Annals of Coloproctology

Volume 30(1); February 2014

Editorials

Hand-Assisted Laparoscopic Right Colectomy: Is It Useful?: Hungdai Kim; Ann Coloproctol. 2014;30(1):1-1. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.1

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Procedural and post-operative complications associated with laparoscopic versus open abdominal surgery for right-sided colonic cancer resection
Yong Sheng Li, Fan Chun Meng, Jun Kai Lin
Medicine.2020; 99(40): e22431. CrossRef
Surgical approach to right colon cancer: From open technique to robot. State of art
Massimiliano Fabozzi, Pia Cirillo, Francesco Corcione
World Journal of Gastrointestinal Surgery.2016; 8(8): 564. CrossRef
Comparative Study on Therapeutic Efficacy Between Hand-Assisted Laparoscopic Surgery and Conventional Laparotomy for Acute Obstructive Right-Sided Colon Cancer
Zhengrong Li, Daojiang Li, Zhigang Jie, Guoyang Zhang, Yi Liu
Journal of Laparoendoscopic & Advanced Surgical Techniques.2015; 25(7): 548. CrossRef

Second Primary Cancers Following Colorectal Cancer: Jung Wook Huh; Ann Coloproctol. 2014;30(1):2-2. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.2

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The Role of Positron Emission Tomography/Computed Tomography in the Initial Staging of Colon Cancer: Hyung Jin Kim, Seong Taek Oh; Ann Coloproctol. 2014;30(1):3-4. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.3

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Total Lesion Glycolysis and Sequential 90Y-Selective Internal Radiation Therapy in Breast Cancer Liver Metastases: Preliminary Results
Oreste Bagni, Luca Filippi, Giuseppe Pelle, Roberto Cianni, Orazio Schillaci
Cancer Biotherapy and Radiopharmaceuticals.2015; 30(10): 421. CrossRef

Is a Microsatellite Instability Still Useful for Tailored Treatment in Stage II and III Colon Cancer?: Nam Kyu Kim; Ann Coloproctol. 2014;30(1):5-6. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.5

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Assessment of the Circulating Tumor Cells and Microsatellite Instability in Colorectal Cancer Patients: Prognostic and Diagnostic Value
Aya Alsayed, Salem E Salem, Mostafa M El Serafi, Mona S Abdellateif, Abdel-Rahman N Zekri, Marwa Mohanad, Abeer A Bahnassy
OncoTargets and Therapy.2021; Volume 14: 1937. CrossRef
5-fluorouracil and other fluoropyrimidines in colorectal cancer: Past, present and future
Sona Vodenkova, Tomas Buchler, Klara Cervena, Veronika Veskrnova, Pavel Vodicka, Veronika Vymetalkova
Pharmacology & Therapeutics.2020; 206: 107447. CrossRef

Individualized Treatment for a Rectourethral Fistula: Rare Complications: In Ja Park; Ann Coloproctol. 2014;30(1):7-8. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.7

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Needlescopic-Assisted Surgery: Single-Incision or Multi-Incision Laparoscopic Surgery?: Chang-Nam Kim; Ann Coloproctol. 2014;30(1):9-10. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.9

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Original Articles

The Role of Hand-Assisted Laparoscopic Surgery in a Right Hemicolectomy for Right-Sided Colon Cancer: Sung Uk Bae, Jin Seok Park, Young Jin Choi, Min Ku Lee, Byung Sun Cho, Yoon Jung Kang, Joo Seung Park, Chang Nam Kim; Ann Coloproctol. 2014;30(1):11-17. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.11

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Abstract PDF

Purpose

The purpose of this study is to evaluate the perioperative and long-term oncologic outcomes of hand-assisted laparoscopic surgery (HALS) and standard laparoscopic surgery (SLS) and assess the role of HALS in the management of right-sided colon cancer.

Methods

The study group included 53 patients who underwent HALS and 45 patients who underwent SLS for right-sided colon cancer between April 2002 and December 2008.

Results

The patients in each group were similar in age, American Society of Anesthesiologist (ASA) score, body mass index, and history of previous abdominal surgeries. Eight patients in the HALS group and no patient in the SLS group exhibited signs of tumor invasion into adjacent structures. No differences were noted in the time to return of normal bowel function, time to toleration of diet, lengths of hospital stay and narcotic usage, and rate of postoperative complications. The median incision length was longer in the HALS group (HALS: 7.0 cm vs. SLS: 4.8 cm, P < 0.001). The HALS group had a significantly higher pathologic TNM stage and significantly larger tumor size (HALS: 6.0 cm vs. SLS: 3.3 cm, P < 0.001). The 5-year overall, disease-free, and cancer-specific survival rates of the HALS and the SLS groups were 87.3%, 75.2%, and 93.9% and 86.4%, 78.0%, and 90.7%, respectively (P = 0.826, P = 0.574, and P = 0.826).

