Annals of Coloproctology

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Original Article

Anorectal benign disease

Cell-assisted lipotransfer in treating uncontrollable sepsis associated perianal fistula: a pilot study: In Seob Jeong, Sung Hwan Hwang, Hye Mi Yu, Hyeonseok Jeong; Ann Coloproctol. 2024;40(2):169-175. Published online February 6, 2023; DOI: https://doi.org/10.3393/ac.2022.00486.0069

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Purpose
Surgeons can treat debilitating conditions of uncontrollable complex anorectal fistulas with sepsis, even after repeated fistula surgeries, for curative intention. Adipose-derived stem cells have shown good outcomes for refractory Crohn fistula. Unfortunately, cell therapy has some limitations, including high costs. We have therefore attempted immediate cell-assisted lipotransfer (CAL) in treating refractory complex anal fistulas and observed its outcomes.
Methods
In a retrospective study, CAL, using a mixture of freshly extracted autologous stromal vascular fraction (SVF) and fat tissues, was used to treat 22 patients of refractory complex anal fistula from March 2018 to May 2021. Preoperative and postoperative assessments were performed with direct visual inspection, digital palpation, and endoanal ultrasonography. A fistula was considered completely healed if (1) the patient had no symptoms of discharge or inflammation; (2) there were no visible secondary openings of fistula tract inside and outside of the anorectal unit and even in the perineum; and (3) there was no primary opening in the anus. The endpoint of complete remission was wound healing without signs of inflammation 3 months after CAL treatment.
Results
In a total of 22 patients who received CAL treatment, 19 patients showed complete remission, 1 patient showed partial improvement, and 2 patients showed no improvement. One of the 2 patients without improvement at primary endpoint showed complete remission 9 months after CAL. There were no significant adverse effects of the procedure.
Conclusion
We found that the immediately-collected CAL procedure for refractory complex anal fistula showed good outcomes without adverse side effects. It can be strongly recommended as an alternative surgical option for the treatment of complex anal fistula that is uncontrollable even after repeated surgical procedures. However, considering the unpredictable characteristics of SVF, long-term follow-up is necessary.

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
Treatment of perianal manifestations of Crohn's disease
I. A. Nikitina, A. V. Leontyev, V. V. Sytkov, M. A. Danilov, A. I. Khavkin, E. A. Yablokova, M. A. Orlyuk
Experimental and Clinical Gastroenterology.2025; (2): 187. CrossRef
Tissue engineering and regenerative medicine approaches in colorectal surgery
Bigyan B. Mainali, James J. Yoo, Mitchell R. Ladd
Annals of Coloproctology.2024; 40(4): 336. CrossRef

Editorial

Benign proctology

The Effort to Reduce Vasovagal Reaction and Abdominal Pain During Stapled Hemorrhoidopexy: Hyeonseok Jeong; Ann Coloproctol. 2020;36(5):291-292. Published online October 31, 2020; DOI: https://doi.org/10.3393/ac.2020.10.13

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1 Web of Science
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Citations

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A prospective randomized controlled study comparing patient-reported scar evaluation of single-port versus multiport laparoscopic appendectomy for acute appendicitis
Kyeong Eui Kim, In Soo Cho, Sung Uk Bae, Woon Kyung Jeong, Hyung Jin Kim, Seong Kyu Baek
Journal of Minimally Invasive Surgery.2023; 26(2): 55. CrossRef
Treatment of Hemorrhoid in Unusual Condition-Pregnancy
Hyo Seon Ryu
The Ewha Medical Journal.2022;[Epub] CrossRef

Original Articles

Effectiveness of Autologous Fat Graft in Treating Fecal Incontinence: Hyeonseok Jeong, Sung Hwan Hwang, Hyoung Rae Kim, Kil O Ryu, Jiyong Lim, Hye Mi Yu, Jihoon Yoon, Chee Young Kim, Kwang-Yong Jeong, Young Jae Jung, In Seob Jeong, Young Gil Choi; Ann Coloproctol. 2019;35(3):144-151. Published online June 30, 2019; DOI: https://doi.org/10.3393/ac.2018.09.15

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105 Download
4 Web of Science
5 Citations

