Annals of Coloproctology

Volume 38(2); April 2022

Editorial

Malignant disease, Rectal cancer,Prognosis

The risk-benefit trade-off in local excision of early rectal cancer: Chang Hyun Kim; Ann Coloproctol. 2022;38(2):95-96. Published online April 14, 2022; DOI: https://doi.org/10.3393/ac.2022.00171.0024

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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
Organ preservation for early rectal cancer using preoperative chemoradiotherapy
Gyung Mo Son
Annals of Coloproctology.2023; 39(3): 191. CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] 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

Review

Malignant disease, Rectal cancer,Colorectal cancer,Prognosis,Biomarker & risk factor

Pretreatment inflammatory markers predicting treatment outcomes in colorectal cancer: Sanghyun An, Hongjin Shim, Kwangmin Kim, Bora Kim, Hui-Jae Bang, Hyejin Do, Hyang-Rae Lee, Youngwan Kim; Ann Coloproctol. 2022;38(2):97-108. Published online March 29, 2022; DOI: https://doi.org/10.3393/ac.2021.01004.0143

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Abstract PDF

We aimed to review whether pretreatment inflammatory markers reflect the short- and long-term outcomes of patients with colon cancer, rectal cancer, colon and rectal cancers, and metastatic colorectal cancer (CRC). We found that pretreatment complete blood count and blood chemistry tests reflect short-term and long-term oncological outcomes in patients with CRC. Specifically, in patients with colon cancer, hypoalbuminemia was associated with worse postoperative morbidity, mortality, and inferior survival. In patients with rectal cancer, elevated neutrophil-lymphocyte ratio (NLR) and thrombocytosis were associated with postoperative complications, poor overall survival (OS), and disease-free survival (DFS). A high C-reactive protein/albumin ratio (CAR) was associated with poor OS and DFS. In patients with metastatic CRC, increased NLR and platelet-lymphocyte ratio (PLR) were associated with poor OS, DFS, and progression-free survival (PFS). In addition, high CAR and a low albumin/globulin ratio on blood chemistry tests were associated with poor OS and PFS. Although universal cut-off values were not available, various types of pretreatment laboratory markers could be utilized as adjuncts to predict prognosis in patients with CRC.

