Annals of Coloproctology

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Review

Stoma

Comparison of purse-string technique versus linear suture for skin closure after stoma reversal: a meta-analysis of high-quality studies: Filippo Carannante, Guglielmo Niccolò Piozzi, Gianluca Costa, Valentina Miacci, Gianfranco Bianco, Vincenzo Schiavone, Jim S. Khan, Marco Caricato, Gabriella Teresa Capolupo; Ann Coloproctol. 2025;41(6):491-500. Published online December 31, 2025; DOI: https://doi.org/10.3393/ac.2025.00801.0114

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Abstract PDF: Purpose
Stoma reversal is associated with notable postoperative morbidity. Several techniques exist for skin closure after stoma reversal, with linear primary closure (LC) and purse-string closure (PS) being the most common. This systematic review and meta-analysis aim to compare LC and PS skin closure after stoma reversal in terms of surgical site infection (SSI) rates, wound healing, and cosmesis.
Methods
In accordance with the PRISMA statement, a systematic review of skin closure after stoma reversal was conducted using MEDLINE (PubMed), Embase, Web of Science, and Scopus.
Results
Eleven studies, enrolling 1,052 patients (PS, n=534; LC, n=518), published between 2006 and 2024, were included. The overall quality of the studies was considered acceptable, with a mean Jadad scale score of 4 (range, 3–5). Patients underwent ileostomy or ileostomy/colostomy in 6 and 5 studies, respectively. No differences were observed between groups in operative time, length of hospital stay, intestinal obstruction, or incisional hernia. However, SSI and overall infection rates were higher in the LC group, with a statistically significant difference for SSI.
Conclusion
Skin closure following stoma reversal using the PS technique may offer advantages over LC. PS is associated with significantly lower SSI rates compared to LC. Although a large randomized controlled trial with long-term follow-up is still required, current findings suggest that PS could be considered the standard of care for wound closure after ileostomy reversal.

Original Articles

Minimally invasive surgery

Expanding the boundaries of minimally invasive surgery: the feasibility of robotic natural orifice transluminal extraction colectomy and robotic no-incision colectomy in colorectal practice: Thalia Petropoulou, Kyriacos Evangelou, Andreas Polydorou; Ann Coloproctol. 2025;41(4):346-353. Published online August 28, 2025; DOI: https://doi.org/10.3393/ac.2025.00647.0092

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Abstract PDF

Purpose
Minimally invasive surgery offers reduced trauma, accelerated recovery, and shorter hospital stays. Robotic technology further enhances laparoscopic precision, particularly in colorectal procedures. This study investigated the safety and effectiveness of robotic natural orifice transluminal extraction colectomy (R-NOTEC) and robotic no-incision colectomy (R-NIC), comparing these techniques to the conventional robotic colectomy.
Methods
Outcomes of patients undergoing robotic-assisted colorectal resection—either conventional robotic colectomy or R-NOTEC/R-NIC—using a single docking technique at a tertiary hospital over 3 years were analyzed. All patients were managed according to established Enhanced Recovery After Surgery protocols.
Results
In total, 100 patients were included, with 25 receiving R-NOTEC or R-NIC. The median age was 65 years (range, 30–82 years), and the median body mass index was 31.0 kg/m2 (range, 20.1–43.0 kg/m2). The median length of stay was significantly shorter in the R-NOTEC/R-NIC group than in the conventional robotic group (2.0 days vs. 3.4 days, P=0.021). Other outcomes, such as circumferential resection margin status, lymph node yield, and mortality, were similar between groups. The R-NOTEC/R-NIC group exhibited a slightly lower complication rate, as well as less opioid use. No conversions to open surgery occurred in either group.
Conclusion
R-NOTEC/R-NIC offer significant promise in colorectal surgery by minimizing trauma, expediting recovery, and maintaining oncologic safety. Nevertheless, these procedures require specialized surgical expertise and careful patient selection. Further research should focus on long-term outcomes and standardization of these techniques.

Citations

Citations to this article as recorded by

Robotic-Assisted Surgery in Emergency General Surgery: A Prospective, Single-Center, Case Series
Thalia Petropoulou, Kyriacos Evangelou, Andreas Polydorou
Cureus.2025;[Epub] CrossRef
Minimally Invasive Versus Conventional Colectomy: Evaluating Clinical Outcomes, Complications, and Recovery in Modern Surgical Practice
Vaseem Akram Vadhooth, Krishnaprasad K, Priyanka L Reddy, Sailesh Kumar S
Cureus.2025;[Epub] CrossRef

Minimally invasive surgery

Propensity score–matched comparison of robot-assisted rectal cancer surgery using hinotori and da Vinci: Hidetoshi Katsuno, Koji Morohara, Tomoyoshi Endo, Kenji Kikuchi, Kenichi Nakamura, Kazuhiro Matsuo, Takahiko Higashiguchi, Tetsuya Koide, Hiromi Kanai, Satoshi Arakawa, Tsunekazu Hanai, Zenichi Morise; Ann Coloproctol. 2025;41(4):310-318. Published online August 25, 2025; DOI: https://doi.org/10.3393/ac.2025.00136.0019

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Graphical Abstract Abstract PDF

Purpose
The hinotori Surgical Robot System (hereafter “hinotori”) is a novel platform for robot-assisted surgery, while the da Vinci Surgical System (“da Vinci”) remains the field standard. This study compared short-term surgical outcomes of rectal cancer surgery between these systems using propensity score–matched analysis.
Methods
A retrospective analysis was conducted of 209 consecutive patients who underwent robot-assisted surgery with the da Vinci and 58 patients with the hinotori system. After 2:1 propensity score matching, 108 da Vinci and 54 hinotori cases were included. Surgical outcomes, including operative time, blood loss, postoperative complications, length of hospital stay, and pathological findings, were compared.
Results
After matching, the baseline demographics were well balanced between groups. The hinotori system was associated with significantly longer operative time (266 minutes vs. 227 minutes, P=0.014) and console time (156 minutes vs. 110 minutes, P=0.001). However, estimated blood loss and postoperative complication rate did not differ significantly. Pathological findings, including the number of lymph nodes retrieved and the incidence of positive surgical margins, were comparable between systems.
Conclusion
In rectal surgery, the hinotori system demonstrates comparable short-term safety outcomes to da Vinci. Despite longer operative times and limited integrated instrumentation, hinotori‐assisted procedures may be feasible in selected patients. Further research should address long-term oncological outcomes and strategies to improve procedural efficiency.

Citations

Citations to this article as recorded by

Racing toward the future of robot-assisted rectal cancer surgery: a comparative study of hinotori and da Vinci
Sung Uk Bae
Annals of Coloproctology.2025; 41(4): 259. CrossRef

Minimally invasive surgery

Robotic surgery may lead to reduced postoperative inflammatory stress in colon cancer: a propensity score–matched analysis: Eun Ji Park, Gyong Tae Noh, Yong Joon Lee, Min Young Park, Seung Yoon Yang, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Byung Soh Min; Ann Coloproctol. 2024;40(6):594-601. Published online December 6, 2024; DOI: https://doi.org/10.3393/ac.2024.00171.0024

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Abstract PDF Supplementary Material

Purpose
Robot-assisted surgery is readily applied to every type of colorectal surgeries. However, studies showing the safety and feasibility of robotic surgery (RS) have dealt with rectal cancer more than colon cancer. This study aimed to investigate how technical advantages of RS can translate into actual clinical outcomes that represent postoperative systemic response.
Methods
This study retrospectively reviewed consecutive cases in a single tertiary medical center in Korea. Patients with primary colon cancer who underwent curative resection between 2006 and 2012 were included. Propensity score matching was done to adjust baseline patient characteristics (age, sex, body mass index, American Society of Anesthesiologists physical status, tumor profile, pathologic stage, operating surgeon, surgery extent) between open surgery (OS), laparoscopic surgery (LS), and RS groups.
Results
After propensity score matching, there were 66 patients in each group for analysis, and there was no significant differences in baseline patient characteristics. Maximal postoperative leukocyte count was lowest in the RS group and highest in the OS group (P=0.021). Similar results were observed for postoperative neutrophil count (P=0.024). Postoperative prognostic nutritional index was highest in the RS group and lowest in the OS group (P<0.001). The time taken to first flatus and soft diet resumption was longest in the OS group and shortest in the RS group (P=0.001 and P<0.001, respectively). Among all groups, other short-term postoperative outcomes such as hospital stay and complications did not show significant difference, and oncological survival results were similar.
Conclusion
Better postoperative inflammatory indices in the RS group may correlate with their faster recovery of bowel motility and diet resumption compared to LS and OS groups.

Citations

Citations to this article as recorded by

Open, Laparoscopic, and robotic approaches in colorectal surgery: a comprehensive review with focus on colorectal cancer
Farhad Shafiei, Fatemeh Kani, Nargess Porkar, Maede Mirzaee, Fatemeh Heidarzadeh, Mahdi Kolivand, Soheila Behdad, Amir Shokri
Journal of Robotic Surgery.2026;[Epub] CrossRef
Übergangsphase zur roboterassistierten Chirurgie beim kolorektalen Karzinom: eine vergleichende konsekutive Kohortenstudie
U. A. Dietz, M. Kalisvaart, S. Maksimovic, R. Frey, M. Ramser, B. M. Erhart, U. Pfefferkorn
Die Chirurgie.2025; 96(11): 942. CrossRef
Comparative clinical efficacy of three surgical modalities for the treatment of malignant tumours of the left hemicolon
Hao Chen, Dong-Ping Han, Jian-Yang Xiong, Zhen-Sheng Li, Teng-Cheng Hu, Zheng-Rong Li, Yi Cao
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Comparison of the perioperative outcomes of robotic vs. open distal pancreatectomy: a meta-analysis of propensity-score-matched studies
Junjie Wang, Yuanjun Liu, Yakun Wu
Frontiers in Surgery.2025;[Epub] CrossRef
Effectiveness of Guardix-SG in Preventing Postoperative Bowel Complications After Radical Cystectomy: A Single-Arm Prospective Observational Study
Jiwoong Yu, Wan Song, Minyong Kang, Hyun Hwan Sung, Hwang Gyun Jeon, Seong Il Seo, Seong Soo Jeon, Byong Chang Jeong
Journal of Urologic Oncology.2025; 23(3): 253. CrossRef
Laparoscopic surgery should be a viable option for T4 colon cancer: evidence from a propensity score matching analysis
Xiaomei Jiang, Hang Zhou, Zhaoyang Zheng, Xiaodong Wang, Zongguang Zhou, Lie Yang
Updates in Surgery.2025;[Epub] CrossRef

Video

Minimally invasive surgery

Robotic abdominoperineal resection, bilateral robotic groin node dissection and simultaneous perineal gracilis flap reconstruction for locally advanced node-positive anal squamous cell carcinoma: Mohammed Ali, Melanie Holzgang, Vivekanandan Kumar, Dhalia Masud, Sandeep Kapur, Ahmed El-Hadi, Dolly Dowsett, Irshad Shaikh; Ann Coloproctol. 2024;40(6):613-615. Published online December 2, 2024; DOI: https://doi.org/10.3393/ac.2023.00801.0114

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PDF Supplementary Material

Original Article

Colorectal cancer

The impact of short-course total neoadjuvant therapy, long-course chemoradiotherapy, and upfront surgery on the technical difficulty of total mesorectal excision: an observational study with an intraoperative perspective: Cheryl Xi-Zi Chong, Frederick H. Koh, Hui-Lin Tan, Sharmini Su Sivarajah, Jia-Lin Ng, Leonard Ming-Li Ho, Darius Kang-Lie Aw, Wen-Hsin Koo, Shuting Han, Si-Lin Koo, Connie Siew-Poh Yip, Fu-Qiang Wang, Fung-Joon Foo, Winson Jianhong Tan; Ann Coloproctol. 2024;40(5):451-458. Published online September 19, 2024; DOI: https://doi.org/10.3393/ac.2023.00899.0128

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Abstract PDF Supplementary Material

Purpose
Total neoadjuvant therapy (TNT) is becoming the standard of care for locally advanced rectal cancer. However, surgery is deferred for months after completion, which may lead to fibrosis and increased surgical difficulty. The aim of this study was to assess whether TNT (TNT-RAPIDO) is associated with increased difficulty of total mesorectal excision (TME) compared with long-course chemoradiotherapy (LCRT) and upfront surgery.
Methods
Twelve laparoscopic videos of low anterior resection with TME for rectal cancer were prospectively collected from January 2020 to October 2021, with 4 videos in each arm. Seven colorectal surgeons assessed the videos independently, graded the difficulty of TME using a visual analog scale and attempted to identify which category the videos belonged to.
Results
The median age was 67 years, and 10 patients were male. The median interval to surgery from radiotherapy was 13 weeks in the LCRT group and 24 weeks in the TNT-RAPIDO group. There was no significant difference in the visual analog scale for difficulty in TME between the 3 groups (LCRT, 3.2; TNT-RAPIDO, 4.6; upfront, 4.1; P=0.12). A subgroup analysis showed similar difficulty between groups (LCRT 3.2 vs. TNT-RAPIDO 4.6, P=0.05; TNT-RAPIDO 4.6 vs. upfront 4.1, P=0.54). During video assessments, surgeons correctly identified the prior treatment modality in 42% of the cases. TNT-RAPIDO videos had the highest recognition rate (71%), significantly outperforming both LCRT (29%) and upfront surgery (25%, P=0.01).
Conclusion
TNT does not appear to increase the surgical difficulty of TME.

