Annals of Coloproctology

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Malignant disease,Prognosis and adjuvant therapy

Survival and Operative Outcomes After Salvage Surgery for Recurrent or Persistent Anal Cancer: In Ja Park, George Chang; Ann Coloproctol. 2020;36(6):361-373. Published online December 31, 2020; DOI: https://doi.org/10.3393/ac.2020.12.29

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Anal squamous cell carcinoma (SCC) is a relatively rare cancer comprising less than 2.5% of all gastrointestinal malignancies. The standard treatment for anal SCC is primary chemoradiation therapy which can result in complete regression. After successful treatment, the 5-year survival is approximately 80%. However, up to 30% of patients experience recurrent persistent or recurrent disease. The role of surgery in the treatment of anal cancer, therefore, is limited to the management of recurrent or persistent disease with abdominoperineal resection and/or en bloc adjacent organ excision. Salvage surgery after irradiated anal cancer can be technically demanding in terms of acquisition of oncologically safe surgical margins and minimization of postoperative morbidity. In addition, 5-year survival outcomes after salvage resection have been reported to vary from 23% to 69%. Positive resection margins are generally regarded as the important risk factor associated with poor survival outcome. Perineal wound complications are the most common major postoperative morbidity. Because of the challenges of primary wound closure after salvage abdominoperineal resection, myocutaneous flap reconstruction has been performed to reduce the severity of perianal would complications. We, therefore, descriptively reviewed contemporary published evidence describing the treatment and outcomes after salvage surgery for persistent or recurrent anal SCC.

