Annals of Coloproctology

Volume 23(5); October 2007

Original Articles

Surgical Management of Colonoscopic Perforations.: Park, Hyoung Chul , Kim, Duck Woo , Kim, Sang Gyun , Park, Kyu Joo , Park, Jae Gahb; J Korean Soc Coloproctol. 2007;23(5):287-291.; DOI: https://doi.org/10.3393/jksc.2007.23.5.287

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PURPOSE
The purpose of this study is to evaluate the clinical features that necessitate a temporary stoma for the treatment of colonoscopic perforations.
RESULTS
Between January 2000 and July 2006, 30 patients were treated for colonoscopic perforation. Based on the perforation sites, we classified these patients into the following groups: proximal colon, sigmoid colon, and rectum; we then reviewed clinical data, including the time to operation and management.
RESULTS
Seventeen patients had a perforation during the diagnostic colonoscopy. Of these patients, 14 patients had sigmoid colon perforation. Six underwent an operation within 10 hours after perforation. Of these six, four were managed by primary repair or resection with anastomosis, one sigmoid colon cancer patient by anterior resection, and one rectal cancer patient by low anterior resection with diverting ileostomy. Eight patients underwent more than 12 hours after perforation. Of these eight, three were managed by resection with anastomosis and diverting ileostomy and five by resection with end colostomy. Thirteen patients had a perforation during the therapeutic colonoscopy. Of these patients, 10 patients had a proximal colon perforation. Of these 10, 3 without fever or peritonitis symptom were managed by conservative management, 6 by primary repair or resection with anastomosis, and 1 transverse colon cancer patient by right hemicolectomy. Three patients had sigmoid colon perforation. Of these three, one was managed by primary repair, one by resection with anastomosis, and one sigmoid colon cancer patient by anterior resection.
CONCLUSIONS
The mechanism of perforation, the site of the perforation, and the time to operation are associated with intraperitoneal contamination and have an influence on surgical treatment.

Citations

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A comparative analysis of traditional meat processing methods
Kasun Dissanayake, Mohamed Rifky, Khabibulla Nurmukhamedov, Jasur Makhmayorov, Bakhodir Abdullayev, Jasur Farmanov, Murodjon Samadiy, T. Itao, V. Perskaya, W. Yanmin, D. Morkovkin
E3S Web of Conferences.2024; 494: 04023. CrossRef
Comparison of the surgical outcomes of laparoscopic versus open surgery for colon perforation during colonoscopy
Jeongsoo Kim, Gil Jae Lee, Jeong-Heum Baek, Won-Suk Lee
Annals of Surgical Treatment and Research.2014; 87(3): 139. CrossRef
Colonoscopic Perforation; A 10-year Experience in Single General Hospital
Ji Eun Oh, Sang Goon Shim
The Korean Journal of Gastroenterology.2009; 54(6): 371. CrossRef
Treatment of Colon Perforation Associated with Colonoscopy
Hae Ran Park, Seong Kyu Baek, Ok Suk Bae, Sung Dae Park
Journal of the Korean Society of Coloproctology.2008; 24(5): 322. CrossRef

Clinical Outcomes of Lateral Internal Sphincterotomy for Patients with Chronic Anal Fissure.: Park, Jung Soo , Lee, Jae Bum , Kim, Tae Sun , Cho, Hang Jun , Kim, Do Sun , Lee, Doo Han; J Korean Soc Coloproctol. 2007;23(5):292-296.; DOI: https://doi.org/10.3393/jksc.2007.23.5.292

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Abstract PDF: PURPOSE
A lateral internal sphincterotomy (LIS) is a safe and effective surgical treatment that is the most commonly used one for patients with chronic anal fissure. However, reports on the recurrence rate and complications after LIS published in Korea are rare. The purpose of our study is to identify the types and rates of recurrence, the complications after LIS, and the differences in clinical outcomes between open and closed LIS.
RESULTS
We used hospital records and telephone interviews to study retrospectively the rates of recurrence and complications of 898 patients who underwent a LIS for chronic anal fissure from July, 2003, to June 30, 2004.
RESULTS
There were 292 male (mean age: 36.8 years, range: 16~84) and 606 female (mean age: 32.4 years, range: 1~68) patients. The preoperative mean maximum resting pressure in anal manommetry was 99.2 cmH2O in male patients and 97.7 cmH2O in female patients. Recurrence of fissure after LIS was present in five cases (0.6%). All underwent a LIS, on the same side of a previous LIS in four cases and on the opposite side in one case. Delayed healing of the fissure was present in six cases (0.7%). All of these patients were improved by conservative management. Complications of the LIS were thrombus formation, perianal abscess, fistula, and incontinence. Thrombus formation was present in eight cases (0.9%). Five patients underwent a thrombectomy and three patients were cured by conservative management. Perianal abscess or fistula was present in three patients (0.3%), who underwent incision and drainage or a simple fistulotomy. Incontinence was present in two cases (0.2%). One patient was lost to follow up, and the other patient was improved by conservative management.
CONCLUSIONS
LIS is a safe and effective treatment for patients with chronic anal fissure, and recurrence and complications of LIS are rare.

