remission (CR) was defined as no rectal bleeding and no abnormally high stool frequency (<3 times per day).
Results
The percentage of MH was 26.4%. High AGR and very high AGR were significantly positively correlated with CR (adjusted odds ratio [OR], 5.85; 95% confidence interval [CI], 2.52–14.18 and adjusted OR, 4.97; 95% CI, 2.14–12.04) and complete MH (adjusted OR, 4.03; 95% CI, 1.56–11.51 and adjusted OR, 5.22; 95% CI, 1.97–14.89), respectively after adjustment for confounding factors (P for trend=0.001). Only in the low C-reactive protein (CRP) group (≤0.1 mg/dL), very high AGR was significantly positively correlated with complete MH but not CR (adjusted OR, 4.38; 95% CI, 1.06–21.77; P for trend=0.017). In the high CRP group, no correlation between AGR and complete MH was found.
Conclusion
Among Japanese patients with UC, AGR may be independently positively correlated with complete MH. In particular, among UC patients with low CRP, AGR might be a useful complementary marker for complete MH.

Citations

Citations to this article as recorded by

Albumin: Bountiful Arrow in the Quiver of Liver and Its Significance in Physiology
Ananda Baral
Livers.2025; 5(2): 27. CrossRef
Prognostic impact of preoperative nutritional and immune inflammatory parameters on liver cancer
Sung Uk Bae
World Journal of Gastrointestinal Surgery.2024; 16(2): 266. CrossRef
Progress in Biomarkers of Inflammatory Bowel Disease
舒陈
Advances in Clinical Medicine.2024; 14(03): 1418. CrossRef
Clinical utility of C‐reactive protein‐to‐albumin ratio in the management of patients with inflammatory bowel disease
Anke L Nguyen, Claudia Brick, David Liu, David J Gibson, Peter R Gibson, Miles P Sparrow
JGH Open.2024;[Epub] CrossRef
Association between Mucosal Healing and Lipid Profiles in Patients with Ulcerative Colitis: A Cross-Sectional Study
Sen Yagi, Shinya Furukawa, Teruki Miyake, Kana Shiraishi, Kazuhiro Tange, Yu Hashimoto, Shogo Kitahata, Tomoyuki Ninomiya, Seiyuu Suzuki, Naozumi Shibata, Hidehiro Murakami, Katsuhisa Ohashi, Hideomi Tomida, Yasunori Yamamoto, Eiji Takeshita, Yoshio Ikeda
Digestion.2023; 104(2): 129. CrossRef
Current and emerging biomarkers for ulcerative colitis
Jan K. Nowak, Rahul Kalla, Jack Satsangi
Expert Review of Molecular Diagnostics.2023; 23(12): 1107. CrossRef

Technical Note

Benign GI diease,Rare disease & stoma,Surgical technique

Endoscopic Removal of a Fecalith or Fecomucolith in a Rectal Stump or Pouch: Evie Yeap, Ratheesraj Ratinam, Asiri Arachchi, James Lim, Yeng Kwang Tay, Zeev Duieb; Ann Coloproctol. 2021;37(5):346-348. Published online August 25, 2021; DOI: https://doi.org/10.3393/ac.2021.00206.0029

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Abstract PDF: Fecaliths or fecomucoliths can form in rectal stumps after a Hartmann procedure or in a coloneovaginal conduit. They can cause significant distress to the patient by causing symptoms such as discharge and odor. We describe a novel and effective method of endoscopic obliteration and removal where other techniques such as removal during examination under anesthesia or serial enemas have failed. By using a combination of hydrodissection with a saline injector gun and biopsy forceps and a polypectomy snare to break down the fecomucolith or fecalith, this troublesome problem can be resolved endoscopically. Successful removal of the fecalith/fecomucolith and resolution of the symptoms for the patients were achieved. No complications are reported. We describe an effective and novel method for endoscopic removal of fecaliths and fecomucoliths.