Conclusion

Although patients in the HALS group had more advanced disease and underwent more complex procedures than those in the SLS group, the short-term benefits and the oncologic outcomes between the two groups were comparable. HALS can, therefore, be considered an alternative to SLS for bulky and fixed right-sided colon cancer.

Citations

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Right hemicolectomy: a network meta-analysis comparing open, laparoscopic-assisted, total laparoscopic, and robotic approach
Emanuele Rausa, Michael Eamon Kelly, Emanuele Asti, Alberto Aiolfi, Gianluca Bonitta, Luigi Bonavina
Surgical Endoscopy.2019; 33(4): 1020. CrossRef
Outcomes of open, laparoscopic, and hand-assisted laparoscopic surgeries in elderly patients with right colon cancers
Mingtian Wei, Xubing Zhang, Pingfan Ma, Wanbin He, Liang Bi, Ziqiang Wang
Medicine.2018; 97(35): e11907. CrossRef
Hand-assisted laparoscopic right hemicolectomy with complete mesocolic excision and central vascular ligation: a novel technique for right colon cancer
Qing-Bin Wu, Xiang-Bing Deng, Xu-Yang Yang, Bing-Chen Chen, Wan-Bin He, Tao Hu, Ming-Tian Wei, Zi-Qiang Wang
Surgical Endoscopy.2017; 31(8): 3383. CrossRef
Hand-assisted laparoscopic surgery versus laparoscopic right colectomy: a meta-analysis
Guosen Wang, Jianping Zhou, Weiwei Sheng, Ming Dong
World Journal of Surgical Oncology.2017;[Epub] CrossRef
Robotic Complete Mesocolic Excision and Intracorporeal Anastomosis Using a Robotic Stapler for Right-Sided Colon Cancer With Reduced-Port Access
Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Diseases of the Colon & Rectum.2017; 60(4): 456. CrossRef
Advances in Laparoscopic Colorectal Surgery
James Michael Parker, Timothy F. Feldmann, Kyle G. Cologne
Surgical Clinics of North America.2017; 97(3): 547. CrossRef
Need for Reappraisal of Hand-Assisted Laparoscopic Surgery for Colorectal Diseases in the Era of Desiring Small Incisions
Chang-Nam Kim
Annals of Coloproctology.2017; 33(4): 119. CrossRef
Hand-Assisted Laparoscopic Surgery Versus Conventional Laparoscopic Surgery for Colorectal Cancer: A Systematic Review and Meta-Analysis
Xubing Zhang, Qingbin Wu, Tao Hu, Chaoyang Gu, Liang Bi, Ziqiang Wang
Journal of Laparoendoscopic & Advanced Surgical Techniques.2017; 27(12): 1251. CrossRef
Hand-Assisted Laparoscopic Right Colectomy: Is It Useful?
Hungdai Kim
Annals of Coloproctology.2014; 30(1): 1. CrossRef

Clinical Characteristics of Colorectal Cancer Patients With a Second Primary Cancer: Jin Woo Lee, Jong Woo Kim, Nam Keun Kim; Ann Coloproctol. 2014;30(1):18-22. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.18

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Abstract PDF

Purpose

The incidence of colorectal cancer is increasing due to a westernized dietary lifestyle, and improvements in treatment and diagnostic tools have resulted in more patients being confirmed of having multiple primary cancers. However, studies regarding multiple primary cancers are insufficient. In this study, the clinical aspects of patients with primary multiple cancers, including colorectal cancers, were investigated, and the results were compared to those of patients with primary colorectal cancer only.

Methods

Seven hundred eighteen patients who received surgery for colorectal cancer between March 2003 and September 2012 in CHA Medical Center were enrolled. A retrograde cohort was done for comparison of the two groups: those with and those without multiple primary cancer. The analysis was done according to sex, age, tumor location, tumor size, metastatic regional lymph-node number, vascular/lymphatic microinvasion, staging, tumor markers, microsatellite instability, and C/T subgroup of polymorphism in methylenetetrahydrofolate reductase.

