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Original Articles
Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection
Yunghuyn Hwang, Yong Sik Yoon, Jun Woo Bong, Hye Yun Choi, In Ho Song, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Ann Coloproctol. 2019;35(4):194-201.   Published online August 31, 2019
DOI: https://doi.org/10.3393/ac.2018.10.18.2
  • 6,197 View
  • 145 Download
  • 14 Web of Science
  • 18 Citations
AbstractAbstract PDF
Purpose
Transanal excision (TAE) is an alternative surgical procedure for early rectal cancer. This study compared long-term TAE outcomes, in terms of survival and local recurrence (LR), with total mesorectal excision (TME) in patients with pathologically confirmed T1 rectal cancer.
Methods
T1 rectal adenocarcinoma patients who underwent surgery from 1990 to 2011 were retrospectively reviewed. Patients that were suspected to have preoperative lymph node metastasis were excluded. Demographics, recurrence, and survival were analyzed based on TAE and TME surgery.
Results
Of 268 individuals, 61 patients (26%) underwent TAE, which was characterized by proximity to the anus, submucosal invasion depth, and lesion infiltration, compared with TME patients (P < 0.001–0.033). During a median follow-up of 10.4 years, 12 patients had systemic and/or LR. Ten-year cancer-specific survival in the TAE and TME groups was not significantly different (98% vs. 100%). However, the 10-year LR rate in the TAE group was greater than that of TME group (10% vs. 0%, P < 0.001). Although 5 of the 6 TAE patients with LR underwent salvage surgery, one of the patients eventually died. The TAE surgical procedure (hazard ratio, 19.066; P = 0.007) was the only independent risk factor for LR.
Conclusion
Although long-term survival after TAE was comparable to that after TME, TAE had a greater recurrence risk than TME. Thus, TAE should only be considered as an alternative surgical option for early rectal cancer in selected patients.

