Annals of Coloproctology

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Original Articles

Colonoscopy

Analysis of adenoma detection rate of colonoscopy among trainees: Young Min Song, Kyung Su Han, Byung Chang Kim, Chang Won Hong, Bun Kim, Min Chul Kim, Myeong Jae Jin, Dae Kyung Sohn; Ann Coloproctol. 2024;40(6):548-554. Published online August 28, 2024; DOI: https://doi.org/10.3393/ac.2023.00199.0028

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Abstract PDF Supplementary Material: Purpose
To analyze adenoma detection rate (ADR) and related quality indicators of colonoscopy among trainees and make recommendations for appropriate colonoscopy training.
Methods
ADR and related indicators of colonoscopies performed by 3 trainees and 5 colonoscopy experts between March and November 2022 were analyzed. These indicators were analyzed in both the entire patients and the screening/surveillance group. In addition, the training period of the 3 trainees was divided into 3 sections, and the changes in these indicators were examined.
Results
The mean ADR of the 3 trainees was 50.6%. In the screening/surveillance group, the mean ADR of the 3 trainees was 51.8%, showing no significant difference from the experts' ADR (53.4%). When the training period was divided into 3 sections and analyzed in the screening/surveillance group, the mean ADR of the trainees gradually increased to 49.4%, 52.6%, and 53.6%, respectively; however, the difference was insignificant. Analyzing each trainee’s ADR, there was a significant difference among the 3 trainees (58.5% vs. 44.7% vs. 50.2%, P=0.008). However, in the third section of the training period, the 3 trainees’ ADRs were 53.0%, 49.2%, and 57.3%, respectively, showing no significant difference (P=0.606).
Conclusion
In the early stages of training, the ADR was higher than recommended; however, there were variances in ADR between individuals. As the training period passed, the ADR became similar at the expert level, whereas the difference in ADR between trainees decreased. Therefore, efforts to increase ADR should be made actively from the beginning of training and continued during the training period.

Colorectal cancer

Long-term clinical outcomes after high and low ligations with lymph node dissection around the root of the inferior mesenteric artery in patients with rectal cancer: Min Wan Lee, Sung Sil Park, Kiho You, Dong Eun Lee, Dong Woon Lee, Sung Chan Park, Kyung Su Han, Dae Kyung Sohn, Chang Won Hong, Bun Kim, Byung Chang Kim, Hee Jin Chang, Dae Yong Kim, Jae Hwan Oh; Ann Coloproctol. 2024;40(1):62-73. Published online February 26, 2024; DOI: https://doi.org/10.3393/ac.2023.00094.0013

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Graphical Abstract Abstract PDF

Purpose
This study aimed to evaluate the long-term clinical outcomes based on the ligation level of the inferior mesenteric artery (IMA) in patients with rectal cancer.
Methods
This was a retrospective analysis of a prospectively collected database that included all patients who underwent elective low anterior resection for rectal cancer between January 2013 and December 2019. The clinical outcomes included oncological outcomes, postoperative complications, and functional outcomes. The oncological outcomes included overall survival (OS) and relapse-free survival (RFS). The functional outcomes, including defecatory and urogenital functions, were analyzed using the Fecal Incontinence Severity Index, International Prostate Symptom Score, and International Index of Erectile Function questionnaires.
Results
In total, 545 patients were included in the analysis. Of these, 244 patients underwent high ligation (HL), whereas 301 underwent low ligation (LL). The tumor size was larger in the HL group than in the LL group. The number of harvested lymph nodes (LNs) was higher in the HL group than in the LL group. There were no significant differences in complication rates and recurrence patterns between the groups. There were no significant differences in 5-year RFS and OS between the groups. Cox regression analysis revealed that the ligation level (HL vs. LL) was not a significant risk factor for oncological outcomes. Regarding functional outcomes, the LL group showed a significant recovery in defecatory function 1 year postoperatively compared with the HL group.
Conclusion
LL with LNs dissection around the root of the IMA might not affect the oncologic outcomes comparing to HL; however, it has minimal benefit for defecatory function.

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Meeting report on the 8th Asian Science Editors’ Conference and Workshop 2024
Eun Jung Park
Science Editing.2025; 12(1): 66. 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

Translational/basic research

Exfoliate cancer cell analysis in rectal cancer surgery: comparison of laparoscopic and transanal total mesorectal excision, a pilot study: Kiho You, Jung-Ah Hwang, Dae Kyung Sohn, Dong Woon Lee, Sung Sil Park, Kyung Su Han, Chang Won Hong, Bun Kim, Byung Chang Kim, Sung Chan Park, Jae Hwan Oh; Ann Coloproctol. 2023;39(6):502-512. Published online December 26, 2023; DOI: https://doi.org/10.3393/ac.2023.00479.0068

