Annals of Coloproctology

Volume 24(3); June 2008

Original Articles

Laparoscopic vs. Conventional Appendectomy in Pregnancy.: Kim, Do Hyoung , Lee, In Kyu , Choi, Seung Bong , Lee, Yoon Suk , Lee, Sang Kuon , Oh, Seong Taek , Jeon, Hae Myung , Kim, Jun Gi , Kim, Eung Kook , Chang, Suk Kyun; J Korean Soc Coloproctol. 2008;24(3):161-165.; DOI: https://doi.org/10.3393/jksc.2008.24.3.161

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PURPOSE
The purpose of this study was to evaluate the clinical course and pregnancy outcome according to operative management of appendictis in the Department of Surgery.
METHODS
We reviewed the charts of pregnant patients who went through a convential appendectomy and a laparoscopic appendectomy at the Department of Surgery, Catholic University of Korea St. Mary's Hospital, from May 1995 to June 2006. RESULTS: The incidence of acute appendicitis during pregnancy was the highest at the 2nd trimester and at ages from 25 to 30 years. The laparoscopic appendectomy was shorter than the open appendectomy in hospital stay and decreased leukocytosis faster in the first postoperative day, except in cases of perforated appendicitis, but the operation times were similar. There was a significant difference in gestational age at delivery between perforated appendicitis and suppurative. We found one fetal anomaly, but it was not related to either the appendicitis or the operation method. CONCLUSIONS: In this study, we found that a laparoscopic appendectomy was better than an open appendectomy for recovery and was safe in pregnant appendicitis patients at any gestational age. However, follow up and investigation in a larger population is needed to get more accurate results.

Citations

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Appendicitis during Pregnancy: The Clinical Experience of a Secondary Hospital
Soo Jung Jung, Do Kyung Lee, Jun Hyun Kim, Pil Sung Kong, Kyung Ha Kim, Sung Woo Bae
Journal of the Korean Society of Coloproctology.2012; 28(3): 152. CrossRef

Patterns of Recurrence and Prognosis in Patients with Intestinal Behcet's Disease Who Underwent a Bowel Resection.: Hur, Hyuk , Min, Byung Soh , Kim, Jin Soo , Lee, Kang Young , Park, Yoon Ah , Baik, Seung Hyuk , Sohn, Seung Kook , Cho, Chang Hwan , Kim, Jae Hak , Kim, Won Ho , Kim, Nam Kyu; J Korean Soc Coloproctol. 2008;24(3):166-174.; DOI: https://doi.org/10.3393/jksc.2008.24.3.166

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Abstract PDF

PURPOSE
We aim to analyze the clinical course and the recurrence patterns after surgical treatment in patients with intestinal Behcet's disease and to determine the prognostic factors. METHODS: Thirty-eight patients with intestinal Behcet's disease who had undergone operations between 1979 and 2007 were analyzed. Clinical characteristics between the recurrent group (n=24) and the non-recurrent group (n=14) were compared. The cumulative recurrence rates were calculated by using the Kaplan-Meier method, and the results were compared by using the log-rank test. RESULTS: The median follow-up was 120 months. The median age of the 38 patients was 36.5 years, and the patients included 26 males and 12 females. Recurrences after surgical treatment were observed in 24 patients, and reoperations were performed in 21 patients. The mean age at operation was 35.7 years in the recurrent group and was less than 43.4 years in the non-recurrent group (P=0.030). Clinical subtypes of Behcet's disease (complete or incomplete vs. suspicious) and the cause of operation (presence vs. absence of a perforation or fistula) were different between the recurrent and the non-recurrent groups (P=0.048, P=0.014, respectively). The 5-year cumulative recurrence rate and reoperation rate for all patients with intestinal Behcet's disease who underwent operations were 52.7% and 36.0%, respectively the clinical subtypes and the cause of the operation were significant factors affecting the cumulative recurrence and the reoperation rates.
CONCLUSIONS
Intestinal Behcet's disease demonstrates high recurrence and reoperation rates after surgical treatment. More careful follow up is needed to these surgical patients with high risk of recurrence and reoperation.

