Annals of Coloproctology

Volume 38(6); December 2022

Editorial

Minimally invasive surgery,Surgical technique

Can assistants’ skills be used to improve colorectal cancer surgery outcomes in a way similar to the “butterfly effect”?: Je-Ho Jang; Ann Coloproctol. 2022;38(6):391-392. Published online December 28, 2022; DOI: https://doi.org/10.3393/ac.2022.01088.0155

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Master Class 2022

Malignant disease,Colorectal cancer

Against all odds: why surgeons need to be more aggressive in the era of the multidisciplinary team approach to colorectal cancer: Kyu Joo Park; Ann Coloproctol. 2022;38(6):393-397. Published online December 28, 2022; DOI: https://doi.org/10.3393/ac.2022.00822.0117

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Citations

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Clinical Effectiveness of Fluorescence Lymph Node Mapping Using ICG for Laparoscopic Right Hemicolectomy: A Prospective Case–Control Study
Gyung Mo Son, Mi Sook Yun, In Young Lee, Sun Bin Im, Kyung Hee Kim, Su Bum Park, Tae Un Kim, Dong-Hoon Shin, Armaan M. Nazir, Gi Won Ha
Cancers.2023; 15(20): 4927. 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
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han
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
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

Review

Applications of propensity score matching: a case series of articles published in Annals of Coloproctology: Hwa Jung Kim; Ann Coloproctol. 2022;38(6):398-402. Published online December 28, 2022; DOI: https://doi.org/10.3393/ac.2022.01060.0151

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Abstract PDF

Propensity score matching (PSM) is an increasingly applied method of ensuring comparability between groups of interest. However, PSM is often applied unconditionally, without precise considerations. The purpose of this study is to provide a nonmathematical guide for clinicians at the stage of designing a PSM-based study. We provide a seed of thought for considering whether applying PSM would be appropriate and, if so, the scope of the list of variables. Although PSM may be simple, its results could vary substantially according to how the propensity score is constructed. Misleading results can be avoided through a critical review of the process of PSM.

Citations

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An analysis of exogenous harmful substance exposure as risk factors for COPD and hypertension co-morbidity using PSM
Qingyang Chen, Haodong Zhou, Jiarong Tang, Yingbiao Sun, Geriletu Ao, Hongjun Zhao, Xuhong Chang
Frontiers in Public Health.2024;[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
Cancers.2023; 15(20): 5098. CrossRef

Original Articles

Benign proctology,Surgical technique

Injection of aluminum potassium sulfate and tannic acid in the treatment of fecal incontinence: a single-center observational study: Tatsuya Abe, Masao Kunimoto, Yoshikazu Hachiro, Kei Ohara, Mitsuhiro Inagaki; Ann Coloproctol. 2022;38(6):403-408. Published online July 21, 2021; DOI: https://doi.org/10.3393/ac.2021.00248.0035

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Graphical Abstract Abstract PDF

Purpose
Perianal injection of bulking agents is an attractive treatment option for patients with mild to moderate fecal incontinence (FI). Various bulking agents have been used for injection therapy, but the optimal injection materials and methods are yet to be standardized. This study aimed to evaluate the effects of injection therapy using aluminum potassium sulfate and tannic acid (ALTA) in the management of FI.
Methods
This study included consecutive patients who underwent ALTA injection therapy for FI at our institution. The procedure was performed with the patient in the jackknife position, under caudal epidural anesthesia. The procedure consisted of a 4-step injection to the 3 main cushions and a multipoint injection to the remaining submucosa of the anal canal.
Results
Seventy-seven patients (mean age, 76 years) were enrolled in the study. The mean Cleveland Clinic incontinence score of 11.9 ± 4.1 at baseline significantly improved to 7.3 ± 5.2 at 3 months following treatment. The mean maximal resting pressure also increased significantly 3 months after the intervention. Postoperative complications were observed in 3 patients (3.9%), and all events were mild. The mean duration of postoperative follow-up was 17.5 months. The cumulative recurrence-free rate at 3 years was 72.4%.
Conclusion
ALTA injection for FI is safe, easy to perform, and provides reasonable mid-term outcomes. Moreover, concomitant anorectal diseases that may be contraindicated by other injectable bulking agents could be treated simultaneously. Therefore, ALTA injection is a promising alternative in the absence of other injectable agents.