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THE ROLE OF SERUM MIDKINE IN THE DIAGNOSIS AND PROGNOSIS OF THE COLORECTAL CARCINOMA
Ali H. Abd-Allah, Haider A. Jabbar, Mazen J. Ibrahim
Military Medical Science Letters.2024; 93(3): 274. CrossRef
Comparison of the efficacy and safety of single-port versus multi-port robotic total mesorectal excision for rectal cancer: A propensity score-matched analysis
Hye Jin Kim, Gyu-Seog Choi, Jun Seok Park, Soo Yeun Park, Seung Ho Song, Sung Min Lee, Min Hye Jeong
Surgery.2024; 175(2): 297. CrossRef
Predictors of Timely Initiation and Completion of Adjuvant Chemotherapy in Stage II/III Colorectal Adenocarcinoma
Said Alnajjar, Sami Shoucair, Anyelin Almanzar, Kan Zheng, David Lisle, Vinay Gupta
The American Surgeon™.2024;[Epub] CrossRef
Associations of lifestyle characteristics with circulating immune markers in the general population based on NHANES 1999 to 2014
Linfen Guo, Yating Huang, Jing He, Deng Li, Wei Li, Haitao Xiao, Xuewen Xu, Yange Zhang, Ru Wang
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C-reactive protein-to-albumin ratio as a risk factor for anastomotic leakage after anterior resection for rectal cancer with intraoperative use of indocyanine green fluorescence imaging
Tatsunosuke Harada, Masakatsu Numata, Shota Izukawa, Yosuke Atsumi, Keisuke Kazama, Sho Sawazaki, Teni Godai, Hiroyuki Mushiake, Nobuhiro Sugano, Mamoru Uchiyama, Akio Higuchi, Hiroshi Tamagawa, Yusuke Suwa, Jun Watanabe, Tsutomu Sato, Chikara Kunisaki, A
Surgical Endoscopy.2024; 38(8): 4236. CrossRef
The conditional recurrence-free survival after R0 hepatectomy for locally advanced intrahepatic cholangiocarcinoma: A competing risk analysis based on inflammation-nutritional status
Guizhong Huang, Pu Xi, Zehui Yao, Chongyu Zhao, Xiaohui Li, Xiaojun Lin
Heliyon.2024; 10(13): e33931. CrossRef
Predictive value of flexible proctosigmoidoscopy and laboratory findings for complete clinical responses after neoadjuvant chemoradiotherapy in patients with locally advanced primary rectal cancer: a retrospective cohort study
Alireza Hadizadeh, Hamed Kazemi-Khaledi, Mohammad-Sadegh Fazeli, Seyed-Mohsen Ahmadi-Tafti, Amir Keshvari, Reza Akbari-Asbagh, Mohammad-Reza Keramati, Alireza Kazemeini, Amir-Reza Fazeli, Behnam Behboudi, Mohammadamin Parsaei
International Journal of Colorectal Disease.2024;[Epub] CrossRef
Clinical significance of positive resection margin for patients with rectal neuroendocrine tumors within 20 mm following initial endoscopic resection: A multi-center study
Mengping Duan, Zhanzhen Liu, Yan Qiao, Pinzhu Huang, Hao Xie, Wei Xiao, Shuangling Luo, Zhuochao Xie, Qiufeng Sun, Liwei Wang, Taixuan Wan, Zhihong Zhang, Huashan Liu, Haoqi Zheng, Yebohao Zhou, Dongxu Lei, Yunxing Shi, Sichong Lai, Ziwei Zhou, Fujin Ye,
European Journal of Surgical Oncology.2024; 50(11): 108651. CrossRef
Machine-Learning Algorithms Using Systemic Inflammatory Markers to Predict the Oncologic Outcomes of Colorectal Cancer After Surgery
Songsoo Yang, Hyosoon Jang, In Kyu Park, Hye Sun Lee, Kang Young Lee, Ga Eul Oh, Chihyun Park, Jeonghyun Kang
Annals of Surgical Oncology.2023; 30(13): 8717. CrossRef
Predictive and prognostic value of inflammatory markers in locally advanced rectal cancer (PILLAR) – A multicentric analysis by the Italian Association of Radiotherapy and Clinical Oncology (AIRO) Gastrointestinal Study Group
Giuditta Chiloiro, Angela Romano, Silvia Mariani, Gabriella Macchia, Diana Giannarelli, Luciana Caravatta, Pierfrancesco Franco, Luca Boldrini, Alessandra Arcelli, Almalina Bacigalupo, Liliana Belgioia, Antonella Fontana, Elisa Meldolesi, Giampaolo Montes
Clinical and Translational Radiation Oncology.2023; 39: 100579. CrossRef
A Novel Prognostic Index for Metastatic Colon Cancer: The Prognostic Immune Nutritional Index
Erkan Kayikcioglu, Gokce Iscan
Cureus.2023;[Epub] CrossRef
Combining prognostic nutritional index (PNI) and controlling nutritional status (CONUT) score as a valuable prognostic factor for overall survival in patients with stage I–III colorectal cancer
Harin Kim, Dong-Min Shin, Jae-Hoon Lee, Eun-Suk Cho, Hye Sun Lee, Su-Jin Shin, Eun Jung Park, Seung Hyuk Baik, Kang Young Lee, Jeonghyun Kang
Frontiers in Oncology.2023;[Epub] CrossRef
Development of preoperative and postoperative machine learning models to predict the recurrence of huge hepatocellular carcinoma following surgical resection
Qinghua Zhang, Guoxu Fang, Tiancong Huang, Guangya Wei, Haitao Li, Jingfeng Liu
Oncology Letters.2023;[Epub] CrossRef
Cancer and Diabetes: Predictive Factors in Patients with Metabolic Syndrome
Mihai Cosmin Stan, Daniel Georgescu, Ciprian Camil Mireștean, Florinel Bădulescu
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ASO Author Reflections: Could the Application of Machine Learning Enhance the Accuracy of Prognosis Estimation Using Serum Inflammatory Markers in Colorectal Cancer Patients?
Jeonghyun Kang
Annals of Surgical Oncology.2023; 30(13): 8522. CrossRef
Prognostic prediction of colorectal cancer using the C-reactive protein to albumin ratio: the importance of inflammatory biomarkers and their association with long-term outcomes
Chul Seung Lee
Annals of Coloproctology.2023; 39(4): 287. CrossRef
Clinical Significance of Combining Preoperative and Postoperative Albumin-Bilirubin Score in Colorectal Cancer
Doyoun Kim, Jae-Hoon Lee, Eun-Suk Cho, Su-Jin Shin, Hye Sun Lee, Hwa-Hee Koh, Kang Young Lee, Jeonghyun Kang
Cancer Research and Treatment.2023; 55(4): 1261. CrossRef
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Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. 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
Preoperative albumin–bilirubin score as a prognostic indicator in patients with stage III colon cancer
Hyun Gu Lee, Seok-Byung Lim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Jin Cheon Kim
Scientific Reports.2022;[Epub] CrossRef