Citations

Citations to this article as recorded by

Short- and long-term outcomes of surgical treatment in patients with intestinal Behcet’s disease
Min Young Park, Yong Sik Yoon, Jae Ha Park, Jong Lyul Lee, Chang Sik Yu
World Journal of Gastrointestinal Surgery.2024; 16(2): 429. CrossRef
Evidence-based diagnosis and clinical practice guidelines for intestinal Behçet’s disease 2020 edited by Intractable Diseases, the Health and Labour Sciences Research Grants
Kenji Watanabe, Satoshi Tanida, Nagamu Inoue, Reiko Kunisaki, Kiyonori Kobayashi, Masakazu Nagahori, Katsuhiro Arai, Motoi Uchino, Kazutaka Koganei, Taku Kobayashi, Mitsuhiro Takeno, Fumiaki Ueno, Takayuki Matsumoto, Nobuhisa Mizuki, Yasuo Suzuki, Tadakaz
Journal of Gastroenterology.2020; 55(7): 679. CrossRef
Prognostic factors and long-term clinical outcomes for surgical patients with intestinal Behcetʼs disease
Yoon Suk Jung, Jin Young Yoon, Jin Ha Lee, Soung Min Jeon, Sung Pil Hong, Tae Il Kim, Won Ho Kim, Jae Hee Cheon
Inflammatory Bowel Diseases.2011; 17(7): 1594. CrossRef
Response Rates to Medical Treatments and Long-term Clinical Outcomes of Nonsurgical Patients With Intestinal Behçet Disease
Moon Jae Chung, Jae Hee Cheon, Seung Up Kim, Jae Jun Park, Tae Il Kim, Nam Kyu Kim, Won Ho Kim
Journal of Clinical Gastroenterology.2010; 44(6): e116. CrossRef

Clinicopathologic Features of Sporadic Colorectal Cancer with MLH1/MSH2 Loss of Expression - Reduced Likelihood of Metastases.: Park, Ji Won , Chang, Hee Jin , Jung, Kyung Hae , Kim, Dae Yong , Sohn, Dae Kyung , Han, Kyung Soo , Hong, Chang Won , Lim, Seok Byung , Choi, Hyo Seong , Jeong, Seung Yong , Lee, Sang Jeon; J Korean Soc Coloproctol. 2008;24(3):175-183.; DOI: https://doi.org/10.3393/jksc.2008.24.3.175

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PURPOSE
This study was designed to determine the frequency of MMR defective sporadic colorectal cancer (CRC) by using immunohistochemistry and to investigate the correlation between the MMR status and the metastatic potential.
METHODS
The study included 249 patients with sporadic colorectal cancer who underwent surgical resection. The MMR status was determined by using an immunohistochemical analysis of MLH1 and MSH2 expression. RESULTS: Twenty seven (10.8%) carcinomas showed abnormal MMR protein expression (18 MLH1 negative and 9 MSH2 negative) and were classified as MMR defective tumors whereas 222 tumors demonstrated normal MLH1/MSH2 immunoreactivity (MMR intact tumor). MMR defective tumors developed at significantly higher frequencies in a proximal site (59.3% vs. 27.5%, P=0.001) and tended to be larger in size (6.3+/-2.4 cm vs. 5.1+/-2.1 cm, P=0.026). They showed significantly lower overall stage, N stage, and M stage at the time of diagnosis (P=0.002, P=0.014, P=0.010, respectively). In patients who had MMR defective tumors, lymphocytic infiltration (40.7% vs. 8.7%, P<0.001) and poor differentiation (22.2% vs. 11.7%, P=0.012) were more frequently observed. Less frequently MMR defective tumors displayed lymphatic invasion (40.7% vs. 67.1%, P=0.007) and infiltrative borders (22.2% vs. 51.8%, P=0.004). The MMR defect was strongly associated with a decreased likelihood of lymph node (odds ratio: 0.34, 95% CI: 0.13~0.95) and distant organ metastases at diagnosis (odds ratio: 0.09, 95% CI: 0.01~0.94), independent of the clinicopathologic features. CONCLUSIONS: mmunohistochemical analysis revealed that 10.8% of sporadic CRC cases showed no staining for MLH1 or MSH2. Lymphatic invasion and distant metastases were found at lower rates in these MMR defective tumors.