Detection of HBV DNA and HCV RNA in Public Bath; A Study about Safety of Prolapsed Hemorrhoidal Patients.: Lee, Jin kwon , Kim, Hyun sung , Lee, Eun yup , Choi, In seok , Oh, Nahm gun; J Korean Soc Coloproctol. 2007;23(5):297-304.; DOI: https://doi.org/10.3393/jksc.2007.23.5.297

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PURPOSE
The Sitz bath is a commonly used nonsurgical treatment for patients with hemorrhoids. When these patients use public baths, possibilities exposure to infectious diseases due to public-bath utilization by exist for person infected with many kinds of diseases. In particular, because Hepatitis type B and type C viruses are infection sources for chronic liver diseases, we shall examine the risks of infections of HBV and HCV in acute hemorrhoids patients by examining the existences of HBV DNA and HCV RNA in the waters of public baths.
RESULTS
From March 2005 to March 2006, 29 hot-water samples and 22 cold-water samples were obtained from public baths within Busan. With each sample, COBAS Amplicor HBV DNA monitor and HCV RNA monitor were used to run a quantitative (PCR) for HBV DNA and HCV RNA. Additionally, HBsAg and HBeAg were examined through chemiluminescent microparticle immuno assay (CMIA).
RESULTS
HBV DNA was detected in 4 samples and HCV RNA was detected in an other 4 samples of the 29 samples from the hot baths. In 22 samples from the cold baths, HBV DNA was detected in 3 samples and HCV RNA in an other 2 samples. The mean levels of HBV DNA detected were 162.8 IU/ml and 1,586 IU/ml and the mean levels of HCV RNA were 276 IU/ml and 3,067 IU/ml from specimens in hot and cold baths, respectively. In the tests for HBs Ag and HBeAg, among 51 samples, 2 hot-water samples showed positive for HBs Ag while the others showed negative.
CONCLUSIONS
HBV DNA and HCV RNA were detected in both the hot and the cold waters of public baths. However, this result cannot be regarded as demonstrating infectivity, but further studies are thought to be needed to examine the risks of infections to patients with acute hemorrhoids of higher than third degree or patients with open wounds or external orifices. A patient with hemorrhoids or fistulas with external orifices should not use public baths and should undergo curative surgery.

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Investigation of Microbial Contamination of Public Bath in Jongno-gu, Seoul
Mi-Soon Kim, Young-Min Lee, Seong-Keun Kim, Ji-Hyun Seo, Kyung-Hee Ji, Ji-Yoon Oh, Ki-Dong Ko, Gwang-Pyo Ko
Korean Journal of Environmental Health Sciences.2009; 35(3): 162. CrossRef

Developmental Pattern and Treatment in Colon Diverticular Disease.: Moon, Byung Chul , Kim, Han Sun; J Korean Soc Coloproctol. 2007;23(5):305-311.; DOI: https://doi.org/10.3393/jksc.2007.23.5.305

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Abstract PDF

PURPOSE
Colon diverticula has continuously increased in Korea. This study is to identify the changes in the developmental patterns of colon diverticula and in the methods of treatment.
RESULTS
A total of 66 patients who were diagnosed colon diverticular disease and hospitalized at Red Cross Hospital from April 1994 to March 2005 were enrolled. This retrospective assessment was performed by analyzing the hospital records of clinical characteristics such as demographics (age, sex), physical findings, distribution of diverticula, diagnosis methods, applicable treatments depending on severity and the stage of the disease, and complications and recurrences with whether the patient underwent a emergency or an elective operation.
RESULTS
The median age was 51.8 years, with 37 males and 29 females. Of the 66 cases, right-side colon diverticula was found in 47 cases, and left side in 15 cases. Transverse and descending colon diverticula occurred concurrently in 2 cases, with 2 entire colon cases. The median number of diverticula per patient was 4.6. Of the 29 operation cases, a right colectomy was done in 10 along with 6 appendectomy and diverticulectomy cases. Postoperative complications occurred in 7 patients, of these 6 occurred in patients who had undergone an emergency operation, and 1 in a patients who had undergone an elective operation; 6 in right colon diverticular disease, and 1 in left color diverticular disease.
CONCLUSIONS
Colon diverticular disease has increased with noticeable increases in left side and both-sides diseases. A one-stage operation is mainly performed for surgical treatment while fewer undergo a two-stage operation. Post-operative complications occurred in 7 cases. Exact preoperative diagnosis and an elective operation that allows bowel preparation are regarded as more crucial factors than the extension of the operation in decreasing the developmental rate and the severity of postoperative complications.

