Annals of Coloproctology

Volume 28(2); April 2012

Editorials

Comparison of a Fistulectomy and a Fistulotomy with Marsupialization in the Management of a Simple Anal Fistula: A Randomized, Controlled Pilot Trial: Do Sun Kim; J Korean Soc Coloproctol. 2012;28(2):67-68. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.67

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Anti TNF treatment of complex perianal fistulas in children without luminal Crohn's disease: Is it an option?
Firas Rinawi, Mary-Louise C. Greer, Thomas Walters, Peter C. Church, Amanda Ricciuto, Jacob C. Langer, Anne M Griffiths
Journal of Pediatric Surgery.2022; 57(11): 569. CrossRef
The Effect of Topical and Oral Phenytoin on Increasing Wound Healing of Enterocutaneus Fistula in Wistar Rat
Victor Kurniawan, Hardian Hardian, Ignatius Riwanto
Open Access Macedonian Journal of Medical Sciences.2022; 10(A): 997. CrossRef
Operation for Posterior Intersphincteric Anal Fistula -Procedures of Fistulotomy-
Naoki Yago
Nippon Daicho Komonbyo Gakkai Zasshi.2013; 66(10): 1026. CrossRef

Is Abdominal Computed Tomography Helpful for the Management of an Intestinal Obstruction Caused by a Bezoar?: Byung-Kwon Ahn; J Korean Soc Coloproctol. 2012;28(2):69-70. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.69

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A Rare Cause of Small Bowel Obstruction: A Case Report
Piaopiao Chen, Qiang Hu, Jinfeng Wu, Yuanshui Sun
Frontiers in Surgery.2022;[Epub] CrossRef
A Magnesium Oxide Bezoar
Masaya Iwamuro, Shunsuke Saito, Masao Yoshioka, Haruo Urata, Kumiko Ueda, Kazuhide Yamamoto, Hiroyuki Okada
Internal Medicine.2018; 57(21): 3087. CrossRef

Factors Influencing Oncologic Outcomes after Tumor-specific Mesorectal Excision for Rectal Cancer: Kil Yeon Lee; J Korean Soc Coloproctol. 2012;28(2):71-72. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.71

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Required distal mesorectal resection margin in partial mesorectal excision: a systematic review on distal mesorectal spread
A. A. J. Grüter, A. S. van Lieshout, S. E. van Oostendorp, J. C. F. Ket, M. Tenhagen, F. C. den Boer, R. Hompes, P. J. Tanis, J. B. Tuynman
Techniques in Coloproctology.2023; 27(1): 11. CrossRef
The feasibility of laparoscopic TSME preserving the left colic artery and superior rectal artery for upper rectal cancer
Chi Zhang, Hao-tang Wei, Wenqing Hu, Yueming Sun, Qinyuan Zhang, Masanobu Abe, Zhuoran Du, Yingying Xu, Liang Zong, Xiang Hu
World Journal of Surgical Oncology.2020;[Epub] CrossRef
High nodal positivity rates even in good clinical responders after chemoradiation of rectal cancer: is organ preservation feasible?
K. C. Vallam, R. Engineer, A. Desouza, P. Patil, A. Saklani
Colorectal Disease.2016; 18(10): 976. CrossRef

Review

Aluminum Potassium Sulfate and Tannic Acid Injection for Hemorrhoids: Seok Won Lim; J Korean Soc Coloproctol. 2012;28(2):73-77. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.73

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A quick hemostatic effect, as well as sclerosing and shrinkage of hemorrhoids, can be attained when internal hemorrhoids are treated by using injection therapy with aluminum potassium sulfate and tannic acid (ALTA), the outcomes of treatment may be similar to those of a hemorrhoidectomy. However, if the type of hemorrhoid or the method of injection is not appropriate for ALTA treatment, complications peculiar to ALTA or recurrence may develop. Accordingly, sufficient understanding of the treatment mechanism of ALTA injection and repeated training for injection are required for effective use of the ALTA treatment.

