Annals of Coloproctology

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Original Articles

Minimally invasive surgery

Body composition index obtained by using a bioelectrical impedance analysis device can be a predictor of prolonged operative time in patients undergoing minimally invasive colorectal surgery: Ho Seung Kim, Kwang Ho Kim, Gyoung Tae Noh, Ryung-Ah Lee, Soon Sup Chung; Ann Coloproctol. 2023;39(4):342-350. Published online June 3, 2022; DOI: https://doi.org/10.3393/ac.2022.00262.0037

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Purpose
Obesity has been known to contribute to technical difficulties in surgery. Until now, body mass index (BMI) has been used to measure obesity. However, there are reports that BMI does not always correspond to the visceral fat. Recently, bioelectrical impedance analysis (BIA) has been used for body composition analysis. This study aimed to evaluate the usefulness of the body composition index obtained using a BIA device in predicting short-term postoperative outcomes.
Methods
Data of patients who underwent elective major colorectal surgery using minimally invasive techniques were reviewed retrospectively. Body composition status was recorded using a commercial BIA device the day before surgery. The relationship between BMI, body composition index, and short-term postoperative outcomes, including operative time, was analyzed.
Results
Sixty-six patients were enrolled in this study. In the correlation analysis, positive correlation was observed between BMI and body composition index. BMI and body composition index were not associated with short-term postoperative outcomes. Percent body fat (odds ratio, 4.226; 95% confidence interval [CI], 1.064–16.780; P=0.041) was found to be a statistically significant factor of prolonged operative time in the multivariate analysis. Correlation analysis showed that body fat mass was related to prolonged operative time (correlation coefficients, 0.245; P=0.048). In the area under curve analysis, body fat mass showed a statistically significant predictive probability for prolonged operative time (body fat mass: area, 0.662; 95% CI, 0.531–0.764; P=0.024).
Conclusion
The body composition index can be used as a predictive marker for prolonged operative time. Further studies are needed to determine its usefulness.

Citations

Citations to this article as recorded by

Pretreatment bioelectrical impedance analysis predicts chemotherapy efficacy and toxicity in metastatic colorectal cancer patients
Rikako Kato, Yuji Miyamoto, Yukiharu Hiyoshi, Yuto Maeda, Mayuko Ouchi, Katsuhiro Ogawa, Keisuke Kosumi, Kojiro Eto, Satoshi Ida, Masaaki Iwatsuki, Yoshifumi Baba, Hideo Baba
Clinical Nutrition ESPEN.2025; 66: 497. CrossRef
Simple perinephric adipose tissue measurement for prediction of failed sentinel lymph node mapping in endometrial cancer
Lina Salman, Paulina Cybulska, Ryley Fowler, Manjula Maganti, Ur Metser, Sarah E. Ferguson
International Journal of Gynecological Cancer.2025; 35(11): 101949. CrossRef
The Antibody Response to the BNT162b2 mRNA COVID-19 Booster in Healthcare Workers: Association between the IgG Antibody Titers and Anthropometric and Body Composition Parameters
Marlena Golec, Adam Konka, Martyna Fronczek, Joanna Zembala-John, Martyna Chrapiec, Karolina Wystyrk, Sławomir Kasperczyk, Zenon Brzoza, Rafał Jakub Bułdak
Vaccines.2022; 10(10): 1638. CrossRef

Malignant disease,Colorectal cancer

Proteomic identification of arginine-methylated proteins in colon cancer cells and comparison of messenger RNA expression between colorectal cancer and adjacent normal tissues: Yongchul Lim, Da Young Gang, Woo Yong Lee, Seong Hyeon Yun, Yong Beom Cho, Jung Wook Huh, Yoon Ah Park, Hee Cheol Kim; Ann Coloproctol. 2022;38(1):60-68. Published online January 27, 2022; DOI: https://doi.org/10.3393/ac.2020.00899.0128

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Abstract PDF Supplementary Material

