Annals of Coloproctology

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Review

Colorectal cancer

Gut microbiome in colorectal cancer: recent advances and clinical implications: Jun Yong Han, Min Jung Kim, Ji Won Park, Seung-Yong Jeong; Ann Coloproctol. 2026;42(1):72-85. Published online February 25, 2026; DOI: https://doi.org/10.3393/ac.2026.00010.0001

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The gut microbiome is not just a bystander of colorectal carcinogenesis but is an active driver of colorectal cancer (CRC). CRC-associated microbiome contributes in the tumorigenesis through chronic inflammation, formation of toxic metabolite and genotoxins, oncogenic signal activation, immune evasion, and barrier disruption—all reinforcing a tumor microenvironment. In contrast, beneficial microbiome supports the barrier-immune-metabolic axis by maintaining mucosal integrity and balanced immune tone. Despite extensive studies of microbiome-based CRC biomarkers, microbiome-based CRC biomarkers have not been yet ready for routine clinical use due to variation across populations and lack of standardization of key steps such as sampling, analysis, cutoffs, and interpretation. Microbiome-based therapies aim to change the overall intestinal ecosystem rather than simply adding or removing single strains. At present, dietary modulation and prebiotics are considered supportive measures, while probiotics or synbiotics are in preclinical stage. Fecal microbiota transplantation (FMT) still faces important challenges in effectiveness, standardization and safety. By its role in reshaping the tumor–host immune environment, FMT is viewed as a potential option for cancer therapy after further development through well-controlled clinical trials with careful safety monitoring.

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Over and above what is visible and conventional: development of new territories in colorectal cancer management
In Ja Park
Annals of Coloproctology.2026; 42(1): 1. CrossRef

Technical Notes

Technical tips

A unique surgical approach to the management of life-threatening, obscure lower gastrointestinal bleeding: Nelson Chen, Tessa Daly, Neil Strugnell, Russell Hodgson, David Bird; Ann Coloproctol. 2024;40(5):515-518. Published online October 17, 2024; DOI: https://doi.org/10.3393/ac.2024.00101.0014

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Lower Gastrointestinal Bleeding
Saba Balvardi, Daniel Galante
Surgical Clinics of North America.2026; 106(1): 133. CrossRef

Technical tips

Transvaginal removal of rectal stromal tumor with Martius flap interposition: a feasible option for a large tumor at the anterior wall of the rectum: Weerapat Suwanthanma, Ploybutsara Kittiwetsakun, Samart Phuwapraisirisan, Pitichote Hiranyatheb; Ann Coloproctol. 2024;40(3):276-281. Published online June 26, 2024; DOI: https://doi.org/10.3393/ac.2023.00556.0079

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Abstract PDF: Neoadjuvant imatinib treatment, followed by complete transvaginal removal, presents a feasible option for large rectal gastrointestinal tumors located on the anterior wall of the rectum and protruding into the vagina. The use of Martius flap interposition is convenient and can be employed to prevent rectovaginal fistula.

Original Article

Translational/basic research

Effects of angiotensin peptides on colonic motility in rats: Gi Won Ha, Jong Hun Kim, Suhn Hee Kim; Ann Coloproctol. 2023;39(3):267-274. Published online March 30, 2022; DOI: https://doi.org/10.3393/ac.2022.00087.0012

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Abstract PDF

Purpose
Renin-angiotensin system (RAS) is involved in the pathophysiology of colonic inflammation. The aim of this study was to investigate whether small angiotensins (Angs) peptides play a role in the regulation of colonic motility and their roles are modulated in colitis.
Methods
Experimental colitis was induced by an intake of 5% dextran sulfate sodium (DSS) dissolved in tap water for 7 days in Sprague-Dawley rats. After sacrifice, plasma hormone concentrations and messenger RNAs (mRNAs) for RAS were measured. Functional analysis of colonic motility in response to Angs peptides was performed using Taenia coli.
Results
DSS-treated colon showed an increased necrosis with massive infiltration of inflammatory cells. The mRNA level of colonic angiotensin II receptor type 2 (AT2R) in DSS-treated rats was higher than that in control rats whereas the mRNA levels of angiotensin II converting enzyme (ACE), ACE2, AT1R, AT4R, and Mars receptor were not different from those in control rats. Ang III, Ang IV, and Ang-(1-9) (1, 3 μM) increased the frequency of basal colonic motility. Ang-(1-7) did not cause any significant changes in frequency and amplitude of basal motility. The order of potency for an increased frequency of basal motility seems to be Ang II>>Ang IV>Ang III=Ang-(1-9). The increased frequency of basal motility by Ang-(1-9) but not Ang IV was significantly enhanced in DSS-treated rat colon.
Conclusion
In conclusion, these data suggest that small Angs peptides are partly involved in the pathophysiological regulation of colonic motility in experimental colitis.

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Systematic-Narrative Hybrid Literature Review: Crosstalk between Gastrointestinal Renin–Angiotensin and Dopaminergic Systems in the Regulation of Intestinal Permeability by Tight Junctions
Nadia Khan, Magdalena Kurnik-Łucka, Gniewomir Latacz, Krzysztof Gil
International Journal of Molecular Sciences.2024; 25(10): 5566. 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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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.

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Beyond the Biliary Tree: A Giant Calcified Rectal Fecalith Treated With Electrohydraulic Lithotripsy
Michael Gianarakis, Ameen Taufiq, Hasan S. Raza, Omar T. Ahmed, Parth Thaker, Jesse Hartpence, Brian Boulay
ACG Case Reports Journal.2025;[Epub] CrossRef

Case Reports

Benign proctology,Complication,Biomarker & risk factor

Recurrent bleeding after posthemorrhoidectomy caused by factor V deficiency: a case report and review of the literature: Jun Seong Chung, Han Deok Kwak, Jae Kyun Ju; Ann Coloproctol. 2022;38(6):449-452. Published online July 27, 2021; DOI: https://doi.org/10.3393/ac.2021.00185.0026

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Congenital factor V (FV) deficiency is a rare hemorrhagic disorder that can cause excessive bleeding during and after surgery in the affected patient. This report is the case of a patient who had FV deficiency with recurrent posthemorrhoidectomy bleeding treated with the hemostatic procedure and fresh frozen plasma (FFP) transfusions. A 45-year-old male patient had previously undergone hemorrhoidectomy for multiple hemorrhoids at a local hospital. Hemorrhoidectomy was successful; however, he was transferred to our hospital for evaluation of the origin of the recurrent posthemorrhoidectomy bleeding and underwent a hemostatic procedure. This bleeding was treated with coagulation using electrocautery, multiple sutures, and FFP transfusion (1,600 mL/day) for 7 consecutive days. The patient’s plasma FV activity was 23%. Early detection of clotting factor deficiency in patients with hemorrhagic events after surgical treatments may prevent unnecessary procedures such as reoperations and minimize the cost of replacement therapy such as large-volume FFP transfusion.

Citations

Citations to this article as recorded by

Factor II and Factor V Deficiencies: Current Management, Care Gaps and Call to Action for Therapeutic Advances
Samantha Pasca, Massimo Franchini, Pier Mannuccio Mannucci
Haemophilia.2026;[Epub] CrossRef
Rare Inherited Coagulation Deficiencies: A Single-center Study
Özlem Terzi, Sadik Sami Hatipoğlu
Journal of Pediatric Hematology/Oncology.2025; 47(2): e90. CrossRef
Plasma/tranexamic-acid/vitamin-k

Reactions Weekly.2023; 1954(1): 383. CrossRef

Benign proctology,Rare disease & stoma

Imaging Diagnosis of Perianal Leiomyoma: A Case Report: Enrique González-Díaz, Blanca García Cengotitabengoa, Ana Belen Dominguez Carbajo, Camino Fernández Fernández, A. Fernández Corona; Ann Coloproctol. 2021;37(Suppl 1):S58-S62. Published online June 9, 2021; DOI: https://doi.org/10.3393/ac.2020.10.13.1

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Abstract PDF Supplementary Material

A leiomyoma is a benign mesenchymal neoplasm that usually develops where smooth muscle is present. In this report, we present the case of a 75-year-old woman who sought medical attention due to pelvic organ prolapse and urinary incontinence, and without defecatory symptoms. Both pelvic floor ultrasound and magnetic resonance imaging (MRI) examination showed a well-defined mass in the ischioanal fossa, eventually diagnosed as a perianal leiomyoma. It is considered a rare entity because of its location involving the anal sphincter and clinical features. We describe the ultrasonographic and MRI findings of this perianal leiomyoma, together with differential diagnoses and immunohistochemical characterization.