Case Reports

Malignant disease

Early Postoperative Anastomotic Obstruction Due to an Intraluminal Blood Clot After Laparoscopic Anterior Resection: A Case Report: Soon Keun Kwon, Jin Soo Han, Jihyun Seo, Yong Sik Yoon; Ann Coloproctol. 2020;36(5):349-352. Published online October 31, 2020; DOI: https://doi.org/10.3393/ac.2020.06.11.2

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Abstract PDF: Early postoperative anastomotic obstruction after colorectal surgery rarely develops. Herein, we present a case of a 50-year-old healthy woman who had an early postoperative anastomotic obstruction which was revealed caused by a blood clot and successfully managed by endoscopic approach. The patient was discharged after laparoscopic anterior resection and visited the emergency department one day after because of abdominal pain. Computed tomography showed that the anastomosis site was obstructed with low-density material. Intraoperative endoscopy was performed under general anesthesia and blood clot filling the lumen were identified. As the scope was advanced to the blood clot with air inflation, the blood clot was evacuated. The anastomosis site could be obstructed by blot clot with mucous debris albeit it is a rare condition. An endoscopic approach seems to be the first option in the diagnosis and treatment of postoperative obstruction at the anastomosis site and it could prevent unnecessary laparotomy.

Malignant disease

Transanal Endoscopic Microsurgery: Endoscopy Assisted Treatment of Colorectal Anastomotic Stenosis: Giancarlo D'Ambrosio, Antonietta Lamazza, Rossella Palma, Andrea Picchetto, Cristina Panetta, Antonello Trecca, Stefano Pontone, Emanuele Lezoche; Ann Coloproctol. 2020;36(4):285-288. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.09.30.3

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3 Web of Science
4 Citations

Abstract PDF

Transanal endoscopic microsurgery (TEM) is a type of natural orifice transluminal endoscopic surgery, developed for rectal tumors and used also to treat other rectal diseases. Anastomotic complications after colorectal surgery, including stenosis, represent a challenging problem. We present the case of a 36-year-old woman with a diagnosis of Hirschsprung disease that was submitted to a modified Duhamel operation. A postoperative barium enema showed a complete stricture of the anastomosis that was impossible to resolve by flexible endoscopic approach. Then an intraoperative endoscopic approach to facilitate the localization of preanastomotic colon (proximal colon from the anastomosis) was performed by a small colotomy and the colonic recanalization was obtained by the creation of a neo-anastomosis by TEM, under fluoroscopic-endoscopic control. The patient underwent a control barium enema showing regular retrograde transit of contrast medium without evidence of stenosis. In our experience, transanal approach by TEM-colonoscopy assisted is safe and feasible and represents a model of combined minimally invasive technique.

Citations

Citations to this article as recorded by

Application of transurethral prostate resection instrumentation for treating rectal anastomotic stenosis: Case series
Wenshan Xu, Yujie Qin, Faying Yang, Jun Qian, Yanbo Dong, Song Tu, Jiaxi Yao
Medicine.2023; 102(19): e33799. CrossRef
Eight Years Experience of Transanal Endoscopic Microsurgery
Seyed Vahid Hosseini, Mohammad Rezazadehkermani, Ali Abdulridha Abbas Algharah, Alimohammad Bananzadeh, Seyedeh Saeideh Shahidinia, Mehrdad Haghazali
Journal of Coloproctology.2023; 43(04): e251. CrossRef
Transanal Minimally Invasive Surgery for Rectal Anastomotic Stenosis After Colorectal Cancer Surgery
Wei Zhou, Lian Xia, Zian Wang, Gaoyang Cao, Li Chen, Engeng Chen, Wei Zhang, Zhangfa Song
Diseases of the Colon & Rectum.2022; 65(8): 1062. CrossRef
Application of endoscopic technique in completely occluded anastomosis with anastomotic separation after radical resection of colon cancer: a case report and literature review
Junnan Gu, Shenghe Deng, Yinghao Cao, Fuwei Mao, Hang Li, Huili Li, Jiliang Wang, Ke Wu, Kailin Cai
BMC Surgery.2021;[Epub] CrossRef

Original Article

Combination Assessment of Clinical Complete Response of Patients With Rectal Cancer Following Chemoradiotherapy With Endoscopy and Magnetic Resonance Imaging: Hye Mi Ko, Yo Han Choi, Jeong Eun Lee, Kyung Ha Lee, Ji Yeon Kim, Jin Soo Kim; Ann Coloproctol. 2019;35(4):202-208. Published online August 31, 2019; DOI: https://doi.org/10.3393/ac.2018.10.15

