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Colorectal cancer
Effects of clinical information on the treatment decisions for good responders to neoadjuvant chemoradiotherapy among rectal cancer patients
Eon Bin Kim, In Ja Park, Hwa Jung Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu
Ann Coloproctol. 2025;41(5):473-482.   Published online July 10, 2025
DOI: https://doi.org/10.3393/ac.2024.00276.0039
  • 1,652 View
  • 35 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDFSupplementary Material
Purpose
The decision for treatment after neoadjuvant chemoradiotherapy (nCRT) in rectal cancer is intricately linked to tumor response and clinical parameters. This study was designed to elucidate determinants influencing treatment decisions for good responders to nCRT, while concurrently evaluating the ramifications of modifications in magnetic resonance imaging (MRI) tumor response evaluation protocols.
Methods
A survey was constructed with 5 cases of good responder after nCRT based on the magnetic resonance–based tumor regression grade (mrTRG) criteria. A total of 35 colorectal surgeons in Korea participated in the survey via email, and they were introduced to 2 discrete MRI-based tumor response evaluation methodologies: the conventional mrTRG and an emergent complete response (CR)/non-CR classification system. Surgeons were directed to select between total mesorectal excision, local excision, or a watch and wait strategy.
Results
Treatment decisions varied significantly (P<0.01), as gradually more clinical information was provided with mrTRG. The paradigm shift from mrTRG to CR/non-CR evaluation criterion instigated the highest alteration in decision (P<0.01). Even comparing with other sets of information, decision change with different tumor response assessment (i.e., mrTRG vs. CR/non-CR) was statistically significant (P<0.01). Three particular cases consistently displayed a declining predilection for total mesorectal excision, favoring a more pronounced inclination towards watch and wait strategy or local excision. Nonetheless, the magnitude of these decisional shifts oscillated depending on the specific endoscopic imagery present.
Conclusion
Our current findings underscore the significant role of tumor response assessment methods in shaping treatment decisions for rectal cancer patients who respond well to nCRT. This highlights the need for clear and accurate tools to interpret MRI results.

Citations

Citations to this article as recorded by  
  • Clinical implications of radiologic criteria and prognostic factors for lateral lymph node metastasis in low rectal cancer
    Gyung Mo Son
    Annals of Coloproctology.2025; 41(6): 489.     CrossRef
Colorectal cancer
Oncologic outcomes and associated factors of colon cancer patients aged 70 years and older
Byeo Lee Lim, In Ja Park, Jun-Soo Ro, Young Il Kim, Seok-Byung Lim, Chang Sik Yu
Ann Coloproctol. 2025;41(3):198-206.   Published online August 5, 2024
DOI: https://doi.org/10.3393/ac.2023.00367.0052
  • 7,936 View
  • 94 Download
  • 4 Web of Science
  • 6 Citations
AbstractAbstract PDFSupplementary Material
Purpose
The aim of this study was to examine the prognosis and associated risk factors, including adjuvant chemotherapy (CTx), in elderly patients with colon cancer.
Methods
This retrospective study included patients who underwent radical resection for colon cancer between January 2010 and December 2014 at Asan Medical Center. The effects of stage, risk factors, and chemotherapy on overall survival (OS) and recurrence-free survival (RFS) were compared in patients aged ≥70 and <70 years.
Results
Of 3,313 patients, 933 (28.1%) was aged ≥70 years. Of the 1,921 patients indicated for adjuvant CTx, 1,294 of 1,395 patients (92.8%) aged <70 years and 369 of 526 patients (70.2%) aged ≥70 years received adjuvant CTx. Old age (≥70 years) was independently associated with RFS in overall cohort. Among patients aged ≥70 years indicated for adjuvant CTx, the 5-year OS (81.6% vs. 50.4%, P<0.001) and RFS (82.9% vs. 67.4%, P=0.025) rates were significantly higher in those who did than did not receive adjuvant CTx. Additionally, adjuvant CTx was confirmed as independent risk factor of both OS and RFS in patients aged ≥70 years indicated for adjuvant CTx.
Conclusion
Old age was associated with poor RFS and adjuvant CTx had benefits in OS as well as RFS in elderly patients eligible for adjuvant CTx.

Citations

Citations to this article as recorded by  
  • Immunological changes and recovery-related factors in older patients with colon cancer: A pilot trial
    Byeo Lee Lim, Young Il Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Yousun Ko, Kyung Won Kim, In Ja Park
    Journal of Geriatric Oncology.2025; 16(3): 102200.     CrossRef
  • Stage II-III colorectal cancer in geriatric patients: Clinicopathological features and chemotherapy utilization
    Yakup Duzkopru, Özlem Doğan
    Turkish Journal of Clinics and Laboratory.2025; 16(1): 118.     CrossRef
  • Does Oxaliplatin-based Adjuvant Therapy Benefit Older Colorectal Cancer Patients?
    Peter Hofland
    Onco Zine - The International Oncology Network.2025;[Epub]     CrossRef
  • Disease-Free Survival of Patients with Stage II Stroma-Rich Colorectal Adenocarcinomas with Microsatellite Stability
    Ángel Romo-Navarro, Juan Ruiz Martín, Irene García-Camacha Gutiérrez, Mariano Amo-Salas, María Recuero Pradillo, César Sánchez-Muñoz, Cristina María Murillo Lázaro, Esperanza Carabias López, Raquel Sánchez Simón, Carlos Quimbayo-Arcila, Yasmina Hernández
    International Journal of Molecular Sciences.2025; 26(24): 11795.     CrossRef
  • Early detection of anastomotic leakage in colon cancer surgery: the role of early warning score and C-reactive protein
    Gyung Mo Son
    Annals of Coloproctology.2024; 40(5): 415.     CrossRef
  • Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-Center Retrospective Analysis
    Jae Seung Kim, Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
    Cancers.2024; 16(24): 4280.     CrossRef
Colorectal cancer
Partial mesorectal excision can be a primary option for middle rectal cancer: a propensity score–matched retrospective analysis
Ee Jin Kim, Chan Wook Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Ann Coloproctol. 2024;40(3):253-267.   Published online March 31, 2023
DOI: https://doi.org/10.3393/ac.2022.00689.0098
  • 6,333 View
  • 223 Download
  • 1 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
Although partial mesorectal excision (PME) and total mesorectal excision (TME) is primarily indicated for the upper and lower rectal cancer, respectively, few studies have evaluated whether PME or TME is more optimal for middle rectal cancer.
Methods
This study included 671 patients with middle and upper rectal cancer who underwent robot-assisted PME or TME. The 2 groups were optimized by propensity score matching of sex, age, clinical stage, tumor location, and neoadjuvant treatment.
Results
Complete mesorectal excision was achieved in 617 of 671 patients (92.0%), without showing a difference between the PME and TME groups. Local recurrence rate (5.3% vs. 4.3%, P>0.999) and systemic recurrence rate (8.5% vs. 16.0%, P=0.181) also did not differ between the 2 groups, in patients with middle and upper rectal cancer. The 5-year disease-free survival (81.4% vs. 74.0%, P=0.537) and overall survival (88.0% vs. 81.1%, P=0.847) also did not differ between the PME and TME groups, confined to middle rectal cancer. Moreover, 5-year recurrence and survival rates were not affected by distal resection margins of 2 cm (P=0.112) to 4 cm (P>0.999), regardless of pathological stages. Postoperative complication rate was higher in the TME than in the PME group (21.4% vs. 14.5%, P=0.027). Incontinence was independently associated with TME (odds ratio [OR], 2.009; 95% confidence interval, 1.015–3.975; P=0.045), along with older age (OR, 4.366, P<0.001) and prolonged operation time (OR, 2.196; P=0.500).
Conclusion
PME can be primarily recommended for patients with middle rectal cancer with lower margin of >5 cm from the anal verge.

Citations

Citations to this article as recorded by  
  • Review of definition and treatment of upper rectal cancer
    Elias Karam, Fabien Fredon, Yassine Eid, Olivier Muller, Marie Besson, Nicolas Michot, Urs Giger-Pabst, Arnaud Alves, Mehdi Ouaissi
    Surgical Oncology.2024; 57: 102145.     CrossRef
  • Tumour-specific mesorectal excision for rectal cancer: Systematic review and meta-analysis of oncological and functional outcomes
    Fabio Carbone, Wanda Petz, Simona Borin, Emilio Bertani, Stefano de Pascale, Maria Giulia Zampino, Uberto Fumagalli Romario
    European Journal of Surgical Oncology.2023; 49(11): 107069.     CrossRef
Colorectal cancer
Efficacy of preoperative chemoradiotherapy in patients with cT2N0 distal rectal cancer
Min Young Park, Chang Sik Yu, Tae Won Kim, Jong Hoon Kim, Jin-hong Park, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Jin Cheon Kim
Ann Coloproctol. 2023;39(3):250-259.   Published online April 4, 2022
DOI: https://doi.org/10.3393/ac.2022.00066.0009
  • 6,275 View
  • 162 Download
  • 7 Web of Science
  • 7 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Purpose
This study was designed to determine the feasibility of preoperative chemoradiotherapy (PCRT) in patients with clinical T2N0 distal rectal cancer.
Methods
Patients who underwent surgery for clinical T2N0 distal rectal cancer between January 2008 and December 2016 were included. Patients were divided into PCRT and non-PCRT groups. Non-PCRT patients underwent radical resection or local excision (LE) according to the surgeon’s decision, and PCRT patients underwent surgery according to the response to PCRT. Patients received 50.0 to 50.4 gray of preoperative radiotherapy with concurrent chemotherapy.
Results
Of 127 patients enrolled, 46 underwent PCRT and 81 did not. The mean distance of lesions from the anal verge was lower in the PCRT group (P=0.004). The most frequent operation was transanal excision and ultralow anterior resection in the PCRT and non-PCRT groups, respectively. Of the 46 patients who underwent PCRT, 21 (45.7%) achieved pathologic complete response, including 15 of the 24 (62.5%) who underwent LE. Rectal sparing rate was significantly higher in the PCRT group (11.1% vs. 52.2%, P<0.001). There were no significant differences in 3- and 5-year overall survival and recurrence-free survival regardless of PCRT or surgical procedures.
Conclusion
PCRT in clinical T2N0 distal rectal cancer patients increased the rectal sparing rate via LE and showed acceptable oncologic outcomes. PCRT may be a feasible therapeutic option to avoid abdominoperineal resection in clinical T2N0 distal rectal cancer.