Citations

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Surgical management of colonic diverticular disease: Discrepancy between right- and left-sided diseases
Heung-Kwon Oh
World Journal of Gastroenterology.2014; 20(29): 10115. CrossRef
Colon Cancer After Acute Diverticulitis Treatment
Kwang Hoon Oh, Koon Hee Han, Eun Jung Kim, Je Hoon Lee, Kyu Un Choi, Myung Sik Han, Jae Hong Ahn, Gab Jin Cheon
Annals of Coloproctology.2013; 29(4): 167. CrossRef
Management of Right Colon Diverticulitis
Jong Ik Jang, Yang Soo Lim, Jong Woo Choi, Yoon Sik Lee
Journal of the Korean Society of Coloproctology.2010; 26(1): 22. CrossRef
A Case of Ascending Colon Diverticulitis with Perforation in a Child
Joon Woo Baek, Jae Young Shin, Jee Hyun Lee, So Young Jung, Ah Young Jung, Jeong Won Kim, Kon Hee Lee
Korean Journal of Pediatric Gastroenterology and Nutrition.2010; 13(2): 193. CrossRef

Effect of Yogurt Enriched Water-soluble Fiber on Functional Constipation.: Huh, Jung Wook , Park, Yoon Ah , Sohn, Seung Kook , Lee, Song Mi , Jung, Eun Joo , Lee, Kang Young , Kim, Sun Jung , Ha, Woel Kyu; J Korean Soc Coloproctol. 2007;23(5):312-320.; DOI: https://doi.org/10.3393/jksc.2007.23.5.312

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Abstract PDF

PURPOSE
Although a diet that is rich in fiber is widely recommended to prevent and treat constipation, the efficacy of fiber supplements with yogurt has not been studied sufficiently. The aim of this study was to evaluate the effect of a yogurt enriched water-soluble fiber on the various symptoms of constipation in female adults with functional constipation.
RESULTS
We did a double-blind and case-controlled study between two groups (placebo vs. fiber group), which were randomly allocated out of 42 subjects with functional constipation by using Rome II criteria. Bowel habits, daily nutritional intakes and physical activities were determined by using a questionnaire, and the segmental colonic transit time was evaluated three times: before treatment, after 4 weeks of treatment, and at the end of the study (2 weeks after treatment).
RESULTS
After 4 weeks of treatment, all defecation symptoms tested, except manual evacuation, showed significant improvements in the fiber group; fiber-enriched yogurt increased the number of bowel movements (P=0.002), reduced the presence of hard stools (P=0.001), improved the frequency of straining (P=0.048), the sense of incomplete evacuation (P= 0.013), and the sense of anorectal obstruction (P= 0.032). The total colonic transit time was shortened after intake of fiber-enriched yogurt (P=0.023). Satisfactory relief was significantly higher in the fiber group (P= 0.011).
CONCLUSIONS
Functional constipation may be improved with water-soluble fiber supplements in yogurt without serious side effects.

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2022 Seoul Consensus on Clinical Practice Guidelines for Functional Constipation
Young Sin Cho, Yoo Jin Lee, Jeong Eun Shin, Hye-Kyung Jung, Seon-Young Park, Seung Joo Kang, Kyung Ho Song, Jung-Wook Kim, Hyun Chul Lim, Hee Sun Park, Seong-Jung Kim, Ra Ri Cha, Ki Bae Bang, Chang Seok Bang, Sung Kyun Yim, Seung-Bum Ryoo, Bong Hyeon Kye,
Journal of Neurogastroenterology and Motility.2023; 29(3): 271. CrossRef
The Effect of Fiber Supplementation on Chronic Constipation in Adults: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials
Alice van der Schoot, Candice Drysdale, Kevin Whelan, Eirini Dimidi
The American Journal of Clinical Nutrition.2022; 116(4): 953. CrossRef
Guidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised Edition
Jeong Eun Shin, Hye-Kyung Jung, Tae Hee Lee, Yunju Jo, Hyuk Lee, Kyung Ho Song, Sung Noh Hong, Hyun Chul Lim, Soon Jin Lee, Soon Sup Chung, Joon Seong Lee, Poong-Lyul Rhee, Kwang Jae Lee, Suck Chei Choi, Ein Soon Shin
The Korean Journal of Medicine.2016; 91(2): 114. CrossRef
Guidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised Edition
Jeong Eun Shin, Hye-Kyung Jung, Tae Hee Lee, Yunju Jo, Hyuk Lee, Kyung Ho Song, Sung Noh Hong, Hyun Chul Lim, Soon Jin Lee, Soon Sup Chung, Joon Seong Lee, Poong-Lyul Rhee, Kwang Jae Lee, Suck Chei Choi, Ein Soon Shin
Journal of Neurogastroenterology and Motility.2016; 22(3): 383. CrossRef
Practical Treatments for Constipation in Korea
Kyung-Sik Park, Suck-Chei Choi, Moo-In Park, Jeong-Eun Shin, Kee-Wook Jung, Seong-Eun Kim, Tae-Hee Lee, Hoon-Sup Koo
The Korean Journal of Internal Medicine.2012; 27(3): 262. CrossRef
Diagnosis and Treatment of Constipation
Han Ho Jeon, Hyojin Park
Korean Journal of Medicine.2012; 83(5): 568. CrossRef
Guidelines for the Treatment of Constipation
Moo In Park, Jeong Eun Shin, Seung-Jae Myung, Kyu Chan Huh, Chang Hwan Choi, Sung-Ae Jung, Suck Chei Choi, Chong-Il Sohn, Myung-Gyu Choi
The Korean Journal of Gastroenterology.2011; 57(2): 100. CrossRef
Effects of Routine Haecho Bibimbab Consumption on the Improvement of Bowel Habits during Short Period
Kyung-Dong Cho, Eun Jin Kim, Mi Young Kim, Ok-Hee Baek, Changsun Choi, Chan-Kyu Han, Bog-Hieu Lee
The Korean Journal of Nutrition.2010; 43(1): 34. CrossRef