Original Articles

Malignant disease, Functional outcomes,Postoperative outcome & ERAS

Improved outcomes with implementation of an Enhanced Recovery After Surgery pathway for patients undergoing elective colorectal surgery in the Philippines: Mayou Martin T. Tampo, Mark Augustine S. Onglao, Marc Paul J. Lopez, Marie Dione P. Sacdalan, Ma. Concepcion L. Cruz, Rosielyn T. Apellido, Hermogenes J. Monroy III; Ann Coloproctol. 2022;38(2):109-116. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.09.02

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Abstract PDF Supplementary Material

Purpose
This study aims to evaluate surgical outcomes (i.e. length of stay [LOS], 30-day morbidity, mortality, reoperation, and readmission rates) with the use of the Enhanced Recovery After Surgery (ERAS) pathway, and determine its association with the rate of compliance to the different ERAS components.
Methods
This was a prospective cohort of patients, who underwent the following elective procedures: stoma reversal (SR), colon resection (CR), and rectal resection (RR). The primary endpoint was to determine the association of compliance to an ERAS pathway and surgical outcomes. These were then retrospectively compared to outcomes prior to the implementation of ERAS.
Results
A total of 267 patients were included in the study. The overall compliance to the ERAS component was 92.0% (SR, 91.8%; CR, 93.1%; RR, 90.7%). There was an associated decrease in morbidity rates across all types of surgery, as compliance to ERAS increased. The average total LOS decreased in all groups but was only found to have statistical significance in SR (12.1±6.7 days vs. 10.0±5.4 days, P=0.002) and RR (19.9±11.4 days vs. 16.9±10.5 days, P=0.04) groups. Decreased postoperative LOS was noted in all groups. Morbidity rates were significantly higher after ERAS implementation, but reoperation and mortality rates were found to be similar.
Conclusion
Increased compliance to ERAS protocol is associated with a decrease in morbidity across all surgery types. The implementation of an ERAS protocol significantly decreased mean hospital LOS, without any increase in major surgical complications. Having your own hospital ERAS pathway improves documentation and accuracy of reporting surgical complications.

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Lessons following implementation of a colorectal enhanced recovery after surgery (ERAS) protocol in a rural hospital setting
Stephen Tolmay, Jamie‐Lee Rahiri, Kim Snoep, Gillian Fewster, Rachel Kee, Yukai Lim, Bridget Watson, Konrad Klaus Richter
ANZ Journal of Surgery.2024; 94(5): 910. 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
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
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
Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer
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The Ewha Medical Journal.2023;[Epub] CrossRef

Benign proctology,Surgical technique

Lithotomy versus prone position for perianal surgery: a randomized controlled trial: Pankaj Kumar, Tushar S. Mishra, Siddhant Sarthak, Prakash Kumar Sasmal; Ann Coloproctol. 2022;38(2):117-123. Published online June 7, 2021; DOI: https://doi.org/10.3393/ac.2020.12.16

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Abstract PDF

Purpose
Studies objectively comparing lithotomy and prone positions regarding surgeon comfort, ergonomics, patient comfort, and position related complications are scarce.
Methods
The patients posted for surgery of either fistula in ano, hemorrhoids, or were included in this study. Subjective Mental Effort Questionnaire (SMEQ) and Local Experienced Discomfort (LED) scale were used to score the level of mental and physical stress among the operating surgeon, assistants, and the scrub nurse. Other parameters studied were the exposure of the operative site, patient comfort level, and position-related complications.
Results
Thirty patients were operated in each position. Mean±standard deviation of jackknife prone vs. lithotomy surgeon SMEQ score (15.6±10.4 vs. 107.0±11.5, P<0.05) and LED score (1.8±1.5 vs. 6.7±0.5, P<0.05) were found to be statistically significant. Prone vs. lithotomy assistant SMEQ score (29.1±13.1 vs. 100.6±8.7, P<0.05) and LED score (4.6±1.1 vs. 7.4±0.8, P<0.05) were also found to be statistically significant. SMEQ (10.0±0.0 vs. 20.6±2.5, P<0.05) and LED scores (1.1±0.3 vs. 3.3±0.5, P<0.05) of scrub nurses and LED scores (2.5±0.5 vs. 6.3±0.7, P<0.05) of patients were also statistically significant. Exposure of the operative site was significantly better in the prone position (5.0 vs. 2.1, P<0.05).
Conclusion
Significantly better SMEQ, LED, and exposure score suggests the superiority of jackknife prone position over the lithotomy in terms of significantly less mental and physical stress to the operating surgeon, assistant, and scrub nurse; better ergonomics, and excellent exposure.