Citations

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Effective non-surgical treatment of hemorrhoids with sclerosing foam and novel injection device
Juan Cabrera Garrido, Gonzalo López González
Gastroenterology & Endoscopy.2024; 2(4): 176. CrossRef
Tissue engineering and regenerative medicine approaches in colorectal surgery
Bigyan B. Mainali, James J. Yoo, Mitchell R. Ladd
Annals of Coloproctology.2024; 40(4): 336. CrossRef
Simple Anal Reinforcement with Anal Encirclement Using an Artificial Ligament in Patients with fecal Incontinence: A Single-center Observational Study
Tatsuya Abe, Masao Kunimoto, Yoshikazu Hachiro, Shigenori Ota, Kei Ohara, Mitsuhiro Inagaki
Journal of the Anus, Rectum and Colon.2022; 6(3): 174. CrossRef

Benign diesease & IBD,Biomarker & risk factor,Minimally invasive surgery

Conversion rate and risk factors of conversion to open in laparoscopic appendicectomy: Nelson Rao Pushpanathan, Mohd Nizam Md Hashim, Zalina Zahari, Syed Hassan Syed Abd. Aziz, Wan Zainira Wan Zain, Rosnelifaizur Ramely, Michael Pak-Kai Wong, Ikhwan Sani Mohamad, Wan Mokhzani Wan Mokhter, Maya Mazuwin Yahya, Siti Rahmah Hashim Isa Merican, Zaidi Zakaria, Andee Dzulkarnaen Zakaria; Ann Coloproctol. 2022;38(6):409-414. Published online August 18, 2021; DOI: https://doi.org/10.3393/ac.2020.00437.0062

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Abstract PDF

Purpose
Laparoscopic appendicectomy (LA) has several advantages over conventional open appendicectomy (OA). However, about 5% to 10% of LA patients still need to be converted to open surgery. Identifying risk factors that contribute to conversion to OA allows for early identification of patients who may benefit from primary OA. This study aimed to determine the conversion rate of LA to OA and to identify its associated risk factors among patients with acute or perforated appendicitis.
Methods
A retrospective review of medical records was performed among patients with acute or perforated appendicitis who underwent LA between December 2015 and January 2017. With the use of multivariable logistic regression analyses, the predictors of conversion from laparoscopic to OA were investigated.
Results
Out of 120 patients, 33 cases were converted to OA which gives a conversion rate of 27.5%. Among 33 patients who were converted to OA, 27 patients (81.8%) had perforated appendix, while in the LA group, perforated appendix cases consisted of 34.5% (P<0.001). Histopathology of the appendix was the predictor of conversion from LA to OA (adjusted odds ratio, 8.82; 95% confidence interval, 3.13–24.91; P<0.001).
Conclusion
The result from our study shows that the overall conversion rate for the study period was high. Patients with perforated appendicitis had a higher risk of conversion to OA. Therefore, preoperative diagnosis of perforated appendicitis may be paramount in predicting conversion to OA.

Citations

Citations to this article as recorded by

Controversies and Future Directions in Management of Acute Appendicitis: An Updated Comprehensive Review
Dushyant Singh Dahiya, Hamzah Akram, Aman Goyal, Abdul Moiz Khan, Syeda Shahnoor, Khawaja M. Hassan, Manesh Kumar Gangwani, Hassam Ali, Bhanu Siva Mohan Pinnam, Saqr Alsakarneh, Andrew Canakis, Abu Baker Sheikh, Saurabh Chandan, Amir Humza Sohail
Journal of Clinical Medicine.2024; 13(11): 3034. CrossRef
Comparison of Clinical, Pathological, and Procedural Characteristics of Adult and Pediatric Acute Appendicitis before and during the COVID-19 Pandemic
Goran Augustin, Jurica Žedelj, Karmen Jeričević, Nora Knez
Children.2024; 11(6): 641. CrossRef
Post-colonoscopy appendicitis: A systematic review
Kostas Tepelenis, Christos K. Stefanou, Stefanos K. Stefanou, Evangelos Sitos, Frideriki Steliou, Konstantinos Mpakas, Dimitra Lepida, Theocharis Chatzoglou, Thomas Iraklis Smyris, Maria Alexandra Kefala
Asian Journal of Surgery.2024;[Epub] CrossRef
Risk Factors for Conversion from Laparoscopic to Open Appendectomy
Bruno Leonardo Bancke Laverde, Matthias Maak, Melanie Langheinrich, Stephan Kersting, Axel Denz, Christian Krautz, Georg F. Weber, Robert Grützmann, Maximilian Brunner
Journal of Clinical Medicine.2023; 12(13): 4299. CrossRef
Risk of Conversion from Laparoscopic Appendectomy to Open Surgery: The Role of Clinical and Radiological Factors in Prediction
Nihan Turhan, Cengiz Duran, Taha Yusuf Kuzan, Beyza Nur Kuzan, Elbrus Zarbaliyev
Journal of Laparoendoscopic & Advanced Surgical Techniques.2023; 33(12): 1176. CrossRef
Conversion from Laparoscopic to Open Appendectomy: Trends, Risk Factors and Outcomes. A 15-Year Single-Center Analysis of 2193 Adult Patients
Manuela Monrabal Lezama, María A. Casas, Cristian A. Angeramo, Camila Bras Harriott, Francisco Schlottmann
World Journal of Surgery.2022; 46(11): 2642. CrossRef