Characteristics of Colorectal Cancer Detected at the Health Promotion Center.: Yoon, Yong Sik , Yu, Chang Sik , Jung, Sang Hoon , Choi, Pyong Wha , Han, Kyong Rok , Kim, Hee Cheol , Kim, Jin Cheon; J Korean Soc Coloproctol. 2007;23(5):321-326.; DOI: https://doi.org/10.3393/jksc.2007.23.5.321

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Abstract PDF

PURPOSE
Colorectal cancer is regarded as preventable with routine checkups. The purpose of this study was to evaluate the usefulness of each test performed during routine checkups and to assess the clinicopathological characteristics of colorectal cancer detected at the Health Promotion Center (HPC).
RESULTS
We recruited 120 colorectal cancer patients identified on routine checkup at the HPC. The control group was composed of 3,829 colorectal cancer patients who underwent surgery during the same period. Clinicopathological variables were compared using the chi-square test.
RESULTS
The male-to-female ratio was 79:41; the mean age was 57.9 (30~78) years. The incidence of right colon cancer was 16.7%, and that of left colon cancer was 83.7%. Sigmoidoscopy (55.5%), colonoscopy (28.3%), and fecal occult blood tests (FOBT, 10.8%) were used for detecting colorectal cancer. The overall positive rates of FOBT and serum carcinoembryonic antigen (CEA) were 28.3% and 20.8%, respectively, but were higher in advanced colon cancer (49.0% and 31.4%) and right colon cancer (60% and 25%). Early colorectal cancer was more frequent in the study group (54.9%) than in the control group (16.9%, P<0.001). Right colon cancer was significantly associated with advanced colon cancer (80%), and left colon cancer was associated with early colon cancer (62.3%, P=0.001).
CONCLUSIONS
Endoscopy, including sigmoidoscopy and colonoscopy, played a crucial role in detecting early colorectal cancer at the HPC. Including endoscopy in basic routine checkup programs should help to increase early detection of colorectal cancer.

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Polymeric chitosan-glycolipid nanocarriers for an effective delivery of marine carotenoid fucoxanthin for induction of apoptosis in human colon cancer cells (Caco-2 cells)
Hindupur Ravi, Nawneet Kurrey, Yuki Manabe, Tatsuya Sugawara, Vallikannan Baskaran
Materials Science and Engineering: C.2018; 91: 785. CrossRef
Features of Late Recurrence Following Transanal Local Excision for Early Rectal Cancer
Bo Young Oh, Hae-Ran Yun, Seok Hyung Kim, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Ho-Kyung Chun, Yong Beom Cho
Diseases of the Colon & Rectum.2015; 58(11): 1041. CrossRef
The green algae Ulva fasciata Delile extract induces apoptotic cell death in human colon cancer cells
Min Ju Ryu, Areum Daseul Kim, Kyoung Ah Kang, Ha Sook Chung, Hye Sun Kim, In Soo Suh, Weon Young Chang, Jin Won Hyun
In Vitro Cellular & Developmental Biology - Animal.2013; 49(1): 74. CrossRef

Distant Metastasis Identified Immediately after Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer.: Park, In Ja , Kim, Hee Cheol , Yu, Chang Sik , Choi, Pyung Hwa , Jung, Sang Hoon , Hong, Dong Hyun , Kim, Dae Dong , Ryu, Min Hee , Chang, Heung Moon , Kim, Jong Hoon , Kim, Jin Cheon; J Korean Soc Coloproctol. 2007;23(5):327-332.; DOI: https://doi.org/10.3393/jksc.2007.23.5.327

