Annals of Coloproctology

Volume 38(1); February 2022

Editorial

Malignant disease,Postoperative outcome & ERAS,Functional outcome

Future direction of Enhanced Recovery After Surgery (ERAS) program in colorectal surgery: In Ja Park; Ann Coloproctol. 2022;38(1):1-2. Published online February 23, 2022; DOI: https://doi.org/10.3393/ac.2022.00094.0013

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Citations

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Multidisciplinary approach toward enhanced recovery after surgery for total knee arthroplasty improves outcomes
Deb Sanjay Nag, Amlan Swain, Seelora Sahu, Ayaskant Sahoo, Gunjan Wadhwa
World Journal of Clinical Cases.2024; 12(9): 1549. CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef

Review

Malignant disease, Rectal cancer,Colorectal cancer

Extended lymphadenectomy in locally advanced rectal cancers: a systematic review: Balaji Mahendran, Supriya Balasubramanya, Simone Sebastiani, Sebastian Smolarek; Ann Coloproctol. 2022;38(1):3-12. Published online November 17, 2021; DOI: https://doi.org/10.3393/ac.2021.00703.0100

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Abstract PDF

Purpose
The surgical treatment of advanced low rectal cancer remains controversial. Extended lymphadenectomy (EL) is the preferred option in the East, especially in Japan, while neoadjuvant radiotherapy is the treatment of choice in the West. This review was undertaken to review available evidence supporting each of the therapies.
Methods
All studies looking at EL were included in this review. A comprehensive search was conducted as per PRISMA guidelines. Primary outcome was defined as 5-year overall survival, with secondary outcomes including 3-year overall survival, 3- and 5-year disease-free survival, length of operation, and number of complications.
Results
Thirty-one studies met the inclusion criteria. There was no significant publication bias. There was statistically significant difference in 5-year survival for patient who underwent EL (odds ratio, 1.34; 95 confidence interval, 0.09–0.5; P=0.006). There were no differences noted in secondary outcomes except for length of the operations.
Conclusion
There is evidence supporting EL in rectal cancer; however, it is difficult to interpret and not easily transferable to a Western population. Further research is necessary on this important topic.

Citations

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Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus R0 resection for resectable colorectal cancer with peritoneal metastases and low peritoneal cancer index scores: a collaborative observational study from Korea and Japan
Daichi Kitaguchi, Eun Jung Park, Seung Hyuk Baik, Shoma Sasaki, Yuichiro Tsukada, Masaaki Ito
International Journal of Surgery.2024; 110(1): 45. CrossRef
Performance reporting design in artificial intelligence studies using image-based TNM staging and prognostic parameters in rectal cancer: a systematic review
Minsung Kim, Taeyong Park, Bo Young Oh, Min Jeong Kim, Bum-Joo Cho, Il Tae Son
Annals of Coloproctology.2024; 40(1): 13. CrossRef
Rectal Cancer: Are 12 Lymph Nodes the Limit?
Paweł Mroczkowski, Łukasz Dziki, Tereza Vosikova, Ronny Otto, Anna Merecz-Sadowska, Radosław Zajdel, Karolina Zajdel, Hans Lippert, Olof Jannasch
Cancers.2023; 15(13): 3447. CrossRef
Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef
Advances in the Treatment of Colorectal Cancer with Peritoneal Metastases: A Focus on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Youngbae Jeon, Eun Jung Park
The Ewha Medical Journal.2023;[Epub] CrossRef

Original Articles

Benign GI diease,Benign diesease & IBD

Long-term evolution of continence and quality of life after sphincteroplasty for obstetric fecal incontinence: Vicente Pla-Martí, Jose Martín-Arévalo, Rosa Martí-Fernández, David Moro-Valdezate, Stephanie García-Botello, Alejandro Espí-Macías, Miguel Mínguez-Pérez, Maria Dolores Ruiz-Carmona, Jose Vicente Roig-Vila; Ann Coloproctol. 2022;38(1):13-19. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.09.16

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Abstract PDF

Purpose
This study was performed to evaluate the long-term evolution of continence and patient’s quality of life after surgical treatment for obstetric fecal incontinence.
Methods
A prospective longitudinal study was conducted including consecutive patients who underwent sphincteroplasty for severe obstetric fecal incontinence. The first phase analyzed changes in continence and impact on quality of life. The second phase studied the long-term evolution reevaluating the same group of patients 6 years later. Degree of fecal incontinence was calculated using the Cleveland Clinic Score (CCS). Quality of life assessment was carried out with the Fecal Incontinence Quality of Life scale.
Results
Thirty-five patients with median age of 55 years (range, 28 to 73 years) completed the study. Phase 1 results: after a postoperative follow-up of 30 months (4 to 132 months), CCS had improved significantly from a preoperative of 15.7 ± 3.1 to 6.1 ± 5.0 (P < 0.001). Phase 2 results: median follow-up in phase 2 was 110 months (76 to 204 months). The CCS lowered to 8.4 ± 4.9 (P = 0.04). There were no significant differences between phases 1 and 2 in terms of quality of life; lifestyle (3.47 ± 0.75 vs. 3.16 ±1.04), coping/behavior (3.13 ±0.83 vs. 2.80 ±1.09), depression/self-perception (3.65 ±0.80 vs. 3.32 ± 0.98), and embarrassment (3.32 ± 0.90 vs. 3.12 ± 1.00).
Conclusion
Sphincteroplasty offers good short-medium term outcomes in continence and quality of life for obstetric fecal incontinence treatment. Functional clinical results deteriorate over time but did not impact on patients’ quality of life.