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Graphical Abstract Abstract PDF Supplementary Material: Purpose
Minimally invasive surgery (MIS) is currently the standard treatment for rectal cancer. However, its limitations include complications and incomplete total mesorectal resection (TME) due to anatomical features and technical difficulties. Transanal TME (TaTME) has been practiced since 2010 to improve this, but there is a risk of local recurrence and intra-abdominal contamination. We aimed to analyze samples obtained through lavage to compare laparoscopic TME (LapTME) and TaTME.
Methods
From June 2020 to January 2021, 20 patients with rectal cancer undergoing MIS were consecutively and prospectively recruited. Samples were collected at the start of surgery, immediately after TME, and after irrigation. The samples were analyzed for carcinoembryonic antigen (CEA) and cytokeratin 20 (CK20) through a quantitative real-time polymerase chain reaction. The primary outcome was to compare the detected amounts of CEA and CK20 immediately after TME between the surgical methods.
Results
Among the 20 patients, 13 underwent LapTME and 7 underwent TaTME. Tumor location was lower in TaTME (7.3 cm vs. 4.6 cm, P=0.012), and negative mesorectal fascia (MRF) was more in LapTME (76.9% vs. 28.6%, P=0.044). CEA and CK20 levels were high in 3 patients (42.9%) only in TaTME. There was 1 case of T4 with incomplete purse-string suture and 1 case of positive MRF with dissection failure. All patients were followed up for an average of 32.5 months without local recurrence.
Conclusion
CEA and CK20 levels were high only in TaTME and were related to tumor factors or intraoperative events. However, whether the detection amount is clinically related to local recurrence remains unclear.

Colorectal cancer

Stratification of rate of lymph node metastasis according to risk factors and oncologic outcomes in patients who underwent radical resection for rectal neuroendocrine tumors: Myung Jae Jin, Sung Sil Park, Dong-Eun Lee, Sung Chan Park, Dong Woon Lee, Kiho You, Hee Jin Chang, Chang Won Hong, Dae Kyung Sohn, Kyung Su Han, Bun Kim, Byung Chang Kim, Jae Hwan Oh; Ann Coloproctol. 2023;39(6):467-473. Published online April 28, 2023; DOI: https://doi.org/10.3393/ac.2022.00913.0130

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Abstract PDF Supplementary Material

Purpose
Most predictive factors for lymph node metastasis in rectal neuroendocrine tumors (NETs) have been based on local and endoscopic resection. We aimed to evaluate the risk factors for lymph node metastasis in patients who underwent radical resection for rectal NETs and stratify the risk of lymph node metastasis.
Methods
Sixty-four patients who underwent radical resection for rectal NETs between January 2001 and January 2018 were included. We investigated the risk factors of lymph node metastasis using clinicopathologic data. We also performed a risk stratification for lymph node metastases using the number of previously known risk factors. For oncologic outcomes, the 5-year overall survival and recurrence-free survival were evaluated in both groups.
Results
Among the patients who underwent radical surgery, 32 (50.0%) had lymph node metastasis and 32 (50.0%) had non–lymph node metastasis. In the multivariable analysis, only the male sex was identified as a risk factor for lymph node metastasis (odds ratio, 3.695; 95% confidence interval, 1.128–12.105; P=0.031). When there were 2 or more known risk factors, the lymph node metastasis rate was significantly higher than when there were one or no risk factors (odds ratio, 3.667; 95% confidence interval, 1.023–13.143; P=0.046). There was also no statistical difference between the 2 groups in 5-year overall survival (P=0.431) and 5-year recurrence-free survival (P=0.144).
Conclusion
We found that the rate of lymph node metastasis increased significantly when the number of known risk factors is 2 or more.

Citations

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Lateral pelvic lymph nodes dissection of rectal neuroendocrine neoplasms: A prospective case-series and literature review
Yueyang Zhang, Yi Yang, Changyuan Gao, Hong Zhao, Haitao Zhou
Surgery.2024; 176(5): 1360. CrossRef

Benign GI diease,Benign diesease & IBD,Complication,Surgical technique

Efficacy and Safety of Endoscopic Clipping for Acute Anastomotic Bleeding After Colorectal Surgery: Ryun Kyong Ha, Kyung Su Han, Sung Sil Park, Dae Kyung Sohn, Chang Won Hong, Byung Chang Kim, Bun Kim; Ann Coloproctol. 2022;38(3):262-265. Published online October 26, 2021; DOI: https://doi.org/10.3393/ac.2021.00297.0042

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Abstract PDF

Purpose
Anastomotic bleeding after colorectal surgery is a rare, mostly self-limiting, postoperative complication that could lead to a life-threatening condition. Therefore, prompt management is required. This study aimed to evaluate the efficacy and safety of endoscopic clipping for acute anastomotic bleeding after colorectal surgery.
Methods
We retrospectively reviewed the data of patients pathologically diagnosed with colorectal cancer at National Cancer Center, Korea from January 2018 to November 2020, which presented with anastomotic bleeding within the first postoperative week and were endoscopically managed with clips.
Results
Nine patients had anastomotic bleeding, underwent endoscopic management, and, therefore, were included in this study. All patients underwent laparoscopic (low/ultralow) anterior resection with mechanical double-stapled anastomosis. Anastomotic bleeding was successfully managed through a colonoscopy with clips on the first trial in all patients. Hypovolemic shock occurred in one patient, following anastomotic breakdown.
Conclusion
Endoscopic clipping seems to be an effective and safe treatment for anastomotic bleeding with minimal physiologic stress, easy accessibility, and scarce postoperative complications. However, a surgical backup should always be considered for massive bleeding.