Citations

Citations to this article as recorded by  
  • Lymph node metastasis following chemoradiotherapy in advanced rectal cancer: ypT2-focused analyses of total mesorectal excision specimens
    A. N. Singhi, T.-G. Lee, H.-M. Ahn, H.-R. Shin, M. J. Choi, M. H. Jo, H.-K. Oh, D.-W. Kim, S.-B. Kang
    Techniques in Coloproctology.2025;[Epub]     CrossRef
  • Is there a role for total neoadjuvant treatment in early-stage rectal cancer?
    Kamil Erozkan, Metincan Erkaya, Jacob A. Miller, Ali Alipouriani, David Liska, Hermann Kessler, Scott R. Steele, Emre Gorgun
    Langenbeck's Archives of Surgery.2025;[Epub]     CrossRef
  • Effects of clinical information on the treatment decisions for good responders to neoadjuvant chemoradiotherapy among rectal cancer patients
    Eon Bin Kim, In Ja Park, Hwa Jung Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu
    Annals of Coloproctology.2025; 41(5): 473.     CrossRef
  • Performance reporting design in artificial intelligence studies using image-based TNM staging and prognostic parameters in rectal cancer: a systematic review
    Minsung Kim, Taeyong Park, Bo Young Oh, Min Jeong Kim, Bum-Joo Cho, Il Tae Son
    Annals of Coloproctology.2024; 40(1): 13.     CrossRef
  • 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
  • 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
Malignant disease,Colorectal cancer,Benign diesease & IBD,Biomarker & risk factor
Molecular characterization of dysplasia-initiated colorectal cancer with assessing matched tumor and dysplasia samples
Sungwon Jung, Jong Lyul Lee, Tae Won Kim, Jongmin Lee, Yong Sik Yoon, Kil Yeon Lee, Ki-hwan Song, Chang Sik Yu, Yong Beom Cho
Ann Coloproctol. 2022;38(1):72-81.   Published online November 17, 2021
DOI: https://doi.org/10.3393/ac.2021.00290.0041
  • 5,981 View
  • 138 Download
  • 3 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
Ulcerative colitis (UC) is known to have an association with the increased risk of colorectal cancer (CRC), and UC-associated CRC does not follow the typical progress pattern of adenoma-carcinoma. The aim of this study is to investigate molecular characteristics of UC-associated CRC and further our understanding of the association between UC and CRC.
Methods
From 5 patients with UC-associated CRC, matched normal, dysplasia, and tumor specimens were obtained from formalin-fixed paraffin-embedded (FFPE) samples for analysis. Genomic DNA was extracted and whole exome sequencing was conducted to identify somatic variations in dysplasia and tumor samples. Statistical analysis was performed to identify somatic variations with significantly higher frequencies in dysplasia-initiated tumors, and their relevant functions were investigated.
Results
Total of 104 tumor mutation genes were identified with higher mutation frequencies in dysplasia-initiated tumors. Four of the 5 dysplasia-initiated tumors (80.0%) have TP53 mutations with frequent stop-gain mutations that were originated from matched dysplasia. APC and KRAS are known to be frequently mutated in general CRC, while none of the 5 patients have APC or KRAS mutation in their dysplasia and tumor samples. Glycoproteins including mucins were also frequently mutated in dysplasia-initiated tumors.
Conclusion
UC-associated CRC tumors have distinct mutational characteristics compared to typical adenoma-carcinoma tumors and may have different cancer-driving molecular mechanisms that are initiated from earlier dysplasia status.

Citations

Citations to this article as recorded by  
  • Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus R0 resection for resectable colorectal cancer with peritoneal metastases and low peritoneal cancer index scores: a collaborative observational study from Korea and Japan
    Daichi Kitaguchi, Eun Jung Park, Seung Hyuk Baik, Shoma Sasaki, Yuichiro Tsukada, Masaaki Ito
    International Journal of Surgery.2024; 110(1): 45.     CrossRef
  • Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
    Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
    Cancers.2023; 15(20): 5098.     CrossRef
Malignant disease, Rectal cancer,Colorectal cancer,Epidemiology & etiology
Clinicopathological Characteristics and Surgical Outcomes of Crohn Disease-Associated Colorectal Malignancy
Yoo Na Lee, Jong Lyul Lee, Chang Sik Yu, Jong Beom Kim, Seok-Byung Lim, In Ja Park, Young Sik Yoon, Chan Wook Kim, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park, Jin Cheon Kim
Ann Coloproctol. 2021;37(2):101-108.   Published online April 30, 2021
DOI: https://doi.org/10.3393/ac.2020.11.02
  • 5,707 View
  • 105 Download
  • 4 Web of Science
  • 4 Citations
AbstractAbstract PDFSupplementary Material
Purpose
Carcinoma arising from Crohn disease (CD) is rare, and there is no clear guidance on how to properly screen for at-risk patients and choose appropriate care. This study aimed to evaluate the clinicopathological characteristics, treatment, and oncologic outcomes of CD patients diagnosed with colorectal cancer (CRC).
Methods
Using medical records, we retrospectively enrolled a single-center cohort of 823 patients who underwent abdominal surgery for CD between January 2006 and December 2015. CD-associated CRC patients included those with adenocarcinoma, lymphoma, or neuroendocrine tumors of the colon and rectum.
Results
Nineteen patients (2.3%) underwent abdominal surgery to treat CD-associated CRC. The mean duration of CD in the CD-associated CRC group was significantly longer than that in the benign CD group (124.7 ± 77.7 months vs. 68.9 ± 60.2 months, P = 0.006). The CD-associated CRC group included a higher proportion of patients with a history of perianal disease (73.7% vs. 50.2%, P = 0.035) and colonic location (47.4% vs. 6.5%, P = 0.001). Among 19 CD-associated CRC patients, 17 (89.5%) were diagnosed with adenocarcinoma, and of the 17 cases, 15 (88.2%) were rectal adenocarcinoma. On multivariable analyses for developing CRC, only colonic location was a risk factor (relative risk, 7.735; 95% confidence interval, 2.862–20.903; P = 0.001).
Conclusion
Colorectal malignancy is rare among CD patients, even among patients who undergo abdominal surgery. Rectal adenocarcinoma accounted for most of the CRC, and colonic location was a risk factor for developing CRC.

Citations

Citations to this article as recorded by  
  • Perianal Fistulizing Crohn’s Disease–Associated Anorectal and Fistula Cancers: Systematic Review and Expert Consensus
    Serre-Yu Wong, Cathy Rowan, Elvira Diaz Brockmans, Cindy C.Y. Law, Elisabeth Giselbrecht, Celina Ang, Sergey Khaitov, David Sachar, Alexandros D. Polydorides, Leon Shin-han Winata, Bram Verstockt, Antonino Spinelli, David T. Rubin, Parakkal Deepak, Dermot
    Clinical Gastroenterology and Hepatology.2025; 23(6): 927.     CrossRef
  • Reduced expression of alanyl aminopeptidase is a robust biomarker of non‐familial adenomatous polyposis and non‐hereditary nonpolyposis colorectal cancer syndrome early‐onset colorectal cancer
    Ye Jin Ha, Yun Jae Shin, Ka Hee Tak, Jong Lyul Park, Jeong Hwan Kim, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seon Young Kim, Jin Cheon Kim
    Cancer Medicine.2023; 12(8): 10091.     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
  • 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
    Annals of Coloproctology.2022; 38(2): 97.     CrossRef
Review
Benign GI diease, Inflammatory bowel disease,Benign diesease & IBD
Treatment Strategy for Perianal Fistulas in Crohn Disease Patients: The Surgeon’s Point of View
Jong Lyul Lee, Yong Sik Yoon, Chang Sik Yu
Ann Coloproctol. 2021;37(1):5-15.   Published online February 28, 2021
DOI: https://doi.org/10.3393/ac.2021.02.08
  • 17,585 View
  • 281 Download
  • 16 Web of Science
  • 20 Citations
AbstractAbstract PDF
Perianal fistula is a frequent complication and one of the subclassifications of Crohn disease (CD). It is the most commonly observed symptomatic condition by colorectal surgeons. Accurately classifying a perianal fistula is the initial step in its management in CD patients. Surgical management is selected based on the type of perianal fistula and the presence of rectal inflammation; it includes fistulotomy, fistulectomy, seton procedure, fistula plug insertion, video-assisted ablation of the fistulous tract, stem cell therapy, and proctectomy with stoma creation. Perianal fistulas are also managed medically, such as antibiotics, immunomodulators, and biologics including anti-tumor necrosis factor-alpha agents. The current standard treatment of choice for perianal fistula in CD patients is the multidisciplinary approach combining surgical and medical management; however, the rate of long-term remission is low and is reported to be 50% at most. Therefore, the optimum management strategy for perianal fistulas associated with CD remains controversial. Currently, the goal of management for CD-related perianal fistulas are controlling symptoms and maintaining long-term anal function without proctectomy, while monitoring progression to anorectal carcinoma. This review evaluates perianal fistula in CD patients and determines the optimal surgical management strategy based on recent evidence.