Citations

Citations to this article as recorded by

Characterization of RNA editome in primary and metastatic lung adenocarcinomas
Lihua Peng, Leo J Lee, Heng Xiong, Hong Su, Junhua Rao, Dakai Xiao, Jianxing He, Kui Wu, Dongbing Liu
Oncotarget.2017; 8(7): 11517. CrossRef
Prognostic Impact of Microsatellite Instability in Colorectal Cancer Presenting With Mucinous, Signet-Ring, and Poorly Differentiated Cells
Sang Hun Jung, So Hyun Kim, Jae Hwang Kim
Annals of Coloproctology.2016; 32(2): 58. CrossRef
Microsatellite instability testing in Korean patients with colorectal cancer
Jung Ryul Oh, Duck-Woo Kim, Hye Seung Lee, Hee Eun Lee, Sung Min Lee, Je-Ho Jang, Sung-Bum Kang, Ja-Lok Ku, Seung-Yong Jeong, Jae-Gahb Park
Familial Cancer.2012; 11(3): 459. CrossRef

Curative Resection Following Neoadjuvant Chemotherapy Including a Molecularly Targeted Agent in Patients with Unresectable Colorectal Distant Metastases.: Kim, Jin Soo , Min, Byung Soh , Hur, Hyuk , Kim, Nam Kyu , Choi, Jin Sub , Sohn, Seung Kook , Cho, Chang Hwan , Ahn, Joong Bae , Roh, Jae Kyung; J Korean Soc Coloproctol. 2008;24(3):184-191.; DOI: https://doi.org/10.3393/jksc.2008.24.3.184

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Abstract PDF: PURPOSE
A colorectal carcinoma is the fourth most common malignancy in the world. Unfortunately, only approximately 20% of the liver metastases are resectable at the initial presentation. Neoadjuvant chemotherapy has been used for downsizing in unresectable disease. In addition, the use of newer biologic agents, such as cetuximab and bevacizumab, has much improved responses in patients with unresectable colorectal liver metastases. The aim of this study was to report on patients who had received a curative resection following neoadjuvant chemotherapy including a molecularly targeted agent for unresectable colorectal liver metastases.
METHODS
Following the neoadjuvant chemotherapy using cetuximab plus FOLFIRI (irinotecan and infused fluorouracil plus leucovorin) or bevacizumab plus FOLFOX (oxaliplatin and infused fluorouracil plus leucovorin), 10 patients with initially unresectable colorectal liver metastases underwent a curative surgical resection between September 2005 and June 2007. RESULTS: One patient underwent a right lobectomy, three patients a segmentectomy and five a wedge resection with or without radiofrequency ablation. With a median postoperative follow-up of 14 months (range, 1 to 22 months), five recurrences (50%) occurred. The common toxic effects were grade 2/3 skin toxicity (60%), grade 4 hematologic toxicity (20%), grade 3 gastrointestinal toxicity (10%), and grade 3 neurologic toxicity (10%).
CONCLUSIONS
Our preliminary data suggests that neoadjuvant chemotherapy including a molecularly targeted agent may improve resectability in patients with initially unresectable colorectal liver metastases although a high recurrence rate exists. Randomized prospective studies comparing neoadjuvant chemotherapy including a targeted agent in cases of unresectable colorectal liver metastases are warranted.

Expression of the Insulin-like Growth Factor Binding Proteins (IGFBPs) in Colon Cancer.: Kim, Chan Dong , Lee, Jeong Eun , Kang, Bo Young , Lee, Ryung Ah , Kim, Kwang Ho; J Korean Soc Coloproctol. 2008;24(3):192-200.; DOI: https://doi.org/10.3393/jksc.2008.24.3.192

