Annals of Coloproctology

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Minimally invasive surgery

Preoperative localization of potentially invisible colonic lesions on the laparoscopic operation field: using autologous blood tattooing: Ji Yeon Mun, Hyunjoon An, Ri Na Yoo, Hyeon-Min Cho, Bong-Hyeon Kye; Ann Coloproctol. 2024;40(3):225-233. Published online June 19, 2024; DOI: https://doi.org/10.3393/ac.2023.00059.0008

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Purpose
Preoperative colonoscopic (POC) localization is recommended for patients scheduled for elective laparoscopic colectomy for early colon cancer. Among the various localization method, POC tattooing localization has been widely used. Several dyes have been used for tattooing, but dye has disadvantages, including foreign body reactions. For this reason, we have used autologous blood tattooing for POC localization. This study aimed to evaluate the safety and efficacy of the autologous blood tattooing method.
Methods
This study included patients who required POC localization of the colonic neoplasm among the patients who were scheduled for elective colon resection. The indication for localization was early colon cancer (clinically T1 or T2) or colonic neoplasms that could not be resected endoscopically. POC autologous blood tattooing was performed after saline injection, and 2 hemoclips were applied.
Results
A total of 45 patients who underwent autologous blood tattooing and laparoscopic colectomy were included in this study. All POC localization sites were visible in the laparoscopic view. POC localization sites showed almost perfect agreement with intraoperative surgical findings. There were no complications like bowel perforation, peritonitis, hemoperitoneum, and mesenteric hematoma.
Conclusion
Autologous blood is a safe and effective agent for localizing materials that can replace previous dyes. However, a large prospective case-control study is required for the routine application of this procedure in early colon cancer or colonic neoplasms.

Citations

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Meeting report on the 8th Asian Science Editors’ Conference and Workshop 2024
Eun Jung Park
Science Editing.2025; 12(1): 66. CrossRef
Preoperative Localization, Margins, and Intraoperative Endoscopy in Minimally Invasive Sigmoid Colectomy: A Matched Cohort
Chang-Lin Lin, Feng-Fan Chiang, Ming-Cheng Chen, Chun-Yu Lin, Shang-Chih Huang, Ching-Shiang Lin
Journal of Surgical Research.2025; 315: 847. CrossRef

Benign bowel disease

Short-term outcomes in patients undergoing laparoscopic surgery for deep infiltrative endometriosis with rectal involvement: a single-center experience of 168 cases: Sara Gortázar de las Casas, Emanuela Spagnolo, Salomone Di Saverio, Mario Álvarez-Gallego, Ana López Carrasco, María Carbonell López, Sergio Torres Cobos, Constantino Fondevila Campo, Alicia Hernández Gutiérrez, Isabel Pascual Miguelañez; Ann Coloproctol. 2023;39(3):216-222. Published online March 7, 2022; DOI: https://doi.org/10.3393/ac.2021.00829.0118

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Abstract PDF

Purpose
The surgical management of deep infiltrative endometriosis (DE) involving the rectum remains a challenge. The objective of this study was to assess the outcomes from a single tertiary center over a decade with an emphasis on the role of a protective loop ileostomy (PI).
Methods
A retrospective review of outcomes for 168 patients managed between 2008 and 2018 is presented including 57 rectal shaves, 23 discoid excisions, and 88 segmental rectal resections.
Results
The nodule size (mean±standard deviation) in the segmental resection group was 32.7±11.2 mm, 23.4±10.5 mm for discoid excision, and 18.8±6.0 mm for rectal shaves. A PI was performed in 19 elective cases (11.3%) usually for an ultra-low anastomosis <5 cm from the anal verge. All Clavien-Dindo grade III/IV complications occurred after segmental resections and included 5 anastomotic leaks, 6 rectovaginal fistulas, 2 ureteric fistulas, and 1 ureteric stenosis. Of 26 stomas (15.5%), there were 19 PIs, 3 secondary ileostomies (after complications), and 4 end colostomies. The median time to PI closure was 5.8 months (range, 0.4–16.7 months) in uncomplicated disease compared with 9.2 months (range, 4.7–18.4 months) when initial postoperative complications were recorded (P=0.019). Only 1 patient with a recurrent rectovaginal fistula had a permanent colostomy.
Conclusion
In patients with DE and rectal involvement a PI is selectively used for low anastomoses and complex pelvic reconstructions. Protective stomas and those used in the definitive management of a major postoperative complication can usually be reversed.

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Surgeons' workload assessment during indocyanine-assisted deep endometriosis surgery using the surgery task load index: The impact of the learning curve
Emanuela Spagnolo, Ignacio Cristóbal Quevedo, Sara Gortázar de las Casas, Ana López Carrasco, Maria Carbonell López, Isabel Pascual Migueláñez, Alicia Hernández Gutiérrez
Frontiers in Surgery.2022;[Epub] CrossRef
Quality of Life in Women after Deep Endometriosis Surgery: Comparison with Spanish Standardized Values
Alicia Hernández, Elena Muñoz, David Ramiro-Cortijo, Emanuela Spagnolo, Ana Lopez, Angela Sanz, Cristina Redondo, Patricia Salas, Ignacio Cristobal
Journal of Clinical Medicine.2022; 11(20): 6192. CrossRef

Benign GI diease,Surgical technique

Laparoscopic Hartmann’s Reversal: Application of a Single-Port Approach Through the Colostomy Site: Byung Mo Kang, Chang Woo Kim, Suk-Hwan Lee; Ann Coloproctol. 2021;37(1):29-34. Published online December 4, 2020; DOI: https://doi.org/10.3393/ac.2020.09.21

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Abstract PDF

Purpose
Recently, laparoscopic reversal of Hartmann’s colostomy was performed with favorable outcomes by many surgeons. We partially applied the concepts of single-port laparoscopic procedure through the colostomy site to remove intraperitoneal adhesion during initial step of the laparoscopic Hartmann’s reversal. This study aimed to evaluate the feasibility and safety of the laparoscopic reversal of Hartmann’s colostomy with the application of single-port laparoscopic techniques through the colostomy site.
Methods
From October 2008 to November 2018, the laparoscopic Hartmann’s reversal was attempted in 20 patients. After colostomy take-downs, the single-port device was installed at the colostomy site and the single-port laparoscopic procedure was performed to remove intraperitoneal adhesions to provide space for additional trocars. After additional trocars were inserted, the descending colon and rectal stump were mobilized, and the colorectal anastomosis was completed. We retrospectively reviewed the medical records and analyzed the data to identify the perioperative complication rates as the primary outcome.
Results
Of the 20 patients, 3 patients (15.0%) had open conversions due to severe adhesions. Intraoperative small bowel injuries occurred in 2 patients (10.0%) and these were repaired through the colostomy site. Postoperative complications developed in 4 patients (20.0%) and were managed with medical treatments or wound closures under local anesthesia.
Conclusion
The single-port laparoscopic procedure through the colostomy site is sufficiently safe in order to complete the Hartmann’s reversal. We recommend that the colostomy site should be used as the access route into the abdominal cavity for the Hartmann’s reversal.

Citations

Citations to this article as recorded by

Single‐port laparoscopic reversal of Hartmann's procedure through the colostomy site: technical aspects and early postoperative outcomes
Ahmet Akmercan, Tayfun Akmercan, Tevfik Kıvılcım Uprak
ANZ Journal of Surgery.2025; 95(1-2): 151. CrossRef
Handmade Single-Port Laparoscopic Hartmann’s Stoma Reversal Procedure
Ahmet Akmercan, Ali Hajali, Tevfik Kıvılcım Uprak
Videoscopy.2025; 35(1): 1. CrossRef
Impact of single-port laparoscopic approach on scar assessment by patients and observers: a multicenter retrospective study
Sung Uk Bae, Kyeong Eui Kim, Chang-Woo Kim, Ji-Hoon Kim, Woon Kyung Jeong, Yoon-Suk Lee, Seong Kyu Baek, Suk-Hwan Lee, Jun-Gi Kim
Annals of Coloproctology.2025; 41(2): 154. CrossRef
Comparison between liquid skin adhesive and wound closure strip for skin closure after subcuticular suturing in single-port laparoscopic appendectomy: a single-center retrospective study in Korea
Kyeong Eui Kim, Yu Ra Jeon, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Journal of Minimally Invasive Surgery.2024; 27(1): 14. CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Laparoskopische Kontinuitätswiederherstellung nach der Hartmann-Operation
Andreas Türler, Nicola Cerasani, Haug-Lambert Loriz, Xenia Kemper, Moritz Weckbecker, Maike Derenbach, Anna Krappitz
coloproctology.2022; 44(1): 35. CrossRef

Malignant disease, Rectal cancer

First Feasibility Study and Short-term Outcomes of Laparoscopic-Assisted Anterior Resection in Colorectal Cancer in Malaysia: Henry Chor Lip Tan, Jih Huei Tan, Nur Akmalrudin Nur Dzainuddin, Koon Khee Chan; Ann Coloproctol. 2020;36(2):94-101. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.05.10

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Abstract PDF

Purpose
The purpose of this study was to demonstrate the feasibility and safety of laparoscopic-assisted anterior resection (LAAR) for colorectal cancer in a local Asian population.
Methods
This is a retrospective review of all patients with colorectal cancer operated from November 2017 to October 2018. Main variables of interest were demography, type and surgery, length of stay (LOS), and the involvement of proximal and distal doughnut. Postoperative complications were analysed using chi-square or Fisher exact and Mann-Whitney tests.
Results
There were 23 patients with a mean age of 62.5 ± 12.2 years. The mean time from diagnosis to surgery was 97.1 ± 154.84 days. There were 12 patients in the LAAR group and 11 in the open anterior resection (OAR) group. Duration of surgery was shorter in OAR (129.58 ± 51.38 minutes) compared to LAAR (147.91 ± 39.37 minutes). Mean LOS was shorter in the LAAR group with 5±1.5 days compared to the OAR group of 7.42 ± 4.25 days. However, there was no significant P-value for both duration of surgery (P = 0.322) or LOS (P = 0.87). A total of 3 complications were recorded after OAR and 2 after LAAR. Both groups had clear proximal and distal margins with 16 (12–18.5) harvested lymph nodes in LAAR and 18 (16–22) in OAR, which were equal (P = 0.155).
Conclusion
This study reports a shorter LOS in the minimally invasive group of 2 days with similar oncologic resection outcomes. This shows that LAAR is feasible in Malaysia and has potential outcome benefits.