Citations

Citations to this article as recorded by

Left colic artery–preserving radical rectal cancer surgery: a literature review
Xiyin Yang, Yuanshui Sun, Qiang Hu
Frontiers in Surgery.2026;[Epub] CrossRef
Non-operative management of locally advanced rectal cancer with an emphasis on outcomes and quality of life: a narrative review
In Ja Park
Ewha Medical Journal.2025; 48(3): e40. CrossRef
Clinical implications of radiologic criteria and prognostic factors for lateral lymph node metastasis in low rectal cancer
Gyung Mo Son
Annals of Coloproctology.2025; 41(6): 489. CrossRef
Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-Center Retrospective Analysis
Jae Seung Kim, Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
Cancers.2024; 16(24): 4280. CrossRef

Videos

Video clip

Robotic total colectomy and ileorectal anastomosis: Jonathan Yu Jin Chua, Nan Zun Teo, James Chi-Yong Ngu; Ann Coloproctol. 2024;40(2):186-187. Published online April 22, 2024; DOI: https://doi.org/10.3393/ac.2024.00066.0009

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Abstract PDF Supplementary Material

The benefits of minimally invasive approaches in colorectal surgery have been well demonstrated. However, some hesitancy remains with regards to the utilization of the robotic platform for total colectomies, mostly due to the perceived need for multiple re-dockings in multiquadrant surgery. This video aims to demonstrate how the robotic platform can be efficiently utilized in multiquadrant surgery without the need for multiple re-dockings, as well as some tips on how to overcome the potential challenges that may be encountered during this procedure.

Citations

Citations to this article as recorded by

Fully Robotic Total Colectomy in High‐Risk Patients and Review of Literature
Igor Monsellato, Teresa Gatto, Maria Antonietta Alagia, Federico Sangiuolo, Marco Palucci, Celeste del Basso, Martina Girardi, Irene Gandini, Gabriela Del Angel‐Millan, Marco Lodin, Fabio Giannone, Gianluca Cassese, Fabrizio Panaro
The International Journal of Medical Robotics and Computer Assisted Surgery.2025;[Epub] CrossRef

Tips and tricks for robotic lateral pelvic node dissection: James Chi-Yong Ngu, Nan-Zun Teo; Ann Coloproctol. 2023;39(6):531-531. Published online December 26, 2023; DOI: https://doi.org/10.3393/ac.2023.00766.0109

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Abstract PDF Supplementary Material: Lateral pelvic node dissection can be challenging. In addition to detailed anatomical knowledge of the pelvic side wall, surgeons also need to be proficient in performing fine dissection within the confines of this limited operative field. While the incorporation of robotics can facilitate the safe completion of this technically demanding procedure, this is nonetheless dependent on the way the robotic system is used. This video aims to demonstrate several tips and tricks for performing robotic lateral pelvic node dissection.

Technical Note

Minimally invasive surgery

Robotic natural orifice specimen extraction surgery (NOSES) for anterior resection: Toan Duc Pham, Tomas Larach, Bushra Othman, Amrish Rajkomar, Alexander G. Heriot, Satish K. Warrier, Philip Smart; Ann Coloproctol. 2023;39(6):526-530. Published online December 19, 2023; DOI: https://doi.org/10.3393/ac.2022.00458.0065

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Abstract PDF Supplementary Material

Minimally invasive colorectal surgery is currently well-accepted, with open techniques being reserved for very difficult cases. Laparoscopic colectomy has been proven to have lower mortality, complication, and ostomy rates; a shorter median length of stay; and lower overall costs when compared to its open counterpart. This trend is seen in both benign and malignant indications. Natural orifice specimen extraction surgery (NOSES) in colorectal surgery was first described in the early 1990s. Three recent meta-analyses comparing transabdominal extraction against NOSES concluded that NOSES was superior in terms of overall postoperative complications, recovery of gastrointestinal function, postoperative pain, aesthetics, and hospital stay. However, NOSES was associated with a longer operative time. Herein, we present our technique of robotic NOSES anterior resection using the da Vinci Xi platform in diverticular disease and sigmoid colon cancers.

Citations

Citations to this article as recorded by

Laparoscopic natural orifice specimen extraction for diverticular disease: a systematic review
Jasmine Mui, Mina Sarofim, Ernest Cheng, Andrew Gilmore
Surgical Endoscopy.2025; 39(5): 3049. CrossRef
Current Application Status and Innovative Development of Surgical Robot
Aimin Jiang, Zhao Tang, Hanzhong Zhang, Jinxin Li, Jialin Meng, Ying Liu, Yu Fang, Juan Lu, Xu Zhang, Le Qu, Anqi Lin, Linhui Wang
Med Research.2025; 1(3): 378. CrossRef
Precision and Power: A Comprehensive Review of Exploring the Role of Laser Treatment in Hemorrhoidal Management
Dheeraj Surya, Pankaj Gharde
Cureus.2024;[Epub] CrossRef
Beyond survival: a comprehensive review of quality of life in rectal cancer patients
Won Beom Jung
Annals of Coloproctology.2024; 40(6): 527. CrossRef

Case Report

Colorectal cancer

Treatment of side limb full-thickness prolapse of the side-to-end coloanal anastomosis following intersphincteric resection: a case report and review of literature: Guglielmo Niccolò Piozzi, Krunal Khobragade, Seon Hui Shin, Jeong Min Choo, Seon Hahn Kim; Ann Coloproctol. 2024;40(Suppl 1):S38-S43. Published online February 8, 2023; DOI: https://doi.org/10.3393/ac.2022.00829.0118

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Abstract PDF

Intersphincteric resection (ISR) with coloanal anastomosis is an oncologically safe anus-preserving technique for very low-lying rectal cancers. Most studies focused on oncological and functional outcomes of ISR with very few evaluating long-term postoperative anorectal complications. Full-thickness prolapse of the neorectum is a relatively rare complication. This report presents the case of a 70-year-old woman presenting with full-thickness prolapse of the side limb of the side-to-end coloanal anastomosis occurring 2 weeks after the stoma closure and 2 months after a robotic partial ISR performed with the Da Vinci single-port platform. The anastomosis was revised through resection of the side limb and conversion of the side-to-end anastomosis into an end-to-end handsewn anastomosis with interrupted stitches. This study describes the first case of full-thickness prolapse of the side limb of the side-to-end handsewn coloanal anastomosis following ISR. Moreover, a revision of all reported cases of post-ISR full-thickness and mucosal prolapse was performed.

Citations

Citations to this article as recorded by

International standardization and optimization group for intersphincteric resection (ISOG‐ISR): modified Delphi consensus on anatomy, definition, indication, surgical technique, specimen description and functional outcome
Guglielmo Niccolò Piozzi, Krunal Khobragade, Vusal Aliyev, Oktar Asoglu, Paolo Pietro Bianchi, Vlad‐Olimpiu Butiurca, William Tzu‐Liang Chen, Ju Yong Cheong, Gyu‐Seog Choi, Andrea Coratti, Quentin Denost, Yosuke Fukunaga, Emre Gorgun, Francesco Guerra, Ma
Colorectal Disease.2023; 25(9): 1896. CrossRef

Original Articles

Minimally invasive surgery

A comparative study of the pathological outcomes of robot-assisted versus open surgery for rectal cancer: René Reyes, Csaba Kindler, Kenneth Smedh, Catarina Tiselius; Ann Coloproctol. 2024;40(2):154-160. Published online December 28, 2022; DOI: https://doi.org/10.3393/ac.2022.00332.0047

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Abstract PDF

Purpose
The use of robot-assisted surgery for rectal cancer is increasing, but the pathological outcomes have not been fully clarified. We compared the surgical and pathological outcomes between robot-assisted and open surgery in specimens from patients operated on for rectal cancer.
Methods
All patients who underwent resection for rectal cancer from 2016 to 2018 were included (n=137). Specimens were divided into 3 sections to analyze the pathology of the lymph nodes.
Results
The total specimen lengths were shorter in the robot-assisted group than in the open surgery group (mean±standard deviation: 29.1±8.6 cm vs. 33.8±9.9 cm, P=0.004) because of a shorter proximal resection margin (21.7±8.7 cm vs. 26.4±10.6 cm, P=0.006). The number of recruited lymph nodes (35.8±21.8 vs. 39.6±16.5, P=0.604) and arterial vessel length (8.84±2.6 cm vs. 8.78±2.4 cm, P=0.891) did not differ significantly between the 2 surgical approaches. Lymph node metastases were found in 33 of 137 samples (24.1%), but the numbers did not differ significantly between the procedures. Among these 33 cases, metastatic lymph nodes were located in the mesorectum (75.8%), in the sigmoid colon mesentery (33.3%), and at the arterial ligation site of the inferior mesenteric artery (12.1%). The circumferential resection margin and the proportion of complete mesorectal fascia were comparable between the groups.
Conclusion
There were no significant differences between the 2 surgical approaches regarding arterial vessel length, recruitment of lymph node metastases, and resection margins.

Citations

Citations to this article as recorded by

Robotic Surgery for Rectal Cancer Treatment: Clinical Outcomes and Quality of Life. Comparison of Surgical Methods
Raminta Akelaitytė, Justas Žilinskas
Lietuvos chirurgija.2025; 24(3): 184. CrossRef
Can robotic surgery lead the way in the treatment of rectal cancer?
Jeonghee Han
Annals of Coloproctology.2024; 40(2): 87. CrossRef
Comparative analysis of short-term outcomes and oncological results between robotic-assisted and laparoscopic surgery for rectal cancer by multiple surgeon implementation: a propensity score-matched analysis
E. Barzola, L. Cornejo, N. Gómez, A. Pigem, D. Julià, N. Ortega, O. Delisau, K. A. Bobb, R. Farrés, P. Planellas
Journal of Robotic Surgery.2023; 17(6): 3013. CrossRef

Minimally invasive surgery

Learning curve for single-port robot-assisted colectomy: Moon Suk Choi, Seong Hyeon Yun, Sung Chul Lee, Jung Kyong Shin, Yoon Ah Park, Jungwook Huh, Yong Beom Cho, Hee Cheol Kim, Woo Yong Lee; Ann Coloproctol. 2024;40(1):44-51. Published online December 20, 2022; DOI: https://doi.org/10.3393/ac.2022.00745.0106

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Abstract PDF

Purpose
Since the introduction of robotic surgery, robots for colorectal cancer have replaced laparoscopic surgery, and a single-port robot (SPR) platform has been launched and is being used to treat patients. We analyzed the learning curve and initial complications of using an SPR platform in colorectal cancer surgery.
Methods
We reviewed 39 patients who underwent SPR colectomy from April to October 2019. All surgeries were performed by the same surgeon using an SPR device. A learning curve was generated using the cumulative sum methodology to assess changes in total operation time, docking time, and surgeon console time. We grouped the patients into 3 groups according to the time period: the first 11 were phase 1, the next 11 were phase 2, and the last 17 were phase 3.
Results
The mean age of the patients was 61.28±13.03 years, and they had a mean body mass index of 23.79±2.86 kg/m2. Among the patients, 23 (59.0%) were male, and 16 (41.0%) were female. The average operation time was 186.59±51.30 minutes, the average surgeon console time was 95.49±35.33 minutes, and the average docking time (time from skin incision to robot docking) was 14.87±10.38 minutes. The surgeon console time differed significantly among the different phases (P<0.001). Complications occurred in 8 patients: 2 ileus, 2 postoperation hemoglobin changes, 3 urinary retentions, and 1 complicated fluid collection.
Conclusion
In our experience, the learning curve for SPR colectomy was achieved after the 18th case.

Citations

Citations to this article as recorded by

Clinical applications of the da Vinci Single-Port robotic system for treatment of colorectal cancer: a narrative review
Gyu-Seog Choi, Hye Jin Kim
Annals of Surgical Treatment and Research.2026; 110(1): 35. CrossRef
A systematic review of the Da Vinci® Single-Port system (DVSP) in the context of colorectal surgery
Francesco Brucchi, Isacco Montroni, Roberto Cirocchi, Giovanni Taffurelli, Marco Vitellaro, Gianluca Mascianà, Giovanni Battista Levi Sandri, Gianlorenzo Dionigi, Sara Lauricella
International Journal of Colorectal Disease.2025;[Epub] CrossRef
Assessing the learning curve in robot-assisted intracorporeal colorectal anastomosis and transrectal extraction (NICE) procedure: from Initial Learning to Mastery
Jacques Bistre-Varon, Muhammed Elhadi, Robert Wei, Jimena Alcocer-Barrios, Ryan Gunter, Joshua Coursey, Priya Prakash, Erin McAtee, Haley Lanser, Rachel Ellsworth, Matthew Weaver, Jean-Paul LeFave, Eric M. Haas
Journal of Robotic Surgery.2025;[Epub] CrossRef
Short-term outcomes of single-port robotic surgery versus single-port laparoscopic surgery for colon cancer: a multicenter matched-cohort analysis
Gyoung Tae Noh, Young Il Kim, Seung Ho Song, Hye Jin Kim, Song-Soo Yang, Yong Sik Yoon, Ji Hoon Kim, Hyung Jin Kim, Byung Mo Kang, Chang Woo Kim, Suk-Hwan Lee, Jun Gi Kim, Yoon Suk Lee
Surgical Endoscopy.2025; 39(12): 8444. CrossRef
Application of the Da Vinci Single‐Port (SP) Robot in General Surgery: A First Systematic Review
Antonio Cubisino, Maurice Chazal, Fabrizio Panaro
The International Journal of Medical Robotics and Computer Assisted Surgery.2025;[Epub] CrossRef
Da Vinci single-port robotic system current application and future perspective in general surgery: A scoping review
Francesco Celotto, Niccolò Ramacciotti, Alberto Mangano, Giacomo Danieli, Federico Pinto, Paula Lopez, Alvaro Ducas, Jessica Cassiani, Luca Morelli, Gaya Spolverato, Francesco Maria Bianco
Surgical Endoscopy.2024; 38(9): 4814. CrossRef
Wristed articulated instrumentation for single‐incision plus one‐port laparoscopic surgery for obstructed sigmoid colon cancer—A video vignette
Sung Uk Bae
Colorectal Disease.2024; 26(9): 1782. CrossRef
Evaluation of the da Vinci single-port system in colorectal cancer surgery: a scoping review
Arcangelo Picciariello, Alfredo Annicchiarico, Gaetano Gallo, Agnese Dezi, Ugo Grossi
Updates in Surgery.2024; 76(7): 2515. CrossRef

Case Report

Metastasis

Peritoneal metastatic mixed adenoneuroendocrine carcinoma treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a case report: Sungchul Lee, Euitae Kim, Dong-Guk Park; Ann Coloproctol. 2024;40(Suppl 1):S18-S22. Published online November 21, 2022; DOI: https://doi.org/10.3393/ac.2022.00339.0048

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Abstract PDF

A 61-year-old man presented with abdominal distension without any symptoms. On colonoscopy and computed tomography findings, it was clinically diagnosed as peritoneal metastasis of sigmoid colon cancer, and diagnostic laparoscopy was performed. Only the peritoneum was partially resected, and the pathology was signet ring cell carcinoma with predominantly local mucinous carcinoma component. However, the patient complained of persistent symptoms and, despite the progress of chemotherapy, the peritoneal dissemination worsened, and additional cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) was performed. Mixed adenoneuroendocrine carcinomas (MANECs) were reported in the appendix with perforated visceral peritoneum. After additional chemotherapy, the patient was discharged. Patients with advanced MANEC with peritoneal spreading may benefit from aggressive treatment by cytoreduction surgery with HIPEC, followed by intravenous chemotherapy.

