Annals of Coloproctology

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Review

Colorectal cancer

Essential knowledge and technical tips for total mesorectal excision and related procedures for rectal cancer: Min Soo Cho, Hyeon Woo Bae, Nam Kyu Kim; Ann Coloproctol. 2024;40(4):384-411. Published online August 30, 2024; DOI: https://doi.org/10.3393/ac.2024.00388.0055

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Total mesorectal excision (TME) has greatly improved rectal cancer surgery outcomes by reducing local recurrence and enhancing patient survival. This review outlines essential knowledge and techniques for performing TME. TME emphasizes the complete resection of the mesorectum along embryologic planes to minimize recurrence. Key anatomical insights include understanding the rectal proper fascia, Denonvilliers fascia, rectosacral fascia, and the pelvic autonomic nerves. Technical tips cover a step-by-step approach to pelvic dissection, the Gate approach, and tailored excision of Denonvilliers fascia, focusing on preserving pelvic autonomic nerves and ensuring negative circumferential resection margins. In Korea, TME has led to significant improvements in local recurrence rates and survival with well-adopted multidisciplinary approaches. Surgical techniques of TME have been optimized and standardized over several decades in Korea, and minimally invasive surgery for TME has been rapidly and successfully adopted. The review emphasizes the need for continuous research on tumor biology and precise surgical techniques to further improve rectal cancer management. The ultimate goal of TME is to achieve curative resection and function preservation, thereby enhancing the patient’s quality of life. Accurate TME, multidisciplinary-based neoadjuvant therapy, refined sphincter-preserving techniques, and ongoing tumor research are essential for optimal treatment outcomes.

Citations

Citations to this article as recorded by

Robotic-assisted colorectal surgery in colorectal cancer management: a narrative review of clinical efficacy and multidisciplinary integration
Engeng Chen, Li Chen, Wei Zhang
Frontiers in Oncology.2025;[Epub] CrossRef
Golden vision: The potential of yellow enhancement in laparoscopic abdominal surgeries and surgical education
Harpreet Singh, Frederick Hong Xiang Koh
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Comparing robot-assisted vs. laparoscopic proctectomy for rectal cancer surgical and oncological outcomes
Wenpeng Wang, Jia Liu, Jiefu Wang, Jinghao Huang, Junfeng Wang
Frontiers in Surgery.2025;[Epub] CrossRef
Early Complication Differences Between Laparoscopic and Open Abdominoperineal Resection
Sarkhail A Sayar, Rehan Ahmed, Syed Shafqatullah, Muhammad Asad, Muhammad Osama Iqbal, Resham Ali, Raja Jawad, Mukkaram Khan, Amna Fareed, Uroosa Shadani
Cureus.2025;[Epub] CrossRef
Robotic Versus Laparoscopic Low Anterior Resection: Comparison of Peri-Operative Outcomes at United Lincolnshire Teaching Hospitals NHS Trust
Nadeem Ahmad Bhat, Rajalakshmi Venkateswaran, Nuha Amri, Trisha Kanani, Athula Tennakoon, Amit Shukla, Sridhar Dharmavaram
Cureus.2025;[Epub] CrossRef
Comparing the Surgical Outcomes of Intersphincteric Resection (ISR) and Transanal Total Mesorectal Excision (TATME) in Rectal Cancer: A Meta-Analysis
Mohsin Farid Sulehri, Mengchuan Wang, Wulikaixi Yagufu, Zhengqi Peng, Yiteng Chen
Cureus.2025;[Epub] CrossRef
From the Editor: Uniting expertise, a new era of global collaboration in coloproctology
In Ja Park
Annals of Coloproctology.2024; 40(4): 285. 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

Case Reports

Malignant disease, Rectal cancer,Colorectal cancer,Complication

Neorectal Mucosal Prolapse After Intersphincteric Resection for Low-Lying Rectal Cancer: A Case Report: Mohammed Alessa, Hyeon Woo Bae, Homoud Alawfi, Ahmad Sakr, Fozan Sauri, Nam Kyu Kim; Ann Coloproctol. 2021;37(Suppl 1):S15-S17. Published online April 22, 2021; DOI: https://doi.org/10.3393/ac.2020.02.22

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Abstract PDF

Radical resection for low rectal cancer is the mainstay among the treatment modalities. Intersphincteric resection (ISR) is considered a relatively new but effective surgical treatment for low-lying rectal tumor. As the sphincter preserving techniques get popularized, we notice uncommon complication associated with it in the form of rectal mucosal prolapse. We presented 2 rare cases that developed neorectal mucosa prolapse after ISR a complication following low rectal cancer surgery. Although ISR is a safe and effective surgical technique for low rectal cancer, it should be considered to correct modifiable possible risk factors. Also, Delorme procedure is good option for management of neorectal mucosal prolapse.