Citations

Citations to this article as recorded by  
  • Clinical Trial Endpoints for Perianal Fistulizing Crohn's Disease
    Walter Reinisch, Raja Atreya, Florian Rieder, Vipul Jairath, Jordi Rimola, Laurent Peyrin-Biroulet, Phil Tozer, Christianne J. Buskens, Ailsa Hart
    American Journal of Gastroenterology.2026;[Epub]     CrossRef
  • Efficacy and Safety of Upadacitinib for Perianal Fistulizing Crohn’s Disease: A Post Hoc Analysis of 3 Phase 3 Trials
    Jean-Frédéric Colombel, Ana P. Lacerda, Peter M. Irving, Remo Panaccione, Walter Reinisch, Florian Rieder, Adam Steinlauf, David Schwartz, Tian Feng, Elena Dubcenco, Samuel I. Anyanwu, F. Stephen Laroux, Colla Cunneen, Nick Powell
    Clinical Gastroenterology and Hepatology.2025; 23(6): 1019.     CrossRef
  • Mucosal advancement flap versus ligation of the inter-sphincteric fistula tract for management of trans-sphincteric perianal fistulas in the elderly: a retrospective study
    Tamer A. A. M. Habeeb, Massimo Chiaretti, Igor A. Kryvoruchko, Antonio Pesce, Aristotelis Kechagias, Abd Al-Kareem Elias, Abdelmonem A. M. Adam, Mohamed A. Gadallah, Saad Mohamed Ali Ahmed, Ahmed Khyrallh, Mohammed H. Alsayed, Esmail Tharwat Kamel Awad, M
    International Journal of Colorectal Disease.2025;[Epub]     CrossRef
  • Lack of IFN-γ response of human uterine myometrium-derived MSCs significantly improve multiple IBD parameters compared to bone marrow MSCs: Implications for anti-TNFα-refractory patients
    Li-Tzu Wang, Hsiu-Huan Wang, Shih-Sheng Jiang, Chia-Chih Chang, Pei-Ju Hsu, Ko-Jiunn Liu, Huey-Kang Sytwu, B. Linju Yen, Men-Luh Yen
    Pharmacological Research.2025; 215: 107716.     CrossRef
  • Review of Various Perianal Lesions on CT and MRI
    Yoo Jin Park, So Hyun Park, Sungjin Yoon, Hee Joong Lim
    Journal of the Korean Society of Radiology.2025; 86(6): 951.     CrossRef
  • Gastrointestinal Fistulas—What Gastroenterologists Need to Know in 2025
    Monjur Ahmed, Aniruddha Pratap Singh
    Canadian Journal of Gastroenterology and Hepatology.2025;[Epub]     CrossRef
  • Defining partial response in inflammatory bowel disease: a Delphi consensus and economic evaluation
    Iago Rodríguez-Lago, Luis Menchén, José Germán Sánchez-Hernández, Jordi Guardiola, Vicente Merino-Bohórquez, Beatriz Garcillán, Elia Moreno-Cubero, Eugenia Vispo, Eugeni Domènech
    Therapeutic Advances in Gastroenterology.2025;[Epub]     CrossRef
  • Mucosal Advancement Flap Versus Ligation of the Intersphincteric Fistula Tract for Transsphincteric Fistula-in-Ano: A Comparative Study in a Tertiary Care Hospital
    Sagar Reddy G, Ashok Reddy R
    Cureus.2025;[Epub]     CrossRef
  • Value of Endoanal Ultrasound in the Comprehensive Management of Crohn's Disease-Associated Anorectal Fistulas: A Case Report
    Alfredo S Abarca Magallon, Hector Norman Solares Sanchez, Gustavo Galicia Negrete, Oscar Coyoli Garcia, Agustín Castro Segovia
    Cureus.2025;[Epub]     CrossRef
  • A Prospective, Single-Arm Study to Evaluate the Safety and Efficacy of an Autologous Blood Clot Product in the Treatment of Anal Fistula
    Edward Ram, Yaniv Zager, Dan Carter, Olga Saukhat, Roi Anteby, Ido Nachmany, Nir Horesh
    Diseases of the Colon & Rectum.2024; 67(4): 541.     CrossRef
  • Insights into treatment of complex Crohn's perianal fistulas
    Gregor Norčič, Nataša Smrekar, Srđan Marković, Goran Barišić, Gediminas Kiudelis, Henrikas Paužas, Tamás Molnár, Attila Szijarto, Zuzana Šerclová, Tina Roblek, Viktor Uršič, Ian White
    BMC Proceedings.2024;[Epub]     CrossRef
  • Cell-assisted lipotransfer in treating uncontrollable sepsis associated perianal fistula: a pilot study
    In Seob Jeong, Sung Hwan Hwang, Hye Mi Yu, Hyeonseok Jeong
    Annals of Coloproctology.2024; 40(2): 169.     CrossRef
  • Management of Perianal Fistulas Associated with Crohn Disease
    Kay Greveson, Ola Haj, Ailsa Hart, Parnia Geransar, Oded Zmora
    Gastroenterology Nursing.2024; 47(6): 428.     CrossRef
  • Real-World Long-Term Persistence and Surgical Procedure-Free Period Among Bio-naïve Patients with Crohn’s Disease and Fistula Initiated on Ustekinumab
    Maryia Zhdanava, Sumesh Kachroo, Porpong Boonmak, Sabree Burbage, Aditi Shah, Patrick Lefebvre, Caroline Kerner, Dominic Pilon
    Advances in Therapy.2024; 41(10): 3922.     CrossRef
  • Optimizing Treatment Outcomes in Crohn’s Disease: A Comprehensive Systematic Review and Meta-Analysis of Regenerative Therapies with Emphasis on Platelet-Rich Plasma
    Marcia Carolina Mazzaro, Ana Emília Carvalho de Paula, Livia Bitencourt Pascoal, Livia Moreira Genaro, Isabela Machado Pereira, Bruno Lima Rodrigues, Priscilla de Sene Portel Oliveira, Raquel Franco Leal
    Pharmaceuticals.2024; 17(11): 1519.     CrossRef
  • Clinical Characteristics That Led to Diagnosis of Crohn’s Disease After Anal Fistula Surgery in Patients Aged 10–19 Years: A Single Center, Retrospective Study
    Ah Young Kang, Ki-Yun Lim, Keehoon Hyun, Heecheol Chang
    Advances in Pediatric Surgery.2024; 30(2): 64.     CrossRef
  • Three‐dimensional modelling as a novel interactive tool for preoperative planning for complex perianal fistulas in Crohn's disease
    Sebastián Jeri‐McFarlane, Álvaro García‐Granero, Aina Ochogavía‐Seguí, Gianluca Pellino, Anaí Oseira‐Reigosa, Alejandro Gil‐Catalan, Leandro Brogi, Daniel Ginard‐Vicens, Margarita Gamundi‐Cuesta, Francisco Xavier Gonzalez‐Argente
    Colorectal Disease.2023; 25(6): 1279.     CrossRef
  • Risk of anorectal cancer in patients with Crohn's disease and perianal fistula: a nationwide Danish cohort study
    Alaa El‐Hussuna, Camilla Engel Lemser, Aske Thorn Iversen, Kristine Højgaard Allin, Tine Jess
    Colorectal Disease.2023; 25(7): 1453.     CrossRef
  • The Impact of Crohn’s Perianal Fistula on Quality of Life: Results of an International Patient Survey
    Antonino Spinelli, Henit Yanai, Paolo Girardi, Slobodan Milicevic, Michele Carvello, Annalisa Maroli, Luisa Avedano
    Crohn's & Colitis 360.2023;[Epub]     CrossRef
  • Crohn disease
    Elizabeth F. Snyder, Stephanie Davis, Kristina Aldrich, Manjakkollai Veerabagu, Tiziana Larussa, Ludovico Abenavoli, Luigi Boccuto
    The Nurse Practitioner.2021; 46(12): 22.     CrossRef
Original Articles
Malignant disease, Rectal cancer,Prognosis and adjuvant therapy
Beware of Early Relapse in Rectal Cancer Patients Treated With Preoperative Chemoradiotherapy
Seul Gi Oh, In Ja Park, Ji-hyun Seo, Young Il Kim, Seok-Byung Lim, Chan Wook Kim, Yong Sik Yoon, Jong Lyul Lee, Chang Sik Yu, Jin Cheon Kim
Ann Coloproctol. 2020;36(6):382-389.   Published online June 17, 2020
DOI: https://doi.org/10.3393/ac.2020.06.11
  • 5,885 View
  • 105 Download
  • 7 Web of Science
  • 7 Citations
AbstractAbstract PDF
Purpose
Recurrence patterns in rectal cancer patients treated with preoperative chemoradiotherapy (PCRT) are needed to evaluate for establishing tailored surveillance protocol.
Methods
This study included 2,215 patients with locally-advanced mid and low rectal cancer treated with radical resection between January 2005 and December 2012. Recurrence was evaluated according to receipt of PCRT; PCRT group (n = 1,258) and no-PCRT group (n = 957). Early recurrence occurred within 1 year of surgery and late recurrence after 3 years. The median follow-up duration was 65.7 ± 29 months.
Results
The overall recurrence rate was similar between the PCRT and no-PCRT group (25.8% vs. 24.9%, P = 0.622). The most common initial recurrence site was the lungs in both groups (50.6% vs. 49.6%, P = 0.864), followed by the liver, which was more common in the no-PCRT group (22.5% vs. 33.6%, P = 0.004). Most of the recurrence occurred within 3 years after surgery in both groups (85.3% vs. 85.8%, P = 0.862). Early recurrence was more common in the PCRT group than in the no-PCRT group (43.1% vs. 32.4%, P = 0.020). Recurrence within the first 6 months after surgery was significantly higher in the PCRT group than in the no-PCRT group (18.8% vs. 7.6%, P = 0.003). Lung (n = 27, 44.3%) and liver (n = 22, 36.1%) were the frequent the first relapsed site within 6 months after surgery in PCRT group.
Conclusion
Early recurrence within the first 1 year after surgery was more common in patients treated with PCRT. This difference would be considered for surveillance protocols and need to be evaluated in further studies.

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  • Efficacies of radiotherapy in rectal cancer patients treated with total mesorectal excision or other types of surgery: an updated meta-analysis
    Wenshu Wang, Runyuan Zhao, Xi Liang, Manjun Liu, Haiyan Bai, Jianli Ge, Binxi Yao, Zheng Zhi, Jianming He
    Oncology Reviews.2025;[Epub]     CrossRef
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    In Ja Park
    Precision and Future Medicine.2022; 6(2): 91.     CrossRef
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    Chan Wook Kim
    The Ewha Medical Journal.2022;[Epub]     CrossRef
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    Chungyeop Lee, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
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Benign GI diease, Inflammatory bowel disease
Clinical Characteristics and Postoperative Outcomes of Patients Presenting With Upper Gastrointestinal Tract Crohn Disease
Joon Suk Moon, Jong Lyul Lee, Chang Sik Yu, Seok-Byung Lim, In Ja Park, Yong Sik Yoon, Chan Wook Kim, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park, Hassan Abdullah Alsaleem, Jin Cheon Kim
Ann Coloproctol. 2020;36(4):243-248.   Published online March 16, 2020
DOI: https://doi.org/10.3393/ac.2019.10.16.1
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  • 9 Citations
AbstractAbstract PDF
Purpose
Upper gastrointestinal (GI) tract involvement in Crohn disease (CD) is rare and effectiveness of surgical treatment is limited. The aim of this study was to evaluate characteristics and surgical outcomes of upper GI CD.
Methods
Medical records of 811 patients who underwent intestinal surgery for CD between January 2006 and December 2015 at a single institution were reviewed. Upper GI CD was defined by involvement of the stomach to the fourth portion of duodenum, with or without concomitant small/large bowel CD involvement according to a modification of the Montreal classification.
Results
We identified 24 patients (21 males, 3 females) who underwent surgery for upper GI CD. The mean age at diagnosis was 27 ± 12 years, the mean age at surgery was 33 ± 11 years, and the mean duration of CD was 73.6 ± 56.6 months. Fifteen patients (62.5%) had history of previous perianal surgery. Ten patients (41.7%) had duodenal or gastric stricture and 14 patients (58.3%) had penetrating fistula; patients with fistula were significantly more likely to develop complications (57.1% vs. 20.0%, P = 0.035). One patient with stricture had surgical recurrence. In seven patients with fistula, fistula was related to previous anastomosis. Patients with fistula had significantly longer hospital stays than those with stricture (16 days vs. 11 days, P = 0.01).
Conclusion
Upper GI CD is rare among CD types (2.96%). In patients with upper GI CD, penetrating fistula was associated with longer hospital stay and more complications.