Citations

Citations to this article as recorded by

Mixed neuroendocrine non-neuroendocrine neoplasms in gastroenteropancreatic tract
Sebastián Díaz-López, Jerónimo Jiménez-Castro, Carlos Enrique Robles-Barraza, Carlos Ayala-de Miguel, Manuel Chaves-Conde
World Journal of Gastrointestinal Oncology.2024; 16(4): 1166. CrossRef

Original Article

Anorectal benign disease

What can patients expect in the long term from radiofrequency thermocoagulation of hemorrhoids on bleeding, prolapse, quality of life, and recurrence: “no pain, no gain” or “no pain but a gain”?: Jean-Michel Didelot, Benjamin Raux, Romain Didelot, Franz Rudler, Aurelien Mulliez, Anthony Buisson, Armando Abergel, Pierre Blanc; Ann Coloproctol. 2024;40(5):481-489. Published online October 11, 2022; DOI: https://doi.org/10.3393/ac.2022.00311.0044

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Abstract PDF

Purpose
The purpose of this study was to assess the long-term efficacy of hemorrhoidal radiofrequency thermocoagulation (RFT) on bleeding, prolapse, quality of life (QoL), and recurrence.
Methods
This retrospective, single-center study, with RFT performed using procedure modified via hemorrhoid exteriorization assessed the evolution of hemorrhoidal prolapse rated by Goligher scale; bleeding and discomfort (0–10), feeling of improvement and satisfaction (–5 to +5/5) by analog scales; the impact of hemorrhoids on QoL by HEMO-FISS-QoL score.
Results
From April 2016 to January 2021, 124 patients underwent surgery and 107 were interviewed in September 2021. The average follow-up was 30 months (range, 8–62 months). The mean work stoppage was 3 days, none in 71.0% of the cases. A mean of 4,334 J was applied. No analgesics were required for 66.4% of patients. External hemorrhoidal thrombosis was the only immediate complication in 9 patients, with no long-term reported complication. Bleeding disappeared in 53 out of 102 patients or dropped from 7 to 3 out of 10 (P<0.001). Prolapse reduced from mean grade 3 to 2 (P<0.001), discomfort from 7 to 2 out of 10 (P<0.001). HEMO-FISS-QoL score improved from 22 to 7 out of 100 (P<0.001). Feeling of improvement and overall satisfaction rate were +4/5. Recurrence occurred in 21.5% of patients at 22 months, and 6 required reoperation. Of the patients, 91.6% would choose the same procedure again and 96.3% recommend it.
Conclusion
RFT, although imperfect, leads to a significant improvement in hemorrhoidal symptoms and a lasting increase in QoL with minimal pain and downtime, high acceptance, and low complication and recurrence rates.

Citations

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Oliver Schwandner
Die Chirurgie.2025; 96(9): 709. CrossRef
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Review

Malignant disease,Rectal cancer,Surgical technique

Transanal total mesorectal excision for rectal cancer: it’s come a long way and here to stay: Jing Yu Ng, Chien-Chih Chen; Ann Coloproctol. 2022;38(4):283-289. Published online August 29, 2022; DOI: https://doi.org/10.3393/ac.2022.00374.0053

7,197 View
170 Download
15 Web of Science
16 Citations

Abstract PDF

Transanal total mesorectal excision (TaTME) was introduced as a novel technique to deal with rectal cancers. Its transanal approach offered the shortest distance to approach a challenging location, allowing an excellent visualization of the distal resection margin. Since its introduction in 2010, a significant amount of research has been put in to measure its development. In this review, we look at its ancestry, the genesis for its introduction and continued evolution as well as some of the important outcomes in its journey thus far. The importance of a structured and proctored learning journey is also stressed to enable the safe application and development of this technique. Beyond this, the TaTME movement has progressed relentlessly and its utility has been expanded to the management of benign conditions such as inflammatory bowel disease, Hartman reversals, and anastomotic strictures. We believe that the continued development and adoption of TaTME worldwide is here to stay.

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Rectal Eversion as an Anus-sparing Technique in Laparoscopic Low Anterior Resection With Double Stapling Anastomosis: Long-term Functional Results
Servet Karagul, Serdar Senol, Oktay Karakose, Huseyin Eken, Cuneyt Kayaalp
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2025;[Epub] CrossRef
Histopathological outcomes of transanal, robotic, open, and laparoscopic surgery for rectal cancer resection. A Bayesian network meta-analysis of randomized controlled trials
Nicola de’Angelis, Carlo Alberto Schena, Danila Azzolina, Maria Clotilde Carra, Jim Khan, Caroline Gronnier, Sébastien Gaujoux, Paolo Pietro Bianchi, Antonino Spinelli, Philippe Rouanet, Aleix Martínez-Pérez, Patrick Pessaux
European Journal of Surgical Oncology.2025; 51(1): 109481. CrossRef
Brief insight regarding the use of transanal, laparoscopic, and robotic total mesorectal excision for rectal cancer
Kevan English
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Oncological and Functional Outcomes After Minimally Invasive Surgery for Mid and Low Rectal Adenocarcinoma: A Review
Antonio Costanzo, Lorenzo Vescovi, Valentina Rampulla, Michela Caprioli, Michele Marini, Andrea Rigamonti, Daniele Passannanti, Valentina Crisafulli, Antonio Floridi
Cureus.2025;[Epub] CrossRef
Laparoscopic total mesorectal excision versus transanal total mesorectal excision for mid and low rectal cancer: A systematic review and meta-analysis
Zhang Yi Chi, Ou Gang, Feng Xiao Li, Lu Ya, Zhou Zhijun, Du Yong Gang, Ran Dan, Liu Xin, Liu Yang, Zhang Peng, Luo Yi, Lin Dong, Zhang De Chun
Medicine.2024; 103(4): e36859. CrossRef
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Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Quality of life and functional outcomes after laparoscopic total mesorectal excision (LaTME) and transanal total mesorectal excision (taTME) for rectal cancer. an updated meta-analysis
Sara Lauricella, Francesco Brucchi, Francesco Maria Carrano, Diletta Cassini, Roberto Cirocchi, Patricia Sylla
International Journal of Colorectal Disease.2024;[Epub] CrossRef
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Neng Wei Wong, Nan Zun Teo, James Chi-Yong Ngu
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Won Beom Jung
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Case report on a rare complication after transanal total mesorectal excision (TaTME) for rectal malignancy vesicorectal fistula
Sapphire Melody Ho, Kishore Rajaguru, Jing Yu Ng, Choon Sheong Seow
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Ji-Hyun Seo, In-Ja Park
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Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
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Gyoung Tae Noh
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In Ja Park
The Ewha Medical Journal.2023;[Epub] CrossRef
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Hyun Gu Lee
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Original Article

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

5,382 View
88 Download
3 Web of Science
3 Citations

Abstract PDF

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.

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Technical Notes

Benign GI diease,Surgical technique

Double-layered hand-sewn anastomosis: a valuable resource for the colorectal surgeon: Cristopher Varela, Manar Nassr, Azharuddin Razak, Nam Kyu Kim; Ann Coloproctol. 2022;38(3):271-275. Published online March 17, 2022; DOI: https://doi.org/10.3393/ac.2021.00990.0141

15,317 View
275 Download
3 Web of Science
3 Citations

Abstract PDF Supplementary Material

Hand-sewn anastomosis is an essential and fundamental skill for surgeons dealing with any gastrointestinal anastomosis. Despite the advances in minimally invasive surgery and stapling devices, there are still complex surgical circumstances when the surgeon’s surgical know-how are necessary. Therefore, a safe hand-sewn technique for bowel anastomosis is required to establish a tension-free, well-perfused, and sealed anastomosis that allows gastrointestinal continuity with no unexpected complications. We describe a step-by-step procedure for hand-sewn double-layered anastomosis that reflects these principles and is practical for small and large bowel anastomosis.

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Grampeadores mecânicos versus sutura manual em Anastomoses intestinais: uma revisão sistemática
Letícia Meneses Teixeira, Yuri Fleury de Melo Prudente Guimarães, Leonardo de Oliveira Leite Coelho, Leo Ferreira Mattos De Miranda
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Reviews

Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer

Surgical Treatment of Low-Lying Rectal Cancer: Updates: Cristopher Varela, Nam Kyu Kim; Ann Coloproctol. 2021;37(6):395-424. Published online December 22, 2021; DOI: https://doi.org/10.3393/ac.2021.00927.0132

14,482 View
429 Download
53 Web of Science
57 Citations

Abstract PDF

Despite innovative advancements, distally located rectal cancer remains a critical disease of challenging management. The crucial location of the tumor predisposes it to a circumferential resection margin (CRM) that tends to involve the anal sphincter complex and surrounding organs, with a high incidence of delayed anastomotic complications and the risk of the pelvic sidewall or rarely inguinal lymph node metastases. In this regard, colorectal surgeons should be aware of other issues beyond total mesorectal excision (TME) performance. For decades, the concept of extralevator abdominoperineal resection to avoid compromised CRM has been introduced. However, the complexity of deep pelvic dissection with poor visualization in low-lying rectal cancer has led to transanal TME. In contrast, neoadjuvant chemoradiotherapy (NCRT) has allowed for the execution of more sphincter-saving procedures without oncologic compromise. Significant tumor regression after NCRT and complete pathologic response also permit applying the watch-and-wait protocol in some cases, now with more solid evidence. This review article will introduce the current surgical treatment options, their indication and technical details, and recent oncologic and functional outcomes. Lastly, the novel characteristics of distal rectal cancer, such as pelvic sidewall and inguinal lymph node metastases, will be discussed along with its tailored and individualized treatment approach.

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It Is a Pleasure to Announce the Issue Titled “Master Class 2021” in Annals of Coloproctology
In Ja Park
Annals of Coloproctology.2021; 37(6): 349. CrossRef

Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer,Surgical technique

Treatment for Peritoneal Metastasis of Patients With Colorectal Cancer: Young Jin Kim, Chang Hyun Kim; Ann Coloproctol. 2021;37(6):425-433. Published online December 22, 2021; DOI: https://doi.org/10.3393/ac.2021.00920.0131

17,252 View
232 Download
30 Web of Science
31 Citations

Abstract PDF

From the perspective of survival outcomes, the cancer survival of colorectal cancer (CRC) in the whole stage has improved. Peritoneal metastasis (PM) is found in approximately 8% to 15% of patients with CRC, with a poorer prognosis than that associated with other sites of metastases. Randomized controlled trials and up-to-date meta-analyses provide firm evidence that cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) could significantly improve overall survival compared with systemic chemotherapy alone in selected patients with CRC-PM. Practical guidelines recommend that the management of CRC-PM should be led by a multidisciplinary team carried out in experienced centers and consider CRS plus HIPEC for selected patients. In this review, we aim to provide the latest results of land mark studies and an overview of recent insights with regard to the management of CRC-PM.

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Cancers.2023; 15(24): 5791. CrossRef
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Youngbae Jeon, Eun Jung Park
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In Ja Park
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Agata Diakun, Tanja Khosrawipour, Agata Mikolajczyk-Martinez, Jakub Nicpoń, Zdzisław Kiełbowicz, Przemysław Prządka, Bartłomiej Liszka, Wojciech Kielan, Kacper Zielinski, Pawel Migdal, Hien Lau, Shiri Li, Veria Khosrawipour
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Eun Jung Park, Seung Hyuk Baik
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It Is a Pleasure to Announce the Issue Titled “Master Class 2021” in Annals of Coloproctology
In Ja Park
Annals of Coloproctology.2021; 37(6): 349. CrossRef

Malignant disease, Rectal cancer ,Functional outcomes,Colorectal cancer,Minimally invasive surgery

Robotic Intersphincteric Resection for Low Rectal Cancer: Technical Controversies and a Systematic Review on the Perioperative, Oncological, and Functional Outcomes: Guglielmo Niccolò Piozzi, Seon Hahn Kim; Ann Coloproctol. 2021;37(6):351-367. Published online November 17, 2021; DOI: https://doi.org/10.3393/ac.2021.00836.0119

10,624 View
217 Download
47 Web of Science
48 Citations

Abstract PDF

Intersphincteric resection (ISR) is the ultimate anus-sparing technique for low rectal cancer and is considered an oncologically safe alternative to abdominoperineal resection. The application of the robotic approach to ISR (RISR) has been described by few specialized surgical teams with several differences regarding approach and technique. This review aims to discuss the technical aspects of RISR by evaluating point by point each surgical controversy. Moreover, a systematic review was performed to report the perioperative, oncological, and functional outcomes of RISR. Postoperative morbidities after RISR are acceptable. RISR allows adequate surgical margins and adequate oncological outcomes. RISR may result in severe bowel and genitourinary dysfunction affecting the quality of life in a portion of patients.