Citations

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Baiona’s Consensus Statement for Fecal Incontinence. Spanish Association of Coloproctology
Javier Cerdán Miguel, Antonio Arroyo Sebastián, Antonio Codina Cazador, Fernando de la Portilla de Juan, Mario de Miguel Velasco, Alberto de San Ildefonso Pereira, Fernando Jiménez Escovar, Franco Marinello, Mónica Millán Scheiding, Arantxa Muñoz Duyos, M
Cirugía Española (English Edition).2024; 102(3): 158. CrossRef
Diagnostic tools for fecal incontinence: Scoring systems are the crucial first step
Peter Liptak, Martin Duricek, Peter Banovcin
World Journal of Gastroenterology.2024; 30(6): 516. CrossRef
Consenso Baiona sobre Incontinencia Fecal: Asociación Española de Coloproctología
Javier Cerdán Miguel, Antonio Arroyo Sebastián, Antonio Codina Cazador, Fernando de la Portilla de Juan, Mario de Miguel Velasco, Alberto de San Ildefonso Pereira, Fernando Jiménez Escovar, Franco Marinello, Mónica Millán Scheiding, Arantxa Muñoz Duyos, M
Cirugía Española.2024; 102(3): 158. CrossRef
How to Avoid Becoming a Risk Factor of Fecal Incontinence Due to OASIS—A Narrative Review
Nikodem Horst
Journal of Clinical Medicine.2024; 13(17): 5071. CrossRef
The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Fecal Incontinence
Liliana G. Bordeianou, Amy J. Thorsen, Deborah S. Keller, Alexander T. Hawkins, Craig Messick, Lucia Oliveira, Daniel L. Feingold, Amy L. Lightner, Ian M. Paquette
Diseases of the Colon & Rectum.2023; 66(5): 647. CrossRef
Validation of the Turkish version of the Quality of Life in Patients with Anal Fistula Questionnaire
Mehmet Ali Koç, Kerem Özgü, Derya Gökmen, Mehmet Süha Sevinç, Şiyar Ersöz, Cihangir Akyol
Turkish Journal of Colorectal Disease.2023; 33(4): 124. CrossRef
A systematic review of translation and experimental studies on internal anal sphincter for fecal incontinence
Minsung Kim, Bo-Young Oh, Ji-Seon Lee, Dogeon Yoon, Wook Chun, Il Tae Son
Annals of Coloproctology.2022; 38(3): 183. CrossRef
Is It a Refractory Disease?- Fecal Incontinence; beyond Medication
Chungyeop Lee, Jong Lyul Lee
The Ewha Medical Journal.2022;[Epub] CrossRef

Malignant disease, Rectal cancer,Colorectal cancer,Surgical technique

The “reverse air leak test”: a new technique for the assessment of low colorectal anastomosis: Francesco Crafa, Augusto Striano, Francesco Esposito, Amalia Rosaria Rita Rossetti, Mario Baiamonte, Valeria Gianfreda, Antonio Longo; Ann Coloproctol. 2022;38(1):20-27. Published online December 4, 2020; DOI: https://doi.org/10.3393/ac.2020.09.21.1

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Abstract PDF

Purpose
Anastomotic leakage is a fearsome complication in rectal surgery. Surgeons perform the classic air leak test, although its real effectiveness is still debated. The aim of this study was to describe a personal technique of reverse air leak test in which low colorectal anastomosis was assessed transanally through the intrarectal irrigation of a few mL of saline solution.
Methods
From October 2014 to November 2019, 11 patients with low rectal cancer (type 1 in Roullier classification) were included in this study. At the beginning of the procedure, a circular anal dilator was inserted into the anus. A side-to-end colorectal anastomosis was performed. A few mL of saline solution were injected into the rectum and the entire anastomotic line was directly explored. The appearance of bubbles was considered as an anastomotic defect and repaired with an interrupted suture. A fluorescence angiography after intravenous injection of indocyanine green was performed in order to evaluate the perfusion of the anastomosis.
Results
The reverse air leak test was positive in 4 cases (36.4%). The defect was repaired and a confirmation test was performed. In all patients, near-infrared evaluation showed no perfusion defect (grade 0) in low colorectal anastomosis. No postoperative fistula was detected in cohort study. A protective stoma was performed in 10 patients. On day 90, there were no complications and stoma closure was performed as planned.
Conclusion
The reverse air leak test is a simple, feasible, and effective procedure to identify anastomotic leaks in low colorectal anastomoses.