Results

Of the 718 subjects, 33 (4.6%) had multiple primary cancers: 12 (36.4%) synchronous and 21 (63.6%) metachronous. The malignancy most frequently accompanying colorectal cancer was gastric cancer, followed by thyroid, prostate, and esophageal malignancies in that order. In the comparison between groups, mean age, tumor location, and microsatellite instability showed statistically significant differences; others parameters did not.

Conclusion

The incidence of multiple primary cancers, including colorectal cancer, is increasing. Therefore, defining the characteristics of patients with multiple primary cancers is crucial, and those characteristics need to be acknowledged in the follow-up of colorectal cancer patients.

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Multiple Primary Malignancies in Patients With Hepatocellular Carcinoma
Wei Xu, Wenjun Liao, Penglei Ge, Jinjun Ren, Haifeng Xu, Huayu Yang, Xinting Sang, Xin Lu, Yilei Mao
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Lessons Learned From a Case of Gastric Cancer After Liver Transplantation for Hepatocellular Carcinoma
Kun Yang, Hong Zhu, Chong-Cheng Chen, Tian-Fu Wen, Wei-Han Zhang, Kai Liu, Xin-Zu Chen, Dong-Jiao Guo, Zong-Guang Zhou, Jian-Kun Hu
Medicine.2016; 95(7): e2666. CrossRef
An Uncommon Presentation of a Metachronous Primary Gastric Tumor in a Patient with a Resected Colorectal Carcinoma: Case Report and Review of the Literature
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Gastric cancer following a liver transplantation for glycogen storage disease type Ia (von Gierke disease): A case report
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Oncology Letters.2014; 8(6): 2803. CrossRef
Second Primary Cancers Following Colorectal Cancer
Jung Wook Huh
Annals of Coloproctology.2014; 30(1): 2. CrossRef

Positron Emission Tomography/Computed Tomography in the Staging of Colon Cancer: Jae Hyung Lee, Min Ro Lee; Ann Coloproctol. 2014;30(1):23-27. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.23

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Abstract PDF

Purpose
Accurate preoperative staging of colon cancer is essential for providing the optimal treatment strategy and evaluating the expected prognosis. The aim of this study is to assess the value of positron emission tomography/computed tomography (PET/CT) over conventional studies in the staging of colon cancer.
Methods
A total of 266 colon cancer patients diagnosed between January 2008 and December 2010 were assessed with both PET/CT and conventional studies. Discordance with PET/CT and conventional studies were evaluated, and changes in the management strategy were assessed for each stage. Discordant findings were verified by using intraoperative examination, pathology reports, and follow-up imaging studies.
Results
Multidetector computed tomography (MDCT) and PET/CT showed similar accuracy in detecting lymph node metastasis in patients with clinical stage III (36.2% vs. 42%, P = 0.822) and stage IV (60.3% vs. 63.5%, P = 0.509) disease. PET/CT led to a change in management strategy for 1 of 40 patients (2.5%) with clinical stage I, 0 of 25 patients (0%) with stage II, 9 of 138 patients (6.5%) with stage III, and 8 of 63 patients (12.7%) with stage IV disease.
Conclusion
PET/CT changed the management plan in 6.5% of patients with clinical stage III and 12.7% of patients with clinical stage IV colon cancer. Our findings suggest that PET/CT may be considered as a routine staging tool for clinical stage III and IV colon cancers.

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The Role of Positron Emission Tomography/Computed Tomography in the Initial Staging of Colon Cancer
Hyung Jin Kim, Seong Taek Oh
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Is Microsatellite Instability Really a Good Prognostic Factor of Colorectal Cancer?: Ui Sup Shin, Sang Sik Cho, Sun Mi Moon, Sun Hoo Park, Sun Hee Jee, Eun-Joo Jung, Dae-Yong Hwang; Ann Coloproctol. 2014;30(1):28-34. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.28

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Abstract PDF

Purpose

The aim of this study was to investigate the clinicopathologic features of and the prognosis for colorectal cancers (CRCs) with microsatellite instabilities (MSIs).

Methods

Between 2006 and 2009, genotyping was performed on 245 patients with stage II/III CRCs to establish the MSI status. The clinicopathologic differences and the prognostic value of MSI were analyzed. The median follow-up period was 38 months (range, 7-68 months).

