Annals of Coloproctology

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Original Article

Complications

Guideline-concordant antibiotic prophylaxis on surgical site infection rates following colorectal surgery: real-world data from Thailand: Prapakorn Tanyakul, Varut Lohsiriwat, Pichapat Ngarmskunroongrote, Naddanai Kaewjaidee; Ann Coloproctol. 2026;42(2):208-215. Published online April 17, 2026; DOI: https://doi.org/10.3393/ac.2025.00913.0130

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Abstract PDF: Purpose
Antibiotic prophylaxis (AP) is a key component in preventing surgical site infections (SSIs). The existing gap between clinical guidelines and real-world practice may influence SSI rates. This study aimed to compare SSI rates between patients receiving guideline-concordant AP based on the 2020 Thailand guideline (group A) and those receiving broader-spectrum and/or prolonged prophylaxis (group B).
Methods
We reviewed a database of adult patients who underwent elective colorectal resection between January 2022 and April 2024 at the largest university hospital in Thailand. SSIs were diagnosed using the US Centers for Disease Control and Prevention’s criteria. SSI rates between the 2 groups were compared, and factors associated with SSIs were determined.
Results
This study included 1,584 patients, with an average age of 66 years, and 822 (51.9%) were male. The most common operation was anterior resection (n=470, 29.7%). A total of 1,030 patients (65.0%) underwent open surgery, and 228 patients (14.4%) had stoma formation. There were 405 patients (25.6%) in group A. Overall, SSIs occurred in 104 patients (6.6%): 69 incisional SSIs (4.4%) and 35 organ/space SSIs (2.2%). There was no significant difference in SSI rates between groups (group A vs. group B: 4.7% [95% confidence interval (CI), 2.9%–7.2%] vs. 7.2% [95% CI, 5.8%–8.8%]; P=0.078). Multivariate analysis identified 3 independent predictors of SSIs: hypoalbuminemia (odds ratio [OR], 2.53; 95% CI, 1.54–4.16; P<0.001), obesity (OR, 1.89; 95% CI, 1.08–3.32; P=0.026), and intraoperative blood loss greater than 400 mL (OR, 1.83; 95% CI, 1.06–3.16; P=0.031).
Conclusion
There was no significant difference in SSI rates following colorectal surgery between patients receiving guideline-concordant AP and those receiving broader-spectrum and/or prolonged prophylaxis.

Guidelines

Colorectal cancer

The Korean Rectal Cancer Multidisciplinary Committee Clinical Practice Guidelines for Rectal Cancer version 2.0: Hyo Seon Ryu, Hyun Jung Kim, Dong Hyun Kang, Yoo-Kang Kwak, Han Deok Kwak, Yoon-Hye Kwon, Dalyong Kim, Baek-Hui Kim, Jae Hyun Kim, Ji Hun Kim, Jin Won Kim, Tae Hyung Kim, Hae Young Kim, Soo Min Nam, Gyoung Tae Noh, Jun Woo Bong, Nak Song Sung, Seon Hui Shin, Kil-Yong Lee, Sung Chul Lee, Sea-Won Lee, Jung Won Lee, Jong Min Lee, Myung Hoon Ihn, Joo Han Lim, Woong Bae Ji, Dae Hee Pyo, Young Ki Hong, Jung-Myun Kwak, on behalf of the Korean Rectal Cancer Multidisciplinary (KRCM) Committee; Ann Coloproctol. 2026;42(1):4-33. Published online February 24, 2026; DOI: https://doi.org/10.3393/ac.2025.01396.0199