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Original Article

Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer,Epidemiology & etiology

Characteristics and outcomes of colorectal cancer surgery by age in a tertiary center in Korea: a retrospective review: Tae-Hoon Lee, Jeong Min Choo, Jeong Sub Kim, Seon Hui Shin, Ji-Seon Kim, Se-Jin Baek, Jung-Myun Kwak, Jin Kim, Seon-Hahn Kim; Ann Coloproctol. 2022;38(3):244-252. Published online November 4, 2021; DOI: https://doi.org/10.3393/ac.2021.00619.0088

7,069 View
167 Download
12 Web of Science
15 Citations

Graphical Abstract Abstract PDF

Purpose
Colorectal cancer (CRC) occurs in all age groups, and the application of treatment may vary according to age. The study was designed to identify the characteristics of CRC by age.
Methods
A total of 4,326 patients undergoing primary resection for CRC from September 2006 to July 2019 were reviewed. Patient and tumor characteristics, operative and postoperative data, and oncologic outcome were compared
Results
Patients aged 60 to 69 years comprised the largest age group (29.7%), followed by those aged 50 to 59 and 70 to 79 (24.5% and 23.9%, respectively). Rectal cancer was common in all age groups, but right-sided colon cancer tended to be more frequent in older patients. In very elderly patients, there were significant numbers of emergency surgeries, and the frequencies of open surgery and permanent stoma were greater. In contrast, total abdominal colectomy or total proctocolectomy was performed frequently in patients in their teens and twenties. The elderly patients showed more advanced tumor stages and postoperative ileus. The incidence of adjuvant treatment was low in elderly patients, who also had shorter follow-up periods. Overall survival was reduced in older patients with stages 0 to 3 CRC (P<0.001), but disease-free survival did not differ by age (P=0.391).
Conclusion
CRC screening at an earlier age than is currently undertaken may be necessary in Korea. In addition, improved surgical and oncological outcomes can be achieved through active treatment of the growing number of elderly CRC patients.

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Technical Note

Malignant disease, Rectal cancer,Minimally invasive surgery

Single-port robot-assisted abdominoperineal resection: a case review of the first four experiences: Moon Suk Choi, Seong Hyeon Yun, Jung Kyong Shin, Yoon Ah Park, Jung Wook Huh, Yong Beom Cho, Hee Cheol Kim, Woo Yong Lee; Ann Coloproctol. 2022;38(1):88-92. Published online October 18, 2021; DOI: https://doi.org/10.3393/ac.2021.00395.0056

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Abstract PDF

Recently, abdominoperineal resection (APR) using a robot has been demonstrated in other studies. However, there has been no report on APR for rectal cancer using the single-port robot (SPR) platform. In response to this research gap, we described the clinical experience of APR using a SPR. From April 2019 to March 2020, APR using a SPR platform was performed in a total of 4 patients. Three patients had a transumbilical approach, and 1 patient had a transstoma site approach. The average operation time was 307 minutes, and the patient docking time to the SPR platform was 133.5 minutes. There were no complications during the operation, and no laparoscopy or open conversion. No reoperation occurred within 30 days. Mild postoperative complications occurred in 2 patients. We found that APR has safety and feasibility in surgery using an SPR platform. There was no intraoperative event and severe postoperative complications.

Citations

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Application of the Da Vinci Single‐Port (SP) Robot in General Surgery: A First Systematic Review
Antonio Cubisino, Maurice Chazal, Fabrizio Panaro
The International Journal of Medical Robotics and Computer Assisted Surgery.2025;[Epub] CrossRef
Single-incision laparoscopic total extraperitoneal inguinal-hernia repair using the new articulating instruments: A video vignette
Chul Seung Lee, Gwan Chul Lee, Choon Sik Chung, Dong Keun Lee
Asian Journal of Surgery.2024; 47(8): 3586. CrossRef
Evaluation of the da Vinci single-port system in colorectal cancer surgery: a scoping review
Arcangelo Picciariello, Alfredo Annicchiarico, Gaetano Gallo, Agnese Dezi, Ugo Grossi
Updates in Surgery.2024; 76(7): 2515. CrossRef
Single-incision robotic colorectal surgery with the da Vinci SP® surgical system: initial results of 50 cases
H. S. Kim, B.-Y. Oh, C. Cheong, M. H. Park, S. S. Chung, R.-A. Lee, K. H. Kim, G. T. Noh
Techniques in Coloproctology.2023; 27(7): 589. CrossRef
Short-term outcomes of single-incision robotic colectomy versus conventional multiport laparoscopic colectomy for colon cancer
Ho Seung Kim, Bo-Young Oh, Soon Sup Chung, Ryung-Ah Lee, Gyoung Tae Noh
Journal of Robotic Surgery.2023; 17(5): 2351. CrossRef
Short-term outcomes of da Vinci SP versus Xi for colon cancer surgery: a propensity-score matching analysis of multicenter cohorts
Jin-Min Jung, Young Il Kim, Yong Sik Yoon, Songsoo Yang, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Journal of Robotic Surgery.2023; 17(6): 2911. CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef

Original Articles

Anorectal benign disease

Radical surgical management of perianal giant condyloma acuminatum of Buschke and Löwenstein: long-term results of 11 cases: Alp Yildiz, Sezai Leventoglu, Aybala Yildiz, Arda Inan, Bedrettin Bulent Mentes; Ann Coloproctol. 2023;39(3):204-209. Published online August 23, 2021; DOI: https://doi.org/10.3393/ac.2021.00080.0011

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Abstract PDF

Purpose
Perianal Buschke-Löwenstein tumor (BLT) is characterized by an exophytic cauliflower-like mass surrounding the perianal region. Its tendency to infiltrate the adjacent tissues, its massiveness, and its high recurrence rate cause difficulties in treatment. The aim of this study is to report our strategy with wide local excision and flap reconstruction for BLT.
Methods
From November 2002 to June 2019, 11 patients (9 men) with a mean age of 33.45 years (range, 19–54 years) were operated on for BLT. All patients underwent wide local excision and V-Y flap reconstruction, supplemented with other flaps whenever needed. No additional modalities were used.
Results
Two patients had a history of anal intercourse while all patients were human immunodeficiency virus-negative. The mean tumor length was 15.54 ± 1.34 cm (range, 10–26 cm). Human papillomavirus 6 was the most common type identified. Partial wound dehiscence developed in 3 patients, while anal stenosis, mucosal ectropion, or local recurrence was not observed during the mean follow-up period of 50.45 ± 1.75 months (range, 10–196 months).
Conclusion
In patients with perianal BLT, wide local excision and flap reconstruction result in a high healing rate without significant complications.

Citations

Citations to this article as recorded by

Unmasking the Giant Condyloma: A Case Report and Literature Review of Buschke-Löwenstein Tumor
Vasileios Tzikoulis, Anastasios Anastasiadis, Dimitrios Memmos, Stavros Tsiakaras, Ioannis Mykoniatis, Fotios Dimitriadis, Konstantinos Papathanasiou, Christos Roidos, Loukas Charalambous, Georgios Gousis, Nikolaos Tserkezis, Maria Kougioni, Dimitrios Oik
Cureus.2025;[Epub] CrossRef
An Anal Lesion in a 27-Year-Old Patient
Jérémy Baude, Hugues Mura, Alexis Lépinoy
JAMA Oncology.2024; 10(10): 1437. CrossRef
Clinicopathological Findings and Comprehensive Review of Buschke–Lowenstein Tumors Based on a Case Study
Andreea Grosu-Bularda, Cristian-Sorin Hariga, Catalina-Stefania Dumitru, Nicolae Calcaianu, Cosmin-Antoniu Creanga, Valentin Enache, Silvia-Elena Tache, Eliza-Maria Bordeanu-Diaconescu, Vladut-Alin Ratoiu, Razvan-Nicolae Teodoreanu, Ioan Lascar
Journal of Personalized Medicine.2024; 14(8): 887. CrossRef
Cirugía más inmunoterapia local en el tratamiento del tumor de Buschke-Löwenstein. A propósito de un caso
Nicole Emily Rojas Espinoza, Juan Pablo Torrico Vilte
Revista de Investigación e Información en Salud.2023; 18(44): 51. CrossRef
Surgical Management of Perianal Giant Condyloma Acuminatum of Buschke and Löwenstein: Case Presentation
Raul Mihailov, Alin Laurențiu Tatu, Elena Niculet, Iulia Olaru, Corina Manole, Florin Olaru, Oana Mariana Mihailov, Mădălin Guliciuc, Adrian Beznea, Camelia Bușilă, Iuliana Laura Candussi, Lavinia Alexandra Moroianu, Floris Cristian Stănculea
Life.2023; 13(9): 1916. CrossRef

Malignant disease,Rectal cancer

Spotlight on laparoscopy in the surgical resection of locally advanced rectal cancer: multicenter propensity score match study: Irfan Ul Islam Nasir, Muhammad Fahd Shah, Sofoklis Panteleimonitis, Nuno Figueiredo, Amjad Parvaiz; Ann Coloproctol. 2022;38(4):307-313. Published online August 11, 2021; DOI: https://doi.org/10.3393/ac.2020.01060.0151

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Graphical Abstract Abstract PDF

Purpose
This study was aimed to assess the feasibility of laparoscopic rectal surgery, comparing quality of surgical specimen, morbidity, and mortality.
Methods
Prospectively acquired data from consecutive patients undergoing laparoscopic surgery for rectal cancer, at 2 minimally invasive colorectal units, operated by the same team was included. Locally advanced rectal tumors were identified as T3B or T4 with preoperative magnetic resonance imaging scans. All the patients were operated on by the same team. The 1:1 propensity score matching was performed to create a perfect match in terms of tumor height.
Results
Total of 418 laparoscopic resections were performed, out of which 109 patients had locally advanced rectal cancer (LARC) and were propensity score matched with non-LARC (NLARC) patients. Median operation time was higher for the LARC group (270 minutes vs. 250 minutes, P=0.011). However, conversion to open surgery was done in 5 vs. 2 patients (P=0.445), reoperation in 8 vs. 7 (P=0.789), clinical anastomotic leak was found in 3 vs. 2 (P=0.670), and 30-day mortality rates was 2 vs. 1 (P>0.999) between LARC and NLARC, respectively. Readmission rate was higher in the NLARC group (33 patients vs. 19 patients, P=0.026), due to stoma-related issues. There was no statistically significant difference in the R0 resection between the 2 groups (99 patients in LARC vs. 104 patients in NLARC, P=0.284).
Conclusion
This study demonstrates that standardized approach to laparoscopy is safe and feasible in LARC. Comparable postoperative short-term clinical and pathological outcomes were seen between LARC and NLARC groups.

Citations

Citations to this article as recorded by

Performance reporting design in artificial intelligence studies using image-based TNM staging and prognostic parameters in rectal cancer: a systematic review
Minsung Kim, Taeyong Park, Bo Young Oh, Min Jeong Kim, Bum-Joo Cho, Il Tae Son
Annals of Coloproctology.2024; 40(1): 13. CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Robotic surgery for locally advanced T4 rectal cancer: feasibility and oncological quality
Marcos Gomez Ruiz, Roberto Ballestero Diego, Patricia Tejedor, Carmen Cagigas Fernandez, Lidia Cristobal Poch, Natalia Suarez Pazos, Julio Castillo Diego
Updates in Surgery.2023; 75(3): 589. CrossRef
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han
The Ewha Medical Journal.2023;[Epub] CrossRef
Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer
In Ja Park
The Ewha Medical Journal.2023;[Epub] CrossRef
Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
Applications of propensity score matching: a case series of articles published in Annals of Coloproctology
Hwa Jung Kim
Annals of Coloproctology.2022; 38(6): 398. CrossRef

Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Minimally invasive surgery

Should transanal total mesorectal excision be implemented in medium-sized colorectal unit? technical and oncological outcome: Man-fung Ho, Dennis Chung-Kei Ng, Janet Fung-yee Lee, Simon Siu-man Ng; Ann Coloproctol. 2022;38(3):207-215. Published online July 28, 2021; DOI: https://doi.org/10.3393/ac.2020.00941.0134

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Abstract PDF

Purpose
This study was performed to evaluate the outcome of implementation of transanal total mesorectal excision (TaTME) for low rectal cancer in a regional hospital and in comparison to laparoscopic (Lap) TME.
Methods
Consecutive patients with low rectal cancer of which the lowest border of the tumour was located beween 1 and 5 cm from the puborectalis who underwent TME at North District Hospital between January 2013 and December 2019 were included. Clinical, operative, and pathologic outcomes were compared between Lap TME and TaTME. The primary end point was complication profile.
Results
Thirty-five patients underwent Lap TME and 45 patients underwent TaTME for low rectal cancer. The conversion rate of the TaTME group was significantly lower than that of the Lap TME group (4.4% vs. 20%, P=0.029), but the operating time was longer (259 minutes vs. 219 minutes, P=0.009). The tumour location was significantly lower in the TaTME group, but the distal resection margins were adequate and not different between both groups. The TaTME group had higher incidence rates of prolonged ileus and urinary tract infection, but the other complications were similar between the two groups. The resection margin positivity rates of the TaTME and Lap TME groups were 2.2% and 5.7%, respectively (P=0.670). At a median follow up of 39 months, no abnormal early recurrence was detected.
Conclusion
It is technically feasible and oncologically safe to perform TaTME in a medium-volume colorectal unit. Patients with difficult pelvic anatomy can benefit by reducing the risk of conversion and margin positivity rate.

Citations

Citations to this article as recorded by

Transanal versus transabdominal total mesorectal excision for rectal cancer in minimally invasive surgery: meta-analysis
Chun-Kai Liao, Yen-Lin Yu, Ya-Ting Kuo, Yu-Jen Hsu, Yih-Jong Chern, Yueh-Chen Lin, Pao-Shiu Hsieh, Jeng-Fu You, Jy-Ming Chiang
BJS Open.2025;[Epub] CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
Ji-Hyun Seo, In-Ja Park
Cancers.2023; 15(21): 5211. CrossRef

Case Reports

Multivisceral resection for colonic splenic flexure malakoplakia: a case report of a minimally invasive approach: Andrés Ramiro Lanza Díaz, Santiago Gallardo Pezet, Osvaldo Soto González, Montserrat Guraieb Trueba, Ivan Azael Martínez Alonso, Mario Alberto López Ramirez; Ann Coloproctol. 2023;39(2):178-182. Published online July 21, 2021; DOI: https://doi.org/10.3393/ac.2021.00178.0025

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Abstract PDF

Malakoplakia is a rare granulomatous inflammatory disorder. Its diagnosis depends on histopathological findings; however, high-quality literature regarding proper medical/surgical treatment is lacking. A 38-year-old diabetic female patient was admitted to the emergency room with a history of lower gastrointestinal hemorrhage. Colonoscopy revealed a lesion in the descending colon, and abdominal computed tomography revealed a splenic flexure mass involving the lower pole of the spleen and upper pole of the left kidney. Biopsies confirmed the diagnosis of malakoplakia. After completing antibiotic treatment, a restaging computed tomography revealed a discrete mass increase; hence, the patient underwent laparoscopic en bloc colectomy and partial nephrectomy. Postoperatively, the patient developed a pancreatic fistula, which was successfully treated with percutaneous drainage and antibiotics. The presence of pathognomonic Michaelis-Gutmann inclusions on histopathology is frequently reported as the key to diagnosing malakoplakia. Herein, we present a successful, minimally invasive surgical treatment for colonic malakoplakia.