Citations

Citations to this article as recorded by  
  • Local resection in rectal cancer: When, who and how?
    Jesus Badia-Closa, Juan Pablo Campana, Gustavo Leandro Rossi, Xavier Serra-Aracil
    Cirugía Española (English Edition).2025; 103(4): 244.     CrossRef
  • Resección local en cáncer de recto: ¿cuándo, a quién y cómo?
    Jesus Badia-Closa, Juan Pablo Campana, Gustavo Leandro Rossi, Xavier Serra-Aracil
    Cirugía Española.2025; 103(4): 244.     CrossRef
  • Transanal excision in early rectal cancer
    Marija Nikolić, Nemanja Trifunović, Damir Jašarović, Tanja Abazović, Milica Radivojević, Nebojša Mitrović
    Medicinski glasnik Specijalne bolnice za bolesti štitaste žlezde i bolesti metabolizma.2025; 30(97): 28.     CrossRef
  • Short- and long-term outcomes of local excision with adjuvant radiotherapy in high-risk T1 rectal cancer patients
    Abdullah Al-Sawat, Jung Hoon Bae, Hyun Ho Kim, Chul Seung Lee, Seung Rim Han, Yoon Suk Lee, Hyeon-Min Cho, Hong Seok Jang, In Kyu Lee
    Annals of Surgical Treatment and Research.2022; 102(1): 36.     CrossRef
  • The Role of Transanal Endoscopic Surgery for Early Rectal Cancer
    Natalie F. Berger, Patricia Sylla
    Clinics in Colon and Rectal Surgery.2022; 35(02): 113.     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
  • Watch and wait strategies for rectal cancer: A systematic review
    In Ja Park
    Precision and Future Medicine.2022; 6(2): 91.     CrossRef
  • Early-rectal Cancer Treatment: A Decision-tree Making Based on Systematic Review and Meta-analysis
    Ignacio Aguirre-Allende, Jose Maria Enriquez-Navascues, Garazi Elorza-Echaniz, Ane Etxart-Lopetegui, Nerea Borda-Arrizabalaga, Yolanda Saralegui Ansorena, Carlos Placer-Galan
    Cirugía Española.2021; 99(2): 89.     CrossRef
  • Oncological Outcomes of Transanal Endoscopic Microsurgery Plus Adjuvant Chemoradiotherapy for Patients with High-Risk T1 and T2 Rectal Cancer
    Kang Xu, Yulin Liu, Peng Yu, Wei Shang, Yongbo Zhang, Mingwen Jiao, Zhonghui Cui, Lijian Xia, Jingbo Chen
    Journal of Laparoendoscopic & Advanced Surgical Techniques.2021; 31(9): 1006.     CrossRef
  • Early-rectal Cancer Treatment: A Decision-tree Making Based on Systematic Review and Meta-analysis
    Ignacio Aguirre-Allende, Jose Maria Enriquez-Navascues, Garazi Elorza-Echaniz, Ane Etxart-Lopetegui, Nerea Borda-Arrizabalaga, Yolanda Saralegui Ansorena, Carlos Placer-Galan
    Cirugía Española (English Edition).2021; 99(2): 89.     CrossRef
  • The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Surveillance and Survivorship Care of Patients After Curative Treatment of Colon and Rectal Cancer
    Karin M. Hardiman, Seth I. Felder, Garrett Friedman, John Migaly, Ian M. Paquette, Daniel L. Feingold
    Diseases of the Colon & Rectum.2021; 64(5): 517.     CrossRef
  • The risk factors of local recurrence and distant metastasis on pT1/T2N0 mid-low rectal cancer after total mesorectal excision
    I-Li Lai, Jeng-Fu You, Yih-Jong Chern, Wen-Sy Tsai, Jy-Ming Chiang, Pao-Shiu Hsieh, Hsin-Yuan Hung, Yu-Jen Hsu
    World Journal of Surgical Oncology.2021;[Epub]     CrossRef
  • Prognostic Factors and Treatment of Recurrence after Local Excision of Rectal Cancer
    Moon Suk Choi, Jung Wook Huh, Jung Kyong Shin, Yoon Ah Park, Yong Beom Cho, Hee Cheol Kim, Seong Hyeon Yun, Woo Yong Lee
    Yonsei Medical Journal.2021; 62(12): 1107.     CrossRef
  • New morphological risk factors for metastasis to regional lymph nodes in rectal cancer with invasion into the submucosa
    O. A. Maynovskaya, E. G. Rybakov, S. V. Chernyshov, Yu. A. Shelygin, S. I. Achkasov
    Koloproktologia.2021; 20(4): 22.     CrossRef
  • Surgical Treatment of Low-Lying Rectal Cancer: Updates
    Cristopher Varela, Nam Kyu Kim
    Annals of Coloproctology.2021; 37(6): 395.     CrossRef
  • Comparison of the transanal surgical techniques for local excision of rectal tumors: a network meta-analysis
    Konstantinos Perivoliotis, Ioannis Baloyiannis, Chamaidi Sarakatsianou, George Tzovaras
    International Journal of Colorectal Disease.2020; 35(7): 1173.     CrossRef
  • What Should Be Considered for Local Excision in Early Rectal Cancer?
    Taesung Ahn
    Annals of Coloproctology.2019; 35(4): 155.     CrossRef
  • Survival analysis of local excision vs total mesorectal excision for middle and low rectal cancer in pT1/pT2 stage and intermediate pathological risk
    I-Li Lai, Jeng-Fu You, Yih-Jong Chern, Wen-Sy Tsai, Jy-Ming Chiang, Pao-Shiu Hsieh, Hsin-Yuan Hung, Chien-Yuh Yeh, Sum-Fu Chiang, Cheng-Chou Lai, Rei-Ping Tang, Jinn-Shiun Chen, Yu-Jen Hsu
    World Journal of Surgical Oncology.2019;[Epub]     CrossRef
Predictors of Morbidity and Mortality After Surgery for Intestinal Perforation
Rumi Shin, Sang Mok Lee, Beonghoon Sohn, Dong Woon Lee, Inho Song, Young Jun Chai, Hae Won Lee, Hye Seong Ahn, In Mok Jung, Jung Kee Chung, Seung Chul Heo
Ann Coloproctol. 2016;32(6):221-227.   Published online December 31, 2016
DOI: https://doi.org/10.3393/ac.2016.32.6.221
  • 10,629 View
  • 95 Download
  • 38 Web of Science
  • 38 Citations
AbstractAbstract PDF
Purpose

An intestinal perforation is a rare condition, but has a high mortality rate, even after immediate surgical intervention. The clinical predictors of postoperative morbidity and mortality are still not well established, so this study attempted to identify risk factors for postoperative morbidity and mortality after surgery for an intestinal perforation.