Results

Of the total 245 patients, 20 (8.2%) had MSI-high (H) and 225 (91.8%) had MSI-low (L) or stable (S) CRCs. Adjuvant chemotherapies were performed on 101 stage II (87.8%) and 107 stage III patients (82.3%). Patients with MSI-H CRCs more frequently had a family history of colon cancer (10% vs. 2.7%, P = 0.003), more frequently had a cancer located at the proximal colon (90.0% vs. 19.1%, P < 0.0001), and more often showed a mucinous phenotype or poor differentiation (35.0% vs. 7.1%, P = 0.001). Despite less frequent lymph node metastasis (25% vs. 55.6%, P = 0.01), the number of retrieved lymph nodes was higher (26.3 ± 13.1 vs. 20.7 ± 1.2, P = 0.04) in the MSI-H group. The overall survival and the disease-free survival (DFS) did not differ with respect to MSI status. However, in the stage II subgroup, the DFS for patients with MSI-H CRCs was significantly worse (72.2% vs. 90.7%, P = 0.03). The multivariate analysis performed on this subgroup revealed that MSI-H was an independent poor prognostic factor (adjusted hazard ratio, 4.0; 95% confidence interval, 1.0-15.6, P = 0.046).

Conclusion

MSI-H CRCs had distinct clinicopathologic features, and MSI-H was an independent poor prognostic factor in stage II CRCs. Considering the majority of stage II patients were administrated adjuvant chemotherapy, the efficacy of adjuvant chemotherapy for treating MSI CRCs might be different from that for treating MSI-L/S tumors.

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Rectourethral Fistula: Systemic Review of and Experiences With Various Surgical Treatment Methods: Ji Hye Choi, Byeong Geon Jeon, Sang-Gi Choi, Eon Chul Han, Heon-Kyun Ha, Heung-Kwon Oh, Eun Kyung Choe, Sang Hui Moon, Seung-Bum Ryoo, Kyu Joo Park; Ann Coloproctol. 2014;30(1):35-41. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.35

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Abstract PDF

Purpose

A rectourethral fistula (RUF) is an uncommon complication resulting from surgery, radiation or trauma. Although various surgical procedures for the treatment of an RUF have been described, none has gained acceptance as the procedure of choice. The aim of this study was to review our experience with surgical management of RUF.

Methods

The outcomes of 6 male patients (mean age, 51 years) with an RUF who were operated on by a single surgeon between May 2005 and July 2012 were assessed.

Results

The causes of the RUF were iatrogenic in four cases (two after radiation therapy for rectal cancer, one after brachytherapy for prostate cancer, and one after surgery for a bladder stone) and traumatic in two cases. Fecal diversion was the initial treatment in five patients. In one patient, fecal diversion was performed simultaneously with definitive repair. Four patients underwent staged repair after a mean of 12 months. Rectal advancement flaps were done for simple, small fistula (n = 2), and flap interpositions (gracilis muscle flap, n = 2; omental flap, n = 1) were done for complex or recurrent fistulae. Urinary strictures and incontinence were observed in patients after gracilis muscle flap interposition, but they were resolved with simple treatments. The mean follow-up period was 28 months, and closure of the fistula was achieved in all five patients (100%) who underwent definitive repairs. The fistula persisted in one patient who refused further definitive surgery after receiving only a fecal diversion.

Conclusion

Depending on the severity and the recurrence status of RUF, a relatively simple rectal advancement flap repair or a more complex gracilis muscle or omental flap interposition can be used to achieve closure of the fistula.

Citations

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Outcomes of a Single-Port Laparoscopic Appendectomy Using a Glove Port With a Percutaneous Organ-Holding Device and Commercially-Available Multichannel Single-Port Device: Jieun Lee, Sung Ryol Lee, Hyung Ook Kim, Byung Ho Son, Wonjun Choi; Ann Coloproctol. 2014;30(1):42-46. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.42

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Abstract PDF

Purpose

A laparoscopic appendectomy is now commonly performed. The push in recent years toward reducing the number of ports required to perform this surgery has led to the development of a single-port laparoscopic appendectomy (SPA). We compared postoperative pain after an SPA using a glove port with a percutaneous organ-holding device (group 1) with that of an SPA using a commercially-available multichannel single-port device (group 2).

Methods

Between March 2010 and July 2011, a retrospective study was conducted of a total of 77 patients who underwent an SPA by three surgeons at department of surgery, Kangbuk Samsung Medical Center. Thirty-eight patients received an SPA using a glove port with a percutaneous organ-holding device. The other 39 patients received an SPA using a commercially-available multichannel single port (Octo-Port or SILS Port). Operative details and postoperative outcomes were collected and evaluated.