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Abstract PDF: PURPOSE
This study was designed to analyze the clinical characteristics of patients with immediate distant metastasis after preoperative chemoradiotherapy for locally advanced rectal cancer and to help select patients for preoperative chemoradiotherapy.
METHODS
Two hundred eight patients, who underwent preoperative chemoradiotherapy for locally advanced rectal cancer, were included. Patients were excluded from the study if they had tumor types other than an adenocarcinoma, prior chemotherapy, radiotherapy, or hereditary nonpolyposis colorectal cancer. The clinicopathological characteristics of patients with distant metastasis immediately after preoperative chemoradioterapy were compared with those of patients without distant metastasis.
RESULTS
Distant metastases immediately after preoperative chemoradiotherapy were identified in 15 patients (7.2%). The liver was the most common site of metastasis (8/15), followed by peritoneal seeding (4), the lung (2), bone (1), and the aortocaval lymph node (1). Age, sex, chemotherapy regimen used, and primary tumor response for patients with distant metastases were similar to those for patients without distant metastasis. In patients with immediate distant metastasis, pre-chemoradiotherapy CEA was significantly higher (11.1 vs. 7.4 ng/ml; P= 0.003).
CONCLUSIONS
Immediate distant metastasis after preoperative chemoradiotherapy is associated with pre-chemoradiotherapy CEA level. A careful work-up is necessary when pre-chemoradiotherapy CEA is higher than the normal range.

Effect of an Irinotencan, 5-Fluorouracil, and Leucovorin Combination Chemotherapy (FOLFIRI) in Metastatic Colorectal Cancer.: Lee, Seung Hyun , Ahn, Byung Kwon , Baek, Sung Uhn; J Korean Soc Coloproctol. 2007;23(5):333-337.; DOI: https://doi.org/10.3393/jksc.2007.23.5.333

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Abstract PDF

PURPOSE
Irinotecan is a recently developed active agent in colorectal cancer. The combination of irinotecan and 5-fluorouracil (5-FU)/lecovorin (LV), known as the FOLFIRI regimen, has been approved for patients with metastatic colorectal cancer. The purpose of this study was to assess the efficacy and toxicity of the FOLFIRI regimen in the treatment of metastatic colorectal cancer.
METHODS
We reviewed the records of 65 patients who had received the FOLFIRI regimen from Jan. 2002 to Dec. 2005. The combination chemotherapy consisted of irinotecan (150~180 mg/m2 on day 1, 15) as a 2~6 hour infusion followed by bolus infusion of 5-FU (400 mg/m2) and continuous infusion of 5-FU (600 mg/m2 on days 1, 2, 15, 16), concurrently with LV (20 mg/m2 on day 1, 2, 15, 16) as a 2 hour infusion. Cycles were repeated in three-week intervals.
RESULTS
Of the 65 patients who had received the FOLFIRI regimen, 34 were male and 31 cases female. The median age was 54.4 years. The primary tumor sites were the colon in 29 cases (44.6%) and the rectum in 36 cases (56.4%). The metastatic sites were the liver in 33 cases (50.8%), the peritoneum in 21 (32.3%), the lung in 14 (21.5%), a lymph node in 4, and the pelvis in 2. Twenty-seven patients (41.5%) had received the combination chemotherapy as the first line. Of the patients who received more than 3 cycles, complete response was none. Partial responses were 3 (7.1%), stable disease status in 25 cases (59.5%) and progressive disease status in 14 cases (33.3%). The rate of progressive disease status for patients who had received FOLFIRI as the 2nd or the 3rd line were much higher than that of those who had received it as the 1st line chemotherapy. Early stops (<3 cycles) of chemotherapy were due to toxicity, such as nausea, as diarrhea, in 15 of 19 cases (78.9%).
CONCLUSIONS
The objective response rate of FOLFIRI was 7.1% in metastatic colorectal cancers. Nausea, vomiting, and diarrhea were the main causes of intolerance to the chemotherapy in most of the patients.

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Quality of Life in Colorectal Cancer Patients according to the Severity of Symptom Clusters Classification
Gyeonghui Jeong, Kyunghee Kim, Yeunhee Kwak
Asian Oncology Nursing.2014; 14(2): 74. CrossRef

Prognostic Value of Preoperative Serum Levels of CEA and CA19-9 in Patients with Colorectal Cancer.: Bae, Byong Ku , Hong, Seong Woo , Chang, Yeo Goo , Hahn, Koo Yong , Paik, In Wook , Lee, Hyucksang; J Korean Soc Coloproctol. 2007;23(5):338-343.; DOI: https://doi.org/10.3393/jksc.2007.23.5.338

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Abstract PDF: PURPOSE
The significance of serum levels of CEA and CA19-9 in forming a prognosis for colorectal cancer patients remains as subject for debating. The aim of this study is to assess their correlations with tumor pathology and their prognostic values.
METHODS
We analysed the data on 274 patients with colorectal cancer who had been treated by resection from Jan. 1997 to Aug. 2005. Correlation of the preoperative serum values of CEA and CA19-9 with clinocopathologic features, including prognosis, of the patients was investigated.
RESULTS
The positivity rates of the two tumor markes were significantly correlated with tumor size, differentiation, TNM staging, venous invasion, and neural invasion. In addition, the positivity rate of CEA was related to lymphatic invasion and that of CA19-9 to gender. In the univariate analysis, CEA (P<0.001), CA19-9 (P<0.001), tumor size (P=0.011), TNM staging (P<0.001), lymphatic invasion (P=0.003), venous invasion (P<0.001), neural invasion (P<0.001), and differentiation (P=0.023) correlated with survival of the patients. In the stepwise multivariate analysis, an advanced TNM stage (P<0.001), positive venous invasion (P=0.011), and positive neural invasion (P=0.013) were independent prognostic factors for poor survival.
CONCLUSIONS
Our results demonstrated that high serum levels of tumor markers were associated with more aggressive cancers, but in the multivariate analysis, CEA and CA19-9 were found not to be independent prognostic factors.