Benign diesease & IBD,Surgical technique

Transanal rectopexy for external rectal prolapse: Shantikumar Dhondiram Chivate, Meghana Vinay Chougule, Rahul Shantikumar Chivate, Palak Harshuk Thakrar; Ann Coloproctol. 2022;38(6):415-422. Published online October 21, 2021; DOI: https://doi.org/10.3393/ac.2021.00262.0037

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Abstract PDF

Purpose
The surgical management of patients with full-thickness rectal prolapse (FTRP) continues to remain a challenge in the laparoscopic era. This study retrospectively assesses a cohort of patients undergoing a transanal suture sacro rectopexy supported by sclerosant injection into the presacral space under ultrasound guidance.
Methods
Patients with FTRP underwent a sutured transrectal presacral fixation of 2/3 of the circumference of the rectum from the third sacral vertebra to the sacrococcygeal junction through a side-viewing operating proctoscope. The procedure was supplemented by ultrasound-guided injection into the retrorectal space of a 2 mL solution of sodium tetradecyl sulfate/polidocanol mixed with air. Patients were functionally assessed before and 6 months after surgery with the Agachan constipation score and the Pescatori incontinence score.
Results
There were 36 adult patients (26 males; the range of age, 23–92 years). The mean operative time was 27 minutes (range, 23–50 minutes) with no recorded perioperative morbidity. The median follow-up was 66 months (range, 48–84 months) with 1 (2.8%) recurrence presenting 18 months after surgery. There were 19 patients (52.8%) who presented with incontinence before surgery with 17 out of 19 (89.5%) reporting improvement in their Pescatori score (P<0.001). No patient had worsening incontinence and there were no de novo incontinence cases. Constipation scores improved in 23 out of 36 patients (63.9%) with a mean score reduction difference of 7.91 (P=0.001).
Conclusion
Transanal sutured sacral rectopexy with supplemental presacral sclerosant injection is safe and effective in the management of FTRP with sustained improvement in bowel function.

Citations

Citations to this article as recorded by

External rectal prolapse: more than meets the eye
M. Yiasemidou, C. Yates, E. Cooper, R. Goldacre, I. Lindsey
Techniques in Coloproctology.2023; 27(10): 783. CrossRef

Benign diesease & IBD,Rare disease & stoma

Determining the etiology of small bowel obstruction in patients without intraabdominal operative history: a retrospective study: Youngjin Jang, Sung Min Jung, Tae Gil Heo, Pyong Wha Choi, Jae Il Kim, Sung-Won Jung, Heungman Jun, Yong Chan Shin, Eunhae Um; Ann Coloproctol. 2022;38(6):423-431. Published online December 8, 2021; DOI: https://doi.org/10.3393/ac.2021.00710.0101

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Abstract PDF Supplementary Material

Purpose
Most of the causes of small bowel obstruction (SBO) in patients without a history of abdominal surgery are unclear at initial assessment. This study was conducted to identify the etiology and clinical characteristics of SBO in virgin abdomens and discuss the proper management.
Methods
A retrospective review involving operative cases of SBO from a single institute, which had no history of abdominal surgery, was conducted between January 2010 and December 2020. Clinical information, including radiological, operative, and pathologic findings, was investigated to determine the etiology of SBO.
Results
A total of 55 patients were included in this study, with a median age of 57 years and male sex (63.6%) constituting the majority. The most frequently reported symptoms were abdominal pain and nausea or vomiting. Neoplasm as an underlying cause accounted for 34.5% of the cases, of which 25.5% were malignant cases. In patients aged ≥60 years (n=23), small bowel neoplasms were the underlying cause in 12 (52.2%), of whom 9 (39.1%) were malignant cases. Adhesions and Crohn disease were more frequent in patients aged <60 years. Coherence between preoperative computed tomography scans and intraoperative findings was found in 63.6% of the cases.
Conclusion
There were various causes of surgical cases of SBO in virgin abdomens. In older patients, hidden malignancy should be considered as a possible cause of SBO in a virgin abdomen. Patients with symptoms of recurrent bowel obstruction who have no history of prior abdominal surgery require thorough medical history and close follow-up.