Citations

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Benign GI diease, Inflammatory bowel disease
Short-term Outcomes of Elective 2-Stage Restorative Proctocolectomy for Ulcerative Colitis in Korea: Does Laparoscopy Have Benefits?
Jun Woo Bong, Yong Sik Yoon, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Ann Coloproctol. 2020;36(1):41-47.   Published online February 29, 2020
DOI: https://doi.org/10.3393/ac.2019.03.29
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  • 3 Citations
AbstractAbstract PDF
Purpose
This study aimed to compare the short-term outcomes of the open and laparoscopic approaches to 2-stage restorative proctocolectomy (RPC) for Korean patients with ulcerative colitis (UC).
Methods
We retrospectively analyzed the medical records of 73 patients with UC who underwent elective RPC between 2009 and 2016. Patient characteristics, operative details, and postoperative complications within 30 days were compared between the open and laparoscopic groups.
Results
There were 26 cases (36%) in the laparoscopic group, which had a lower mean body mass index (P = 0.025), faster mean time to recovery of bowel function (P = 0.004), less intraoperative blood loss (P = 0.004), and less pain on the first and seventh postoperative days (P = 0.029 and P = 0.027, respectively) compared to open group. There were no deaths, and the overall complication rate was 43.8%. There was no between-group difference in the overall complication rate; however, postoperative ileus was more frequent in the open group (27.7% vs. 7.7%, P = 0.043). Current smoking (odds ratio [OR], 44.4; P = 0.003) and open surgery (OR, 5.4; P = 0.014) were the independent risk factors for postoperative complications after RPC.
Conclusion
Laparoscopic RPC was associated with acceptable morbidity and faster recovery than the open approach. The laparoscopic approach is a feasible and safe option for surgical treatment for UC in selective cases.

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  • Patient-reported Outcome Measures in Ileoanal Pouch Surgery: a Systematic Review
    Zakary Ismail Warsop, Carlo Alberto Manzo, Natalie Yu, Bilal Yusuf, Christos Kontovounisios, Valerio Celentano
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Original article
Defunctioning Protective Stoma Can Reduce the Rate of Anastomotic Leakage after Low Anterior Resection in Rectal Cancer Patients
Byoung Chul Lee, Seok-Byung Lim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Chang Sik Yu, Jin Cheon Kim
Received October 22, 2019  Accepted November 19, 2019  Published online January 16, 2020  
DOI: https://doi.org/10.3393/ac.2019.11.19.1
  • 6,920 View
  • 246 Download
  • 20 Citations
AbstractAbstract PDF
PURPOSE
This study aimed to identify risk factors for anastomotic leakage and to evaluate the impact of protective stoma on the rate of anastomotic leakage and subsequent management.
METHODS
This retrospective study analyzed data from 4,282 patients who underwent low anterior resection between 2007 and 2014. Among these, 1,367 (31.9%) underwent surgery to create protective diverting stoma and 232 (5.4%) experienced anastomotic leakage. At 6-month timepoints, data were evaluated to identify any correlation between the presence of diverting stoma and the incidence of anastomotic leakage. In addition, clinicopathological parameters were investigated to identify risk factors for anastomotic leakage.
RESULTS
Diverting stomas significantly reduced the rate of anastomotic leakage [HR 0.334, 95% CI 0.212

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Original Articles
Sensitivity of Various Evaluating Modalities for Predicting a Pathologic Complete Response After Preoperative Chemoradiation Therapy for Locally Advanced Rectal Cancer
Sungwoo Jung, Anuj Parajuli, Chang Sik Yu, Seong Ho Park, Jong Seok Lee, Ah Young Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Jin Cheon Kim
Ann Coloproctol. 2019;35(5):275-281.   Published online October 31, 2019
DOI: https://doi.org/10.3393/ac.2019.01.07
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  • 5 Citations
AbstractAbstract PDF
Purpose
We investigated the sensitivity of various evaluating modalities in predicting a pathologic complete response (pCR) after preoperative chemoradiation therapy (PCRT) for locally advanced rectal cancer (LARC).
Methods
From a population of 2,247 LARC patients who underwent PCRT followed by surgery at Asan Medical Center, Seoul, Korea from January 2007 to June 2016, we retrospectively analyzed 313 patients (14.1%) who showed a pCR after surgery. Transrectal ultrasound (TRUS), high-resolution magnetic resonance imaging (MRI), abdominopelvic computed tomography (AP-CT), and endoscopy were performed within 2 weeks prior to surgery.
Results
Of the 313 patients analyzed, 256 (81.8%) had a pCR after radical surgery and 57 (18.2%) showed total regression after local excision. Preoperative TRUS, MRI, and AP-CT were performed in 283, 305, and 139 patients, respectively. Among these 3 groups, a prediction of a pCR of the primary tumor was made in 41 (14.5%), 51 (16.7%), and 27 patients (19.4%), respectively, before surgery. A prediction of a clinical N0 stage was made in 204 patients (88.3%) using TRUS, 130 (52.2%) using MRI, and 78 (65.5%) using AP-CT. Of the 211 patients who underwent endoscopy, 87 (41.2%) had a mention of clinical CR in their records. A prediction of a pathologic CR was made for 124 patients (39.6%) through at least one diagnostic modality.
Conclusion
The various evaluation methods for predicting a pCR after PCRT show a predictive sensitivity of 0.15–0.41 for primary tumors and 0.52–0.88 for lymph nodes. Endoscopy is a relatively superior modality for predicting the pCR of the primary tumor of LARC patients.

Citations

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  • Predicting the effectiveness of neoadjuvant therapy in rectal cancer patients: Model construction based on radiomics and carcinoembryonic antigens
    Biyao Liu, Jinyue Feng, Yiguang Hu, Ruisi Tang, Yutong Zhang, Yidian Wang, Yong Wang, Liya Wang, Hang Qiu, Xiaodong Wang
    Intelligent Oncology.2026; 2(1): 100035.     CrossRef
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    Daniel Gonzalez-Nunez, Luis Torres, Mauricio Gonzalez-Dorado, Juan C. Reyes
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    Soo Young Oh, In Ja Park, Young IL Kim, Jong-Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
    Cancers.2021; 13(19): 4823.     CrossRef
  • Predicting Neoadjuvant Chemoradiotherapy Response in Locally Advanced Rectal Cancer Using Tumor-Infiltrating Lymphocytes Density
    Yao Xu, Xiaoying Lou, Yanting Liang, Shenyan Zhang, Shangqing Yang, Qicong Chen, Zeyan Xu, Minning Zhao, Zhenhui Li, Ke Zhao, Zaiyi Liu
    Journal of Inflammation Research.2021; Volume 14: 5891.     CrossRef
  • A Nine-Gene Signature for Predicting the Response to Preoperative Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer
    In Ja Park, Yun Suk Yu, Bilal Mustafa, Jin Young Park, Yong Bae Seo, Gun-Do Kim, Jinpyo Kim, Chang Min Kim, Hyun Deok Noh, Seung-Mo Hong, Yeon Wook Kim, Mi-Ju Kim, Adnan Ahmad Ansari, Luigi Buonaguro, Sung-Min Ahn, Chang-Sik Yu
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Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection
Yunghuyn Hwang, Yong Sik Yoon, Jun Woo Bong, Hye Yun Choi, In Ho Song, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Ann Coloproctol. 2019;35(4):194-201.   Published online August 31, 2019
DOI: https://doi.org/10.3393/ac.2018.10.18.2
  • 8,141 View
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  • 18 Citations
AbstractAbstract PDF
Purpose
Transanal excision (TAE) is an alternative surgical procedure for early rectal cancer. This study compared long-term TAE outcomes, in terms of survival and local recurrence (LR), with total mesorectal excision (TME) in patients with pathologically confirmed T1 rectal cancer.
Methods
T1 rectal adenocarcinoma patients who underwent surgery from 1990 to 2011 were retrospectively reviewed. Patients that were suspected to have preoperative lymph node metastasis were excluded. Demographics, recurrence, and survival were analyzed based on TAE and TME surgery.
Results
Of 268 individuals, 61 patients (26%) underwent TAE, which was characterized by proximity to the anus, submucosal invasion depth, and lesion infiltration, compared with TME patients (P < 0.001–0.033). During a median follow-up of 10.4 years, 12 patients had systemic and/or LR. Ten-year cancer-specific survival in the TAE and TME groups was not significantly different (98% vs. 100%). However, the 10-year LR rate in the TAE group was greater than that of TME group (10% vs. 0%, P < 0.001). Although 5 of the 6 TAE patients with LR underwent salvage surgery, one of the patients eventually died. The TAE surgical procedure (hazard ratio, 19.066; P = 0.007) was the only independent risk factor for LR.
Conclusion
Although long-term survival after TAE was comparable to that after TME, TAE had a greater recurrence risk than TME. Thus, TAE should only be considered as an alternative surgical option for early rectal cancer in selected patients.

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    Abdullah Al-Sawat, Jung Hoon Bae, Hyun Ho Kim, Chul Seung Lee, Seung Rim Han, Yoon Suk Lee, Hyeon-Min Cho, Hong Seok Jang, In Kyu Lee
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    Ignacio Aguirre-Allende, Jose Maria Enriquez-Navascues, Garazi Elorza-Echaniz, Ane Etxart-Lopetegui, Nerea Borda-Arrizabalaga, Yolanda Saralegui Ansorena, Carlos Placer-Galan
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    Taesung Ahn
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    I-Li Lai, Jeng-Fu You, Yih-Jong Chern, Wen-Sy Tsai, Jy-Ming Chiang, Pao-Shiu Hsieh, Hsin-Yuan Hung, Chien-Yuh Yeh, Sum-Fu Chiang, Cheng-Chou Lai, Rei-Ping Tang, Jinn-Shiun Chen, Yu-Jen Hsu
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Oncologic Outcomes of Organ Preserving Approaches in Patients With Rectal Cancer Treated With Preoperative Chemoradiotherapy
In Ja Park, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Ann Coloproctol. 2019;35(2):65-71.   Published online April 30, 2019
DOI: https://doi.org/10.3393/ac.2019.03.17
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AbstractAbstract PDF
Purpose
We evaluated the oncologic outcomes of organ-preserving strategies in patients with rectal cancer treated with preoperative chemoradiotherapy (PCRT).
Methods
Between January 2008 and January 2013, 74 patients who underwent wait-and-watch (WW) (n = 42) and local excision (LE) (n = 32) were enrolled. Organ-preserving strategies were determined based on a combination of magnetic resonance imaging, sigmoidoscopy, and physical examination 4–6 weeks after completion of PCRT. The rectum sparing rate, 5-year recurrence-free survival (RFS), and overall survival (OS) were evaluated.
Results
The rectum was more frequently spared in the LE (100% vs. 87.5%, P = 0.018) at last follow-up. Recurrence occurred in 9 (28.1%) WW and 7 (16.7%) LE (P = 0.169). In the WW, 7 patients had only luminal regrowth and 2 had combined lung metastasis. In the LE, 2 (4.8%) had local recurrence only, 4 patients had distant metastasis, and 1 patient had local and distant metastasis. Among 13 patients who indicated salvage surgery (WW, n = 7; LE, n = 11), all in the WW received but all of LE refused salvage surgery (P = 0.048). The 5-year OS and 5-year RFS in overall patients was 92.7% and 76.9%, respectively, and were not different between WW and LE (P = 0.725, P = 0.129).
Conclusion
WW and LE were comparable in terms of 5-year OS and RFS. In the LE group, salvage treatment was performed much less among indicated patients. Therefore, methods to improve the oncologic outcomes of patients indicated for salvage treatment should be considered before local excision.