Citations

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Solo surgery for low rectal cancer: trans‐circular anal dilator low rectal dissection associated with laparoscopic total mesorectal excision—A Video Vignette
Crafa Francesco, Vanella Serafino, Emanuele Caruso, Madoka Hamada, Nozomi Ueno
Colorectal Disease.2024; 26(4): 805. CrossRef
Colorectal eversion technique combined with modified single‐stapled double‐purse‐string low colorectal anastomosis
Crafa Francesco, Vanella Serafino
Colorectal Disease.2024; 26(4): 772. CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Treatment of anastomotic leak in colorectal surgery by endoluminal vacuum therapy with the VACStent avoiding a stoma - a pilot study
Markus M. Heiss, Jonas Lange, Judith Knievel, Alexander Yohannes, Ulrich Hügle, Arno J. Dormann, Claus F. Eisenberger
Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
Risk stratification of anastomotic leakages after colonic resection and reconstructive procedures
A. A. Vaganov, A. Yu. Korol’kov, P. I. Bogdanov, Z. Kh. Osmanov, V. P. Morozov, A. V. Babich
Grekov's Bulletin of Surgery.2023; 181(6): 98. CrossRef
Colorectal eversion technique combined with modified DST (CET‐M‐DST) for low colorectal anastomosis after laparoscopic TME for colorectal cancer – Video correspondence
Crafa Francesco, Vanella Serafino, Baiamonte Mario, Longo Antonio
Colorectal Disease.2023; 25(12): 2473. CrossRef
Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
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Laparoscopic PME with colorectal anstomosis with transanal control – A video vignette
Francesco Crafa, Serafino Vanella, Adele Noviello, Giuseppe Longo, Francesco Longo
Colorectal Disease.2022; 24(7): 887. CrossRef
Laparoscopic TME and hepatic resection after total neoadjuvant chemotherapy plus short course radiotherapy for low rectal cancer with single synchronous liver metastases – A video vignette
Francesco Crafa, Serafino Vanella
Colorectal Disease.2022; 24(10): 1264. CrossRef
Initial experience with intraoperative testing and repair of colorectal anastomosis using a TAMIS approach after a positive leak test
J. Valdes-Hernandez, J. Cintas-Catena, F. J. Del Rio-Lafuente, A. Cano-Matias, C. Torres-Arcos, A. Perez-Sanchez, L. Capitan-Morales, F. Oliva-Mompean, J. C. Gomez-Rosado
Techniques in Coloproctology.2022; 26(11): 901. CrossRef
Minimally invasive colorectal surgery learning curve
Serafino Vanella, Enrico Coppola Bottazzi, Giancarlo Farese, Rosa Murano, Adele Noviello, Tommaso Palma, Maria Godas, Francesco Crafa
World Journal of Gastrointestinal Endoscopy.2022; 14(11): 731. CrossRef

Malignant disease, Rectal cancer,Colorectal cancer,Functional outcome,Surgical technique

Oncological and functional outcomes of transanal total mesorectal excision in a teaching hospital in the Netherlands: Joost A.G. van der Heijden, Kelly G.H. van de Pas, Frank J.C. van den Broek, Francois M.H. van Dielen, Gerrit D. Slooter, Adriana J.G. Maaskant-Braat; Ann Coloproctol. 2022;38(1):28-35. Published online June 29, 2021; DOI: https://doi.org/10.3393/ac.2020.00773.0110

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Abstract PDF

Purpose
Transanal total mesorectal excision (TaTME) was developed to overcome surgical difficulties experienced in distal pelvic dissection. Concerns have been raised about potential worse postoperative functional outcomes after TaTME. Also, the oncological safety was questioned. This study aimed to describe the functional, surgical, oncological outcomes and quality of life (QoL) after TaTME.
Methods
All consecutive TaTME cases for rectal cancer without disseminated disease between December 2016 and April 2019 were included. The Wexner incontinence score, low anterior resection syndrome (LARS) score, fecal incontinence-related QoL, and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-core questionnaire and 29-item module (EORTC QLQ-C30/CR29) were collected. Kaplan-Meier analysis was used to calculate local recurrence-free survival.
Results
Thirty patients were eligible for analysis of which 23 received questionnaires. Response rate was 74%. After a median follow-up of respectively 20.0 and 23.0 months for functional and oncological outcomes, the median (interquartile range) of Wexner incontinence and LARS scores were 9.0 (7.0–12.0) and 33.1 (25.0–39.0). Major LARS was present in 73.3%. Fecal incontinence, general and colorectal-specific QoL subdomains that are associated with poor bowel function scored in line with previously reported data. The 2-year actuarial cumulative local recurrence rate was 3.7% (95% confidence interval, 2.4%–5.0%).
Conclusion
TaTME may lead to significant functional impairments. Patients should receive preoperative counseling on this topic and be fully aware of the potential consequences of their treatment. Oncological data were in line with other short- to moderate-term data and did not show alarming results.

