Annals of Coloproctology

Volume 39(2); April 2023

Editorial

To what extent does endoscopic tattooing marking boost lymph node retrieval?: Won Beom Jung; Ann Coloproctol. 2023;39(2):95-96. Published online April 28, 2023; DOI: https://doi.org/10.3393/ac.2023.00213.0030

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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

Reviews

Optimal anastomotic technique in rectal surgery to prevent anastomotic leakage: Daichi Kitaguchi, Masaaki Ito; Ann Coloproctol. 2023;39(2):97-105. Published online January 3, 2023; DOI: https://doi.org/10.3393/ac.2022.00787.0112

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Abstract PDF

Complications after colorectal surgery remain inevitable, and anastomotic leakage is one of the most severe and potentially fatal complications. Generally, anastomotic leakage is associated with severe peritonitis, the need for emergency reoperation, and an increased mortality rate. Additionally, particularly after rectal cancer surgery, it has a negative impact on long-term outcomes, including postoperative anorectal function, local recurrence, and survival. To prevent anastomotic leakage, understanding the characteristics of each anastomotic technique and establishing a stable anastomotic procedure are important. Transanal total mesorectal excision (TaTME) is a relatively new advanced surgical access technique for pelvic dissection and facilitates different anastomotic techniques without the need for transabdominal rectal transection. Especially, stapled anastomosis in TaTME, also known as double purse-string circular stapled anastomosis or the single stapling technique (SST), has gained much attention as an alternative to the conventional double stapling technique (DST). In this article, we describe the DST, SST, and hand-sewn anastomosis as anastomotic techniques after rectal surgery, focusing mainly on the differences between conventional anastomotic techniques and SST in TaTME. Furthermore, the blood flow evaluation method for the reconstructive colon before anastomosis, which is extremely important in anastomotic leakage prevention regardless of the anastomotic type, is also described.

Citations

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Dissection layer selection based on an understanding of pelvic fascial anatomy in transanal total mesorectal excision
Daichi Kitaguchi, Masaaki Ito
Annals of Coloproctology.2024; 40(4): 375. CrossRef
Successful Clinical Avoidance of Colorectal Anastomotic Leakage through Local Decontamination
Gerhard Ernst Steyer, Markus Puchinger, Johann Pfeifer
Antibiotics.2024; 13(1): 79. CrossRef
Combined Robotic Transanal Transection Single-Stapled Technique in Ultralow Rectal Endometriosis Involvement Associated With Parametrial and Vaginal Infiltration
Gianmarco D'Ancona, Benjamin Merlot, Quentin Denost, Stefano Angioni, Thomas Dennis, Horace Roman
Journal of Minimally Invasive Gynecology.2024; 31(4): 267. CrossRef
Risk factors for the failure of endoscopic balloon dilation to manage anastomotic stricture from colorectal surgery: retrospective cohort study
Young Il Kim, Seung Wook Hong, Seok-Byung Lim, Dong-Hoon Yang, Eon Bin Kim, Min Hyun Kim, Chan Wook Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Chang Sik Yu
Surgical Endoscopy.2024; 38(4): 1775. CrossRef
The impact of powered circular staplers on anastomotic leak in left-sided colorectal cancer surgeries
Hayoung Lee, Yong Sik Yoon, Young Il Kim, Eun Jung Park, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim
Surgical Endoscopy.2024;[Epub] CrossRef
The Safe Values of Quantitative Perfusion Parameters of ICG Angiography Based on Tissue Oxygenation of Hyperspectral Imaging for Laparoscopic Colorectal Surgery: A Prospective Observational Study
Gyung Son, Armaan Nazir, Mi Yun, In Lee, Sun Im, Jae Kwak, Sang-Ho Park, Kwang-Ryul Baek, Ines Gockel
Biomedicines.2023; 11(7): 2029. 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

Gene and protein expression of epithelial to mesenchymal transition for intestinal and anal fistula: a systematic review: Nadila Haryani Osman, Ruhi Fadzlyana Jailani, Hayati Abd Rahman, Nazefah Abdul Hamid; Ann Coloproctol. 2023;39(2):106-114. Published online December 3, 2021; DOI: https://doi.org/10.3393/ac.2021.00584.0083

