Annals of Coloproctology

Guideline

Colorectal cancer

Colon cancer: the 2023 Korean clinical practice guidelines for diagnosis and treatment: Hyo Seon Ryu, Hyun Jung Kim, Woong Bae Ji, Byung Chang Kim, Ji Hun Kim, Sung Kyung Moon, Sung Il Kang, Han Deok Kwak, Eun Sun Kim, Chang Hyun Kim, Tae Hyung Kim, Gyoung Tae Noh, Byung-Soo Park, Hyeung-Min Park, Jeong Mo Bae, Jung Hoon Bae, Ni Eun Seo, Chang Hoon Song, Mi Sun Ahn, Jae Seon Eo, Young Chul Yoon, Joon-Kee Yoon, Kyung Ha Lee, Kyung Hee Lee, Kil-Yong Lee, Myung Su Lee, Sung Hak Lee, Jong Min Lee, Ji Eun Lee, Han Hee Lee, Myong Hoon Ihn, Je-Ho Jang, Sun Kyung Jeon, Kum Ju Chae, Jin-Ho Choi, Dae Hee Pyo, Gi Won Ha, Kyung Su Han, Young Ki Hong, Chang Won Hong, Jung-Myun Kwak, Korean Colon Cancer Multidisciplinary Committee; Ann Coloproctol. 2024;40(2):89-113. Published online April 30, 2024; DOI: https://doi.org/10.3393/ac.2024.00059.0008

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Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients’ values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.

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Optimal extent of lymph node dissection in clinical early-stage right colon cancer: a retrospective analysis
Hyeung-min Park, Jaram Lee, Soo Young Lee, Suk Hee Heo, Yong Yeon Jeong, Hyeong Rok Kim, Chang Hyun Kim
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Effects of Microsatellite Instability on the Clinical and Pathological Characteristics of Colon Cancer and the Diagnostic Accuracy of Preoperative Abdominal CT Scans
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2023 Korean Multidisciplinary Guidelines for Colon Cancer Management: Summary of Radiological Points
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Gyung Mo Son, Tae Un Kim, Mi Sook Yun, ChangYeop Kim, In Young Lee, Su Bum Park, Dong-Hoon Shin, Gi Won Ha
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Nuclear medicine based multimodal molecular imaging facilitates precision medicine for gastrointestinal tumors
Jing Zhao, Fei Wang, Rong-Fu Wang
World Chinese Journal of Digestology.2024; 32(10): 727. CrossRef
Impact of Early Oral Feeding on Postoperative Outcomes after Elective Colorectal Surgery: A Systematic Review and Meta-Analysis
Soo Young Lee, Eon Chul Han
Digestive Surgery.2024; : 1. CrossRef

Case Report

Benign proctology,Complication,Biomarker & risk factor

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

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Abstract PDF

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

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Rare Inherited Coagulation Deficiencies: A Single-center Study
Özlem Terzi, Sadik Sami Hatipoğlu
Journal of Pediatric Hematology/Oncology.2025; 47(2): e90. CrossRef
Plasma/tranexamic-acid/vitamin-k

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

Original Article

Malignant disease, Functional outcomes,Colorectal cancer

The Relationship Between High-Output Stomas, Postoperative Ileus, and Readmission After Rectal Cancer Surgery With Diverting Ileostomy: Naa Lee, Soo Young Lee, Chang Hyun Kim, Han Deok Kwak, Jae Kyun Ju, Hyeong Rok Kim; Ann Coloproctol. 2021;37(1):44-50. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.08.03