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17 Citations

Abstract PDF

Purpose
The response to neoadjuvant chemoradiotherapy (CRT) for rectal cancer can be assessed using digital rectal examination, endoscopy and magnetic resonance imaging (MRI). Precise assessment of clinical complete response (CR) after CRT is essential when deciding between optimizing surgery or organ-preserving treatment. The objectives of this study were to correlate the CR finding in endoscopy and MRI with pathologic CR and to determine the appropriate approach for combining endoscopy and MRI to predict the pathologic CR in patients with rectal cancer after neoadjuvant CRT.
Methods
This retrospective cohort study included 102 patients with rectal cancer who underwent endoscopy and MRI at 2–4 weeks after CRT. We assigned a confidence level (1–4) for the endoscopic and MRI assessments. Accuracy, sensitivity, and specificity were analyzed based on the endoscopy, MRI, and combination method findings. Diagnostic modalities were compared using the likelihood ratios.
Results
Of 102 patients, 17 (16.7%) had a CR. The accuracy, sensitivity, and specificity for the prediction CR of endoscopy with biopsy were 85.3%, 52.9%, and 91.8%, while those of MRI were 91.2%, 70.6%, and 95.3%, and those of combined endoscopy and MRI were 89.2%, 52.9%, and 96.5%, respectively. No significant differences were noted in the sensitivity and specificity of any each modality. The prediction rate for CR of the combination method was 92.6% after the posttest probability test.
Conclusion
Our study demonstrated that combining the interpretation of endoscopy with biopsy and MRI could provide a good prediction rate for CR in patients with rectal cancer after CRT.

