Annals of Coloproctology

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Case Reports

Black Anal Canal: Acute Necrosis: Sandra Barbeiro, Catarina Martins, Cláudia Gonçalves, Paulo Alves, Inês Gil, Manuela Canhoto, Filipe Silva, Isabel Cotrim, Cristina Amado, Liliana Eliseu, Helena Vasconcelos; Ann Coloproctol. 2016;32(4):156-158. Published online August 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.4.156

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Abstract PDF: Acute ischemia of the rectum or anal canal resulting in necrosis is extremely uncommon because both the rectum and the anal canal have excellent blood supplies. We present a case with spontaneous necrosis of the anal canal without rectal involvement. Surgical debridement was accomplished, and the recovery was uneventful. The patient was elderly, with probable atherosclerotic arterial disease, and presented with hypotension. Due to the lack of other precipitating factors, the hypoperfusion hypothesis seems to be the most suitable in this case. To the best of our knowledge, no similar cases have been reported in the literature on this subject.

Colon Stricture After Ischemia Following a Robot-Assisted Ultra-Low Anterior Resection With Coloanal Anastomosis: Dae Ro Lim, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Nam Kyu Kim; Ann Coloproctol. 2015;31(4):157-162. Published online August 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.4.157

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Four consecutive cases of a colonic stricture following a da Vinci robot-assisted ultra-low anterior resection (LAR) with coloanal anastomosis and diverting ileostomy for the treatment of rectal cancer are reported. The colonic strictures developed after early proximal colonic ischemia without anastomotic site leakage or disruption. All patients were treated with preoperative chemoradiation therapy. During the postoperative recovery period, patients developed colonic ischemia, presenting with a high, spiking fever, but without any symptoms of peritonitis. Patients were treated with conservative management (antibiotic therapy) and discharged after two weeks when in good condition. Several months after discharge, all four patients developed a long-segment colonic stricture from the anastomosis site to the distal colon. Management of the colon strictures, including the anastomotic site, involved colonic dilation with a Hegar dilator in an outpatient clinic for several months. The ileostomies in three patients could not be closed.

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Laparoscopic Abdominoperineal Resection for Ischemic Colitis after Laparoscopic Partial Resection of the Descending Colon: Case Report
Mitsuki Yokota, Hidekazu Takahashi, Asako Mike, Kei Fukumori, Yuka Iwami, Juavijitjan Watsapol, Satoshi Ishikawa, Shohei Takaichi, Masakatsu Paku, Kazuya Iwamoto, Tomofumi Ohashi, Yujiro Nakahara, Kohei Murakami, Tadafumi Asaoka, Ichiro Takemasa, Takeshi
Surgical Case Reports.2026; 12(1): n/a. CrossRef
Pathophysiology of anastomotic stricture following rectal anastomosis: Insights into mechanisms, risk factors, and preventive strategies
Ahmet Yavuz, Hikmet Pehlevan-Özel, Mesut Tez
World Journal of Gastrointestinal Pathophysiology.2025;[Epub] CrossRef
Comment on “Risk Factors for Benign Anastomotic Stenosis After Esophagectomy for Cancer”
Rachana Mehta, Ranjana Sah
Annals of Surgical Oncology.2025; 32(12): 9306. CrossRef
Magnetic resonance imaging in the diagnosis of necrosis of a pulled-through colon segment after abdomino-anal resection of the rectum for cancer
Sofiya A. Myalina, Ksenia I. Paziuk, Tatiana P. Berezovskaya, Alexey A. Nevolskikh, Aleksandr L. Potapov, Sergey A. Ivanov
Digital Diagnostics.2023; 4(1): 61. CrossRef
Prolonged ischemia of the ileum and colon after surgical mucosectomy explains contraction and failure of “mucus free” bladder augmentation
Dániel Urbán, Gabriella Varga, Dániel Érces, Mahmoud Marei Marei, Raimondo Cervellione, David Keene, Anju Goyal, Tamás Cserni
Journal of Pediatric Urology.2022; 18(4): 500.e1. CrossRef
Robotic Intersphincteric Resection for Low Rectal Cancer: Technical Controversies and a Systematic Review on the Perioperative, Oncological, and Functional Outcomes
Guglielmo Niccolò Piozzi, Seon Hahn Kim
Annals of Coloproctology.2021; 37(6): 351. CrossRef
Surgical specimen extraction via a prophylactic ileostomy procedure: A minimally invasive technique for laparoscopic rectal cancer surgery
Peng Wang, Jian-Wei Liang, Hai-Tao Zhou, Zheng Wang, Zhi-Xiang Zhou
World Journal of Gastroenterology.2018; 24(1): 104. CrossRef
Risk factors including the presence of inflammation at the resection margins for colorectal anastomotic stenosis following surgery for diverticular disease
A. Bressan, L. Marini, M. Michelotto, A. C. Frigo, G. Da Dalt, S. Merigliano, L. Polese
Colorectal Disease.2018; 20(10): 923. CrossRef
Vascular anatomy of inferior mesenteric artery in laparoscopic radical resection with the preservation of left colic artery for rectal cancer
Ke-Xin Wang, Zhi-Qiang Cheng, Zhi Liu, Xiao-Yang Wang, Dong-Song Bi
World Journal of Gastroenterology.2018; 24(32): 3671. CrossRef