Citations

Citations to this article as recorded by

Tailoring rectal cancer surgery: Surgical approaches and anatomical insights during deep pelvic dissection for optimal outcomes in low‐lying rectal cancer
Youn Young Park, Nam Kyu Kim
Annals of Gastroenterological Surgery.2024; 8(5): 761. CrossRef
Treatment of side limb full-thickness prolapse of the side-to-end coloanal anastomosis following intersphincteric resection: a case report and review of literature
Guglielmo Niccolò Piozzi, Krunal Khobragade, Seon Hui Shin, Jeong Min Choo, Seon Hahn Kim
Annals of Coloproctology.2024; 40(Suppl 1): S38. CrossRef
Surgical Treatment for Mucosal Prolapse after Intersphincteric Resection
Rina Takahashi, Makoto Takahashi, Yuki Ii, Megumi Kawaguchi, Hirotaka Momose, Shunsuke Motegi, Ryoichi Tsukamoto, Yu Okazawa, Masaya Kawai, Kiichi Sugimoto, Yutaka Kojima, Kazuhiro Sakamoto
Nippon Daicho Komonbyo Gakkai Zasshi.2023; 76(3): 299. 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
Clinical outcome of the Gant-Miwa-Thiersch procedure for colonic mucosal prolapse after intersphincteric resection—a single-center report from Japan
Toshikatsu Nitta, Masatsugu Ishii, Jun Kataoka, Sedakatsu Senpuku, Yasuhiko Ueda, Ryo Iida, Ayumi Matsutani, Takashi Ishibashi
Annals of Medicine and Surgery.2021; 72: 103005. CrossRef
Robotic Intersphincteric Resection for Low Rectal Cancer: Technical Controversies and a Systematic Review on the Perioperative, Oncological, and Functional Outcomes
Guglielmo Niccolò Piozzi, Seon Hahn Kim
Annals of Coloproctology.2021; 37(6): 351. CrossRef
Surgical Treatment of Low-Lying Rectal Cancer: Updates
Cristopher Varela, Nam Kyu Kim
Annals of Coloproctology.2021; 37(6): 395. CrossRef

Benign GI diease,Benign diesease & IBD,Complication

Clostridium difficile Infection After Ileostomy Reversal: Ho Seung Kim, Jae Hyun Kang, Han-gil Kim, Young Hun Kim, Hyeonwoo Bae, Nam Kyu Kim; Ann Coloproctol. 2021;37(Suppl 1):S4-S6. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.09.24

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129 Download
2 Web of Science
2 Citations

Abstract PDF

Clostridium difficile infection (CDI) after ileostomy reversal is rare, with few reports available in the available literature describing this condition. The diagnosis of CDI after ileostomy reversal is challenging because symptoms such as diarrhea observed in these patients can occur frequently after surgery. However, CDI can be fatal, so early diagnosis and prompt treatment are important. We discuss 2 patients with positive C. difficile toxin assay results on stool cultures performed after ileostomy reversal. Clinical progression differed between these patients: one patient who presented with severe CDI and shock was successfully treated following a prolonged intensive care unit stay for the management of vital signs and underwent hemodialysis, while another patient showed symptoms of mild colitis but we could not confirm whether diarrhea was associated with CDI or with the usual postoperative state. To our knowledge, these represent 2 of just a few cases reported in the literature describing CDI after ileostomy reversal.

Citations

Citations to this article as recorded by

Influence of additional prophylactic oral antibiotics during mechanical bowel preparation on surgical site infection in patients receiving colorectal surgery
Hayoung Lee, Jong Lyul Lee, Ji Sung Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok‐Byung Lim
World Journal of Surgery.2024; 48(6): 1534. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef

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