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Angioleiomyoma originating from the ano-rectal wall presenting as a perineal mass: a case report
Sayali Valiyeva, Elena Cicerone, Elisabetta Iacobelli, Gina R. Quaglione, Renato Pietroletti
International Journal of Colorectal Disease.2025;[Epub] CrossRef
A Case of Rectal Leiomyoma with Myxoid Degeneration
玉婷施
Advances in Clinical Medicine.2025; 15(03): 399. CrossRef
Rare giant perianal smooth muscle tumor: A case report
Yuanchao Guo, Yi Song, Xiaona Li, Houhua Liu, Tao Wei, Maowei Yang, Chaonan Zhang, Xingang Li
Journal of International Medical Research.2025;[Epub] CrossRef

Benign diesease & IBD,Rare disease & stoma

Calcium polystyrene sulfonate associated colonic mucosal injury—innocent bystander or pathogenic culprit?: a case report and literature review: Setthachai Piwchan, Ekawee Sripariwuth, Peerayut Sitthichaiyakul; Ann Coloproctol. 2022;38(6):453-456. Published online May 28, 2021; DOI: https://doi.org/10.3393/ac.2021.03.19

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Abstract PDF

Colonic mucosal injury is rare, but may severely fatal, complications following the administration of calcium polystyrene sulfonate resins. The incidence rate is about 0.57%, administered without sorbitol, and increases to 1.8% when it is concomitant with sorbitol, especially in postoperative patients. In this case report, we demonstrated the case of a 77-year-old female with stage 3b chronic kidney disease presented with in-hospital hematochezia after 3 weeks of calcium polystyrene sulfonate administration. The colonoscopic findings showed several serpiginous ulcers with some oozing at descending and sigmoid colon. The histological findings revealed some focal inflammation and ulcerations with crystal-like materials, compatible with cation exchange resins. The recent in vitro study, explaining the pathogenesis of cation exchange resin-associated colonic mucosal injury, was also reviewed.

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Crystals in the Colon: A Surprising Culprit Behind Massive GI Bleeding in End‐Stage Renal Disease
Chi Hyuk Oh, Ji Eun Kim, Chang Kyun Lee
Journal of Gastroenterology and Hepatology.2025; 40(2): 349. CrossRef
Sodium zirconium cyclosilicate (Lokelma) to enable ACEIs/ARBs use in the treatment of patients with diabetic kidney disease
Xu Hao, Jian Liu, Leyi Gu, Xiujuan Zang, Na Liu, Yangbin Pan, Chunming Jiang, Ying Li, Gengru Jiang, Zhiguo Mao, Jun Xue, Rong Zhou, Weiming Wang
Diabetes Research and Clinical Practice.2025; 227: 112413. CrossRef
Calcium Polystyrene Sulfonate Crystal-related Airway Obstruction
Hideshige Seki, Kensuke Narukawa, Yurika Mitsui, Yukari Shirasugi, Shigeki Morita, Tsuyoshi Takahashi
Internal Medicine.2024; 63(19): 2699. CrossRef
Calcium polystyrene sulfonate-induced rectal ulcer causing E. coli native-valve infective endocarditis
Shinnosuke Fukushima, Hideharu Hagiya, Hiroyuki Honda, Tomoharu Ishida, Ryohei Shoji, Kou Hasegawa, Fumio Otsuka
Clinical Journal of Gastroenterology.2024; 17(3): 472. CrossRef
Pharmacological intestinal obstruction because of calcium polystyrene sulfonate administration
Benjamin Thorpe, Salustiano Gonzalez Vinagre, Daniel Santos, Javier Caneiro Gomez, Manuel Bustamante Montalvo
Journal of Surgical Case Reports.2024;[Epub] CrossRef
Histopathological lesions of the gastrointestinal tract associated with the use of polystyrene sulfonate and sevelamer: a meta-analysis
Gianluca Di Rienzo, Pellegrino Crafa, Marco Delsante, Enrico Fiaccadori, Giuseppe Pedrazzi, Nicoletta Campanini, Emilia Corradini
Pathologica.2024; 116(4): 216. CrossRef
Calcium-polystyrene-sulfonate

Reactions Weekly.2023; 1944(1): 174. CrossRef

Original Articles

Benign proctology

Proposal for a New Score: Hemorrhoidal Bleeding Score: Nadia Fathallah, Hélène Beaussier, Gilles Chatellier, Jean Meyer, Marc Sapoval, Nadia Moussa, Vincent de Parades; Ann Coloproctol. 2021;37(5):311-317. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.08.19

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Abstract PDF

Purpose
We conducted a prospective study to evaluate a new hemorrhoidal bleeding score (HBS).
Methods
All consecutive patients who had consulted between May 1, 2016 and June 30, 2017 for bleeding hemorrhoidal disease were prospectively assessed at a proctological department. The study was conducted in 2 stages. The first stage assessed the validity of the score on a prospective patient cohort. A second stage assessed the interobserver reproducibility of the score on another prospective cohort.
Results
One hundred consecutive patients were studied (57 males; mean age, 49.70 years). A positive association between HBS and surgery indication was found (P<0.001). A cut-off value of the score of 5 (≤5 vs. >5) separated patients from surgical to medical-instrumental treatment with a sensitivity and specificity of 75.00% and 81.25%, respectively. In the multivariate analysis, only HBS was significantly associated with the operative decision (odds ratio, 12.22). Prolapse was no longer significantly associated with the surgical indication. After a mean follow-up after treatment of 7 months, HBS improved statistically significantly (P<0.0001). For the reproducibility of the score, an additional 30 consecutive patients (13 males; mean age, 53.14 years) were enrolled with an excellent agreement between 2 proctologists (kappa=0.983).
Conclusion
HBS is sensitive, specific, and reproducible. It can assess the severity of hemorrhoidal bleeding. It can discriminate between the most severe surgery-indicated patients and does so in a more efficient way than the Goligher prolapse score. It also allows quantifying the extent of change in hemorrhoidal bleeding after treatment.

Citations

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Arterial Embolization for the Internal Hemorrhoids Management: A Systematic Review
Mohammad Hossein Golezar, Hamed Ghorani, Fakhroddin Alemi, Farzad Fayedeh, Maryam Yeganegi, Samaneh Toutounchian, Hanieh Amani, Hadi Rokni Yazdi
Health Science Reports.2026;[Epub] CrossRef
The efficacy of Aescin combined with MPFF for early control of bleeding from acute hemorrhoids, A randomized controlled trial
Suwan Sanmee, Witcha Vipudhamorn, Pawit Sutharat, Ekkarin Supatrakul
Asian Journal of Surgery.2025; 48(1): 193. CrossRef
Hemorrhoidal disease: what role can rectal artery embolization play?
Julien Panneau, Diane Mege, Mathieu Di Bisceglie, Julie Duclos, Idir Khati, Vincent Vidal, Gaetano Gallo, Farouk Tradi
Frontiers in Surgery.2025;[Epub] CrossRef
Artery Embolization in the Treatment of Refractory Internal Hemorrhoids
Layth Alkhani, Jessica Stewart, Osman Ahmed
Applied Radiology.2025; 1(1): 1. CrossRef
Hemorrhoidal disease: Epidemiological study and analysis of predictive factors for surgical management
Nadia Fathallah, Amine Alam, Anne L. Rentien, Giorgio La Greca, Joshua Co, Elise Pommaret, Amélie Barré, Stéphane Kegne, Hélène Beaussier, Lucas Spindler, Vincent de Parades
Journal of Visceral Surgery.2024; 161(3): 161. CrossRef
Pathologie hémorroïdaire : étude épidémiologique et analyse des facteurs de risque de chirurgie
Nadia Fathallah, Amine Alam, Anne-Laure Rentien, Giorgio La Greca, Joshua Co, Elise Pommaret, Amélie Barré, Stéphane Kegne, Hélène Beaussier, Lucas Spindler, Vincent de Parades
Journal de Chirurgie Viscérale.2024; 161(3): 177. CrossRef
Imaging for Hemorrhoidal Disease: Navigating Rectal Artery Embolization from Planning to Follow-up
Jonathan Lindquist, James Hart, Katherine Marchak, Eduardo Bent Robinson, Premal Trivedi
Seminars in Interventional Radiology.2024; 41(03): 263. CrossRef
Russian multicenter observational HDQ study on the validation of the questionnaire for hemorrhoidal disease
Yu. A. Shelygin, Yu. M. Stoyko, Ivan V. Kostarev, E. A. Zagriadskiǐ, A. M. Bogomazov, E. B. Golovko, Yu. V. Khomitskaya, B. B. Kvasnikov, O. Zh. Linnik
Koloproktologia.2024; 23(4): 101. CrossRef
Emborrhoid technique performed on a patient with portal hypertension and chronic hemorrhoidal bleeding as a salvage therapy
Filipa Alves e Sousa, Pedro Marinho Lopes, Inês Bolais Mónica, Ana Catarina Carvalho, Pedro Sousa
CVIR Endovascular.2022;[Epub] CrossRef
Emborrhoid: Rectal Artery Embolization for Hemorrhoid Disease
Julien Panneau, Diane Mege, Mathieu Di Biseglie, Julie Duclos, Paul Habert, Vincent Vidal, Farouk Tradi
Seminars in Interventional Radiology.2022; 39(02): 194. CrossRef
Rectal Artery Embolization for Hemorrhoidal Disease: Anatomy, Evaluation, and Treatment Techniques
Julien Panneau, Diane Mege, Mathieu Di Biseglie, Julie Duclos, Paul Habert, Axel Bartoli, Vincent Vidal, Farouk Tradi
RadioGraphics.2022; 42(6): 1829. CrossRef
Treatment of Hemorrhoid in Unusual Condition-Pregnancy
Hyo Seon Ryu
The Ewha Medical Journal.2022;[Epub] CrossRef
Hemorrhoid embolization: A review of current evidences
Reza Talaie, Pooya Torkian, Arash Dooghaie Moghadam, Farouk Tradi, Vincent Vidal, Marc Sapoval, Jafar Golzarian
Diagnostic and Interventional Imaging.2021;[Epub] CrossRef