Citations

Citations to this article as recorded by

Implementation of Organ Preservation for Locally Advanced Rectal Cancer in Canada: A National Survey of Clinical Practice
Megan Delisle, Victoria Ivankovic, Doris Goubran, Eliane Yvonne Paglicauan, Mariam Alsobaei, Nicole Alcasid, Mary Farnand, Kristopher Dennis
Current Oncology.2025; 32(6): 341. CrossRef
Assessing Endoscopic Response in Locally Advanced Rectal Cancer Treated with Total Neoadjuvant Therapy: Development and Validation of a Highly Accurate Convolutional Neural Network
Hannah Williams, Hannah M. Thompson, Christina Lee, Aneesh Rangnekar, Jorge T. Gomez, Maria Widmar, Iris H. Wei, Emmanouil P. Pappou, Garrett M. Nash, Martin R. Weiser, Philip B. Paty, J. Joshua Smith, Harini Veeraraghavan, Julio Garcia-Aguilar
Annals of Surgical Oncology.2024; 31(10): 6443. CrossRef
Transanal endoscopic microsurgery after radiation or chemoradiation therapy for rectal cancer — peculiarities and results
A А. Nevolskikh, A. R. Brodskiy, V. A. Avdeenko, T. P. Pochuev, Yu. Yu. Mihaleva, T. P. Berezovskaya, R. F. Zibirov, S. A. Myalina, I. A. Orehov, L. O. Petrov, S. A. Ivanov, A. D. Kaprin
Koloproktologia.2024; 23(1): 82. CrossRef
Nonoperative management of rectal cancer
Hannah Williams, Christina Lee, Julio Garcia-Aguilar
Frontiers in Oncology.2024;[Epub] CrossRef
Diagnostic performance of MRI and endoscopy for assessing complete response in rectal cancer after neoadjuvant chemoradiotherapy: a systematic review of the literature
Nicolai Egholt Munk, Peter Bondeven, Bodil Ginnerup Pedersen
Acta Radiologica.2023; 64(1): 20. CrossRef
Correlation of Tumor Response Between Flexible Sigmoidoscopy and Magnetic Resonance Imaging in Patients Undergoing Neoadjuvant Therapy for Locally Advanced Rectal Cancer: A Retrospective Review
Maria A. Rojas, Jose Cataneo, Marianne Gagnon-Konamna, Daniel J. Borsuk, Angela J. Jarzabek, Slawomir J. Marecik, John J. Park, Kunal Kochar
The American Surgeon™.2023; 89(6): 2595. CrossRef
Endoscopy and MRI for restaging early rectal cancer after neoadjuvant treatment
Rutger C. H. Stijns, Jeroen Leijtens, Eelco de Graaf, Simon P. Bach, Geerard Beets, Andre J. A. Bremers, Regina G. H. Beets‐Tan, Johannes H. W. de Wilt
Colorectal Disease.2023; 25(2): 211. CrossRef
Deep learning of endoscopic features for the assessment of neoadjuvant therapy response in locally advanced rectal cancer
Anqi Wang, Jieli Zhou, Gang Wang, Beibei Zhang, Hongyi Xin, Haiyang Zhou
Asian Journal of Surgery.2023; 46(9): 3568. CrossRef
MRI Evaluation of Complete and Near-Complete Response after Neoadjuvant Therapy in Patients with Locally Advanced Rectal Cancer
Anca-Raluca Popita, Cosmin Lisencu, Adriana Rusu, Cristian Popita, Calin Cainap, Alexandru Irimie, Liliana Resiga, Alina Munteanu, Zsolt Fekete, Radu Badea
Diagnostics.2022; 12(4): 921. CrossRef
Watch and wait strategies for rectal cancer: A systematic review
In Ja Park
Precision and Future Medicine.2022; 6(2): 91. CrossRef
Early conformational changes at tumour bed and long term response after neoadjuvant therapy in locally-advanced rectal cancer
Inês Santiago, Maria-João Barata, Nuno Figueiredo, Oriol Parés, Celso Matos
European Journal of Radiology.2021; 140: 109742. CrossRef
Improvement in the Assessment of Response to Preoperative Chemoradiotherapy for Rectal Cancer Using Magnetic Resonance Imaging and a Multigene Biomarker
Eunhae Cho, Sung Woo Jung, In Ja Park, Jong Keon Jang, Seong Ho Park, Seung-Mo Hong, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
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High-Resolution T2-Weighted MRI to Evaluate Rectal Cancer: Why Variations Matter
Kirsten L Gormly
Korean Journal of Radiology.2021; 22(9): 1475. CrossRef
Comparison between Local Excision and Radical Resection for the Treatment of Rectal Cancer in ypT0-1 Patients: An Analysis of the Clinicopathological Factors and Survival Rates
Soo Young Oh, In Ja Park, Young IL Kim, Jong-Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
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MRI T2-weighted sequences-based texture analysis (TA) as a predictor of response to neoadjuvant chemo-radiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC)
Filippo Crimì, Giulia Capelli, Gaya Spolverato, Quoc Riccardo Bao, Anna Florio, Sebastiano Milite Rossi, Diego Cecchin, Laura Albertoni, Cristina Campi, Salvatore Pucciarelli, Roberto Stramare
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MRI Assessment of Complete Response to Preoperative Chemoradiation Therapy for Rectal Cancer: 2020 Guide for Practice from the Korean Society of Abdominal Radiology
Seong Ho Park, Seung Hyun Cho, Sang Hyun Choi, Jong Keon Jang, Min Ju Kim, Seung Ho Kim, Joon Seok Lim, Sung Kyoung Moon, Ji Hoon Park, Nieun Seo
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Case Reports

Transvaginal Endoscopic Appendectomy: Eung Jin Shin, Gui Ae Jeong, Jun Chul Jung, Gyu Seok Cho, Chul Wan Lim, Hyung Chul Kim, Ok Pyung Song; J Korean Soc Coloproctol. 2010;26(6):429-432. Published online December 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.6.429

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Abstract PDF

Since Kalloo and colleagues first reported the feasibility and safety of a peroral transgastric approach in the porcine model in 2004, various groups have reported more complex natural orifice transluminal endoscopic surgery (NOTES) procedures, such as the cholecystectomy, splenectomy and liver biopsy, in the porcine model. Natural orifice access to the abdominal cavity, such as transgastric, transvesical, transcolonic, and transvaginal, has been described. Although a novel, minimally invasive approach to the abdominal cavity is a peroral endoscopic transgastric approach, there are still some challenging issues, such as the risk of infection and leakage, and the method of gastric closure. Hybrid-NOTES is an ideal first step in humans. Human hybrid transvaginal access has been used for years by many surgeons for diagnostic and therapeutic purposes. Here, we report a transvaginal flexible endoscopic appendectomy, with a 5-mm umbilical port using ultrasonic scissors in a 74-year-old woman with acute appendicitis.