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Abstract PDF

Purpose
This study aimed to evaluate the relationship between high-output stomas (HOSs), postoperative ileus (POI), and readmission after rectal cancer surgery with diverting ileostomy.
Methods
We included 302 patients with rectal cancer who underwent restorative resection with diverting ileostomy between January 2011 and December 2015. HOSs were defined as stomas with ≥ 2,000 mL/day output. We analyzed predictive factors for readmission of these patients.
Results
Forty-eight patients (15.9%) had HOSs during the hospital stay, and 41 patients (13.6%) experienced POI. HOSs were strongly associated with POI (45.8% vs. 7.5%, P < 0.001). The all-cause readmission rate was 16.9%, with 19 (6.3%) and 20 (6.6%) experiencing ileus and acute kidney injury, respectively. HOSs (27.1% vs. 15.0%, P = 0.040) and POI (34.1% vs. 14.2%, P = 0.002) were associated with all-cause readmission, and POI was associated with readmission with ileus (17.1% vs. 4.6%, P = 0.007). POI was an independent risk factor for all-cause readmission (adjusted odds ratio [OR], 2.640; 95% confidence interval [CI], 1.162 to 6.001; P = 0.020) and readmission with ileus (adjusted OR = 3.869; 95% CI 1.387 to 10.792; P = 0.010).
Conclusion
POI was associated with readmission, particularly for subsequent ileus, in patients with diverting ileostomy. We should make efforts to reduce POI, such as strong control of HOSs, to prevent readmission.

Citations

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High output stoma after surgery for rectal cancer - a risk factor for low anterior resection syndrome?
Xuena Zhang, Qingyu Meng, Jianna Du, Zhongtao Tian, Yinju Li, Bin Yu, Wenbo Niu
BMC Gastroenterology.2025;[Epub] CrossRef
Summary of Best Evidence for the Dietary Management in Patients with High-Output Ileostomy
Ying Wang, Hua Peng, Cui Cui, Qi Zou, Mudi Yang
Journal of Multidisciplinary Healthcare.2025; Volume 18: 877. CrossRef
Maximizing Readmission Reduction in Colon Cancer Patients
Mario Schootman, Chenghui Li, Jun Ying, Sonia T. Orcutt, Jonathan Laryea
Journal of Surgical Research.2024; 295: 587. CrossRef
Analysis of decision-making factors for defunctioning ileostomy after rectal cancer surgery and their impact on perioperative recovery: a retrospective study of 1082 patients
Xiaojiang Yi, Huaguo Yang, Hongming Li, Xiaochuang Feng, Weilin Liao, Jiaxin Lin, Zhifeng Chen, Dechang Diao, Manzhao Ouyang
Surgical Endoscopy.2024; 38(11): 6782. CrossRef
Effect of intracorporeal anastomosis on postoperative ileus after laparoscopic right colectomy
Sangwoo Kim, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek, Young-Gil Son
Annals of Surgical Treatment and Research.2023; 104(3): 156. CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Overall readmissions and readmissions related to dehydration after creation of an ileostomy: a systematic review and meta-analysis
I. Vogel, M. Shinkwin, S. L. van der Storm, J. Torkington, J. A.Cornish, P. J. Tanis, R. Hompes, W. A. Bemelman
Techniques in Coloproctology.2022; 26(5): 333. CrossRef
Postoperative paralytic ileus following debulking surgery in ovarian cancer patients
Eva K. Egger, Freya Merker, Damian J. Ralser, Milka Marinova, Tim O. Vilz, Hanno Matthaei, Tobias Hilbert, Alexander Mustea
Frontiers in Surgery.2022;[Epub] CrossRef
Obstructive and secretory complications of diverting ileostomy
Shingo Tsujinaka, Hideyuki Suzuki, Tomoya Miura, Yoshihiro Sato, Chikashi Shibata
World Journal of Gastroenterology.2022; 28(47): 6732. CrossRef

Editorial

Malignant disease, Rectal cancer

Is Whole-Mount Section in Rectal Cancer Effective for Measuring Lateral Margin?: Jun Seong Chung, Han Deok Kwak, Jae Kyun Ju; Ann Coloproctol. 2020;36(3):131-132. Published online June 30, 2020; DOI: https://doi.org/10.3393/ac.2020.06.12