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1 Citations

Abstract PDF Supplementary Material

Rectal cancer, which accounts for approximately 40% of colorectal cancers, remains a major clinical concern. Recent advances in diagnostic imaging, surgical techniques, radiotherapy, and systemic treatment have steadily improved rectal cancer outcomes. Considering this, the Korean Rectal Cancer Multidisciplinary (KRCM) Committee has aimed to provide clinicians and policymakers with up-to-date, evidence-based clinical practice guidelines to support optimal decision-making, reflecting current evidence, the Korean healthcare context, and patient values and preferences. The Clinical Practice Guidelines for Rectal Cancer version 2.0 were developed through multidisciplinary collaboration with related academic societies, building upon and updating the KRCM Clinical Practice Guidelines version 1.0 (titled “Multidisciplinary guidelines for the management of rectal cancer”). These consensus guidelines of the KRCM were established based on a comprehensive literature review, evidence synthesis, with recommendation development guided by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology, and consideration of applicability in real-world clinical practice under the national health insurance system. Each recommendation has been presented with its strength and level of evidence.

Citations

Citations to this article as recorded by

Advances in Neoadjuvant Therapy for Colorectal Cancer
达练
Advances in Clinical Medicine.2026; 16(05): 2273. CrossRef

ERAS

The 2024 Korean Enhanced Recovery After Surgery (ERAS) guidelines for colorectal cancer: a secondary publication: Kil-yong Lee, Soo Young Lee, Miyoung Choi, Moonjin Kim, Ji Hong Kim, Ju Myung Song, Seung Yoon Yang, In Jun Yang, Moon Suk Choi, Seung Rim Han, Eon Chul Han, Sang Hyun Hong, Do Joong Park, Sang-Jae Park, the Korean Enhanced Recovery After Surgery (ERAS) Committee within the Korean Society of Surgical Metabolism and Nutrition; Ann Coloproctol. 2025;41(1):3-26. Published online February 20, 2025; DOI: https://doi.org/10.3393/ac.2024.00836.0119

30,542 View
504 Download
8 Web of Science
8 Citations

Abstract PDF Supplementary Material

The Korean Enhanced Recovery After Surgery (ERAS) Committee within the Korean Society of Surgical Metabolism and Nutrition was established to develop ERAS guidelines tailored to the Korean context. This guideline focuses on creating the most current evidence-based practice guidelines for ERAS purposes, based on systematic reviews. All key questions targeted randomized controlled trials exclusively, and if fewer than 2 were available, studies employing propensity score matching were also included. Recommendations for each key question were marked with strength of recommendation and level of evidence following internal and external review processes by the committee.

Citations

Citations to this article as recorded by

Quadratus Lumborum Block Versus Transversus Abdominis Plane Block in Laparoscopic Colorectal Surgery: A Systematic Review and Meta-Analysis
Abdullah M. Alharran, Waleed Bader Alazemi, Saad A. Alajmi, Yousiff A. Bahman, Osamah Alhajri, Ali A. Alenezi, Jarrah J. Alenezi, Duaij Salman Saif
Medicina.2026; 62(1): 92. CrossRef
Clinical impact of acupuncture on post-operative nausea and vomiting (PONV) in enhanced recovery after surgery (ERAS) protocols for patients undergoing colorectal surgery: A case control study
Luisa Ciatti, Piercarlo Ballo, Barbara Berti, Chiara Fricelli, Giulia Ferri, Martina Martinelli, Virginia Manetti, Duccio Conti
Saudi Journal of Anaesthesia.2026; 20(2): 351. CrossRef
ERAS compliance outweighs patient risk in high-risk colon cancer surgery
Jeonghyun Kang
Annals of Surgical Treatment and Research.2026; 110(4): 203. CrossRef
Advances in ERAS to Reduce the Incidence of Chronic Post-Surgical Pain and Persistent Postoperative Opioid Use: A Narrative Review
Zhiyou Peng, Pavan Tankha, Zhiying Feng, Jijun Xu
Journal of Investigative Surgery.2026;[Epub] CrossRef
Lymphopenia and C-reactive protein elevation on postoperative day 2 are independent risk factors for occurrence of major and minor complications in elective colorectal cancer surgery
Minsuh Park, Kyung Jong Kim, Young-hun Kim
Annals of Coloproctology.2026; 42(3): 333. CrossRef
Enhancing anastomosis safety with intraoperative perfusion assessment: a visual grading system for tailoring resection and ostomy formation in sigmoid colon and rectal cancer surgery
Soo Young Oh, Seok-Byung Lim, Eu-Tteum Choi, Min Hyun Kim, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, In Ja Park, Chang Sik Yu
Annals of Coloproctology.2026; 42(3): 303. CrossRef
Efficacy of preoperative immunonutrition in malnourished patients undergoing colorectal cancer surgery: a study protocol for a multicenter randomized clinical trial
Soo Young Lee, Chang Hyun Kim, Gi Won Ha, Soo Yeun Park, In Jun Yang, Jin Soo Kim, Gyung Mo Son, Sung Il Kang, Sung Uk Bae
Trials.2025;[Epub] CrossRef
Oral antibiotics alone for bowel preparation in colorectal surgery: time to rethink tradition?
Soo Young Lee
Annals of Coloproctology.2025; 41(5): 367. CrossRef

