Annals of Coloproctology

Original Articles

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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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.

Citations

Citations to this article as recorded by

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

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

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.

Citations

Citations to this article as recorded by

Changes in Incidence and Survival by Decade of Patients With Primary Colorectal Lymphoma: A SEER Analysis
Qingguo Li, Shaobo Mo, Weixing Dai, Yaqi Li, Ye Xu, Xinxiang Li, Guoxiang Cai, Sanjun Cai
Frontiers in Public Health.2020;[Epub] CrossRef
Successful Endoscopic Resection of Mucosa-Associated Lymphoid Tissue Lymphoma of the Colon
Brian L. Schwartz, Robert C. Lowe
ACG Case Reports Journal.2019; 6(10): e00228. CrossRef
Synchronous MALT lymphoma of the colon and stomach and regression after eradication ofStrongyloides stercoralisandHelicobacter pylori
Kevin Singh, Soren Gandhi, Behzad Doratotaj
BMJ Case Reports.2018; 2018: bcr-2018-224795. CrossRef
Mucosal leishmaniasis mimicking T-cell lymphoma in a patient receiving monoclonal antibody against TNFα
Antonio Carlos Nicodemo, Daniel Fernandes Duailibi, Diego Feriani, Maria Irma Seixas Duarte, Valdir Sabbaga Amato, Zvi Bentwich
PLOS Neglected Tropical Diseases.2017; 11(9): e0005807. CrossRef

Original Article

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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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.

Citations

Citations to this article as recorded by

Removal of GIT lesions and the role of impedance of the injection solution—an innovative approach to known methods
Martina Lösle, K. E. Grund, B. Duckworth-Mothes
Journal of Molecular Medicine.2024; 102(8): 1009. CrossRef
An eco-friendly synthesis of Enterococcus sp.–mediated gold nanoparticle induces cytotoxicity in human colorectal cancer cells
Mathivadani Vairavel, Ezhilarasan Devaraj, Rajeshkumar Shanmugam
Environmental Science and Pollution Research.2020; 27(8): 8166. CrossRef
Evaluating the Cost-Effective Use of Follow-Up Colonoscopy Based on Screening Findings and Age
Grace N. Joseph, Farid Heidarnejad, Eric A. Sherer
Computational and Mathematical Methods in Medicine.2019; 2019: 1. CrossRef
Impact of a new distal attachment on colonoscopy performance in an academic screening center
Zacharias P. Tsiamoulos, Ravi Misra, Rajaratanam Rameshshanker, Timothy R. Elliott, Iosif Beintaris, Siwan Thomas-Gibson, Adam Haycock, Noriko Suzuki, Colin Rees, Brian P. Saunders
Gastrointestinal Endoscopy.2018; 87(1): 280. CrossRef
What Matters in Colonoscopy?
Hyun Shig Kim
Annals of Coloproctology.2013; 29(6): 223. CrossRef

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