Purpose
Identification of type I protein arginine methyltransferase (PRMT) substrates and their functional significance during tumorigenesis is becoming more important. The present study aimed to identify target substrates for type I PRMT using 2-dimensional (2D) gel electrophoresis (GE) and 2D Western blotting (WB).
Methods
Using immunoblot analysis, we compared the expression of type I PRMTs and endogenous levels of arginine methylation between the primary colorectal cancer (CRC) and adjacent noncancerous tissues paired from the same patient. To identify arginine-methylated proteins in HCT116 cells, we carried out 2D-GE and 2D-WB with a type I PRMT product-specific antibody (anti-dimethyl-arginine antibody, asymmetric [ASYM24]). Arginine-methylated protein spots were identified by mass spectrometry, and messenger RNA (mRNA) levels corresponding to the identified proteins were analyzed using National Center for Biotechnology Information (NCBI) microarray datasets between the primary CRC and noncancerous tissues.
Results
Type I PRMTs and methylarginine-containing proteins were highly maintained in CRC tissues compared to noncancerous tissues. We matched 142 spots using spot analysis software between a Coomassie blue (CBB)-stained 2D gel and 2D-WB, and we successfully identified 7 proteins that reacted with the ASYM24 antibody: CACYBP, GLOD4, MAPRE1, CCT7, TKT, CK8, and HSPA8. Among these proteins, the levels of 4 mRNAs including MAPRE1, CCT7, TKT, and HSPA8 in CRC tissues showed a statistically significant increase compared to noncancerous tissues from patients using the NCBI microarray datasets.
Conclusion
Our results indicate that the method shown here is useful in identifying arginine-methylated proteins, and significance of arginine modification in the proteins identified here should be further identified during CRC development.

Citations

Citations to this article as recorded by

Monitoring Changes in the Levels of Newly Synthesized Proteins in Response to Nutlin‐3 Treatment
Luke Way, Lenka Hernychova, Jerome Vialaret, Li Ruidong, Borek Vojtesek, Ted Hupp, Atef Mahmoud Mannaa
PROTEOMICS.2025;[Epub] CrossRef
Multi-omics data-based analysis characterizes molecular alterations of the vesicle genes in human colorectal cancer
Xi Wang
American Journal of Cancer Research.2024; 14(3): 1402. CrossRef
Expression of GLOD4 in the Testis of the Qianbei Ma Goat and Its Effect on Leydig Cells
Jinqian Wang, Xiang Chen, Wei Sun, Wen Tang, Jiajing Chen, Yuan Zhang, Ruiyang Li, Yanfei Wang
Animals.2024; 14(17): 2611. CrossRef
Sperm protein antigen 17 and Sperm flagellar 1 cancer testis antigens are expressed in a rare case of ciliated foregut cyst of the common hepatic duct
Fabio Grizzi, Maurizio Chiriva-Internati, Elena Miranda, Roxana Zaharie, Nadim Al Hajjar, Florin Zaharie, Cristina Díaz Del Arco, M.Jesús Fernández-Aceñero, Robert S. Bresalier, Emil Moiş
Pathology - Research and Practice.2023; 247: 154546. CrossRef
Inflammatory Response Markers as Predictors of Colorectal Cancer Prognosis
Minsung Kim, Il Tae Son, Bo Young Oh
The Ewha Medical Journal.2023;[Epub] CrossRef

Benign GI diease,Surgical technique

Foley balloons’ tamponade is an effective method for controlling massive pelvic bleeding during colorectal surgery: Tzu-Chi Hsu; Ann Coloproctol. 2022;38(1):69-71. Published online January 24, 2022; DOI: https://doi.org/10.3393/ac.2020.00682.0097

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Abstract PDF

Purpose
Hemostasis can be achieved by various methods, but it can be difficult to stop active bleeding in the pelvis. An effective method is described to stop massive active bleeding in the pelvis during colorectal surgery.
Methods
When there were massive bleedings in the pelvis, 3 to 5 Foley catheters were inserted through stab wounds on the abdomen. The tips of catheters were placed in the pelvis. Each balloon was inflated with 40 mL of sterile water. The water inside each balloon was removed gradually from the third postoperative day. If there is no further bleeding, all catheters were removed on the 7th postoperative day.
Results
There were 8 patients (4 males and 4 females) with massive pelvic bleeding encountered from January 1998 to December 2018. Four patients underwent low anterior resection for primary rectal cancer, 2 patients for colon cancer with pelvic recurrence, 1 patient for ovary cancer with pelvic recurrence, and 1 patient for presacral parachordoma with a bleeding tendency. All of the patients survived without further bleeding after surgery.
Conclusion
The technique is a simple method to control massive pelvic bleeding during colorectal surgery. It is also inexpensive and effective even in patients with a bleeding tendency.