Citations

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Post-Surgical Imaging Assessment in Rectal Cancer: Normal Findings and Complications
Federica De Muzio, Roberta Fusco, Carmen Cutolo, Giuliana Giacobbe, Federico Bruno, Pierpaolo Palumbo, Ginevra Danti, Giulia Grazzini, Federica Flammia, Alessandra Borgheresi, Andrea Agostini, Francesca Grassi, Andrea Giovagnoni, Vittorio Miele, Antonio B
Journal of Clinical Medicine.2023; 12(4): 1489. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef

Malignant disease, Rectal cancer,Prognosis

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

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Abstract PDF

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

Citations

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Performance reporting design in artificial intelligence studies using image-based TNM staging and prognostic parameters in rectal cancer: a systematic review
Minsung Kim, Taeyong Park, Bo Young Oh, Min Jeong Kim, Bum-Joo Cho, Il Tae Son
Annals of Coloproctology.2024; 40(1): 13. CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Survival prognostic in different age groups of patients undergoing local versus radical excision for rectal cancer: a study based on the SEER database
Jinghui Li, Liang Wen, Yongli Ma, Guosheng Zhang, Ping Wang, Chengzhi Huang, Xueqing Yao
Updates in Surgery.2024; 76(3): 975. CrossRef
Comparative analysis of organ preservation attempt and radical surgery in clinical T2N0 mid to low rectal cancer
Hyeung-min Park, Jaram Lee, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
International Journal of Colorectal Disease.2024;[Epub] CrossRef
Organ preservation for early rectal cancer using preoperative chemoradiotherapy
Gyung Mo Son
Annals of Coloproctology.2023; 39(3): 191. CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han
The Ewha Medical Journal.2023;[Epub] CrossRef
Multidisciplinary treatment strategy for early rectal cancer
Gyung Mo Son, In Young Lee, Sung Hwan Cho, Byung-Soo Park, Hyun Sung Kim, Su Bum Park, Hyung Wook Kim, Sang Bo Oh, Tae Un Kim, Dong Hoon Shin
Precision and Future Medicine.2022; 6(1): 32. CrossRef
The risk-benefit trade-off in local excision of early rectal cancer
Chang Hyun Kim
Annals of Coloproctology.2022; 38(2): 95. CrossRef
Applications of propensity score matching: a case series of articles published in Annals of Coloproctology
Hwa Jung Kim
Annals of Coloproctology.2022; 38(6): 398. CrossRef

Case Report

Benign GI diease

Small Bowel Perforation Associated With Gastrointestinal Graft-Versus-Host Disease and Cytomegalovirus Enteritis in a Patient With Leukemia: A Case Report With Literature Review: Kwang-Seop Song, Min Jung Kim, Han-Ki Lim, Yoon Hwa Hong, Sung Sil Park, Chang Won Hong, Sung Chan Park, Dae Kyung Sohn, Kyung Su Han, Jae Hwan Oh; Ann Coloproctol. 2020;36(4):281-284. Published online August 31, 2020; DOI: https://doi.org/10.3393/ac.2018.10.01.1

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Abstract PDF

Gastrointestinal graft-versus-host disease (GVHD) is a common complication after hematopoietic stem cell transplantation. Concomitant cytomegalovirus (CMV) enteritis worsens the prognosis of this condition. We report a case of small bowel perforation associated with gastrointestinal GVHD and CMV enteritis in a patient with leukemia who was successfully treated surgically. A 39-year-old man presented with intestinal perforation necessitating emergency surgical intervention. He was diagnosed with T-cell acute lymphoblastic leukemia and developed severe gastrointestinal GVHD and CMV enteritis after hematopoietic stem cell transplantation. His terminal ileum showed a perforation with diffuse wall thinning, and petechiae were observed over long segments of the distal ileum and the proximal colon. Small bowel segmental resection and a subtotal colectomy with a double-barreled ileocolostomy were performed. The patient recovered uneventfully after the operation. Based on reports described in the literature, surgery plays a minor role in the management of gastrointestinal GVHD; however, timely surgical intervention could be effective in selected patients.

Citations

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Cytomegalovirus enteritis resistant to antiviral drugs improved following total colectomy
Sae Kawata, Jumpei Takamatsu, Yuichi Yasue, Aya Fukuhara, Jinkoo Kang
Surgical Case Reports.2023;[Epub] CrossRef

Original Articles

Malignant disease

Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy With Mitomycin C Used for Colorectal Peritoneal Carcinomatosis: Seung Jae Roh, Sung Chan Park, Jaehee Choi, Joon Sang Lee, Dong Woon Lee, Chang Won Hong, Kyung Su Han, Hyoung Chul Park, Dae Kyung Sohn, Jae Hwan Oh; Ann Coloproctol. 2020;36(1):22-29. Published online February 29, 2020; DOI: https://doi.org/10.3393/ac.2019.04.30