Citations

Citations to this article as recorded by

Long-term oncological outcomes after salvage surgery for anal squamous cell carcinoma – a national cohort study
Stephanie Jacobsen, Eva Angenete, Anders Johnsson, Marie-Louise Lydrup, Per J. Nilsson, Pamela Buchwald
European Journal of Surgical Oncology.2026; 52(4): 111482. CrossRef
Management of Recurrent Anal Cancer
James Blake Littlejohn, Kelly Ann Brister
Surgical Oncology Clinics of North America.2025; 34(1): 91. CrossRef
Prognostic factors associated with worse outcomes following chemoradiation therapy in patients with anal carcinoma
Muhammad Khurrum, Alejandro Cruz, David Schaub, Joseph Gunderson, Andrea Moreno, Daniom Tecle, Amanda Gong, Manijeh Assar, McKenzie Hargis, Danielle Alexandra Dooley, Jose Cruz, Valentine Nfonsam
Colorectal Disease.2025;[Epub] CrossRef
Impact of perineal healing on oncological outcome following surgery for squamous cell carcinoma of the anus
Naseer Baloch, A. Kiasat, Mikael Machado, Jonas Nygren, Per J. Nilsson
Colorectal Disease.2025;[Epub] CrossRef
Analkarzinom – Zusammenspiel ambulanter und stationärer Patientenversorgung
Stefan Fritz, Arne Mathias Ruder, Dieter Bussen, Christoph Reißfelder, Julia Hardt
Die Chirurgie.2025; 96(9): 743. CrossRef
Short‐term morbidity and mortality following surgical treatment of anal squamous cell carcinoma in Sweden – A national multicentre study
Stephanie Jacobsen, Eva Angenete, Anders Johnsson, Marie‐Louise Lydrup, Per J. Nilsson, Pamela Buchwald
Colorectal Disease.2025;[Epub] CrossRef
Resolving Clinically Indeterminate Findings During Anal Cancer Surveillance with TTMV-HPV DNA
Rafi Kabarriti, Shane Lloyd, James Jabalee, Laurie M. Gay, Tyler Slater, Kayleen Guzman, Corbin Jacobs, Sean Inocencio, Ray Lin, Cammie Nguyen, Iain MacEwan, Alexandra H. Crawford, Michael Rutenberg, Jaswinder Singh, Jennifer Ross, Sophia Kim-Wang, Chance
Cancers.2025; 18(1): 35. CrossRef
Brazilian Society of Surgical Oncology: Guidelines for the management of anal canal cancer
Marcus Valadão, Rachel P. Riechelmann, José Antonio Cunha e Silva, Jorge Mali, Bruno Azevedo, Samuel Aguiar, Rodrigo Araújo, Mario Feitoza, Eid Coelho, Arthur Accioly Rosa, Naomi Jay, Alexcia Camila Braun, Rodrigo Pinheiro, Héber Salvador
Journal of Surgical Oncology.2024; 130(4): 810. CrossRef
Improving R0 Resection Rates With a Posterior-First, 2-Stage Approach for En Bloc Resection of Locally Advanced Primary and Recurrent Anorectal Cancers Involving the Deep Pelvic Sidewall
Shinichiro Sakata, S. Mohammed Karim, Jorys Martinez-Jorge, David W. Larson, Kellie L. Mathis, Scott R. Kelley, Peter S. Rose, Eric J. Dozois
Diseases of the Colon & Rectum.2024; 67(1): 90. CrossRef
Oncologic Outcomes of Salvage Abdominoperineal Resection for Anal Squamous Cell Carcinoma Initially Managed with Chemoradiation
Roni Rosen, Felipe F. Quezada-Diaz, Mithat Gönen, Georgios Karagkounis, Maria Widmar, Iris H. Wei, J. Joshua Smith, Garrett M. Nash, Martin R. Weiser, Philip B. Paty, Andrea Cercek, Paul B. Romesser, Francisco Sanchez-Vega, Mohammad Adileh, Diana Roth O’B
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Anal carcinoma - exploring the epidemiology, risk factors, pathophysiology, diagnosis, and treatment
Kevan J English
World Journal of Experimental Medicine.2024;[Epub] CrossRef
A systematic review on the role of interventional radiotherapy for treatment of anal squamous cell cancer: multimodal and multidisciplinary therapeutic approach
Maria Concetta Campisi, Valentina Lancellotta, Bruno Fionda, Martina De Angeli, Stefania Manfrida, Patrizia Cornacchione, Gabriella Macchia, Alessio Giuseppe Morganti, Gian Carlo Mattiucci, Maria Antonietta Gambacorta, Roberto Iezzi, Luca Tagliaferri
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Wallace Henrique Pinho da PAIXÃO, Gelcio Luiz Quintella MENDES, Débora Santos da SILVA, Rosyane Garcês Moreira Lima de SOUZA, Rodrigo Otavio de Castro ARAUJO, Karina Cardoso MEIRA, Rafael Tavares JOMAR
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Comparison of Perineal Closure Techniques after Abdominoperineal Resections for Carcinoma of the Anus
Jose L. Cataneo, Sydney A. Mathis, Sabreen Faqihi, Diana D. del Valle, Alejandra M. Perez-Tamayo, Anders F. Mellgren, Lee W. T. Alkureishi, Gerald GanttJr
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Follow-up imaging of anal cancer after treatment
Maria El Homsi, Shannon P. Sheedy, Gaiane M. Rauch, Dhakshina M. Ganeshan, Randy D. Ernst, Jennifer S. Golia Pernicka
Abdominal Radiology.2023; 48(9): 2888. CrossRef
Survival outcomes following salvage abdominoperineal resection for recurrent and persistent anal squamous cell carcinoma
Daichi Kitaguchi, Yuichiro Tsukada, Masaaki Ito, Satoshi Horasawa, Hideaki Bando, Takayuki Yoshino, Kazutaka Yamada, Yoichi Ajioka, Kenichi Sugihara
European Journal of Surgical Oncology.2023; 49(9): 106929. CrossRef
Risk factors and outcome following salvage surgery for squamous cell carcinoma of the anus
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European Journal of Surgical Oncology.2023; 49(10): 107050. CrossRef
Pelvic Exenteration for Squamous Cell Carcinoma of the Anus: Oncological, Morbidity, and Quality-of-Life Outcomes
Kilian G.M. Brown, Michael J. Solomon, Daniel Steffens, Kheng-Seong Ng, Christopher M. Byrne, Kirk K.S. Austin, Peter J. Lee
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Clinical Colorectal Cancer.2022; 21(4): 362. CrossRef
Rekonstruktion onkologischer Defekte der Perianalregion
Raymund E. Horch, Ingo Ludolph, Andreas Arkudas
Der Chirurg.2021; 92(12): 1159. CrossRef
Rekonstruktion onkologischer Defekte der Perianalregion
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Original Article

Clinical Outcomes of a Redo for a Failed Colorectal or Coloanal Anastomosis: In Teak Woo, Jun Seok Park, Gyu-Seog Choi, Soo Yeun Park, Hye Jin Kim, In Kyu Park; Ann Coloproctol. 2018;34(5):259-265. Published online October 31, 2018; DOI: https://doi.org/10.3393/ac.2018.05.04

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137 Download
12 Web of Science
13 Citations

Abstract PDF

Purpose
Redo surgery in patients with a persistent anastomotic failure (PAF) is a rare procedure, and data about this procedure are lacking. This study aimed to evaluate the surgical outcomes of redo surgery in such patients.
Methods
Patients who underwent a redo anastomosis for PAF from January 2004 to November 2016 were retrospectively evaluated. Data from a prospective colorectal database were analyzed. Success was defined as the combined absence of any anastomosis-related complications and a stoma at the last follow-up.
Results
A total of 1,964 patients who underwent curative surgery for rectal cancer during this study period were included. Among them, 32 consecutive patients underwent a redo anastomosis for PAF. Thirteen patients of those 32 had major anastomotic dehiscence with a pelvic sinus, 12 had a recto-vaginal fistula, and 7 had anastomosis stenosis. There were no postoperative deaths. The median operation time was 255 minutes (range, 80–480 minutes), and the median blood loss was 80 mL (range, 30–1,000 mL). The overall success rate was 78.1%, and the morbidity rate was 40.6%. Multivariable analyses showed that the primary tumor height at the lower level was the only statistically significant risk factor for redo surgery (P = 0.042; hazard ratio, 2.444).
Conclusion
In our experience, a redo anastomosis is a feasible surgical option that allows closure of a stoma in nearly 80% of patients. Lower tumor height (<5 cm from the anal verge) is the only independent risk factor for nonclosure of defunctioning stomas after primary rectal surgery.