Citations

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A Randomized Controlled Comparative Study of the Three Over-Bed Techniques for Positioning and Repositioning the Lithotomy Position While Using Stirrups
Ling-Ling Zhang, Zhi-Fang Luo, Guang-Jing Yang
Journal of Multidisciplinary Healthcare.2023; Volume 16: 4255. CrossRef
Transvaginal repair of vesicouterine fistulae: our experience of three cases
Mingxin Cao, Junlong Zhang, Yu Chen, Yueyou Liang
International Urogynecology Journal.2022; 33(3): 737. CrossRef
Human factors in pelvic surgery
Matthew M. Symer, Deborah S. Keller
European Journal of Surgical Oncology.2022; 48(11): 2346. CrossRef

Benign GI diease,Benign diesease & IBD,Complication,Biomarker & risk factor

A development study of drain fluid gastrografin as a biomarker of anastomotic leak: David A. Clark, Edward Yeoh, Aleksandra Edmundson, Craig Harris, Andrew Stevenson, Daniel Steffens, Michael Solomon; Ann Coloproctol. 2022;38(2):124-132. Published online January 11, 2021; DOI: https://doi.org/10.3393/ac.2020.12.24

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Abstract PDF

Purpose
Anastomotic leakage (AL) is the anathema of colorectal surgery. Its occurrence leads to increased morbidity and mortality and a prolonged hospital stay. Much work has gone into studying various biomarkers in drain fluid to facilitate early detection of AL. This stage 2a development study aims to assess the safety and feasibility of reliably detecting the iodine in Gastrografin (GG; Bayer Australia Ltd.) in drain fluid and stool samples by dual-energy computed tomography (DECT).
Methods
This is a prospective, observational, controlled, consecutive cohort study establishing the safety and feasibility of the detection of GG in surgical drain fluid and stool as a biomarker of AL when patients with a low pelvic colorectal anastomosis undergo luminal flushing of the rectal tube with GG.
Results
Ten consecutive patients were allocated to the saline flush group and the following 10 to the GG flush group. Three patients in the saline flush group developed an AL. One patient in the GG flush group developed an AL. An elevation in the drain fluid GG was detected using DECT on the day of clinical deterioration. None of the patients in the control group were found to have a positive result on DECT.
Conclusion
This study demonstrates the safety of a novel approach to the early detection of AL from extraperitoneal colorectal anastomoses. The technique requires validation in a larger cohort and a multicenter study is planned to investigate the efficacy of GG rectal tube flushes as an early biomarker of AL in low pelvic anastomoses.

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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
Successful colorectal anastomotic leakage management: a two oncological centres' 12-year experience
Kiril G. KIROV, Tsvetomir M. IVANOV, Nadya S. IVANOVA
Chirurgia.2022;[Epub] CrossRef
Neoadjuvant chemoradiotherapy determines the prognostic impact of anastomotic leakage in advanced rectal cancer
Bo Young Oh, Yoon Ah Park, Jung Wook Huh, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee
Annals of Surgical Treatment and Research.2022; 103(4): 235. CrossRef
Does an ileostomy cover the surgeon or the anastomosis?
David A. Clark, Andrew Stevenson, John Lumley, Damien Petersen, Craig Harris, Daniel Steffens, Michael Solomon
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Benign proctology

Long-term outcomes after anal fistula surgery: results from two university hospitals in Thailand: Weeraput Chadbunchachai, Varut Lohsiriwat, Krisada Paonariang; Ann Coloproctol. 2022;38(2):133-140. Published online June 7, 2021; DOI: https://doi.org/10.3393/ac.2021.01.06