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Abstract PDF: PURPOSE
The purpose of this study was to demonstrate the hypothesis that tussue IGFBP-2,-3, and -4 levels would differ between colon cancer tissue and adjacent normal tissue and to determine whether these factors could affect the clinicopathologic characteristics such as age, tumor stage, differentiation, serosal invasion, and CEA in patients with colon cancer. METHODS: This study group consisted of 102 patients with colorectal cancer who under went operations between January 2004 and December 2006. Postoperative colon cancer specimens and adjacent normal colon tissues were obtained immediately. Histopathologic examinations were made by on pathologist for each specimen. The gene expressions of IGFBP-2,-3,-4 in cancer and normal tissues were measured using a reverse transcriptase-polymerase chain reaction (RT-PCR). In additional, the various clinic-opathologic factors were evaluated for both tissues by comparing the IGFBP-2, -3, -4 expression densities. RESULTS: No significant difference was found in the expression of IGFBP-3, -4 between colon cancer and normal colon tissues. A statistically significant expression of IGFBP-2 was detected in the cancer specimens compared with the normal colon tissues. IGFBP-3 was significantly associated with pathologic N stage.
CONCLUSIONS
This is a rare report comparing colon cancer with normal colon tissue for IGFBP expression by means of a systemical evaluation of colon cancer patients. Our data suggest that IGFBP-2 may be intimately associated with malignant phenotypes, and may confer some growth advantage on tumor cells, which means that IGFBP-2 shows a high sensitivity for colorectal cancer. Interestingly, IGFBP-3 was strongly associated with the pathologic N stage. We think further studies are needed to understand this phenomenon.

Positron Emission Tomography (PET)-Computed Tomography (CT) for Preoperative Staging of Colorectal Cancers.: Yoo, Joong Jae , Lee, Seung Hyun , Ahn, Byung Kwon , Baek, Sung Uhn , Lee, Seok Mo; J Korean Soc Coloproctol. 2008;24(3):201-206.; DOI: https://doi.org/10.3393/jksc.2008.24.3.201

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Abstract PDF

PURPOSE
The purpose of this study is to evaluate the usefulness of positron emission tomography (PET)-computed tomography (CT) for preoperative tumor staging in cases of colorectal cancer. METHODS: Between July 2006 and September 2007, seventy-six patients with a diagnosis of colorectal cancer (43 males and 33 females; mean age: 60.4+/-10.13 years; range: 34~82 years) selected prospectively were studied for staging by using Chest X-ray, abdominal CT and PET-CT. RESULTS: The sensitivities and the specificities for N-staging were 76.9% and 35.1% for CT, 61.8% and 66.7% for PET-CT, and both procedures showed a relatively low diagnostic accuracy (CT 57.9%, PET-CT 61.8%). In the PET-CT alone, six distant metastatic lesions and four multiple primary malignancies were found. The locations of the distant metastases were the liver, the axillary node, the common iliac node, the subclavicular node, the peritoneum, and the lung. The locations of the multiple primary maligancies in extracolonic sites were 3 in the thyroid and 1 in the nasopharynx. CONCLUSIONS: For N-staging, preoperative PET-CT is no more useful than CT, but PET-CT is required before surgery to find lesions that cannot be found with conventional studies.

Citations

Citations to this article as recorded by

Preoperative Staging With Positron Emission Tomography in Patients With Colorectal Cancer
Young Wan Kim, Ik Yong Kim
Annals of Coloproctology.2014; 30(6): 247. CrossRef
The Usefulness of FDG-PET/CT for the Prediction of Regional Lymph Node Metastases in Colorectal Cancer
Mi Ji Bang, Sang Hun Jung, Jae Hwang Kim, Min Chul Shim
Journal of the Korean Surgical Society.2010; 79(1): 43. CrossRef

Pattern of Recurrences and Metastases after a Curative Resection for Primary Colorectal Cancer.: Park, In Ja , Kim, Hee Cheol , Yu, Chang Sik , Kim, Jin Cheon; J Korean Soc Coloproctol. 2008;24(3):207-213.; DOI: https://doi.org/10.3393/jksc.2008.24.3.207