Citations

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Aluminum potassium sulfate and tannic acid (ALTA) sclerotherapy for hemorrhoidal disease: a systematic review and meta-analysis
Vasiliki Manaki, Vangelis Bontinis, Alkis Bontinis, Argirios Giannopoulos, Ioannis Kontes, Angeliki Chorti, Kiriakos Ktenidis
Acta Chirurgica Belgica.2024; 124(4): 253. CrossRef
ANTI-HEMORRHOIDAL ACTIVITY OF AYURVEDIC CREAM IN RATS
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INDIAN DRUGS.2023; 60(01): 84. CrossRef
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Effectiveness of Endoscopic Sclerotherapy with Aluminum Potassium Sulfate and Tannic Acid as a Non-Surgical Treatment for Internal Hemorrhoids
Yuichi Tomiki, Jun Aoki, Shunsuke Motegi, Rina Takahashi, Toshiaki Hagiwara, Yu Okazawa, Kosuke Mizukoshi, Masaya Kawai, Shinya Munakata, Shun Ishiyama, Kiichi Sugimoto, Kazuhiro Sakamoto
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Dorin Dragos, Marilena Gilca
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BMC Surgery.2018;[Epub] CrossRef
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Evidence-Based Complementary and Alternative Medicine.2017;[Epub] CrossRef
Liver injury after aluminum potassium sulfate and tannic acid treatment of hemorrhoids
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World Journal of Gastroenterology.2017; 23(27): 5034. CrossRef
Treatment of Internal Hemorrhoids by Endoscopic Sclerotherapy with Aluminum Potassium Sulfate and Tannic Acid
Yuichi Tomiki, Seigo Ono, Jun Aoki, Rina Takahashi, Shun Ishiyama, Kiichi Sugimoto, Yukihiro Yaginuma, Yutaka Kojima, Michitoshi Goto, Atsushi Okuzawa, Kazuhiro Sakamoto
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Aluminum Potassium Sulfate and Tannic Acid - A New Option for the Treatment of Grade 3 Hemorrhoids
Yong Hee Hwang
Annals of Coloproctology.2015; 31(3): 83. CrossRef
Comparison of Injection Sclerotherapy Between 5% Phenol in Almond Oil and Aluminum Potassium Sulfate and Tannic Acid for Grade 3 Hemorrhoids
Takaaki Yano, Kenji Yano
Annals of Coloproctology.2015; 31(3): 103. CrossRef
Distal Hemorrhoidectomy With ALTA Injection: A New Method for Hemorrhoid Surgery
Tatsuya Abe, Yoshikazu Hachiro, Yoshiaki Ebisawa, Houhei Hishiyama, Masao Kunimoto
International Surgery.2014; 99(3): 295. CrossRef

Original Articles

Comparison of a Fistulectomy and a Fistulotomy with Marsupialization in the Management of a Simple Anal Fistula: A Randomized, Controlled Pilot Trial: Bhupendra Kumar Jain, Kumar Vaibhaw, Pankaj Kumar Garg, Sanjay Gupta, Debajyoti Mohanty; J Korean Soc Coloproctol. 2012;28(2):78-82. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.78

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Abstract PDF

Purpose

This randomized clinical trial was conducted to compare a fistulectomy and a fistulotomy with marsupialization in the management of a simple anal fistula.

Methods

Forty patients with simple anal fistula were randomized into two groups. Fistulous tracts were managed by using a fistulectomy (group A) while a fistulotomy with marsupialization was performed in group B. The primary outcome measure was wound healing time while secondary outcome measures were operating time, postoperative wound size, postoperative pain, wound infection, anal incontinence, recurrence and patient satisfaction.

Results

Postoperative wounds in group B healed earlier in comparison to group A wounds (4.85 ± 1.39 weeks vs. 6.75 ± 1.83 weeks, P = 0.035). No significant differences existed between the operating times (28.00 ± 6.35 minutes vs. 28.20 ± 6.57 minutes, P = 0.925) and visual analogue scale scores for postoperative pain on the first postoperative day (4.05 ± 1.47 vs. 4.50 ± 1.32, P = 0.221) for the two groups. Postoperative wounds were larger in group A than in group B (2.07 ± 0.1.90 cm² vs. 1.23 ± 0.87 cm²), however this difference did not reach statistical significance (P = 0.192). Wound discharge was observed for a significantly longer duration in group A than in group B (4.10 ± 1.91 weeks vs. 2.75 ± 1.71 weeks, P = 0.035). There were no differences in social and sexual activities after surgery between the patients of the two groups. No patient developed anal incontinence or recurrence during the follow-up period of twelve weeks.