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Abstract PDF

Purpose
This study aimed to evaluate long-term outcomes after anal fistula surgery from university hospitals in Thailand.
Methods
A prospectively collected database of patients with cryptoglandular anal fistula undergoing surgery from 2011 to 2017 in 2 university hospitals was reviewed. Outcomes were treatment failure (persistent or recurrent fistula), fecal continence status, and chronic postsurgical pain.
Results
This study included 247 patients; 178 (72.1%) with new anal fistula and 69 (27.9%) with recurrent fistula. One hundred twenty-one patients (49.0%) had complex fistula; 53 semi-horseshoe (21.5%), 41 high transsphincteric (16.6%), 24 horseshoe (9.7%), and 3 suprasphincteric (1.2%). Ligation of intersphincteric fistula tract (LIFT) was the most common operation performed (n=88, 35.6%) followed by fistulotomy (n=79, 32.0%). With a median follow-up of 23 months (interquartile range, 12–45 months), there were 18 persistent fistulas (7.3%) and 33 recurrent fistulae (13.4%)—accounting for 20.6% overall failure. All recurrence occurred within 24 months postoperatively. Complex fistula was the only significant predictor for recurrent fistula with a hazard ratio of 4.81 (95% confidence interval, 1.82–12.71). There was no significant difference in healing rates of complex fistulas among seton staged fistulotomy (85.0%), endorectal advancement flap (72.7%), and LIFT (65.9%) (P=0.239). Four patients (1.6%) experienced chronic postsurgical pain. Seventeen patients (6.9%) reported worse fecal continence.
Conclusion
Overall failure for anal fistula surgery was 20.6%. Complex fistula was the only predictor for recurrent fistula. At least 2-year period of follow-up is suggested for detecting recurrent diseases and assessing patient-reported outcomes such as chronic pain and continence status.

Citations

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Exploring Health-Related Quality of Life in Patients with Anal Fistulas: A Comprehensive Study
Tudor Mateescu, Lazar Fulger, Durganjali Tummala, Aditya Nelluri, Manaswini Kakarla, Lavinia Stelea, Catalin Dumitru, George Noditi, Amadeus Dobrescu, Cristian Paleru, Ana-Olivia Toma
Life.2023; 13(10): 2008. CrossRef
Lower Fistula Recurrence with Pulling Seton: A Retrospective Cohort Study
Ahmad Izadpanah, Ali Reza Safarpour, Mohammad Rezazadehkermani, Ali Zahedian, Reza Barati-Boldaji
Shiraz E-Medical Journal.2022;[Epub] CrossRef

Malignant disease,Rectal cancer,Postoperative outcome & ERAS,Complication,Surgical technique

Effectiveness and early postoperative outcomes of palliative endoluminal stenting versus Hartmann’s procedure in acute malignant bowel obstruction in high-risk patients: Mohammed Fayek Mahfouz, Tamer M. Saeid Salama, Amr H. Afifi, Hany Mansour Khalil Dabous; Ann Coloproctol. 2022;38(2):141-145. Published online May 11, 2021; DOI: https://doi.org/10.3393/ac.2021.01.28

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Abstract PDF

Purpose
The emergency intervention for acute malignant left-sided colonic obstruction remains controversial. Conflicting reports exist regarding the efficacy and safety of endoscopic placement of self-expandable metallic stents (SEMS) vs. primary surgery. Most reports focus on SEMS insertion as a bridge to surgery.
Methods
An observational nonrandomized study at a single center in Cairo, Egypt included 65 high-risk patients (American Society of Anesthesiologists physical status classification ≥ III, age > 60 years) with acute malignant metastatic (stage IV) colonic obstruction. Twenty-nine patients underwent primary surgery (Hartmann’s procedure, HP), and 35 patients underwent SEMS insertion.
Results
All cases that underwent SEMS insertion were technically successful. The 2 procedures were comparable in clinical success rates but a statistically significant difference existed between them regarding the duration of postoperative hospital stay in the HP and SEMS group (7.7 ± 3.1 days vs. 3.5 ± 0.6 days, retrospectively; P < 0.001), the interval before regaining oral feeding (41.8 ± 26.8 hours vs. 27.6 ± 18.5 hours, retrospectively; P = 0.015), and the duration of intensive care unit (ICU) admission (5.0 ± 1.7 days vs. 1.5 ± 0.7 days, retrospectively; P = 0.035). Six patients (20.7%) in the HP group and 2 patients (5.7%) in the SEMS group required postoperative ICU admission.
Conclusion
SEMS placement provides comparable efficacy and safety to HP in managing acute malignant obstruction of the rectosigmoid region in high-risk individuals, with faster recovery and less hospital and ICU admission time.