Methods

We retrospectively analyzed the cases of 117 patients who underwent surgery for an intestinal perforation at a single institution in Korea from November 2008 to June 2014. Factors related with postoperative mortality at 1 month and other postoperative complications were investigated.

Results

The mean age of enrolled patients was 66.0 ± 15.8 years and 66% of the patients were male. Fifteen patients (13%) died within 1 month after surgical treatment. Univariate analysis indicated that patient-related factors associated with mortality were low systolic and diastolic blood pressure, low serum albumin, low serum protein, low total cholesterol, and high blood urea nitrogen; the surgery-related factor associated with mortality was feculent ascites. Multivariate analysis using a logistic regression indicated that low systolic blood pressure and feculent ascites independently increased the risk for mortality; postoperative complications were more likely in both females and those with low estimated glomerular filtration rates and elevated serum C-reactive protein levels.

Conclusion

Various factors were associated with postoperative clinical outcomes of patients with an intestinal perforation. Morbidity and mortality following an intestinal perforation were greater in patients with unstable initial vital signs, poor nutritional status, and feculent ascites.

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Analysis of Risk Factors for the Development of Incisional and Parastomal Hernias in Patients after Colorectal Surgery
In Ho Song, Heon-Kyun Ha, Sang-Gi Choi, Byeong Geon Jeon, Min Jung Kim, Kyu Joo Park
J Korean Soc Coloproctol. 2012;28(6):299-303.   Published online December 31, 2012
DOI: https://doi.org/10.3393/jksc.2012.28.6.299
  • 5,305 View
  • 46 Download
  • 29 Citations
AbstractAbstract PDF
Purpose

The purpose of this study was to evaluate the overall rate and risk factors for the development of an incisional hernia and a parastomal hernia after colorectal surgery.

Methods

The study cohort consisted of 795 consecutive patients who underwent open colorectal surgery between 2005 and 2007 by a single surgeon. A retrospective analysis of prospectively collected data was performed.

Results

The overall incidence of incisional hernias was 2% (14/690). This study revealed that the cumulative incidences of incisional hernia were 1% at 12 months and 3% after 36 months. Eighty-six percent of all incisional hernias developed within 3 years after a colectomy. The overall rate of parastomal hernias in patients with a stoma was 6.7% (7/105). The incidence of parastomal hernias was significantly higher in the colostomy group than in the ileostomy group (11.9% vs. 0%; P = 0.007). Obesity, abdominal aortic aneurysm, American Society of Anesthesiologists score, serum albumin level, emergency surgery and postoperative ileus did not influence the incidence of incisional or parastomal hernias. However, the multivariate analysis revealed that female gender and wound infection were significant risk factors for the development of incisional hernias female: P = 0.009, wound infection: P = 0.041). There were no significant factors related to the development of parastomal hernias.

Conclusion

Our results indicate that most incisional hernias develop within 3 years after a colectomy. Female gender and wound infection were risk factors for the development of an incisional hernia after colorectal surgery. In contrast, no significant factors were found to be associated with the development of a parastomal hernia.