Citations

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Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
Annals of Surgical Treatment and Research.2023; 105(6): 341. CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han
The Ewha Medical Journal.2023;[Epub] CrossRef
Quality of life and functional outcomes after transanal total mesorectal excision for rectal cancer—results from the implementation period in Denmark
M. X. Bjoern, F. B. Clausen, M. Seiersen, O. Bulut, F. Bech-Knudsen, J. E. Jansen, I. Gögenur, M. F. Klein
International Journal of Colorectal Disease.2022; 37(9): 1997. CrossRef
Analgesic effect of structured anal skin care for perianal dermatitis after low anterior resection in the rectal cancer patients: prospective, single-center, open-label, therapeutic confirmatory, randomized clinical trial
Gyung Mo Son, In Young Lee, Mi Sook Yun, Jung-Hea Youn, Hong Min An, Kyung Hee Kim, Seung Mi Yeo, Bokyung Ku, Myeong Suk Kwon, Kun Hyung Kim
Annals of Surgical Treatment and Research.2022; 103(6): 360. CrossRef
Surgical Treatment of Low-Lying Rectal Cancer: Updates
Cristopher Varela, Nam Kyu Kim
Annals of Coloproctology.2021; 37(6): 395. CrossRef
Functional outcomes after sphincter-preserving surgeries for low-lying rectal cancer: A review
Eun Jung Park, Seung Hyuk Baik
Precision and Future Medicine.2021; 5(4): 164. CrossRef

Malignant disease,Prognosis and adjuvant therapy,Functional outcomes,Postoperative outcome & ERAS

The impact of variations in care and complications within a colorectal Enhanced Recovery After Surgery program on length of stay: James Wei Tatt Toh, Jack Cecire, Kerry Hitos, Karen Shedden, Fiona Gavegan, Nimalan Pathmanathan, Toufic El Khoury, Angelina Di Re, Annelise Cocco, Alex Limmer, Tom Liang, Kar Yin Fok, James Rogers, Edgardo Solis, Grahame Ctercteko; Ann Coloproctol. 2022;38(1):36-46. Published online May 6, 2021; DOI: https://doi.org/10.3393/ac.2020.11.23

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Abstract PDF Supplementary Material

Purpose
Enhanced Recovery After Surgery (ERAS) has become standard of care in colorectal surgery. However, there is not a universally accepted colorectal ERAS protocol and significant variations in care exist between institutions. The aim of this study was to examine the impact of variations in ERAS interventions and complications on length of stay (LOS).
Methods
This study was a single-center review of the first 200 consecutive patients recruited into our prospectively collected ERAS database. The primary outcome of this study was to examine the rate of compliance to ERAS interventions and the impact of these interventions on LOS. The secondary outcome was to assess the impact of complications (anastomotic leak, ileus, and surgical site infections) on LOS. ERAS interventions, rate of adherence, LOS, readmissions, morbidity, and mortality were recorded, and statistical analysis was performed.
Results
ERAS variations and complications significantly influenced patient LOS on both univariate and multivariate analysis. ERAS interventions identified as the most important strategies in reducing LOS included laparoscopic surgery, mobilization twice daily postoperative day (POD) 0 to 1, discontinuation of intravenous fluids on POD 0 to 1, upgrading to solid diet by POD 0 to 2, removal of indwelling catheter by POD 0 to 2, avoiding nasogastric tube reinsertion and removing drains early. Both major and minor complications increased LOS. Anastomotic leak and ileus were associated with the greatest increase in LOS.
Conclusion
Seven high-yield ERAS interventions reduced LOS. Major and minor complications increased LOS. Reducing variations in care and complications can improve outcomes following colorectal surgery.