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Purpose
Intestinal fibrosis is a common complication of inflammatory bowel diseases. However, the possible involvement of epithelial-mesenchymal transition (EMT) has been scarcely investigated. This systematic review aims to search through research papers that are focusing on messenger RNA (mRNA) and protein expression profile in EMT in fistula or in intestinal fibrosis.
Methods
Electronic exploration was performed until April 24, 2019 through PubMed, Ovid, Science Direct, and Scopus databases with the terms of “fistula” OR “intestinal fibrosis” AND “epithelial-mesenchymal transition”. Two independent reviewers scrutinized the suitability of the title and abstract before examining the full text that met the inclusion criteria. For each study, the sample types that were used, methods for analysis, and genes expressed were identified. The list of genes was further analyzed using DAVID (Database for Annotation, Visualization, and Integrated Discovery) and KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway.
Results
There were 896 citations found; however, only 3 studies fulfilled the requirements. Among the EMT-related genes, 5 were upregulated genes at mRNA level while 6 were at protein level. However, only 2 downregulated genes were found at each mRNA and protein level. Of the 4 inflammation-related genes found, 3 genes were upregulated at mRNA level and 1 at protein level. These genes were confirmed to be involved in the development of inflammatory induced fibrosis and fistula through EMT. Results from quantitative real-time polymerase chain reaction analysis were consistent with the process of EMT, confirmed by the western blot protein analysis.
Conclusion
Many significant genes which are involved in the process of EMT in fistula and intestinal fibrosis have been identified. With high-end technology many more genes could be identified. These genes will be good molecular targets in the development of biomarkers for precision drug targeting in the future treatment of intestinal fibrosis and fistula.

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Role of Adipose Tissue Hormones in Pathogenesis of Cryptoglandular Anal Fistula
Marcin Włodarczyk, Jakub Włodarczyk, Kasper Maryńczak, Anna Waśniewska-Włodarczyk, Urszula Doboszewska, Piotr Wlaź, Łukasz Dziki, Jakub Fichna
International Journal of Molecular Sciences.2024; 25(3): 1501. CrossRef
Exosomes Derived from Colon Cancer Cells Promote Tumor Progression and Affect the Tumor Microenvironment
Minsung Kim, Il Tae Son, Gyoung Tae Noh, So-Youn Woo, Ryung-Ah Lee, Bo Young Oh
Journal of Clinical Medicine.2023; 12(12): 3905. CrossRef

Original Articles

Preoperative endoscopic tattoo marking improves lymph node retrieval in laparoscopic rectal resection: a retrospective cohort study: Kouki Imaoka, Takuya Yano, Masanori Yoshimitsu, Sotaro Fukuhara, Ko Oshita, Kanyu Nakano, Masaki Kunihiro, Hitoshi Idani, Masazumi Okajima; Ann Coloproctol. 2023;39(2):115-122. Published online September 16, 2021; DOI: https://doi.org/10.3393/ac.2021.00458.0065

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Graphical Abstract Abstract PDF

Purpose
Harvesting at least 12 lymph nodes (LNs) is recommended for adequate tumor staging in colon surgery. Although preoperative endoscopic tattooing has been used for primary localization of tumors, its impact on LN retrieval in colorectal surgery remains controversial. We aimed to investigate the relationship between preoperative tattooing and LN retrieval after laparoscopic rectal resection.
Methods
We reviewed the records of 92 patients with rectal cancer who underwent laparoscopic resection from January 1, 2018 to December 31, 2019. Patients were categorized into 2 groups according to whether preoperative endoscopic tattooing was performed. The rate of adequate LN retrieval (≥12) was compared.
Results
The tattooed and non-tattooed groups comprised 49 and 43 patients, respectively. In the tattooed and non-tattooed groups, the rates of adequate LN retrieval were 75.5% and 55.8%, respectively (P=0.046). Univariate analysis revealed that female sex, tattooing, LN metastasis status, pathological pathological stage (p-stage), and LN dissection were predictive factors for adequate LN retrieval. In the multivariate analysis, female sex (odds ratio [OR], 3.34; 95% confidence interval [CI], 1.15–9.73; P=0.027), tattooing (OR, 2.87; 95% CI, 1.03–7.94; P=0.043), and p-stage (OR, 3.34; 95% CI, 1.04–10.75; P=0.043) were independent predictive factors for adequate LN retrieval after surgery.
Conclusion
This study revealed that preoperative endoscopic tattooing was statistically significantly associated with adequate LN retrieval in patients with rectal cancer who underwent laparoscopic rectal resection. Preoperative endoscopic tattooing should be considered to improve disease assessment and avoid stage migration.