Benign GI diease, Inflammatory bowel disease

Clinical Characteristics and Postoperative Outcomes of Patients Presenting With Upper Gastrointestinal Tract Crohn Disease: Joon Suk Moon, Jong Lyul Lee, Chang Sik Yu, Seok-Byung Lim, In Ja Park, Yong Sik Yoon, Chan Wook Kim, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park, Hassan Abdullah Alsaleem, Jin Cheon Kim; Ann Coloproctol. 2020;36(4):243-248. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.10.16.1

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Abstract PDF

Purpose
Upper gastrointestinal (GI) tract involvement in Crohn disease (CD) is rare and effectiveness of surgical treatment is limited. The aim of this study was to evaluate characteristics and surgical outcomes of upper GI CD.
Methods
Medical records of 811 patients who underwent intestinal surgery for CD between January 2006 and December 2015 at a single institution were reviewed. Upper GI CD was defined by involvement of the stomach to the fourth portion of duodenum, with or without concomitant small/large bowel CD involvement according to a modification of the Montreal classification.
Results
We identified 24 patients (21 males, 3 females) who underwent surgery for upper GI CD. The mean age at diagnosis was 27 ± 12 years, the mean age at surgery was 33 ± 11 years, and the mean duration of CD was 73.6 ± 56.6 months. Fifteen patients (62.5%) had history of previous perianal surgery. Ten patients (41.7%) had duodenal or gastric stricture and 14 patients (58.3%) had penetrating fistula; patients with fistula were significantly more likely to develop complications (57.1% vs. 20.0%, P = 0.035). One patient with stricture had surgical recurrence. In seven patients with fistula, fistula was related to previous anastomosis. Patients with fistula had significantly longer hospital stays than those with stricture (16 days vs. 11 days, P = 0.01).
Conclusion
Upper GI CD is rare among CD types (2.96%). In patients with upper GI CD, penetrating fistula was associated with longer hospital stay and more complications.

Citations

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Diagnosis and Management of Upper Gastrointestinal Involvement in Adult Patients With Crohn’s Disease: A Systematic Review
Nathaniel A. Cohen, Neta Sror, Maliha Naseer, Dominik Bettenworth, Cathy Lu, Raneem Khedraki, Maria T. Abreu, Raja Atreya, Badr Al-Bawardy, Susan J. Connor, Geert d’Haens, Iris Dotan, Axel Dignass, Sara El Ouali, Brian Feagan, Roger Feakins, Richard Gearr
Clinical Gastroenterology and Hepatology.2026; 24(4): 932. CrossRef
Definitions, diagnosis, management, and outcomes of upper gastrointestinal Crohn's disease: an international, expert RAND/UCLA appropriateness study
Nathaniel A Cohen, Dominik Bettenworth, Neta Sror, Raneem Khedraki, Qijun Yang, Maria T Abreu, Raja Atreya, Badr Al-Bawardy, Susan J Connor, Geert D'Haens, Iris Dotan, Axel Dignass, Sara El Ouali, Brian Feagan, Roger Feakins, Richard Gearry, Ilyssa O Gord
The Lancet Gastroenterology & Hepatology.2026; 11(3): 243. CrossRef
Upper Gastrointestinal Crohn’s Disease: Shedding Light on the Obscure L4 Classification Meaning
Francesca Lusetti, Cristina Bezzio, Alice De Bernardi, Michele Puricelli, Gianpiero Manes, Simone Saibeni
Journal of Clinical Medicine.2025; 14(22): 8260. CrossRef
Update S2k-Guideline Helicobacter pylori and gastroduodenal ulcer disease of the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS)
Wolfgang Fischbach, Jan Bornschein, Jörg C. Hoffmann, Sibylle Koletzko, Alexander Link, Lukas Macke, Peter Malfertheiner, Kerstin Schütte, Dieter-Michael Selgrad, Sebastian Suerbaum, Christian Schulz
Zeitschrift für Gastroenterologie.2024; 62(02): 261. CrossRef
Aktualisierte S2k-Leitlinie Helicobacter pylori und gastroduodenale Ulkuskrankheit der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – Juli 2022 – AWMF-Registernummer: 021–001

Zeitschrift für Gastroenterologie.2023; 61(05): 544. CrossRef
A systematic review and meta‐analysis of prevalence and clinical features of upper gastrointestinal (UGI) tract Crohn's disease in adults compared to non‐UGI types
Babak Tamizifar, Peyman Adibi, Maryam Hadipour, Vahid Mohamadi
JGH Open.2023; 7(5): 325. CrossRef
Upper gastrointestinal tract involvement of Crohn disease: clinical implications in children and adolescents
Eun Sil Kim, Mi Jin Kim
Clinical and Experimental Pediatrics.2022; 65(1): 21. CrossRef
Profiling non-coding RNA levels with clinical classifiers in pediatric Crohn’s disease
Ranjit Pelia, Suresh Venkateswaran, Jason D. Matthews, Yael Haberman, David J. Cutler, Jeffrey S. Hyams, Lee A. Denson, Subra Kugathasan
BMC Medical Genomics.2021;[Epub] CrossRef
Surgical Treatment of Upper Gastrointestinal Tract Crohn Disease: A Long Way to Go to Identify the Optimal Method
Soo Yeun Park
Annals of Coloproctology.2020; 36(4): 207. CrossRef

Review

Differences Regarding the Molecular Features and Gut Microbiota Between Right and Left Colon Cancer: Kwangmin Kim, Ernes John T. Castro, Hongjin Shim, John Vincent G. Advincula, Young-Wan Kim; Ann Coloproctol. 2018;34(6):280-285. Published online December 31, 2018; DOI: https://doi.org/10.3393/ac.2018.12.17

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Abstract PDF

For many years, developmental and physiological differences have been known to exist between anatomic segments of the colorectum. Because of different outcomes, prognoses, and clinical responses to chemotherapy, the distinction between right colon cancer (RCC) and left colon cancer (LCC) has gained attention. Furthermore, variations in the molecular features and gut microbiota between right and LCCs have recently been a hot research topic. CpG island methylator phenotype-high, microsatellite instability-high colorectal cancers are more likely to occur on the right side whereas tumors with chromosomal instability have been detected in approximately 75% of LCC patients and 30% of RCC patients. The mutation rates of oncogenes and tumor suppressor genes also differ between RCC and LCC patients. Biofilm is more abundant in RCC patients than LLC patients, as are Prevotella, Selenomonas, and Peptostreptococcus. Conversely, Fusobacterium, Escherichia/Shigella, and Leptotrichia are more abundant in LCC patients compared to RCC patients. Distinctive characteristics are apparent in terms of molecular features and gut microbiota between right and LCC. However, how or to what extent these differences influence diverging oncologic outcomes remains unclear. Further clinical and translational studies are needed to elucidate the causative relationship between primary tumor location and prognosis.