Original Article

Adipose-tissue-derived Stem Cells Enhance the Healing of Ischemic Colonic Anastomoses: An Experimental Study in Rats: Jong Han Yoo, Jae Ho Shin, Min Sung An, Tae Kwun Ha, Kwang Hee Kim, Ki Beom Bae, Tae Hyeon Kim, Chang Soo Choi, Kwan Hee Hong, Jeong Kim, Soo Jin Jung, Sun Hee Kim, Kuk Hwan Rho, Jong Tae Kim, Young Il Yang; J Korean Soc Coloproctol. 2012;28(3):132-139. Published online June 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.3.132

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Abstract PDF

Purpose

This experimental study verified the effect of adipose-tissue-derived stem cells (ASCs) on the healing of ischemic colonic anastomoses in rats.

Methods

ASCs were isolated from the subcutaneous fat tissue of rats and identified as mesenchymal stem cells by identification of different potentials. An animal model of colonic ischemic anastomosis was induced by modifying Nagahata's method. Sixty male Sprague-Dawley rats (10-week-old, 370 ± 50 g) were divided into two groups (n = 30 each): a control group in which the anastomosis was sutured in a single layer with 6-0 polypropylene without any treatment and an ASCtreated group (ASC group) in which the anastomosis was sutured as in the control group, but then ASCs were locally transplanted into the bowel wall around the anastomosis. The rats were sacrificed on postoperative day 7. Healing of the anastomoses was assessed by measuring loss of body weight, wound infection, anastomotic leakage, mortality, adhesion formation, ileus, anastomotic stricture, anastomotic bursting pressure, histopathological features, and microvascular density.

Results

No differences in wound infection, anastomotic leakage, or mortality between the two groups were observed. The ASC group had significantly more favorable anastomotic healing, including less body weight lost, less ileus, and fewer ulcers and strictures, than the control group. ASCs augmented bursting pressure and collagen deposition. The histopathological features were significantly more favorable in the ASC group, and microvascular density was significantly higher than it was in the control group.

Conclusion

Locally-transplanted ASCs enhanced healing of ischemic colonic anastomoses by increasing angiogenesis. ASCs could be a novel strategy for accelerating healing of colonic ischemic risk anastomoses.