Citations

Citations to this article as recorded by

To what extent does endoscopic tattooing marking boost lymph node retrieval?
Won Beom Jung
Annals of Coloproctology.2023; 39(2): 95. CrossRef
The effect of preoperative endoscopic tattooing on lymph node retrieval in colorectal cancer: a systematic review and meta-analysis
Mohamad Nawras, Karan Chawla, Armelle DeRiso, Christina Dubchuk, Azizullah Beran, Muhammad Aziz, Stephanie M. Pannell
International Journal of Colorectal Disease.2023;[Epub] CrossRef
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
Association between the number of retrieved lymph nodes and demographic/tumour-related characteristics in colorectal cancer: a systematic review and meta-analysis
Qianqian Liu, Min Huang, Jing Yang, Mengyuan Jiang, Ziru Zhao, Haitong Zhao, Tingting He, Yuping Bai, Rui Zhang, Min Zhang
BMJ Open.2023; 13(12): e072244. CrossRef

Right-sided acute diverticulitis in the West: experience at a university hospital in Argentina: René M. Palacios Huatuco, Diana A. Pantoja Pachajoa, Julian E. Liaño, Héctor A. Picón Molina, Rafael Palencia, Alejandro M. Doniquian, Matías Parodi; Ann Coloproctol. 2023;39(2):123-130. Published online November 24, 2021; DOI: https://doi.org/10.3393/ac.2021.00402.0057

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Abstract PDF: Purpose
In the West, diverticular disease is located mainly in the left colon. However, it can also present in the right colon, with an incidence of 1% to 2% in Caucasians. The purpose of this study was to describe our experience in right-sided acute diverticulitis (RD).
Methods
In this retrospective study, 410 patients with acute diverticulitis treated from 2013 to 2020 were included in a university hospital in Córdoba, Argentina. Colonic diverticulitis was stratified into 2 groups; RD and left-sided acute diverticulitis. Demographic and clinical variables, laboratory and imaging findings, type of treatment, follow-up, and recurrence were analyzed.
Results
Sixteen patients (3.9%) with RD were identified; 62.5% were male and the mean age was 40.7±11.7 years. A total of 81.3% were Caucasian and 18.7% Native American. Significant differences were found between both groups of diverticulitis; patients with RD were younger (P=0.001), with lower BMI (P=0.01), comorbidity rate (P=0.01), Charlson comorbidity index (P=0.02), hospital stay (P=0.01), severity according to the Hinchey classification (P=0.001) and had a lower recurrence rate (P=0.001). There were no significant differences in sex (P=0.95), duration of pain until admission (P=0.05), laboratory findings (P=0.23) and treatment (P=0.34).
Conclusion
Conservative treatment predominated in RD, with a lower rate of complications and recurrences, providing data that support conservative therapy as initial treatment in RD in our environment.

The importance of topical metronidazole in the treatment of acute anal fissure: a double-blind study controlled for prospective randomization: Tuba Mert; Ann Coloproctol. 2023;39(2):131-138. Published online January 18, 2022; DOI: https://doi.org/10.3393/ac.2021.00675.0096

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Graphical Abstract Abstract PDF

Purpose
Acute anal fissure, a disease characterized by severe pain in the anorectal area, reduces quality of life and becomes chronic absent appropriate treatment. More recently, anaerobic infections have been noted as contributive to etiopathogenesis. This study investigates topical metronidazole’s effect in the treatment of acute anal fissure.
Methods
Our prospective randomized controlled double-blind study included 2 groups of 100 patients older than 18 years from our General Surgery Clinic with anal fissure complaints for less than 8 weeks. Topical diltiazem treatment was started in group 1, and topical diltiazem and metronidazole treatment in group 2. Pain levels were evaluated by the visual analogue scale (VAS) score, and recovery status was evaluated by physical examination findings ab initio and at the 1st, 4th, and 6th weeks. VAS score levels, demographic, clinical, and recovery status were then compared.
Results
There was no difference between the groups as to age, sex, pain on defecation, bleeding, constipation, and duration of pain, bleeding and constipation (P>0.05). From week 1, fissure epithelialization and healing rates were higher in group 2 (P<0.001); group 2 VAS score levels were lower than in group 1 (P<0.001) and achieved by group 1 only in week 4 (P=0.073).
Conclusion
Adding topical metronidazole to treatment reduces the duration and severity of pain, shortens healing time, and increases the healing rate.