Citations

Citations to this article as recorded by

Case Report: Minimally invasive management of suspected active bleeding from intercostal vessel after axillary thoracotomy ventricular septal defect repair: an application of Foley catheter
Yunfei Tian, Erjia Huang, Mengdi Zhang, Jinzhe Fan, Wei Li, XiaoHui Yang, Wei Su, Xicheng Deng
Frontiers in Cardiovascular Medicine.2025;[Epub] CrossRef
Surgical management options for control of presacral venous plexus hemorrhage – a review
Sajad Ahmad Salati, Mohammad Al Fehaid
Polish Journal of Surgery.2025; 97(4): 49. CrossRef
Principles of minimize bleeding and the transfusion of blood and its components in operated patients – surgical aspects
Tomasz Banasiewicz, Waldemar Machała, Maciej Borejsza Wysocki, Maciej Lesiak, Sebastian Krych, Małgorzata Lange, Piotr Hogendorf, Adam Durczyński, Jarosław Cwaliński, Tomasz Bartkowiak, Adam Dziki, Wojciech Kielan, Stanisław Kłęk, Łukasz Krokowicz, Krzysz
Polish Journal of Surgery.2023; 95(5): 14. CrossRef

Case Report

Malignant disease,Benign diesease & IBD,Rare disease & stoma

Actinomycosis of the Appendix Mimicking Cecal Tumor Treated by Single-Port Laparoscopic Approach: In Soo Cho, Sung Uk Bae, Hye Ra Jung, Kyung Sik Park, Woon Kyung Jeong, Seong Kyu Baek; Ann Coloproctol. 2021;37(2):125-128. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.08.10.1

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5 Citations

Abstract PDF

Actinomycosis is an inflammatory disease with various clinical presentations including inflammation and formation of masses. There are several reports suggesting the infiltrative mass-like nature of actinomycosis that is misunderstood as a tumor. A 39-year-old male clinically presented with a fungating mass-like lesion during colonoscopy for healthcare screening. Biopsy was performed for the lesion, and chronic inflammation was diagnosed. Abdominal computed tomography (CT) suggested severe edematous changes in the appendix with an appendicolith, suspected chronic inflammation, and wall thickening of the cecal base, but malignancy could not be definitively ruled out. The patient underwent a laparoscopic single-port cecectomy based on the possibility of cecal cancer. The final biopsy was diagnosed as actinomycosis, and the patient was prescribed antibiotics and showed no recurrence in the follow-up CT scan. We present this rare case of mass-like appendiceal actinomycosis treated with the single-port laparoscopic method.

Citations

Citations to this article as recorded by

Appendiceal actinomycosis mimicking malignant tumor: a rare case report
Nathan Khabyeh-Hasbani, Sivan Zino, Elena Dima, Shmuel Avital
Annals of Medicine & Surgery.2024; 86(2): 1076. CrossRef
Laparoscopic Cecectomy for Diseases of the Appendix and Cecum
Muharrem Oner, Maher A. Abbas
Journal of Coloproctology.2023; 43(04): e256. CrossRef
Appendiceal actinomycosis presenting as acute appendicitis: A diagnostic and therapeutic challenge
SP Tendulkar, PA Jain, MG Mehta, S George
Journal of Postgraduate Medicine.2023; 69(1): 63. CrossRef
Benign multicystic mesothelioma of appendiceal origin treated by hyperthermic intraperitoneal chemotherapy: A case report
Suk Jun Lee, Ji Hae Nahm, Jeonghyun Kang, Seung Hyuk Baik, Eun Jung Park
International Journal of Surgery Case Reports.2022; 99: 107665. CrossRef
Abdominal Actinomycosis Abscess Presenting as an Isolated Gastrointestinal Pseudotumor
Danisa Clarrett, Jennifer Michelle Ray, Jason R. Taylor
ACG Case Reports Journal.2021; 8(11): e00672. CrossRef