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    Cong Meng, Wenlong Shu, Liting Sun, Si Wu, Pengyu Wei, Jiale Gao, Jinyao Shi, Yang Li, Zhengyang Yang, Hongwei Yao, Zhongtao Zhang
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    Quoc Riccardo Bao, Stefania Ferrari, Giulia Capelli, Cesare Ruffolo, Marco Scarpa, Amedea Agnes, Giuditta Chiloiro, Elisa Palazzari, Emanuele Damiano Luca Urso, Salvatore Pucciarelli, Gaya Spolverato
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    Gyung Mo Son
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    Sang Hyun An, Ik Yong Kim
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    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
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    In Ja Park
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    Chungyeop Lee, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
    Annals of Surgical Treatment and Research.2022; 103(6): 350.     CrossRef
  • Improvement in the Assessment of Response to Preoperative Chemoradiotherapy for Rectal Cancer Using Magnetic Resonance Imaging and a Multigene Biomarker
    Eunhae Cho, Sung Woo Jung, In Ja Park, Jong Keon Jang, Seong Ho Park, Seung-Mo Hong, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
    Cancers.2021; 13(14): 3480.     CrossRef
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    Soo Young Oh, In Ja Park, Young IL Kim, Jong-Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
    Cancers.2021; 13(19): 4823.     CrossRef
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Variation in the Height of Rectal Cancers According to the Diagnostic Modalities
Seung-Seop Yeom, In Ja Park, Dong-Hoon Yang, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seok-Byung Lim, Sung Ho Park, Hwa Jung Kim, Chang Sik Yu, Jin Cheon Kim
Ann Coloproctol. 2019;35(1):24-29.   Published online February 28, 2019
DOI: https://doi.org/10.3393/ac.2018.07.31
  • 8,730 View
  • 125 Download
  • 13 Web of Science
  • 13 Citations
AbstractAbstract PDF
Purpose
Although the height of a rectal tumor above the anal verge (tumor height) partly determines the treatment strategy, no practical standard exists for reporting this. We aimed to demonstrate the differences in tumor height according to the diagnostic modality used for its measurement.
Methods
We identified 100 patients with rectal cancers located within 15 cm of the anal verge who had recorded tumor heights measured by using magnetic resonance imaging (MRI), colonoscopy, and digital rectal examination (DRE). Tumor height measured by using MRI was compared with those measured by using DRE and colonoscopy to assess reporting inconsistencies. Factors associated with differences in tumor height among the modalities were also evaluated.
Results
The mean tumor heights were 77.8 ± 3.3, 52.9 ± 2.3, and 68.9 ± 3.1 mm when measured by using MRI, DRE, and colonoscopy, respectively (P < 0.001). Agreement among the 3 modalities in terms of tumor sublocation within the rectum was found in only 39% of the patients. In the univariate and the multivariate analyses, clinical stage showed a possible association with concordance among modalities, but age, sex, and luminal location of the tumor were not associated with differences among modalities.
Conclusion
The heights of rectal cancer differed according to the diagnostic modality. Tumor height has implications for rectal cancer’s surgical planning and for interpreting comparative studies. Hence, a consensus is needed for measuring and reporting tumor height.

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  • The efficacy of open transanal drainage tube against anastomotic leakage in left-sided colorectal cancer surgery: a propensity score matching study
    Gen Tsujio, Tatsunari Fukuoka, Atsushi Sugimoto, Ken Yonemitsu, Yuki Seki, Hiroaki Kasashima, Yuichiro Miki, Mami Yoshii, Tatsuro Tamura, Masatsune Shibutani, Takahiro Toyokawa, Shigeru Lee, Kiyoshi Maeda
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Does the Different Locations of Colon Cancer Affect the Oncologic Outcome? A Propensity-Score Matched Analysis
Kwan Mo Yang, In Ja Park, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seok-Byung Lim, Na Young Kim, Shinae Hong, Chang Sik Yu, Jin Cheon Kim
Ann Coloproctol. 2019;35(1):15-23.   Published online February 28, 2019
DOI: https://doi.org/10.3393/ac.2018.07.25
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  • 3 Citations
AbstractAbstract PDF
Purpose
We evaluate the prognostic value of primary tumor location for oncologic outcomes in patients with colon cancer (CC).
Methods
CC patients treated with curative surgery between 2009 and 2012 were classified into 2 groups: right-sided colon cancer (RCC) and left-sided colon cancer (LCC). Recurrence-free survival (RFS) and overall survival (OS) were examined based on tumor stage. Propensity scores were created using eight variables (age, sex, T stage, N stage, histologic grade, presence of lymphovascular invasion/perineural invasion, and microsatellite instability status).
Results
Overall, 2,329 patients were identified. The 5-year RFSs for RCC and LCC patients were 89.7% and 88.4% (P = 0.328), respectively, and their 5-year OSs were 90.9% and 93.4% (P = 0.062). Multivariate survival analyses were carried out by using the Cox regression proportional hazard model. In the unadjusted analysis, a marginal increase in overall mortality was seen in RCC patients (hazard ratio [HR], 1.297; 95% confidence interval [CI], 0.987–1.704, P = 0.062); however, after multivariable adjustment, similar OSs were observed in those patients (HR, 1.219; 95% CI, 0.91–1.633; P = 0.183). After propensity-score matching with a total of 1,560 patients, no significant difference was identified (P = 0.183). A slightly worse OS was seen for stage III RCC patients (HR, 1.561; 95% CI, 0.967–2.522; P = 0.068) than for stage III LCC patients. The 5-year OSs for patients with stage III RCC and stage III LCC were 85.5% and 90.5%, respectively (P = 0.133).
Conclusion
Although the results are inconclusive, tumor location tended to be associated with OS in CC patients with lymph node metastasis, but it was not related to oncologic outcome.

Citations

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  • Prognostic value of primary tumor location in colorectal cancer: an updated meta-analysis
    Hanieh Gholamalizadeh, Nima Zafari, Mahla Velayati, Hamid Fiuji, Mina Maftooh, Elnaz Ghorbani, Seyed Mahdi Hassanian, Majid Khazaei, Gordon A. Ferns, Elham Nazari, Amir Avan
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    Kristian-Christos Ngamsri, Christoph Jans, Rizki A. Putri, Katharina Schindler, Jutta Gamper-Tsigaras, Claudia Eggstein, David Köhler, Franziska M. Konrad
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Current Status and Trends in Inflammatory Bowel Disease Surgery in Korea: Analysis of Data in a Nationwide Registry
Se-Jin Baek, Kil Yeon Lee, Ki Hwan Song, Chang Sik Yu, for the Inflammatory Bowel Disease (IBD) Study Group of the Korean Society of Coloproctology
Ann Coloproctol. 2018;34(6):299-305.   Published online December 31, 2018
DOI: https://doi.org/10.3393/ac.2018.07.21
  • 8,535 View
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  • 18 Web of Science
  • 17 Citations
AbstractAbstract PDF
Purpose
Inflammatory bowel disease (IBD) in Korea has been increasing in recent years, but accurate statistics about operations for IBD are lacking. The purpose of this study was to investigate the trends and current status of IBD surgeries in Korea.
Methods
Using a national database from the Korea Health Insurance Review and Assessment Service, we analyzed data from patients who underwent surgery for Crohn disease and ulcerative colitis from January 2009 to October 2016. Results: The mean number of patients who underwent surgery for Crohn disease was 791.8 per year. Colorectal surgery, small bowel surgery, and anal surgery were performed fairly often (31.2%, 29.4%, 39.4%, respectively), and laparoscopic surgery continued to increase, recently exceeding 30%. About 50% of Crohn patients used biologics before and after surgery, and those patients also underwent a relatively high rate of anal surgeries (44.2%). The mean number of patients who underwent surgery for ulcerative colitis was 247.6 per year. Colorectal surgery accounted for more than half of all operations, and laparoscopic surgery has been increasing rapidly, having been performed in about 60% of patients in recent years. The incidence of colorectal cancer in patients with ulcerative colitis was very high and increased rapidly during the study period, reaching about 80%.
Conclusion
The number of patients undergoing laparoscopic surgery for IBD in Korea has increased significantly. Biologics are actively used by patients with Crohn disease, with a high proportion of anal surgeries required. Many of the surgical indications for ulcerative colitis have shifted into colorectal cancer.

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  • The impact of advanced medical therapies on time to resection and colorectal cancer outcomes in ulcerative colitis patients undergoing colectomy
    Eva Visser, Antonio Luberto, Lianne Heuthorst, Roel Hompes, Séverine Vermeire, Geert R D’Haens, Willem A Bemelman, André D’Hoore, Gabriele Bislenghi, Christianne J Buskens
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Trephine Transverse Colostomy Is Effective for Patients Who Have Previously Undergone Rectal Surgery
Seung-Seop Yeom, Chan Wook Kim, Sung Woo Jung, Se Heon Oh, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Ann Coloproctol. 2018;34(2):72-77.   Published online April 30, 2018
DOI: https://doi.org/10.3393/ac.2017.09.29
  • 8,258 View
  • 153 Download
  • 4 Web of Science
  • 3 Citations
AbstractAbstract PDF
Purpose
Colostomy creation is an essential procedure for colorectal surgeons, but the preferred method of colostomy varies by surgeon. We compared the outcomes of trephine colostomy creation with open those for the (laparotomy) and laparoscopic methods and evaluated appropriate indications for a trephine colostomy and the advantages of the technique.
Methods
We retrospectively evaluated 263 patients who had undergone colostomy creation by trephine, open and laparoscopic approaches between April 2006 and March 2016. We compared the clinical features and the operative and postoperative outcomes according to the approach used for stoma creation.
Results
One hundred sixty-three patients (62%) underwent colostomy surgery for obstructive causes and 100 (38%) for fistulous problems. The mean operative time was significantly shorter with the trephine approach (trephine, 46.0 ± 1.9 minutes; open, 78.7 ± 3.9 minutes; laparoscopic, 63.5 ± 5.0 minutes; P < 0.001), as was the time to flatus (1.8 ± 0.1 days, 2.1 ± 0.1 days, 2.2 ± 0.3 days, P = 0.025). Postoperative complications (<30 days) were not different among the 3 approaches (trephine, 4.3%; open, 1.2%; laparoscopic, 0%; P = 0.828). In patients who underwent rectal surgery, a trephine colostomy was feasible for a diversion colostomy (P < 0.001).
Conclusion
The trephine colostomy is safe and can be implemented quickly in various situations, and compared to other colostomy procedures, the patient’s recovery is faster. Previous laparotomy history was not a contraindication for a trephine colostomy, and a trephine transverse colostomy is feasible for patients who have undergone previous rectal surgery.