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    A. S. Ermolov, V. T. Koroshvili, D. A. Blagovestnov, P. A. Yartsev, I. A. Shlyakhovsky
    Khirurgiya. Zhurnal im. N.I. Pirogova.2017; (5): 76.     CrossRef
  • Risk factors of severe incisional hernia after renal transplantation: a retrospective multicentric case–control study on 225 patients
    E. Broggi, F. Bruyère, F. Gaudez, F. Desgrandchamps
    World Journal of Urology.2017; 35(7): 1111.     CrossRef
  • Assessing the predictive accuracy of the American College of Surgeons National Surgical Quality Improvement Project Surgical Risk Calculator in open ventral hernia repair
    Marten N. Basta, Andrew R. Bauder, Stephen J. Kovach, John P. Fischer
    The American Journal of Surgery.2016; 212(2): 272.     CrossRef
  • Prevention of postoperative ventral hernias: current state of the art
    B. S. Sukhovatykh, N. M. Valuyskaya, N. V. Pravednikova, E. V. Gerasimchuk, T. V. Mutova
    Khirurgiya. Zhurnal im. N.I. Pirogova.2016; (3): 76.     CrossRef
  • Collagenopathies—Implications for Abdominal Wall Reconstruction: A Systematic Review
    Bridget Harrison, Kyle Sanniec, Jeffrey E. Janis
    Plastic and Reconstructive Surgery - Global Open.2016; 4(10): e1036.     CrossRef
  • The state of midline closure of the abdominal wall
    A H Petter-Puchner
    British Journal of Surgery.2015; 102(12): 1446.     CrossRef
  • Laparoscopic ventral/incisional hernia repair: updated guidelines from the EAES and EHS endorsed Consensus Development Conference
    Gianfranco Silecchia, Fabio Cesare Campanile, Luis Sanchez, Graziano Ceccarelli, Armando Antinori, Luca Ansaloni, Stefano Olmi, Giovanni Carlo Ferrari, Diego Cuccurullo, Paolo Baccari, Ferdinando Agresta, Nereo Vettoretto, Micaela Piccoli
    Surgical Endoscopy.2015; 29(9): 2463.     CrossRef
  • Mesh herniorrhaphy with simultaneous colorectal surgery: a case-matched study from the American College of Surgeons National Surgical Quality Improvement Program
    Cigdem Benlice, Emre Gorgun, Erman Aytac, Gokhan Ozuner, Feza H. Remzi
    The American Journal of Surgery.2015; 210(4): 766.     CrossRef
  • A review of the incidence of iatrogenic hernia in both laparoscopic and open colorectal surgery: Using CT as the gold standard of detection, cohort study
    Nader Naguib, Henna Rafique, Pawan Kumar Dhruva Rao, Tomos Longworth, Jean Mark Soukias, Ashraf Masoud
    International Journal of Surgery.2015; 19: 87.     CrossRef
  • Incidence and Risk Factors of Parastomal Hernia in Patients Undergoing Radical Cystectomy and Ileal Conduit Diversion
    Nick W. Liu, Jeromy T. Hackney, Paul T. Gellhaus, M. Francesca Monn, Timothy A. Masterson, Richard Bihrle, Thomas A. Gardner, Michael G. House, Michael O. Koch
    Journal of Urology.2014; 191(5): 1313.     CrossRef
  • Incidence of and risk factors for incisional hernia after abdominal surgery
    K Itatsu, Y Yokoyama, G Sugawara, H Kubota, Y Tojima, Y Kurumiya, H Kono, H Yamamoto, M Ando, M Nagino
    British Journal of Surgery.2014; 101(11): 1439.     CrossRef
  • Prophylactic synthetic mesh can be safely used to close emergency laparotomies, even in peritonitis
    Nuria Argudo, José A. Pereira, Juan J. Sancho, Estela Membrilla, M. José Pons, Luis Grande
    Surgery.2014; 156(5): 1238.     CrossRef
  • Risk Factors for the Development of Parastomal Hernia after Radical Cystectomy
    Timothy F. Donahue, Bernard H. Bochner, John P. Sfakianos, Matthew Kent, Melanie Bernstein, William M. Hilton, Eugene K. Cha, Alyssa M. Yee, Guido Dalbagni, Hebert A. Vargas
    Journal of Urology.2014; 191(6): 1708.     CrossRef
  • Increased Risk of Incisional Hernia after Sigmoid Colectomy for Diverticulitis Compared with Colon Cancer
    Javier S. Pogacnik, Evangelos Messaris, Susan M. Deiling, Tara M. Connelly, Arthur S. Berg, David B. Stewart, Kevin J. McKenna, Lisa S. Poritz, Walter A. Koltun
    Journal of the American College of Surgeons.2014; 218(5): 920.     CrossRef
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