Citations

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Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
So many measures in ERAS protocol: Which matters most?
Nan Xie, Hua Xie, Wei Li, Zhongxian Zhu, Xu Wang, Weibing Tang
Nutrition.2024; 122: 112384. CrossRef
Results of selective decontamination with oral neomycin and metronidazole for major colorectal surgery in Australia: A cohort study
James Wei Tatt Toh, Devansh Shah, Henry Wang, Charlotte Kwik, Joseph Do Woong Choi, Chelsie Leonie Beinke, Paul Morris, Eleni Baird-Gunning, Geoffrey Peter Collins, Fiona Gavegan, Karen Shedden, Toufic El-Khoury, Nimalan Pathma-Nathan, Kerry Hitos
Laparoscopic, Endoscopic and Robotic Surgery.2024; 7(2): 72. CrossRef
Influence of additional prophylactic oral antibiotics during mechanical bowel preparation on surgical site infection in patients receiving colorectal surgery
Hayoung Lee, Jong Lyul Lee, Ji Sung Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok‐Byung Lim
World Journal of Surgery.2024; 48(6): 1534. CrossRef
Outcomes before and after Implementation of the ERAS (Enhanced Recovery after Surgery) Protocol in Open and Laparoscopic Colorectal Surgery: A Comparative Real-World Study from Northern Italy
Lucia Mangone, Federica Mereu, Maurizio Zizzo, Andrea Morini, Magda Zanelli, Francesco Marinelli, Isabella Bisceglia, Maria Barbara Braghiroli, Fortunato Morabito, Antonino Neri, Massimiliano Fabozzi
Current Oncology.2024; 31(6): 2907. CrossRef
Implementation of an Enhanced Recovery after Surgery Protocol in Advanced and Recurrent Rectal Cancer Patients after beyond Total Mesorectal Excision Surgery: A Feasibility Study
Stefi Nordkamp, Davy M. J. Creemers, Sofie Glazemakers, Stijn H. J. Ketelaers, Harm J. Scholten, Silvie van de Calseijde, Grard A. P. Nieuwenhuijzen, Jip L. Tolenaar, Hendi W. Crezee, Harm J. T. Rutten, Jacobus W. A. Burger, Johanne G. Bloemen
Cancers.2023; 15(18): 4523. CrossRef
Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef
Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer
In Ja Park
The Ewha Medical Journal.2023;[Epub] CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Future direction of Enhanced Recovery After Surgery (ERAS) program in colorectal surgery
In Ja Park
Annals of Coloproctology.2022; 38(1): 1. CrossRef

Malignant disease,Prognosis and adjuvant therapy,Functional outcomes,Colorectal cancer,Postoperative outcome & ERAS

Clinical validation of implementing Enhanced Recovery After Surgery protocol in elderly colorectal cancer patients: Wooree Koh, Chul Seung Lee, Jung Hoon Bae, Abdullah Al-Sawat, In Kyu Lee, Hyeong Yong Jin; Ann Coloproctol. 2022;38(1):47-52. Published online July 21, 2021; DOI: https://doi.org/10.3393/ac.2021.00283.0040

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Abstract PDF Supplementary Material

Purpose
The aim of this study was to evaluate the safety and feasibility of applying enhanced recovery after surgery (ERAS) protocol in elderly colorectal cancer patients.
Methods
The medical records of patients who underwent elective colorectal cancer surgery at our institution, from January 2017 to December 2017, were reviewed. Patients were divided into 2 groups: the young group (YG, patients aged 70 and under 70 years) and the old group (OG, patients over 70 years old). Perioperative outcomes and length of hospital stay were compared between both groups.
Results
In total, 335 patients were enrolled; 237 were YG and 98 were OG. Despite the poorer baseline characteristics of OG, the perioperative outcomes were similar. Length of hospital stay was not different between the groups (YG, 5 days vs. OG, 5 days; P=0.320). When comparing the postoperative complications using the comprehensive complication index (CCI), there was no significant difference (YG, 8.0±13.2 vs. OG, 11.7±23.0; P=0.130). In regression analysis, old age (>70 years) was not a risk factor for high CCI in all patients. In multivariate analysis, C-reactive protein (CRP) level on postoperative day (POD) 3 to 4 was the only strong predictive factor for high CCI in elderly patients.
Conclusion
Implementing the ERAS protocol in patients aged >70 years is safe and feasible. High CRP (≥6.47 mg/dL) on POD 3 to 4 can be used as a safety index to postpone discharge in elderly patients.

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Perioperative outcomes of laparoscopic low anterior resection using ArtiSential® versus robotic approach in patients with rectal cancer: a propensity score matching analysis
I. K. Kim, C. S. Lee, J. H. Bae, S. R. Han, W. Alshalawi, B. C. Kim, I. K. Lee, D. S. Lee, Y. S. Lee
Techniques in Coloproctology.2024;[Epub] CrossRef
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He Han, Rong Wan, Jixiang Chen, Xin Fan, LiWen Zhang
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The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
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The Ewha Medical Journal.2023;[Epub] CrossRef
Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer
In Ja Park
The Ewha Medical Journal.2023;[Epub] CrossRef
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In Ja Park
Annals of Coloproctology.2022; 38(1): 1. CrossRef
Implementation and improvement of Enhanced Recovery After Surgery protocols for colorectal cancer surgery
Bo Yoon Choi, Jung Hoon Bae, Chul Seung Lee, Seung Rim Han, Yoon Suk Lee, In Kyu Lee
Annals of Surgical Treatment and Research.2022; 102(4): 223. CrossRef

Benign proctology,Postoperative outcome & ERAS,Complication

Predictors of postoperative urinary retention after semiclosed hemorrhoidectomy: Hong Yoon Jeong, Seok Gyu Song, Jong Kyun Lee; Ann Coloproctol. 2022;38(1):53-59. Published online July 21, 2021; DOI: https://doi.org/10.3393/ac.2021.00304.0043