Original Articles

A Survey of Colonoscopic Surveillance After Polypectomy: Dae Kyung Sohn; Ann Coloproctol. 2014;30(2):88-92. Published online April 25, 2014; DOI: https://doi.org/10.3393/ac.2014.30.2.88

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43 Download
9 Web of Science
7 Citations

Abstract PDF

Purpose

Several guidelines have been proposed for surveillance colonoscopy after polypectomy. However, some discrepancies still exist between the guidelines and clinical practice. This study was conducted to identify Korean doctors' recommendations for the colonoscopic surveillance interval after polypectomy.

Methods

A survey of the attendees at the symposium of the 64th Annual Congress of the Korean Surgical Society was conducted. When the prepared clinical scenarios were given, attendees answered using a wireless radio-frequency audience response system. All responders' results were automatically counted immediately. Frequencies of different answers to each question were calculated, and our results were compared with those of previous surveys performed using the same questionnaire in the United States or Japan.

Results

The number of responder varied from 38 to 41. About 50% of valid responders selected 'follow-up in 3 years' for low-risk lesions, such as a 6-mm hyperplastic polyp, a 6-mm tubular adenoma, or two 6-mm tubular adenomas. Responders most-commonly selected 'follow-up in 1 year' for high-risk lesions, such as a 12-mm tubular adenoma with high grade dysplasia or a 12-mm tubulovillous adenoma. The majority of Korean doctors recommend postpolypectomy colonoscopic surveillance more frequently than American physicians did.

Conclusion

A discrepancy between the guidelines and clinical practice for the surveillance after polypectomy still exists in Korea. A surveillance program that can be easily and widely applied in clinical practice needs to be established.