Citations

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Transvaginal Laparoscopic Appendectomy: A Systematic Review
Ethan Slouha, Stefan J Biput, Brandon Krumbach, Lucy A Clunes, Theofanis F Kollias
Cureus.2024;[Epub] CrossRef
Recent Technical Developments in the Field of Laparoscopic Surgery: A Literature Review
Lama Islem Basunbul, Lenah Sulaiman S Alhazmi, Shahad Amro Almughamisi, Najd Muhammed Aljuaid, Hisham Rizk, Rana Moshref
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Transvaginal laparoscopic appendectomy using innovative submucosal tunnels: a conducive modification for improving hybrid NOTES access and its critical appraisal
Priyadarshan A Jategaonkar, Sudeep P Yadav, Dilip Gupta
Tropical Doctor.2020; 50(3): 209. CrossRef
Natural Orifice Transluminal Endoscopic Surgery in Korea
Dae Kyung Sohn
The Journal of Minimally Invasive Surgery.2016; 19(2): 52. CrossRef
Clinical NOTES appendectomy study: comparison of transvaginal NOTES appendectomy in hybrid technique with laparoscopic appendectomy
Joern Bernhardt, Holger Steffen, Sylke Schneider-Koriath, Kaja Ludwig
International Journal of Colorectal Disease.2015; 30(2): 259. CrossRef
Transvaginal Approach for Nongynecologic Intraperitoneal Procedures
José F. Noguera, Gonzalo Martín, José M. Muñoz, Antonio Melero, Raúl Sánchez, Javier Valdivia, Marcos Bruna, Antonio Salvador, Cristóbal Zaragoza
International Journal of Clinical Medicine.2014; 05(21): 1417. CrossRef
Transvaginal hybrid-NOTES appendectomy in routine clinical use: prospective analysis of 13 cases and description of the procedure
Jurgen Knuth, Markus Maria Heiss, Dirk Rolf Bulian
Surgical Endoscopy.2014; 28(9): 2661. CrossRef
Natural orifice transluminal endoscopic surgery for intra-abdominal emergency conditions
J Bingener, I Ibrahim-zada
Journal of British Surgery.2014; 101(1): e80. CrossRef
Transvaginal Appendectomy: A Systematic Review
Mehmet Ali Yagci, Cuneyt Kayaalp
Minimally Invasive Surgery.2014; 2014: 1. CrossRef
Colorectal natural orifice transluminal endoscopic surgery (NOTES) and transvaginal/transrectal specimen extraction
J. E. Sanchez, J. E. Marcet
Techniques in Coloproctology.2013; 17(S1): 69. CrossRef
Natural orifice translumenal endoscopic surgery (NOTES) second-look peritoneoscopy for staging of limited peritoneal carcinomatosis
Mircea Beuran, Ionut Negoi, Sorin Paun, Adrian Lobontiu, Florin Filipoiu, Alin Moldoveanu, Ruxandra Negoi, Sorin Hostiuc
Medical Hypotheses.2013; 80(6): 745. CrossRef
Comparison between single-incision and conventional three-port laparoscopic appendectomy: a meta-analysis from eight RCTs
Jun Gao, Ping Li, Qingguo Li, Dong Tang, Dao-Rong Wang
International Journal of Colorectal Disease.2013; 28(10): 1319. CrossRef
Comparative Study Between Single-Incision and Three-Port Laparoscopic Appendectomy: A Prospective Randomized Trial
Bong-Hyeon Kye, Junhyun Lee, Wook Kim, Dongjae Kim, Dosang Lee
Journal of Laparoendoscopic & Advanced Surgical Techniques.2013; 23(5): 431. CrossRef
Transvaginal natural orifice transluminal endoscopic surgery for adnexal masses
Yun Seok Yang, Myung Haeng Hur, Kwoan Young Oh, Soo Young Kim
Journal of Obstetrics and Gynaecology Research.2013; 39(12): 1604. CrossRef
Endoscopic approach to pancreatic pseudocyst, abscess and necrosis: Review on recent progress
Jie Chen, Norio Fukami, Zhaoshen Li
Digestive Endoscopy.2012; 24(5): 299. CrossRef
Natural orifice translumenal endoscopic surgery applications in clinical practice
Ross S Coomber
World Journal of Gastrointestinal Endoscopy.2012; 4(3): 65. CrossRef
The Performance of Multiple Transgastric Procedures Using the Natural Orifice Transluminal Endoscopic Surgery Technique: Is Pure NOTES Satisfactory?
Tae Jun Song, Dong Wan Seo, Su Hui Kim, Do Hyun Park, Sang Soo Lee, Sung Koo Lee, Myung-Hwan Kim
Gut and Liver.2012; 6(4): 457. CrossRef
Transvaginal Sigmoid Cancer Resection: First Case with 12 Months of Follow-Up—Technique Description
Francisco Alba Mesa, Antonio Amaya Cortijo, Jose Manuel Romero Fernandez, Andrzej L. Komorowski, Miguel Angel Sanchez Hurtado, Enrique Fernandez Ortega, Francisco Miguel Sanchez Margallo
Journal of Laparoendoscopic & Advanced Surgical Techniques.2012; 22(6): 587. CrossRef
Disinfection of the Access Orifice in NOTES: Evaluation of the Evidence Base
Mikael H. Sodergren, Philip Pucher, James Clark, David R. C. James, Jenny Sockett, Nagy Matar, Julian Teare, Guang-Zhong Yang, Ara Darzi
Diagnostic and Therapeutic Endoscopy.2011; 2011: 1. CrossRef