Conclusion

In comparison to a fistulectomy, a fistulotomy with marsupialization results in faster healing and a shorter duration of wound discharge without increasing the operating time.

Citations

Citations to this article as recorded by

European Society of Coloproctology: Guidelines for diagnosis and treatment of cryptoglandular anal fistula
Lillian Reza, Kevin Gottgens, Jos Kleijnen, Stephanie Breukink, Peter C. Ambe, Felix Aigner, Erman Aytac, Gabriele Bislenghi, Andreas Nordholm‐Carstensen, Hossam Elfeki, Gaetano Gallo, Ugo Grossi, Baris Gulcu, Nusrat Iqbal, Rosa Jimenez‐Rodriguez, Sezai L
Colorectal Disease.2024; 26(1): 145. CrossRef
Use of Non-Thermal Plasma as Postoperative Therapy in Anal Fistula: Clinical Experience and Results
Régulo López-Callejas, Pasquinely Salvador Velasco-García, Mario Betancourt-Ángeles, Benjamín Gonzalo Rodríguez-Méndez, Guillermo Berrones-Stringel, César Jaramillo-Martínez, Fernando Eliseo Farías-López, Antonio Mercado-Cabrera, Raúl Valencia-Alvarado
Biomedicines.2024; 12(8): 1866. CrossRef
The efficacy of Ksharsutra, Fistulectomy and Ligation of Intersphincteric Fistula Tract (LIFT) procedure in management of Fistula in ano a prospective observational study
Chinniahnapalaya Pandurangaiah Hariprasad, Anil Kumar, Manoj Kumar, Manoj Kumar, Shiv Shankar Paswan, Gupta Rohit, Shiv Kishor, Prem Kumar
BMC Surgery.2023;[Epub] CrossRef
Efficacy of different surgical treatments for management of anal fistula: a network meta-analysis
S. Bhat, W. Xu, C. Varghese, N. Dubey, C. I. Wells, C. Harmston, G. O’Grady, I. P. Bissett, A. Y. Lin
Techniques in Coloproctology.2023; 27(10): 827. CrossRef
Spaltung von Analfisteln – noch zeitgemäß?
Ralph Schneider, Andreas Ommer
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The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula
Wolfgang B. Gaertner, Pamela L. Burgess, Jennifer S. Davids, Amy L. Lightner, Benjamin D. Shogan, Mark Y. Sun, Scott R. Steele, Ian M. Paquette, Daniel L. Feingold
Diseases of the Colon & Rectum.2022; 65(8): 964. CrossRef
Fistulotomy versus Fistulectomy for Fistula-in-Ano: A Randomized Prospective Study
Srikantaiah Chandra Sekhariah Hiremath, Rakesh Patil
The Surgery Journal.2022; 08(04): e336. CrossRef
A meta-analysis of marsupialisation versus none in the treatment of simple fistula-in-ano
Shaheel Mohammad Sahebally, Lisa O’Byrne, Alexandra Troy, Kevin Gerard Byrnes, John Burke, Deborah McNamara
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Simple fistula-in-ano: is it all simple? A systematic review
F. Litta, A. Parello, L. Ferri, N. O. Torrecilla, A. A. Marra, R. Orefice, V. De Simone, P. Campennì, M. Goglia, C. Ratto
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Is Fistulotomy with Marsipulization more Effective than Fistulectomy alone for Low Fistula in Ano?
Danish Aslam, Farhan Zaheer, Sarush Ahmed Siddiqui, Foad Ali Moosa, Shafaq Naseer, Rabia Arsalan, Muhammed Osama
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Surgical Management of Idiopathic Perianal Fistulas: A Systematic Review and Meta-Analysis
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Keyhole deformity – routinely heard, commonly feared but perhaps never seen!
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A randomized controlled trial on the effect of topical phenytoin 2% on wound healing after anal fistulotomy
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Drainage Seton Versus External Anal Sphincter–Sparing Seton After Rerouting of the Fistula Tract in the Treatment of Complex Anal Fistula: A Randomized Controlled Trial
Waleed Omar, Abdallah Alqasaby, Mahmoud Abdelnaby, Mohamed Youssef, Mostafa Shalaby, Mohamed Anwar Abdel-Razik, Sameh Hany Emile
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Fistulotomy with or without marsupialisation of wound edges in treatment of simple anal fistula: a randomised controlled trial
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The treatment of anal fistula: secondACPGBIPosition Statement – 2018
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S3-Leitlinie: Kryptoglanduläre Analfisteln
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COMPARATIVE STUDY OF FISTULECTOMY BY CORING TECHNIQUE IN FISTULA IN ANO, USING RADIOFREQUENCY CAUTERY AND MONOPOLAR CAUTERY
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Operation for Posterior Intersphincteric Anal Fistula -Procedures of Fistulotomy-
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Intestinal Anastomosis by Use of a Memory-shaped Compression Anastomosis Clip (Hand CAC 30): Early Clinical Experience: Hak-Youn Lee, Jin-Hee Woo, Si-Young Park, Nam-Wook Kang, Ki-Jae Park, Hong-Jo Choi; J Korean Soc Coloproctol. 2012;28(2):83-88. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.83