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Clostridioides difficile: A suspected pro-carcinogenic bacterium for gastrointestinal tumors
Ju Zou, Biyue Tian, Yuanyuan Xiao, Anhua Wu, Chunhui Li
Chinese Medical Journal.2026; 139(1): 7. CrossRef
From laboratory bench to surgical room: Molecular profiling and single-cell technologies in precision surgery for colorectal cancer patients
Maria Teresa De Angelis, Gianluca Santamaria, Angela Amaddeo, Antonio Maria Iannello, Giuseppe Viglietto, Antonia Rizzuto
Surgical Oncology.2026; 65: 102382. CrossRef
Clinicopathological Features of Right vs. Left Colorectal Carcinomas: Do the Differences Really Matter?
Aura Jurescu, Alis Dema, Sorina Tăban, Robert Barna, Adrian Ovidiu Văduva, Octavia Vița, Remus Cornea, Dorela-Codruța Lăzureanu, Anca Mureșan, Mărioara Cornianu, Bianca Natarâș, Ioana Hurmuz, Adelina Vidac, Sorin Dema
Life.2026; 16(2): 242. CrossRef
Distinct clinical and microbial profiles in left-sided and right-sided colorectal cancer: a comprehensive analysis
Jianjiong Li, Buyuan Dong, Cezar M. Khursigara
Microbiology Spectrum.2026;[Epub] CrossRef
Integrating E-cadherin expression levels with TNM staging for enhanced prognostic prediction in colorectal cancer patients
Jae-Ghi Lee, Ilkyu Park, Hannah Lee, Seungyoon Nam, Jisup Kim, Won-Suk Lee, Myunghee Kang, Jung Ho Kim
BMC Cancer.2025;[Epub] CrossRef
The Gut Microbiota and Colorectal Cancer: Understanding the Link and Exploring Therapeutic Interventions
Imen Zalila-Kolsi, Dhoha Dhieb, Hussam A. Osman, Hadjer Mekideche
Biology.2025; 14(3): 251. CrossRef
Diagnostic utility of the preoperative cachexia index for malnutrition in colorectal cancer: A prospective cohort study
Katarzyna Chawrylak, Wojciech Górski, Katarzyna Sędłak, Radoslaw Mlak, Marta Kaus, Agnieszka Hotloś, Zuzanna Chilimoniuk, Konrad Gładysz, Katarzyna Mielniczek, Magdalena Leśniewska, Zuzanna Pelc, Michał Bednarz, Wiktor Grela, Natalia Gniaź, Aleksandra Gór
Surgical Oncology.2025; 62: 102275. CrossRef
Differences in the expression of CMTM3 and SSTR2 genes in right and left colon tumors: A molecular insight into colorectal cancer
Tuğçe Binen, Etem Akbaş, Tahsin Çolak, Tuba Kara, Aslıhan Bakır, Badel İnce
Medical Oncology.2025;[Epub] CrossRef
Distinctive chromosomal, mutational and transcriptional profiling in colon versus rectal cancers
Maria Teresa De Angelis, Antonia Rizzuto, Angela Amaddeo, Carlo Sagnelli, Niccolò Vono, Michela Reda, Valentina Lise, Luca Parrillo, Carmela De Marco, Donatella Malanga, Gianluca Santamaria, Giuseppe Viglietto
Journal of Translational Medicine.2025;[Epub] CrossRef
Oral microbiota analysis of tongue coating in patients with esophageal adenocarcinoma
Huijie Wang, Jinfeng Wang, Jinli Liu, Xiaoyang Shi, Zhichao Wang, Xu Cao
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Genetic, Epidemiological, Clinical, and Therapeutic Trajectories in Colon and Rectal Cancers
Maurizio Capuozzo, Carmine Picone, Francesco Sabbatino, Mariachiara Santorsola, Francesco Caraglia, Domenico Iervolino, Roberto Sirica, Oreste Gualillo, Giordana Di Mauro, Rosa Castiello, Monica Ianniello, Alessia Maria Cossu, Angela Nebbioso, Lucia Altuc
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Case Reports

Abdominosacral Resection in the Management of Large-Size Retrorectal Tumors: A Report of 2 Rare Cases: Yuda Handaya, Sutamto Wibowo; Ann Coloproctol. 2018;34(5):271-276. Published online October 10, 2018; DOI: https://doi.org/10.3393/ac.2017.12.01

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Abstract PDF: Management of large-size retrorectal gastrointestinal stromal tumors (GISTs) is complex and challenging from diagnosis to treatment. This may create technical difficulties in surgical access and complete resection of the tumor. The abdominosacral resection has the benefit of improved visualization via the anterior incision, with enhanced exposure of the midrectal area, which makes resecting the tumor completely via the posterior approach easier. We report 2 cases of patients with a retrorectal GIST and neurofibromatosis type 1, one in a 27-year-old woman with a defecation complaint and the other in a 58-year-old woman with a defecation and urination complaint. Based on the anatomical pathology, both patients were diagnosed with a GIST. The tumors were excised via an abdominosacral resection. Retrorectal GISTs are rare, and abdominosacral resection allows complete resection of a large-size retrorectal GIST with low morbidity and an absence of functional impairment. The abdominosacral resection should be considered in certain situations.

A Granular Cell Tumor of the Rectum: A Case Report and Review of the Literature: Seung Yoon Yang, Byung Soh Min, Woo Ram Kim; Ann Coloproctol. 2017;33(6):245-248. Published online December 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.6.245

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Abstract PDF

A granular cell tumor (GCT) is an uncommon mesenchymal lesion that rarely occurs in the colon and the rectum. We describe the case of 51-year-old man with a 2-cm-sized rectal GCT 10 cm above the anal verge that was incidentally detected after a screening colonoscopy. Preoperative radiologic studies demonstrated a suspicious submucosal rectal mass with mesorectal fat infiltration, but without circumferential resection margin threatening, extramural vessel invasion, and regional lymph-node enlargement. The tumor was resected by using a transanal endoscopic operation (TEO) without immediate postoperative complications. The final pathology revealed that the tumor consisted of a GCT that had invaded the subserosa with clear margins. It had no other risk factors for malignancy according to Fanburg-Smith criteria. We systematically reviewed the English literature by using PubMed and Google Scholar. This report may be the first documented case in the literature to describe a TEO for a GCT that had invaded the subserosa in the rectum.

Citations

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Granular Cell Tumor of the Anal Canal: Case Report and Literature Review
Jorge Arche Prats, Diego García Prado, Gonzalo Campaña Villegas, Mónica Martínez Mardónez
Journal of Coloproctology.2024; 44(04): e281. CrossRef
Rectal Granular Cell Carcinoma Requiring Abdominoperineal Resection
Michaelia S. Sunderland, Anthony Dakwar, Sowsan Rasheid
The American Surgeon™.2023; 89(4): 1304. CrossRef
Experience of surgical treatment in a granular cell tumor in the qscending colon: a case report
In-Kyeong Kim, Young-Tae Ju, Han-Gil Kim, Jin-Kwon Lee, Dong-Chul Kim, Jae-Myung Kim, Jin Kyu Cho, Ji-Ho Park, Ju-Yeon Kim, Chi-Young Jeong, Soon-Chan Hong, Seung-Jin Kwag
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Granular cell tumour. Case report.
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Granular cell tumor of the perineum (clinical case)
R. R. Shakirov, O. Yu. Karpukhin, M. I. Ziganshin, I. S. Raginov
Koloproktologia.2023; 22(4): 121. CrossRef
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Saman Anwar Wahid, Han N. Mohammed Fadhl, Alaa Abbas Ali, Rebaz Karim Mohammed
Urology Case Reports.2022; 42: 102034. CrossRef
Granular cell tumor of the cecum
Roberto Cantella, Giuseppe Evola, Carla Di Stefano, Ezio Trusso Zirna, Marianna Iudica, Luigi Piazza
International Journal of Surgery Case Reports.2021; 87(C): 106397. CrossRef
Granular Cell Tumor of the Perianal Region
Marina Pérez-Flecha González, Enrique Revilla Sánchez, Carolina Ibarrola de Andrés, Ramón Gómez Sanz
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Hematochezia due to Angiodysplasia of the Appendix: Je-Min Choi, Seung-Hun Lee, Seung-Hyun Lee, Byung-Kwon Ahn, Sung-Uhn Baek; Ann Coloproctol. 2016;32(3):117-119. Published online June 30, 2016; DOI: https://doi.org/10.3393/ac.2016.32.3.117

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Abstract PDF

Common causes of lower gastrointestinal bleeding include diverticular disease, vascular disease, inflammatory bowel disease, neoplasms, and hemorrhoids. Lower gastrointestinal bleeding of appendiceal origin is extremely rare. We report a case of lower gastrointestinal bleeding due to angiodysplasia of the appendix. A 72-year-old man presented with hematochezia. Colonoscopy showed active bleeding from the orifice of the appendix. We performed a laparoscopic appendectomy. Microscopically, dilated veins were found at the submucosal layer of the appendix. The patient was discharged uneventfully. Although lower gastrointestinal bleeding of appendiceal origin is very rare, clinicians should consider it during differential diagnosis.