Citations

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Short-Term Surgical Outcomes of Curative Colorectal Resections from an Evolving Low-Volume Cancer Center in a Tier-2 City in India
Vishnu S. Menon, Amita Sekhar Padhy, Rigved Nittala, Mounika Basani, Sidaksingh R. Arora
Indian Journal of Surgical Oncology.2025;[Epub] CrossRef
Five-year follow-up retrospective review of colorectal cancer patients in Johor Bahru
Jih Huei Tan, Hoo Zhi Ai, Keith Tan Jian Li, Lai Yong Sheng, Anoopurany Subramaniam, Aishath Rahy Abdul Latheef, Cheah Suang Yao, Kelly Loo Kai Li, Ian Chiew Juin Liang, Raymond Lim Zhun Ming, Henry Tan Chor Lip, Koon Khee Chan
Proceedings of Singapore Healthcare.2025;[Epub] CrossRef
A single-center retrospective cohort study on the effects of different surgical routes on complications after radical resection of low rectal cancer
Ruifeng Ye, Weixin Wu, Chongbiao Chen, Long Yi, Qin Gao
BMC Surgery.2025;[Epub] CrossRef
Perforated caecal carcinoma within a strangulated inguinal hernia
Wick Champ Lai, Mogaraj Sellapan, Novinth Kumar Raja Ram, Henry Tan Chor Lip
ANZ Journal of Surgery.2022; 92(6): 1512. CrossRef
Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and Current Management
Seung Mi Yeo, Gyung Mo Son
The Ewha Medical Journal.2022;[Epub] CrossRef
Critical adjustments and trauma surgery trends in adaptation to COVID-19 pandemic in Malaysia
Henry Tan Chor Lip, Tan Jih Huei, Yuzaidi Mohamad, Rizal Imran Alwi, Tuan Nur' Azmah Tuan Mat
Chinese Journal of Traumatology.2020; 23(4): 207. CrossRef

Malignant disease, Rectal cancer,Prognosis and adjuvant therapy

Effect of Age on Laparoscopic Surgery and Postoperative Chemotherapy in Elderly Patients With Colorectal Cancer: Hyun Hee Kim, Myong Hoon Ihn, Yun Hee Lee, Jihyoun Lee, Sangchul Yun, Sung Woo Cho; Ann Coloproctol. 2020;36(4):229-242. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2019.10.03

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Abstract PDF Supplementary Material

Purpose
We aimed to evaluate the postoperative complications of laparoscopic colorectal cancer (CRC) surgery and the adverse events of postoperative chemotherapy in elderly patients compared to younger patients and to identify the factors influencing the termination of postoperative chemotherapy.
Methods
Between June 2015 and May 2018, 188 patients with CRC underwent laparoscopic surgery with curative intent. Patients aged ≥ 70 were defined as elderly. Postoperative complications and adverse events of chemotherapy were assessed by using the Clavien-Dindo classification and the Common Terminology Criteria for Adverse Events, respectively. The clinicopathological factors were analyzed retrospectively.
Results
Seventy-eight patients were considered elderly with a mean age of 77.5 ± 5.5 years. Overall postoperative complications occurred in 68 patients (36.2%). Age and primary tumor location were independent predictors of overall postoperative complications. Smoking history was the only independent predictor of major postoperative complications. Of 113 patients who were recommended postoperative chemotherapy, 90 patients (79.6%) received postoperative chemotherapy. Overall adverse events occurred in 40 patients (44.4%). The American Society of Anesthesiologists physical status classification and chemotherapy regimen were significantly associated with overall adverse events. The chemotherapy regimen was the only factor significantly associated with severe adverse events. Of 90 patients, postoperative chemotherapy could not be completed in 11 (12.2%). Age was the only factor significantly associated with stopping postoperative chemotherapy (P = 0.003).
Conclusion
This study shows that laparoscopic CRC surgery and postoperative chemotherapy were feasible in elderly patients. Further efforts are needed to ensure that elderly patients have the opportunity to make informed decisions regarding postoperative chemotherapy.

Citations

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Outcome of robotic colon surgery in older patients with colon cancer
Ellen Van Eetvelde, Manu Verweirder, Lore Decoster, Daniel Jacobs-Tulleneers-Thevissen
Journal of Geriatric Oncology.2025; 16(3): 102205. CrossRef
Survival Benefits of Postoperative Chemotherapy in Patients With Colorectal Mucinous Adenocarcinoma: An Analysis Utilizing Propensity Score Matching From the Surveillance, Epidemiology, and End Results Database
Jun Rong, Wensheng Deng
The American Surgeon™.2024; 90(11): 2969. CrossRef
Nutritional Status Indicators Predict Tolerability to Adjuvant Chemotherapy in Patients with Stage II/III Rectal Cancer Undergoing Neoadjuvant Chemoradiotherapy
Shinya Abe, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Yuichiro Yokoyama, Hiroyuki Matsuzaki, Yuzo Nagai, Takahide Shinagawa, Hirofumi Sonoda, Soichiro Ishihara
Digestion.2024; 105(5): 345. CrossRef
Abdominal Aortic Calcification as a Predictor of Incomplete Adjuvant Chemotherapy in Stage III Colorectal Cancer: A Retrospective Cohort Study
Kouki Imaoka, Manabu Shimomura, Hiroshi Okuda, Takuya Yano, Shintaro Akabane, Masahiro Ohira, Yuki Imaoka, Tetsuya Mochizuki, Minoru Hattori, Hideki Ohdan
Cureus.2024;[Epub] CrossRef
Effect of continuous wound infiltration on patients using intravenous patient-controlled analgesia for pain management after reduced-port laparoscopic colorectal surgery
Hyeon Deok Choi, Sung Uk Bae
Annals of Coloproctology.2024; 40(6): 564. CrossRef
Differences in prognosis and underuse of adjuvant chemotherapy between elderly and non‐elderly patients in stage III colorectal cancer
Takuya Shiraishi, Hiroomi Ogawa, Ikuma Shioi, Naoya Ozawa, Katsuya Osone, Takuhisa Okada, Makoto Sohda, Ken Shirabe, Hiroshi Saeki
Annals of Gastroenterological Surgery.2023; 7(1): 91. CrossRef
Clinical outcomes and cost comparison of laparoscopic versus open surgery in elderly colorectal cancer patients over 80 years
Aik Yong Chok, Ivan En-Howe Tan, Yun Zhao, Madeline Yen Min Chee, Hui Lionel Raphael Chen, Kwok Ann Ang, Marianne Kit Har Au, Emile John Kwong Wei Tan
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Association between social background and implementation of postoperative adjuvant chemotherapy for older patients undergoing curative resection of colorectal cancers, sub-analysis of the HiSCO-04 study
Tomoaki Bekki, Manabu Shimomura, Yasufumi Saito, Masahiro Nakahara, Tomohiro Adachi, Satoshi Ikeda, Yosuke Shimizu, Masatoshi Kochi, Yasuyo Ishizaki, Masanori Yoshimitsu, Yuji Takakura, Wataru Shimizu, Daisuke Sumitani, Shinya Kodama, Masahiko Fujimori, M
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Operative and Survival Outcomes of Robotic-Assisted Surgery for Colorectal Cancer in Elderly and Very Elderly Patients: A Study in a Tertiary Hospital in South Korea
Hugo Cuellar-Gomez, Siti Mayuha Rusli, María Esther Ocharan-Hernández, Tae-Hoon Lee, Guglielmo Niccolò Piozzi, Seon-Hahn Kim, Cruz Vargas-De-León, Yazhou He
Journal of Oncology.2022; 2022: 1. CrossRef
Multidisciplinary treatment strategy for early colon cancer
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Korean Medical Association.2022; 65(9): 558. CrossRef
Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 203. CrossRef
Adjuvant Chemotherapy in Elderly Colorectal Cancer Patients
Bengt Glimelius, Erik Osterman
Cancers.2020; 12(8): 2289. CrossRef

Impact of Patient’s Pain and Fatigue on Decision of Discharge After Laparoscopic Surgery for Colorectal Cancer: Gyeora Lee, Jun-Suh Lee, Ji Hoon Kim, Duk Yeon Hwang, Yoon-Suk Lee; Ann Coloproctol. 2019;35(4):209-215. Published online August 31, 2019; DOI: https://doi.org/10.3393/ac.2018.11.29

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Abstract PDF

Purpose
Hospital stays after laparoscopic surgery for colorectal cancer tend to be much shorter than those after conventional open surgery. Many factors, including surgical outcomes and complications, are associated with patient discharge planning. However, few studies have analyzed the impact of patient subjective discomfort (including pain and fatigue) on the decision to discharge after surgery. Therefore, the purpose of this study was to determine how patient pain and fatigue play a role in the decision to discharge after laparoscopic surgery for colorectal cancer.
Methods
Between March 2014 and February 2015, we conducted a questionnaire survey of 91 patients who underwent laparoscopic surgery for colorectal cancer to estimate the expectation criteria for discharge and patient subjective discomfort at that time. Patients were divided into the following 2 groups: group A, those who complied with the medical professional’s decision to discharge; and group B, those who refused discharge despite the medical professional’s decision. The participants’ subjective factors were analyzed.
Results
Preoperatively, 78 of 91 patients (85.7%) identified activity level, amount of food (tolerance), and bowel movements as important factors that should be considered in the decision to discharge a patient postoperatively. Postoperatively, 17 patients (18.7%) refused discharge despite a discharge recommendation. Subjective pain and fatigue were significantly different in linear-by-linear association between the group of patients who agreed to be discharge and those who disagreed. Despite this difference, there was no significant difference in mean length of hospital stay between the 2 groups.
Conclusion
A patient’s subjective feelings of pain and fatigue can impact their decision regarding hospital discharge.