Citations

Citations to this article as recorded by

A Surgical Challenge Generated by Colonic Malakoplakia in Disguise as a Locally Advanced Colonic Malignancy—A Case Report
Cristina Șerban, Alexandra Toma, Dragoș Cristian Voicu, Constantin Popazu, Dorel Firescu, George Țocu, Raul Mihailov, Laura Rebegea
Medicina.2023; 59(1): 156. CrossRef

Colorectal cancer

Experience of surgical treatment in a granular cell tumor in the ascending colon: a case report: In-Kyeong Kim, Young-Tae Ju, Han-Gil Kim, Jin-Kwon Lee, Dong-Chul Kim, Jae-Myung Kim, Jin Kyu Cho, Ji-Ho Park, Ju-Yeon Kim, Chi-Young Jeong, Soon-Chan Hong, Seung-Jin Kwag; Ann Coloproctol. 2023;39(3):275-279. Published online July 6, 2021; DOI: https://doi.org/10.3393/ac.2020.00836.0119

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Abstract PDF: We report a case about successful surgical treatment of a granular cell tumor in the ascending colon. A 36-year-old man underwent screening colonoscopy. An endoscopic examination revealed a 10-mm yellowish and hemispheric mass in the ascending colon, and lower endoscopic ultrasonography revealed a hypoechoic-to-isoechoic mass invaded the submucosal layer. The mass was suspected to be a colonic carcinoid tumor. Based on the preoperative evaluation, endoscopic complete resection was considered difficult. Therefore, the lesion was removed via laparoscopic right hemicolectomy. Histological examination revealed that the tumor consisted of nests of polygonal cells with abundant granular eosinophilic cytoplasm. Immunohistochemical staining revealed diffuse positivity for S100 and CD68. Therefore, the tumor was diagnosed as a granular cell tumor. We suggest that surgical resection should be considered if it is located in the thin-walled ascending colon prone to perforation, difficult to rule out malignant tumor due to submucosal invasion, or to remove endoscopically.

Original Articles

Malignant disease,Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer,Minimally invasive surgery

Laparoscopy offers better clinical outcomes and long-term survival in patients with right colon cancer: experience from national cancer center: Muhammad Fahd Shah, Awais Naeem, Ihtisham ul Haq, Shehryar Riaz, Osama Shakeel, Sofoklis Panteleimonitis, Shahid Khattak, Aamir Ali Syed, Amjad Parvaiz; Ann Coloproctol. 2022;38(3):223-229. Published online June 24, 2021; DOI: https://doi.org/10.3393/ac.2021.00045.0006

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Abstract PDF

Purpose
Laparoscopic approach to colonic tumor requires skill set and resources to be established as routine standard of care in most centers around the world. It presents particular challenge in country like Pakistan due to economic constrain and lack of teaching and training opportunities available for surgeons to be trained to deliver such service. The aim of this study is to look into changing practice of our institution from conventional approach of open to laparoscopic surgery for right colon cancer.
Methods
Consecutive patients between January 2010 to December 2018 who presented to Shaukat Khanum Memorial Cancer Hospital and Research Centre with diagnosis of right colon (cecum, ascending and transverse colon) adenocarcinoma and underwent surgical resections were included in this study.
Results
A total of 230 patients with adenocarcinoma of the right colon underwent curative resections during the study period. Of these, 141 patients (61.3%) underwent laparoscopic surgery while open resection was performed in 89 patients (38.7%). Five-year disease-free survival (DFS) of patients with American Joint Committee on Cancer (AJCC) stage III (80.9% vs. 54.8%, P = 0.021) was significantly better if these patients underwent laparoscopic surgery while a trend toward better DFS (96.7% vs. 84.1%, P = 0.111) was also observed in AJCC stage II patients, although this difference was not significant.
Conclusion
This study demonstrates the adoption of a laparoscopic approach for right colon cancer over 10 years. With a standardized approach and using the principle of oncological surgery, we incorporated this in our minimally invasive surgery practice at our institution.

Citations

Citations to this article as recorded by

Emergency Laparoscopy for Complex and Trauma Cases: Feasibility and Outcomes in Experienced Surgical Teams
Thalia Petropoulou, Aphrodite Fotiadou, Kyriacos Evangelou, Dominika Krasicka, Andreas Polydorou, Manousos Konstantoulakis
Cureus.2025;[Epub] CrossRef
Short-Term Outcomes of First 100 Laparoscopic Colorectal Surgeries at a Newly Developed Surgical Setup at Peshawar
Muhammad F Shah, Irfan Ul Islam Nasir, Riaz Ahmad, Sajjad Ahmad, Aalia Amjad, Khush Bakht Zaineb, Romana Rehman
Cureus.2024;[Epub] CrossRef
Effect of Fluorescence Lymph Node Mapping on Improving Diagnostic Values of CT D3 Lymph Node Staging for Right-Sided Colon Cancer
Gyung Mo Son, Tae Un Kim, Mi Sook Yun, ChangYeop Kim, In Young Lee, Su Bum Park, Dong-Hoon Shin, Gi Won Ha
Cancers.2024; 16(20): 3496. CrossRef
Optimal Indocyanine Green Dosage for Repetitive Angiography for Laparoscopic Colorectal Surgery
Gyung Mo Son, Sang-Ho Park, Nam Su Kim, Mi Sook Yun, In Young Lee, Myeong-Sook Kwon, Tae Kyun Kim, Eun Hwa Lee, Eun Jung Hwang, Kwang-Ryul Baek
Medicina.2024; 60(12): 1966. CrossRef
Clinical Effectiveness of Fluorescence Lymph Node Mapping Using ICG for Laparoscopic Right Hemicolectomy: A Prospective Case–Control Study
Gyung Mo Son, Mi Sook Yun, In Young Lee, Sun Bin Im, Kyung Hee Kim, Su Bum Park, Tae Un Kim, Dong-Hoon Shin, Armaan M. Nazir, Gi Won Ha
Cancers.2023; 15(20): 4927. CrossRef
Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
Ji-Hyun Seo, In-Ja Park
Cancers.2023; 15(21): 5211. CrossRef
Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef
Ileal long-segment ischemia after the unintended ligation of variant ileal branch during laparoscopic right hemicolectomy
Gyung Mo Son, Tae Un Kim, Dong-Hoon Shin, Joo-Young Na, In Young Lee, Shin Hoo Park
Journal of Minimally Invasive Surgery.2022; 25(3): 116. CrossRef
Is Laparoscopic Complete Mesocolic Excision and Central Vascular Ligation Really Necessary for All Patients With Right-Sided Colon Cancer?
Gyung Mo Son, In Young Lee, Yoon Suk Lee, Bong-Hyeon Kye, Hyeon-Min Cho, Je-Ho Jang, Chang-Nam Kim, Kil Yeon Lee, Suk-Hwan Lee, Jun-Gi Kim
Annals of Coloproctology.2021; 37(6): 434. CrossRef

Benign GI diease,Benign proctology,Surgical technique

Pilonidal Sinus Management; Bascom Flap Versus Pilonidal Pits Excision: A Single-Center Experience: Ashraf Imam, Harbi Khalayleh, Guy Pines, Deeb Khoury, Eli Mavor, Arie Pelta; Ann Coloproctol. 2021;37(2):109-114. Published online November 6, 2020; DOI: https://doi.org/10.3393/ac.2019.11.19.2

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Abstract PDF

Purpose
This study aimed to evaluate the outcomes of the Bascom cleft lift (flap) and the pilonidal pits excision (Gips procedure).
Methods
The records of all the patients who underwent pilonidal sinus excision between November 2013 and August 2017 were reviewed. Inclusion criteria included either pilonidal pits excision or the Bascom cleft lift procedure. All procedures were performed by a single surgeon. Perioperative complications and recurrence rates were reviewed.
Results
Fifty-three patients met the inclusion criteria. Male/female ratio was 36/17, with a mean age of 23.4 ± 7 years. In this study, 21 patients underwent the Bascom cleft lift (skin flap) procedure and 32 underwent the Gips-style operation. The mean follow-up was 3.5 months. Twenty-eight patients (52.8%) underwent prior drainage of pilonidal abscess. Eleven patients had a previous wide local excision with recurrent disease. A higher rate of recurrence was observed among patients who underwent pits picking following failure of a previous wide local excision (80% vs. 0%, P = 0.02). Minor wound dehiscence developed in 8 patients; all of which were in the Bascom flap group (40% vs. 0%, P < 0.005). All of these wounds healed completely between 3 and 6 weeks.
Conclusion
The Gips procedure is the recommended treatment for simple pilonidal disease. For recurrent pilonidal disease, the Bascom cleft lift (flap) procedure is an excellent option since it demonstrates a short wound healing time and a good success rate. This calls into question the continued use of the wide excision technique used by most surgeons in this country and abroad.

Citations

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Efficiency of the new modified inverted Y cleft lift advancement flap in primary and recurrent sacrococcygeal pilonidal sinus disease with low-lying tracts near the anus
Walid G. Elshazly, Ahmed Radwan, Mohmed A. Elhalim, Ahmed Moaz
The Egyptian Journal of Surgery.2024; 43(2): 548. CrossRef
ЭФФЕКТИВНОСТЬ КОЛЛАГЕНОВОЙ ГУБКИ ПРОПИТАННОЙ ДОКСИЦИКЛИНОМ ПРИ ХИРУРГИЧЕСКОМ ЛЕЧЕНИИ ПИЛОНИДАЛЬНОГО СИНУСА
G.A. Kosayeva
Azerbaijan Medical Journal.2024; (2): 16. CrossRef
Pilonidal diseases in children
Yu. Yu. Koinov, Yu. V. Chikinev, P. V. Trushin, A. I. Shevela, V. V. Sytkov, A. I. Khavkin
Experimental and Clinical Gastroenterology.2024; (10): 206. CrossRef
The application of the Limberg flap repair technique in the surgical treatment of pilonidal sinus disease
Yaoyao Song, Yu Zang, Zequn Chen, Jianjun Li, Minhui Zhu, Hongjuan Zhu, Wanli Chu, Gang Liu, Chuan'an Shen
International Wound Journal.2023; 20(6): 2241. CrossRef
Minimally invasive surgery for pilonidal disease: Outcomes of the Gips technique—A systematic review and meta-analysis
Marta Amorim, José Estevão-Costa, Cristina Santos, Sara Fernandes, Ana Catarina Fragoso
Surgery.2023; 174(3): 480. CrossRef
Progress in the surgical treatment of sacrococcygeal pilonidal sinus: a review
Peiliang Wu, Yingyi Zhang, Yewei Zhang, Shuang Wang, Zhe Fan
International Journal of Surgery.2023; 109(8): 2388. CrossRef
Minimally invasive treatment of pilonidal sinus disease in a paediatric population: comparison of two techniques
Sara Fernandes, Carolina Soares‐Aquino, Inês Teixeira, Joana Mafalda Monteiro, Miguel Campos
ANZ Journal of Surgery.2022; 92(12): 3288. CrossRef

Review

Malignant disease, Rectal cancer

Robotic Total Mesorectal Excision for Rectal Cancer: Current Evidences and Future Perspectives: Je-Ho Jang, Chang-Nam Kim; Ann Coloproctol. 2020;36(5):293-303. Published online October 31, 2020; DOI: https://doi.org/10.3393/ac.2020.06.16

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Abstract PDF

Despite the technical limitations of minimally invasive surgery, laparoscopic total mesorectal excision (LTME) for rectal cancer has short-term advantages over open surgery, but the pathological outcomes reported in randomized clinical trials are still in controversy. Minimally invasive robotic total mesorectal excision (RTME) has recently been gaining popularity as robotic surgical systems potentially provide greater benefits than LTME. Compared to LTME, RTME is associated with lower conversion rates and similar or better genitourinary functions, but its long-term oncological outcomes have not been established. Although the operating time of RTME is longer than that of LTME, RTME has a shorter learning curve, is more convenient for surgeons, and is better for sphincter-preserving operations than LTME. The robotic surgical system is a good technical tool for minimally invasive surgery for rectal cancer, especially in male patients with narrow deep pelvises. Robotic systems and robotic surgical techniques are still improving, and the contribution of RTME to the treatment of rectal cancer will continue to increase in the future.