Original Articles

Benign GI diease

Factors Predicting the Need for Early Surgical Intervention for Small Bowel Obstruction: Young Jae Cho, In Seok Park, Jungbin Kim, Hyun Jin Cho, Geum Hee Gwak, Keun Ho Yang, Byung Noe Bae, Ki Hwan Kim; Ann Coloproctol. 2020;36(4):223-228. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2019.09.30

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12 Citations

Abstract PDF

Purpose
Small bowel obstruction (SBO) is a common disease that requires hospitalization. The most common cause of SBO is postoperative adhesion. Delayed timing of operations in patients who need surgical intervention results in mortality or morbidity. A number of studies on SBO have established criteria for emergency surgery. However, few objective clinical parameters are available for screening patients who need a delayed operation. Therefore, we analyzed factors that affect the clinical course of SBO to select appropriate therapeutic plans for reducing the risk of complications in these patients.
Methods
We investigated the clinical characteristics of patients admitted to the surgery department of our hospital between January 1, 2015, and December 31, 2016, who were diagnosed with SBO. Patients were divided into an operative treatment group (n = 12) and a conservative treatment group (n = 96). We compared clinical characteristics between the 2 groups.
Results
The operative treatment group underwent more operations before SBO than the conservative treatment group (P = 0.007). Initial leukocyte counts (P = 0.004) and C-reactive protein (CRP) levels (P = 0.028) were elevated in the operative group. Body mass index (BMI) was lower in the operative group (P = 0.013).
Conclusion
The number of operations before SBO, leukocyte counts, CRP levels, and BMI were useful parameters for selecting patients who needed an urgent operation for SBO.

Citations

Citations to this article as recorded by

Correlates of Markedly Elevated C-reactive Protein >200 mg/L and Its Prognostic Role in Intensive Care Unit Admission and Mortality: A Record-based Retrospective Study
Avelyn Thazhuthadath Kishore, Rosmi Jose
Journal of Applied Sciences and Clinical Practice.2025; 6(1): 32. CrossRef
Chronic Comorbidities and Failure of Non-Operative Management in Adhesive Small Bowel Obstruction: Results of Analysis of National Inpatient Data from the United States
Gal Malkiely, Maya Paran, Miri Elgabsi, Boris Kessel
Journal of Clinical Medicine.2025; 14(17): 5989. CrossRef
Prediction and Risk Evaluation for Surgical Intervention in Small Bowel Obstruction †
Timur Buniatov, Matthias Maak, Anne Jacobsen, Franziska Czubayko, Axel Denz, Christian Krautz, Georg F. Weber, Robert Grützmann, Maximilian Brunner, Anke Mittelstädt
Journal of Clinical Medicine.2025; 15(1): 297. CrossRef
The predictive role of computed tomography with oral contrast in the successful management of adhesive small bowel obstruction
Mohamed Khattab, Amr Ayad, Sameh Aziz, Peter Alaa, Marie N. Grace, Mohamed Saber
The Egyptian Journal of Surgery.2024; 43(1): 16. CrossRef
Associated factors with non operative management failure in bowel obstruction
Omar Gutierrez Moreno, Nicolas Arredondo Mora, Oscar Rincon Barbosa, Francisco Gil Quintero
Surgery Open Digestive Advance.2024; 16: 100185. CrossRef
Preventable diagnostic errors of lower gastrointestinal perforation: a secondary analysis of a large-scale multicenter retrospective study
Taku Harada, Takashi Watari, Satoshi Watanuki, Seiko Kushiro, Taiju Miyagami, Syunsuke Syusa, Satoshi Suzuki, Tetsuya Hiyoshi, Suguru Hasegawa, Shigeki Nabeshima, Hidetoshi Aihara, Shun Yamashita, Masaki Tago, Fumitaka Yoshimura, Kotaro Kunitomo, Takahiro
International Journal of Emergency Medicine.2024;[Epub] CrossRef
Clinical and Radiological Factors Associated with Nonoperative Management Failure for Small Bowel Obstruction: A Retrospective Study from a Resource-Limited Setting
Saleh Al-wageeh, Qasem Alyhari, Faisal Ahmed, Hanan Mohammed, Noha Dahan, Abdullatif Almohtadi, Sameer AL-Nuzili, Mohamed Badheeb, Abdulsattar Naji
Therapeutics and Clinical Risk Management.2024; Volume 20: 893. CrossRef
Development of a predictive model for the need for early surgery in patients with adhesive small-bowel obstruction
Yanhao Sun, Yilong Hu, Yuanfang Sun
Journal of International Medical Research.2024;[Epub] CrossRef
Predictive factors for operative intervention and ideal length of non-operative trial in adhesive small bowel obstruction
Tara van Veen, Purushotham Ramanathan, Lolita Ramsey, Jonathan Dort, Dina Tabello
Surgical Endoscopy.2023; 37(11): 8628. CrossRef
Surgical management of adhesive small bowel obstruction: Is it still mandatory to wait? – An update
R. Demessence, Y. Lyoubi, F. Feuerstoss, A. Hamy, C. Aubé, A. Paisant, A. Venara
Journal of Visceral Surgery.2022; 159(4): 309. CrossRef
Prise en charge chirurgicale des syndromes occlusifs de l’intestin grêle sur bride et adhérences postopératoires : faut-il toujours attendre ?
R. Demessence, Y. Lyoubi, F. Feuerstoss, A. Hamy, C. Aubé, A. Paisant, A. Venara
Journal de Chirurgie Viscérale.2022; 159(4): 326. CrossRef
Small bowel obstruction
David J. Detz, Jerica L. Podrat, Jose C. Muniz Castro, Yoon K. Lee, Feibi Zheng, Shawn Purnell, Kevin Y. Pei
Current Problems in Surgery.2021; 58(7): 100893. CrossRef