Citations

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Effect of continuous wound infiltration on patients using intravenous patient-controlled analgesia for pain management after reduced-port laparoscopic colorectal surgery
Hyeon Deok Choi, Sung Uk Bae
Annals of Coloproctology.2024; 40(6): 564. CrossRef
The Impact of an Enhanced Recovery Protocol in a High-Risk Population Undergoing Colon Cancer Surgery
Denise L. Wong, Alexis Holland, Mehmet Kocak, Mace Coday, Caroline Brown, Justin J. Monroe, Nathan M. Hinkle, Jeremiah L. Deneve, Evan S. Glazer, David Shibata
The American Surgeon™.2023; 89(11): 4485. CrossRef
Effectiveness of Aromatherapy on Ameliorating Fatigue in Adults: A Meta-Analysis
Qiuting Wang, Lin Wei, Yueming Luo, Lijun Lin, Chong Deng, Ping Hu, Lijia Zhu, Yangchen Liu, Meizhen Lin, Azizah Ugusman
Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1. CrossRef
Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge
Thaís T. T. Tweed, Carmen Woortman, Stan Tummers, Maikel J. A. M. Bakens, James van Bastelaar, Jan H. M. B. Stoot
International Journal of Colorectal Disease.2021; 36(7): 1535. CrossRef
The Impact of Patient’s Pain and Fatigue on the Discharge Decision After Laparoscopic Surgery for Colorectal Cancer
Won Beom Jung
Annals of Coloproctology.2019; 35(4): 158. CrossRef

Video

Reduced-Port Laparoscopic Surgery for Patients With Proximal Transverse Colon Cancer With Situs Inversus Totalis: A Case Report: Seung-Seop Yeom, Kyung Hwan Kim, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim, Young Jin Kim; Ann Coloproctol. 2018;34(6):322-325. Published online December 31, 2018; DOI: https://doi.org/10.3393/ac.2018.05.29.1

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Abstract PDF Supplementary Material

Situs inversus is a rare hereditary disorder in which various anomalies have been reported with internal rotation abnormalities. This case involved an 85-year-old woman who had been diagnosed with transverse colon cancer and who underwent reduced-port laparoscopic surgery. All intra-abdominal organs were reversed left to right and right to left. The aberrant midcolic artery was identified during surgery. The total surgery time was 170 minutes, and the patient lost 20 mL of blood. The patient was discharged on the 8th postoperative day without complications.

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Laparoscopic common bile duct exploration to treat choledocholithiasis in situs inversus patients: A technical review
Bo-Ya Chiu, Shu-Hung Chuang, Shih-Chang Chuang, Kung-Kai Kuo
World Journal of Clinical Cases.2023; 11(9): 1939. CrossRef
Laparoscopic radical resection for situs inversus totalis with colonic splenic flexure carcinoma: A case report
Zi-Ling Zheng, Shou-Ru Zhang, Hao Sun, Mao-Cai Tang, Jing-Kun Shang
World Journal of Clinical Cases.2022; 10(16): 5435. CrossRef
MicroRNA-129-3p Inhibits Colorectal Cancer Proliferation
Lei Kang, Dongmei Guo, Yanhai Dong, Xiaowei Chen, Chao Yuan
Journal of Biomaterials and Tissue Engineering.2022; 12(12): 2413. CrossRef
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Original Articles

Clinical Outcomes of Reduced-Port Laparoscopic Surgery for Patients With Sigmoid Colon Cancer: Surgery With 1 Surgeon and 1 Camera Operator: Jung Ryul Oh, Sung Chan Park, Sung Sil Park, Beonghoon Sohn, Hyoung Min Oh, Bun Kim, Min Jung Kim, Chang Won Hong, Kyung Su Han, Dae Kyung Sohn, Jae Hwan Oh; Ann Coloproctol. 2018;34(6):292-298. Published online December 3, 2018; DOI: https://doi.org/10.3393/ac.2018.04.06

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Abstract PDF

Purpose
This study compared the perioperative clinical outcomes of reduced-port laparoscopic surgery (RPLS) with those of conventional multiport laparoscopic surgery (MPLS) for patients with sigmoid colon cancer and investigated the safety and feasibility of RPLS performed by 1 surgeon and 1 camera operator.
Methods
From the beginning of 2010 until the end of 2014, 605 patients underwent a colectomy for sigmoid colon cancer. We compared the characteristics, postoperative outcomes, and pathologic results for the patients who underwent RPLS and for the patients who underwent MPLS. We also compared the clinical outcomes of single-incision laparoscopic surgery (SILS) and 3-port laparoscopic surgery.
Results
Of the 115 patients in the RPLS group, 59 underwent SILS and 56 underwent 3-port laparoscopic surgery. The MPLS group included 490 patients. The RPLS group had shorter operating time (137.4 ± 43.2 minutes vs. 155.5 ± 47.9 minutes, P < 0.001) and shorter incision length (5.3 ± 2.2 cm vs. 7.8 ± 1.2 cm, P < 0.001) than the MPLS group. In analyses of SILS and 3-port laparoscopic surgery, the SILS group showed younger age, longer operating time, and shorter incision length than the 3-port surgery group and exhibited a more advanced T stage, more lymphatic invasion, and larger tumor size.
Conclusion
RPLS performed by 1 surgeon and 1 camera operator appears to be a feasible and safe surgical option for the treatment of patients with sigmoid colon cancer, showing comparable clinical outcomes with shorter operation time and shorter incision length than MPLS. SILS can be applied to patients with favorable tumor characteristics.

Citations

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Efficacy and safety of reduced-port laparoscopic surgery versus conventional laparoscopic surgery for colorectal cancer
Zhi-min Liu, Qi-jun Yao, Fengyun Pei, Fang He, Yandong Zhao, Jun Huang
BMC Cancer.2025;[Epub] CrossRef
Short-term and long-term outcomes of single-incision plus one-port laparoscopic surgery for colorectal cancer: a propensity-matched cohort study with conventional laparoscopic surgery
Mingyi Wu, Hao Wang, Xuehua Zhang, Jiaolong Shi, Xiaoliang Lan, Tingyu Mou, Yanan Wang
BMC Gastroenterology.2023;[Epub] CrossRef
Long-term Oncologic Outcomes of Single-Incision Plus One-Port Laparoscopic Surgery for Rectal Cancer
Yasumitsu Hirano, Chikashi Hiranuma, Masakazu Hattori, Kenji Douden
Indian Journal of Surgery.2021; 83(3): 691. CrossRef
LongTerm Outcomes of Three-Port Laparoscopic Right Hemicolectomy Versus Five-Port Laparoscopic Right Hemicolectomy: A Retrospective Study
Tao Zhang, Yaqi Zhang, Xiaonan Shen, Yi Shi, Xiaopin Ji, Shaodong Wang, Zijia Song, Xiaoqian Jing, Feng Ye, Ren Zhao
Frontiers in Oncology.2021;[Epub] CrossRef
Short‐ And medium‐term outcomes of reduced‐port laparoscopic surgery in elderly patients with upper rectal cancer: A retrospective cohort study
Huawen Wu, Zhijian Zheng, Lewei Xu, Yingying Wu, Ziyi Guan, Wenhuan Li, Guofu Chen
Cancer Medicine.2020; 9(15): 5320. CrossRef

Preoperative Tattooing Using Indocyanine Green in Laparoscopic Colorectal Surgery: Sang Jae Lee, Dae Kyung Sohn, Kyung Su Han, Byung Chang Kim, Chang Won Hong, Sung Chan Park, Min Jung Kim, Byung Kwan Park, Jae Hwan Oh; Ann Coloproctol. 2018;34(4):206-211. Published online July 26, 2018; DOI: https://doi.org/10.3393/ac.2017.09.25

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Abstract PDF

Purpose
The aim of the present study was to evaluate the usefulness of indocyanine green (ICG) as a preoperative marking dye for laparoscopic colorectal surgery.
Methods
Between March 2013 and March 2015, 174 patients underwent preoperative colonoscopic tattooing using 1.0 to 1.5 mL of ICG and saline solution before laparoscopic colorectal surgery. Patients’ medical records and operation videos were retrospectively assessed to evaluate the visibility, duration, and adverse effects of tattooing.
Results
The mean age of the patients was 65 years (range, 34–82 years), and 63.2% of the patients were male. The median interval between tattooing and operation was 1.0 day (range, 0–14 days). Tattoos placed within 2 days of surgery were visualized intraoperatively more frequently than those placed at an earlier date (95% vs. 40%, respectively, P < 0.001). For tattoos placed within 2 days before surgery, the visualization rates by tattoo site were 98.6% (134 of 136) from the ascending colon to the sigmoid colon. The visualization rates at the rectosigmoid colon and rectum were 84% (21 of 25) and 81.3% (13 of 16), respectively (P < 0.001). No complications related to preoperative ICG tattooing occurred.
Conclusion
Endoscopic ICG tattooing is more useful for the preoperative localization of colonic lesions than it is for rectal lesions and should be performed within 2 days before laparoscopic surgery.