The Efficacy of UGT1A1 Polymorphism in Chemoradiation Therapy Using Irinotecan in Patients with Locally Advanced Rectal Cancer.: Oh, Seung Yeop , Kim, Young Bae , Chun, Mi Son , Suh, Kwang Wook; J Korean Soc Coloproctol. 2007;23(5):344-349.; DOI: https://doi.org/10.3393/jksc.2007.23.5.344

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Abstract PDF

PURPOSE
Irinotecan (CPT-11) is hydrolyzed to an active SN-38, which is further detoxicated to SN-38G through conjugation by uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) enzymes. There are many reports that UGT1A1 polymorphisms are associated with irinotecan related dose-limiting toxicity. The aim of the present study is to determine whether UGT1A1 polymorphisms affect individual variations of the toxicity due to and the tumor response to irinotecan via the alteration of bioavailability of SN-38 in Korean patients with locally advanced rectal cancer.
METHODS
Twenty patients with locally advanced rectal cancer, who had received surgery after irinotecan-containing chemoradiation from 2003 to 2006, were enrolled. We analyzed the association of UGT1A1 genotypes with toxicity and tumor response to chemoradiation therapy. A tumor response was assumed when a tumor regression grade I or II was obtained. Toxicity was graded in accordance with the NCI common toxicity criteria.
RESULTS
The frequence of square53(TA)6>7 (UGT1A1*28), 211G>A (UGT1A1*6), 686C>A (UGT1A1*27), square3279T>G (UGT1A1*60), and square3156G>A were 25% (5/20), 25% (5/20), 0% (0/20), 55% (11/20), and 20% (4/20), respectively. There were five grade III neutropenia and one severe diarrhea. Patients with UGT1A1*28 and square3156G>A showed higher complete tumor response rates (40% vs. 6.7%, P=0.07; 50% vs. 6.3%, P=0.08), but there was no differences in toxicity and tumor response between responders and non-responders. Patients with square3279T>G (UGT1A1*60) showed a tendency for lower tumor response in tumor responders, but there was no statistically significant difference (P=0.07).
CONCLUSIONS
This study suggested that square3279T>G (UGT1A1*60) may be useful in predicting tumor response of irinotecan. In the future, further study is warranted using large numbers of cases to reach statistical significance.

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The UGT1A9*22 genotype identifies a high-risk group for irinotecan toxicity among gastric cancer patients
Choong-kun Lee, Hong Jae Chon, Woo Sun Kwon, Hyo-Jeong Ban, Sang Cheol Kim, Hyunwook Kim, Hei-Cheul Jeung, Jimyung Chung, Sun Young Rha
Genomics & Informatics.2022; 20(3): e29. CrossRef
Pretreatment selection of regimen according to genetic analysis improves the efficacy of chemotherapy in the first line treatment of metastatic colorectal cancer
Do Yoon Kim, Tae Yoon Paek, Seung Yeop Oh, Young Bae Kim, Je Hee Lee, Mi Young Lee, Zi Sun Choi, Kwang Wook Suh
Journal of Surgical Oncology.2014; 109(3): 250. CrossRef

Anastomotic Leakage after Laparoscopic versus Open Resection for Rectal Cancer: A Retrospective Study.: Lee, Doo Seok , Youk, Eui Gon , Choi, Sung Il , Lee, Doo Han , Kim, Do Sun , Moon, Hong Young; J Korean Soc Coloproctol. 2007;23(5):350-357.; DOI: https://doi.org/10.3393/jksc.2007.23.5.350

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Abstract PDF

PURPOSE
This study is to compare the rate and pattern of anastomotic leakage (AL) for rectal cancer after laparoscopic vs. conventional open surgery at high and low rectal anastomosis and to evaluate whether the number of linear staples used for distal rectal resection is related to AL in laparoscopic group.
RESULTS
One hundred ninety-seven patients who underwent a curative resection for rectal cancer between March 2002 and February 2006 were studied retrospectively (107 laparoscopic, 90 open). The proportions of patients with anastomosis above vs. below 5 cm from AV were not different between the laparoscopic and the open groups; (above/below: 54/53 and 41/49, respectively, P=0.57). The protective stoma rate, the overall rate of AL, the rate of AL according to the height of the anastomosis, and the number of distal linear staples were evaluated for both groups.
RESULTS
Clinical AL occurred in 11 of 107 patients (10.3%) for the laparoscopic group and in 5 of 90 patients (5.6%) for the open group. The rates of AL in patients without protective stoma were not significantly different for high rectal anastomosis (6.0% for laparoscopic vs. 2.6% for open, P= 0.63) and for low rectal anastomosis (25.8% for laparoscopic vs. 12.1% for open, P=0.21). The risk of AL was 4.9 times higher when 3 linear staples were used than when 2 linear staples were used in the laparoscopic group.
CONCLUSIONS
There was no statistical difference in AL between the laparoscopic group and the open group. The rate of AL could be reduced by using fewer linear staples for distal rectal resection in the laparoscopic group.