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A comparison of whole-mount and conventional sections for pathological mesorectal extension and circumferential resection margin assessment after total mesorectal excision
Francisco Giner, Matteo Frasson, Hanna Cholewa, Jorge Sancho-Muriel, Enrique García-Gómez, Josselyn A. Hernández, Blas Flor-Lorente, Eduardo García-Granero
Cirugía Española (English Edition).2024; 102(8): 417. CrossRef
A comparison of whole-mount and conventional sections for pathological mesorectal extension and circumferential resection margin assessment after total mesorectal excision
Francisco Giner, Matteo Frasson, Hanna Cholewa, Jorge Sancho-Muriel, Enrique García-Gómez, Josselyn A. Hernández, Blas Flor-Lorente, Eduardo García-Granero
Cirugía Española.2024; 102(8): 417. CrossRef
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Guiling Ding, Meng Guo, Yelin Yang, Chen Sun, Shengyong Wu, Xingchen Liu, Jin Wang, Hui Jiang, Yanfang Liu, Jianming Zheng
Frontiers in Oncology.2021;[Epub] CrossRef

Case Report

Malignant disease, Rectal cancer

Laparoscopic Resection of a Huge Retrorectal Tumor: Han Deok Kwak, Jae Kyun Ju; Ann Coloproctol. 2020;36(1):54-57. Published online February 29, 2020; DOI: https://doi.org/10.3393/ac.2018.07.31.1

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Abstract PDF

Retrorectal space tumors are rare, and so are frequently unrecognized, misdiagnosed, and mistreated. A 57-year-old man visited the outpatient clinic with the chief complaints of thin stool and lower pelvic heaviness. A smooth, round huge palpable mass on the right posterolateral rectal wall was detected and pelvic computed tomography showed a 7.8-cm cystic lesion in the right retrorectal space. Laparoscopic procedures were initiated with perirectal dissection for rectal mobilization. After fixation of the peritoneum and tying the rectum for intracorporeal traction, the rectum was mobilized to identify the cyst. The cyst was removed using an endo-bag, with completion of cyst dissection. The final pathologic diagnosis was a tailgut cyst, or retrorectal cystic hamartoma without evidence of malignancy. The patient was discharged without any complications. The patient had no dyschezia or problems with bowel function. Laparoscopic resection is a safe and feasible method for surgical treatment, even for bulky retrorectal tumors, with an early recovery period.

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Tailgut Cyst—Gynecologist’s Pitfall: Literature Review and Case Report
Andrei Mihai Malutan, Viorela-Elena Suciu, Florin Laurentiu Ignat, Doru Diculescu, Razvan Ciortea, Emil-Claudiu Boțan, Carmen Elena Bucuri, Maria Patricia Roman, Ionel Nati, Cristina Ormindean, Dan Mihu
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Intraoperative endoscopic ultrasound‐guided robotic retrorectal dermoid cyst excision—A video vignette
Piercarmine Panzera, Francesco Vittore, Francesco Paolo Prete, Giuseppe Massimiliano De Luca, Silvia Malerba, Nicola Tartaglia, Arianna Pontrelli, Enrico Fischetti, Angela Gurrado, Mario Testini
Colorectal Disease.2025;[Epub] CrossRef
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Rui Li, Zhiyuan Yu, Jiahu Ye, Xin Liu, Peiyu Li, Xudong Zhao
World Journal of Surgical Oncology.2024;[Epub] CrossRef
Total Laparoscopic Excision of a Large Tailgut Cyst
Ajay Nimbalkar, Anand Zingade, Balaji Dhaigude
Cureus.2024;[Epub] CrossRef
Epidemiology, diagnostic approach and therapeutic management of tailgut cysts: A systematic review
Aikaterini Mastoraki, Ilias Giannakodimos, Karmia Panagiotou, Maximos Frountzas, Dimosthenis Chrysikos, Stylianos Kykalos, Georgios E. Theodoropoulos, Dimitrios Schizas
International Journal of Clinical Practice.2021;[Epub] CrossRef
Robotic approach to large tailgut cyst with malignant transformation: A case report
Alessandra Marano, Maria Carmela Giuffrida, Chiara Peluso, Valentina Testa, Paolo Bosio, Felice Borghi
International Journal of Surgery Case Reports.2020; 77: S57. CrossRef

Original Articles

Malignant disease

Thirty-Day Readmission After Elective Colorectal Surgery for Colon Cancer: A Single-Center Cohort Study: Jun Seong Chung, Han Deok Kwak, Jae Kyun Ju; Ann Coloproctol. 2020;36(3):186-191. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2019.11.04