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Abstract PDF

Purpose
This study aimed to assess the evaluation of clinical outcomes and consequences of complications after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for the peritoneal carcinomatosis (PC) from colorectal cancer.
Methods
A total 26 patients underwent CRS and HIPEC for PC from colorectal cancer between March 2009 and April 2018. All the patients underwent CRS with the purpose of complete or near-complete cytoreduction. Intraoperative HIPEC was performed simultaneously after the CRS. Mitomycin C was used as chemotherapeutic agent for HIPEC.
Results
Median disease-free survival was 27.8 months (range, 13.4–42.2 months). Median overall survival was 56.0 months (range, 28.6–83.5 months). The mean peritoneal cancer index (PCI) was 8.73 ± 5.54. The distributions thereof were as follows: PCI <10, 69.23%; PCI 10–19, 23.08%; and PCI ≥20, 7.69%. The completeness of cytoreduction was 96.2% of patients showed CC-0, with 3.8% achieved CC-1. The mean operation time was 8.5 hours, and the mean postoperative hospital stay was 21.6 days. The overall rate of early postoperative complications was 88.5%; the rate of late complications was 34.6%. In the early period, most complications were grades I–II complications (65.4%), compared to grades III–V (23.1%). All late complications, occurring in 7.7% of patients, were grades III–V. There was no treatment-related mortality.
Conclusion
Although the complication rate was approximately 88%, but the rate of severe complication rate was low. In selective patients with peritoneal recurrence, more aggressive strategies for management, such as CRS with HIPEC, were able to be considered under the acceptable general condition and life-expectancy.

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Harnessing Hyperthermia: Molecular, Cellular, and Immunological Insights for Enhanced Anticancer Therapies
Szilvia Lukácsi, Gyöngyi Munkácsy, Balázs Győrffy
Integrative Cancer Therapies.2024;[Epub] CrossRef
Diagnostic and Prognostic Potential of Long Non-Coding RNAs GAS5, MALAT1, CCAT2, HOTAIR and H19 in Colorectal Cancer Cases with Peritoneal Metastases
Alpaslan Tanoglu, Esra Guzel Tanoglu, Erdal Polat, Muhammed Fevzi Esen, Nagehan Ozdemir Barisik
Brazilian Archives of Biology and Technology.2024;[Epub] CrossRef
Albumin Leakage Level during Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Is Associated with Major Complications
Hyun-Chang Kim, Dong Woo Han, Eun Jung Park, Yeon Hwa Hong, Young Song
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Challenges following CRS and HIPEC surgery in cancer patients with peritoneal metastasis: a comprehensive review of clinical outcomes
Mehdi Karimi, Niyousha Shirsalimi, Eshagh Sedighi
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Analgesic effects of combined transversus abdominis plane block and intramuscular electrical stimulation in patients undergoing cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy: a randomized controlled trial
Hyun-Chang Kim, Jinyoung Park, Jinyoung Oh, Minjae Kim, Eun Jung Park, Seung Hyuk Baik, Young Song
International Journal of Surgery.2023; 109(5): 1199. CrossRef
The Design of an Automatic Temperature Compensation System through Smart Heat Comparison/Judgment and Control for Stable Thermal Treatment in Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Surgery
Kicheol Yoon, Sangyun Lee, Tae-Hyeon Lee, Kwang Gi Kim
Sensors.2023; 23(15): 6722. CrossRef
Epidemiology of psychiatric disorders following cytoreductive surgeries plus hyperthermic intraperitoneal chemotherapy: a prospective cohort analysis
Guillaume Economos, Vahan Kepenekian, Cécile Barbaret, Laurent Villeneuve, Julie Haesebaert, Olivier Glehen
Scientific Reports.2023;[Epub] CrossRef
Impact of Mitomycin-C-Induced Neutropenia after Hyperthermic Intraperitoneal Chemotherapy with Cytoreductive Surgery in Colorectal Cancer Patients with Peritoneal Carcinomatosis
Suk Jun Lee, Youngbae Jeon, Hae Won Lee, Jeonghyun Kang, Seung Hyuk Baik, Eun Jung Park
Annals of Surgical Oncology.2022; 29(3): 2077. CrossRef
What is the ideal management of Krukenberg syndrome?
Carolina Arró Ortiz, Darío Ramallo, Nicolás Guerrini
Journal of Surgical Case Reports.2022;[Epub] CrossRef
ASO Author Reflections: Is it Correct to Use 5% Dextrose Solution as a Carrier Fluid for Oxaliplatin-based HIPEC?
Eun Jung Park, Sung-Joo Hwang, Seung Hyuk Baik
Annals of Surgical Oncology.2022; 29(13): 8593. CrossRef
Pharmacologic Effects of Oxaliplatin Instability in Chloride-Containing Carrier Fluids on the Hyperthermic Intraperitoneal Chemotherapy to Treat Colorectal Cancer In Vitro and In Vivo
Eun Jung Park, Junhyun Ahn, Sharif Md Abuzar, Kyung Su Park, Sung-Joo Hwang, Seung Hyuk Baik
Annals of Surgical Oncology.2022; 29(13): 8583. CrossRef
Benign multicystic mesothelioma of appendiceal origin treated by hyperthermic intraperitoneal chemotherapy: A case report
Suk Jun Lee, Ji Hae Nahm, Jeonghyun Kang, Seung Hyuk Baik, Eun Jung Park
International Journal of Surgery Case Reports.2022; 99: 107665. CrossRef
Molecular analyses of peritoneal metastasis from colorectal cancer
Chang Hyun Kim
Journal of the Korean Medical Association.2022; 65(9): 586. CrossRef
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Chan Wook Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
Hyperthermic Intraperitoneal Chemotherapy Following Cytoreductive Surgery for Colorectal Peritoneal Carcinomatosis Patients: A Review
Sarah S Alhumaidan, Abeer M Alharbi, Ayesha Farhana Syeda, Fatimah A Alghaidani, Manal M Almutairi, Nourah A Alharbi, Reham K Alenezi
Cureus.2022;[Epub] CrossRef
Hyperthermia generated by magnetic nanoparticles for effective treatment of disseminated peritoneal cancer in an orthotopic nude-mouse model
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Young Jin Kim, Chang Hyun Kim
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Hyperthermic Intrathoracic Chemoperfusion for Malignant Pleural Mesothelioma: Systematic Review and Meta-Analysis
Tommi Järvinen, Juuso Paajanen, Ilkka Ilonen, Jari Räsänen
Cancers.2021; 13(14): 3637. CrossRef
Oxaliplatin versus mitomycin C in HIPEC for peritoneal metastasis from colorectal cancer: a systematic review and meta-analysis of comparative studies
Xubing Zhang, Qingbin Wu, Mingtian Wei, Xiangbing Deng, Chaoyang Gu, Ziqiang Wang
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Clinical Outcomes of Reduced-Port Laparoscopic Surgery for Patients With Sigmoid Colon Cancer: Surgery With 1 Surgeon and 1 Camera Operator: Jung Ryul Oh, Sung Chan Park, Sung Sil Park, Beonghoon Sohn, Hyoung Min Oh, Bun Kim, Min Jung Kim, Chang Won Hong, Kyung Su Han, Dae Kyung Sohn, Jae Hwan Oh; Ann Coloproctol. 2018;34(6):292-298. Published online December 3, 2018; DOI: https://doi.org/10.3393/ac.2018.04.06