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8 Citations

Abstract PDF

Purpose

The safety and the efficacy of the compression anastomosis clip (Hand CAC 30) have been demonstrated by animal studies. This study was designed to evaluate the clinical validity of the Hand CAC 30 in enterocolic side-to-side anastomosis after colonic or enteric resections.

Methods

A non-randomized prospective data collection was performed for patients undergoing a side-to-side anastomosis using the Hand CAC 30. Eligibility criteria for the use of the Hand CAC 30 were for anastomoses between the colon and the ileum or between two small bowels. The primary short-term endpoint was the rate of anastomotic leakage. Other clinical outcomes, including intra- and postoperative complications, length of operation time and hospital stay, and the clip elimination time were recorded.

Results

A total of 63 patients (male, 36) underwent an enteric or right-sided colonic resection followed by a side-to-side anastomosis using the Hand CAC 30. Laparoscopic surgery was performed in 36 patients, in whom one patient who underwent a laparoscopic right hemicolectomy was converted to an open procedure (1/32, 3.1%). One patient with ascending colon cancer showed postoperative anastomotic leakage and died of co-morbid ischemic heart disease. There were no other surgical mortalities. The exact date of expulsion of the clip could not be recorded because most patients were not aware of clip elimination. No patients manifested clinical symptoms of anastomotic stricture.

Conclusion

Short-term evaluation of the Hand CAC 30 anastomosis in patients undergoing enterocolic surgery proved it to be a safe and efficacious alternative to the standard hand-sewn or stapling technique.

Citations

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Biodegradable anastomotic tube prepared from diblock copolymers of mPEG-b-PLA and mPEG-b-PLGA
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Laparoscopic colonic anastomosis using a degradable stent in a porcine model
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Colorectal anastomosis using a compression device
Quintín Héctor González-Contreras, Mónica de Jesús-Mosso, Jesús Alberto Bahena-Aponte, Omar Aldana-Martínez, Karen Pineda-Solís, Sari Narsil Mejia-Arcadia
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Long term results of the use of compression anastomosis clips (CAC) in gastrointestinal surgery – the first report
Katarzyna Kuśnierz, Paweł Lampe
Polish Journal of Surgery.2015;[Epub] CrossRef
A nickel–titanium memory-shape device for gastrojejunostomy: comparison of the compression anastomosis clip and a hand-sewn anastomosis
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Bezoar-induced Small Bowel Obstruction: Se Heon Oh, Hwan Namgung, Mi Hyun Park, Dong-Guk Park; J Korean Soc Coloproctol. 2012;28(2):89-93. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.89

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43 Citations

Abstract PDF

Purpose

The aim of this study was to observe the clinical features of a bezoar-induced small bowel obstruction and to investigate the role of abdominal computed tomography (CT) in establishing the diagnosis.