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Management of obstructed colorectal carcinoma in an emergency setting: An update
Efstathios T Pavlidis, Ioannis N Galanis, Theodoros E Pavlidis
World Journal of Gastrointestinal Oncology.2024; 16(3): 598. CrossRef
Laparoscopic Hartmann Procedure—A Surgery That Still Saves Lives
Costel Bradea, Eugen Tarcoveanu, Valentina Munteanu, Cristian Dumitru Lupascu, Florina Delia Andriesi-Rusu, Delia Gabriela Ciobanu, Alin Mihai Vasilescu
Life.2023; 13(4): 914. CrossRef
Recurrence Patterns and Risk Factors after Curative Resection for Colorectal Cancer: Insights for Postoperative Surveillance Strategies
Hyo Seon Ryu, Jin Kim, Ye Ryung Park, Eun Hae Cho, Jeong Min Choo, Ji-Seon Kim, Se-Jin Baek, Jung-Myun Kwak
Cancers.2023; 15(24): 5791. CrossRef

Benign proctology,Surgical technique

Hemorrhoidectomy versus rubber band ligation in grade III hemorrhoidal disease: a large retrospective cohort study with long-term follow-up: Lisette Dekker, Michiel T.J. Bak, Willem A. Bemelman, Richelle J.F. Felt-Bersma, Ingrid J.M. Han-Geurts; Ann Coloproctol. 2022;38(2):146-152. Published online July 27, 2021; DOI: https://doi.org/10.3393/ac.2020.01011.0144

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Abstract PDF

Purpose
Standard therapy for grade III hemorrhoids is rubber band ligation (RBL) and hemorrhoidectomy. The long-term clinical and patient-reported outcomes of these treatments in a tertiary referral center for proctology were evaluated.
Methods
A retrospective analysis was performed in all patients with grade III hemorrhoids who were treated between January 2013 and August 2018. Medical history, symptoms, reinterventions, complications, and patient-reported outcome measurements (PROM) were retrieved from individual electronic patient files, which were prospectively entered as standard questionnaires in our clinic.
Results
Overall, 327 patients (163 males) were treated by either RBL (n=182) or hemorrhoidectomy (n=145). The median follow-up was 44 months. The severity of symptoms and patient preference led to the treatment of choice. The most commonly experienced symptoms were prolapse (83.2%) and blood loss (69.7%). Hemorrhoidectomy was effective in 95.9% of the cases as a single procedure, while a single RBL procedure was only effective in 51.6%. In the RBL group, 34.6% received a second RBL session. Complications were not significantly different, 11 (7.6%) after hemorrhoidectomy versus 6 (3.3%) after RBL. However, 4 fistulas developed after hemorrhoidectomy and none after RBL (P<0.05). The pre-procedure PROM score was higher in the hemorrhoidectomy group whereas the post-procedure PROM score did not significantly differ between the groups.
Conclusion
Treatment of grade III hemorrhoids usually requires more than one session RBL whereas 1-time hemorrhoidectomy suffices. Complications were more common after hemorrhoidectomy. The patient-related outcome did not differ between procedures.

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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

Malignant disease,Colorectal cancer

Upregulation of prostaglandin E₂ by inducible microsomal prostaglandin E synthase-1 in colon cancer: Young Hun Kim, Kyung Jong Kim; Ann Coloproctol. 2022;38(2):153-159. Published online August 31, 2021; DOI: https://doi.org/10.3393/ac.2021.00374.0053

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Abstract PDF

Purpose
Prostaglandin E₂ (PGE₂) is known to promote carcinogenesis and cancer progression in colon cancer. Enzymes involved in the metabolism of PGE₂ include cyclooxygenase (COX)-2, microsomal prostaglandin E synthase-1 (mPGES-1), and 15-prostaglandin dehydrogenase (15-PGDH). The current study aims to determine how PGE₂ is expressed by examining patients with colorectal cancer and evaluating colon cancer cells to gain insight into changes in relevant enzymes upon induction of PGE₂.
Methods
The concentration of PGE₂ was measured in tumor tissues and adjacent normal mucosal tissues of 26 patients with colon cancer. The expression of COX-1, COX-2, mPGES-1, and 15-PGDH proteins was measured. The concentration of PGE₂ in FET colon cancer cells was measured both in the initial status and after stimulation by tumor necrosis factor (TNF)-α. The expression levels of PGE₂-related enzymes were measured as well.
Results
There was no significant difference in the average concentration of PGE₂, which was measured at 453.1 pg/mL in cancer tissues and 401.2 pg/mL in normal mucosa. Among PGE₂-related enzymes, 15-PGDH was expressed at a lower level in tumor cells than in normal mucosa. In colon cancer cells, PGE₂ was found to be upregulated upon stimulation by TNF-α, which led to strong induction of mPGES-1 without any change in the expression of COX-2 among the PGE₂-related enzymes.
Conclusion
These results demonstrated that PGE₂ can be induced by stimuli such as TNF-α, and suggest that activation of mPGES-1 is more closely related than that of COX-2 in the induction of PGE₂ on colon cancer.