Citations

Citations to this article as recorded by

Long-term Complications of Laparoscopic or Robotic Lateral Pelvic Node Dissection After Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer
Hye Jin Kim, Gyu-Seog Choi, Jun Seok Park, Soo Yeun Park, Seung Ho Song, Sung Min Lee, Min Hye Jeong, Seung Hyun Cho
Diseases of the Colon & Rectum.2024; 67(4): 505. CrossRef
Outcomes of redo for failed colorectal or coloanal anastomoses: a systematic review and meta-analysis
Ricardo Purchio Galletti, Gabriel Andrade Agareno, Lucas de Abreu Sesconetto, Rafael Benjamim Rosa da Silva, Rafael Vaz Pandini, Lucas Soares Gerbasi, Victor Edmond Seid, Sérgio Eduardo Alonso Araujo, Francisco Tustumi
Annals of Coloproctology.2023; 39(5): 375. CrossRef
Turnbull-Cutait Pull-Through Procedure Is an Alternative to Permanent Ostomy in Patients With Complex Pelvic Fistulas
Olga A. Lavryk, Carla F. Justiniano, Bethany Bandi, Crinuta Floruta, Scott R. Steele, Tracy L. Hull
Diseases of the Colon & Rectum.2023; 66(12): 1539. CrossRef
Dealing with Complications of Colorectal Surgery Using the Transanal Approach—When and How?
K. Talboom, P. J. Tanis, W. A. Bemelman, R. Hompes
Clinics in Colon and Rectal Surgery.2022; 35(02): 155. CrossRef
Multimodal treatment of colorectal postsurgical leaks: long-term results of the over-the-scope clip (OTSC) application
Damiano CHIARI, Carlotta LA RAJA, Benedetto MANGIAVILLANO, Paolo VERONESI, Marco PLATTO, Walter ZULIANI
Minerva Surgery.2022;[Epub] CrossRef
Re-do laparoscopic esophagojejunostomy for anastomotic stenosis after laparoscopic total gastrectomy in gastric cancer
Dai Manaka, Sayuri Konishi, Hideo An, Kiyotaka Kawaguchi, Machi Yoneda, Masashi Fushitani, Takano Ota, Michina Morioka, Yusuke Okamura, Atsushi Ikeda, Naoya Sasaki, Shinya Hamasu, Ryuta Nishitai
Langenbeck's Archives of Surgery.2022; 407(7): 3133. CrossRef
Redo-laparoscopy in the management of complications after laparoscopic colorectal surgery: a systematic review and meta-analysis of surgical outcomes
P. Fransvea, G. Costa, L. D’Agostino, G. Sganga, A. Serao
Techniques in Coloproctology.2021; 25(4): 371. CrossRef
Transanal Minimally Invasive Surgery: An Effective Approach for Patients Who Require Redo Pelvic Surgery for Anastomotic Failure
Susanna S. Hill, Cristina R. Harnsberger, Sue J. Hahn, Paul R. Sturrock, Jennifer S. Davids, Karim Alavi, Justin A. Maykel
Diseases of the Colon & Rectum.2021; 64(3): 349. CrossRef
Re-Operative Laparoscopic Colorectal Surgery: A Systematic Review
Constantine Halkias, Athanasios Zoikas, Zoe Garoufalia, Michalis K. Konstantinidis, Argyrios Ioannidis, Steven Wexner
Journal of Clinical Medicine.2021; 10(7): 1447. CrossRef
Second redo surgery after two consecutive failures of a colorectal or coloanal anastomosis: is it reasonable?
Camélia Labiad, Marie Monsinjon, Massimo Giacca, Yves Panis
International Journal of Colorectal Disease.2021; 36(9): 2057. CrossRef
Treatment Modalities for Anastomotic Leakage in Rectal Cancer Surgery
Deborah S. Keller, K. Talboom, C.P.M van Helsdingen, Roel Hompes
Clinics in Colon and Rectal Surgery.2021; 34(06): 431. CrossRef
Optimal strategies of rectovaginal fistula after rectal cancer surgery
In Teak Woo, Jun Seok Park, Gyu-Seog Choi, Soo Yeun Park, Hye Jin Kim, Hee Jae Lee
Annals of Surgical Treatment and Research.2019; 97(3): 142. CrossRef
Safety of coloanal/ileoanal anastomosis during cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis: results of 20 consecutive patients
Ozgul Duzgun, Murat Kalin
Journal of International Medical Research.2019; 47(10): 4911. CrossRef

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