Citations

Citations to this article as recorded by

Efficacy of local metronidazole with glyceryl trinitrate versus topical glyceryl trinitrate alone in the treatment of acute anal fissure: a randomized clinical trial
Hesham M. Elgendy, Ahmed AbdelMawla, Ahmed F. Hussein
The Egyptian Journal of Surgery.2024; 43(1): 304. CrossRef
Belgian consensus guideline on the management of anal fissures
P Roelandt, G Bislenghi, G Coremans, D De Looze, M.A. Denis, H De Schepper, P Dewint, J Geldof, I Gijsen, N Komen, H Ruymbeke, J Stijns, M Surmont, D Van de Putte, S Van den Broeck, B Van Geluwe, J Wyndaele
Acta Gastro Enterologica Belgica.2024; 87(2): 304. CrossRef
Local plus oral antibiotics and strict avoidance of constipation is effective and helps prevents surgery in most cases of anal fissure
Pankaj Garg, Vipul D. Yagnik, Kaushik Bhattacharya
Annals of Coloproctology.2023; 39(2): 188. CrossRef
COMPARATIVE STUDY ON THE EFFICACY OF TOPICAL METRONIDAZOLE, TOPICAL NITROGLYCERINE, AND TOPICAL DILTIAZEM IN THE MANAGEMENT OF CHRONIC ANAL FISSURE
PURSHOTAM DASS GUPTA, FAHAD TAUHEED, ANURAG SARASWAT, Karthik P
Asian Journal of Pharmaceutical and Clinical Research.2023; : 141. CrossRef
The Italian Unitary Society of Colon-proctology (SIUCP: Società Italiana Unitaria di Colonproctologia) guidelines for the management of anal fissure
Antonio Brillantino, Adolfo Renzi, Pasquale Talento, Francesca Iacobellis, Luigi Brusciano, Luigi Monaco, Domenico Izzo, Alfredo Giordano, Michele Pinto, Corrado Fantini, Marcello Gasparrini, Michele Schiano Di Visconte, Francesca Milazzo, Giovanni Ferrer
BMC Surgery.2023;[Epub] CrossRef
Comparative Efficacy of Topical Metronidazole and Glyceryl Trinitrate Versus Topical Glyceryl Trinitrate Alone in the Treatment of Acute Anal Fissure: A Randomized Clinical Trial
M Hasaan Shahid, Sidra Javed, Saryia Javed, Anwar Zeb Khan, Adeel Kaiser, Reda H Mithany
Cureus.2022;[Epub] CrossRef

Effect of reinforcement suture on anastomotic healing in rectal and sigmoid tumor resections, single-center experience: a retrospective case-controlled study: Tomáš Řezáč, Petr Špička, Pavel Zbořil, Martin Stašek, Radek Vrba, Dušan Klos; Ann Coloproctol. 2023;39(2):139-146. Published online March 11, 2022; DOI: https://doi.org/10.3393/ac.2021.00948.0135

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Abstract PDF: Purpose
Healing of colorectal anastomosis is burdened with a number of risk factors and the development of leak carries with it higher morbidity and mortality associated not only with worse quality of life but also worse oncological outcomes. The purpose of the study was an evaluation of the effect of reinforcement suture in the healing of stapler rectal anastomosis and risk factors for anastomotic leakage in mid, upper rectal and sigmoid tumors.
Methods
A total of 357 patients who underwent curative resection for rectal or sigmoid tumor over 5 years were analyzed. Risk factors, baseline demographic and clinical data, and presence of leak were recorded. All statistical analyses were carried out at a significance level of P<0.05.
Results
One hundred fifty-one patients met the inclusion criteria for the study. The overall incidence of leak was 2.8% in the group with reinforcement suture and 6.3% in the group without reinforcement suture. Because of the low incidence of leak the results were not statistically significant. Further results also show that none of the monitored parameters (age, weight, body mass index, tumor distance, preoperative radiotherapy, tumor stage, type of surgery) were significant predictors of anastomotic leakage.
Conclusion
Although the reinforcement suture is a safe and simple option for anastomosis protection after rectal or sigmoid resections, its statistical significance was not demonstrated in our study.

Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy: a retrospective cohort study of anastomotic complications: Jonathan Frigault, Samuel Avoine, Sébastien Drolet, François Letarte, Alexandre Bouchard, Jean-Pierre Gagné, Claude Thibault, Roger C. Grégoire, Naomee Jutras Bouthillette, Maude Gosselin, Philippe Bouchard; Ann Coloproctol. 2023;39(2):147-155. Published online March 29, 2022; DOI: https://doi.org/10.3393/ac.2021.00983.0140

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Abstract PDF

Purpose
Laparoscopic right hemicolectomy (LRH) can be performed with an intracorporeal anastomosis (IA) or extracorporeal anastomosis (EA). It is not clear which technique is best. This study evaluated the impact of each anastomosis technique on perioperative safety and postoperative evolution.
Methods
We performed a retrospective study at a tertiary colorectal surgery center. All patients who had an elective LRH from 2015 to 2019 were analyzed according to the anastomosis technique used.
Results
In total, 285 patients were included in the study. IA was performed in 64 patients (22.5%). Mean operative time was longer in the patients with IA (IA, 160±31 minutes vs. EA, 138±42 minutes; P<0.001). No differences were observed in intraoperative complications, time to first bowel movement, length of stay, reoperation, or rehospitalization. Time to first flatus was longer in the patients with IA (P=0.049). At 30 days after surgery, there were no differences in the frequency of anastomotic leak (IA, 0% vs. EA, 2.3%; P=0.59), bleeding (IA, 3.1% vs. EA, 2.7%; P>0.99), or intraabdominal abscess (IA, 0% vs. EA, 0.5%; P>0.99). During follow-up, we noted more incisional hernias in patients with EA (IA, 1.6% vs. EA, 11.3%; P=0.01) and a trend toward more hernia in patients with EA in multivariate analysis (hazard ratio, 7.13; P=0.06). Anastomosis technique had no influence on recurrence.
Conclusion
For LRH, both IA and EA are safe, with a low incidence of complications when performed by experienced surgeons. IA may be associated with a lower incidence of incisional hernia.

Citations

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Comparison of intracorporeal and extracorporeal anastomosis in laparoscopic right colectomy: an updated meta-analysis and trial sequential analysis
Konstantinos Perivoliotis, George Tzovaras, Konstantinos Tepetes, Ioannis Baloyiannis
Updates in Surgery.2024; 76(2): 375. CrossRef
Effectiveness and safety of self-pulling and latter transection reconstruction in totally laparoscopic right hemicolectomy
Fuyu Yang, Fan He, Chenglin Tang, Defei Chen, Junjie Xiong, Yu Zou, Saed Woraikat, Kun Qian, Hui Li
Frontiers in Oncology.2024;[Epub] CrossRef
Single-Center Experiences: A Comparison of Intracorporeal and Extracorporeal Anastomosis Outcomes in Right Hemicolectomy
Audrey Kim, Munyaradzi G Nyandoro, Linda Vu, Ruben Rajan, Abraham Jacob
Cureus.2024;[Epub] CrossRef
Comparing extracorporeal, semi-extracorporeal, and intracorporeal anastomosis in laparoscopic right hemicolectomy: introducing a bridging technique for colorectal surgeons
Hye Jung Cho, Jong Woo Kim, Woo Ram Kim
Annals of Surgical Treatment and Research.2024; 107(1): 42. CrossRef
Effect of Specimen Extraction Site on Postoperative Incisional Hernia after Minimally Invasive Right Colectomy
Josh A Johnson, Andrea Mesiti, Margo Herre, Cyrus Farzaneh, Ying Li, Wini Zambare, Joseph Carmichael, Alessio Pigazzi, Mehraneh D Jafari
Journal of the American College of Surgeons.2024; 239(2): 107. CrossRef
Extracorporeal versus intracorporeal anastomosis for right colon cancer surgery
Seong Kyu Baek
Journal of Minimally Invasive Surgery.2022; 25(3): 91. CrossRef

The albumin to globulin ratio is associated with clinical outcome in Japanese patients with ulcerative colitis: Sen Yagi, Shinya Furukawa, Kana Shiraishi, Teruki Miyake, Kazuhiro Tange, Yu Hashimoto, Shogo Kitahata, Tomoe Kawamura, Tomoyuki Ninomiya, Kenichirou Mori, Seiyuu Suzuki, Naozumi Shibata, Hidehiro Murakami, Katsuhisa Ohashi, Aki Hasebe, Hideomi Tomida, Yasunori Yamamoto, Eiji Takeshita, Yoshio Ikeda, Yoichi Hiasa; Ann Coloproctol. 2023;39(2):155-163. Published online March 30, 2022; DOI: https://doi.org/10.3393/ac.2021.01032.0147