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    Yongjun Park, Dong Uk Choi, Hyung Ook Kim, Yong Bog Kim, Chungki Min, Jung Tack Son, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim
    Annals of Coloproctology.2022; 38(4): 319.     CrossRef
  • Minimally invasive colostomy with endoscopy as a novel technique for creation of a trephine stoma
    Teppei Kamada, Hironori Ohdaira, Junji Takahashi, Wataru Kai, Keigo Nakashima, Yuichi Nakaseko, Norihiko Suzuki, Masashi Yoshida, Yutaka Suzuki
    Scientific Reports.2021;[Epub]     CrossRef
Does Anastomosis Configuration Influence Long-term Outcomes in Patients With Crohn Disease?
Parajuli Anuj, Yong Sik Yoon, Chang Sik Yu, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Jin Cheon Kim
Ann Coloproctol. 2017;33(5):173-177.   Published online October 31, 2017
DOI: https://doi.org/10.3393/ac.2017.33.5.173
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  • 9 Citations
AbstractAbstract PDF
Purpose

In this study, we evaluated the role of various anastomoses in surgical recurrence for patients with Crohn disease (CD).

Methods

We analyzed data retrospectively from consecutive laparotomy cases involving complicated CD between 1991 and 2008. Clinical data were compared in terms of reoperation-free survival (RFS) according to the types of anastomoses, the materials used for the anastomoses, and the operating surgeon.

Results

Of 233 patients with entero-enteric or entero-colic anastomoses, 199 (85%), 11 (5%), and 23 (10%) experienced side-to-side (SS), side-to-end (SE), and end-to-end (EE) anastomoses, respectively. The SS group had the following characteristics: more extensive bowel involvement, frequent obstruction, and greater stapler use; the SS anastomoses were also frequently made by specialized surgeons (P < 0.001–0.004). EE anastomoses were frequently made by general surgeons using a hand-sewing technique (P < 0.001). No differences in RFS were noted among the 3 groups according to the type of anastomosis and the operating surgeon. However, the hand-sewn group showed better RFS than the stapler group (P = 0.04).

Conclusion

The roles of the anastomotic configuration, the material used, and the operating surgeon were not significantly correlated with reoperations or complications in our retrospective CD cohort, irrespective of the higher risk of anastomosis site stricture for EE anastomoses.

Citations

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    Carla Newton, Alessandro Fichera
    Clinics in Colon and Rectal Surgery.2025; 38(02): 104.     CrossRef
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    Joana Roseira, Maria Manuela Estevinho, Beatriz Gros, Irene Marafini, Virginia Solitano, Paula Sousa, Cristina Carretero, Winnie Zou, Nasim Parsa, Aline Charabaty, Lumir Kunovsky
    Best Practice & Research Clinical Gastroenterology.2025; 78: 102055.     CrossRef
  • New anti-mesenteric delta-shaped stapled anastomosis: Technical report with short-term postoperative outcomes in patients with Crohn’s disease
    Jong Lyul Lee, Yong Sik Yoon, Hyun Gu Lee, Young Il Kim, Min Hyun Kim, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
    World Journal of Gastrointestinal Surgery.2024; 16(8): 2592.     CrossRef
  • Results of the Eighth Scientific Workshop of ECCO: Pathophysiology and Risk Factors of Postoperative Crohn’s Disease Recurrence after an Ileocolonic Resection
    Pauline Rivière, Gabriele Bislenghi, Nassim Hammoudi, Bram Verstockt, Steven Brown, Melissa Oliveira-Cunha, Willem Bemelman, Gianluca Pellino, Paulo Gustavo Kotze, Gabriele Dragoni, Mariangela Allocca, Nurulamin M Noor, Lieven Pouillon, Míriam Mañosa, Edo
    Journal of Crohn's and Colitis.2023; 17(10): 1557.     CrossRef
  • Ileocolic Resection for Crohn Disease: The Influence of Different Surgical Techniques on Perioperative Outcomes, Recurrence Rates, and Endoscopic Surveillance
    Benjamin Click, Amit Merchea, Dorin T Colibaseanu, Miguel Regueiro, Francis A Farraye, Luca Stocchi
    Inflammatory Bowel Diseases.2022; 28(2): 289.     CrossRef
  • Anastomotic Techniques for Abdominal Crohn's Disease: Tricks and Tips
    Marco Bertucci Zoccali, Alessandro Fichera
    Journal of Laparoendoscopic & Advanced Surgical Techniques.2021; 31(8): 861.     CrossRef
  • Short-term and long-term outcomes of laparoscopic vs open ileocolic resection in patients with Crohn's disease: Propensity-score matching analysis
    Shin Jeong Pak, Young Il Kim, Yong Sik Yoon, Jong Lyul Lee, Jung Bok Lee, Chang Sik Yu
    World Journal of Gastroenterology.2021; 27(41): 7159.     CrossRef
  • The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Surgical Management of Crohn’s Disease
    Amy L. Lightner, Jon D. Vogel, Joseph C. Carmichael, Deborah S. Keller, Samir A. Shah, Uma Mahadevan, Sunanda V. Kane, Ian M. Paquette, Scott R. Steele, • Daniel L. Feingold
    Diseases of the Colon & Rectum.2020; 63(8): 1028.     CrossRef
  • Correlation Between Anastomotic Configuration and Long-term Outcomes in Surgery for Crohn Disease
    Jin-Su Kim, Ji-Yeon Kim
    Annals of Coloproctology.2017; 33(5): 159.     CrossRef
Transanal Minimally-Invasive Surgery for Treating Patients With Regressed Rectal Cancer After Preoperative Chemoradiotherapy
Byoung Chul Lee, Seonok Oh, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Ann Coloproctol. 2017;33(2):52-56.   Published online April 28, 2017
DOI: https://doi.org/10.3393/ac.2017.33.2.52
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  • 9 Web of Science
  • 9 Citations
AbstractAbstract PDF
Purpose

Although the standard treatment for patients with locally advanced rectal cancer managed by preoperative chemoradiotherapy (CRT) is a radical resection, local excisions are used in highly-selective cases. Recently, transanal minimally-invasive surgery (TAMIS) has emerged as a feasible technique for local excision of midrectal lesions. We assess the feasibility of using TAMIS to treat patients with locally advanced rectal cancer who showed good response to CRT.

Methods

From October 2010 to June 2013, 35 consecutive patients with rectal cancer managed by using preoperative CRT underwent TAMIS. After a single-incision laparoscopic surgery port had been introduced into the anal canal, a full-thickness local excision with conventional laparoscopic instruments was performed. We retrospectively reviewed a prospectively collected database of these cases.

Results

Of the 35 patients analyzed, 18 showed pathologic complete responses and 17 had residual lesions (2 ypTis, 4 ypT1, 9 ypT2, and 2 ypT3); 34 (97.1%) showed clear deep, lateral margins. The median distance of lesions from the anal verge was 5 cm. All procedures were completed laparoscopically, and the median operating time was 84 minutes. No intraoperative events or morbidities were seen in any of the patients, except one with wound dehiscence, who was treated conservatively. The median postoperative hospital stay and follow-up period were 4 days and 36 months, respectively. During the study period, no patients died, but 5 (14.3%) experienced recurrence, including one recurrence at the TAMIS site.

Conclusion

TAMIS seems to be a feasible, safe modality for treating patients with locally advanced rectal cancer who show good response to preoperative CRT.

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    Anders C. Larsen, Joceline V. Vu
    Clinics in Colon and Rectal Surgery.2026;[Epub]     CrossRef
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    Nurhilal Kızıltoprak, Jack Aaron, Camila Diez, Sam Atallah
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    Precision and Future Medicine.2022; 6(1): 32.     CrossRef
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    Na Wang, Daguang Wang, Weihua Tong, Jinguo Wang
    Indian Journal of Surgery.2021; 83(5): 1127.     CrossRef
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    Myung Jo Kim, Taek-Gu Lee
    World Journal of Gastrointestinal Surgery.2021; 13(10): 1149.     CrossRef
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    Hernan A. Sanchez-Trejo, Daniel Hakakian, Terrence Curran, Luca Antonioli, Balazs Csoka, Zoltan H. Nemeth
    Journal of Investigative Surgery.2019; 32(4): 377.     CrossRef
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    Jun Woo Bong, Seok‐Byung Lim
    Asian Journal of Endoscopic Surgery.2019; 12(2): 175.     CrossRef
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    Radiotherapy and Oncology.2019; 133: 20.     CrossRef
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    Min Jung Kim, Jae Hwan Oh
    Annals of Coloproctology.2017; 33(2): 43.     CrossRef
Prognostic Factors in Terms of the Number of Metastatic Nodules in Patients With Colorectal Cancer Liver Metastases
Ki Ung Jang, Chan Wook Kim, Ki-Hun Kim, Seok-Byung Lim, Chang Sik Yu, Tae Won Kim, Pyo Nyun Kim, Jong Hoon Kim, Jin Cheon Kim
Ann Coloproctol. 2016;32(3):92-100.   Published online June 30, 2016
DOI: https://doi.org/10.3393/ac.2016.32.3.92
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  • 17 Web of Science
  • 14 Citations
AbstractAbstract PDF
Purpose

The hepatic resection is the gold-standard treatment for patients with colorectal-cancer liver metastases (CLM). This study aimed to identify prognostic factors in patients with synchronous CLM who underwent a surgical curative (R0) resection with respect to the number of metastatic nodules.

Methods

Of 1,261 CLM patients treated between January 1991 and December 2010, 339 who underwent a R0 resection for synchronous CLM were included in this retrospective analysis. Patients were grouped according to the number of CLM nodules: 1–2 CLM nodules, n = 272 (group 1) and 3–8 CLM nodules, n = 67 (group 2).

Results

The 5-year progression-free survival (PFS) rate in group 1was better than that in group 2 (P = 0.020). The multivariate analysis identified lymph-node metastasis (N2), lymphovascular invasion (LVI), and three or more CLM nodules as independent poor prognostic factors for PFS in all patients and lymph-node metastasis (N2) and LVI as independent poor prognostic factors for patients in group 1. No independent prognostic factors were identified for patients in group 2. CLM treatment method and neoadjuvant chemotherapy were not associated with survival.

Conclusion

Three or more metastatic nodules, lymph-node metastasis (N2), and LVI were independent poor prognostic factors for PFS in patients with synchronous CLM who underwent a R0 resection. The latter 2 factors were also independent prognostic factors for PFS in patients with less than 3 CLM nodules; however, in patients with three or more CLM nodules, the prognosis for PFS may be related only to liver metastasis.