Results

There were no differences in the mean operative times, times to pass gas, postoperative hospital stays, or cosmetic satisfaction scores between the two groups. The pain score in the first 24 hours after surgery was higher in group 2 than group 1 patients (P < 0.001). Furthermore, the trocar used in group 2 was more expensive than that used in group 1.

Conclusion

An SPA using a glove port with a percutaneous organ-holding device was associated with a lower pain score during the first 24 hours after surgery because of the shorter fascia incision length and a cheaper cost than an SPA using a commercially-available multichannel single-port device.

Citations

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The use of expanding ports in laparo-endoscopic single-site surgery may cause more pain: a meta-analysis of randomized clinical trials
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Two-port laparoscopic anterior resection through a self-made glove device versus conventional laparoscopic anterior resection for rectal cancer: a comparison of short-term surgical results
Hong Zhang, Yunzhi Ling, Jinchun Cong, Mingming Cui, Dingsheng Liu, Chunsheng Chen
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Case Reports

Transanal Evisceration Caused by Rectal Laceration: Aleix Martínez Pérez, María Teresa Torres Sánchez, Jose Manuel Richart Aznar, Eva María Martí Martínez, Manuel Martínez-Abad; Ann Coloproctol. 2014;30(1):47-49. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.47

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Abstract PDF

Transrectal evisceration caused by colorectal injury is an unusual entity. This pathology is more frequent in elderly patients and it is usually produced spontaneously. Rectal prolapse is the principal predisposing factor. An 81-year-old woman was taken to the hospital presenting exit of intestinal loops through the anus. After first reanimation measures, an urgent surgery was indicated. We observed the absence of almost every small intestine loop in the abdominal cavity; these had been moved to the pelvis. After doing the reduction, a 3 to 4 cm linear craniocaudal perforation in upper rectum was objectified, and Hartmann's procedure was performed. We investigated and knew that she frequently manipulate herself to extract her faeces. The fast preoperative management avoided a fatal conclusion or an extensive intestinal resection. Reasons that make us consider rectal self-injury as the etiologic factor are explained.

Citations

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Transanal evisceration of small bowel in two patients with chronic rectal prolapse: case presentation and literature review
S Hajiev, A Ezzat, V Sivarajah, G Reese, N El-Masry
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Ana Alicia Tejera Hernández, David Fernández San Millan, Carlos David Trujillo Flores, Juan Ramón Hernández Hernández
Revista Española de Geriatría y Gerontología.2016; 51(1): 58. CrossRef
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Adama Sanou, Moussa Bazongo, Edgar Ouangré, Maurice Zida, Gilbert Patindé Bonkoungou, Rodrique Namékinsba Doamba, Sylvain Wendmi Karfo, Elie Yamba Sawadogo, Nayi Zongo, Si Simon Traoré
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Iatrogenic Rectal Diverticulum With Pelvic-Floor Dysfunction in Patients After a Procedure for a Prolapsed Hemorrhoid: Sun Kyung Na, Hye-Kyung Jung, Ki-Nam Shim, Sung-Ae Jung, Soon Sup Chung; Ann Coloproctol. 2014;30(1):50-53. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.50

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Abstract PDF

Diverticula are frequently seen in the sigmoid, descending, ascending and transverse colons whereas rectal diverticula are extremely rare. The stapled rectal mucosectomy for the treatment of a prolapsed hemorrhoid is less painful and has lower morbidity; therefore, it has been commonly used despite possible complications. This paper reports a case of a rectal diverticulum that developed after a procedure for prolapsed hemorrhoids (PPH). A 42-year-old man with a history of hemorrhoidectomies came to the hospital because of constipation. On sigmoidoscopy, a 2-cm-sized, feces-filled pocket was located just above the anorectal junction. After removal of the fecal material, a huge rectal diverticulum (-4 cm in diameter) was seen. Pelvic magnetic resonance imaging (MRI) confirmed the diagnosis of rectal diverticulum outpouching through the muscular layer of the intestine in a left posterolateral direction. The patient was discharged without complication after a transanal diverticulectomy had been performed, and the direct rectal wall had been repaired.

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Letter to the Editor

Commentary on "Characteristics and Survival of Korean Anal Cancer From the Korea Central Cancer Registry Data": Mohammad Mohammadianpanah; Ann Coloproctol. 2014;30(1):54-55. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.54

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