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Abstract PDF

Purpose
There is a concern that enhanced recovery after surgery may affect other proposed quality measures, including the rate of readmission due to early discharge. We examine the 30-day readmission rate, risk factors associated with readmission after elective colorectal surgery for colon cancer, causes of readmission, disease-free survival (DFS), and overall survival (OS) in a single institution.
Methods
We retrospectively investigated 292 patients who underwent elective colorectal surgery for colon cancer between 2010 and 2015. Baseline data including age, sex, body mass index, American Society of Anesthesiologists physical status classification, preoperative comorbidities, previous operation history, TNM stage, surgical approach, operation time, gas passage time, and length of hospital stay were obtained. Univariate and multivariate logistic regression analyses were performed to identify risk factors associated with 30-day readmission.
Results
A total of 229 patients who underwent elective colorectal surgery were enrolled. Twenty-four patients were readmitted 30 days after discharge. The most common readmission diagnoses were wound bleeding or surgical site infection. Multivariate analysis indicated that patients who had preoperative hepatic disease were at the highest risk of readmission (odds ratio [OR], 8.98; 95% confidence interval [CI], 7.35–10.61). Survival outcomes were significantly better in the nonreadmitted group (OS, P=0.00; DFS, P=0.04).
Conclusion
This study identified that preoperative comorbidities including hepatic and pulmonary diseases were associated with higher readmission rates after elective colorectal surgery. Moreover, the most common cause of readmission in patients who underwent elective colorectal surgery was wound bleeding or surgical site infection.

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Sanghyun An, Sung Eun Hong, Moo Hyun Kim, Ik Yong Kim
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Risk factors for unplanned 31-day readmission after surgery for colorectal cancer patients: a meta-analysis
Nan Qu, Tiantian Li, Lifeng Zhang, Xingyu Liu, Liping Cui
BMC Gastroenterology.2025;[Epub] CrossRef
Readmission rates following major colorectal surgery
Aoife Shorten, Matthew G. Davey, William P. Joyce
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Michael M. Vu, Jace J. Franko, Anna Buzadzhi, Beau Prey, Maksim Rusev, Marta Lavery, Laila Rashidi
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2024; 34(2): 163. CrossRef
Meta-analysis of postoperative incision infection risk factors in colorectal cancer surgery
Li Jia, Huacai Zhao, Jia Liu
Frontiers in Surgery.2024;[Epub] CrossRef
The 30-day readmission rate of patients with an overlap of probable sarcopenia and malnutrition undergoing major oncological surgery
Hadassa Hillary Novaes Pereira Rodrigues, Kathyelli Thaynara Pimenta de Araujo, José Eduardo de Aguilar-Nascimento, Diana Borges Dock-Nascimento
einstein (São Paulo).2024;[Epub] CrossRef
Risk factors for early readmission to hospital in patients with malignancy-related ascites: a retrospective cohort study
Zhenhua Tian, Zhilong Huang, Yaqi Guo, Xiaolin Zhao, Luna Liu, Chunxiao Yu, Qingbo Guan
Frontiers in Oncology.2024;[Epub] CrossRef
A National Cancer Database analysis of the predictors of unplanned 30-day readmission after proctectomy for rectal adenocarcinoma: The CCF RETURN-30 Score
Sameh Hany Emile, Nir Horesh, Michael R. Freund, Zoe Garoufalia, Rachel Gefen, Emanuela Silva-Alvarenga, Steven D. Wexner
Surgery.2023; 173(2): 342. CrossRef
Data analytics and artificial intelligence in predicting length of stay, readmission, and mortality: a population-based study of surgical management of colorectal cancer
Shamsul Masum, Adrian Hopgood, Samuel Stefan, Karen Flashman, Jim Khan
Discover Oncology.2022;[Epub] CrossRef
The 30-day hospital readmission and mortality after surgery in colorectal cancer patients
Mesnad S. Alyabsi, Anwar H. Alqarni, Latifah M. Almutairi, Mohammed A. Algarni, Kanan M. Alshammari, Adel Almutairi, Nahar A. Alselaim
BMC Gastroenterology.2022;[Epub] CrossRef