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  • Association Between Colorectal Cancer Primary Features and Liver Metastases Histological Growth Patterns: Inflammation on the Primary Tumor is Associated with Desmoplastic Growth Pattern
    Ana Margarida Abrantes, Rui Caetano-Oliveira, Bárbara Oliveiros, Maria Augusta Cipriano, José Guilherme Tralhão
    Clinical Colorectal Cancer.2025; 24(2): 239.     CrossRef
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    Yixin Ding, Xiaoxi Han, Shufen Zhao, Shasha Wang, Jing Guo, Chuanyu Leng, Xiangxue Li, Kongjia Wang, Wensheng Qiu, Weiwei Qi
    Clinical and Translational Oncology.2024; 26(12): 3169.     CrossRef
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    Bruno Mirandola Bulisani, Milena Arruda de Oliveira Leite, Jaques Waisberg
    einstein (São Paulo).2024;[Epub]     CrossRef
  • More Liver Metastases Detected Intraoperatively Indicates Worse Prognosis for Colorectal Liver Metastases Patients after Resection Combined with Microwave Ablation
    Ling-Min Jiang, Yuan-Ping Zhang, Chen-Wei Wang, Wei-Dong Zhang, Wei He, Ji-Liang Qiu, Yi-Chuan Yuan, Bin-Kui Li, Yun-Fei Yuan, Ren-Chun Lai, Dan-Dan Hu, Yun Zheng, Alessandro Granito
    Journal of Oncology.2022; 2022: 1.     CrossRef
  • The Tumor Microenvironment in Liver Metastases from Colorectal Carcinoma in the Context of the Histologic Growth Patterns
    Gemma Garcia-Vicién, Artur Mezheyeuski, María Bañuls, Núria Ruiz-Roig, David G. Molleví
    International Journal of Molecular Sciences.2021; 22(4): 1544.     CrossRef
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    Xiao-Zhan Zhang, Hong-Li Mao, Shi-Jie Zhang, Li Sun, Wen-Jing Zhang, Qing-Zhou Chen, Lei Wang, Hong-Chun Liu
    Life Sciences.2020; 249: 117478.     CrossRef
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    Yuma Wada, Yuji Morine, Satoru Imura, Tetsuya Ikemoto, Yu Saito, Chie Takasu, Shinichiro Yamada, Mitsuo Shimada
    World Journal of Surgical Oncology.2020;[Epub]     CrossRef
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    Heeji Shin, Chan Wook Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok‐Byung Lim, Chang Sik Yu, Jin Cheon Kim
    ANZ Journal of Surgery.2019; 89(1-2): 61.     CrossRef
  • Liver Metastases and Histological Growth Patterns: Biological Behavior and Potential Clinical Implications—Another Path to Individualized Medicine?
    Rui Caetano Oliveira, Henrique Alexandrino, Maria Augusta Cipriano, José Guilherme Tralhão
    Journal of Oncology.2019; 2019: 1.     CrossRef
  • Which Patients with Isolated Para-aortic Lymph Node Metastasis Will Truly Benefit from Extended Lymph Node Dissection for Colon Cancer?
    Sung Uk Bae, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Kang Young Lee, Nam Kyu Kim
    Cancer Research and Treatment.2018; 50(3): 712.     CrossRef
  • Resection after preoperative chemotherapy versus synchronous liver resection of colorectal cancer liver metastases
    Chan W. Kim, Jong L. Lee, Yong S. Yoon, In J. Park, Seok-Byung Lim, Chang S. Yu, Tae W. Kim, Jin C. Kim
    Medicine.2017; 96(7): e6174.     CrossRef
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    Rui Mao, Jian-Jun Zhao, Xin-Yu Bi, Ye-Fan Zhang, Zhi-Yu Li, Jian-Guo Zhou, Xiao-Long Wu, Chen Xiao, Hong Zhao, Jian-Qiang Cai
    Oncotarget.2017; 8(60): 102531.     CrossRef
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    Daniel Krell, Rob Glynne-Jones
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    Min Ro Lee, Jong Hun Kim
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The Clinical Features and Predictive Risk Factors for Reoperation in Patients With Perianal Crohn Diseases; A Multi-Center Study of a Korean Inflammatory Bowel Disease Study Group
Jae Bum Lee, Seo-Gue Yoon, Kyu Joo Park, Kang Young Lee, Dae Dong Kim, Sang Nam Yoon, Chang Sik Yu
Ann Coloproctol. 2015;31(5):176-181.   Published online October 31, 2015
DOI: https://doi.org/10.3393/ac.2015.31.5.176
  • 4,899 View
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  • 8 Web of Science
  • 8 Citations
AbstractAbstract PDF
Purpose

Perianal lesions are common in Crohn disease, but their clinical course is unpredictable. Nevertheless, predicting the clinical course after surgery for perianal Crohn disease (PCD) is important because repeated operations may decrease patient's quality of life. The aim of this study was to predict the risk of reoperation in patients with PCD.

Methods

From September 1994 to February 2010, 377 patients with PCD were recruited in twelve major tertiary university-affiliated hospitals and two specialized colorectal hospitals in Korea. Data on the patient's demographics, clinical features, and surgical outcomes were analyzed.

Results

Among 377 patients, 227 patients were ultimately included in the study. Among the 227 patients, 64 patients underwent at least one reoperation. The median period of reoperation following the first perianal surgery was 94 months. Overall 3-year, 5-year, and 10-year cumulative rates of reoperation-free individuals were 68.8%, 61.2%, and 50.5%, respectively. In multivariate analysis (Cox-regression hazard model), reoperation was significantly correlated with an age of onset less than 20 years (hazard ratio [HR], 1.93; 95% confidence interval [CI], 1.07-3.48; P = 0.03), history of abdominal surgery (HR, 1.99; 95% CI, 1.08-3.64; P = 0.03), and the type of surgery. Among types of surgery, fistulotomy or fistulectomy was associated with a decreased incidence of reoperation in comparison with incision and drainage (HR, 0.19; 95% CI, 0.09-0.42; P < 0.001).

Conclusion

Young age of onset and a history of abdominal surgery were associated with a high risk of reoperation for PCD, and the risk of reoperation were relatively low in fistulotomy or fistulectomy procedures.

Citations

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  • A nanofiber-hydrogel composite improves tissue repair in a rat model of Crohn’s disease perianal fistulas
    Ling Li, Zhi-Cheng Yao, Alyssa Parian, Yueh-Hsun Yang, Jeffrey Chao, Jason Yin, Kevan J. Salimian, Sashank K. Reddy, Atif Zaheer, Susan L. Gearhart, Hai-Quan Mao, Florin M. Selaru
    Science Advances.2023;[Epub]     CrossRef
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    Kwangwoo Nam, Won Beom Jung, Seung Bum Lee, Jae Seung Soh, Song Soo Yang, Seok Won Jung
    Journal of Digestive Diseases.2021; 22(6): 334.     CrossRef
  • Perianal and Luminal Relapse Following Perianal Surgical Intervention in Crohn’s Disease
    Feihong Deng, Pianpian Xia, Zengrong Wu, Hejun Zhou, Xuehong Wang
    International Journal of General Medicine.2021; Volume 14: 3387.     CrossRef
  • Predictors of Perianal Fistula Relapse in Crohn’s Disease
    Audrey Malian, Pauline Rivière, Dominique Bouchard, François Pigot, Marianne Eléouet-Kaplan, Charlotte Favreau-Weltzer, Florian Poullenot, David Laharie
    Inflammatory Bowel Diseases.2020; 26(6): 926.     CrossRef
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    Dana J Lukin
    Inflammatory Bowel Diseases.2019;[Epub]     CrossRef
  • Management of Perianal Fistulas in Crohn’s Disease
    Steffen Seyfried, Alexander Herold
    Visceral Medicine.2019; 35(6): 338.     CrossRef
  • Surgical management of fistulating perianal Crohn's disease: a UK survey
    M. J. Lee, N. Heywood, P. M. Sagar, S. R. Brown, N. S. Fearnhead
    Colorectal Disease.2017; 19(3): 266.     CrossRef
  • Risk of Repeat Surgery for Perianal Crohn Disease
    Doo Han Lee
    Annals of Coloproctology.2015; 31(5): 169.     CrossRef
Characteristics and Survival of Korean Anal Cancer From the Korea Central Cancer Registry Data
Hyoung-Chul Park, Kyu-Won Jung, Byung-Woo Kim, Aesun Shin, Young-Joo Won, Jae Hwan Oh, Seung-Yong Jeong, Chang Sik Yu, Bong Hwa Lee
Ann Coloproctol. 2013;29(5):182-185.   Published online October 31, 2013
DOI: https://doi.org/10.3393/ac.2013.29.5.182
  • 10,834 View
  • 43 Download
  • 10 Citations
AbstractAbstract PDF
Purpose

In Korea, anal cancer is rare disease entity with specific clinical characteristics. Therefore, no survival analysis with a sufficient patient population has been performed. The aim of this study was to evaluate the characteristics of Korean anal cancer, focusing on the survival according to tumor histologies, sex, and a specific age group, using the nationwide cancer registry.

Methods

Using the Korea Central Cancer Registry, we analyzed a total of 2,552 cases from 1993 to 2010. We assessed the 5-year relative survival by using tumor histology. In addition, survival differences of Surveillance Epidemiology and End Results (SEER) stage were analyzed for both sexes and for young-age cancer (younger than 40 years) and advanced-age cancer (older than 70 years).

Results

The 5-year relative survival among anal cancer patients increased from 38.9% for the period 1993-1995 to 65.6% for the period 2006-2010. The anal squamous cell carcinoma was the most common histology and showed better survival than other types of cancer. Females demonstrated better survival than males in all SEER stages. The 5-year survivals for patients in whom anal cancer developed before the age of 40 and at or after the age of 40 were 62.4% and 51.6%, respectively. The 5-year survival for patients in whom cancer developed at or after the age of 70 was much worse than that for patients in whom the cancer had developed prior to that age.

Conclusion

Korean anal cancer has certain distinctive characteristics of survival according to tumor histology, sex, and age. Despite limitations on available data, this study used the nationwide database to provide important information on the survival of Korean patients with anal cancer.

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    Dijing You, Jianchao Quan, David Bishai, Wendy Wing Tak Lam, Karen Ann Grépin, Linda Chan, Diana Dan Wu, David Ka Ki Wong, William Chi Wai Wong, Jiandong Zhou
    Vaccine.2025; 63: 127625.     CrossRef
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    Byung-Wook Eun, Enas Bahar, Stebin Xavier, Hyungwoo Kim, Dorota Borys
    Human Vaccines & Immunotherapeutics.2023;[Epub]     CrossRef
  • Long-term Oncologic Outcome and Its Relevant Factors in Anal Cancer in Korea: A Nationwide Data Analysis
    Hyuk Hur, Kyu-Won Jung, Byung-Woo Kim, Chang-Mo Oh, Young-Joo Won, Jae Hwan Oh, Nam Kyu Kim
    Annals of Coloproctology.2020; 36(1): 35.     CrossRef
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    Young-Tak Kim, Beatriz Serrano, Jae-Kwan Lee, Hyunju Lee, Shin-Wha Lee, Crystal Freeman, Jin-Kyoung Oh, Laia Alemany, Francesc-Xavier Bosch, Laia Bruni
    Papillomavirus Research.2019; 7: 26.     CrossRef
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    Dae Ro Lim, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Kang Young Lee, Nam Kyu Kim
    Korean Journal of Clinical Oncology.2016; 12(1): 41.     CrossRef
  • Trends and Analysis of Cancer Incidence for Common Male and Female Cancers in the Population of Punjab Province of Pakistan during 1984 to 2014
    Khalid Masood, Andleeb Masood, Junaid Zafar, Abubaker Shahid, Mujahid Kamran, Sohail Murad, Misbah Masood, Zafar Alluddin, Masooma Riaz, Naseem Akhter, Munir Ahmad, Fayyaz Ahmad, Javaid Akhtar, Muhammad Naeem
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  • Reply on "Characteristics and Survival of Korean Anal Cancer From the Korea Central Cancer Registry Data"
    Hyoung-Chul Park, Bong Hwa Lee
    Annals of Coloproctology.2014; 30(1): 56.     CrossRef
  • Patterns and Trends with Cancer Incidence and Mortality Rates Reported by the China National Cancer Registry
    Peng-Lai Chen, Ting Zhao, Rui Feng, Jing Chai, Gui-Xian Tong, De-Bin Wang
    Asian Pacific Journal of Cancer Prevention.2014; 15(15): 6327.     CrossRef
  • Commentary on "Characteristics and Survival of Korean Anal Cancer From the Korea Central Cancer Registry Data"
    Mohammad Mohammadianpanah
    Annals of Coloproctology.2014; 30(1): 54.     CrossRef
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    Nam Kyu Kim
    Annals of Coloproctology.2013; 29(5): 177.     CrossRef
Data on the Characteristics and the Survival of Korean Patients With Colorectal Cancer From the Korea Central Cancer Registry
Hyoung-Chul Park, Aesun Shin, Byung-Woo Kim, Kyu-Won Jung, Young-Joo Won, Jae Hwan Oh, Seung-Yong Jeong, Chang Sik Yu, Bong Hwa Lee
Ann Coloproctol. 2013;29(4):144-149.   Published online August 29, 2013
DOI: https://doi.org/10.3393/ac.2013.29.4.144
  • 8,547 View
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  • 36 Citations
AbstractAbstract PDF
Purpose