Citations

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Dieulafoy's Disease Causing Appendiceal Hemorrhage: A Case Report
Ruitao Liu, Yang Yan, Guibing Chen
Cureus.2025;[Epub] CrossRef
Appendiceal bleeding caused by vascular malformation: A case report
Qin Ma, Jin-Jie Du
World Journal of Clinical Cases.2024; 12(14): 2457. CrossRef
Appendiceal bleeding, a rare yet important cause of lower gastrointestinal bleed
Ayman Tabcheh, Johny Salem, Karim Zodeh, Ammar Ghazale
European Journal of Case Reports in Internal Medicine.2024;[Epub] CrossRef
A rare case of appendiceal haemorrhage causing life-threatening haematochezia
Howard H Y Tang, Daming Pan, Andrew Fitzdowse, Aaron Ow, Stephen Chan, Jason S C Tan
Journal of Surgical Case Reports.2024;[Epub] CrossRef
Beyond the Usual Suspects: Appendiceal Bleeding as the Surprising Cause of Lower Gastrointestinal (GI) Bleeding
Asher Siddiqui, Nowera Zafar, Mahdi Hakiminezhad, Zohaib Jamal, Imran Alam, Zeeshan Khawaja
Cureus.2024;[Epub] CrossRef
WITHDRAWN: Appendiceal bleeding caused by vascular malformation: A case report and literature review
Qin Ma, Jinjie Du
International Journal of Surgery Case Reports.2023; : 108903. CrossRef
Clinical features, treatments and prognosis of appendiceal bleeding: a case series study
Xiao-cun Xing, Jin-lin Yang, Xue Xiao
BMC Gastroenterology.2023;[Epub] CrossRef
Angiodysplasia of the appendix: a diagnostic challenge and the importance of colonoscopy
Obiajulu Johnson, Naomi Mackenzie, Jamil Choudhury, Sanjay Furtado
BMJ Case Reports.2023; 16(12): e255498. CrossRef
Appendiceal bleeding: A case report
Sheng-Yue Zhou, Mao-Dong Guo, Xiao-Hua Ye
World Journal of Clinical Cases.2022; 10(18): 6314. CrossRef
Appendiceal bleeding in an elderly male: a case report and a review of the literature
Yuto Maeda, Seiya Saito, Mayuko Ohuchi, Yuka Tamaoki, Jiro Nasu, Hideo Baba
Surgical Case Reports.2021;[Epub] CrossRef
Acute Eosinophilic Appendicitis: A Rare Cause of Lower Gastrointestinal Hemorrhage
So Ra Ahn, Joo Hyun Lee
The Korean Journal of Gastroenterology.2021; 78(2): 134. CrossRef
Appendix bleeding with painless bloody diarrhea: A case report and literature review
Wanqun Chen, Hong Qiu, Xiaojun Yang, Jinwei Zhang
Open Medicine.2019; 14(1): 735. CrossRef

An Extragastrointestinal Stromal Tumor in the Omentum With Peritoneal Seeding Mimicking an Appendiceal Mucinous Cancer With Carcinomatosis: Jeonghyun Kang, Tae Joo Jeon, Sun Och Yoon, Kang Young Lee, Seung-Kook Sohn; Ann Coloproctol. 2014;30(2):93-96. Published online April 25, 2014; DOI: https://doi.org/10.3393/ac.2014.30.2.93

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6 Citations

Abstract PDF

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. These tumors tend to present most frequently in the stomach, followed by the small intestine. GISTs can also arise from the omentum, retroperitoneum, mesentery, or pleura and are termed extragastrointestinal stromal tumors (EGISTs) when they do so. EGISTs arising from the omentum are very rare. Due to the limited incidence of EGISTs in the omentum, the diagnostic criteria are not well established, and making a correct diagnosis may be difficult. In this report, we present a case of an EGIST of the omentum with peritoneal metastasis that was initially suspected to be an appendiceal mucinous carcinoma with carcinomatosis on positron emission tomography/computed tomography imaging.

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An update on gastrointestinal stromal tumors (GISTs) with a focus on extragastrointestinal stromal tumors (EGISTs)
Fatima Usama, Rohullah Rasikh, Khawaja Hassam, Mansoor Rahman, FNU Khalil Ur Rehman, Iman Waheed Khan, Daryl T -Y Lau
Gastroenterology Report.2025;[Epub] CrossRef
Primary Extragastrointestinal Stromal Tumor of Greater Omentum with Intraperitoneal Bleeding
Masatoshi Kataoka, Tsukasa Saitoh, Kousaku Kawashima, Tomotaka Yazaki, Hiroki Sonoyama, Eiko Okimoto, Akihiko Oka, Yoshiyuki Mishima, Tsuyoshi Mishiro, Naoki Oshima, Kotaro Shibagaki, Hiroshi Tobita, Ichiro Moriyama, Norihisa Ishimura, Mamiko Nagase, Nori
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Extra-gastrointestinal stromal tumour. Report of primary tumour in the omentum
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Original Article

The Safety and Efficacy of Mesenteric Embolization in the Management of Acute Lower Gastrointestinal Hemorrhage: Ker-Kan Tan, David Hugh Strong, Timothy Shore, Mohammmad Rafei Ahmad, Richard Waugh, Christopher John Young; Ann Coloproctol. 2013;29(5):205-208. Published online October 31, 2013; DOI: https://doi.org/10.3393/ac.2013.29.5.205

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Abstract PDF

Purpose

Mesenteric embolization is an integral part in the management of acute lower gastrointestinal (GI) bleeding. The aim of this study was to highlight our experience after adopting mesenteric embolization in the management of acute lower GI hemorrhage.

Methods

A retrospective review of all cases of mesenteric embolization for acute lower GI bleeding from October 2007 to August 2012 was performed.

Results

Twenty-seven patients with a median age of 73 years (range, 31 to 86 years) formed the study group. More than half (n = 16, 59.3%) of the patients were on either antiplatelet and/or anticoagulant therapy. The underlying etiology included diverticular disease (n = 9), neoplasms (n = 5) and postprocedural complications (n = 6). The colon was the most common bleeding site and was seen in 21 patients (left, 10; right, 11). The median hemoglobin prior to the embolization was 8.6 g/dL (6.1 to 12.6 g/dL). A 100% technical success rate with immediate cessation of hemorrhage at the end of the session was achieved. There were three clinical failures (11.1%) in our series. Two patients re-bled, and both underwent a successful repeat embolization. The only patient who developed an infarcted bowel following embolization underwent an emergency operation and died one week later. There were no factors that predicted clinical failure.

Conclusion

Mesenteric embolization for acute lower GI bleeding can be safely performed and is associated with a high clinical success rate in most patients. A repeat embolization can be considered in selected cases, but postembolization ischemia is associated with bad outcomes.

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Kathryn Oakland, Georgina Chadwick, James E East, Richard Guy, Adam Humphries, Vipul Jairath, Simon McPherson, Magdalena Metzner, A John Morris, Mike F Murphy, Tony Tham, Raman Uberoi, Andrew McCulloch Veitch, James Wheeler, Cuthbert Regan, Jonathan Hoare
Gut.2019; 68(5): 776. CrossRef
Making decisions using radiology in lower GI hemorrhage
Assad Zahid, Christopher John Young
International Journal of Surgery.2016; 31: 100. CrossRef
Transcatheter Arterial Embolization for Gastrointestinal Bleeding Secondary to Gastrointestinal Lymphoma
Lin Zheng, Ji Hoon Shin, Kichang Han, Jiaywei Tsauo, Hyun-Ki Yoon, Gi-Young Ko, Jong-Soo Shin, Kyu-Bo Sung
CardioVascular and Interventional Radiology.2016; 39(11): 1564. CrossRef
Study protocol: first nationwide comparative audit of acute lower gastrointestinal bleeding in the UK
Kathryn Oakland, Richard Guy, Raman Uberoi, Frances Seeney, Gary Collins, John Grant-Casey, Neil Mortensen, Mike Murphy, Vipul Jairath
BMJ Open.2016; 6(8): e011752. CrossRef
Diverticular Disease: Changing Epidemiology and Management
Roshan Razik, Geoffrey C. Nguyen
Drugs & Aging.2015; 32(5): 349. CrossRef
Mesenteric Embolization: Is It Safe in Patients With Acute Lower Gastrointestinal Hemorrhage?
Dong Won Lee, Seon Hahn Kim
Annals of Coloproctology.2013; 29(5): 181. CrossRef

Case Reports

A Case of Sigmoid Colon Tuberculosis Mimicking Colon Cancer: Seong-Min Yu, Jong-Hwan Park, Min-Dae Kim, Hee-Ryong Lee, Peel Jung, Tae-Hyun Ryu, Seung-Ho Choi, Il-Seon Lee; J Korean Soc Coloproctol. 2012;28(5):275-277. Published online October 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.5.275

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Abstract PDF

Tuberculosis of the sigmoid colon is a rare disorder. An 80-year-old man visited Bongseng Memorial Hospital for medical examination. A colonoscopy was performed, and a lesion in the sigmoid colon that was suspected to be colon cancer was found. A biopsy was performed, and tuberculous enteritis with chronic granulomatous inflammation was diagnosed. Intestinal tuberculosis is most frequent in the ileocecal area, followed by the ascending colon, transverse colon, duodenum, stomach, and sigmoid colon, in descending order. Hence, we report a case of intestinal tuberculosis in the sigmoid colon, which is rare and almost indistinguishable from colon cancer.