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Abstract PDF

Purpose
This study was performed to analyze the predictors that might contribute to urinary retention following semiclosed hemorrhoidectomy under spinal anesthesia.
Methods
This retrospective study enrolled 2,176 consecutive patients with symptomatic grade III to IV hemorrhoids who underwent semiclosed hemorrhoidectomy between September 2018 and September 2019.
Results
Among the 2,176 patients, 1,878 (86.3%) had no postoperative urinary retention, whereas 298 (13.7%) developed urinary retention after hemorrhoidectomy. The percentage of males was significantly higher in the retention group than in the non-retention group (60.4% vs. 48.1%; P=0.001). The risk of urinary retention was 1.52-fold higher in males than in females (95% confidence interval [CI], 1.13–2.04; P=0.005), 1.62-fold higher in old age (95% CI, 1.14–2.28; P=0.006), and 1.37-fold higher with high body mass index (BMI) (95% CI, 1.04–1.81; P=0.025). Patients with ≥4 resected hemorrhoids had a higher odds ratio (OR) of 1.46 (95% CI, 1.12–1.89; P=0.005) than patients with <4 resected hemorrhoids. Among the supplementary medication, patients who used analgesics had a higher OR of 2.06 (95% CI, 1.57–2.68; P=0.001) than those who did not.
Conclusion
Male sex, age, high BMI, number of resected hemorrhoids, and supplementary analgesics are independent risk factors for urinary retention after semiclosed hemorrhoidectomy.

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Comparison of the effect of hot and cold compresses on post‐operative urinary retention in older patients: A clinical trial study
Tayebeh Mirzaei, Farkhondeh Roudbari, Ali Ravari, Sakineh Mirzaei, Elham Hassanshahi
International Journal of Urological Nursing.2024;[Epub] CrossRef
General anesthesia with local infiltration reduces urine retention rate and prolongs analgesic effect than spinal anesthesia for hemorrhoidectomy
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Gastroenterology & Endoscopy.2024; 2(4): 176. CrossRef
Ten-year multicentric retrospective analysis regarding postoperative complications and impact of comorbidities in hemorrhoidal surgery with literature review
Cosmin Moldovan, Elena Rusu, Daniel Cochior, Madalina Elena Toba, Horia Mocanu, Razvan Adam, Mirela Rimbu, Adrian Ghenea, Florin Savulescu, Daniela Godoroja, Florin Botea
World Journal of Clinical Cases.2023; 11(2): 366. CrossRef
Effect of single spinal anesthesia with two doses ropivacaine on urinary retention after hemorrhoidectomy in male patients
Lei-lei Wang, Meng Kang, Li-xin Duan, Xu-fei Chang, Xiao-xin Li, Xiang-yang Guo, Zhi-yu Kang, Yong-zheng Han
Frontiers in Surgery.2023;[Epub] CrossRef
Efficacy of Low-Frequency Electroacupuncture on Urinary Retention After Spinal Anesthesia
Mina Olia, Aliakbar Jafarian, Masood Mohseni
Journal of PeriAnesthesia Nursing.2023; 38(5): 745. CrossRef
Laser hemorrhoidoplasty combined with blind hemorrhoidal artery ligation compared to Milligan–Morgan hemorrhoidectomy in patients with second and third degree piles; a prospective randomized study
Amir F. Abdelhamid, Mohamed M. Elsheikh, Osama H. Abdraboh
The Egyptian Journal of Surgery.2023; 42(3): 669. CrossRef
Tarlov cyst with self-healing cauda equina syndrome following combined spinal-epidural anesthesia: a case report
Zhexuan Chen, Chuxi Lin
BMC Anesthesiology.2023;[Epub] CrossRef

Malignant disease,Colorectal cancer

Proteomic identification of arginine-methylated proteins in colon cancer cells and comparison of messenger RNA expression between colorectal cancer and adjacent normal tissues: Yongchul Lim, Da Young Gang, Woo Yong Lee, Seong Hyeon Yun, Yong Beom Cho, Jung Wook Huh, Yoon Ah Park, Hee Cheol Kim; Ann Coloproctol. 2022;38(1):60-68. Published online January 27, 2022; DOI: https://doi.org/10.3393/ac.2020.00899.0128

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Abstract PDF Supplementary Material

Purpose
Identification of type I protein arginine methyltransferase (PRMT) substrates and their functional significance during tumorigenesis is becoming more important. The present study aimed to identify target substrates for type I PRMT using 2-dimensional (2D) gel electrophoresis (GE) and 2D Western blotting (WB).
Methods
Using immunoblot analysis, we compared the expression of type I PRMTs and endogenous levels of arginine methylation between the primary colorectal cancer (CRC) and adjacent noncancerous tissues paired from the same patient. To identify arginine-methylated proteins in HCT116 cells, we carried out 2D-GE and 2D-WB with a type I PRMT product-specific antibody (anti-dimethyl-arginine antibody, asymmetric [ASYM24]). Arginine-methylated protein spots were identified by mass spectrometry, and messenger RNA (mRNA) levels corresponding to the identified proteins were analyzed using National Center for Biotechnology Information (NCBI) microarray datasets between the primary CRC and noncancerous tissues.
Results
Type I PRMTs and methylarginine-containing proteins were highly maintained in CRC tissues compared to noncancerous tissues. We matched 142 spots using spot analysis software between a Coomassie blue (CBB)-stained 2D gel and 2D-WB, and we successfully identified 7 proteins that reacted with the ASYM24 antibody: CACYBP, GLOD4, MAPRE1, CCT7, TKT, CK8, and HSPA8. Among these proteins, the levels of 4 mRNAs including MAPRE1, CCT7, TKT, and HSPA8 in CRC tissues showed a statistically significant increase compared to noncancerous tissues from patients using the NCBI microarray datasets.
Conclusion
Our results indicate that the method shown here is useful in identifying arginine-methylated proteins, and significance of arginine modification in the proteins identified here should be further identified during CRC development.