Citations

Citations to this article as recorded by

Spontaneous Right-Sided Diaphragmatic Hernia: A Rare Cause of Small Bowel Obstruction
Phoebe Douzenis, Ali Yasen Y Mohamedahmed, Sreekanth Sukumaran, Zbigniew Muras, Najam Husain
Cureus.2024;[Epub] CrossRef
Colonic pseudo-obstruction in a patient with dyssynergic defecation: A case report
Yejun Jeong, Yongjae Kim, Wonhyun Kim, Seoyeon Park, Su-Jin Shin, Eun Jung Park
International Journal of Surgery Case Reports.2022; 98: 107524. CrossRef

Minimally invasive surgery,Surgical technique

The impact of assistants’ reverse alignment surgical skill proficiency on laparoscopic colorectal surgery: Seunghun Lee; Ann Coloproctol. 2022;38(6):432-441. Published online January 20, 2022; DOI: https://doi.org/10.3393/ac.2021.00689.0098

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Graphical Abstract Abstract PDF

Purpose
We aimed to investigate the difference in the surgical outcome based on whether the assistant overcame the mirror image in laparoscopic colorectal surgery.
Methods
Three hundred patients who underwent laparoscopic colorectal surgery performed by single operator were divided into 2 groups. Based on the assistants’ experience, patients who underwent surgery involving 1 of 6 residents with an experience of fewer than 30 surgeries each were classified into group 1. Patients who underwent surgery involving a single fellow as an assistant with an experience of over 1,000 surgeries were classified into group 2. According to the type of surgery, patients were divided into left and right colon resection groups and the surgical outcome of groups 1 and 2 was investigated.
Results
Group 2 exhibited shorter operation time, less bleeding, shorter postoperative hospital stay, lower open conversion, and anastomotic leakage rate than group 1. In right colon resection, the operation time was shorter in group 2. In left colon resection, group 2 exhibited shorter operation time, less bleeding, shorter postoperative hospital stay, and lower anastomotic leakage rate. In the multivariate analysis, the assistant was a factor affecting the operation time in the entire surgery.
Conclusion
Assistants’ reverse alignment surgical skill proficiency was a factor affecting the operation time.

Citations

Citations to this article as recorded by

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
Can assistants’ skills be used to improve colorectal cancer surgery outcomes in a way similar to the “butterfly effect”?
Je-Ho Jang
Annals of Coloproctology.2022; 38(6): 391. CrossRef

Malignant disease,Colorectal cancer,Complication,Biomarker & risk factor

Presepsin (soluble CD14 subtype) as a risk factor for the development of infectious and inflammatory complications in operated colorectal cancer patients: Kayrat Shakeyev, Yermek Turgunov, Alina Ogizbayeva, Olga Avdiyenko, Miras Mugazov, Sofiko Grigolashvili, Ilya Azizov; Ann Coloproctol. 2022;38(6):442-448. Published online April 4, 2022; DOI: https://doi.org/10.3393/ac.2022.00115.0016

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Abstract PDF

Purpose
In this pilot study the dynamic of presepsin (soluble CD14 subtype, sCD14-ST) in blood serum was assessed as a possible risk factor for the development of systemic inflammatory response syndrome (SIRS) and infectious and inflammatory complications in operated colorectal cancer patients.
Methods
To determine sCD14-ST by enzyme-linked immunosorbent assay method venous blood was taken 1 hour before surgery and 72 hours after it (3rd day). The presence of SIRS and organ dysfunctions (ODs) according to the Sequential Organ Failure Assessment scale were assessed.
Results
Thiry-six patients with colorectal cancer were enrolled in the study. sCD14-ST level before surgery was 269.8±103.1 pg/mL (interquartile range [IQR], 196.7–327.1 pg/mL). Despite the presepsin level on the 3rd day being higher (291.1±136.5 pg/mL; IQR, 181.2–395.5 pg/mL), there was no statistical significance in its dynamics (P=0.437). sCD14-ST value both before surgery and on the 3rd day after it was significantly higher in patients with bowel obstruction (P=0.038 and P=0.007). sCD14-ST level before surgery above 330 pg/mL showed an increase in the probability of complications, SIRS, and OD (odds ratio [OR], 5.5; 95% confidence interval [CI], 1.1–28.2; OR, 7.0; 95% CI, 1.3–36.7; and OR, 13.0; 95% CI, 1.1–147.8; respectively). Patients with OD had higher levels on the 3rd day after surgery (P=0.049).
Conclusion
sCD14-ST level in operated colorectal cancer patients was much higher if they were admitted with complication like bowel obstruction. Higher preoperative levels of sCD14-ST increase the probability of postoperative complications, SIRS, and OD. Therefore, further studies with large sample size are needed.