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Abstract PDF

Purpose
This study compared the perioperative clinical outcomes of reduced-port laparoscopic surgery (RPLS) with those of conventional multiport laparoscopic surgery (MPLS) for patients with sigmoid colon cancer and investigated the safety and feasibility of RPLS performed by 1 surgeon and 1 camera operator.
Methods
From the beginning of 2010 until the end of 2014, 605 patients underwent a colectomy for sigmoid colon cancer. We compared the characteristics, postoperative outcomes, and pathologic results for the patients who underwent RPLS and for the patients who underwent MPLS. We also compared the clinical outcomes of single-incision laparoscopic surgery (SILS) and 3-port laparoscopic surgery.
Results
Of the 115 patients in the RPLS group, 59 underwent SILS and 56 underwent 3-port laparoscopic surgery. The MPLS group included 490 patients. The RPLS group had shorter operating time (137.4 ± 43.2 minutes vs. 155.5 ± 47.9 minutes, P < 0.001) and shorter incision length (5.3 ± 2.2 cm vs. 7.8 ± 1.2 cm, P < 0.001) than the MPLS group. In analyses of SILS and 3-port laparoscopic surgery, the SILS group showed younger age, longer operating time, and shorter incision length than the 3-port surgery group and exhibited a more advanced T stage, more lymphatic invasion, and larger tumor size.
Conclusion
RPLS performed by 1 surgeon and 1 camera operator appears to be a feasible and safe surgical option for the treatment of patients with sigmoid colon cancer, showing comparable clinical outcomes with shorter operation time and shorter incision length than MPLS. SILS can be applied to patients with favorable tumor characteristics.

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Efficacy and safety of reduced-port laparoscopic surgery versus conventional laparoscopic surgery for colorectal cancer
Zhi-min Liu, Qi-jun Yao, Fengyun Pei, Fang He, Yandong Zhao, Jun Huang
BMC Cancer.2025;[Epub] CrossRef
Short-term and long-term outcomes of single-incision plus one-port laparoscopic surgery for colorectal cancer: a propensity-matched cohort study with conventional laparoscopic surgery
Mingyi Wu, Hao Wang, Xuehua Zhang, Jiaolong Shi, Xiaoliang Lan, Tingyu Mou, Yanan Wang
BMC Gastroenterology.2023;[Epub] CrossRef
Long-term Oncologic Outcomes of Single-Incision Plus One-Port Laparoscopic Surgery for Rectal Cancer
Yasumitsu Hirano, Chikashi Hiranuma, Masakazu Hattori, Kenji Douden
Indian Journal of Surgery.2021; 83(3): 691. CrossRef
LongTerm Outcomes of Three-Port Laparoscopic Right Hemicolectomy Versus Five-Port Laparoscopic Right Hemicolectomy: A Retrospective Study
Tao Zhang, Yaqi Zhang, Xiaonan Shen, Yi Shi, Xiaopin Ji, Shaodong Wang, Zijia Song, Xiaoqian Jing, Feng Ye, Ren Zhao
Frontiers in Oncology.2021;[Epub] CrossRef
Short‐ And medium‐term outcomes of reduced‐port laparoscopic surgery in elderly patients with upper rectal cancer: A retrospective cohort study
Huawen Wu, Zhijian Zheng, Lewei Xu, Yingying Wu, Ziyi Guan, Wenhuan Li, Guofu Chen
Cancer Medicine.2020; 9(15): 5320. CrossRef