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Enhancing remanent magnetization of injectable hydrogels improves realtime transluminal localization of tumor in hollow soft viscera
Junnan Gu, Yuxuan Sun, Tianyi Zhang, Zhenxing Jiang, Falong Zou, Denglong Cheng, Wentai Cai, Hao Wen, Shenghe Deng, Jun Wang, Shuang Zhao, Quanliang Cao, Yinghao Cao, Zichun Yang, Liang Li, Jun Ouyang, Kailin Cai
Bioactive Materials.2026; 55: 410. CrossRef
Utility and safety of near-infrared fluorescent marking clips for tumor localization in robot-assisted laparoscopic gastric cancer surgery
Koshi Kumagai, Masashi Yoshida, Hiroki Ishida, Naoki Ishizuka, Manabu Ohashi, Rie Makuuchi, Masaru Hayami, Satoshi Ida, Yohei Ikenoyama, Ken Namikawa, Yoshitaka Tokai, Shoichi Yoshimizu, Yusuke Horiuchi, Akiyoshi Ishiyama, Toshiyuki Yoshio, Toshiaki Hiras
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Accuracy evaluation of preoperative indocyanine green tattooing and intraoperative colonoscopy in determining surgical resection margins for left-sided colorectal cancer: a retrospective study in Korea
Byung-Soo Park, Sung Hwan Cho, Gyung Mo Son, Hyun Sung Kim, Jin Ook Jang, Dae Gon Ryu, Su Jin Kim, Su Bum Park, Hyung Wook Kim
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Comparison of Surgical Skills in Laparoscopic and Robotic Tasks Between Experienced Surgeons and Novices in Laparoscopic Surgery: An Experimental Study: Hye Jin Kim, Gyu-Seog Choi, Jun Seok Park, Soo Yeun Park; Ann Coloproctol. 2014;30(2):71-76. Published online April 25, 2014; DOI: https://doi.org/10.3393/ac.2014.30.2.71

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Abstract PDF

Purpose

Robotic surgery is known to provide an improved technical ability as compared to laparoscopic surgery. We aimed to compare the efficiency of surgical skills by performing the same experimental tasks using both laparoscopic and robotic systems in an attempt to determine if a robotic system has an advantage over laparoscopic system.

Methods

Twenty participants without any robotic experience, 10 laparoscopic novices (LN: medical students) and 10 laparoscopically-experienced surgeons (LE: surgical trainees and fellows), performed 3 laparoscopic and robotic training-box-based tasks. This entire set of tasks was performed twice.

Results

Compared with LN, LEs showed significantly better performances in all laparoscopic tasks and in robotic task 3 during the 2 trials. Within the LN group, better performances were shown in all robotic tasks compared with the same laparoscopic tasks. However, in the LE group, compared with the same laparoscopic tasks, significantly better performance was seen only in robotic task 1. When we compared the 2 sets of trials, in the second trial, LN showed better performances in laparoscopic task 2 and robotic task 3; LE showed significantly better performance only in robotic task 3.

Conclusion

Robotic surgery had better performance than laparoscopic surgery in all tasks during the two trials. However, these results were more noticeable for LN. These results suggest that robotic surgery can be easily learned without laparoscopic experience because of its technical advantages. However, further experimental trials are needed to investigate the advantages of robotic surgery in more detail.

Citations

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Safety and Feasibility of a Laparoscopic Colorectal Cancer Resection in Elderly Patients: Duck Hyoun Jeong, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Nam Kyu Kim; Ann Coloproctol. 2013;29(1):22-27. Published online February 28, 2013; DOI: https://doi.org/10.3393/ac.2013.29.1.22

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21 Citations

Abstract PDF

Purpose

The aim of this study is to assess the effects of age on the short-term outcomes of a laparoscopic resection of colorectal cancer in elderly (≥75 years old), as compared with younger (<75 years old), patients.

Methods

A retrospective analysis of patients who underwent laparoscopic surgery for colorectal cancer between January 2007 and December 2009 was performed. There were two groups: age <75 years old (group A) and age ≥75 years old (group B). The perioperative outcomes between group A and group B were compared.

Results

The study included 824 patients in group A and 92 patients in group B. The body mass index (BMI) and the American Society of Anesthesiologists (ASA) score were significantly different between group B and group A (BMI: 22.5 vs. 23.5, P = 0.002; ASA score: 1.88 vs. 1.48, P = 0.001). Mean operating times were similar between the groups (325.4 minutes vs. 351.6 minutes, P = 0.07). We observed a higher overall complication rate in group B than in group A (12.0% vs. 6.2%, P = 0.047), but the number of severe complications of Accordion Severity Classification ≥3 (those that required an invasive procedure) was not significantly different between the two groups (6.5% vs. 3.4%, P = 0.142). There was no significant difference in the length of hospital stay (13.0 days vs. 12.0 days, P = 0.053).

Conclusion

Although the elderly patients had a significantly higher overall postoperative complication rate, no significant difference was seen in either the number of severe complications of Accordion Severity Classification ≥3 or in the length of hospital stay. A laparoscopic colorectal cancer resection in elderly patients, especially those aged 75 years or older, is safe and feasible.

Citations

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The Journal of Minimally Invasive Surgery.2017; 20(3): 108. CrossRef
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Laparoscopic surgery for patients with colorectal cancer produces better short‐term outcomes with similar survival outcomes in elderly patients compared to open surgery
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Feasibility of Hand-Assisted Laparoscopic Surgery as Compared to Open Surgery for Sigmoid Colon Cancer: A Case-Controlled Study: Sang Eun Nam, Eun-Joo Jung, Chun-Geun Ryu, Jin Hee Paik, Dae-Yong Hwang; Ann Coloproctol. 2013;29(1):17-21. Published online February 28, 2013; DOI: https://doi.org/10.3393/ac.2013.29.1.17

5,702 View
18 Download
5 Citations

Abstract PDF

Purpose

The aim of this study was to evaluate short-term clinical outcomes by comparing hand-assisted laparoscopic surgery (HALS) with open surgery for sigmoid colon cancer.

Methods

Twenty-six patients who underwent a hand-assisted laparoscopic anterior resection (HAL-AR group) and 52 patients who underwent a conventional open anterior resection during the same period were enrolled (open group) in this study with a case-controlled design.

Results

Pathologic parameters were similar between the two groups. The incidences of immediate postoperative leukocytosis were 38.5% in the HAL-AR group and 69.2% in the open group (P = 0.009). There were no significant differences between the two groups as to leukocyte count, hemoglobin, and hematocrits (P = 0.758, P = 0.383, and P = 0.285, respectively). Of the postoperative recovery indicators, first flatus, sips of water and soft diet started on postoperative days 3, 5, 7 in the HALS group and on days 4, 5, 6 in the open group showed statistical significance (P = 0.021, P = 0.259, and P = 0.174, respectively). Administration of additional pain killers was needed for 1.2 days in the HAL-AR group and 2.4 days in the open group (P = 0.002). No significant differences in the durations of hospital stay and the rates of postoperative complications were noted, and no postoperative mortality was encountered in either group.

Conclusion

The patients with sigmoid colon cancer who underwent a HAL-AR had a lower incidence of postoperative leukocytosis, less administration of pain killers, and faster first flatus than those who underwent open surgery. Clinical outcomes for patients' recovery and pathology status were similar between the two groups. Therefore, a HAL-AR for sigmoid colon cancer is feasible and has the same benefit as minimally invasive surgery.

Citations

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Case Report

Giant Peritoneal Loose Body in the Pelvic Cavity: Joung Teak Jang, Haeng Ji Kang, Ji Young Yoon, Seo Gue Yoon; J Korean Soc Coloproctol. 2012;28(2):108-110. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.108

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Abstract PDF

We report a case of a large peritoneal loose body diagnosed on computed tomography. The most common causes of a peritoneal loose body are thought to be torsion and separation of the appendices epiploicae. Peritoneal loose bodies are usually small, 0.5 to 2.5 cm in diameter. However, "giant" peritoneal loose bodies, larger than 4 cm in diameter, are an uncommon disease and present with various symptoms, and are difficult to diagnose preoperatively. Especially, abdominal large peritoneal loose bodies are frequently misdiagnosed as tumorous disease preoperatively. In our case, the loose body appeared as a round pelvic mass with central calcifications and a distinct fat plane separating it from adjacent organs. Preoperatively, we suspected a tumorous lesion from the wall of the upper rectum; however, at laparoscopy, a large peritoneal loose body was detected. An extraction of the giant peritoneal loose body was performed laparoscopically.

Citations

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Original Article

Comparison of Short-term Surgical Outcomes between a Robotic Colectomy and a Laparoscopic Colectomy during Early Experience: Jin Yong Shin; J Korean Soc Coloproctol. 2012;28(1):19-26. Published online February 29, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.1.19

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Abstract PDF

Purpose

Although robotic surgery was invented to overcome the technical limitations of laparoscopic surgery, the role of a robotic (procto)colectomy (RC) for the treatment of colorectal cancer compared to that of a laparoscopic (procto)colectomy (LC) was not well defined during the initial adoption periods of both procedures. This study aimed to evaluate the efficacy and the safety of a RC for the treatment of colorectal cancer by comparing the authors' initial experiences with both a RC and a LC.