Preoperative Body Mass Index, 30-Day Postoperative Morbidity, Length of Stay and Quality of Life in Patients Undergoing Pelvic Exenteration Surgery for Recurrent and Locally-Advanced Rectal Cancer: Jessica Beaton, Sharon Carey, Michael J Solomon, Ker-Kan Tan, Jane Young; Ann Coloproctol. 2014;30(2):83-87. Published online April 25, 2014; DOI: https://doi.org/10.3393/ac.2014.30.2.83

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Abstract PDF

Purpose

Malnutrition is associated with an increased risk of developing complications following gastrointestinal surgery, especially following radical surgeries such as pelvic exenteration. This study aims to determine if preoperative body mass index (BMI) is associated with 30-day morbidity, length of hospital stay and/or quality of life (QoL) in patients undergoing pelvic exenteration surgery for recurrent and locally-advanced rectal cancer prior to a prospective trial.

Methods

A review of all patients who underwent pelvic exenteration surgery prior to 2008 was performed. Patients were included if they had a documented BMI as well as a QoL measurement (Functional Assessment Cancer Therapy - Colorectal questionnaire).

Results

Thirty-one patients, with a mean age of 56 years, had preoperative height and weight data, as well as measures of postoperative QoL, and formed the study group. The numbers of patients with recurrent (n = 17) or locally-advanced rectal cancer (n = 14) were similar. The mean length of stay was 21 days while the mean BMI of the patients was 24.3 (± 5.9) kg/m². The majority of the patients were either of normal weight (n = 15) or overweight/obese (n = 11). The average length of hospital stay was significantly longer in patients who were underweight compared to those who were of normal weight (F = 6.508, P = 0.006) and those who were overweight and obese (F = 6.508, P = 0.007).

Conclusion

This study suggests that a lower body mass index preoperatively is associated with a longer length of hospital stay. BMI is not associated with long-term QoL in this patient group. However, further prospective research is required.

Citations

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Prospective longitudinal trajectory of cancer survivorship among patients with recurrent rectal cancer: impact of treatment modalities and resection status
Tarik Sammour, Oliver Peacock, Brian K. Bednarski, Arvind Dasari, Prajnan Das, Benny Johnson, Grace L. Smith, George J. Chang, John Skibber, Y. Nancy You
Colorectal Disease.2025;[Epub] CrossRef
Living After Pelvic Exenteration: A Mixed-Methods Synthesis of Quality-of-Life Outcomes and Patient Perspectives
Vlad Rotaru, Elena Chitoran, Aisa Gelal, Giuseppe Gullo, Daniela-Cristina Stefan, Laurentiu Simion
Journal of Clinical Medicine.2025; 14(18): 6541. CrossRef
Defining Standard Data Reporting in Pelvic Exenteration Surgery for Rectal Cancer: A PelvEx Collaborative Review of Current Data Reporting