Citations

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Robotic total mesorectal excision for low rectal cancer: Transluminal illumination of the recto‐vaginal septum, transanal low rectal dissection and handmade low colorectal anastomosis—A video vignette
Francesco Crafa, Serafino Vanella, Alfonso Amendola, Emanuele Caruso
Colorectal Disease.2025;[Epub] CrossRef
Comparing the perioperative, postoperative, and oncological outcomes between robotic and transanal total mesorectal excision for rectal cancer: an updated systematic review and meta-analysis of prospective studies with a subgroup analysis for overweight p
Konstantinos Kossenas, Riad Kouzeiha, Hamada Hashem, Ali Elshamsy, Filippos Georgopoulos
Journal of Robotic Surgery.2025;[Epub] CrossRef
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Frontline Gastroenterology.2025; : flgastro-2024-103022. CrossRef
The articulated laparoscopic total mesorectal excision for rectal cancer (ATOME trial): a single-arm, prospective trial with pre-specified comparison to robotic surgery
Kyeong Eui Kim, Sung Uk Bae, Seung Hyun Lee, Dae-Ro Lim, Heon-Kyun Ha, Jin Kim, Hyo Seon Ryu, Soo Yeon Park, Sung Il Kang, Gyung Mo Son, Soo Young Lee, Chang Hyun Kim, Kyung Ha Lee, Gi Won Ha, Hye Jin Kim, Woong Bae Ji, Woo Ram Kim, Sang Hee Kang, Nak Son
Trials.2025;[Epub] CrossRef
Can robotic surgery lead the way in the treatment of rectal cancer?
Jeonghee Han
Annals of Coloproctology.2024; 40(2): 87. CrossRef
Laparoscopic Low Anterior Resection for Rectal Cancer With a Wristed Articulated Instrument
Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Diseases of the Colon & Rectum.2023; 66(1): e1. CrossRef
Short-term outcomes of da Vinci SP versus Xi for colon cancer surgery: a propensity-score matching analysis of multicenter cohorts
Jin-Min Jung, Young Il Kim, Yong Sik Yoon, Songsoo Yang, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Journal of Robotic Surgery.2023; 17(6): 2911. CrossRef
Cirugía del cáncer de recto asistida por robot (X y Xi)
P. Rouanet, M. Lehiany, A. Mourregot, P.-E. Colombo, C. Taoum
EMC - Técnicas Quirúrgicas - Aparato Digestivo.2023; 39(4): 1. CrossRef
Chirurgia del cancro del retto mediante assistenza robotica (X e Xi)
P. Rouanet, M. Lehiany, A. Mourregot, P.-E. Colombo, C. Taoum
EMC - Tecniche Chirurgiche Addominale.2023; 29(4): 1. CrossRef
Chirurgie du cancer du rectum par assistance robotique (X et Xi)
P. Rouanet, M. Lehiany, A. Mourregot, P.-E. Colombo, C. Taoum
EMC - Techniques chirurgicales - Appareil digestif.2023; 40(3): 1. CrossRef
The clinical impact of robot‐assisted laparoscopic rectal cancer surgery associated with robot‐assisted radical prostatectomy
Anri Maeda, Hiroki Takahashi, Kaori Watanabe, Takeshi Yanagita, Takuya Suzuki, Nozomu Nakai, Yuzo Maeda, Kazuyoshi Shiga, Takahisa Hirokawa, Ryo Ogawa, Masayasu Hara, Yoichi Matsuo, Shuji Takiguchi
Asian Journal of Endoscopic Surgery.2022; 15(1): 36. CrossRef
Clinical Implication of Lateral Pelvic Lymph Node Metastasis in Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy
In Ja Park
The Ewha Medical Journal.2022; 45(1): 3. CrossRef
Multidisciplinary treatment strategy for early rectal cancer
Gyung Mo Son, In Young Lee, Sung Hwan Cho, Byung-Soo Park, Hyun Sung Kim, Su Bum Park, Hyung Wook Kim, Sang Bo Oh, Tae Un Kim, Dong Hoon Shin
Precision and Future Medicine.2022; 6(1): 32. CrossRef
Direction of diagnosis and treatment improvement in colorectal cancer
In Ja Park
Journal of the Korean Medical Association.2022; 65(9): 540. CrossRef
Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and Current Management
Seung Mi Yeo, Gyung Mo Son
The Ewha Medical Journal.2022;[Epub] CrossRef
Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
Robot-assisted laparoscopic rectal surgery: operative technique and initial experiences
Bianka Hummel, Anna Nagel, Benjamin Süsoy, Linda Tarantik, Linda Michlmayr, Friedrich Längle, Clemens Bittermann
European Surgery.2021; 53(4): 175. CrossRef
Robotic Intersphincteric Resection for Low Rectal Cancer: Technical Controversies and a Systematic Review on the Perioperative, Oncological, and Functional Outcomes
Guglielmo Niccolò Piozzi, Seon Hahn Kim
Annals of Coloproctology.2021; 37(6): 351. CrossRef
Functional outcomes after sphincter-preserving surgeries for low-lying rectal cancer: A review
Eun Jung Park, Seung Hyuk Baik
Precision and Future Medicine.2021; 5(4): 164. CrossRef

Video

Malignant disease, Rectal cancer,Minimally invasive surgery,Surgical technique

Standardized Step-by-step Technique Using Surgical Landmarks in Robotic Lateral Pelvic Lymph Node Dissection: Jung Hoon Bae, Wooree Koh, Hyun Ho Kim, Yoon Suk Lee; Ann Coloproctol. 2021;37(1):58-60. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.08.05

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Abstract PDF Supplementary Material

We aimed to show that a standardized step-by-step robotic approach using surgical landmarks could make lateral pelvic lymph node dissection (LPND) less complicated. We performed robot-assisted LPND consisting of 4 steps using surgical landmarks. The first step is a dissection of uretero-hypogastric fascia, which envelopes the ureter and the hypogastric nerve. The second step is a dissection of the medial side of the external iliac vein located at the lateral border of the obturator lymph nodes (LNs) group. The third step is a dissection of the vesico-hypogastric fascia, which is at the medial border of the obturator LNs group. The final step is a dissection of the internal iliac artery until the Alcock’s canal. Indocyanine green was injected just before surgery around the dentate line to identify the lateral pelvic LNs. Standardization using a robotic approach for LPND guided by surgical landmarks allows a safer and more effective surgery.

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The first video comparison of lateral pelvic lymph node dissection in rectal cancer: Laparoscopic approach using articulating instruments (ArtiSential) versus robotic Xi platform—A video vignette
In Kyeong Kim, Jung Hoon Bae, In Kyu Lee, Yoon Suk Lee
Colorectal Disease.2025;[Epub] CrossRef
MRI-based scoring systems for selective lateral lymph node dissection in locally advanced low rectal cancer after neoadjuvant chemoradiotherapy
Min Jeong Cho, Kyunghwa Han, Hye Jung Shin, Woong Sub Koom, Kang Young Lee, Joo Hee Kim, Joon Seok Lim
European Radiology.2025; 35(8): 4967. CrossRef
Short- and long-term outcomes of robot-assisted versus laparoscopic lateral lymph node dissection for rectal cancer
Daichi Kitaguchi, Tsuyoshi Enomoto, Kinji Furuya, Shuntaro Tsukamoto, Tatsuya Oda
Langenbeck's Archives of Surgery.2025;[Epub] CrossRef
Is lateral pelvic lymph node dissection necessary for good responder to neoadjuvant chemoradiation in locally advanced rectal cancer?
Jung Hoon Bae, Jumyung Song, Ji Hoon Kim, Bong-Hyeon Kye, In Kyu Lee, Hyeon-Min Cho, Yoon Suk Lee
Surgical Oncology.2025; 61: 102249. CrossRef
Was there any change in surgical treatment for colorectal cancer during the COVID-19 pandemic?
Yeajin Moon, Seung Hun Lee, Seung Hyun Lee
Kosin Medical Journal.2025; 40(3): 207. CrossRef
The use of indocyanine green for lateral lymph node dissection in rectal cancer—preliminary data from an emerging procedure: a systematic review of the literature
D. Kehagias, C. Lampropoulos, A. Bellou, I. Kehagias
Techniques in Coloproctology.2024;[Epub] CrossRef
Japanese expert consensus on the standardization of robot‐assisted pelvic lymph node dissection in urological surgery: Extent of pelvic lymph node and surgical technique
Shuichi Morizane, Jun Miki, Masaki Shimbo, Toru Kanno, Noriyoshi Miura, Yuta Yamada, Takeshi Yamasaki, Takashi Saika, Atsushi Takenaka
International Journal of Urology.2024; 31(12): 1300. CrossRef
Simplified approach to the medial internal iliac region using a uretero‐hypogastric nerve fascia development procedure for extended pelvic lymph node dissection during robot‐assisted radical prostatectomy for high‐risk prostate cancer
Masaki Shimbo, Takehiro Ohyama, Fumiyasu Endo, Kenji Komatsu, Yoko Kyono, Masayuki Sano, Kazutaka Narimoto, Kazunori Hattori
International Journal of Urology.2023; 30(2): 190. CrossRef
Lateral Lymph Node Size and Tumor Distance From Anal Verge Accurately Predict Positive Lateral Pelvic Lymph Nodes in Rectal Cancer: A Multi-Institutional Retrospective Cohort Study
Jung Hoon Bae, Jumyung Song, Ji Hoon Kim, Bong-Hyeon Kye, In Kyu Lee, Hyeon-Min Cho, Yoon Suk Lee
Diseases of the Colon & Rectum.2023; 66(6): 785. CrossRef
Robotic Lateral Pelvic Lymph Node Dissection Could Harvest More Lateral Pelvic Lymph Nodes over Laparoscopic Approach for Mid-to-Low Rectal Cancer: A Multi-Institutional Retrospective Cohort Study
Jung Hoon Bae, Jumyung Song, Ri Na Yoo, Ji Hoon Kim, Bong-Hyeon Kye, In Kyu Lee, Hyeon-Min Cho, Yoon Suk Lee
Biomedicines.2023; 11(6): 1556. CrossRef
Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer
In Ja Park
The Ewha Medical Journal.2023;[Epub] CrossRef
Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
Enhanced recovery after surgery: importance of compliance audits
Jung Hoon Bae
Journal of the Korean Medical Association.2021; 64(12): 820. CrossRef

Case Report

Benign GI diease

Small Bowel Perforation Associated With Gastrointestinal Graft-Versus-Host Disease and Cytomegalovirus Enteritis in a Patient With Leukemia: A Case Report With Literature Review: Kwang-Seop Song, Min Jung Kim, Han-Ki Lim, Yoon Hwa Hong, Sung Sil Park, Chang Won Hong, Sung Chan Park, Dae Kyung Sohn, Kyung Su Han, Jae Hwan Oh; Ann Coloproctol. 2020;36(4):281-284. Published online August 31, 2020; DOI: https://doi.org/10.3393/ac.2018.10.01.1

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Abstract PDF

Gastrointestinal graft-versus-host disease (GVHD) is a common complication after hematopoietic stem cell transplantation. Concomitant cytomegalovirus (CMV) enteritis worsens the prognosis of this condition. We report a case of small bowel perforation associated with gastrointestinal GVHD and CMV enteritis in a patient with leukemia who was successfully treated surgically. A 39-year-old man presented with intestinal perforation necessitating emergency surgical intervention. He was diagnosed with T-cell acute lymphoblastic leukemia and developed severe gastrointestinal GVHD and CMV enteritis after hematopoietic stem cell transplantation. His terminal ileum showed a perforation with diffuse wall thinning, and petechiae were observed over long segments of the distal ileum and the proximal colon. Small bowel segmental resection and a subtotal colectomy with a double-barreled ileocolostomy were performed. The patient recovered uneventfully after the operation. Based on reports described in the literature, surgery plays a minor role in the management of gastrointestinal GVHD; however, timely surgical intervention could be effective in selected patients.

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Cytomegalovirus enteritis resistant to antiviral drugs improved following total colectomy
Sae Kawata, Jumpei Takamatsu, Yuichi Yasue, Aya Fukuhara, Jinkoo Kang
Surgical Case Reports.2023;[Epub] CrossRef

Review

Benign proctology, Functional outcomes

Still a Case of “No Pain, No Gain”? An Updated and Critical Review of the Pathogenesis, Diagnosis, and Management Options for Hemorrhoids in 2020: Kheng-Seong Ng, Melanie Holzgang, Christopher Young; Ann Coloproctol. 2020;36(3):133-147. Published online June 30, 2020; DOI: https://doi.org/10.3393/ac.2020.05.04

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39 Citations

Abstract PDF

The treatment of haemorrhoids remains challenging: multiple treatment options supported by heterogeneous evidence are available, but patients rightly demand a tailored approach. Evidence for newer surgical techniques that promise to be less painful has been conflicting. We review the current evidence for management options in patients who present with varying haemorrhoidal grades. A review of the English literature was performed utilizing MEDLINE/PubMed, Embase, and Cochrane databases (31 May 2019). The search terms (haemorrhoid OR haemorrhoid OR haemorrhoids OR haemorrhoids OR “Hemorrhoid”[Mesh]) were used. First- and second-degree haemorrhoids continue to be managed conservatively. The easily repeatable and cost-efficient rubber band ligation is the preferred method to address minor haemorrhoids; long-term outcomes following injection sclerotherapy remain poor. Conventional haemorrhoidectomies (Ferguson/Milligan-Morgan/Ligasure haemorrhoidectomy) still have their role in third- and fourth-degree haemorrhoids, being associated with lowest recurrence; nevertheless, posthaemorrhoidectomy pain is problematic. Stapled haemorrhoidopexy allows quicker recovery, albeit at the costs of higher recurrence rates and potentially serious complications. Transanal Haemorrhoidal Dearterialization has been promoted as nonexcisional and less invasive, but the recent HubBLe trial has questioned its overall place in haemorrhoid management. Novel “walk-in-walk-out” techniques such as radiofrequency ablations or laser treatments will need further evaluation to define their role in modern-day haemorrhoid management. There are numerous treatment options for haemorrhoids, each with their own evidence-base. Newer techniques promise to be less painful, but recurrence rates remain an issue. The balance continues to be sought between long-term efficacy, minimisation of postoperative pain, and preservation of anorectal function.