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Effects of Local and Systematic Administration of Adipose Tissue–Derived Stem Cells to Intestinal Anastomosis in Intestinal Ishemic Rerfusion Injury: Ani̇mal Experi̇ment Model
İbrahim Doğan, Bahar Kartal, Bülent Cavit Yüksel, Umut Fırat Turan, Metin Bozkaya, Gökçe Yağmur Summak, Ömür Besbinar, Açelya Yilmazer, Sadettin Er
Journal of Surgical Research.2026; 318: 290. CrossRef
Experimental models of high-risk bowel anastomosis in rats: A systematic review
Georgios Ntampakis, Manousos-Georgios Pramateftakis, Elissavet Anestiadou, Stefanos Bitsianis, Orestis Ioannidis, Chryssa Bekiari, George Koliakos, Maria Karakota, Anastasia Tsakona, Angeliki Cheva, Stamatios Angelopoulos
World Journal of Experimental Medicine.2024;[Epub] CrossRef
The Role of Adipose Tissue Mesenchymal Stem Cells in Colonic Anastomosis Healing in Inflammatory Bowel Disease: Experimental Study in Rats
Georgios Ntampakis, Manousos-Georgios Pramateftakis, Orestis Ioannidis, Stefanos Bitsianis, Panagiotis Christidis, Savvas Symeonidis, Georgios Koliakos, Maria Karakota, Chrysanthi Bekiari, Anastasia Tsakona, Angeliki Cheva, Stamatios Aggelopoulos
Journal of Clinical Medicine.2023; 12(19): 6336. CrossRef
The application of regenerative medicine in colorectal surgery
Ilan Kent, Michael R. Freund, Samir Agarwal, Steven D. Wexner
Surgery.2022; 171(4): 867. CrossRef
Stem cell therapy applied for digestive anastomosis: Current state and future perspectives
Jacobo Trébol, Tihomir Georgiev-Hristov, Isabel Pascual-Miguelañez, Hector Guadalajara, Mariano García-Arranz, Damian García-Olmo
World Journal of Stem Cells.2022; 14(1): 117. CrossRef
Stem Cell Therapies for Gastrointestinal Anastomotic Healing: A Systematic Review and Meta-Analysis on Results from Animal Studies
Apostolos Gaitanidis, Leonidas Kandilogiannakis, Eirini Filidou, Alexandra Tsaroucha, George Kolios, Michail Pitiakoudis
European Surgical Research.2022; 63(4): 173. CrossRef
Effect of Adipose-Derived Stem Cells on Colonic Anastomosis in Rats Immunosuppressed With Everolimus: An Experimental Study
Emre Karakaya, Aydincan Akdur, Alev Ok Atilgan, Ahmet Cagri Uysal, Huriye Eda Ozturan Ozer, Sedat Yildirim, Mehmet Haberal
Experimental and Clinical Transplantation.2021; 19(9): 970. CrossRef
The use of mesenchymal stem cells in animal models for gastrointestinal anastomotic leak: A systematic review
Joshua Richard Burke, Jack Helliwell, Jason Wong, Aaron Quyn, Sarah Herrick, David Jayne
Colorectal Disease.2021; 23(12): 3123. CrossRef
Human Oral Mucosal Stem Cells Reduce Anastomotic Leak in an Animal Model of Colonic Surgery
Ilan Kent, Cyrus Jahansouz, Amandeep Ghuman, Baruch Shpitz, Debora Kidron, Victoria Yaffe, Imad Abu El-Naaj, Shareef Araidy, Luciana Reina, Sandu Pitaru, Steven David Wexner, Shmuel Avital
European Surgical Research.2021; 62(1): 32. CrossRef
Anastomotic leak in colorectal cancer patients: New insights and perspectives
Caterina Foppa, Siew Chien Ng, Marco Montorsi, Antonino Spinelli