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Multi-omics data-based analysis characterizes molecular alterations of the vesicle genes in human colorectal cancer
Xi Wang
American Journal of Cancer Research.2024; 14(3): 1402. CrossRef
Expression of GLOD4 in the Testis of the Qianbei Ma Goat and Its Effect on Leydig Cells
Jinqian Wang, Xiang Chen, Wei Sun, Wen Tang, Jiajing Chen, Yuan Zhang, Ruiyang Li, Yanfei Wang
Animals.2024; 14(17): 2611. CrossRef
Sperm protein antigen 17 and Sperm flagellar 1 cancer testis antigens are expressed in a rare case of ciliated foregut cyst of the common hepatic duct
Fabio Grizzi, Maurizio Chiriva-Internati, Elena Miranda, Roxana Zaharie, Nadim Al Hajjar, Florin Zaharie, Cristina Díaz Del Arco, M.Jesús Fernández-Aceñero, Robert S. Bresalier, Emil Moiş
Pathology - Research and Practice.2023; 247: 154546. CrossRef
Inflammatory Response Markers as Predictors of Colorectal Cancer Prognosis
Minsung Kim, Il Tae Son, Bo Young Oh
The Ewha Medical Journal.2023;[Epub] CrossRef

Benign GI diease,Surgical technique

Foley balloons’ tamponade is an effective method for controlling massive pelvic bleeding during colorectal surgery: Tzu-Chi Hsu; Ann Coloproctol. 2022;38(1):69-71. Published online January 24, 2022; DOI: https://doi.org/10.3393/ac.2020.00682.0097

4,790 View
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1 Citations

Abstract PDF

Purpose
Hemostasis can be achieved by various methods, but it can be difficult to stop active bleeding in the pelvis. An effective method is described to stop massive active bleeding in the pelvis during colorectal surgery.
Methods
When there were massive bleedings in the pelvis, 3 to 5 Foley catheters were inserted through stab wounds on the abdomen. The tips of catheters were placed in the pelvis. Each balloon was inflated with 40 mL of sterile water. The water inside each balloon was removed gradually from the third postoperative day. If there is no further bleeding, all catheters were removed on the 7th postoperative day.
Results
There were 8 patients (4 males and 4 females) with massive pelvic bleeding encountered from January 1998 to December 2018. Four patients underwent low anterior resection for primary rectal cancer, 2 patients for colon cancer with pelvic recurrence, 1 patient for ovary cancer with pelvic recurrence, and 1 patient for presacral parachordoma with a bleeding tendency. All of the patients survived without further bleeding after surgery.
Conclusion
The technique is a simple method to control massive pelvic bleeding during colorectal surgery. It is also inexpensive and effective even in patients with a bleeding tendency.

Citations

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Principles of minimize bleeding and the transfusion of blood and its components in operated patients – surgical aspects
Tomasz Banasiewicz, Waldemar Machała, Maciej Borejsza Wysocki, Maciej Lesiak, Sebastian Krych, Małgorzata Lange, Piotr Hogendorf, Adam Durczyński, Jarosław Cwaliński, Tomasz Bartkowiak, Adam Dziki, Wojciech Kielan, Stanisław Kłęk, Łukasz Krokowicz, Krzysz
Polish Journal of Surgery.2023; 95(5): 14. CrossRef

Malignant disease,Colorectal cancer,Benign diesease & IBD,Biomarker & risk factor

Molecular characterization of dysplasia-initiated colorectal cancer with assessing matched tumor and dysplasia samples: Sungwon Jung, Jong Lyul Lee, Tae Won Kim, Jongmin Lee, Yong Sik Yoon, Kil Yeon Lee, Ki-hwan Song, Chang Sik Yu, Yong Beom Cho; Ann Coloproctol. 2022;38(1):72-81. Published online November 17, 2021; DOI: https://doi.org/10.3393/ac.2021.00290.0041