Methods

The first 30 patients treated by using a RC for colorectal cancer from July 2010 to March 2011 were compared with the first 30 patients treated by using a LC for colorectal cancer from December 2006 to June 2007 by the same surgeon. Perioperative variables and short-term outcomes were analyzed. In addition, the 30 RC and the 30 LC cases involved were divided into rectal cancer (n = 17 and n = 12, respectively), left-sided colon cancer (n = 7 and n = 12, respectively) and right-sided colon cancer (n = 6 and n = 6, respectively) for subgroup analyses.

Results

The mean operating times for RC and LC were significantly different at 371.8 and 275.5 minutes, respectively, but other perioperative parameters (rates of open conversion, numbers of retrieved lymph node, estimated blood losses, times to first flatus, maximal pain scores before discharge and postoperative hospital stays) were not significantly different in the two groups. Subgroup analyses showed that the mean operative times for a robotic proctectomy and a laparoscopic proctectomy were 396.5 and 298.8 minutes, respectively (P < 0.000). Postoperative complications occurred in five patients in the RC group and in six patients in the LC group (P = 0.739).

Conclusion

Although the short-term outcomes of a RC during its initial use were better than those of a LC (with the exception of operating time), differences were not found to be significantly different. On the other hand, the longer operation time of a robotic proctectomy compared to that of a laparoscopic proctectomy during the early period may be problematic.

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Case Report

Laparoscopic Approach to a Case of Appendicular Schwannoma: Suk Won Suh, Joong Min Park, Yoo Shin Choi, Sung Jae Cha, In Taik Chang, Beom Gyu Kim; J Korean Soc Coloproctol. 2010;26(4):302-306. Published online August 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.4.302

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Abstract PDF

Appendicular schwannoma is a rare tumor originating from Schwann's cells in the Auerbach plexus. The preoperative diagnosis is difficult because the clinical features are nonspecific, and it is mostly found accidentally via a radiologic image as a tumor, mimicking malignancy. We report a case of an appendicular schwannoma coexisting with an adenocarcinoma in the lung. A laparoscopic appendectomy was done with a clear resection margin, and the immunohistochemical staining showed positive S-100 protein, which confirmed the schwannoma. The patient also underwent a left upper lobectomy of the lung. The patient has been free of recurrence for the 6 months since the operation. The laparoscopic approach could be available for treatment of an appendicular schwannoma, thus avoiding an unnecessary laparotomy.

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Original Articles

Risk Factors for Anastomotic Leakage after Laparoscopic Rectal Resection: Dong Hyun Choi, Jae Kwan Hwang, Yong Tak Ko, Han Jeong Jang, Hyeon Keun Shin, Young Chan Lee, Cheong Ho Lim, Seung Kyu Jeong, Hyung Kyu Yang; J Korean Soc Coloproctol. 2010;26(4):265-273. Published online August 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.4.265

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Abstract PDF

Purpose

The anastomotic leakage rate after rectal resection has been reported to be approximately 2.5-21 percent, but most results were associated with open surgery. The aim of this study was to identify risk factors and their relationship to the experience of the surgeon for anastomotic leakage after laparoscopic rectal resection.

Methods

Between March 2003 and December 2008, 156 patients underwent a laparoscopic rectal resection without a diverting ileostomy. The patients' characteristics, the details of treatment, the intraoperative results, and the postoperative results were recorded prospectively. Univariate and multivariate analyses were applied to identify risk factors for anastomotic leakage.

Results

The majority of operations were performed for malignant disease (n = 150; 96.2%), and 96 patients (61.5%) were males. Conversion to open surgery occurred in 1 case (0.6%). The anastomotic leak rate was 10.3% (16/156), and there were no mortalities. In the univariate analysis, tumor location, anastomotic level, intraoperative events, and operation time were associated with increased anastomotic leakage rate. In the multivariate analysis, anastomotic level (odds ratio [OR], 6.855; 95% confidence interval [CI], 1.271 to 36.964) and operation time (OR, 8.115; 95% CI, 1.982 to 33.222) were significantly associated with anastomotic leakage.

Conclusion

The important risk factors for anastomotic leakage after laparoscopic rectal resection without a diverting ileostomy were low anastomosis and long operation time. An additional procedure, such as diverting stoma, may reduce the anastomotic leakage if it is selectively applied in cases with these risk factors.

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Laparoscopic Appendectomy with a Single Incision in a Single Institute: Jin A Lee, Ki Young Sung, Jun Hyun Lee, Do Sang Lee; J Korean Soc Coloproctol. 2010;26(4):260-264. Published online August 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.4.260

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Abstract PDF

Purpose

The laparoscopic appendectomy has become popular for the treatment of acute appendicitis. A single-incision laparoscopic appendectomy offers better cosmesis. We present the results of single-incision laparoscopic appendectomies in our hospital as initial experience.

Methods

A single-incision laparoscopic appendectomy was performed in 75 patients at The Catholic University of Korea, Bucheon St. Mary's hospital. The operating time, operation type, hospital stay, surgical morbidities, and body mass index were compared.

Results

This retrospective study revealed equal operation times in both the suppurative and the perforated appendicitis group. There was an increase in the hospital stay in the perforated appendicitis group. The postoperative complication rate was 4%, and the median operation time was 58.55 ± 31.79 minutes.

Conclusion

The single-incision laparoscopic appendectomy was easy and safe procedure for treating acute appendicitis. There were no differences in degree of inflammation and body mass index.

Citations

Citations to this article as recorded by

Single-incision versus conventional multi-incision laparoscopic appendicectomy for suspected uncomplicated appendicitis
Ahmer Irfan, Ahsan Rao, Irfan Ahmed
Cochrane Database of Systematic Reviews.2025;[Epub] CrossRef
Single-incision versus conventional multi-incision laparoscopic appendicectomy for suspected uncomplicated appendicitis
Ahmer Irfan, Ahsan Rao, Irfan Ahmed
Cochrane Database of Systematic Reviews.2024;[Epub] CrossRef
A Comparative Study Between Single-Incision Laparoscopic Appendicectomy Using Conventional Instruments and Glove-Port (SILACIG) and Conventional Multiport Laparoscopic Appendicectomy (CMLA)
Ahamed Muneef, Uday Kumbhar, Chellappa Vijayakumar, Oseen Shaikh
Cureus.2020;[Epub] CrossRef
Feasibility of Single Port Laparoscopic Surgery in Patients with Perforated Appendicitis
Byung Seo Choi, Geon Young Byun, Seong Bae Hwang, Sung Ryul Lee
The Journal of Minimally Invasive Surgery.2016; 19(1): 19. CrossRef
A COMPARATIVE STUDY BETWEEN SINGLE INCISION MULTIPORT LAPAROSCOPIC APPENDICECTOMY AND CONVENTIONAL LAPAROSCOPIC APPENDECTOMY
Karunamoorthy Rajachidambaram, Dhinakaran Kaarthesan
Journal of Evolution of Medical and Dental Sciences.2016; 5(39): 2372. CrossRef
The Twin Forceps: A New Instrument for SILS
Antonia Rizzuto, Mario Donnici, Paola Nudo, Basilio Sinopoli, Rosario Sacco, Guido Danieli
BioMed Research International.2015; 2015: 1. CrossRef
Estudio comparativo prospectivo aleatorizado entre apendicectomía laparoscópica por puerto único y apendicectomía laparoscópica convencional
Rafael Villalobos Mori, Jordi Escoll Rufino, Fernando Herrerías González, M.Carmen Mias Carballal, Alfredo Escartin Arias, Jorge Juan Olsina Kissler
Cirugía Española.2014; 92(7): 472. CrossRef
Prospective, Randomized Comparative Study Between Single-port Laparoscopic Appendectomy and Conventional Laparoscopic Appendectomy
Rafael Villalobos Mori, Jordi Escoll Rufino, Fernando Herrerías González, M. Carmen Mias Carballal, Alfredo Escartin Arias, Jorge Juan Olsina Kissler
Cirugía Española (English Edition).2014; 92(7): 472. CrossRef
Surgical Outcomes of Single-port Laparoscopic Appendectomy versus Conventional Laparoscopic Appendectomy in Children: Preliminary Report of a Prospective Randomized Trial
Jung Rae Cho, Won Me Kang, Soo Min Ahn
Journal of the Korean Association of Pediatric Surgeons.2014; 20(2): 48. CrossRef
Single-incision laparoscopic appendectomy versus traditional three-port laparoscopic appendectomy: an analysis of outcomes at a single institution
F. Paul Buckley, Hannah Vassaur, Sharon Monsivais, Daniel Jupiter, Rob Watson, John Eckford
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Comparison between single-incision and conventional three-port laparoscopic appendectomy: a meta-analysis from eight RCTs
Jun Gao, Ping Li, Qingguo Li, Dong Tang, Dao-Rong Wang
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Single-Port Laparoscopic Appendectomy Versus Conventional Laparoscopic Appendectomy
Won-Suk Lee, Sang Tae Choi, Jung Nam Lee, Keon Kug Kim, Yeon Ho Park, Woon Kee Lee, Jeong-Heum Baek, Tae-Hoon Lee
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Comparative Study Between Single-Incision and Three-Port Laparoscopic Appendectomy: A Prospective Randomized Trial
Bong-Hyeon Kye, Junhyun Lee, Wook Kim, Dongjae Kim, Dosang Lee
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Outcomes of Single-Incision Laparoscopic Appendectomy at a Single Center
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A Review of Minimally Invasive Single-Port/Incision Laparoscopic Appendectomy
Haroon Rehman, Tim Mathews, Irfan Ahmed
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Single incision versus conventional multi-incision appendicectomy for suspected appendicitis
Haroon Rehman, Ahsan M Rao, Irfan Ahmed
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Nereo Vettoretto, Vincenzo Mandalà
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H Rehman, I Ahmed
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A Comparison of Standard Laparoscopic Surgery and Hand-Assisted Laparoscopic Surgery in Patients with Diverticular Diseases of the Large and the Small Bowel.: Jung, Jae Hak , Kim, Chang Nam , Park, Jin Seok , Kim, Jong Yup , Cho, Byung Sun , Lee, Min Koo , Choi, Young Jin , Kang, Yoon Jung , Park, Joo Seung; J Korean Soc Coloproctol. 2009;25(6):380-386.; DOI: https://doi.org/10.3393/jksc.2009.25.6.380