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Fernando Arevalo, Soledad Rayme, Rocío Ramírez, Romy Rolando, Jaime Fustamante, Mario Monteghirfo, Rocio Chavez, Eduardo Monge
BMC Gastroenterology.2024;[Epub] CrossRef
Infections in the gastrointestinal tract that can mimic malignancy
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Diagnostic Histopathology.2022; 28(10): 435. CrossRef
Colonic Tuberculosis Mimicking Ascending Colon Neoplasm: A Case Report
Ni Nyoman Ayu Widyanti, Wayan Wahyu Semara Putra, Ni Made Dwita Yaniswari, Novitasari, Kadek Agus Suhardinatha P
European Journal of Medical and Health Sciences.2022; 4(6): 28. CrossRef
Left-Sided Colonic Tuberculosis Presenting as Colonic Stricture: A Rare Presentation of a Common Disease
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ACG Case Reports Journal.2022; 9(11): e00928. CrossRef
More Than Just a Polyp: Diagnosis of Tuberculosis From a Screening Colonoscopy
Adham E Obeidat, Thomas Namiki, Traci T Murakami
Cureus.2021;[Epub] CrossRef
“MUCINOUS ADENOCARCINOMA OF COLON MIMICKING CYSTIC LYMPHANGIOMA: REPORT OF AN UNUSUAL PRESENTATION WITH BRIEF REVIEW OF LITERATURE.”
Manjari Kishore, Prajwala Gupta, Purnima Malhotra, Minakshi Bhardwaj
GLOBAL JOURNAL FOR RESEARCH ANALYSIS.2021; : 201. CrossRef
Case of extra-pulmonary tuberculosis mycobacterium mimicking a colon cancer
Jordan Powell, Michael Bath, Heman Joshi, Michael Machesney
BMJ Case Reports.2020; 13(5): e235486. CrossRef
Tuberculous Enteritis: A Rare Complication of Miliary Tuberculosis
Danisha Figueroa, Nilmarie Guzman, Carmen Isache
Case Reports in Infectious Diseases.2016; 2016: 1. CrossRef
Gastrointestinal Tuberculosis
Eric H. Choi, Walter J. Coyle, David Schlossberg
Microbiology Spectrum.2016;[Epub] CrossRef
Tuberculosis intestinal que simula carcinoma colorrectal diseminado
José Miguel García-Castro, Rosario Javier-Martínez, Manuel López-Gómez, Carmen Hidalgo-Tenorio, Miguel Ángel López-Ruz, Juan Jiménez-Alonso
Gastroenterología y Hepatología.2013; 36(7): 461. CrossRef

Efficacy of Imatinib Mesylate Neoadjuvant Treatment for a Locally Advanced Rectal Gastrointestinal Stromal Tumor: Kyu Jong Yoon, Nam Kyu Kim, Kang Young Lee, Byung Soh Min, Hyuk Hur, Jeonghyun Kang, Sarah Lee; J Korean Soc Coloproctol. 2011;27(3):147-152. Published online June 30, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.3.147

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10 Citations

Abstract PDF

Surgery is the standard treatment for a primary gastrointestinal stromal tumor (GIST); however, surgical resection is often not curative, particularly for large GISTs. In the past decade, with imatinib mesylate (IM), management strategies for GISTs have evolved significantly, and now IM is the standard care for patients with locally advanced, recurrent or metastatic GISTs. Adjuvant therapy with imatinib was recently approved for use, and preoperative imatinib is an emerging treatment option for patients who require cytoreductive therapy. IM neoadjuvant therapy for primary GISTs has been reported, but there is no consensus on the dose of the drug, the duration of treatment and the optimal time of surgery. These are critical because drug resistance or tumor progression can develop with a prolonged treatment. This report describes two cases of large rectal malignant GISTs, for which a abdominoperineal resection was initially anticipated. The two patients received IM preoperative treatment; we followed-up with CT or magnetic resonance imaging to access the response. After 9 months of treatment, a multi-disciplinary consensus that maximal benefit from imatinib had been achieved was reached. We determined the best time for surgical intervention and successfully performed sphincter-preserving surgery before resistance to imatinib or tumor progression occurred. We believe that a multidisciplinary team approach, considerating the optimal duration of therapy and the timing of surgery, is required to optimize treatment outcome.

Citations

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Safety, effectiveness and the optimal duration of preoperative imatinib in locally advanced gastric gastrointestinal stromal tumors: A retrospective cohort study
Xiangfei Sun, Xiaohan Lin, Qiang Zhang, Chao Li, Ping Shu, Xiaodong Gao, Kuntang Shen
Cancer Medicine.2024;[Epub] CrossRef
Clinicopathological and Immunohistochemical Characterization of Gastrointestinal Stromal Tumour at Four Tertiary Health Centers in Nigeria Using CD117, DOG1, and Human Epidermal Growth Factor Receptor-2 Biomarkers
Mumini Wemimo Rasheed, Afolayan Enoch Abiodun, Uchechukwu Brian Eziagu, Najeem Adedamola Idowu, Abdullahi Kabiru, Taiwo Adeyemi Adegboye, Waheed Akanni Oluogun, Adekunle Adebayo Ayoade
Annals of African Medicine.2023; 22(4): 501. CrossRef
Open transanal resection of low rectal stromal tumor following neoadjuvant therapy of imatinib mesylate: Report of 11 cases and review of literature
Qiang Sun, Ning Su, Xinxing Li, Zhiqian Hu, Weijun Wang
Asia-Pacific Journal of Clinical Oncology.2020; 16(3): 123. CrossRef
Using endoscopy to minimize the extent of resection in the management of giant GISTs of the stomach
Hishaam Ismael, Yury Ragoza, Steven Cox
International Journal of Surgery Case Reports.2017; 36: 26. CrossRef
Combined Therapy of Gastrointestinal Stromal Tumors
Piotr Rutkowski, Daphne Hompes
Surgical Oncology Clinics of North America.2016; 25(4): 735. CrossRef
Indications for surgery in advanced/metastatic GIST
Samuel J. Ford, Alessandro Gronchi
European Journal of Cancer.2016; 63: 154. CrossRef
Surgical treatment of gastrointestinal stromal tumour of the rectum in the era of imatinib
M J Wilkinson, J E F Fitzgerald, D C Strauss, A J Hayes, J M Thomas, C Messiou, C Fisher, C Benson, P P Tekkis, I Judson
British Journal of Surgery.2015; 102(8): 965. CrossRef
Intolerance to Imatinib in Gastrointestinal Stromal Tumors: A Case Report and a Review of Literature
Yousra Akasbi, Samia Arifi, Sami Aziz Brahmi, Fatima Zahra El Mrabet, Nawfel Mellas, Fatima Zahra Mernisi, Omar El Mesbahi
Journal of Gastrointestinal Cancer.2014; 45(S1): 71. CrossRef
Primary localized rectal/pararectal gastrointestinal stromal tumors: results of surgical and multimodal therapy from the French Sarcoma group
Thanh-Khoa Huynh, Pierre Meeus, Philippe Cassier, Olivier Bouché, Sophie Lardière-Deguelte, Antoine Adenis, Thierry André, Julien Mancini, Olivier Collard, Michael Montemurro, Emmanuelle Bompas, Maria Rios, Nicolas Isambert, Didier Cupissol, Jean-Yves Bla
BMC Cancer.2014;[Epub] CrossRef
Neoadjuvant Imatinib in Locally Advanced Gastrointestinal Stromal Tumors (GIST): The EORTC STBSG Experience
Piotr Rutkowski, Alessandro Gronchi, Peter Hohenberger, Sylvie Bonvalot, Patrick Schöffski, Sebastian Bauer, Elena Fumagalli, Pawel Nyckowski, Buu-Phuc Nguyen, Jan Martijn Kerst, Marco Fiore, Elzbieta Bylina, Mathias Hoiczyk, Annemieke Cats, Paolo G. Casa
Annals of Surgical Oncology.2013; 20(9): 2937. CrossRef

Original Articles

Clinicopathological Features of Primary Jejunoileal Tumors: Chang Hyun Kim, Bong Hyeon Kye, Jae Im Lee, Soo Hong Kim, Hyung Jin Kim, Won Kyung Kang, Seong Taek Oh; J Korean Soc Coloproctol. 2010;26(5):334-338. Published online October 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.5.334

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Abstract PDF

Purpose

Tumors of the small bowel are rare, accounting for about 3-6% of all gastrointestinal neoplasms, though they cover more than 90% of the intestinal surface. However, diagnosis and treatment are difficult and present an ongoing challenge for both gastrointestinal surgeons and gastroenterologists. The aim of this study was to investigate the clinical features of small bowel tumors.