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2 Citations

Abstract PDF

Purpose
Ulcerative colitis (UC) is known to have an association with the increased risk of colorectal cancer (CRC), and UC-associated CRC does not follow the typical progress pattern of adenoma-carcinoma. The aim of this study is to investigate molecular characteristics of UC-associated CRC and further our understanding of the association between UC and CRC.
Methods
From 5 patients with UC-associated CRC, matched normal, dysplasia, and tumor specimens were obtained from formalin-fixed paraffin-embedded (FFPE) samples for analysis. Genomic DNA was extracted and whole exome sequencing was conducted to identify somatic variations in dysplasia and tumor samples. Statistical analysis was performed to identify somatic variations with significantly higher frequencies in dysplasia-initiated tumors, and their relevant functions were investigated.
Results
Total of 104 tumor mutation genes were identified with higher mutation frequencies in dysplasia-initiated tumors. Four of the 5 dysplasia-initiated tumors (80.0%) have TP53 mutations with frequent stop-gain mutations that were originated from matched dysplasia. APC and KRAS are known to be frequently mutated in general CRC, while none of the 5 patients have APC or KRAS mutation in their dysplasia and tumor samples. Glycoproteins including mucins were also frequently mutated in dysplasia-initiated tumors.
Conclusion
UC-associated CRC tumors have distinct mutational characteristics compared to typical adenoma-carcinoma tumors and may have different cancer-driving molecular mechanisms that are initiated from earlier dysplasia status.

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Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus R0 resection for resectable colorectal cancer with peritoneal metastases and low peritoneal cancer index scores: a collaborative observational study from Korea and Japan
Daichi Kitaguchi, Eun Jung Park, Seung Hyuk Baik, Shoma Sasaki, Yuichiro Tsukada, Masaaki Ito
International Journal of Surgery.2024; 110(1): 45. CrossRef
Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef

Case Report

Malignant disease,Rare disease & stoma

Outcomes of surgical management of buschke-lowenstein tumor in a Philippine tertiary hospital: Sofia Isabel T. Manlubatan, Mark Augustine S. Onglao, Mayou Martin T. Tampo, Marc Paul J. Lopez; Ann Coloproctol. 2022;38(1):82-87. Published online February 23, 2022; DOI: https://doi.org/10.3393/ac.2020.00731.0104

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1 Citations

Abstract PDF

Buschke-Lowenstein tumor (BLT) is a sexually transmitted infection (STI) caused by the human papillomavirus. This study investigated the profile, management, and outcomes of patients who underwent surgery for BLT from 2015 to 2019 at the Philippine General Hospital. Seven patients underwent surgery for BLT. All were male, with ages ranging from 21 to 41 years. Presenting symptoms were anal mass, foul-smelling discharge, pain, bleeding, and pruritus. All were positive for human immunodeficiency virus. All admitted to having engaged in both insertive and receptive anal intercourse, with multiple partners. All underwent excision with healing by secondary intention. Two had recurrence of warts. Four had an anal stricture. Of these, 3 underwent anal dilatation, while 1 had to undergo proximal bowel diversion. One had intraepithelial carcinoma without dermal invasion on histopathologic analysis. BLT is a rare STI characterized by local aggressiveness but with low malignant potential. Wide excision remains to be the mainstay of treatment.

Citations

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Sex Steroid Modulators and the Development of Buschke-Lowenstein Tumor: A Case Report of an Immunocompetent Patient
Paige Stratton , Vithal Vernenkar, Aeryn J Fulton, Varun Soti
Cureus.2023;[Epub] CrossRef

Technical Note

Malignant disease, Rectal cancer,Minimally invasive surgery

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

3,202 View
126 Download
5 Web of Science
5 Citations

Abstract PDF

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

Citations

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Single-incision laparoscopic total extraperitoneal inguinal-hernia repair using the new articulating instruments: A video vignette
Chul Seung Lee, Gwan Chul Lee, Choon Sik Chung, Dong Keun Lee
Asian Journal of Surgery.2024; 47(8): 3586. CrossRef
Single-incision robotic colorectal surgery with the da Vinci SP® surgical system: initial results of 50 cases
H. S. Kim, B.-Y. Oh, C. Cheong, M. H. Park, S. S. Chung, R.-A. Lee, K. H. Kim, G. T. Noh
Techniques in Coloproctology.2023; 27(7): 589. CrossRef
Short-term outcomes of single-incision robotic colectomy versus conventional multiport laparoscopic colectomy for colon cancer
Ho Seung Kim, Bo-Young Oh, Soon Sup Chung, Ryung-Ah Lee, Gyoung Tae Noh
Journal of Robotic Surgery.2023; 17(5): 2351. CrossRef
Short-term outcomes of da Vinci SP versus Xi for colon cancer surgery: a propensity-score matching analysis of multicenter cohorts
Jin-Min Jung, Young Il Kim, Yong Sik Yoon, Songsoo Yang, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Journal of Robotic Surgery.2023; 17(6): 2911. CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef

Letter to the Editor

Benign proctology

Comments on: factors predicting the presence of concomitant enterocele and rectocele in female patients with external rectal prolapse: Ingrid Melo-Amaral, Adrian Teran-Cardoza, Cristopher Varela; Ann Coloproctol. 2022;38(1):93-94. Published online November 29, 2021; DOI: https://doi.org/10.3393/ac.2021.00892.0127

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