Methods

We retrospectively reviewed 20 cases of bezoar-induced small bowel obstruction in our hospital from 1996 to 2010.

Results

Thirteen patients (65%) had a history of abdominal surgery. Nine patients (45%) were diagnosed with a bezoar before surgery, seven patients were diagnosed by using abdominal CT, and two patients were diagnosed with a small bowel series. Abdominal CT was performed in 15 patients, and the diagnostic accuracy was 47% (7/15). Surgery revealed ten bezoars in the jejunum and 11 in the ileum. Two patients had bezoars found concurrently in the stomach. Spontaneous removal took place in two patients. An enterotomy and bezoar extraction was performed in 15 patients. Fragmentation and milking, a small bowel resection, and a Meckel's diverticulectomy were performed in one patient each. Early operative treatment was possible (P = 0.036) once the bezoar had been diagnosed by using abdominal CT. There tended to be fewer postoperative complications in patients who were diagnosed with a bezoar by using abdominal CT, but the result was not statistically significant (P = 0.712).

Conclusion

A preoperative diagnosis of bezoar-induced small bowel obstruction by using clinical features was difficult. Increased use of abdominal CT led to a more accurate diagnosis and to earlier surgery for bezoar-induced small bowel obstructions, thereby reducing the rate of complications.

Citations

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Mariana Claro, Daniel Costa Santos, Alberto Abreu Silva, Cláudia Deus, João Grilo, Diogo Sousa, José Augusto Martins
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Atef Mejri, Emna Trigui
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Woo Yong Lee
International Journal of Surgery Case Reports.2021; 85: 106177. CrossRef
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Dimitra G. Delimpaltadaki, Ioannis G. Gkionis, Mathaios E. Flamourakis, Andreas F. Strehle, Emmanouil N. Bachlitzanakis, Michail I. Giakoumakis, Manousos S. Christodoulakis, Konstantinos G. Spiridakis
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Gaik Huey Ng, Li Ying Teoh, Mei Sze Teh, Suniza Jamaris, Mee Hoong See
Journal of Surgical Case Reports.2020;[Epub] CrossRef
Clinical Case of a Patient with Small Bowel Obstruction and Multiple Diospirobesoaras of the Gastrointestinal Tract
A. S. Harutyunyan, V. D. Levitsky, V. V. Kiselev, P. A. Yartsev, A. V. Vodyasov, N. V. Shavrina
Russian Sklifosovsky Journal "Emergency Medical Care".2020; 9(2): 281. CrossRef
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Jia Wei Valerie Tong, Pravin Lingam, Vishalkumar Girishchandra Shelat
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Intestinal obstruction by a phytobezoar in a patient with a history of gastroplasty
Luiz de Abreu Junior, Gustavo Garcia Marques, Ingredy Tavares da Silva, Flávia Munhos Granja, Marcelo Zindel Salem
Radiologia Brasileira.2019; 52(2): 133. CrossRef
Parsnip phytobezoar causing small bowel obstruction
Denise I. Garcia, William Taylor Head, Aaron P. Lesher
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Clinics in diagnostic imaging (198)
YQA Soon, HM Low, CWT Huey, GKL Wansaicheong
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When a cure becomes the pathology: mechanical bowel obstruction due to herbal pharmacobezoar. A case report with review of literature
Saurabh Gandhi, Eham Arora, Ajay Bhandarwar, Arun Patil, Amol Wagh, Shubham Gupta
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An unusual cause of small bowel obstruction due to an ingested mango seed: a case report
A. R. Fernando, R. Bulathsinghela, D. N. Samarasekera
BMC Research Notes.2017;[Epub] CrossRef
Small Bowel Obstruction Caused by Aloe vera Bezoars: A Case Report
In Taik Hong, Jae Myung Cha, Hye Jin Ki, Min Seob Kwak, Jin Young Yoon, Hyun Phil Shin, Jung Won Jeoun, Sung Il Choi
The Korean Journal of Gastroenterology.2017; 69(5): 312. CrossRef
Small bowel obstruction attributable to phytobezoar
Nasrin Razavianzadeh, Behzad Foroutan, Farhad Honarvar, Mohammad Forozeshfard