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Abstract PDF

PURPOSE
We aimed to verify the pattern of recurrences or metastases after a curative resection for primary colorectal cancer. METHODS: From the prospective colorectal cancer database of Asan Cancer Center, 2,810 paitents who underwent a curative resection for primary colon (1,295) or rectal (1,515) cancer between October 1995 and December 2003 were studied retrospectively. Patients were followed for more than three years or until disease recurrence. Risk factors considered were age, gender, site of primary tumor, stage, histologic differentiation, and lymphovascular invasion. The mean follow-up duration was 60+/-29 months. RESULTS: Overall recurrence occurred in 546 patients (19.4%). According to stage, the recurrence rates were 4.7% (20/423) in stage I, 10.8% (128/1,185) in stage II, and 33.1% (398/1,202) in stage III. More than 70% of the recurrences occurred within 2 years of surgery. The most common metastatic site was the liver in colon cancer and the lung in rectal cancer. In colon cancer, recurrence was more common in left than in right colon cancer (P=0.012). In rectal cancer, local recurrence was the most common in lower rectal cancer and was more common in patients receiving abdominoperineal resection than in those receiving a sphincter-preserving operation. The liver was the most common site of metastasis within 2 years postoperatively, but metastasis to lung was significantly increased after the second postoperative year. Factors such as sex, T category, N category, and location of the primary tumor were identified to be independent risk covariates for recurrence. CONCLUSIONS: Patterns of recurrences differed according to the characteristics of the primary tumor and varied with the follow-up period.

Citations

Citations to this article as recorded by

Clinicopathologic Factors Affecting Recurrence after Curative Surgery for Stage I Colorectal Cancer
Min Ae Keum, Seok-Byung Lim, Sun A Kim, Yong Sik Yoon, Chan Wook Kim, Chang Sik Yu, Jin Cheon Kim
Journal of the Korean Society of Coloproctology.2012; 28(1): 49. CrossRef
Oncologic Outcomes and Risk Factors for Recurrence after Tumor-specific Mesorectal Excision of Rectal Cancer: 782 Cases
Sam Hee Kim, Ki Beom Bae, Jung Min Kim, Jae Ho Shin, Min Sung An, Tae Geun Ha, Sung Mok Ryu, Kwang Hee Kim, Tae Hyeon Kim, Chang Soo Choi, Jin Yong Shin, Minkyung Oh, Seung Hun Baek, Kwan Hee Hong
Journal of the Korean Society of Coloproctology.2012; 28(2): 100. CrossRef

Case Reports

Colonic Obstruction Caused by Sigmoid Volvulus Combined with a Transomental Hernia: A Case Report.: Choi, Pyong Wha , Heo, Tae Gil , Park, Je Hoon , Lee, Myung Soo , Kim, Chul Nam , Chang, Surk Hyo , Kim, Nam Hoon , Bae, Won Ki , Moon, Young Soo; J Korean Soc Coloproctol. 2008;24(3):214-218.; DOI: https://doi.org/10.3393/jksc.2008.24.3.214

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Abstract PDF: The case of sigmoid volvulus combined with a transomental hernia is reported. A 70-year-old man was admitted to our hospital with mild abdominal pain and distension. Although no signs of peritoneal irritation were apparent, a plain abdominal X-ray showed a markedly dilated loop of the sigmoid colon, and CT revealed a whirl pattern of the sigmoid mesentery. These findings suggested sigmoid volvulus. Colonoscopic reduction was attempted as an initial nonoperative treatment, and an urgent laparotomy was performed after the reduction failed. The sigmoid loop was herniated through the great omentum, with torsion in the clockwise direction. The colon was manually untwisted in the counter-clockwise direction, and the sigmoid loop was released by dividing the great omentum. During this one-stage operation, intraoperative colonic irrigation, sigmoid resection, and primary anastomosis were performed. The postoperative course was uneventful. Although sigmoid volvulus combined with a transomental hernia is rare, urgent surgical intervention is essential on failure of endoscopic reduction.