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Abstract PDF

Purpose
The albumin to globulin ratio (AGR) is a recognized chronic inflammation marker. No evidence regarding the relationship between AGR level and ulcerative colitis (UC) exists. The aim of this study was to evaluate the association between AGR and clinical outcomes among Japanese subjects with UC.
Methods
The study subjects consisted of 273 Japanese individuals with UC. AGR was divided into 4 categories (low, moderate, high, and very high). The definition of complete mucosal healing (MH) was based on the Mayo endoscopic subscore of 0. Clinical remission (CR) was defined as no rectal bleeding and no abnormally high stool frequency (<3 times per day).
Results
The percentage of MH was 26.4%. High AGR and very high AGR were significantly positively correlated with CR (adjusted odds ratio [OR], 5.85; 95% confidence interval [CI], 2.52–14.18 and adjusted OR, 4.97; 95% CI, 2.14–12.04) and complete MH (adjusted OR, 4.03; 95% CI, 1.56–11.51 and adjusted OR, 5.22; 95% CI, 1.97–14.89), respectively after adjustment for confounding factors (P for trend=0.001). Only in the low C-reactive protein (CRP) group (≤0.1 mg/dL), very high AGR was significantly positively correlated with complete MH but not CR (adjusted OR, 4.38; 95% CI, 1.06–21.77; P for trend=0.017). In the high CRP group, no correlation between AGR and complete MH was found.
Conclusion
Among Japanese patients with UC, AGR may be independently positively correlated with complete MH. In particular, among UC patients with low CRP, AGR might be a useful complementary marker for complete MH.

Citations

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Prognostic impact of preoperative nutritional and immune inflammatory parameters on liver cancer
Sung Uk Bae
World Journal of Gastrointestinal Surgery.2024; 16(2): 266. CrossRef
Progress in Biomarkers of Inflammatory Bowel Disease
舒陈
Advances in Clinical Medicine.2024; 14(03): 1418. CrossRef
Clinical utility of C‐reactive protein‐to‐albumin ratio in the management of patients with inflammatory bowel disease
Anke L Nguyen, Claudia Brick, David Liu, David J Gibson, Peter R Gibson, Miles P Sparrow
JGH Open.2024;[Epub] CrossRef
Association between Mucosal Healing and Lipid Profiles in Patients with Ulcerative Colitis: A Cross-Sectional Study
Sen Yagi, Shinya Furukawa, Teruki Miyake, Kana Shiraishi, Kazuhiro Tange, Yu Hashimoto, Shogo Kitahata, Tomoyuki Ninomiya, Seiyuu Suzuki, Naozumi Shibata, Hidehiro Murakami, Katsuhisa Ohashi, Hideomi Tomida, Yasunori Yamamoto, Eiji Takeshita, Yoshio Ikeda
Digestion.2023; 104(2): 129. CrossRef
Current and emerging biomarkers for ulcerative colitis
Jan K. Nowak, Rahul Kalla, Jack Satsangi
Expert Review of Molecular Diagnostics.2023; 23(12): 1107. CrossRef

Radiofrequency ablation (Rafaelo Procedure) for the treatment of hemorrhoids: a case series in the United Kingdom: Sarah Hassan, Daniel McGrath, Richard Barnes, Simon Middleton; Ann Coloproctol. 2023;39(2):164-167. Published online August 18, 2021; DOI: https://doi.org/10.3393/ac.2021.00276.0039

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Abstract PDF

Purpose
Hemorrhoidal disease remains a common condition that can have a significant effect on a patient’s quality of life. Various methods have been introduced over the years; however, their overall success rates remain low. Although the traditional Milligan Morgan technique is effective, the associated pain level prevents it from being an attractive form of treatment. This study was devised to assess the safety and efficacy associated with a novel minimally invasive approach, radiofrequency ablation (RFA).
Methods
Forty-two patients underwent RFA at a single center, by 1 of 2 surgeons. This was performed under local anesthetic and sedation. Outcomes including postoperative pain levels, recurrence rates, and patient satisfaction scores were recorded and analyzed using medians and interquartile ranges
Results
The median postoperative pain score was 2.5/10 (interquartile range [IQR], 0–4.5) and the overall patient satisfaction score was 9 out of 10 (IQR, 6.5–10). Recurrence rates (6–12 months following the procedure) were low at 12% and all patients reported milder symptoms at recurrence. There were no serious adverse complications
Conclusion
The results from this case series supports other limited data in concluding that RFA is a safe and effective method in the treatment of hemorrhoids and patients report a high level of satisfaction following