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Frontiers in Pharmacology.2023;[Epub] 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
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Lorena Lobos-González, Lorena Oróstica, Natalia Díaz-Valdivia, Victoria Rojas-Celis, America Campos, Eduardo Duran-Jara, Nicole Farfán, Lisette Leyton, Andrew F. G. Quest
International Journal of Molecular Sciences.2023; 24(23): 16947. 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,Benign diesease & IBD,Surgical technique

Clinical outcomes of locking polymeric clip for laparoscopic appendectomy in patients with appendicitis: a retrospective comparison with loop ligature: Seokwon Kim, Byong Ho Jeon, Sang Sik Cho, Ui Sup Shin, Sun Mi Moon; Ann Coloproctol. 2022;38(2):160-165. Published online January 18, 2022; DOI: https://doi.org/10.3393/ac.2021.00598.0085

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Abstract PDF

Purpose
This study aimed to compare the clinical outcomes of laparoscopic appendectomy (LA) according to the method of appendiceal stump closure.
Methods
Patients who underwent LA for appendicitis between 2010 and 2020 were retrospectively reviewed. Patients were classified into locking polymeric clip (LPC) and loop ligature (LL) groups. Clinical outcomes were compared between the groups.
Results
LPC and LL were used in 188 (56.6%) and 144 patients (43.4%), respectively for appendiceal stump closure. No significant differences were observed in sex, age, comorbidities, and the severity of appendicitis between the groups. The median operative time was shorter in the LPC group than in the LL group (64.5 minutes vs. 71.5 minutes, P=0.027). The median hospital stay was longer in the LL group than in the LPC group (4 days vs. 3 days, P=0.020). Postoperative incidences of intraabdominal abscess and ileus were higher in the LL group than in the LPC group (4.2% vs. 1.1%, P=0.082 and 2.8% vs. 0%, P=0.035; respectively). The readmission rate was higher in the LL group than that in the LPC group (6.3% vs. 1.1%, P=0.012).
Conclusion
Using LPC for appendiceal stump closure during LA for appendicitis was associated with lower postoperative complication rate, shorter operative time, and shorter hospital stay compared to the use of LL. Operative time above 60 minutes and the use of LL were identified as independent risk factors for postoperative complications in LA. Therefore, LPC could be considered a more favorable closure method than LL during LA for appendicitis.

Citations

Citations to this article as recorded by

Comparison of polymeric clip and endoloop in laparoscopic appendectomy: A systematic review and meta-analysis
Aashish Kumar, Muhammad Saqlain Mustafa, Muhammad Ashir Shafique, Abdul Haseeb, Hussain Sohail Rangwala, Haimath Kumar, Burhanuddin Sohail Rangwala, Adarsh Raja, Sandesh Raja, Syed Muhammad Sinaan Ali
Surgery.2024;[Epub] CrossRef
Advantages of using a polymeric clip versus an endoloop during laparoscopic appendectomy in uncomplicated appendicitis: a randomized controlled study
Kil-yong Lee, Jaeim Lee, Youn Young Park, Seong Taek Oh
World Journal of Emergency Surgery.2023;[Epub] CrossRef

Malignant disease, Rectal cancer,Prognosis

Initial local excision for clinical T1 rectal cancer showed comparable overall survival despite high local recurrence rate: a propensity-matched analysis: Jong Hee Hyun, Mohamed K. Alhanafy, Hyoung-Chul Park, Su Min Park, Sung-Chan Park, Dae Kyung Sohn, Duck-Woo Kim, Sung-Bum Kang, Seung-Yong Jeong, Kyu Joo Park, Jae Hwan Oh, on behalf of the Seoul Colorectal Research Group (SECOG); Ann Coloproctol. 2022;38(2):166-175. Published online October 6, 2021; DOI: https://doi.org/10.3393/ac.2021.00479.0068