Methods

Between November 1994 and November 2007, 81 patients underwent treatments for primary tumors in the jejuno-ileal region at the Department of Surgery, Kangnam St. Mary's Hospital, the Catholic University of Korea. A retrospective review of the patients' characteristics and variable tumor factors was performed.

Results

The mean age of the patients was 53.2 years with 48 men and 33 women. The most common symptom was abdominal pain (59.3%), followed by bleeding (22.2%) and an abdominal mass (6.2%). We found that the patients with ileal tumors complained mainly of abdominal pain (72.9%) whereas the patients with jejunal tumors presented with gastrointestinal bleeding (36.4%) (P = 0.048). Seventy-six of the 81 patients (93.8%) had malignant tumors, including 40 (49.4%) gastrointestinal stromal tumors, 26 (32.1%) lymphomas and 5 (6.2%) adenocarcinomas. No postoperative mortalities were observed. The overall 5-year survival rate of the patients with malignant small bowel tumors was 31.8%.

Conclusion

Because the clinical features of a primary tumor of the small bowel are obscure and its diagnosis is difficult, maintaining a high degree of suspicion and recognizing the possibility of a primary small bowel tumor are important.

Citations

Citations to this article as recorded by

Symptoms Contributing to the Diagnosis of Small Bowel Tumors
Kozo Tsuruta, Hidetoshi Takedatsu, Shinichiro Yoshioka, Masahiro Yoshikai, Kensuke Tomiyasu, Masaru Morita, Kotaro Kuwaki, Keiichi Mitsuyama, Takumi Kawaguchi
Digestion.2023; 104(6): 430. CrossRef
Clinicopathologic features, surgical treatments and outcomes of small bowel tumors
Anh Doanh Nguyen, Tu Hoang Le
Vietnam Journal of Endolaparoscopic Surgey.2022;[Epub] CrossRef
Clinicopathological Features of Small Bowel Tumors Diagnosed by Video Capsule Endoscopy and Balloon-Assisted Enteroscopy: A Single Center Experience
Ah Young Yoo, Beom Jae Lee, Won Shik Kim, Seong Min Kim, Seung Han Kim, Moon Kyung Joo, Hyo Jung Kim, Jong-Jae Park
Clinical Endoscopy.2021; 54(1): 85. CrossRef
Small Bowel Adenocarcinoma – Report of Two Cases and Review of Literature
Philip Umman, Vineeth Adiyodi, Chanchal Narayan
Indian Journal of Surgery.2013; 75(2): 123. CrossRef
Les tumeurs malignes primitives de l’intestin grêle : à propos de 11 cas
A. Farouk, A. Diffaa, R. Hafidi, F. Hlili, K. Krati
Journal Africain d'Hépato-Gastroentérologie.2012; 6(4): 284. CrossRef
A Gastrointestinal Stromal Tumor Presenting as an Emergency: a Case Report
Konstantinos Bouliaris, Aikaterini Michopoulou, Konstantinos Spanos, Vassilios Simopoulos, Ioannis Bolanis, Stylianos Germanos
Journal of Gastrointestinal Cancer.2012; 43(S1): 178. CrossRef

Changes in Migrating Motor Complex after Bowel Obstruction in the Murine Ileum.: Moon, Sang Hui , Oh, Heung Kwon , Ryoo, Seungbum , Choe, Eun Kyung , Moon, Jung Sun , Park, Kyu Joo; J Korean Soc Coloproctol. 2010;26(3):171-178.; DOI: https://doi.org/10.3393/jksc.2010.26.3.171

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1 Citations

Abstract PDF

PURPOSE
Partial obstruction of the small bowel causes hypertrophy of smooth muscle cells and enteric neurons. After small bowel obstruction, slow waves have also been reported to disappear or to be greatly reduced at the oral site of the obstruction in the murine ileum. The purpose of this research was to study the changes in migrating motor complexes (MMCs) after partial obstruction in order to compensate for the attenuated function of slow waves.
METHODS
A ring of film (6 mm in length, 4 mm in internal diameter) was placed over the small intestine 5-6 cm oral to the ileocecal valve in 8-10 wk old female ICR mice. These rings resulted in a partial obstruction of the intestine after 2 wk. The mechanical activities of the small intestine were recorded and the amplitude, interval, and half-duration of the MMCs were analyzed.
RESULTS
The MMCs from a partially obstructed ileum occurred every 1.58+/-1.06 min and had a half-duration of 6.90+/-5.54 sec. The interval and the half-duration of the control MMCs were 3.60+/-1.11 min and 31.5+/-11.4 sec, respectively. The difference in interval and the half-duration of the MMCs reached statistical significance (P=0.03; P=0.00). The amplitude and the area under the curve (AUC) of the MMCs of the obstructed ileum were much higher than those of the control (31.3+/-8.86 vs. 6.05+/-1.92 mN; 161.18+/-44.09 vs. 72.95+/-2.45 mN . sec/MMC wave; P=0.00, 0.02).
CONCLUSION
The MMCs with higher amplitude and AUC, with shorter interval, and with shorter half-duration, compared with those of the control, were recorded from the partially obstructed murine ileum, reflecting efforts to overcome the effect of obstruction by increasing the power of contractions.

Citations

Citations to this article as recorded by

Migrating motor complex changes after side-to-side ileal bypass in mouse ileumex-vivo: mechanism underlying the blind loop syndrome?
Suk-Bae Moon, Kyu-Joo Park, Jung-Sun Moon, Eun-Kyoung Choe, In-Suk So, Sung-Eun Jung
Journal of the Korean Surgical Society.2011; 80(4): 251. CrossRef

Gastrointestinal Stromal Tumors of the Colon and Rectum.: Paek, Ok Joo , Kim, Young Bae , Oh, Seung Yeop , Suh, Kwang Wook; J Korean Soc Coloproctol. 2009;25(5):318-322.; DOI: https://doi.org/10.3393/jksc.2009.25.5.318

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3 Citations

Abstract PDF

PURPOSE
This study was designed to review the clinical characteristics of gastrointestinal stromal tumors (GISTs) of the colon and rectum and to evaluate their immunohistochemical and pathologic features based on the current National Institutes of Health criteria.
METHODS
Patient and disease characteristics, pathologic features, surgical or endoscopic management, and clinical outcomes of 11 patients with GISTs diagnosed and primarily treated at our institution between March 1995 and February 2009 were evaluated.
RESULTS
Colorectal GISTs accounted for 4.4% of all GISTs. The primary location was the rectum (8 cases). Four patients had high-risk GISTs, 4 patients had low-risk GISTs, and 3 patients had very low-risk GISTs. All tumors were c-kit positive. Four patients underwent a radical resection, whereas 7 patients underwent an endoscopic resection (n=3) or a transanal excision (n=4). Two high-risk patients without adjuvant Imatinib mesylate therapy developed metastases, but the other high-risk patients with adjuvant Imatinib mesylate therapy didn't.
CONCLUSION
Colorectal GISTs occurred predominantly in the rectum. Because GISTs do not metastasize through the lymphatics, small GISTs that are amenable to local excision or endoscopic resection can be treated by either of these techniques as long as negative microscopic margins are obtained around the primary tumor. Patients with high-risk GISTs should be considered for the use of Imatinib mesylate as adjuvant therapy.