Citations

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Radiofrequency Ablation for Internal Hemorrhoids: A Case Series
Kean leong Koay, Nabil Mohammad Azmi, Soma Chandrakanthan, Nurafdzillah Abdul Rahman, Diana Melissa Dualim
Cureus.2024;[Epub] CrossRef
Protocol for the ORION trial (RadiO fRequency ablatION for haemorrhoids): a randomised controlled trial
C. Girling, M. J. Lee, D. Vimalchandran, D. J. Jayne, S. Stancliffe, A. Wailoo, M. Bradburn, D. Hind, M. Bursnall, L. K. Robinson, S. R. Brown
Techniques in Coloproctology.2023; 27(2): 117. CrossRef
The role of the Rafaelo procedure in the management of hemorrhoidal disease: a systematic review and meta-analysis
Prokopis Christodoulou, Ioannis Baloyiannis, Konstantinos Perivoliotis, Dimitrios Symeonidis, George Tzovaras
Techniques in Coloproctology.2023; 27(2): 103. CrossRef
Radiofrequency thermocoagulation of haemorrhoids: learning curve of a novel approach
Valentin Butnari, Ahmer Mansuri, Sandeep Kaul, Veeranna Shatkar, Richard Boulton
Journal of Surgical Case Reports.2023;[Epub] CrossRef
French multicentre prospective evaluation of radiofrequency ablation in the management of haemorrhoidal disease
A. Laurain, D. Bouchard, J.-M. Rouillon, P. Petit, A. Liddo, B. Vinson Bonnet, A. Venara, J.-M. Didelot, G. Bonnaud, A. Senéjoux, T. Higuero, P. Delasalle, A.-L. Tarrerias, F. Devulder, A. Castinel, C. Thomas, H. Pillant Le Moult, C. Favreau-Weltzer, L. A
Techniques in Coloproctology.2023; 27(10): 873. CrossRef
Early and midterm results of radiofrequency ablation (Rafaelo® procedure) for third-degree haemorrhoids: a prospective, two-centre study
S. Tolksdorf, D. Tübergen, C. Vivaldi, M. Pisek, F. Klug, M. Kemmerling, H. Schäfer
Techniques in Coloproctology.2022; 26(6): 479. CrossRef

Predisposing factors for high output stoma in patients with a diverting loop ileostomy after colorectal surgeries: Dan Assaf, David Hazzan, Almog Ben-Yaacov, Shachar Laks, Douglas Zippel, Lior Segev; Ann Coloproctol. 2023;39(2):168-174. Published online August 6, 2021; DOI: https://doi.org/10.3393/ac.2021.00241.0034

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Abstract PDF

Purpose
One of the most common ileostomy-related complications is high output stoma (HOS) which causes significant fluids and electrolytes disturbances. We aimed to analyze the incidence, severity, and risk factors for readmission for HOS.
Methods
We reviewed all patients who underwent loop ileostomy closure in a single institution between 2010 and 2020. Patients that were readmitted for dehydration due to HOS during the time interval between the creation and the closure of the stoma were identified and divided into a study (HOS) group. The remaining patients constructed the control group.
Results
A total of 307 patients were included in this study, out of which, 41 patients were readmitted 73 times (23.7% readmission rate) for the HOS group, and the remaining 266 patients constructed the control group. Multivariate analysis identified; advanced American Society of Anesthesiologists (ASA) physical status (PS) classification, elevated baseline creatinine, and open surgery as risk factors for HOS. Renal function worsened among the entire cohort between the construction of the stoma to its closure (mean creatinine of 0.82 vs. 0.96, P<0.0001).
Conclusion
Loop ileostomy formation is associated with a substantial readmission rate for dehydration as a result of HOS, and increasing the risk for renal impairment during the duration of the diversion. We identified advanced ASA PS classification, open surgery, and elevated baseline creatinine as predictors for HOS.

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Case Reports

Metachronous carcinoma at the colostomy site after abdominoperineal resection of rectal cancer: a case report: Young Sun Choi, Kil-young Lee, Youn Young Park, Hyung Jin Kim, Jaeim Lee; Ann Coloproctol. 2023;39(2):175-177. Published online July 27, 2021; DOI: https://doi.org/10.3393/ac.2020.00185.0026

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Metachronous carcinoma at the colostomy site is very rare after abdominoperineal resection. A 53-year-old male patient underwent an abdominoperineal resection 6 years earlier for rectal cancer developed metachronous carcinoma at the site of stoma. A portion of the colon, including the stoma and the surrounding skin, was resected and a new stoma was created in the transverse colon. Although the occurrence of carcinoma at the stoma site is a rare condition, careful observation for the stoma and colonoscopy for surveillance are necessary.