The incidence rates of colorectal cancer (CRC) in Korea have been increasing during the past decade. Therefore, it is important to understand the characteristics, including survival, of Korean CRC patients. The aim of this study was to use the nationwide cancer registry to evaluate the characteristics of Korean CRC, focusing on the survival, according to tumor location, sex, and specific age groups.

Methods

Using the Korea Central Cancer Registry (KCCR), we analyzed a total of 226,352 CRC cases diagnosed from 1993 to 2010. The five-year relative survivals were compared for the proximal colon, the distal colon, and the rectum. Survival rates were compared between men and women and between patients of young age (less than 40 years old) and patients of advanced age (70 years old or older).

Results

The 5-year survival rates were improved in all subsites between 1993 and 2010. Distal colon cancer showed favorable survival compared to proximal colon or rectal cancer. Females demonstrated worse survival for local or regional cancers, and this difference was significant in for patients in their seventies. Young patients (<40 years old) showed better survival rates for overall and proximal colon cancer comparable to those for older patients (≥40 years old), but advanced age patients (≥70 years old) had worse survivals for all tumor subsites compared to their younger counterparts (<70 years old). These trends were similar in distant CRC.

Conclusion

Korean CRC has certain distinct characteristics of survival according to tumor location, sex, and age. Despite the limitations of available data, this study contributes to a better understanding of survival differences in Korean CRC.

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    Aura Jurescu, Alis Dema, Sorina Tăban, Robert Barna, Adrian Ovidiu Văduva, Octavia Vița, Remus Cornea, Dorela-Codruța Lăzureanu, Anca Mureșan, Mărioara Cornianu, Bianca Natarâș, Ioana Hurmuz, Adelina Vidac, Sorin Dema
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    Ilgiz G. Gataullin, Rishat M. Dinov, Bulat I. Gataullin, Yana А. Erpert
    Science and Innovations in Medicine.2024; 9(2): 138.     CrossRef
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The Role of Diverting Stoma After an Ultra-low Anterior Resection for Rectal Cancer
Seok In Seo, Chang Sik Yu, Gwon Sik Kim, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seok-Byung Lim, Jin Cheon Kim
Ann Coloproctol. 2013;29(2):66-71.   Published online April 30, 2013
DOI: https://doi.org/10.3393/ac.2013.29.2.66
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AbstractAbstract PDF
Purpose

A diverting stoma is known to reduce the consequences of distal anastomotic failure following colorectal surgery. The aim of this study was to evaluate the efficacy of a diverting stoma after an ultra-low anterior resection (uLAR) for rectal cancer.

Methods

Between 2000 and 2007, 836 patients who underwent an uLAR were divided into two groups, depending on the fecal diversion: 246 received fecal diversion, and 590 had no diversion. Patient- and disease-related variables were compared between the two groups.

Results

Thirty-two of the 836 patients (3.8%) had immediate anastomosis-related complications and required reoperation. Anastomosis leakage comprised 72% of the complications (23/32). The overall immediate complication rate was significantly lower in patients with a diverting stoma (0.8%, 2/246) compared to those without a diverting stoma (5.1%, 30/590; P = 0.005). The fecal diversion group had lower tumor location, lower anastomosis level, and more preoperative chemo-radiation therapy (P < 0.001). In total, 12% of patients in the diverting stoma group had complications either in making or reversing the stoma (30/246).

Conclusion

The diverting stoma decreased the rate of immediate anastomosis-related complications. However, the rate of complications associated with the diverting stoma was non-negligible, so strict criteria should be applied when deciding whether to use a diverting stoma.

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Risk Factors for Repeat Abdominal Surgery in Korean Patients with Crohn's Disease: A Multi-Center Study of a Korean Inflammatory Bowel Disease Study Group
Kil Yeon Lee, Chang Sik Yu, Kang Young Lee, Yong Beom Cho, Kyu Joo Park, Gyu-Seog Choi, Sang Nam Yoon, Hanna Yoo
J Korean Soc Coloproctol. 2012;28(4):188-194.   Published online August 31, 2012
DOI: https://doi.org/10.3393/jksc.2012.28.4.188
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  • 8 Citations
AbstractAbstract PDF
Purpose

The purpose of this study was to assess the risk factors for repeated abdominal surgery in Crohn's disease (CD) patients after the first abdominal surgery. Prior studies have tried to identify the risk factors for postoperative recurrence in CD patients, but the results of the studies have been inconsistent. Furthermore, few data on the risk factors for repeated abdominal surgery are available.

Methods

Clinical data on CD patients who underwent abdominal surgery from January 2000 to December 2009 were collected from seventeen university hospitals and one colorectal clinic. Data from a total of 708 patients were analyzed to find the risk factors for repeated abdominal surgery in CD patients. The mean follow-up period was 72 months.

Results

The risk of repeated abdominal surgery was 3 times higher in young patients (below 16 years old) than in older patients (odds ratio [OR], 3.056; 95% confidence interval [CI], 1.021 to 9.150); P = 0.046). Stricturing behavior at diagnosis was also a risk factor for repeated abdominal surgery (OR, 2.438; 95% CI, 1.144 to 5.196; P = 0.021). Among operative indications, only intra-abdominal abscess was associated with repeated abdominal surgery (OR, 2.393; 95% CI, 1.098 to 5.216; P = 0.028). Concerning type of operation, an ileostomy might be a risk factor for repeated abdominal surgery (OR, 11.437; 95% CI, 1.451 to 90.124; P = 0.021). Emergency surgery (OR, 4.994; 95% CI, 2.123 to 11.745; P < 0.001) and delayed diagnosis after surgery (OR, 2.339; 95% CI, 1.147 to 4.771; P = 0.019) also increased the risk of repeated abdominal surgery.

Conclusion

Young age (below 16 years), stricturing behavior, intra-abdominal abscess, emergency surgery, and delayed diagnosis after surgery were identified as possible risk factors for repeated abdominal surgery in CD patients.

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Clinicopathologic Factors Affecting Recurrence after Curative Surgery for Stage I Colorectal Cancer
Min Ae Keum, Seok-Byung Lim, Sun A Kim, Yong Sik Yoon, Chan Wook Kim, Chang Sik Yu, Jin Cheon Kim
J Korean Soc Coloproctol. 2012;28(1):49-55.   Published online February 29, 2012
DOI: https://doi.org/10.3393/jksc.2012.28.1.49
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AbstractAbstract PDF
Purpose

The objective of the current study was to identify the clinicopathological risk factors affecting recurrence after a curative resection for stage I colorectal cancer.

Methods

We retrospectively studied 434 patients who underwent a curative resection for stage I colorectal cancer between January 1999 and December 2004. Postoperative oral chemotherapy was performed in 189 patients (45.3%). The following prognostic factors were correlated with recurrence: age, gender, preoperative carcinoembryonic antigen level, location of tumor, T stage, size of tumor, histologic differentiation, growth pattern, and lymphovascular invasion. The median follow-up duration was 65 months.

Results

The overall recurrence rate was 4.6% (20/434). The median time to recurrence was 33 months. Two-thirds of the recurrence occurred more than two years after surgery. Risk factors associated with recurrence were rectal cancer (P = 0.009), T2 stage (P = 0.010), and infiltrative growth pattern (P = 0.020). A Cox proportional hazards regression analysis demonstrated that the infiltrative growth pattern was an independent predictor for recurrence. Tumor cell budding was observed in all pathologic reviews with recurrence.

Conclusion

Long-term follow-up is necessary for stage I colorectal patients with high risk factors like rectal cancer, T2 stage, and infiltrative growth pattern.

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Surgical Outcomes after Total Colectomy with Ileorectal Anastomosis in Patients with Medically Intractable Slow Transit Constipation
Guiyun Sohn, Chang Sik Yu, Chan Wook Kim, Jae Young Kwak, Tae Young Jang, Kyung Ho Kim, Song Soo Yang, Yong Sik Yoon, Seok-Byung Lim, Jin Cheon Kim
J Korean Soc Coloproctol. 2011;27(4):180-187.   Published online August 31, 2011
DOI: https://doi.org/10.3393/jksc.2011.27.4.180
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  • 33 Citations
AbstractAbstract PDF
Purpose

The aim of this study was to evaluate outcomes of a total colectomy with ileorectal anastomosis in patients with slow transit constipation.

Methods

A retrospective review of 37 consecutive patients with slow transit constipation who underwent a total colectomy between 1994 and 2008 was undertaken. Preoperative and postoperative Wexner's constipation scores were collected and used to evaluate the outcomes after surgical treatment. Also patients' postoperative satisfaction scores were collected using a 4-point scale.

Results

The 37 patients consisted of 31 women and 6 men, with a median age of 41 years (range, 17 to 71 years). Pre- and post-operative Wexner's scores were collected from 33 patients (89.1%), and the mean preoperative Wexner's score was 19.3 (range, 11 to 24), which decreased to an average post-operative score of 2.3 (range, 0 to 8). Neither intraoperative complications nor postoperative mortalities were noted. Five patients (13.5%) had early postoperative complications, and the most common complication was postoperative ileus (10.8%). Seven patients (18.9%) had late postoperative complications, and postoperative ileus (10.8%) was also the most common. Twenty seven of 33 patients were satisfied with their surgical outcome (81.8%).

Conclusion

A total colectomy with ileorectal anastomosis might be an effective surgical procedure with acceptable morbidity to treat medically intractable slow transit constipation.

Citations

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