Citations

Citations to this article as recorded by

Analysis of adenoma detection rate of colonoscopy among trainees
Young Min Song, Kyung Su Han, Byung Chang Kim, Chang Won Hong, Bun Kim, Min Chul Kim, Myeong Jae Jin, Dae Kyung Sohn
Annals of Coloproctology.2024; 40(6): 548. CrossRef
Adherence to Surveillance Guidelines after the Removal of Colorectal Polyps: A Multinational, Multicenter, Prospective Survey
Chang Kyo Oh, Satimai Aniwan, Panida Piyachaturawat, Zhiqin Wong, Thida Soe, Bayasgalan Luvsandagva, Quang Trung Tran, Achmad Fauzi, Jeong-Sik Byeon, Young-Seok Cho
Gut and Liver.2021; 15(6): 878. CrossRef
The current capacity and quality of colonoscopy in Korea
Jae Ho Choi, Jae Myung Cha, Jin Young Yoon, Min Seob Kwak, Jung Won Jeon, Hyun Phil Shin
Intestinal Research.2019; 17(1): 119. CrossRef
Guideline Adherence to Colonoscopic Surveillance Intervals after Polypectomy in Korea: Results from a Nationwide Survey
Seri Hong, Mina Suh, Kui Son Choi, Boyoung Park, Jae Myung Cha, Hyun-Soo Kim, Jae Kwan Jun, Dong Soo Han
Gut and Liver.2018; 12(4): 426. CrossRef
Determining the optimal surveillance interval after a colonoscopic polypectomy for the Korean population?
Jung Lok Lee, Jae Myung Cha, Hye Min Lee, Jung Won Jeon, Min Seob Kwak, Jin Young Yoon, Hyun Phil Shin, Kwang Ro Joo, Joung Il Lee, Dong Il Park
Intestinal Research.2017; 15(1): 109. CrossRef
Factors Associated With Shorter Colonoscopy Surveillance Intervals for Patients With Low-Risk Colorectal Adenomas and Effects on Outcome
Joseph C. Anderson, John A. Baron, Dennis J. Ahnen, Elizabeth L. Barry, Roberd M. Bostick, Carol A. Burke, Robert S. Bresalier, Timothy R. Church, Bernard F. Cole, Marcia Cruz-Correa, Adam S. Kim, Leila A. Mott, Robert S. Sandler, Douglas J. Robertson
Gastroenterology.2017; 152(8): 1933. CrossRef
Association Between Exposure to Environmental Tobacco Smoke at the Workplace and Risk for Developing a Colorectal Adenoma: A Cross-Sectional Study
Seung-Hwa Lee, Ji-Yeon Hong, Jung-Un Lee, Dong Ryul Lee
Annals of Coloproctology.2016; 32(2): 51. CrossRef

Optimal Time of Initiating Adjuvant Chemotherapy After Curative Surgery in Colorectal Cancer Patients: Kyu Min Kang, Kyung Sook Hong, Gyoung Tae Noh, Bo-Young Oh, Soon Sup Chung, Ryung-Ah Lee, Kwang Ho Kim; Ann Coloproctol. 2013;29(4):150-154. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.150

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44 Download
16 Citations

Abstract PDF

Purpose

Adjuvant chemotherapy is routinely recommended for locally advanced colorectal cancer (CRC). There are very few data for the optimal starting date of adjuvant chemotherapy after the surgery. This study aimed to evaluate the effectiveness of earlier adoption of adjuvant chemotherapy after curative surgery for stage III CRC.

Methods

In this study, 159 patients with stage III CRC, who had undergone a curative resection, were enrolled retrospectively. Patients were categorized into 3 groups representing different timings to initiate the chemotherapy; less than 2 weeks (group 1), 3 to 4 weeks (group 2), and more than 5 weeks (group 3). The overall survival rate (OS) and the relapse-free survival rate (RFS) were analyzed to evaluate the effectiveness of adjuvant chemotherapy.

Results

The 5-year OSs of the patients were 73.7% in group 1, 67.0% in group 2, and 55.2% in group 3. The 5-year RFSs of the patients were 48.8% in group 1, 64.7% in group 2, and 57.1% in group 3. There were no significant differences in either the OS or the RFS (P = 0.200, P = 0.405).

Conclusion

Starting chemotherapy earlier than 6 weeks after surgery does not show any significant difference. Thus, although adjuvant chemotherapy should preferably begin within 6 weeks, the starting date should not necessarily be hastened, and the patient's general condition should be taken into consideration.