Laparoscopy-assisted Surgical Removal of a Retained Wireless Capsule Endoscopy: A case report.: Lee, Sang Hoon , Han, Sang Ah , Park, Chi Min , Yun, Seong Hyeon , Lee, Woo Yong , Chun, HoKyung; J Korean Soc Coloproctol. 2006;22(3):192-196.

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Abstract PDF: Occult bleeding of the gastrointestinal tract is a major cause of iron deficiency anemia. Even with endoscopic evaluation of the upper and the lower gastrointestinal tract in these patients, in 30~50% of the cases, the cause of bleeding still remains undiscovered. Wireless capsule endoscopy (WCE) is a novel method of evaluating the small bowel mucosa by using a small capsule equipped with a camera and transmission device. Complications of WCE include impaction within the gastrointestinal tract, sometimes requiring surgical removal. The authors report a case of capsule impaction in the small bowel in a patient evaluated for anemia due to occult gastrointestinal tract bleeding. The patient is a 19 year-old female with a history of anemia since age 4. The stool guaiac test was positive, but upper and lower gastrointestinal tract endoscopy showed no abnormalities, so WCE was done. A short segment of circular ulcers with lumen narrowing were seen in the distal jejunum. Seven days after ingestion of the capsule, the patient denied passage of the capsule. Small bowel enteroclysis was performed, and the capsule was seen along with a segment of lumen narrowing distal to the site of retention. Surgery was done, and upon laparoscopic examination, the entire bowel appeared normal. Retrieval of the capsule was done along with a resection of an 8 cm segment of the small bowel. Three linear ulcers were seen in the resected bowel specimen. Pathology revealed no evidence of Crohn's disease or tuberculosis. The patient is still on iron supplements, but her hemoglobin level remains stable at 11~12 g/dl.

Intraoperative Enteroscopic Total Polypectomy for the Patients with Peutz-Jeghers Syndrome.: Yoo, Sang Bum , Kim, Ik Yong , Sung, Seong Hoon , Kim, Dae Sung , Rhoe, Byoung Seon; J Korean Soc Coloproctol. 2004;20(6):405-410.

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Abstract PDF: Patients with Peutz-Jeghers syndrome often suffer complications of the polyps, such as intussusception, bowel obstruction, and bleeding. Furthermore, repeated operations may be required in some patients, which may result in short-bowel syndrome. Intraoperative enteroscopy during a laparotomy for this syndrome was introduced. This can avert multiple enterotomies and decrease bowel resection segments. We report the cases of three consecutive patients with Peutz-Jeghers syndrome who recently underwent intraoperative enteroscopy via enterotomy with successful removal of most small-bowel polyps. The large polyps of the jejunum required an enterotomy for their removal, but smaller polyps at the lower ileum were identified and removed by using intra-operative total enteroscopy. A more complete polypectomy can be performed using this technique, thus allowing patients with Peutz- Jeghers syndrome a longer interval between laparotomies and a reduction in the symptoms attributed to polyps.

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