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Modified Ferguson hemorrhoidectomy for grade II–IV hemorrhoids offers low recurrence and complication rates: a retrospective cohort study
Run-Yi Geng, Lu Yin, Yong-Qing Cao, Xiao Shen, Ya-Qing Ding, Yi-Bo Yao, Chen Wang
Frontiers in Medicine.2026;[Epub] CrossRef
The efficacy of Aescin combined with MPFF for early control of bleeding from acute hemorrhoids, A randomized controlled trial
Suwan Sanmee, Witcha Vipudhamorn, Pawit Sutharat, Ekkarin Supatrakul
Asian Journal of Surgery.2025; 48(1): 193. CrossRef
Rectal Artery Embolization for the Treatment of Hemorrhoidal Disease
Seyed S. Zakavi, Mohammad Mirza-Aghazadeh-Attari, Arian Mansur, Peiman Habibollahi, Nariman Nezami, Juan C. Camacho
Seminars in Interventional Radiology.2025; 42(01): 093. CrossRef
Comparative analysis of Ferguson hemorrhoidectomy combined with doppler-guided hemorrhoidal artery ligation and Ferguson hemorrhoidectomy in hemorrhoidal disease treatment
Ismail Cem Eray, Ugur Topal, Serdar Gumus, Kubilay Isiker, Burak Yavuz, Ishak Aydin
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Superselective superior rectal artery embolization in the treatment of hemorrhoidal disease
Tao Jiang, Lichao Fan, Xuesong Tang, Zhigang Xu, Wenjiang Wu
Frontiers in Medicine.2025;[Epub] CrossRef
EXPLORING THE ANTI-INFLAMMATORY PROPERTIES OF METFORMIN IN EXPERIMENTAL HEMORRHOID MODELS
DARMAWI DARMAWI, MUHAMMAD YULIS HAMIDY, SORAYA SORAYA, NURUL AZIZAH, LALU MUHAMMAD IRHAM, BAIQ LENY NOPITASARI, INA F. RANGKUTI, A. A. MUHAMMAD NUR KASMAN, WIRAWAN ADIKUSUMA
International Journal of Applied Pharmaceutics.2025; : 190. CrossRef
The real clinical practice of surgery for hemorrhoidal disease
T. N. Garmanova, E. A. Kazachenko, D. R. Markaryan, A. M. Lukyanov, M. A. Agapov
Koloproktologia.2025; 24(2): 67. CrossRef
Multicenter analysis of the efficacy and factors related to recurrence of endoscopic sclerotherapy for internal hemorrhoids: a large-sample, retrospective cohort study
Ying Zhu, Yingying Yang, Wen Xu, Xiaohua Bao
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Efficacy and Safety Evaluation of Endoscopic Rubber Band Ligation at Different Sites for Grades I~III Internal Hemorrhoids
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Laser hemorrhoidoplasty versus LigaSure™ hemorrhoidectomy versus diathermy hemorrhoidectomy in treatment of grade III and IV Hemorrhoids: A non-randomized prospective trial
Mohammad Ashour Khadr, Walid Galal El Shazly, Mohamed Mazloum Zakria, Ahmed Mohamed Moaz
Surgery Open Digestive Advance.2024; 13: 100129. CrossRef
A Retrospective Study of Milligan-Morgan Versus LigaSure Hemorrhoidectomy in the Treatment of Symptomatic Hemorrhoids at an Institute in North India
Anant Kaur Virk, Rohin Kansal, Carol Singh, Madhav Mehta, Baninder Arora, Anmol Singh, Kashish Malhotra, Jasneet Grewal, Himel Mondal, Ashvind Bawa
Cureus.2024;[Epub] CrossRef
The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease
Antonio Brillantino, Adolfo Renzi, Pasquale Talento, Luigi Brusciano, Luigi Marano, Maurizio Grillo, Mauro Natale Maglio, Fabrizio Foroni, Alessio Palumbo, Maria Laura Sandoval Sotelo, Luciano Vicenzo, Michele Lanza, Giovanna Frezza, Massimo Antropoli, Cl
Annals of Coloproctology.2024; 40(4): 287. CrossRef
Conventional Excisional Haemorrhoidectomy versus Transanal Haemorrhoidal Dearterialization for Haemorrhoids: A Systematic Review and Meta-Analysis
Juliana Jee, Lauren Vourneen O’Connell, Ishapreet Kaur, Shaheel Mohammad Sahebally
Digestive Surgery.2024; 41(4): 204. CrossRef
Treatment of Hemorrhoidal Disease in Patients with Liver Cirrhosis: A Systematic Review
Sofia Bizarro Ponte, Joana Oliveira, Andreia Rei, Paulo Salgueiro
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Systemic and local therapy of chronic hemorrhoids: Results of the prospective comparative study “VITA”
I. V. Kostarev, G. V. Rodoman, A. K. Batishev, I. S. Bogormistrov, N. V. Tuktagulov
Ambulatornaya khirurgiya = Ambulatory Surgery (Russia).2024; 21(2): 153. CrossRef
Utility of botulinum toxin injection for post-operative pain management after conventional hemorrhoidectomy: a systematic review and meta-analysis of clinical trials
Hendry Lie, Patrick Putra Lukito, Taufik Sudirman, Antonius Agung Purnama, Rudy Sutedja, Andre Setiawan, Wifanto Saditya Jeo, Andry Irawan, Willi Satriya, Heru Sutanto Koerniawan, Timotius Ivan Hariyanto
Scandinavian Journal of Gastroenterology.2023; 58(2): 116. CrossRef
Hemorrhoid laser dearterialization: systematic review and meta-analysis
Paola De Nardi, Giulia Maggi, Michele Pagnanelli, Iliyan Vlasakov, Davide Corbetta
Lasers in Medical Science.2023;[Epub] CrossRef
Altered Gut Microbic Flora and Haemorrhoids: Could They Have a Possible Relationship?
Vincenzo Davide Palumbo, Roberta Tutino, Marianna Messina, Mauro Santarelli, Casimiro Nigro, Giacomo Lo Secco, Chiara Piceni, Elena Montanari, Gabriele Barletta, Paolina Venturelli, Girolamo Geraci, Sebastiano Bonventre, Attilio Ignazio Lo Monte
Journal of Clinical Medicine.2023; 12(6): 2198. CrossRef
Comparison of the long-term efficacy and safety of multiple endoscopic rubber band ligations in a single session for varying grades of internal hemorrhoids
Kangwei Xiong, Qian Zhao, Wanli Li, Tingting Yao, Yuan Su, Jiajia Wang, Haiming Fang
Irish Journal of Medical Science (1971 -).2023; 192(6): 2747. CrossRef
Therapeutic effect of Achillea millefolium on the hemorrhoids; A randomized double-blind placebo-controlled clinical trial
Aynaz Mahmoudi, Mirsalim Seyedsadeghi, Mansour Miran, Saeid Sadeghieh Ahari, Hojat Layegh, Sara Mostafalou
Journal of Herbal Medicine.2023; 39: 100657. CrossRef
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I. A. Matveev, N. A. Borodin, V. T. Dgebuadze, L. A. Morozova, N. N. Povarnin
Ambulatornaya khirurgiya = Ambulatory Surgery (Russia).2023; 20(1): 140. CrossRef
Results of sclerotherapy and mucopexy with haemorrhoidal dearterialization in II and III degree haemorrhoids. A 4 years' single centre experience
Pierluigi Lobascio, Rita Laforgia, Angela Pezzolla
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Evaluation of Clinical Manifestations of Hemorrhoidal Disease, Carried Out Surgeries and Prolapsed Anorectal Tissues: Associations with ABO Blood Groups of Patients
Inese Fišere, Valērija Groma, Šimons Svirskis, Estere Strautmane, Andris Gardovskis
Journal of Clinical Medicine.2023; 12(15): 5119. CrossRef
A retrospective comparative study of hemorrhoidal artery ligation versus ligasure hemorrhoidectomy for the third degree hemorrhoidal disease
Tolga Onder, Merih Altiok
Asian Journal of Surgery.2023; 46(10): 4385. CrossRef
Comparison of ointment-based agents after excisional procedures for hemorrhoidal disease: a network meta-analysis of randomized controlled trials
Konstantinos Perivoliotis, Charito Chatzinikolaou, Dimitrios Symeonidis, Konstantinos Tepetes, Ioannis Baloyiannis, George Tzovaras
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
Comparison of the Efficacy of Rubber Band Ligation and Injection Sclerotherapy for 2nd Degree Hemorrhoids
Uzma Khan, Yasir Naseem Khan
Indian Journal of Colo-Rectal Surgery.2023; 6(2): 26. CrossRef
A Case of Long-Term Complication of Faecal Impaction after PPH
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Advances in Clinical Medicine.2022; 12(01): 399. CrossRef
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Nathália Nascentes Coelho dos Santos Omer, Ivana Duval de Araujo, Geraldo Magela Gomes da Cruz, Fábio Gontijo Rodrigues
Journal of Coloproctology.2022; 42(01): 085. CrossRef
Comparison of post-operative bleeding incidence in laser hemorrhoidoplasty with and without hemorrhoidal artery ligation: a double-blinded randomized controlled trial
Shu Yu Lim, Retnagowri Rajandram, April Camilla Roslani
BMC Surgery.2022;[Epub] CrossRef
Evaluation of the clinical efficacy and safety of TST33 mega hemorrhoidectomy for severe prolapsed hemorrhoids
Liu Tao, Jun Wei, Xu-Feng Ding, Li-Jiang Ji
World Journal of Clinical Cases.2022; 10(18): 6060. CrossRef
Haemorrhoids
Ian Peate
British Journal of Healthcare Assistants.2022; 16(10): 464. CrossRef
Treatment of Hemorrhoid in Unusual Condition-Pregnancy
Hyo Seon Ryu
The Ewha Medical Journal.2022;[Epub] CrossRef
SURGICAL TREATMENT OF CHRONIC HEMORRHOIDS (LITERATURE REVIEW)
S. M. Vasyliuk, A. I. Gutculiak, V. I. Gudyvok, O. M. Dmytruk, V. S. Osadetc, I. R. Labyak
Kharkiv Surgical School.2022; (4-5): 134. CrossRef
Rubber band ligation of symptomatic hemorrhoids: an old solution to an everyday problem
Vasileios Komporozos, Vasiliki Ziozia, Aikaterini Komporozou, George Stravodimos, Ageliki Kolinioti, Antonia Papazoglou
International Journal of Colorectal Disease.2021; 36(8): 1723. CrossRef
Pudendal Nerve Block in Hemorrhoid Surgery: A Systematic Review and Meta-analysis
Francesco Mongelli, Giorgio Treglia, Davide La Regina, Matteo Di Giuseppe, Jacopo Galafassi, Pietro E. Majno-Hurst, Dimitrios Christoforidis
Diseases of the Colon & Rectum.2021; 64(5): 617. CrossRef
Superior Rectal Artery Embolization with Tris-Acryl Gelatin Microspheres: A Randomized Comparison of Particle Size
Murat Bülent Küçükay, Fahrettin Küçükay
Journal of Vascular and Interventional Radiology.2021; 32(6): 819. CrossRef
Lifestyle and Risk Factors in Hemorrhoidal Disease
Stefania De Marco, Domenico Tiso
Frontiers in Surgery.2021;[Epub] CrossRef
The Laser Therapy for Hemorrhoidal Disease: A Prospective Study
Rafique Umer Harvitkar, Giri Babu Gattupalli, Seshu Kumar Bylapudi
Cureus.2021;[Epub] CrossRef
Emergency treatment of bleeding hemorrhoids in a patient taking aspirin and clopidogrel using a 1470 nm diode laser and the ELITE minimal invasive technique
Chris Bachtsetzis, Antigoni Papaioannou, Spyridon Bekas, Athina Lazaridou, George Bachtsetzis
Journal of Surgical Case Reports.2020;[Epub] CrossRef

Case Report

Benign GI diease

Double Pedicle Artery Rotation Sigmoid Vaginoplasty for Vaginal Aplasia Management: Adeodatus Yuda Handaya, Nurcahya Setyawan, Nuring Pangastuti, Marijata , Agus Barmawi, Imam Sofii, Muhamad Nurhadi Rahman, Ida Ayu Setyawati, Hamzah Muhammad Hafiq; Ann Coloproctol. 2020;36(3):198-203. Published online January 20, 2020; DOI: https://doi.org/10.3393/ac.2018.10.30

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1 Web of Science
1 Citations

Abstract PDF

Sigmoid vaginoplasty has been popular for neovagina reconstruction in vaginal aplasia. The most common surgical complication was vaginal stenosis caused by inadequate vascularization and tension because of graft length. Therefore, ischemia ensued and disrupted wound healing. The selection of double pedicle artery rotation sigmoid vaginoplasty is expected to reduce this problem. Five patients from April to December 2016 were diagnosed with vaginal aplasia; 4 had history of neovagina stenosis. These patients underwent sigmoid vaginoplasty with double pedicle artery rotation. No complications occurred during or after the procedure. Assessment postsurgery was conducted at 1 year. These results suggest that double pedicle artery rotation sigmoid vaginoplasty is a safe and acceptable technique for management of vaginal aplasia. The procedure decreased tension inside vascular pedicles as a result of maintaining abundant vascularization supply. Consequently, this procedure could avert graft necrosis, leakage, and severe stenosis. All of the patients exhibited regular menstrual cycle and satisfactory sexual activity. The outcomes were excellent with remarkable anatomical and functional results.

Citations

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Defining and measuring acceptability of surgical interventions: A scoping review
Sophie James, Jennie Lister, Joy Adamson, Catherine Hewitt, Antonina Yakimova, Andrew Mott, Helen Fulbright, Catriona McDaid, Federico Romano
PLOS One.2025; 20(6): e0323738. CrossRef

Reviews

Reconsideration of the Safety of Laparoscopic Rectal Surgery for Cancer: Gyung Mo Son, Bong-Hyeon Kye, Min Ki Kim, Jun-Gi Kim; Ann Coloproctol. 2019;35(5):229-237. Published online October 31, 2019; DOI: https://doi.org/10.3393/ac.2019.10.16

6,279 View
117 Download
6 Web of Science
6 Citations

Abstract PDF

The oncological outcomes of laparoscopic rectal cancer surgery were evaluated in recent multicenter randomized clinical trials (RCTs). The MRC-CLASSIC, COLOR II, and COREAN trials found no differences in local recurrence or diseasefree survival rate between laparoscopic and open surgery. However, the noninferiority of laparoscopic surgery with respect to open surgery for rectal cancer was not established on statistical analysis in the ACOSOG Z6051 and the ALaCaRT trials. Quality of total mesorectal excision (TME) is one of the most important prognostic factors. Incomplete TME had unfavorable oncologic outcomes compared to complete TME. Although TME quality can be clearly identified on pathologic evaluation, there is controversy regarding the acceptable range of oncologically safe TME for laparoscopic surgery. It is not certain whether near-complete TME has an unfavorable oncologic impact and whether laparoscopic surgery with near-complete TME is an oncological threat. Therefore, the surgical community will be interested in the long-term outcomes and meta-analyses of ongoing large-scale RCTs. Laparoscopic rectal cancer surgery has been steadily improving its safety for oncology surgery, which has been reported consistently in various multicenter RCTs. To improve surgical quality, colorectal surgeons should choose the most appropriate surgical technique, including laparoscopic surgery.