Abstract PDF

Purpose
The most common risk factor for fecal incontinence (FI) is obstetric injury. FI affects 1.4%–18% of adults. Most patients are unaware when they are young, when symptoms appear suddenly and worsen with aging. Autologous fat graft is widely used in cosmetic surgical field and may substitute for injectable bulky agents in treating FI. Authors have done fat graft for past several years. This article reports the effectiveness of the fat graft in treating FI and discusses satisfaction with the procedure.
Methods
Fat was harvested from both lateral thighs using 10-mL Luer-loc syringe. Pure fat was extracted from harvests and mixed with fat, oil, and tumescent through refinement. Fats were injected into upper border of posterior ano-rectal ring, submucosa of anal canal and intersphincteric space. Thirty-five patients with FI were treated with this method from July 2016 to February 2017 in Busan Hangun Hospital. They were 13 male (mean age, 60.8 years) and 22 female patients (mean age, 63.3 years). The Wexner score was checked before procedure. We evaluated outcome in outpatients by asking the patients. For 19 patients we checked the Wexner score after procedure.
Results
Symptom improved in 29 (82.9%), and not improved in 6 (17.1%). In 2 of 6 patients, they felt better than before procedure, although not satisfied. No improvement in 4. Mean Wexner score was 9.7 before procedure. There were no serious complications such as inflammation or fat embolism.
Conclusion
Autologous fat graft can be an effective alternative treatment for FI. It is safe and easy to perform, and cost effective.

Citations

Citations to this article as recorded by

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
Efficacy of injection of autologous adipose tissue in the treatment of patients with complex and recurrent fistula-in-ano of cryptoglandular origin
S. Guillaumes, N. J. Hidalgo, I. Bachero, R. Pena, S. T. Nogueira, J. Ardid, M. Pera
Techniques in Coloproctology.2024;[Epub] CrossRef
Role of Autologous Fat Grafting in the Conservative Treatment of Fecal Incontinence in Children
Valentina Pinto, Marco Pignatti, Giovanni Parente, Neil Di Salvo, Luca Contu, Mario Lima
Journal of Clinical Medicine.2023; 12(4): 1258. CrossRef
Clinical and physiological efficacy of the application of autologous fat with platelet rich plasma in treating faecal incontinence
Elvis Vargas Castillo, Ingrid Melo Amaral, Arisel Domínguez, Sthephfania López, Daniel Chiantera, Mariangela Pérez Paz, Jenils Daniela Coacuto, Andrés Eloy Soto
Journal of Coloproctology.2020; 40(03): 227. CrossRef
Preliminary Study on the Echo-Assisted Intersphincteric Autologous Microfragmented Adipose Tissue Injection to Control Fecal Incontinence in Children Operated for Anorectal Malformations
Giovanni Parente, Valentina Pinto, Neil Di Salvo, Simone D’Antonio, Michele Libri, Tommaso Gargano, Vincenzo Davide Catania, Giovanni Ruggeri, Mario Lima
Children.2020; 7(10): 181. CrossRef

Early Experience With a Partial Stapled Hemorrhoidopexy for Treating Patients With Grades III–IV Prolapsing Hemorrhoids: Hyeonseok Jeong, Sunghwan Hwang, Kil O Ryu, Jiyong Lim, Hyun Tae Kim, Hye Mi Yu, Jihoon Yoon, Ju-Young Lee, Hyoung Rae Kim, Young Gil Choi; Ann Coloproctol. 2017;33(1):28-34. Published online February 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.1.28

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135 Download
14 Web of Science
13 Citations

Abstract PDF

Purpose

Circular stapled hemorrhoidopexy (CSH) is widely used to treat patients with grades III–IV hemorrhoids because of less pain and short hospital stay. However, this procedure is associated with some complications, such as urge to defecate, anal stenosis, staple line dehiscence, abscess and sepsis. To avoid these complications, surgeons perform a partial stapled hemorrhoidopexy (PSH). The aim of this study is to present our early experience with the PSH.

Methods

We retrospectively reviewed the medical records of 58 patients with hemorrhoids who were treated with a PSH at Busan Hang-Un Hospital from January 2016 to June 2016. A specially designed tri-window anoscope was used, and a purse string suture was made at the mucosae of the protruding hemorrhoids through the window of the anoscope. The hemorrhoidopexy was done by using a circular stapler.

Results

Of the 58 patients included in this study, 34 were male and 24 were female patients (mean age, 50.4 years). The mean operation time was 12.4 minutes, and the mean postoperative hospital stay was 3.8 days. Three patients experienced bleeding (5.1%) 5 urinary retention (8.6%) and 5 skin tags (8.6%). Urge to defecate, tenesmus, abscess, rectovaginal fistula, anal stricture, incontinence, and recurrence did not occur.