Oxford Medical Case Reports.2016; 2016(12): omw092. CrossRef
Intestinal obstruction due to phytobezoars: An update
Enis Dikicier
World Journal of Clinical Cases.2015; 3(8): 721. CrossRef
Bezoar-induced small bowel obstruction: Clinical characteristics and diagnostic value of multi-slice spiral computed tomography
Pei-Yuan Wang
World Journal of Gastroenterology.2015; 21(33): 9774. CrossRef
Imaging differentiation of phytobezoar and small-bowel faeces: CT characteristics with quantitative analysis in patients with small- bowel obstruction
Ya-Cheng Chen, Chang-Hsien Liu, Hsian-He Hsu, Chih-Yung Yu, Hong-Hau Wang, Hsiu-Lung Fan, Ran-Chou Chen, Wei-Chou Chang
European Radiology.2015; 25(4): 922. CrossRef
Ultrasonographic differentiation of bezoar from feces in small bowel obstruction
Kyung Hoon Lee, Hyun Young Han, Hee Jin Kim, Hee Kyung Kim, Moon Soo Lee
Ultrasonography.2015; 34(3): 211. CrossRef
Bulbus psododivertikülde mide çıkış obstrüksiyonuna neden olan ve gastroskopi ile mideye alınması sonrası ileus gelişen bezoar: olgu sunumu ve literatürün gözden geçirilmesi (duodenal bezoar)
Ahmet UYANIKOĞLU, Haşim NAR, Ahmet ŞEKER, Ferzan AYDIN, Yusuf YÜCEL, Necati YENİCE
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Two cases of small bowel obstruction secondary to a swallowed potato
E Castren, A Hakeem, N S Mahmood, K Aryal
BMJ Case Reports.2015; : bcr2015213744. CrossRef
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Faustine Deront Bourdin, Antonio Iannelli, Jerôme Delotte
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Bezoar: An unusual cause of intestinal obstruction
K. Stratakis, A. Tsepelaki, E. Karallas, K. Koutsopoulos
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Yana Puckett, Jon Nathan, Sharmila Dissanaike
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Acute small bowel obstruction in a girl, caused by a jejunal bezoar composed of textile fibers
S. Zwaveling, D.C. van der Zee
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Kam Lun Ellis Hon, Jean Cheng, Chung Mo Chow, Hon Ming Cheung, Kam Lau Cheung, Yuk Him Tam, Alexander K. C. Leung
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Clinical Characteristics and Surgical Safety in Patients with Acute Appendicitis Aged over 80: Kwon Sang Moon, Yong Hwan Jung, Eun Hun Lee, Yong Hee Hwang; J Korean Soc Coloproctol. 2012;28(2):94-99. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.94

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Abstract PDF: Purpose
The aim of this study was to evaluate the clinical characteristics and treatment outcomes, including surgical safety, in patients over 80 years of age who underwent an appendectomy.
Methods
This study involved 160 elderly patients who underwent an appendectomy for acute appendicitis: 28 patients over 80 years old and 132 patients between 65 and 79 years old.
Results
The rate of positive rebound tenderness was significantly higher in the over 80 group (P = 0.002). Comparisons of comorbidity, diagnostic tool and delay in surgical treatment between the two groups were not statistically different. American Society of Anesthesiologists score was significantly higher in the over 80 group than in the 65 to 79 group (2.4 ± 0.5 vs. 1.6 ± 0.5; P < 0.00005). Comparisons of operative times and use of drainage between the two groups were not statistically different. In the pathologic findings, periappendiceal abscess was more frequent in the over 80 group (P = 0.011). No significant differences existed between the two groups when comparing the results of gas out and the time to liquid diet, but the postoperative hospital stay was significantly longer in the over 80 group (P = 0.001). Among the postoperative complications, pulmonary complication was significantly higher in the over 80 group (P = 0.005). However, operative mortality was zero in each group.
Conclusion
In case of suspicious appendicitis in elderly patients, efforts should be made to use aggressive diagnostic intervention, do appropriate surgery and prevent pulmonary complications especially in patients over 80 years of age.