Lifestyle Factors and Bowel Preparation for Screening Colonoscopy: Jong Hee Hyun, Sang Jin Kim, Jung Hun Park, Gyung Ah Wie, Jeong-seon Kim, Kyung Su Han, Byung Chang Kim, Chang Won Hong, Dae Kyung Sohn; Ann Coloproctol. 2018;34(4):197-205. Published online August 31, 2018; DOI: https://doi.org/10.3393/ac.2018.03.13

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Abstract PDF

Purpose
The quality of bowel preparation is a major determinant of the quality of colonoscopy. This study evaluated lifestyle factors, including usual dietary style, associated with bowel preparation.
Methods
This retrospective study evaluated 1,079 consecutive subjects who underwent complete colonoscopy from December 2012 to April 2014 at National Cancer Center of Korea. Questionnaires on bowel preparation were completed by the subjects, with the quality of bowel preparation categorized as optimal (excellent or good) or suboptimal (fair, poor or inadequate). Lifestyle factors associated with bowel preparation were analyzed.
Results
The 1,079 subjects included 680 male (63.0%) and 399 female patietns (37.0%), with a mean age of 49.6 ± 8.32 years. Bowel preparation was categorized as optimal in 657 subjects (60.9%) and as suboptimal in 422 (39.1%). Univariate analyses showed no differences between groups in lifestyle factors, such as regular exercise, alcohol intake, smoking, and dietary factor. Body mass index (BMI) > 25 kg/m² was the only factor associated with suboptimal bowel preparation on both the univariate (P = 0.007) and the multivariate (odds ratio, 1.437; 95% confidence interval, 1.104–1.871; P = 0.007) analyses.
Conclusion
Most lifestyle factors, including dietary patterns, exercise, alcohol intake and smoking, were not associated with suboptimal bowel preparation in Koreans. However, BMI > 25 kg/m² was independently associated with suboptimal bowel preparation. More intense preparation regimens before colonoscopy can be helpful in subjects with BMI > 25 kg/m².

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Shi Jun-li, Wang Lei, Ying Chun-ying, Fu Xin-zi, Li Bing-qing
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Efficacy and tolerability of colonoscopies in overweight and obese patients: Results from a national database on gastrointestinal endoscopic outcomes
Monica Passi, Farial Rahman, Christopher Koh, Sheila Kumar
Endoscopy International Open.2022; 10(04): E311. CrossRef
Risk Factors for Suboptimal Bowel Preparation for Colonoscopy in Pediatric Patients
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Efrat L. Amitay, Tobias Niedermaier, Anton Gies, Michael Hoffmeister, Hermann Brenner
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A Randomized Trial of Split Dose 3 L Polyethylene Glycol Lavage Solution, 2 L Polyethylene Glycol Lavage Combined With Castor Oil, and 1 L of Polyethylene Glycol Lavage Solution Combined With Castor Oil and Ascorbic Acid for Preparation for Colonoscopy
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Preoperative Tattooing Using Indocyanine Green in Laparoscopic Colorectal Surgery: Sang Jae Lee, Dae Kyung Sohn, Kyung Su Han, Byung Chang Kim, Chang Won Hong, Sung Chan Park, Min Jung Kim, Byung Kwan Park, Jae Hwan Oh; Ann Coloproctol. 2018;34(4):206-211. Published online July 26, 2018; DOI: https://doi.org/10.3393/ac.2017.09.25

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Abstract PDF

Purpose
The aim of the present study was to evaluate the usefulness of indocyanine green (ICG) as a preoperative marking dye for laparoscopic colorectal surgery.
Methods
Between March 2013 and March 2015, 174 patients underwent preoperative colonoscopic tattooing using 1.0 to 1.5 mL of ICG and saline solution before laparoscopic colorectal surgery. Patients’ medical records and operation videos were retrospectively assessed to evaluate the visibility, duration, and adverse effects of tattooing.
Results
The mean age of the patients was 65 years (range, 34–82 years), and 63.2% of the patients were male. The median interval between tattooing and operation was 1.0 day (range, 0–14 days). Tattoos placed within 2 days of surgery were visualized intraoperatively more frequently than those placed at an earlier date (95% vs. 40%, respectively, P < 0.001). For tattoos placed within 2 days before surgery, the visualization rates by tattoo site were 98.6% (134 of 136) from the ascending colon to the sigmoid colon. The visualization rates at the rectosigmoid colon and rectum were 84% (21 of 25) and 81.3% (13 of 16), respectively (P < 0.001). No complications related to preoperative ICG tattooing occurred.
Conclusion
Endoscopic ICG tattooing is more useful for the preoperative localization of colonic lesions than it is for rectal lesions and should be performed within 2 days before laparoscopic surgery.