Conclusion

PSH is a minimally invasive, feasible, and safe technique for treating patients with grades III–IV hemorrhoids. A PSH, instead of a CSH, can be used to treat certain patients with hemorrhoids.

Citations

Citations to this article as recorded by

Assessment of the efficacy and safety of pudendal nerve block in post-hemorrhoidectomy pain: A meta-analysis of randomized controlled trials
Jun Li, Hai-Qiong Wu, Jun-Tao Zhang, Shi-Jian Liu, Ke-Lin Peng
Asian Journal of Surgery.2025; 48(3): 1607. CrossRef
Efficacy of metronidazole in reducing pain after hemorrhoidectomy: a meta-analysis of randomized controlled trials
Hui Dong, Wen-Xing Chen, Yue-Juan Li, Deng-Chao Wang
BMC Surgery.2025;[Epub] CrossRef
A comparative study on efficacy and safety of modified partial stapled hemorrhoidopexy versus conventional hemorrhoidectomy: a prospective randomized controlled trial
Tae Gyu Kim, Chul Seung Lee, Dong Geun Lee, Choon Sik Chung, Seung Han Kim, Sang Hwa Yu, Jeong Eun Lee, Gwan Cheol Lee, Dong Woo Kang, Jeong Sub Kim, Gyu Young Jeong
Annals of Coloproctology.2025; 41(2): 145. CrossRef
Modified stapled hemorrhoidopexy for lower postoperative stenosis: A five-year experience
Yu-Hong Liu, Tzu-Chiao Lin, Chao-Yang Chen, Ta-Wei Pu
World Journal of Gastrointestinal Surgery.2024; 16(9): 2787. CrossRef
Outcomes of Modified Tissue Selection Therapy Stapler in the Treatment of Prolapsing Hemorrhoids
Chenchen Yuan, Chongjun Zhou, Rong Xue, Xiaofeng Jin, Chun Jin, Chenguo Zheng
Frontiers in Surgery.2022;[Epub] CrossRef
Evaluation of the clinical efficacy and safety of TST33 mega hemorrhoidectomy for severe prolapsed hemorrhoids
Liu Tao, Jun Wei, Xu-Feng Ding, Li-Jiang Ji
World Journal of Clinical Cases.2022; 10(18): 6060. CrossRef
Perirectal Hematoma and Intra-Abdominal Bleeding after Stapled Hemorrhoidopexy and STARR—A Proposal for a Decision-Making Algorithm
Georgi Popivanov, Piergiorgio Fedeli, Roberto Cirocchi, Massimo Lancia, Domenico Mascagni, Michela Giustozzi, Ivan Teodosiev, Kirien Kjossev, Marina Konaktchieva
Medicina.2020; 56(6): 269. CrossRef
The Effort to Reduce Vasovagal Reaction and Abdominal Pain During Stapled Hemorrhoidopexy
Hyeonseok Jeong
Annals of Coloproctology.2020; 36(5): 291. CrossRef
Partial Stapled Hemorrhoidopexy Versus Circumferential Stapled Hemorrhoidopexy for Grade III to IV Prolapsing Hemorrhoids: A Randomized, Noninferiority Trial
Hong-Cheng Lin, Qiu-Lan He, Wan-Jin Shao, Xin-Lin Chen, Hui Peng, Shang-Kui Xie, Xiao-Xue Wang, Dong-Lin Ren
Diseases of the Colon & Rectum.2019; 62(2): 223. CrossRef
Transanale Hämorrhoiden-Dearterialisation vs. selektive Stapler-Hämorrhoidopexie
R. Proßt
coloproctology.2018; 40(1): 47. CrossRef
Hemorrhoids
Danny O. Jacobs
Current Opinion in Gastroenterology.2018; 34(1): 46. CrossRef
Partial Stapled Hemorrhoidopexy Versus Circular Stapled Hemorrhoidopexy
Jin Sub Kim
Annals of Coloproctology.2017; 33(1): 7. CrossRef
A prospective randomized controlled trial evaluating the short-term outcomes of transanal hemorrhoidal dearterialization versus tissue-selecting technique
A. L. H. Leung, T. P. P. Cheung, K. Tung, Y. P. Tsang, H. Cheung, C. W. Lau, C. N. Tang
Techniques in Coloproctology.2017; 21(9): 737. CrossRef

Comparison of Compliance of Adjuvant Chemotherapy Between Laparoscopic and Open Surgery in Patients With Colon Cancer: Kan Ho Chun, Byung Noe Bae, Hoon An, Hyeonseok Jeong, Hyunjin Cho, Geumhee Gwak, Keun Ho Yang, Ki Hwan Kim, Hong Ju Kim, Young Duk Kim; Ann Coloproctol. 2014;30(6):274-279. Published online December 31, 2014; DOI: https://doi.org/10.3393/ac.2014.30.6.274

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49 Download
6 Web of Science
7 Citations

Abstract PDF

Purpose

Many studies have shown that the completion of adjuvant chemotherapy improves the survival rate. Recently, laparoscopic surgery has been used to treat patients with colon cancer. We analyzed the relationship between the completion of adjuvant chemotherapy and the operation method.