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; J Korean Soc Coloproctol. 2012;28(2):100-107. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.100

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Abstract PDF

Purpose

The aim of this study was to analyze the oncologic outcomes and the risk factors for recurrence after a tumor-specific mesorectal excision (TSME) of resectable rectal cancer in a single institution.

Methods

A total of 782 patients who underwent a TSME for resectable rectal cancer between February 1995 and December 2005 were enrolled retrospectively. Oncologic outcomes included 5-year cancer-specific survival and its affecting factors, as well as risk factors for local and systemic recurrence.

Results

The 5-year cancer-specific survival rate was 77.53% with a mean follow-up period of 61 ± 31 months. The overall local and systemic recurrence rates were 9.2% and 21.1%, respectively. The risk factors for local recurrence were pN stage (P = 0.015), positive distal resection margin, and positive circumferential resection margin (P < 0.001). The risk factors for systemic recurrence were pN stage (P < 0.001) and preoperative carcinoembryonic antigen level (P = 0.005). The prognostic factors for cancer-specific survival were pT stage (P < 0.001), pN stage (P < 0.001), positive distal resection margin (P = 0.005), and positive circumferential resection margin (P = 0.016).

Conclusion

The oncologic outcomes in our institution after a TSME for patients with resectable rectal cancer were similar to those reported in other recent studies, and we established the risk factors that could be crucial for the planning of treatment and follow-up.

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Case Reports

Giant Peritoneal Loose Body in the Pelvic Cavity: Joung Teak Jang, Haeng Ji Kang, Ji Young Yoon, Seo Gue Yoon; J Korean Soc Coloproctol. 2012;28(2):108-110. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.108

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Abstract PDF

We report a case of a large peritoneal loose body diagnosed on computed tomography. The most common causes of a peritoneal loose body are thought to be torsion and separation of the appendices epiploicae. Peritoneal loose bodies are usually small, 0.5 to 2.5 cm in diameter. However, "giant" peritoneal loose bodies, larger than 4 cm in diameter, are an uncommon disease and present with various symptoms, and are difficult to diagnose preoperatively. Especially, abdominal large peritoneal loose bodies are frequently misdiagnosed as tumorous disease preoperatively. In our case, the loose body appeared as a round pelvic mass with central calcifications and a distinct fat plane separating it from adjacent organs. Preoperatively, we suspected a tumorous lesion from the wall of the upper rectum; however, at laparoscopy, a large peritoneal loose body was detected. An extraction of the giant peritoneal loose body was performed laparoscopically.

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A Case of Primary Ovarian Lymphoma Presenting as a Rectal Submucosal Tumor: Il Soon Jung, Seul Young Kim, Kyu Seup Kim, Kwang Hun Ko, Jae Kyu Sung, Hyun Young Jeong, Ji Yeoun Kim, Hee Seok Moon; J Korean Soc Coloproctol. 2012;28(2):111-115. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.111

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Abstract PDF

Primary ovarian lymphoma is a rare malignancy whose symptoms or signs are usually nonspecific. In this article, we report a very rare case initially presenting as a rectal submucosal-tumor-like lesion with a defecation disturbance caused by primary ovarian lymphoma with bilateral involvement. A 42-year-old woman visited chungnam national university hospital complaining of persistent defecation disturbance for 6 months. Colonoscopy demonstrated compression of the rectum by an extrinsic mass mimicking a rectal submucosal tumor. Magnetic resonance imaging detected bilateral ovarian tumors, 9.3 cm and 5.4 cm each in diameter, compressing the rectum without enlarged lymph nodes. The diagnosis was established following a bilateral adnexectomy and histological studies of the excised tissue. The tumor was classified as a diffuse large B-cell lymphoma. The patient was prescribed six cycles of standard CHOP (cyclophosphamide, hydroxydaunorubicin, vincristine, prednisolone) regimen and is presently on treatment.

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