European Journal of Surgical Oncology.2020; 46(6): 943. CrossRef
Locally Transplanted Adipose Stem Cells Reduce Anastomotic Leaks in Ischemic Colorectal Anastomoses: A Rat Model
Andrew Morgan, Andrew Zheng, Kimberly M. Linden, Ping Zhang, Spencer A. Brown, Jeffrey P. Carpenter, Francis R. Spitz, Michael E. Kwiatt
Diseases of the Colon & Rectum.2020; 63(7): 955. CrossRef
The Proliferation and Differentiation of Adipose-Derived Stem Cells in Neovascularization and Angiogenesis
Greg Hutchings, Krzysztof Janowicz, Lisa Moncrieff, Claudia Dompe, Ewa Strauss, Ievgeniia Kocherova, Mariusz J. Nawrocki, Łukasz Kruszyna, Grzegorz Wąsiatycz, Paweł Antosik, Jamil A. Shibli, Paul Mozdziak, Bartłomiej Perek, Zbigniew Krasiński, Bartosz Kem
International Journal of Molecular Sciences.2020; 21(11): 3790. CrossRef
Wound healing and fibrosis: current stem cell therapies
Ruth Ellen Jones, Deshka S. Foster, Michael S. Hu, Michael T. Longaker
Transfusion.2019; 59(S1): 884. CrossRef
Protective effect of adipose tissue–derived mesenchymal stromal cells in an experimental model of high-risk colonic anastomosis
Valter Alvarenga, Pedro Teixeira da Silva, Natália Deoclécio Bonfá, Beatriz Pêgo, Hayandra Nanini, Cláudio Bernardazzi, Kalil Madi, Wagner Baetas da Cruz, Morgana Teixeira Castelo-Branco, Heitor Siffert Pereira de Souza, Alberto Schanaider
Surgery.2019; 166(5): 914. CrossRef
Adipose Tissue-Derived Stem Cell Sheet Application for Tissue Healing In Vivo : A Systematic Review
Panithi Sukho, Abigael Cohen, Jan Willem Hesselink, Jolle Kirpensteijn, Femke Verseijden, Yvonne M. Bastiaansen-Jenniskens
Tissue Engineering Part B: Reviews.2018; 24(1): 37. CrossRef
Adipose-Derived Mesenchymal Stromal Cells Improve the Healing of Colonic Anastomoses Following High Dose of Irradiation Through Anti-Inflammatory and Angiogenic Processes
Dirk Van de putte, Christelle Demarquay, Elke Van Daele, Lara Moussa, Christian Vanhove, Marc Benderitter, Wim Ceelen, Piet Pattyn, Noëlle Mathieu
Cell Transplantation.2017; 26(12): 1919. CrossRef
Autologous adipose-derived stem cell sheets enhance the strength of intestinal anastomosis
Yasuhiro Maruya, Nobuo Kanai, Shinichiro Kobayashi, Kurodo Koshino, Teruo Okano, Susumu Eguchi, Masayuki Yamato
Regenerative Therapy.2017; 7: 24. CrossRef
Effects of adipose stem cell sheets on colon anastomotic leakage in an experimental model: Proof of principle
Panithi Sukho, Geesien S.A. Boersema, Abigael Cohen, Nicole Kops, Johan F. Lange, Jolle Kirpensteijn, Jan Willem Hesselink, Yvonne M. Bastiaansen-Jenniskens, Femke Verseijden
Biomaterials.2017; 140: 69. CrossRef
Novel therapy for pancreatic fistula using adipose-derived stem cell sheets treated with mannose
Hirokazu Kaneko, Toshio Kokuryo, Yukihiro Yokoyama, Junpei Yamaguchi, Tokunori Yamamoto, Rei Shibata, Momokazu Gotoh, Toyoaki Murohara, Akira Ito, Masato Nagino
Surgery.2017; 161(6): 1561. CrossRef
Therapeutic angiogenesis of adipose-derived stem cells for ischemic diseases
Lina Zhao, Takerra Johnson, Dong Liu
Stem Cell Research & Therapy.2017;[Epub] CrossRef