Immunological Differences Between Right-Sided and Left-Sided Colorectal Cancers: A Comparison of Embryologic Midgut and Hindgut: Han Deok Kwak, Jae Kyun Ju; Ann Coloproctol. 2019;35(6):342-346. Published online December 31, 2019; DOI: https://doi.org/10.3393/ac.2019.03.17.1

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Abstract PDF

Purpose
There are known differences in embryology, clinical symptoms, incidences, molecular pathways involved, and oncologic outcomes of right-sided and left-sided colorectal cancers. However, immunologic study has only been characterized for healthy adults. The present study was designed to identify differences in immune cell populations in patients with right-sided and left-sided colorectal cancers.
Methods
A total of 35 patients who underwent colorectal resection for cancer between November 2016 and August 2017 at a tertiary teaching hospital were enrolled in this study. Patients were excluded if they had a disease affecting their immune system. Populations of immune cells, including mucosal-associated invariant T (MAIT), gamma delta T, invariant natural killer T, T, natural killer, and B cells, were measured in the peripheral blood and cancer tissues using flow cytometry, and then assessed based on the origin of the colorectal cancer.
Results
Fifteen had right-side and 20 had left-side colorectal cancer. There were no significant differences between the 2 cohorts for patient characteristics including pathologic stage. Peripheral blood from patients with right-side colon cancers contained fewer MAIT (0.87% right-side vs. 1.74% left-side, P = 0.028) and gamma delta T cells (1.10% right-side vs. 3.05% left-side, P = 0.002). Although the group with right-side colorectal cancer had more MAIT cells in cancer tissues (1.71% vs. 1.00%), this difference was not statistically significant.
Conclusion
There is a difference in population sizes of immune cells in blood between patients with right-sided and leftsided colon cancers. The immune cell composition was determined to be distinct based on embryologic origin.

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Alimohammad Bananzadeh, Sara Shojaei-Zarghani, Amir Reza Bahadori, Ali Reza Safarpour
Shiraz E-Medical Journal.2024;[Epub] CrossRef
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Vaishak Kaviyarasan, Alakesh Das, Dikshita Deka, Biki Saha, Antara Banerjee, Neeta Raj Sharma, Asim K. Duttaroy, Surajit Pathak
International Journal of Colorectal Disease.2024;[Epub] CrossRef
Intertwined leukocyte balances in tumours and peripheral blood as robust predictors of right and left colorectal cancer survival
Ramón Cantero-Cid, Karla Marina Montalbán-Hernández, Jenny Guevara, Alejandro Pascual-Iglesias, Elisa Pulido, José Carlos Casalvilla, Cristóbal Marcano, Cristina Barragán Serrano, Jaime Valentín, Gloria Cristina Bonel-Pérez, José Avendaño-Ortiz, Verónica
World Journal of Gastrointestinal Oncology.2022; 14(1): 295. CrossRef
Epidemiology, risk factors, and prevention of colorectal cancer
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
Journal of the Korean Medical Association.2022; 65(9): 549. CrossRef
Epidemiology, Risk Factors, and Prevention of Colorectal Cancer-An English Version
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 231. CrossRef
Variants of creating heterotopic and orthotopic PDX models of human colorectal cancer
A. A. Kiblitskaya, A. Y. Maksimov, A. S. Goncharova, Ye. M. Nepomnyashchaya, Ye. Y. Zlatnik, G. Y. Yegorov, Ye. A. Lukbanova, Ye. V. Zaikina, A. V. Volkova
Bulletin of Siberian Medicine.2022; 21(3): 50. CrossRef
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Jin Cheon Kim, Walter F. Bodmer
Annals of Coloproctology.2021; 37(6): 368. CrossRef
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Annals of Coloproctology.2019; 35(6): 291. CrossRef

Editorial

Tailgut Cyst, Report of 24 Cases Single Center Experience: Han Deok Kwak, Chang Hyun Kim; Ann Coloproctol. 2019;35(5):227-228. Published online October 31, 2019; DOI: https://doi.org/10.3393/ac.2019.10.14

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Minimally invasive approach for retrorectal tumors above and below S3: a multicentric tertiary center retrospective study (MiaRT study)
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Open surgical treatment for giant presacral tailgut cyst – a case report
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South African Journal of Surgery.2024; 62(4): 358. CrossRef

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