Methods

We retrospectively analyzed the medical records of 147 patients diagnosed with colon cancer from January 1, 2009, to May 31, 2012. The numbers of patients who underwent laparoscopic and open surgery were 91 and 56, respectively. We analyzed the relationship between the operation method and various factors such as the completion rate of chemotherapy, the patient's age, gender, and physical activity, the postoperative hospital stay, the start time of chemotherapy, and the patient's body mass index (BMI), TNM stage, and type of health insurance.

Results

In the laparoscopic surgery group, the postoperative hospital stay (13.5 ± 14.82 days vs. 19.6 ± 11.38 days, P = 0.001) and start time of chemotherapy (17.7 ± 17.48 days vs. 23.0 ± 15.00 days, P = 0.044) were shorter, but the percent complete of chemotherapy (71/91 [78.0%] vs. 38/56 [67.8%], P = 0.121), and survival rate (88/91 [96.7%], 47/56 [83.9%], P = 0.007) were higher than they were in the open surgery group. Patients who were elderly, had a low BMI, and a high American Society of Anesthesiologists score were less likely to complete adjuvant chemotherapy than other patients were.

Conclusion

Laparoscopic surgery shows a shorter postoperative hospital stay, a shorter start time of chemotherapy, and a higher survival rate. Laparoscopic surgery may be expected to increase compliance of chemotherapy and to improve survival rate.

Citations

Citations to this article as recorded by

Return to intended oncologic therapy after colectomy for stage III colon adenocarcinoma: Does surgical approach matter?
David T. Pointer, Seth I. Felder, Benjamin D. Powers, Sophie Dessureault, Julian A. Sanchez, Iman Imanirad, Ibrahim Sahin, Hao Xie, Samer A. Naffouje
Colorectal Disease.2023; 25(9): 1760. CrossRef
A comparison of minimally invasive vs open distal pancreatectomy for resectable pancreatic ductal adenocarcinoma: Propensity score matching analysis
Jaewoo Kwon, Seo Young Park, Yejong Park, Eunsung Jun, Woohyung Lee, Ki Byung Song, Jae Hoon Lee, Dae Wook Hwang, Song Cheol Kim
Journal of Hepato-Biliary-Pancreatic Sciences.2021; 28(11): 967. CrossRef
N1c colon cancer and the use of adjuvant chemotherapy: a current audit of the National Cancer Database
Hillary L. Simon, Thais Reif de Paula, Zachary A. Spigel, Deborah S. Keller
Colorectal Disease.2021; 23(3): 653. CrossRef
Comparison of Minimally Invasive versus Open Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma: A Propensity Score Matching Analysis
Jaewoo Kwon, Ki Byung Song, Seo Young Park, Dakyum Shin, Sarang Hong, Yejong Park, Woohyung Lee, Jae Hoon Lee, Dae Wook Hwang, Song Cheol Kim
Cancers.2020; 12(4): 982. CrossRef
Short-term results of laparoscopic and open complete mesocolic excision with D3 lymph node dissection for left-sided colon cancer
P. V. Tsarkov, I. A. Tulina, A. Yu. Kravchenko, A. V. Leont’Yev
Russian Journal of Gastroenterology, Hepatology, Coloproctology.2016; 26(1): 99. CrossRef
Impact of type of surgery (laparoscopic versus open) on the time to initiation of adjuvant chemotherapy in operable rectal cancers
Snita Sinukumar, Shaesta Mehta, Vikas Ostwal, Sudhir Jatal, Avanish Saklani
Indian Journal of Gastroenterology.2015; 34(4): 310. CrossRef
Effect of Laparoscopic Surgery on the Initiation and Completion of Chemotherapy in Patients With Colon Cancer
Min-Ki Kim, Won-Kyung Kang
Annals of Coloproctology.2014; 30(6): 250. CrossRef

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