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Pietro Fransvea, Michelangelo Miccini, Fabio Rondelli, Giuseppe Brisinda, Alessandro Costa, Giovanni Maria Garbarino, Gianluca Costa
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Indocyanine Green Fluorescence Guided Surgery in Colorectal Surgery
Zoe Garoufalia, Steven D. Wexner
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Michael K. Konstantinidis, Argyrios Ioannidis, Panteleimon Vassiliu, Nikolaos Arkadopoulos, Ioannis S. Papanikolaou, Konstantinos Stavridis, Gaetano Gallo, Dimitrios Karagiannis, Manish Chand, Steven D. Wexner, Konstantinos Konstantinidis
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S Khazali, B Mondelli, K Fleischer, M Adamczyk
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Zavier Yongxuan Lim, Swetha Mohan, Sunder Balasubramaniam, Saleem Ahmed, Caroline Ching Hsia Siew, Vishal G Shelat
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Jeffrey Dalli, Eamon Loughman, Niall Hardy, Anwesha Sarkar, Mohammad Faraz Khan, Haseeb A. Khokhar, Paul Huxel, Donal F. O’Shea, Ronan A. Cahill
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Manuel Barberio, Margherita Pizzicannella, Giovanni Guglielmo Laracca, Mahdi Al-Taher, Andrea Spota, Jacques Marescaux, Eric Felli, Michele Diana
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Correlation Between Bowel Preparation and the Adenoma Detection Rate in Screening Colonoscopy: Jung Hun Park, Sang Jin Kim, Jong Hee Hyun, Kyung Su Han, Byung Chang Kim, Chang Won Hong, Sang-Jeon Lee, Dae Kyung Sohn; Ann Coloproctol. 2017;33(3):93-98. Published online June 30, 2017; DOI: https://doi.org/10.3393/ac.2017.33.3.93

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Abstract PDF

Purpose

The adenoma detection rate is commonly used as a measure of the quality of colonoscopy. This study assessed both the association between the adenoma detection rate and the quality of bowel preparation and the risk factors associated with the adenoma detection rate in screening colonoscopy.

Methods

This retrospective analysis involved 1,079 individuals who underwent screening colonoscopy at the National Cancer Center between December 2012 and April 2014. Bowel preparation was classified by using the Aronchick scale. Individuals with inadequate bowel preparations (n = 47, 4.4%) were excluded because additional bowel preparation was needed. The results of 1,032 colonoscopies were included in the analysis.

Results

The subjects' mean age was 53.1 years, and 657 subjects (63.7%) were men. The mean cecal intubation time was 6.7 minutes, and the mean withdrawal time was 8.7 minutes. The adenoma and polyp detection rates were 28.1% and 41.8%, respectively. The polyp, adenoma, and advanced adenoma detection rates did not correlate with the quality of bowel preparation. The multivariate analysis showed age ≥ 60 years (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.02–1.97; P = 0.040), body mass index ≥ 25 kg/m² (HR, 1.56; 95% CI, 1.17–2.08; P = 0.002) and current smoking (HR, 1.44; 95% CI, 1.01–2.06; P = 0.014) to be independent risk factors for adenoma detection.

Conclusion

The adenoma detection rate was unrelated to the quality of bowel preparation for screening colonoscopy. Older age, obesity, and smoking were independent risk factors for adenoma detection.

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Case Report

Mucosa-Associated Lymphoid-Tissue Lymphoma of the Cecum and Rectum: A Case Report: Myung Jin Nam, Byung Chang Kim, Sung Chan Park, Chang Won Hong, Kyung Su Han, Dae Kyung Sohn, Weon Seo Park, Hee Jin Chang, Jae Hwan Oh; Ann Coloproctol. 2017;33(1):35-38. Published online February 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.1.35

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Abstract PDF

A colonic mucosa-associated lymphoid-tissue (MALT) lymphoma is relatively rare compared to lymphomas of the stomach or small intestine. We present a case of a MALT lymphoma in the cecum and rectum found during screening colonoscopy. A 54-year-old female, who had undergone right-breast-conserving surgery with axillary dissection due to an invasive ductal carcinoma and a left-breast excisional biopsy due to microcalcification following adjuvant chemoradiation therapy 3 years earlier, was found to have 3-mm-sized smooth elevated lesions in both the cecum and rectum. No pathologic lesion or lymphadenopathy was found at any other site, but chronic gastritis negative for Helicobacter pylori infection was found. The polyps were removed by using an endoscopic biopsy and revealed an extra nodal marginal zone B-cell MALT lymphoma, showing positive for CD3 and CD20 by immunohistochemical staining. The patient underwent close observation without any additional treatment and has shown no evidence of recurrence as of her last visit.

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Successful Endoscopic Resection of Mucosa-Associated Lymphoid Tissue Lymphoma of the Colon
Brian L. Schwartz, Robert C. Lowe
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Original Articles

A Survey of Colonoscopic Surveillance After Polypectomy: Dae Kyung Sohn; Ann Coloproctol. 2014;30(2):88-92. Published online April 25, 2014; DOI: https://doi.org/10.3393/ac.2014.30.2.88

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7 Citations

Abstract PDF

Purpose

Several guidelines have been proposed for surveillance colonoscopy after polypectomy. However, some discrepancies still exist between the guidelines and clinical practice. This study was conducted to identify Korean doctors' recommendations for the colonoscopic surveillance interval after polypectomy.

Methods

A survey of the attendees at the symposium of the 64th Annual Congress of the Korean Surgical Society was conducted. When the prepared clinical scenarios were given, attendees answered using a wireless radio-frequency audience response system. All responders' results were automatically counted immediately. Frequencies of different answers to each question were calculated, and our results were compared with those of previous surveys performed using the same questionnaire in the United States or Japan.