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Takayuki Kodama, Maki Kanzawa, Hiroshi Hasegawa, Shuichi Tsukamoto, Mari Nishio, Manabu Shigeoka, Yu‐ichiro Koma, Tomoo Itoh, Hiroshi Yokozaki
Pathology International.2024; 74(1): 33. CrossRef
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Muhammed Huzaifa, Ankita Singh, Vaibhav Aggarwal, Anita Dhar
Clinical Cancer Investigation Journal.2023; 12(2): 1. CrossRef
Peristomal adenocarcinoma 16 years after colorectal adenocarcinoma resection with curative intent
Kayleigh A M van Dam, Thaís T T Tweed, Bart de Vries, Henricus J Belgers
Journal of Surgical Case Reports.2023;[Epub] CrossRef

Multivisceral resection for colonic splenic flexure malakoplakia: a case report of a minimally invasive approach: Andrés Ramiro Lanza Díaz, Santiago Gallardo Pezet, Osvaldo Soto González, Montserrat Guraieb Trueba, Ivan Azael Martínez Alonso, Mario Alberto López Ramirez; Ann Coloproctol. 2023;39(2):178-182. Published online July 21, 2021; DOI: https://doi.org/10.3393/ac.2021.00178.0025

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Malakoplakia is a rare granulomatous inflammatory disorder. Its diagnosis depends on histopathological findings; however, high-quality literature regarding proper medical/surgical treatment is lacking. A 38-year-old diabetic female patient was admitted to the emergency room with a history of lower gastrointestinal hemorrhage. Colonoscopy revealed a lesion in the descending colon, and abdominal computed tomography revealed a splenic flexure mass involving the lower pole of the spleen and upper pole of the left kidney. Biopsies confirmed the diagnosis of malakoplakia. After completing antibiotic treatment, a restaging computed tomography revealed a discrete mass increase; hence, the patient underwent laparoscopic en bloc colectomy and partial nephrectomy. Postoperatively, the patient developed a pancreatic fistula, which was successfully treated with percutaneous drainage and antibiotics. The presence of pathognomonic Michaelis-Gutmann inclusions on histopathology is frequently reported as the key to diagnosing malakoplakia. Herein, we present a successful, minimally invasive surgical treatment for colonic malakoplakia.

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A Surgical Challenge Generated by Colonic Malakoplakia in Disguise as a Locally Advanced Colonic Malignancy—A Case Report
Cristina Șerban, Alexandra Toma, Dragoș Cristian Voicu, Constantin Popazu, Dorel Firescu, George Țocu, Raul Mihailov, Laura Rebegea
Medicina.2023; 59(1): 156. CrossRef

A rare presentation of low-grade appendiceal mucinous neoplasm within an amyand’s hernia: a case report: Hani Atiqah Saim, Ian Chik, Fahrol Fahmy Jaafar, Zamri Zuhdi, Razman Jarmin, Azlanudin Azman; Ann Coloproctol. 2023;39(2):183-187. Published online October 18, 2021; DOI: https://doi.org/10.3393/ac.2021.00430.0061

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An Amyand’s hernia is characterised as the presence of the appendix in an inguinal hernial sac. During laparoscopic cholecystectomy for gallbladder polyps, an incidental Amyand’s hernia was discovered in a 75-year-old female patient. On examination, the hernia contained an appendiceal mucocele but no evidence of perforation. An open appendicectomy with tension-free mesh repair was performed for the hernia. The histopathological report of the appendix was a low-grade appendiceal mucinous neoplasm (LAMN), an entity that is just as rare as an Amyand’s hernia. The patient had the right inguinal swelling for over 10 years but it was thought to be an inguinal intramuscular cyst as reported on a previous abdominal ultrasound. Mucocele of the appendix may have a benign or malignant appendiceal progress, leading to individualised diagnosis and treatment. We review an Amyand’s hernia with LAMN and discuss the asymptomatic tendency yet malignant potential of appendiceal mucoceles along with treatment strategies.

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Complicated Appendicitis Associated With Appendiceal Mucinous Neoplasm Within Amyand’s Hernia in a Patient With Previous Hernia Repair: A Case Report and Literature Review
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Letter to the Editor

Local plus oral antibiotics and strict avoidance of constipation is effective and helps prevents surgery in most cases of anal fissure: Pankaj Garg, Vipul D. Yagnik, Kaushik Bhattacharya; Ann Coloproctol. 2023;39(2):188-189. Published online November 29, 2022; DOI: https://doi.org/10.3393/ac.2022.00731.0104

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