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OF RECONSTRUCTIVE SURGERY IN PATIENTS WITH COLOSTOMY
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PREVENTION OF COLORECTAL ANASTOMOTIC LEAK
Andrii Klymenko, Igor Kononenko
Kharkiv Surgical School.2019; (5-6): 21. CrossRef
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European Journal of Surgical Oncology (EJSO).2015; 41(2): 175. CrossRef
Risk Factors for Anastomotic Leakage after Laparoscopic Rectal Resection
Dong Hyun Choi, Jae Kwan Hwang, Yong Tak Ko, Han Jeong Jang, Hyeon Keun Shin, Young Chan Lee, Cheong Ho Lim, Seung Kyu Jeong, Hyung Kyu Yang
Journal of the Korean Society of Coloproctology.2010; 26(4): 265. CrossRef
Risk Factors for Anastomotic Leakage after Laparoscopic Intracorporeal Colorectal Anastomosis with a Double Stapling Technique
Jin Soo Kim, Sun Yeon Cho, Byung Soh Min, Nam Kyu Kim
Journal of the American College of Surgeons.2009; 209(6): 694. CrossRef

Preliminary Study of the Clinical Features of the Chemosensitivity Test in Colorectal Cancer.: Park, Chan Sup , Choi, Sung Ho , Kim, Hung Dai; J Korean Soc Coloproctol. 2007;23(5):358-364.; DOI: https://doi.org/10.3393/jksc.2007.23.5.358

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Abstract PDF: PURPOSE
Colorectal cancers have been known to be refractory to chemotherapy in the past decades. Recently, novel agents have been developed and various data have shown an improved response rate and a survival benefit. However, considerable heterogeneity exists between cancers of the same tissue type, including colorectal cancer. Thus, Individualized chemotherapy that is tailored specifically to the characteristics of the tumor is necessary for an improved clinical outcome.
RESULTS
We evaluate the chemosensitivity of colorectal cancer to standard drugs (5-FU, oxaliplatin, and irinotecan) and to drugs used for other cancers (mitomycin, paclitaxel, and gemcitabine) by using Adenosine-triphosphate-based chemotherapy response assay (ATP-CRA).
RESULTS
The degree of in-vitro response to a single anticancer medication was highest for 5-FU. According to stages, 5-FU is the most sensitive chemotherapeutic agent in Duke's B, irinotecan in Duke's C, and 5-FU in Duke's D patients. With tumor location, irinotecan is most sensitive in colon cancers and 5-FU in rectal cancers. The effect of treatment is superior in the test-guided therapy group in Duke's D colorectal cancer patients.
CONCLUSIONS
Chemosensitivity tests may be useful in selecting optimum drugs for patient who require chemotherapy. However, the results of this study do not strongly support the usefulness of this assay; further studies with a sufficient number of cases and an extended observation period are ongoing.

Risk Factors for Anastomotic Leakage after a Low Anterior Resection for Rectal Cancer.: Yoon, Seok jun , Kim, Jin soo , Min, Byung so , Kim, Nam Kyu , Baik, Seung Hyuk , Lee, Kang Young , Sohn, Seung Kook , Cho, Jang Hwan; J Korean Soc Coloproctol. 2007;23(5):365-373.; DOI: https://doi.org/10.3393/jksc.2007.23.5.365

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Abstract PDF

PURPOSE
Clinical anastomotic leakage remains a major problem after a low anterior resection for rectal cancer, so indentifing risk factors influencing anastomotic leakage is important. The aim of this study was to assess the association between risk factors and anastomotic leakage.
RESULTS
One thousand two hundred eight patients underwent a primary resection for rectal cancer from June 1993 to March 2007. We used hospital records and the colorectal cancer registry to analyze retrospectively the case histories of those patients. The operations were performed using a low anterior resection with the double stapling method. All patients underwent a tumor-specific mesorectal excision. Of the total, thirty-eight patients showed anastomotic leakage. Univariate and multivariate analyses were performed to assess the risk factors affecting to the anastomotic leakage.
RESULTS
The rate of anastomotic leakage was 3.2% (38 of 1,208 patients) with a mortality rate of 7.9% (3 of 38 patients). The overall mortality rate was 0.3% (3 of 1,208 patients). Males accounted for 28 of the 38 patients with leakage, and female accounted for the the account for the remnant 10. The mean age was 53.7 years (33~74 years). The mean leakage day was 11.8th day (3~37th day) after the operation, and the mean hospital day was 39.2 days (7~131 days). The mean body mass index (BMI) was 22.7 kg/m2 (15.7~30.8 kg/m2). The mean operation time was 230.5 minutes (90~425 minutes), and the mean bleeding loss was 519.5 cc (0~3,500 cc).
CONCLUSIONS
Significant risk factors for anastomotic leakage after primary resection for rectal cancer were the transfusion amount during surgery, a preliminary colostomy, and nodal stage.