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Abstract PDF

Purpose
Local excision (LE) is an alternative initial treatment for clinical T1 rectal cancer, and has avoided potential morbidity. This study aimed to evaluate the clinical outcomes of LE compared with total mesorectal excision (TME) for clinical T1 rectal cancer.
Methods
Between January 2000 and December 2011, we retrospectively reviewed from multicenter data in patients with clinically suspected T1 rectal cancer treated with either LE or TME. Of 1,071 patients, 106 were treated with LE and 965 were treated with TME. The data were analyzed using propensity score matching, with each group comprising 91 patients.
Results
After propensity score matching, the median follow-up time was 60.8 months (range, 0.6–150.6 months). After adjustment for the necessary variables, patients who underwent LE showed a significantly higher local recurrence rate than did those who underwent TME; however, there were no differences in disease-free survival and overall survival. In the multivariate analysis, age (hazard ratio [HR], 9.620; 95% confidence interval [CI], 3.415–27.098; P<0.001) and angiolymphatic invasion (HR, 3.63; 95% confidence interval, 1.33–9.89; P=0.012) were independently associated with overall survival. However, LE was neither associated with overall survival nor disease-free survival.
Conclusion
LE for clinical T1 rectal cancer yielded a higher local recurrence rate than did TME. Nevertheless, LE provided comparable overall survival rate and can be proposed as an optional treatment in terms of organ-preserving strategies.

Citations

Citations to this article as recorded by

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
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
Survival prognostic in different age groups of patients undergoing local versus radical excision for rectal cancer: a study based on the SEER database
Jinghui Li, Liang Wen, Yongli Ma, Guosheng Zhang, Ping Wang, Chengzhi Huang, Xueqing Yao
Updates in Surgery.2024; 76(3): 975. CrossRef
Comparative analysis of organ preservation attempt and radical surgery in clinical T2N0 mid to low rectal cancer
Hyeung-min Park, Jaram Lee, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
International Journal of Colorectal Disease.2024;[Epub] CrossRef
Organ preservation for early rectal cancer using preoperative chemoradiotherapy
Gyung Mo Son
Annals of Coloproctology.2023; 39(3): 191. 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
Multidisciplinary treatment strategy for early rectal cancer
Gyung Mo Son, In Young Lee, Sung Hwan Cho, Byung-Soo Park, Hyun Sung Kim, Su Bum Park, Hyung Wook Kim, Sang Bo Oh, Tae Un Kim, Dong Hoon Shin
Precision and Future Medicine.2022; 6(1): 32. CrossRef
The risk-benefit trade-off in local excision of early rectal cancer
Chang Hyun Kim
Annals of Coloproctology.2022; 38(2): 95. CrossRef
Applications of propensity score matching: a case series of articles published in Annals of Coloproctology
Hwa Jung Kim
Annals of Coloproctology.2022; 38(6): 398. CrossRef

Case Report

Benign GI diease,Benign diesease & IBD

Ileocolonic intussusception caused by epithelioid leiomyosarcoma of the ileum: a report of case and review of the literature: Han-Gil Kim, Jung Wook Yang, Soon-Chan Hong, Young-Tae Ju, Chi-Young Jeong, Ju-Yeon Kim, Ji-Ho Park, Jin-Kwon Lee, Jae-Myung Kim, Jin-Kyu Cho, Seung-Jin Kwag; Ann Coloproctol. 2022;38(2):176-180. Published online May 28, 2021; DOI: https://doi.org/10.3393/ac.2020.12.08

2,985 View
154 Download
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Abstract PDF

Small intestinal malignant tumor accounts for about 3% of all malignant tumors in the gastrointestinal tract, among which 13% are leiomyosarcoma (LMS). In addition, epithelioid LMS is of very rare occurrence. As small intestinal malignant tumors are initially asymptomatic and nonspecific, diagnosis is often delayed, and this can lead to large tumor at the time of detection and lead to intussusception. We observed ileocolonic intussusception in an 80-year-old male patient who was admitted to the hospital with a complaint of abdominal pain and palpable mass on right lower quadrant. The laparoscopic ileocecectomy was performed by the emergency operation because of obstruction. The pathologic examination revealed that the epithelioid LMS developed in the terminal ileum was the leading point of intussusception. To the best of our knowledge, laparoscopic surgery for ileocolonic intussusception with epithelioid LMS has not yet been reported.

Citations

Citations to this article as recorded by

Ileum intussusception secondary to submucosal liposarcoma in adult：A case report
Hong-wei Yu, Jin-gang Yan, Lei Zheng, Jun-hua Huang
Heliyon.2024; 10(1): e23432. CrossRef
Current landscape of primary small bowel leiomyosarcoma: cases report and a decade of insights
Junjie Zhou, Houyun Xu, Jibo Hu, Qiang Hong, Xiping Yu, Wei Liu, Jiaxin Zhao, Hongjie Hu
Frontiers in Oncology.2024;[Epub] CrossRef

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