Citations

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Positive-Effect (PE) of Biomedicines Song with Exercise (BMSWE) fit for Election-Duty (ED)-2026 on Aged Colorectal Major Surgery Chemotherapy (ACRMSCT) Follow-Up Patient (FUP) with Prolonged Side-Effects (PSE)
Subhas Chandra Datta
Open Journal of Tropical Medicine.2026; 10(1): 1. CrossRef
Optimal timing of cancer treatments: a call for emerging evidence from clinical trials and real-world studies
Jianrong Zhang, Rebecca Venchiarutti, Xiaofei Wang, Qihua He
British Journal of Cancer.2025; 132(12): 1085. CrossRef
Minimally Invasive Approach Provides Oncological Benefit in Patients with High Risk of Very Early Recurrence (VER) After Surgery for Intrahepatic Cholangiocarcinoma (iCCA)
Francesca Ratti, Cecilia Maina, Lucrezia Clocchiatti, Rebecca Marino, Federica Pedica, Andrea Casadei Gardini, Francesco De Cobelli, Luca Antonio Maria Aldrighetti
Annals of Surgical Oncology.2024; 31(4): 2557. CrossRef
The optimal time of starting adjuvant chemotherapy after curative surgery in patients with colorectal cancer
Yuchong Yang, Yao Lu, Hui Tan, Ming Bai, Xia Wang, Shaohua Ge, Tao Ning, Le Zhang, Jingjing Duan, Yansha Sun, Rui Liu, Hongli Li, Yi Ba, Ting Deng
BMC Cancer.2023;[Epub] CrossRef
Apurinic/apyrimidinic endonuclease 1 is associated with poor prognosis after curative resection followed by adjuvant chemotherapy in patients with stage III colon cancer
Ji Hyeong Song, Myung Sun Lee, Eun Young Cha, Kyung Ha Lee, Ji Yeon Kim, Jin Soo Kim
Korean Journal of Clinical Oncology.2022; 18(1): 1. CrossRef
Impact of the Time Interval Between Primary Debulking Surgery and Start of Adjuvant Chemotherapy in Advanced Epithelial Ovarian Cancer
Hao Lin, Wen-Hsin Chen, Chen-Hsuan Wu, Yu-Che Ou, Yu-Jen Chen, Ying-Yi Chen, Yu-Han Lin, Hung-Chun Fu
Cancer Management and Research.2021; Volume 13: 5413. CrossRef
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Timing of Adjuvant Chemotherapy and Survival in Colorectal, Gastric, and Pancreatic Cancer. A Systematic Review and Meta-Analysis
Fausto Petrelli, Alberto Zaniboni, Antonio Ghidini, Michele Ghidini, Luca Turati, Claudio Pizzo, Margherita Ratti, Michela Libertini, Gianluca Tomasello
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Jeonghyun Kang, Su-Weon Chong, Eun Jung Park, Seung Hyuk Baik, Kang Young Lee
Medicine.2019; 98(18): e15371. CrossRef
Stage II/III Rectal Cancer Patients Benefit from Extremely Early Initiation of Postoperative Adjuvant Chemotherapy: A Retrospective Study
Liuniu Xiao, Li Zhu, Yingming Chen, Zhenlin Hou, Lingwei Jia, Junbo Hu, Yongdong Feng
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Surgical stress response and promotion of metastasis in colorectal cancer: a complex and heterogeneous process
Corina Behrenbruch, Carolyn Shembrey, Sophie Paquet-Fifield, Christina Mølck, Hyun-Jung Cho, Michael Michael, Benjamin N. J. Thomson, Alexander G. Heriot, Frédéric Hollande
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Intensity modulated radiotherapy delivers competitive local control rate with limited acute toxicity in the adjuvant treatment of rectal cancer
Cheng-Yen Lee, Chih-Chia Chang, Hsin-Yi Yang, Pin-Yi Chiang, Yuk-Wah Tsang
Japanese Journal of Clinical Oncology.2018; 48(7): 653. CrossRef
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Association Between Time (Initiation and Length) and Oncological Outcomes for the Patients with Colon Cancer Treated with Adjuvant Chemotherapy
In Seob Jeong, Jong Han Yoo, Sang Hyuk Seo, Min Sung An, Kwang Hee Kim, Ki Beom Bae, Chang Soo Choi, Jin Won Hwang, Ji Hyun Kim, Mi Seon Kang, Min Kyung Oh, Kwan Hee Hong
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Timing of Adjuvant Chemotherapy in Colorectal Cancer Patients
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