Cancers.2025; 17(17): 2764. CrossRef
Systematic Review of Patient-Reported Outcome Measures in Locally Recurrent Rectal Cancer
Niamh McKigney, Fergus Houston, Ellen Ross, Galina Velikova, Julia Brown, Deena Pravin Harji
Annals of Surgical Oncology.2023; 30(7): 3969. CrossRef
Prevention and management of complications in pelvic exenteration
Pia Persson, Peter Chong, Colin W Steele, Martha Quinn
European Journal of Surgical Oncology.2022; 48(11): 2277. CrossRef
Patient‐reported outcomes after pelvic exenteration for colorectal cancer: A systematic review
Andreas Denys, Yves van Nieuwenhove, Dirk Van de putte, Eva Pape, Piet Pattyn, Wim Ceelen, Gabriëlle H. van Ramshorst
Colorectal Disease.2022; 24(4): 353. CrossRef
Pelvic exenteration: Pre-, intra-, and post-operative considerations
Kheng-Seong Ng, Peter J.M. Lee
Surgical Oncology.2022; 43: 101787. CrossRef
Pelvic exenteration: Pre-, intra-, and post-operative considerations
Kheng-Seong Ng, Peter J.M. Lee
Surgical Oncology.2021; 37: 101546. CrossRef
Functional outcomes following pelvic exenteration: results from a prospective cohort study
Preet G. S. Makker, Cherry E. Koh, Michael J. Solomon, James Ratcliffe, Daniel Steffens
Colorectal Disease.2021; 23(10): 2647. CrossRef
Quality of life outcomes in patients undergoing surgery for locally recurrent rectal cancer
Tamara Glyn, Frank Frizelle
Seminars in Colon and Rectal Surgery.2020; 31(3): 100767. CrossRef
The obesity paradox in beyond total mesorectal excision surgery for locally advanced and recurrent rectal cancer
Daniel L. H. Baird, Constantinos Simillis, Gianluca Pellino, Christos Kontovounisios, Shahnawaz Rasheed, Paris P. Tekkis
Updates in Surgery.2019; 71(2): 313. CrossRef
The effect of preoperative nutritional status on postoperative complications and overall survival in patients undergoing pelvic exenteration: A multi-disciplinary, multi-institutional cohort study
N.J. Lyell, M. Kitano, B. Smith, A.L. Gleisner, F.J. Backes, G. Cheng, M.D. McCarter, S. Abdel-Misih, E.L. Jones
The American Journal of Surgery.2019; 218(2): 275. CrossRef
Preoperative Nutrition Status and Postoperative Outcomes in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Lauren Reece, Helen Dragicevich, Claire Lewis, Caila Rothwell, Oliver M. Fisher, Sharon Carey, Nayef A. Alzahrani, Winston Liauw, David L. Morris
Annals of Surgical Oncology.2019; 26(8): 2622. CrossRef
Factors affecting hospital length of stay following pelvic exenteration surgery
Ying Guo, Eugene Chang, Mehtap Bozkurt, Minjeong Park, Diane Liu, Jack B. Fu
Journal of Surgical Oncology.2018; 117(3): 529. CrossRef
Is BMI associated with post‐operative complication risk among patients undergoing major abdominal surgery for cancer? A systematic review
Tasha M. Hughes, Kejal Shah, Sabrena Noria, Timothy Pawlik
Journal of Surgical Oncology.2018; 117(5): 1009. CrossRef
A systematic review examining quality of life following pelvic exenteration for locally advanced and recurrent rectal cancer
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Systematic review of health-related quality of life in patients undergoing pelvic exenteration
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Exenteración pélvica total por cáncer primario del recto: resultados inmediatos y alejados
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Revista Chilena de Cirugía.2016; 68(3): 237. CrossRef
Translation from clinical trials to routine practice: How to demonstrate community benefit
David Roder, Elizabeth Buckley
Asia-Pacific Journal of Clinical Oncology.2015; 11(1): 1. CrossRef
Preoperative Body Mass Index and Postoperative Complications After Pelvic Exenteration in Recurrent or Locally Advanced Rectal Cancer Patients
Moo-Jun Baek
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Management of Appendicitis Presenting with Abscess or Mass: Jeong-Ki Kim, Seungbum Ryoo, Heung-Kwon Oh, Ji Sun Kim, Rumi Shin, Eun Kyung Choe, Seung-Yong Jeong, Kyu Joo Park; J Korean Soc Coloproctol. 2010;26(6):413-419. Published online December 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.6.413