Case Report

Extensive Bowel Ischemia with Heavy Alcohol Consumption: Report of a Case: Ji Hyoun Lee, Gyoung Tae Noh, Ryung-Ah Lee; J Korean Soc Coloproctol. 2012;28(1):61-65. Published online February 29, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.1.61

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Abstract PDF

Alcohol is well-recognized systemic toxin that causes numerous adverse effects, including psychosocial problems, fatal myocardial infarction, stroke and atherosclerosis. The intra-abdominal complications caused by acute alcohol consumption have not been defined. We report an 80-year-old man with sub-acute small bowel and colonic ischemia after heavy alcohol intake in one sitting. We performed a resection of gangrenous bowel segments. Microscopically, there were diffuse infarction, with vasoconstriction of the mesenteric vessels in the ileum and colon without any thrombotic occlusion of the intestinal vessels. The clinicians should always be assured by confirmation of a history of recent substance abuse in patients with unexplained abdominal pain, and mesenteric ischemia should be considered in the differential diagnosis of acute or chronic abdominal pain in consumers of alcohol.

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Hybrid surgery in a young patient with mesenteric thrombosis induced by psychoactive substances (clinical observation)
M. Rogal, P. Yartsev, N. Stinskaya, A. Spassky, R. Elokhovsky, Yu. Sadzaya, N. Shavrina
Vrach.2025; : 39. CrossRef
Alcohol use disorders associated with an increased risk of mesenteric ischemia: A nationwide cohort study
Chieh-Fan Chen, Wei-Tsung Kao, Kuan-Ting Liu, Shu-Ling Chen, Yu-Tung Huang, Chun-Che Huang
Drug and Alcohol Dependence.2019; 194: 264. CrossRef
Increased Risk of Mesenteric Ischemia in Patients With Alcohol Use Disorder
Chih-Wei Wei, Yu-Chiao Wang, Dong-Zong Hung, Yu-Ting Chung, Wei-Kung Chen, Chia-Hung Kao
Mayo Clinic Proceedings.2016; 91(2): 189. CrossRef

Original Article

Is There Any Relationship between the Chronicity of Chronic Anal Fissure and Endothelin-1?: Cheong Ho Lim, Hyeon Keun Shin, Wook Ho Kang, Seung Kyu Jeong, Hyung Kyu Yang; J Korean Soc Coloproctol. 2011;27(5):237-240. Published online October 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.5.237

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3 Citations

Abstract PDF

Purpose

Many kinds of substances are produced on vascular endothelial activation. The aim of this study is to confirm an increase in Endothelin-1 (ET-1), the most potent vasoconstrictor, which is produced by endothelial activation, in patients with chronic anal fissure and to infer the relationship between ET-1 and anal fissure chronicity.

Methods

The study groups are divided into three different groups with 30 subjects each. Group 1 is comprised of healthy volunteers, group 2 of chronic anal fissure patients, and Group 3 of patients with higher than 3rd degree hemorrhoids. Blood samples were taken to measure the ET-1 levels in subject's serum and to compare the results with those for the control groups.

Results

Among the 90 subjects, 38 were male, and 52 were female. The average age was 36.8. The average ET-1 level marked 1.47 ± 0.78 pg/mL for male subjects and 1.16 ± 0.47 pg/mL for female subjects (P = 0.02). The average ET-1 level in the patient groups is as follow: 1.21 ± 0.44 pg/mL in group 1, 1.46 ± 0.83 pg/mL in group 2, and 1.20 ± 0.56 pg/mL in group 3 (P = 0.14).

Conclusion

Group 2, the chronic anal fissure patient group, showed a higher ET-1 level than groups 1 and 3, the control group and the hemorrhoid patient group, but this difference had no statistical significance.

Citations

Citations to this article as recorded by

Impact of Anal Fissure on Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness: A Case-Control Study
Paloma Luri-Prieto, Asunción Candela-Gomis, Antonio Palazón-Bru, Felipe Navarro-Cremades, Vicente Francisco Gil-Guillén, Antonio Fernando Compañ-Rosique
Visceral Medicine.2021; 37(2): 128. CrossRef
Anatomie und Pathogenese der Analfissur
Martin Mitteregger
coloproctology.2020; 42(6): 441. CrossRef
Cost considerations in the treatment of anal fissures
Giuseppe Brisinda, Giuseppe Bianco, Nicola Silvestrini, Giorgio Maria
Expert Review of Pharmacoeconomics & Outcomes Research.2014; 14(4): 511. CrossRef

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