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Abstract PDF

PURPOSE
In complicated diverticular disease, hand-assisted laparoscopic surgery (HALS) has been considered as a useful alternative treatment to standard laparoscopic surgery (SLS) and open surgery. As compared with standard laparoscopic surgery, HALS offers advantages such as tactile sense, better exposure, and shorter learning curve. Minimally invasive surgery is another advantage of HALS. The aim of this study was to compare SLS to HALS in patients with diverticular diseases of the small bowel and the colon.
METHODS
We retrospectively reviewed the records of 32 patients who had undergone SLS and HALS for diverticular disease between February 2002 and March 2009. RESULTS: Of the 32 patients, 20 patients (62.5%) were in the SLS group, and 12 patients (37.5%) were in the HALS group. The mean maximal incision length was longer in the HALS group (SLS group vs. HALS group, 4.5 vs. 7.4 cm, P<0.001). However, the mean operating time, the time to flatus, the time to diet, the mean duration of narcotic analgesia, the length of hospital stay, and the postoperative complications were similar. There was no mortality in either group. CONCLUSION: The longest incision length for the HALS group was longer than that for the SLS group, but HALS could reduce the conversion rate and has the many advantages of minimally invasive surgery. For complicated diverticular disease, HALS may be considered as a useful alternative treatment.

Citations

Citations to this article as recorded by

Emergent Colorectal Surgery: What Should Be Considered?
Chang-Nam Kim
Annals of Coloproctology.2016; 32(4): 124. CrossRef

The Impact of Bowel Preparation on Anastomotic Complications after Laparoscopic Colorectal Resection: A Prospective Comparative Study between Oral Polyethylene Glycol and Phosphate Enema.: Baek, Se Jin , Choi, Dong Jin , Kim, Jin , Woo, Si Uk , Min, Byung Wook , Kim, Seon Hahn , Moon, Hong Young; J Korean Soc Coloproctol. 2009;25(5):294-299.; DOI: https://doi.org/10.3393/jksc.2009.25.5.294

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Abstract PDF: PURPOSE
Although most randomized trials demonstrated no advantage of mechanical bowel preparation for colorectal resection, an oral solution is still widely used. The aims of this study were to evaluate whether a single phosphate enema is as effective as oral polyethylene glycol (PEG) solution in preventing anastomotic complications after laparoscopic colorectal surgery and to examine the clinical courses of anastomotic complications.
METHODS
Between September 2006 and December 2007, 309 patients underwent laparoscopic colorectal resection with primary anastomosis. The bowel preparation used was PEG solution during initial period (PEG group), but since February 2007, a single phosphate enema (enema group) was utilized. Postoperative data were prospectively recorded. In patients with anastomotic complications, the clinical course was compared between the two groups.
RESULTS
There were 150 patients in the PEG group and 159 patients in the enema group. Demographics did not differ between the two groups. Anastomotic leakage occurred in 3.3 percent of the patients in the PEG group and 5.7 percent of the patients in the enema group (P=0.326). The rates of anastomotic bleeding were 2.0 and 2.5 percent, respectively (P=0.761). The hospital stays for patients with anastomotic complication were not different between the two groups (P=0.137), but patients in the PEG group (80%) needed reoperation more frequently than those in the enema group (11.1%) (P=0.023).
CONCLUSION
These results suggest that laparoscopic colorectal surgery may be safely performed with a single phosphate enema instead of oral polyethylene glycol.

Initial Experiences with a Laparoscopic Colorectal Resection: a Comparison of Short-term Outcomes for 50 Early Cases and 51 Late Cases.: Seon, Jang Won , Huh, Jung Wook , Cho, Sang Hyuk , Joo, Jae Kyoon , Kim, Hyeong Rok , Kim, Young Jin; J Korean Soc Coloproctol. 2009;25(4):252-258.; DOI: https://doi.org/10.3393/jksc.2009.25.4.252

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PURPOSE
The present study aimed to investigate the safety and the feasibility of laparoscopic colorectal surgery performed by a surgeon during a learning period. METHODS: Between April and December 2008, 101 consecutive patients with colorectal cancers underwent laparoscopic surgery by one colorectal surgeon who previously had no experience with laparoscopic colorectal surgery. Standard laparoscopy with a lymphadenectomy using a 5-port technique was performed according to the tumor location. The patients were divided into two chronological groups: 50 cases early in learning period (early cases) and 51 cases later in the learning period (late cases). RESULTS: The operations were 29 right hemicolectomies, 9 left hemicolectomies, 18 anterior resections, 35 low anterior resections, 6 intersphincteric resections, 2 abdominoperineal resections, and 2 Hartmann's operation. There were 7 conversions (6.9%). The median operating time was 205 (range, 95-385) min, and the median blood loss was 258 (50-800) mL. The median times to flatus per anus and to feeding of soft diet were 2 (1-5) and 4 (2-13) days, respectively. The median hospital stay was 9 (6-27) days. There were 21 postoperative complications, including 7 anastomotic complications (3 leakages, 3 abscesses, and 1 stenosis). The median number of lymph nodes harvested was 20 (4-65). The operating time, blood loss, and complication rates were significantly decreased in the late group. CONCLUSION: Our initial experience with laparoscopic colorectal surgery appears to have acceptable perioperative results and short-term oncologic outcomes, which improved with the experience of the surgeon.

Citations

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Initial experience of a surgical fellow in laparoscopic colorectal cancer surgery under training protocol and supervision: comparison of short-term results for 70 early cases (under supervision) and 73 late cases (without supervision)
Ji-Hun Kim, In-Kyu Lee, Won-kyung Kang, Seung-Teak Oh, Jun-Gi Kim, Yoon-Suk Lee
Surgical Endoscopy.2013; 27(8): 2900. CrossRef

Case Report

Laparoscopic Management of Sigmoid Volvulus for Which Endoscopic Reduction had Failed.: Choi, Sung Il , Lee, Suk Hwan; J Korean Soc Coloproctol. 2008;24(5):390-393.; DOI: https://doi.org/10.3393/jksc.2008.24.5.390

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The laparoscopic approach to the treatment of sigmoid volvulus has been challenging because of the different anatomy of the colon and the mesentery. We report a case of a laparoscopic sigmoidectomy and anastomosis for a patient with sigmoid volvulus for whom endoscopic reduction had failed. A 68-year-old man with sigmoid colon volvulus underwent laparoscopic surgery. The laparoscopic surgery was difficult because of the tortuous and dilated bowel and the many fibrous bands. We performed an intraoperative decompression by using a rectal tube through the anus and a primary anastomosis without on- table preparation. The patient was discharged six days later without complications. We assumed that laparoscopic resection and anastomosis is a safe, effective procedure for the management of sigmoid volvulus.

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Single-port laparoscopic surgery for sigmoid volvulus
Byung Jo Choi
World Journal of Gastroenterology.2015; 21(8): 2381. CrossRef

Original Articles

Mid-term Results of Laparoscopic Surgery and Open Surgery for Radical Treatment of Colorectal Cancer.: Lee, Gil Jae , Lee, Jung Nam , Oh, Jae Hwan , Baek, Jeong Heum; J Korean Soc Coloproctol. 2008;24(5):373-379.; DOI: https://doi.org/10.3393/jksc.2008.24.5.373

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7 Citations

Abstract PDF

PURPOSE
The aims of this study were to assess the oncologic safety of laparoscopic colorectal surgery compared to that of conventional open surgery and to compare the disease-free survival (DFS) rates between laparoscopic and open colorectal surgery for radical treatment of colorectal cancer.
METHODS
From January 2001 to December 2005, 583 patients underwent laparoscopic or conventional open surgery. To address only radical treatment of colorectal cancer, we excluded subjects who had undergone emergency or palliative operation. Four hundred ninety patients were identified for this study. The laparoscopic (LG) and open group (OG) had 74 and 166 patients, respectively, for colon cancer, and 92 and 158 patients, respectively, for the rectal cancer.
RESULTS
No difference was noted in the lengths of the distal margins of the resected bowels between the LG and the OG for rectal cancer (P>0.05). In addition, no significant difference was found in DFS rates between the LG and the OG for both colon and rectal cancer (P>0.05).
CONCLUSIONS
The laparoscopic technique does not seem to present any disadvantages and is safe and feasible for the treatment of colorectal cancer. No difference was found between laparoscopic and open surgery in terms of DFS for colorectal cancer.