Citations

Citations to this article as recorded by

Transanal endoscopic microsurgery with alternative neoadjuvant imatinib for localized rectal gastrointestinal stromal tumor: a single center experience with long-term surveillance
Xueshan Bai, Weixun Zhou, Yunhao Li, Guole Lin
Surgical Endoscopy.2021; 35(7): 3607. CrossRef
Primary localized rectal/pararectal gastrointestinal stromal tumors: results of surgical and multimodal therapy from the French Sarcoma group
Thanh-Khoa Huynh, Pierre Meeus, Philippe Cassier, Olivier Bouché, Sophie Lardière-Deguelte, Antoine Adenis, Thierry André, Julien Mancini, Olivier Collard, Michael Montemurro, Emmanuelle Bompas, Maria Rios, Nicolas Isambert, Didier Cupissol, Jean-Yves Bla
BMC Cancer.2014;[Epub] CrossRef
Efficacy of Imatinib Mesylate Neoadjuvant Treatment for a Locally Advanced Rectal Gastrointestinal Stromal Tumor
Kyu Jong Yoon, Nam Kyu Kim, Kang Young Lee, Byung Soh Min, Hyuk Hur, Jeonghyun Kang, Sarah Lee
Journal of the Korean Society of Coloproctology.2011; 27(3): 147. CrossRef

Case Reports

Benign Solitary Cecal Ulcer Accompanied by Massive Lower Gastrointestinal Tract Hemorrhage.: Park, Jong Ik , Park, Sang Su , Kang, Sung Gu , Shin, Dong Gue , Yoon, Jin , Kim, Il Myung; J Korean Soc Coloproctol. 2006;22(6):424-427.

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Abstract PDF: A benign cecal ulcer is an uncommon lesion. The etiology remains unknown, and there are no pathognomonic lesions or symptoms. Lower gastrointestinal tract hemorrhage secondary to benign cecal ulcer is the most common complication. Herein, the case of a 24-year-old man with a benign cecal ulcer presenting with a massive lower gastrointestinal tract hemorrhage requiring transfusion until a exploratory laparotomy and right hemicolectomy, is reported with a review of the literature. Surgical intervention is warranted if malignancy is suspected or if the patient has signs of uncontrollable hemorrhage, perforation, or peritonitis.

A Case of Adult Duplication Cyst Presenting with Lower Gastrointestinal Bleeding.: Park, Min Su , Lee, Kil Yeon , Lee, Suk Hwan , Kim, Youn Wha; J Korean Soc Coloproctol. 2006;22(4):271-275.

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Abstract PDF: Congenital cystic duplications of the alimentary tract are rare, but can occur anywhere along the GI tract. Ileal duplication cysts account for the majority of diagnosed cases. Symptoms generally develop during infancy or childhood, with diverse presentations. Common manifestations include abdominal pain, an abdominal mass, vomiting, occasional intussusception, perforation, bleeding, and obstructive symptoms. In this report, we present the case of a 20-year-old man with an ileal duplication cyst with obscure lower gastrointestinal bleeding. The patient underwent cyst excision with a primary end to end anastomosis. The patient was discharged on the postoperative 7th day without any complications.

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.

Original Articles

Clinicopathologic and Immunohistochemical Features of Gastrointestinal Stromal Tumors (GISTs) in the Colon & Rectum.: Park, Kil Chun , Kim, Hee Cheol , Park, In Ja , Yu, Chang Sik , Kim, Jung Sun , Kim, Jin Cheon; J Korean Soc Coloproctol. 2004;20(6):371-377.

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Abstract PDF: PURPOSE
A gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. There are only few reports in the literature describing colorectal GISTs. The aim of this study was to evaluate the clinicopathologic features of colorectal GISTs and to verify prognostic factors.
METHODS
We reviewed 14 patients diagnosed as having primary colorectal GISTs between 1992 and 2003. Clinicopathologic variables and immunohistochemical expressions were analyzed. The diagnostic criteria and grading system for the GISTs were based on the proposal by the National Institutes of Health in April 2001. The median follow-up period was 27 (1~137) months.
RESULTS
The male-to-female ratio was 9 : 5, and the mean age was 61 (37~76) years. The primary location was the rectum (11 cases, 78.6%). The mean tumor size was 7.7 (1.5~17) cm, and the mean number of mitoses was 33.4 (1~150) per 50 HPF. Of the 14 patients, 10 patients (71.4%) were regarded as a high-risk group and four patients as an intermediate-risk group. KIT protein and CD34 were expressed in 92.9% and 78.6% of the cases, respectively. The patients were subclassified based on immunohistochemical expressions as an uncommitted type in 11 cases (78.6%), a combined type in 2 cases (14.3%), and a myoid type in 1 (7.1%) case. Recurrence occured in three patients (21.4%) who were in the high-risk group.
CONCLUSIONS
Colorectal GISTs occurred predominantly in the rectum and tended to be classified as high risk, which was the most important risk factor for recurrence. Accurate diagnosis and grading are important for adequate treatment and accurate prognosis.

Analysis of c-kit Gene Mutation and Prognostic Factors of GISTs in the Small and the Large Bowel.: Park, Jong Kyung , Yun, Sang Seob , Kang, Won Kyung , Cho, Hyeon Min , Kim, Ji Youn , Choi, Seung Hye , Oh, Seong Taek , Oh, Se Jeong , Oh, Seong Lee , Jeon, Hae Myung; J Korean Soc Coloproctol. 2004;20(1):1-7.

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Abstract PDF: PURPOSE
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors which arise anywhere in the tubular GI tract. The prognosis for GISTs that develop in the small and the large bowel is worse than it is for those that develop at other sites. We examined the significance of c-kit mutation as an independent prognostic factor for GISTs.
METHODS
The hospital records of 27 patients with GISTs in the small and the large bowel who were seen from January 1991 to December 2001 at the Department of Surgery, The Catholic University School of Medicine, were reviewed. c-kit mutation was measured by using the PCR and DNA sequencing.
RESULTS
Mutations in exon 11 were found in 5 cases (83.3%), exon 9 in 1 case (16.7%), and no mutations were noted in exon 13 and exon 17. All mutations in exon 11 were found in codon 560-570. c-kit mutation was observed more frequently in high-risk patients, and there was a significant difference between c-kit mutation and the survival rate (P=0.048).
CONCLUSIONS
We think that codon 550~560 in exon 11 of the c-kit gene is a hotspot of mutation, but c-kit mutation is uncertain as an independent prognostic factor for GISTs.

Gastrointestinal Stromal Tumors (GISTs) of the Colon and Rectum: Clinicopathological Analysis.: Kim, Eun Kyu , Lee, Ho Chang , Lee, Min Ro , Lim, Seok Byung , Kang, Sung Bum , Park, Kyu Joo , Kim, Woo Ho , Park, Jae Gahb; J Korean Soc Coloproctol. 2003;19(5):282-289.

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Abstract PDF: PURPOSE
This study was undertaken to investigate the clinicopathological features of GISTs (gastrointestinal stromal tumors) of the colon and rectum.
Method
At Seoul National University Hospital from Jan. 1994 to Dec. 2002, 11 patients were diagnosed as having GISTs, leiomyomas, or leiomyosarcomas of the colon and rectum. For those 11 patients, immunohistochemical staining for CD117 (c-kit) was undertaken in order to differentiate true GISTs from leiomyomas and leiomyosarcomas. Ten patients were positive for CD117 (c-kit) and were finally diagnosed as having GISTs. Then, we retrospectively analyzed the clinical and the pathological features of those 10 cases and investigated the recurrence of disease and the survival.
RESULTS
Colorectal GISTs accounted for 0.3% of all colorectal malignancies (10 cases/2,964 cases). The male- female ratio for the 10 patients with GISTs was 8:2, and the median age was 56.5 (34~75) years. The locations of the tumor were the rectum in 9 cases (90%) and the ascending colon in 1 case. The most common symptoms were decreased stool caliber and GI bleeding (3 cases, respectively). A curative-intent resection was possible in 8 cases. There were two cases of recurrence after curative resection (25.0%). The median survival period of the 10 patients was 33.5 (2~70) months. The median tumor size was 7.5 (5~20) cm, and the median number of mitosis per 50 high-power fields was 36.5 (8~123). There was a statistically significant correlation between size and mitotic count (r=0.942, P=0.001).
CONCLUSIONS
Colorectal GISTs are very rare disease entities (0.3% of the colorectal malignancies). However, all colorectal GISTs were classified as malignant based on their sizes and mitotic counts in our study. For introduction of STI-571 in the treatment of colorectal GISTs and for further study, accurate diagnosis of GISTs by special immunohistochemical staining (c-kit) is very important in differential diagnosis of primary gastrointestinal mesenchymal tumors and recurred leiomyosarcomas.

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