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Abstract PDF

Purpose

Management strategy in acute appendicitis patients initially presenting with abscess or mass is surrounded with controversy. This study was performed to identify the outcomes of management for this condition.

Methods

We retrospectively analyzed prospectively registered 76 patients (male:female = 39:37; mean age, 50.8 years) with appendicitis presenting with abscess or mass over a 9-year period at the Seoul National University Hospital. Patients were divided into three groups (emergency operation group, delayed operation group, and follow-up group), and clinical characteristics and outcomes of treatment were investigated.

Results

Twenty-eight patients (36.8%) underwent an emergency operation. Of the remaining 48 patients, 20 (41.7%) were initially treated with conservative management through the use of antibiotics only; the other 28 (58.3%) with and additional ultrasound-guided percutaneous drainage of the abscess. Twenty-six (54.2%) patients underwent planned operations after conservative management, and 22 (45.8%) were followed without surgery (median duration, 37.8 month), of which 3 (13%) underwent an appendectomy due to recurrent appendicitis (mean of 56.7 days after initial attack). There were no statistical differences in types of operation performed (appendectomy or ileocecectomy), postoperative complications, and postoperative hospital stay among the patients who underwent emergency operations, delayed operations and operations for recurrence during follow-up.

Conclusion

Although the recurrence rate was relatively low after conservative management for appendicitis patients presenting with abscess or mass, there was no difference in surgical outcome between the emergent, elective, or recurrent groups. Our results indicate that proper management of appendicitis with abscess or mass can be selected according to surgeon's preference.

Citations

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Merle Koerner, Safiullah Najem, Nariman Mokhaberi, Vasileios Vasileiadis, Annette Aigner, Julia Elrod, Konrad Reinshagen, Ingo Koenigs
Journal of Pediatric Surgery Open.2026; 14: 100262. CrossRef
High Diagnostic Accuracy but Persistent Risk of Complicated Appendicitis: A Retrospective Analysis from Hail Province, Saudi Arabia
Alfatih Mohamed Ahmed Aljanib, Faisal Fawaz Alshammari, Fahad Maiyah Alshammari, Ali Ahmed Alqahtani, Bandar Alsaif, Jerold C. Alcantara, Abdulaziz Bin Ali Alshammari, Talal Alharazi
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Cureus.2025;[Epub] CrossRef
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Koray Ersahin, Sebastian Sanduleanu, Sithin Thulasi Seetha, Johannes Bremm, Cavid Abbasli, Chantal Zimmer, Tim Damer, Jonathan Kottlors, Lukas Goertz, Christiane Bruns, David Maintz, Nuran Abdullayev
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Comparison of outcomes of nonoperative management with versus without interval appendectomy for periappendiceal abscess in Korea: a retrospective cohort study
Jae Gil Lee, Chang Sung Park, Im Kyung Kim
Journal of Acute Care Surgery.2025; 15(3): 108. CrossRef
Study on the Curative Effect of Different Treatment Methods on 122 Cases of Periappendiceal Abscess
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Jahangir Sarwar, Abul Shamsuddin, Sirajam Munira
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Charbel Chidiac, Oussama Issa, Alejandro V. Garcia, Daniel S. Rhee, Mark B. Slidell
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Intra-abdominal abscesses: Microbiological epidemiology and empirical antibiotherapy
F. Méchaï, A. Kolakowska, E. Carbonnelle, O. Bouchaud, C. Tresallet, F. Jaureguy
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Upfront appendectomy vs interval appendectomy in acute appendicitis with mass formation in pediatric age group: Little difference in major outcome
Hussam Widatella, Ahmed Abdulmanan, Ibraheem Abdelraheem, Fadi Atwan, Sri Paran
Journal of Pediatrics & Neonatal Care.2023; 13(2): 137. CrossRef
Diagnosis and treatment of appendicitis: systematic review and meta-analysis
Ryan Lamm, Sunjay S. Kumar, Amelia T. Collings, Ivy N. Haskins, Ahmed Abou-Setta, Nisha Narula, Pramod Nepal, Nader M. Hanna, Dimitrios I. Athanasiadis, Stefan Scholz, Joel F. Bradley, Arianne T. Train, Philip H. Pucher, Francisco Quinteros, Bethany Slate
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Case Reports