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Effects of Heated-Humidified Anesthetic Gas in the Elderly Patients with Colorectal Cancer during Laparoscopic Surgery: Randomized Controlled Trial
Hyo-Sun Park, Younhee Kang
Korean Journal of Adult Nursing.2018; 30(2): 206. CrossRef
Comparison of long-term oncologic outcomes of stage III colorectal cancer following laparoscopic versus open surgery
Jeong-Heum Baek, Gil-Jae Lee, Won-Suk Lee
Annals of Surgical Treatment and Research.2015; 88(1): 8. CrossRef
Experience of Colorectal Cancer Survival Journeys: Born Again after Going Through an Altered Self Image
Jung-Ae Park, Kyung Sook Choi
Asian Oncology Nursing.2013; 13(3): 163. CrossRef
Robotic and laparoscopic total mesorectal excision for rectal cancer: a case-matched study
Jeong-Heum Baek, Carlos Pastor, Alessio Pigazzi
Surgical Endoscopy.2011; 25(2): 521. CrossRef
Long-term Outcomes of Laparoscopic Surgery for Colorectal Cancer
Jeong-Eun Lee, Yong-Geul Joh, Sang-hwa Yoo, Geu-Young Jeong, Sung-Han Kim, Choon-Sik Chung, Dong-Gun Lee, Seon Hahn Kim
Journal of the Korean Society of Coloproctology.2011; 27(2): 64. CrossRef
Oncologic Outcomes of Robotic-Assisted Total Mesorectal Excision for the Treatment of Rectal Cancer
Jeong-Heum Baek, Shaun McKenzie, Julio Garcia-Aguilar, Alessio Pigazzi
Annals of Surgery.2010; 251(5): 882. CrossRef
Complications of Robotic Total Mesorectal Excision
Jeong-Heum Baek, Shaun McKenzie, Alessio Pigazzi
Seminars in Colon and Rectal Surgery.2009; 20(4): 190. CrossRef

Learning Curve for Laparoscopic Colorectal Surgery: Hand Assisted Laparoscopic Surgery (HALS) versus Conventional Laparoscopic Surgery (CLS).: Yun, Hae Ran , Lee, Won Suk , Yun, Seong Hyeon , Lee, Woo Yong , Chun, Ho Kyung; J Korean Soc Coloproctol. 2007;23(3):161-166.; DOI: https://doi.org/10.3393/jksc.2007.23.3.161

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Purpose
Laparoscopic colorectal surgery is technically demanding and needs a longer learning curve than open surgery. HALS (hand-assisted laparoscopic surgery) is a useful alternative to conventional laparoscopic surgery (CLS) because of its palpability and hand dissection. We compared the learning curves between HALS and CLS for colorectal surgery. Methods: A prospective study without randomization was conducted with the participation of two colorectal surgeons who had not experienced a laparoscopic colorectal operation. The collected data included operative features, oncologic outcomes, and early clinical outcomes. Fifty patients were enrolled in each group, the HALS group and the CLS group. Results: None of the operations converted to open surgery. The operative time was significantly shorter in the HALS group than in the CLS group (149.6+/-34.6 minutes versus 179.1+/-36.5 minutes, P<0.001). On a subgroup analysis of the operative time in the anterior resection, the operative time was consistent after the 13th operation in HALS group. However, in CLS group, there was a continuous fluctuation of the operative time until 25 cases. In regard to the oncologic outcome, the numbers of total harvested lymph nodes and the proximal and the distal margins in the anterior resection showed no statistical differences (P=0.400, P=0.908, and P=0.073, respectively). The early clinical results were similar in both groups.
Conclusions
In the learning curve study, the HALS group had a shorter operative time and reached a learning curve plateau earlier than the CLS group. Other parameters, such as the oncologic results and the early postoperative clinical outcomes, showed no differences between the two groups.

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Comparison and short-term outcomes between hand-assisted laparoscopic surgery and conventional laparoscopic surgery for anterior resections of left-sided colon cancer
Hae Ran Yun, Yong Kwon Cho, Yong Beom Cho, Hee Cheol Kim, Seong Hyeon Yun, Woo Yong Lee, Ho-Kyung Chun
International Journal of Colorectal Disease.2010; 25(8): 975. CrossRef

Comparative Evaluation of Immune Responses after Laparoscopic and Open Surgery in Patients with Colorectal Cancer.: Lee, In Taek , Choi, Gyu Seog , Weidong, Liu , Won, Dong Il , Jo, Min Jung , Jun, Soo Han; J Korean Soc Coloproctol. 2006;22(5):314-321.

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Abstract PDF: PURPOSE
The laparoscopic approach is thought to reduce postoperative immunologic and metabolic effects after surgery compared to the open approach. This study was designed to compare the systemic immune and metabolic responses after laparoscopic and open surgery in patients with colorectal cancer.
METHODS
Forty-four patients with colorectal cancer were prospectively assigned to undergo either a laparoscopic (n=22) or open (n=22) approach. The postoperative immune and metabolic responses were assessed by measuring the serum level of the relative proportion of lymphocytes, the T-cell count, the natural killer cell (NK-cell) count, the human leukocyte antigen-DR (HLA-DR) expression on monocytes, the interleukin-6 (IL-6), and the C-reactive protein (CRP) at specific time intervals.
RESULTS
Both approaches resulted in a significant decrease in lymphocyte count, T-cell count, NK-cell count, and HLA-DR expression on monocytes at 2, 24, and 72 hours postoperatively. However, the decrease in HLA-DR expression on monocytes was more significant in open surgery at 2 hour postoperatively (mean level, laparoscopic: 90.9% vs. open: 83.1%, P<0.001). Significant rises in IL-6 and CRP were demonstrated within 72 hour postoperatively in both groups. However, no significant difference between the two groups was seen.
CONCLUSIONS
Although both laparoscopic and open surgery in patients with colorectal cancer evoked an alteration of the systemic inflammatory and immune response, our data showed that a HLA-DR expression on monocytes may be less compromised after laparoscopic approach for an immediate postoperative period. However, clearer evidence from large-scaled prospective randomized trials are needed.

Safety and Efficacy of Colonoscopic Tattooing of a Colorectal Neoplasm Prior to a Laparoscopic Resection.: Kim, Duck Woo , Sohn, Dae Kyung , Choi, Hyo Seong , Chang, Hee Jin , Han, Kyung Soo , Lim, Seok Byung , Chung, Seung Yong , Park, Jae Gahb; J Korean Soc Coloproctol. 2006;22(2):97-102.

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Abstract PDF: PURPOSE
Accurate tumor localization prior to a laparoscopic surgical resection is the critical. India ink tattoos properly placed in the colorectum are long lasting and have been reported to probably remain constantly in previous studies. The present study was done to review the safety and reliability of colonoscopic tattooing prior to a laparoscopic resection of a colorectal neoplasm.
METHODS
Between May 2003 and August 2004, 20 patients underwent colonoscopic tattooing of a colorectal neoplasm prior to laparoscopic surgery. The clinical data were retrospectively reviewed.
RESULTS
Among the 20 patients, 14 (70%) had tumors located in the sigmoid colon, 4 (20%) had tumors in the rectosigmoid junction, and 1 had a tumor (5%) in the upper rectum and descending colon. In six patients (30%) who had received an endoscopic mucosal resection (EMR), an additional surgical resection was required to remove the tumor completely, and those 6 patients needed another preoperative colonoscopy for India ink tattooing. The median time between tattooing and resection was 2 days (range: 1 to 18 days). Tattoos were visualized intraoperatively and localized the tumor accurately in 15 patients (75%). Seven patients underwent intraoperative colonoscopy; five didn't have tattoos that could be visualized intraoperatively, and two patients with visible tattoos needed intraoperative colonoscopy to confirm the site of tumor. Only one patient (5%) had mild fever with abdominal discomfort, which were relieved by hydration and administration of intravenous antibiotics for one day.
CONCLUSIONS
A colorectal neoplasm can be localized with an acceptable reliability by using preoperative colonoscopic tattooing. India ink tattooing at the time of the EMR may reduce unnecessary colonoscopies if we doubt a complete resection has been achieved by using an EMR. The complications following colonoscopic tattooing were minimal.

Comparison of Long-term Survival for Laparoscopic-assisted Surgery and Open Surgery for Right Colon Cancer: A Case-Control Study.: Choi, Seok Kyoung , Lee, Jong Ho , Choi, Gyu Seog; J Korean Soc Coloproctol. 2004;20(6):384-390.

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Abstract PDF: PURPOSE
The aim of this study was to compare the long-term oncologic outcomes of laparoscopy assisted and open surgery for patients with right colon cancer.
METHODS
From June 1996 to May 2000, 35 patients underwent curative surgery with a laparoscopic-assisted right hemicolectomy (LAC), and from among the patients who had curative open surgery, 35 patients with clinicopathologic characteristics comparable to those of the LAC group were selected and matched as a control group (OC). A comparative analysis of long-term survival and patterns of recurrence between these two groups was done.
RESULTS
There were no statistical differences in demographic, laboratory and pathologic characteristics between the two groups. The mean follow-up period was 54.5 months. The overall five-year survival was 82.9% in the LAC group and 68.6% in the OC group, but was not statistically significant (P=0.17). Interestingly, the five-year survival of patients with TNM stage III tumors was significantly higher in the LAC group (84.2%) than in the OC group (52.6%) (P=0.04). There were no port-site recurrences or operative deaths.
CONCLUSIONS
The long-term oncologic outcomes of laparoscopic surgery for right-sided colon cancer were similar to those of open surgery. Interestingly, laparoscopic surgery for stage III tumors showed better survival than open surgery. However, a more large-scaled randomized study will be needed to clarify the oncologic safety of laparoscopic surgery for colon cancer.