Results

The number of responder varied from 38 to 41. About 50% of valid responders selected 'follow-up in 3 years' for low-risk lesions, such as a 6-mm hyperplastic polyp, a 6-mm tubular adenoma, or two 6-mm tubular adenomas. Responders most-commonly selected 'follow-up in 1 year' for high-risk lesions, such as a 12-mm tubular adenoma with high grade dysplasia or a 12-mm tubulovillous adenoma. The majority of Korean doctors recommend postpolypectomy colonoscopic surveillance more frequently than American physicians did.

Conclusion

A discrepancy between the guidelines and clinical practice for the surveillance after polypectomy still exists in Korea. A surveillance program that can be easily and widely applied in clinical practice needs to be established.

Citations

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Analysis of adenoma detection rate of colonoscopy among trainees
Young Min Song, Kyung Su Han, Byung Chang Kim, Chang Won Hong, Bun Kim, Min Chul Kim, Myeong Jae Jin, Dae Kyung Sohn
Annals of Coloproctology.2024; 40(6): 548. CrossRef
Adherence to Surveillance Guidelines after the Removal of Colorectal Polyps: A Multinational, Multicenter, Prospective Survey
Chang Kyo Oh, Satimai Aniwan, Panida Piyachaturawat, Zhiqin Wong, Thida Soe, Bayasgalan Luvsandagva, Quang Trung Tran, Achmad Fauzi, Jeong-Sik Byeon, Young-Seok Cho
Gut and Liver.2021; 15(6): 878. CrossRef
The current capacity and quality of colonoscopy in Korea
Jae Ho Choi, Jae Myung Cha, Jin Young Yoon, Min Seob Kwak, Jung Won Jeon, Hyun Phil Shin
Intestinal Research.2019; 17(1): 119. CrossRef
Guideline Adherence to Colonoscopic Surveillance Intervals after Polypectomy in Korea: Results from a Nationwide Survey
Seri Hong, Mina Suh, Kui Son Choi, Boyoung Park, Jae Myung Cha, Hyun-Soo Kim, Jae Kwan Jun, Dong Soo Han
Gut and Liver.2018; 12(4): 426. CrossRef
Determining the optimal surveillance interval after a colonoscopic polypectomy for the Korean population?
Jung Lok Lee, Jae Myung Cha, Hye Min Lee, Jung Won Jeon, Min Seob Kwak, Jin Young Yoon, Hyun Phil Shin, Kwang Ro Joo, Joung Il Lee, Dong Il Park
Intestinal Research.2017; 15(1): 109. CrossRef
Factors Associated With Shorter Colonoscopy Surveillance Intervals for Patients With Low-Risk Colorectal Adenomas and Effects on Outcome
Joseph C. Anderson, John A. Baron, Dennis J. Ahnen, Elizabeth L. Barry, Roberd M. Bostick, Carol A. Burke, Robert S. Bresalier, Timothy R. Church, Bernard F. Cole, Marcia Cruz-Correa, Adam S. Kim, Leila A. Mott, Robert S. Sandler, Douglas J. Robertson
Gastroenterology.2017; 152(8): 1933. CrossRef
Association Between Exposure to Environmental Tobacco Smoke at the Workplace and Risk for Developing a Colorectal Adenoma: A Cross-Sectional Study
Seung-Hwa Lee, Ji-Yeon Hong, Jung-Un Lee, Dong Ryul Lee
Annals of Coloproctology.2016; 32(2): 51. CrossRef

Importance of Early Follow-up Colonoscopy in Patients at High Risk for Colorectal Polyps: Sung Taek Jung, Dae Kyung Sohn, Chang Won Hong, Byung Chang Kim, Ji Won Park, Kyung Su Han, Hee Jin Chang, Hyo Sung Choi, Jae Hwan Oh; Ann Coloproctol. 2013;29(6):243-247. Published online December 31, 2013; DOI: https://doi.org/10.3393/ac.2013.29.6.243

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29 Download
5 Citations

Abstract PDF

Purpose

Minimizing the polyp miss rate during colonoscopy is important for patients at high risk for colorectal polyps. We investigated the polyp miss rate and the factors associated with it in high-risk patients.

Methods

The medical records of 163 patients who underwent follow-up colonoscopy between January 2001 and April 2010, which was within 9 months after a polypectomy, because the index colonoscopy had shown multiple (more than 3) adenomas or advanced adenoma were retrospectively reviewed. Miss rates were calculated for all polyps, for neoplastic polyps and for advanced adenomas. Factors associated with the miss rates in these patients, such as the location, shape and size of the polyp, were analyzed.

Results

The miss rates for polyps, adenomas, adenomas <5 mm, adenomas ≥5 mm and advanced adenomas were 32.6%, 20.9%, 17.7%, 3.2%, and 0.9%, respectively. No carcinoma, except for one small carcinoid tumor, was missed. Flat shape and small size (<5 mm) were significantly associated with adenoma miss rate. The miss rate was significantly higher for flat-type advanced adenomas than for protruded-type advanced adenomas (27.7% vs 4.1%).

Conclusion

The polyp miss rate in patients at high risk for colorectal polyps was higher than expected. Efforts are needed to reduce miss rates and improve the quality of colonoscopy. Also, early follow-up colonoscopy is mandatory, especially in patients at high risk.

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