Impaction of a Foreign Body in the Rectum by Improper Use of a (Electronic) Massager: A Case Report: Eun-Joo Jung, Chun-Geun Ryu, Gangmi Kim, Dae-Yong Hwang; J Korean Soc Coloproctol. 2010;26(4):298-301. Published online August 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.4.298

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Abstract PDF

A male, 67 years old, visited the emergency room because of a foreign body impacted in his rectum. While he was being treated for grade-II hemorrhoids conservatively, he heard that massage of the peri-anal area could be helpful for preventing hemorrhoids. Thus, while using an electronic massager after placing the head of the machine into a short round bar, the head became separated from the machine, and this was inserted into the anus and impacted. The patient had anal discomfort without abdominal pain. His vital signs were stable, and no abnormal physical findings were found for the abdomen. On digital rectal examination, the rim of the foreign body was palpated about 8 cm from the anal verge. Anal bleeding, abnormal discharge, or foul odor was not found. On a simple abdominal X-ray, a radio-opaque foreign body was observed in the pelvic cavity, and mild leukocytosis was noted on the laboratory test. To avoid injury to the anal sphincter, we tried to remove the foreign body under the spinal anesthesia. After anesthesia had been administered, the foreign body was palpated more distally at 5-6 cm from the anal verge by digital examination, and the foreign body was found to have a hole in its center. This was held using a Kelly clamp, and with digital guiding, was removed through the anus. After removal, an anoscopic examination was performed to determine if mucosal injury had occurred in the rectum or anal canal. The patient was discharged without complication after 24 hours of close observation.

Citations

Citations to this article as recorded by

Rectal perforation caused by a sharp pig backbone in a middle-aged patient with mild depression
Hyeong Ju Sun, Jeonghun Lee, Dong Min Kim, Myeong-Su Chu, Kyoung Sun Park, Dong Jin Choi
Yeungnam University Journal of Medicine.2015; 32(1): 31. CrossRef

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

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

Original Article

Impact of Body Mass Index on Surgical Outcomes of Laparoscopic Colorectal Cancer Resection.: Joh, Yong Geul , Kim, Seon Han , Yoon, Jin Seok , Chung, Choon Sik , Lee, Dong Keun; J Korean Soc Coloproctol. 2003;19(4):243-247.

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Abstract PDF: PURPOSE
The purpose of this study was to determine whether obesity increases the risk of performing a laparoscopic resection for colorectal cancer.
METHODS
Prospectively collected data were obtained for 103 patients who had undergone laparoscopic resection for colorectal cancer from September 2001 to August 2002. Patients who had had a previous abdominal operation, a total colectomy or an additional surgical procedure at the time of colon resection were excluded from the analysis. The patients were divided into two groups based on body mass index (BMI kg/m2): the normal group (BMI <25) and the obesity group (BMI 25). Intraoperative blood loss, operative time, conversion, length of hospital stay and complications were analyzed.
RESULTS
Nineteen patients (25%) were obese. Operation time (183.2 min vs 202.1 min) and the blood loss (98.2 ml vs 168.2 ml) were significantly increased in the obese patients, but hospital discharge after surgery (11.7 days vs 11.9 days) and the morbidity rate (8.5% vs 5.3%) were not different between the groups. Conversion to the an open precedure occurred with one obese patient, but that was not related to obesity. In the analysis of the low anterior resection, blood loss (94.6 ml vs 186.6 ml) was significantly higher in obese patients, but no statistically significant differences existed for other surgical outcomes between the two groups.
CONCLUSIONS
A laparoscopic resection for colorectal cancer can be safely performed in obese patients.

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