Citations

Citations to this article as recorded by

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 Reports

Benign proctology,Complication,Biomarker & risk factor

Recurrent bleeding after posthemorrhoidectomy caused by factor V deficiency: a case report and review of the literature: Jun Seong Chung, Han Deok Kwak, Jae Kyun Ju; Ann Coloproctol. 2022;38(6):449-452. Published online July 27, 2021; DOI: https://doi.org/10.3393/ac.2021.00185.0026

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Abstract PDF

Congenital factor V (FV) deficiency is a rare hemorrhagic disorder that can cause excessive bleeding during and after surgery in the affected patient. This report is the case of a patient who had FV deficiency with recurrent posthemorrhoidectomy bleeding treated with the hemostatic procedure and fresh frozen plasma (FFP) transfusions. A 45-year-old male patient had previously undergone hemorrhoidectomy for multiple hemorrhoids at a local hospital. Hemorrhoidectomy was successful; however, he was transferred to our hospital for evaluation of the origin of the recurrent posthemorrhoidectomy bleeding and underwent a hemostatic procedure. This bleeding was treated with coagulation using electrocautery, multiple sutures, and FFP transfusion (1,600 mL/day) for 7 consecutive days. The patient’s plasma FV activity was 23%. Early detection of clotting factor deficiency in patients with hemorrhagic events after surgical treatments may prevent unnecessary procedures such as reoperations and minimize the cost of replacement therapy such as large-volume FFP transfusion.

Citations

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Plasma/tranexamic-acid/vitamin-k

Reactions Weekly.2023; 1954(1): 383. CrossRef

Benign diesease & IBD,Rare disease & stoma

Calcium polystyrene sulfonate associated colonic mucosal injury—innocent bystander or pathogenic culprit?: a case report and literature review: Setthachai Piwchan, Ekawee Sripariwuth, Peerayut Sitthichaiyakul; Ann Coloproctol. 2022;38(6):453-456. Published online May 28, 2021; DOI: https://doi.org/10.3393/ac.2021.03.19

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4 Citations

Abstract PDF

Colonic mucosal injury is rare, but may severely fatal, complications following the administration of calcium polystyrene sulfonate resins. The incidence rate is about 0.57%, administered without sorbitol, and increases to 1.8% when it is concomitant with sorbitol, especially in postoperative patients. In this case report, we demonstrated the case of a 77-year-old female with stage 3b chronic kidney disease presented with in-hospital hematochezia after 3 weeks of calcium polystyrene sulfonate administration. The colonoscopic findings showed several serpiginous ulcers with some oozing at descending and sigmoid colon. The histological findings revealed some focal inflammation and ulcerations with crystal-like materials, compatible with cation exchange resins. The recent in vitro study, explaining the pathogenesis of cation exchange resin-associated colonic mucosal injury, was also reviewed.

Citations

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Calcium Polystyrene Sulfonate Crystal-related Airway Obstruction
Hideshige Seki, Kensuke Narukawa, Yurika Mitsui, Yukari Shirasugi, Shigeki Morita, Tsuyoshi Takahashi
Internal Medicine.2024; 63(19): 2699. CrossRef
Calcium polystyrene sulfonate-induced rectal ulcer causing E. coli native-valve infective endocarditis
Shinnosuke Fukushima, Hideharu Hagiya, Hiroyuki Honda, Tomoharu Ishida, Ryohei Shoji, Kou Hasegawa, Fumio Otsuka
Clinical Journal of Gastroenterology.2024; 17(3): 472. CrossRef
Pharmacological intestinal obstruction because of calcium polystyrene sulfonate administration
Benjamin Thorpe, Salustiano Gonzalez Vinagre, Daniel Santos, Javier Caneiro Gomez, Manuel Bustamante Montalvo
Journal of Surgical Case Reports.2024;[Epub] CrossRef
Calcium-polystyrene-sulfonate

Reactions Weekly.2023; 1944(1): 174. CrossRef

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