Citations

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Anna D’Amore, Pietro Anoldo, Michele Manigrasso, Giovanni Aprea, Giovanni Domenico De Palma, Marco Milone
Journal of Clinical Medicine.2023; 12(15): 5152. CrossRef
New Hope for Wound Healing after Bowel Resection
Ryung-Ah Lee
Journal of the Korean Society of Coloproctology.2012; 28(3): 117. CrossRef
Risk Factors for Anastomotic Leakage after Laparoscopic Rectal Resection
Dong Hyun Choi, Jae Kwan Hwang, Yong Tak Ko, Han Jeong Jang, Hyeon Keun Shin, Young Chan Lee, Cheong Ho Lim, Seung Kyu Jeong, Hyung Kyu Yang
Journal of the Korean Society of Coloproctology.2010; 26(4): 265. CrossRef
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International Journal of Colorectal Disease.2010; 25(5): 601. CrossRef

Case Reports

Four Cases of Postoperative Sclerosing Mesenteritis.: Kim, Eu Gene , Kang, Yong Won , Yoon, Seo Gu , Kim, Heung Dai , Kim, Kwang Yun; J Korean Soc Coloproctol. 2007;23(5):374-380.; DOI: https://doi.org/10.3393/jksc.2007.23.5.374

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Abstract PDF

Mesenteric panniculitis is an extremely rare inflammatory condition of the adipose tissue of unknown etiology. It is characterized by extensive, progressive fibrosis of the mesenteric fat tissue, leading to tumor formation. Clinical manifestations vary according to the process involving the structures. Abdominal pain accompanied by nausea, malaise, pyrexia, and weight loss and a poorly defined mass are common presentations. Major pathologic changes include (1) degeneration of mesenteric fat, (2) an inflammatory reaction, and (3) fibrosis of the adipose tissue. We present four patients with an aggressive form of mesenteric pannicultis with characteristic histopathologic features. We discuss the relationship between the histopathologic features and the surgical intervention in these cases.

Citations

Citations to this article as recorded by

Immunoglobulin G4 Unrelated Idiopathic Mesenteric Sclerosis
Tae Hyung Kwon, Kwang Bum Cho, Hyun Jik Lee, Sun Young Kwon, Yoon Suk Lee
The Korean Journal of Gastroenterology.2019; 73(1): 50. CrossRef
A Case of IgG4-Related Sclerosing Mesenteritis Associated with Crohn's Disease
Eui Jung Kim, Eun Young Kim, Jung Eun Song, Hyeon Chul Lee, Gyu Hwan Bae, Hoon Kyu Oh, Tae Sung Lee
The Korean Journal of Gastroenterology.2014; 63(3): 176. CrossRef
A Case of Idiopathic Sclerosing Mesenteritis with Retroperitoneal Fibrosis
June Ho Bae, Seong Hwan Kim, Sang Bong Ahn, Byoung Kwan Son, Yun Ju Jo, Young Sook Park, Yu Min Jung, Yeon Soo Chang
The Korean Journal of Gastroenterology.2011; 58(4): 221. CrossRef

CT Enteroclysis and Intraoperative Endoscopic Polypectomy for Peutz-Jeghers Syndrome with Advanced Rectal Carcinoma: A Case Report.: Han, Sang Ah , Park, Chi Min , Yun, Seong Hyeon , Lee, Woo Yong , Chun, Ho Kyung; J Korean Soc Coloproctol. 2007;23(5):381-385.; DOI: https://doi.org/10.3393/jksc.2007.23.5.381

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Abstract PDF: Patients with Peutz-Jeghers syndrome often suffer from complications of polyps, such as intussusception, bowel obstruction, and bleeding. Another major problem of these patients is malignancy through the hamartoma-adenoma-carcinoma sequence. If the complications and the cancer risk of small intestinal polyps are to be reduced, early detection of these polyps and a polypectomy are important. Traditionally, a small bowel series, small bowel enteroclysis, and conventional endoscopy have been used for the proper evaluation, and management of polyps. Recently, several reports showed the advantages of enteroscopy and intraoperative endoscopy for achieving a more complete polypectomy of the small intestine. However, CT enteroclysis, which has been introduced as a reliable, less invasive, and tolerable diagnostic tool for small intestinal disease, may be useful for the evaluation of patients with gastrointestinal polyposis. We report the case of a patient with Peutz-Jeghers syndrome who had small-bowel polyposis and a rectal adenocarcinoma and who underwent preoperative CT enteroclysis and intraoperative endoscopy.

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