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Why did we encounter a pCRM-positive specimen whose preoperative MRI indicates negative mesorectal fascia involvement in middle to low rectal cancer?
F. Sumiyama, M. Hamada, T. Kobayashi, Y. Matsumi, R. Inada, H. Kurokawa, Y. Uemura
Techniques in Coloproctology.2025;[Epub] CrossRef
Efficacy of laparoscopic radical resection of colorectal cancer in older patients and its effects on inflammatory factors
Zhen-Yu Min, Jie Zhou, Zhong-Wei Zhu, Zhen-Zhong Fa
World Journal of Gastrointestinal Surgery.2025;[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
Evidenz in der minimal-invasiven onkologischen Chirurgie des Kolons und des Rektums
Carolin Kastner, Joachim Reibetanz, Christoph-Thomas Germer, Armin Wiegering
Der Chirurg.2021; 92(4): 334. CrossRef
The Safety and Feasibility of Laparoscopic Surgery for Very Low Rectal Cancer: A Retrospective Analysis Based on a Single Center’s Experience
Hyuk-Jun Chung, Jun-Gi Kim, Hyung-Jin Kim, Hyeon-Min Cho, Bong-Hyeon Kye
Biomedicines.2021; 9(11): 1720. CrossRef
Reoperative laparoscopic rectal surgery: Another potential tool for the expert’s toolbox
Marc D. Basson
The American Journal of Surgery.2020; 219(6): 894. CrossRef

Postoperative Bowel Function After Anal Sphincter-Preserving Rectal Cancer Surgery: Risks Factors, Diagnostic Modalities, and Management: Chris George Cura Pales, Sanghyun An, Jan Paolo Cruz, Kwangmin Kim, Youngwan Kim; Ann Coloproctol. 2019;35(4):160-166. Published online August 31, 2019; DOI: https://doi.org/10.3393/ac.2019.08.10

12,284 View
245 Download
39 Web of Science
40 Citations

Abstract PDF

Low anterior resection syndrome (LARS) refers to a disturbance of bowel function that commonly manifests within 1 month after rectal cancer surgery. A low level of anastomosis and chemoradiotherapy have been consistently found to be risk factors for developing LARS. Thorough history taking and physical examination with adjunctive procedures are essential when evaluating patients with LARS. Anorectal manometry, fecoflowmetry, and validated questionnaires are important tools for assessing the quality of life of patients with LARS. Conservative management (medical, physiotherapy, transanal irrigation), invasive procedures (neuromodulation), and multimodal therapy are the mainstay of treatment for patients with LARS. A stoma could be considered when other treatment modalities have failed. An initial meticulous surgical procedure for rectal cancer, creation of a neorectal reservoir during anastomosis, and proper exercise of the anal sphincter muscle (Kegel’s maneuver) are essential to combat LARS. Pretreatment counseling is a crucial step for patients who have risk factors for developing LARS.

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Truly Inevitable—Our Perspective on the Complications After Surgery for Rectal Cancer
Kumar Vinchurkar, Manoj Togale, Preeti Maste, Saurin Chaudhary, Imtiaz Ahmed, Sapna Krishnamurthy, Rohan Bhise, Jyoti Mane, Praveen Kumbar
Indian Journal of Surgical Oncology.2025; 16(2): 667. CrossRef
Systematic review of the management options available for low anterior resection syndrome (LARS)
G. Sharp, N. Findlay, D. Clark, J. Hong
Techniques in Coloproctology.2025;[Epub] CrossRef
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Song Wang, A-Jian Li, Hui-Hong Jiang, Yin Lin, Hai-Bo Ding
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
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Original Articles

Transanal Minimally-Invasive Surgery for Treating Patients With Regressed Rectal Cancer After Preoperative Chemoradiotherapy: Byoung Chul Lee, Seonok Oh, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2017;33(2):52-56. Published online April 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.2.52

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Abstract PDF

Purpose

Although the standard treatment for patients with locally advanced rectal cancer managed by preoperative chemoradiotherapy (CRT) is a radical resection, local excisions are used in highly-selective cases. Recently, transanal minimally-invasive surgery (TAMIS) has emerged as a feasible technique for local excision of midrectal lesions. We assess the feasibility of using TAMIS to treat patients with locally advanced rectal cancer who showed good response to CRT.

Methods

From October 2010 to June 2013, 35 consecutive patients with rectal cancer managed by using preoperative CRT underwent TAMIS. After a single-incision laparoscopic surgery port had been introduced into the anal canal, a full-thickness local excision with conventional laparoscopic instruments was performed. We retrospectively reviewed a prospectively collected database of these cases.

Results

Of the 35 patients analyzed, 18 showed pathologic complete responses and 17 had residual lesions (2 ypTis, 4 ypT1, 9 ypT2, and 2 ypT3); 34 (97.1%) showed clear deep, lateral margins. The median distance of lesions from the anal verge was 5 cm. All procedures were completed laparoscopically, and the median operating time was 84 minutes. No intraoperative events or morbidities were seen in any of the patients, except one with wound dehiscence, who was treated conservatively. The median postoperative hospital stay and follow-up period were 4 days and 36 months, respectively. During the study period, no patients died, but 5 (14.3%) experienced recurrence, including one recurrence at the TAMIS site.

Conclusion

TAMIS seems to be a feasible, safe modality for treating patients with locally advanced rectal cancer who show good response to preoperative CRT.

Citations

Citations to this article as recorded by

Local Excision in the Era of Total Neoadjuvant Therapy
Anders C. Larsen, Joceline V. Vu
Clinics in Colon and Rectal Surgery.2026;[Epub] CrossRef
TAMIS: New Horizons in Modern Colorectal Surgery
Nurhilal Kızıltoprak, Jack Aaron, Camila Diez, Sam Atallah
Turkish Journal of Colorectal Disease.2025; 35(2): 33. CrossRef
Multidisciplinary treatment strategy for early rectal cancer
Gyung Mo Son, In Young Lee, Sung Hwan Cho, Byung-Soo Park, Hyun Sung Kim, Su Bum Park, Hyung Wook Kim, Sang Bo Oh, Tae Un Kim, Dong Hoon Shin
Precision and Future Medicine.2022; 6(1): 32. CrossRef
Minimally Invasive Treatment of a Completely Obstructed Rectal Anastomosis by Using a Transanal Plasmakinetic Resectoscope: a Case Report and Review of Literature
Na Wang, Daguang Wang, Weihua Tong, Jinguo Wang
Indian Journal of Surgery.2021; 83(5): 1127. CrossRef
Transanal minimally invasive surgery using laparoscopic instruments of the rectum: A review
Myung Jo Kim, Taek-Gu Lee
World Journal of Gastrointestinal Surgery.2021; 13(10): 1149. CrossRef
Transanal Minimally Invasive Surgery: A Promising Alternative for Certain Advanced Rectal Cancer Patients
Hernan A. Sanchez-Trejo, Daniel Hakakian, Terrence Curran, Luca Antonioli, Balazs Csoka, Zoltan H. Nemeth
Journal of Investigative Surgery.2019; 32(4): 377. CrossRef
Transanal minimally invasive surgery as a treatment option for a completely occluded anastomosis after low anterior resection: A new approach to severe anastomotic stenosis
Jun Woo Bong, Seok‐Byung Lim
Asian Journal of Endoscopic Surgery.2019; 12(2): 175. CrossRef
A systematic review and meta-analysis of pT2 rectal cancer spread and recurrence pattern: Implications for target design in radiation therapy for organ preservation
Joanna Socha, Lucyna Pietrzak, Anna Zawadzka, Anna Paciorkiewicz, Anna Krupa, Krzysztof Bujko
Radiotherapy and Oncology.2019; 133: 20. CrossRef
Transanal Minimally Invasive Surgery After Chemoradiotherapy: Widening Scope of Indications for Local Excision
Min Jung Kim, Jae Hwan Oh
Annals of Coloproctology.2017; 33(2): 43. CrossRef

Single Center Experience With Hyperthermic Intraperitoneal Chemotherapy: Woo Ram Kim, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Kang Young Lee, Nam Kyu Kim; Ann Coloproctol. 2017;33(1):16-22. Published online February 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.1.16

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4 Citations

Abstract PDF

Purpose

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been proposed for controlling peritoneal seeding metastasis in some kinds of cancers, including those of colorectal origin, but their safety and oncological benefits are subjects of debate. We present our early experience with those procedures.

Methods

Data were retrospectively collected from all patients with peritoneal carcinomatosis (PC) and pseudomyxoma peritonei (PMP) treated using CRS and HIPEC at Yonsei Cancer Center between July 2014 and July 2015. Short-term outcomes and risk factors for postoperative complications were analyzed.

Results

Twenty-three patients with PC (n = 18) and PMP (n = 5) underwent CRS and HIPEC. Median follow-up and age were 2 months and 54 years, respectively. The median peritoneal carcinomatosis index score was 15, and CC0-1 was achieved in 78.3% of all patients. The median operation time and bleeding loss were 590 minutes and 570 mL, respectively. Grade-IIIa/grade-IIIb complications occurred in 4.3% (n = 1)/26.1% (n = 6) of the patients within 30 days postoperatively, and no 30-day mortalities were reported. Factors related to postoperative complications with CRS and HIPEC were number of organ resection (P = 0.013), longer operation time (P < 0.001), and amount of blood loss (P = 0.003). All patients treated with cetuximab for recurred colorectal cancer had grade-III postoperative complication.

Conclusion

Our initial experience with CRS and HIPEC presented about 30% grade-III postoperative complications. Therefore, expert surgeons need to perform those procedures with great caution in selected patients who might benefit from it.

Citations

Citations to this article as recorded by

Multisocietal Consensus on the Use of Cytoreductive Surgery and HIPEC for the Treatment of Diffuse Malignant Peritoneal Mesothelioma: A GRADE Approach for Evidence Evaluation and Recommendation
Shigeki Kusamura, Michela Cinquini, David Morris, Pompiliu Piso, Hedy Kindler, Andreas Brandl, Edward Levine, Olivier Glehen, Vahan Kepenekian, Olivia Sgarbura, Paul H. Sugarbaker, Dario Baratti, Guaglio Marcello, Deraco Marcello
Journal of Surgical Oncology.2025; 131(5): 810. CrossRef
Pharmacologic Effects of Oxaliplatin Instability in Chloride-Containing Carrier Fluids on the Hyperthermic Intraperitoneal Chemotherapy to Treat Colorectal Cancer In Vitro and In Vivo
Eun Jung Park, Junhyun Ahn, Sharif Md Abuzar, Kyung Su Park, Sung-Joo Hwang, Seung Hyuk Baik
Annals of Surgical Oncology.2022; 29(13): 8583. CrossRef
Treatment for Peritoneal Metastasis of Patients With Colorectal Cancer
Young Jin Kim, Chang Hyun Kim
Annals of Coloproctology.2021; 37(6): 425. CrossRef
Is Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy a Safe and Effective Procedure for Treating Patients With a Peritoneal Surface Malignancy?
Dong-Guk Park
Annals of Coloproctology.2017; 33(1): 3. CrossRef

Review

Optimal Treatment of Symptomatic Hemorrhoids: Seok-Gyu Song, Soung-Ho Kim; J Korean Soc Coloproctol. 2011;27(6):277-281. Published online December 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.6.277

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21 Citations

Abstract PDF

Hemorrhoids are the most common anorectal complaint, and approximately 10 to 20 percent of patients with symptomatic hemorrhoids require surgery. Symptoms of hemorrhoids, such as painless rectal bleeding, tissue protrusion and mucous discharge, vary. The traditional therapeutic strategies of medicine include surgical, as well as non-surgical, treatment. To alleviate symptoms caused by hemorrhoids, oral treatments, such as fiber, suppositories and Sitz baths have been applied to patients. Other non-surgical treatments, such as infrared photocoagulation, injection sclerotherapy and rubber band ligation have been used to fixate the hemorrhoid's cushion. If non-surgical treatment has no effect, surgical treatments, such as a hemorrhoidectomy, procedure for prolapsed hemorrhoids, and transanal hemorrhoidal dearterialization are used.

Citations

Citations to this article as recorded by

Comparative analysis of Ferguson hemorrhoidectomy combined with doppler-guided hemorrhoidal artery ligation and Ferguson hemorrhoidectomy in hemorrhoidal disease treatment
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World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
HEMORRHOIDS: A COMPREHENSIVE REVIEW OF ETIOLOGY, PATHOPHYSIOLOGY, RISK FACTOR AND TREATMENT OPTION
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International Journal of Colorectal Disease.2025;[Epub] CrossRef
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Samrobinson J, Jeyaganesh R, Geetha Arumugam, Nawin J Vignesh
Cureus.2024;[Epub] CrossRef
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Randomized Controlled Trial

Efficacy of Ligasure(TM) in a Hemorrhoidectomy: Comparison with Semi-open Hemorrhoidectomy.: Suh, Hae Hyeon; J Korean Soc Coloproctol. 2003;19(5):271-275.

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Abstract PDF: PURPOSE
Ligasure(TM) is a feedback-controlled bipolar diathermy originally devised to seal vessels and developed to weld tissue bundles. The tissue fusion mechanism consists of melting collagen and elastin, and the tissue welding property of Ligasure(TM) can be used in a hemorrhoidectomy. To confirm the efficacy of Ligasure(TM) in hemorrhoidectomies, I compared it with the conventional semi-open method.
METHODS
One hundred patients with grade III or IV hemorrhoids were randomly assigned to the Ligasure(TM) (n=50) or the conventional semi-open (n=50) hemorrhoidectomy group. The operation time, the postoperative analgesic requirement, the hospital stay, the time to return to normal life, and complications were prospectively recorded and analyzed.
RESULTS
There was no difference in sex and age between the two groups. The operation time was markedly shorter in the Ligasure(TM) group than semi-open group (10.8+/-4.0 versus 23.7+/-5.2 min; P<0.001). Although the hospital stay was not statistically different, the time to return to the normal life was shorter in the Ligasure(TM) group (9.5+/-3.8 versus 12.7+/-4.0 days; P<0.05). The requirement for postoperative analgesics within 48 hours (nalbuphine, 5mg) was not significantly different. In each group, an urinary retention was noted and treated with urinary catheterization. In Ligasure(TM) group, an anal stenosis was developed and was successfully treated with advancement flap surgery. In each group a secondary bleeding and a skin tag were noted. There was no wound infection or incontinence.
CONCLUSIONS
Ligasure(TM) hemorrhoidectomy reduces the operation time and the time to return to the normal life. If anal stenosis is to be prevented, careful attention is required to preserve the anal skin and mucosa. Ligasure(TM) is simple to use and is useful in the treatment of patients with grade III or IV hemorrhoids.

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