Comparison of Recovery of Bowel Motility after Laparoscopic-assisted and Open Surgery for Right Colon Cancer: A Study of Gastric Emptying by Using Sitz-marker(TM) and Changes of Intraperitoneal Temperature.: Park, Chan Wook , Choi, Gyu Seog , Jun, Soo Han; J Korean Soc Coloproctol. 2004;20(6):351-357.

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Abstract PDF: PURPOSE
Early recovery of gastrointestinal motility is one of the main advantages of laparoscopic intestinal surgery. However, the reasons for this advantage are still not well known. To compare recovery of bowel motility after laparoscopic-assisted and open surgery for right colon cancer, we analyzed early clinical results, including both the gastric emptying time by using a Sitz-marker(TM) and the intraperitoneal temperature.
METHODS
From January 1996 to December 1999, 80 curative right hemicolectomies, which were divided into a laparoscopic-assisted surgery group (LS) with 36 patients and an open surgery group (OS) with 44 patients, were prospectively, but not randomly, studied for recovery of bowel motility. Clinical results, such as the pain score, the time to gas passage, the time to resumption of meals the hospital stay and the gastric emptying time obtained by using a Sitz-markers(TM), were evaluated. At the beginning and the end of the operation, the intraperitoneal temperature was checked at three different points.
RESULTS
In the LS and OS groups, the first flatus passed at the 3.0 and the 3.67 postoperative day (POD) and oral intake resumed at the 3.9 and the 5.2 POD, respectively (P<0.05). The numbers of Sitz-markers(TM) remaining in the stomach after surgery were 15.0 and 18.7 at the 1st POD (P<0.0001), 6.4 and 10.8 at the 2nd POD (P>0.05), 1.7 and 4.2 at the 3rd POD (P<0.05) and 0 and 1.1 at the 4th POD (P<0.05), respectively. No difference in intraperitoneal temperature was noted.
CONCLUSIONS
We found earlier recovery of bowel function after laparoscopic surgery than after open surgery, but could not identify any relationship between bowel function and the possible parameter of intraperitoneal temperature.

Laparoscopic Total Proctocolectomy with Ileal pouch-anal Anastomosis for Patients of Familial Adenomatous Polyposis with or without Coexisting Colorectal Cancer.: Choi, Gyu Seog; J Korean Soc Coloproctol. 2004;20(6):344-350.

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Familial adenomatous polyposis (FAP) normally appears in the early twenties and needs a restorative total proctocolectomy with ileal pouch-anal anastomosis (TPC/ IPAA). Thus, most patients with FAP are young, in socially active stage, and very concerned about their body image. Vast experience with laparoscopic colorectal surgery led us to perform laparoscopic-assissted TPC/IPAA for patients with FAP with or without cancer, and we evaluated the results from technical and oncologic aspects.
METHODS
Seventeen of 20 FAP patients underwent laparoscopic- assisted surgery between July 1996 and June 2004. All procedures were done in a totally laparoscopic, a laparoscopic-assisted, or a hand-assisted laparoscopic fashion.
RESULTS
Fifteen patients underwent laparoscopic-assisted TCP/IPAA; two others had a total colectomy with ileorectal anastomosis and a TCP with permanent ileostomy laparoscopically. Eight patients showed coexisting colorectal cancers. The mean operation time was 396.5 min. Patients passed flatus or liquid at the 2.2 post-operative day (POD), resumed meals at the 4th. POD, and were discharged at the 10th. POD. There were no intra-operative complications or open conversions. Post-operative complications occurred in 5 different patients. One patient with colon cancer had multiple hepatic metastases at 11 months after the operation and died at 24 months after the operation.
CONCLUSIONS
Laparoscopic-assisted surgery for the patients with FAP was technically feasible and could be an alternative method. The systematized and experienced approach could reduce a operation time to be acceptable. In selected cases and with a vast of experience, coexisting colorectal cancer would not be contraindicated for laparoscopic approach for the treatment of FAP.

Laparoscopic Anterior Resection for Rectal Cancer: an Analysis of Early Experiences.: Yoon, Jin Seok , Kim, Seon Han , Lee, Dong Keun , Moon, Hong Young; J Korean Soc Coloproctol. 2002;18(1):15-21.

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Abstract PDF: PURPOSE
Regarding laparoscopic colon cancer resection, the surgical society is currently waiting for the long-term oncologic result of multi-center randomized trials with over thousands patients. For rectal cancer surgery, however, laparoscopic approach is in much debate. The aim of this study was to evaluate the feasibility and safety of laparoscopic anterior resection for rectal cancer, based on the early results of our initial experiences.
METHODS
Nineteen patients (M:F=10:9, median age 55 years) underwent laparoscopic anterior resection for rectal cancer among the 71 malignant neoplasms of the colon and rectum resected laparoscopically between October 1997 and February 2001. All clinical data were prospectively collected. During the initial period, rectosigmoid lesion was the only indication. With the development of a new roticulating stapler for distal rectal transection, the indication was extended to the lesions of the upper and middle third of the rectum. The operation parameters (operation time, blood loss), tumor parameters (stage, resection margins, and number of resected lymph nodes), and postoperative clinical course (bowel function recovery, hospital stay, and complication) were evaluated.
RESULTS
The tumors located in the rectosigmoid (n=13), upper third of the rectum (n=4), and the middle third of the rectum (n=2). Four cases were converted to an open procedure. The reasons for conversion were bladder invasion (1), tumor located too low (1), inappropriate distal resection margin (1), and tumor fixation to the sacrum (1). Median operation time was 210 minutes. Median blood loss was 400 ml. Median times to passage of flatus and oral feeding were 2 days and 3 days after surgery, respectively. Median length of the distal resection margin was 3 cm. Median number of harvested lymph nodes were 22. TNM stages were as follows; 0:I:II:III:IV=1:2:6:9:1. Two anastomotic leaks occurred in the converted patients. There were no major postoperative complications in other patients. There was no operative mortality. Median time to hospital discharge was 13 days. During a median follow-up period of 15 months, one patient developed distant metastases. There were no local/port sites recurrences.
CONCLUSIONS
Laparoscopic anterior resection is a safe alternative to conventional surgery for rectal cancer. Long- term follow-up is mandatory to evaluate the oncologic safety.

Laparoscopic-assisted Colorectal Resection in Malignant Polyps and Benign Disease.: Kang, Jung Gu , Kim, Nam Kyu , Yun, Seong Hyeon , Park, Jea Kun , Sohn, Seung Kook , Min, Jin Sik; J Korean Soc Coloproctol. 2001;17(2):84-90.

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Abstract PDF: PURPOSE
Laparoscopic colorectal procedures are widely used for benign disease but controversial for malignant disease. In early colorectal cancer, laparoscopic colectomy can be performed safely on the basis of oncologic principles. The purpose of this study is to evaluate the safety and effectiveness of laparoscopic-assisted colorectal resection for malignant polyps and benign disease.
METHODS
Twenty five patients submitted to surgical treatment between Oct. 1996 to June 2000 were reviewed retrospectively.
RESULTS
Malignant polyps comprized 7 cases whose resection margins were all positive for cancer cells after endoscopic polypectomy and benign diseases in 18 cases (benign polyp: 7, diverticular disease: 4, submucosal tumor: 4 etc.). The common sugical procedures were anterior or low anterior resection (7 cases) and segmental resection (6 cases). There was no conversion to an open surgery. In malignant polyps, pathologic results revealed early cancer with no lymph node metastasis. There was no operative mortality. Postoperative recovery was uneventful except 2 cases (9.0%) of complications, which were, prolonged ileus in one patient and subcutaneous emphysema in another patient.
CONCLUSIONS
Laparoscopic-assisted resection can be recommended as a safe and effective procedure for treatment of colonic malignant polyps and benign disease.

Is Laparoscopic Procedure Adequate for Colorectal Cancer Surgery?.: Kim, Jae Hwang , Huh, Jin Myeung , Yoon, Sung Su , Kim, Sang Woon , Shim, Min chul , Kwun, Koing Bo; J Korean Soc Coloproctol. 1999;15(5):434-442.

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Abstract PDF: PURPOSE
To evaluate the possibility that laparoscopic procedure could perform surgeries keeping the principle of oncologic surgery.
METHODS
From July 1993 to June 1996, thrity patients undergone laparoscopic assisted colon and rectal resections (LR) for malignant disease at Yeungman university hospital. Margins of resection and lymph nodes (LNs) recovered were compared with those of thirty stage matched open resection cases (OR, n=30) retrospectively. There was no operative mortality in both group. Operative techniques used in LR vs OR were colectomy, 5:6; anterior resection, 6:5; low anterior resection, 11:12 and abdominoperineal resection, 8:7. Parameters were analgesic use, duration of postoperative ileus, operative time, hospital stay, margins of rescetion, lymph node yield (LNs), and recurrence.
RESULTS
Patients who underwent LR had less pain, a shorter period of postoperative ileus and hospital stay than patients who underwent OR. But, the length of operative time was greater for patients undergoing LR. Mean lymph node yield in the laparoscopic group was 16 compared with 18.1 in the open group (P=0.560). Average margins of resection in LR vs OR were 13.9 cm vs 14.1 cm proximally (P=0.823), 3.6 cm vs 5.2 cm distally (P=0.498). In no case did the margins contain tumor. There was no statistical significance in dissected LNs and the length of both resection margins in both groups. Recurrence was similar in both groups.
CONCLUSIONS
In this study, there is no evidence that laparoscopic technique is inadequate in following the cancer surgery principle.

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