Acute Perforated Appendicitis in a Patient with Nonrotation of the Midgut: A Case Report.: Park, Seong Jun , Ju, Young Tae , Jeong, Chi Young , Jung, Eun Jung , Lee, Young Joon , Hong, Soon Chan , Ha, Woo Song , Park, Soon Tae , Choi, Sang Kyung; J Korean Soc Coloproctol. 2008;24(3):219-222.; DOI: https://doi.org/10.3393/jksc.2008.24.3.219

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Abstract PDF: The presence of a malrotation of the midgut in adults is identified in asymptomatic patients most commonly as an incidental finding during a workup for an unrelated disease. We report here a rare case of acute perforated appendicitis in a patient with nonrotation of the midgut. A 28-year-old man was referred to our hospital with lower abdominal pain. The radiological examination, including abdominal computed tomography, ultrasonography, an upper gastrointestinal series, and a barium enema, revealed acute perforated appendicitis accompanied by nonrotation of the midgut. Emergency surgery revealed a complicated appendix located in the middle area of the lower abdomen with a periappendiceal abscess and nonrotation of the midgut. An ileocecal resection was performed with no postoperative complication. In this case, the atypical position of the appendix led to confusion regarding the diagnosis and to a more invasive surgical intervention.

Appendiceal Intussusception Resected by Laparoscopy.: Park, Jin Young; J Korean Soc Coloproctol. 2008;24(3):223-227.; DOI: https://doi.org/10.3393/jksc.2008.24.3.223

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Abstract PDF: The appendix has been reported to be a very rare leading point in intussusception with an incidence of 0.01% in surgical and postmortem specimens. In many cases it was developed by secondary conditions, such as polyps, carcinomas, or mucoceles. Some other cases had none of the initiating causes. Therefore, making an accurate diagnosis is important in providing the optimal treatment for the patient. Here, the author presents an appendiceal intussusception case of a 37-year-old male patient whose vermiform appendix had none of the initiating causes. The preoperative diagnosis was an appendiceal mucocele, but an appendiceal intussusception was detected after the operation. The patient was managed with a laparoscopic partial cecectomy and has been followed up.

Review

Minor Procedures of Hemorrhoids.: Hwang, Do Yeon; J Korean Soc Coloproctol. 2008;24(3):228-237.; DOI: https://doi.org/10.3393/jksc.2008.24.3.228

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Abstract PDF

Hemorrhoids have afflicted man since the dawn of history. They are among the first conditions described as contributing to the discomfort of humans. When we consider over 90 percent of accurately diagnosed, symptomatic hemorrhoids can be treated without an operation, we have to get detailed information on the several techniques of nonsurgical treatment of hemorrhoids. Modern as well as traditional, drugs are being increasingly used in all grades of symptomatic hemorrhoids. Although drugs can reduce edema, relieve pain, and help in thrombosis, they cannot definitively cure hemorrhoids. Several modes of therapy, not involving surgical excision, have been advocated for the treatment of hemorrhoid patients. These include injection sclerotherapy, cryotherapy, rubber band ligation, infrared photocoagulation, and diathermy. The mechanisms are principally the same, irrespective of which is chosen, as all function ablatively by thrombosis, sclerosis, or necrosis of a part of the internal portion of the hemorrhoidal complex and thereby decrease the volume of the cushions, possibly fixating them in the distal rectum. Usually, rubber band ligation is considered the first treatment for first- to third- degree hemorrhoids, and a hemorrhoidectomy should be reserved for those failing to respond to a ligature procedure. Recently, new treatment modalities for hemorrhoids, such as radiofrequency or hemorrhoidal artery ligation, have been developed to treat symptomatic hemorrhoids. We can choose suitable procedures according to the degree of the hemorrhoids.

Citations

Citations to this article as recorded by

A Case Study of Four Hemorrhoid Patients Treated by Korean Medical Treatment
Jin-hyuk Lee, Min-ji Oh
The Journal of Internal Korean Medicine.2018; 39(2): 209. CrossRef
Comparison of Early Clinical Outcomes Between ALTA (Aluminum Potassium Sulfate and Tannic Acid, Ziohn®) Injection Therapy and a Submucosal Hemorrhoidectomy in Patients with Internal Hemorrhoids
Young Chan Lee, Hyun Keun Shin, Cheong Ho Lim, Hyung Kyu Yang, Jung Hyun Kang, Kang Young Lee, Nam Kyu Kim
Journal of the Korean Society of Coloproctology.2010; 26(3): 179. CrossRef

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