Annals of Coloproctology

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Anorectal benign disease

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; Ann Coloproctol. 2025;41(2):145-153. Published online April 28, 2025; DOI: https://doi.org/10.3393/ac.2024.00535.0076

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Abstract PDF Supplementary Material: Purpose
The long-term outcomes and efficacy of partial stapled hemorrhoidopexy (PSH) compared with those of conventional hemorrhoidectomy (CH) are not fully understood. This study aimed to introduce a modified PSH (mPSH) and compare its clinical efficacy and safety with those of CH.
Methods
A prospective randomized controlled trial was conducted. This study was performed at a single hospital and involved 6 colorectal surgeons. In total, 110 patients were enrolled between July 2019 and September 2020. Patients were randomly assigned to undergo either mPSH group (n=55) or CH group (n=55). The primary outcome was to compare postoperative average pain and postoperative peak pain using visual analog scale score between the 2 groups.
Results
The required duration of analgesia was shorter in the mPSH group than in the CH group, although the difference was not statistically significant (P=0.096). However, the laxative requirement duration (P<0.010), return to work (P<0.010), satisfaction score (P<0.010), and Vaizey score (P=0.014) were significantly better in the mPSH group. The average and peak postoperative pain scores were significantly lower in the mPSH group during the 15 days after surgery (P<0.001). The overall complication rate in both groups was 9.1%, with no significant difference between the groups (P=0.867).
Conclusion
The mPSH group demonstrated better improvement in symptoms, lower pain scores, and greater patient early satisfaction after surgery than the CH group. Therefore, this surgical technique appears to be a safe and effective alternative for CH.

Colorectal cancer

Computed tomography–assessed presarcopenia and clinical outcomes after laparoscopic surgery for rectal cancer: Ji Hyeong Song, Rak Kyun Oh, Jeong Eun Lee, Kyung Ha Lee, Ji Yeon Kim, Jin Soo Kim; Ann Coloproctol. 2023;39(6):513-520. Published online December 12, 2023; DOI: https://doi.org/10.3393/ac.2023.00031.0004

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Abstract PDF: Purpose
Previous studies have reported that presarcopenia negatively affects rectal cancer treatment. However, most studies have analyzed patients including majority of open surgery, and the association between presarcopenia and clinical outcomes after laparoscopic rectal cancer surgery remains unclear. This study aimed to evaluate the impact of presarcopenia on the clinical and oncological outcomes after laparoscopic rectal cancer surgery.
Methods
Three hundred and one patients undergoing laparoscopic rectal cancer surgery between December 2009 and May 2016 were enrolled. Body composition was assessed using computed tomography by measuring the muscle and fat areas at the third lumbar (L3) vertebra. The L3 skeletal muscle area was used to calculate the skeletal muscle index and evaluate presarcopenia.
Results
Presarcopenia was more common in older ( ≥ 70 years, P = 0.008) or female patients (P = 0.045). Patients with presarcopenia had decreased skeletal muscle area (P < 0.001), lower hemoglobin level (P = 0.034), longer time to first flatus (P < 0.001), and more frequent surgical site infection (P = 0.001). However, survival rates were not significantly different between those with and without presarcopenia.
Conclusion
Computed tomography-assessed presarcopenia was associated with delayed functional recovery and increased surgical site infection, although it was not revealed as a prognostic factor for oncological outcomes.

Combination Assessment of Clinical Complete Response of Patients With Rectal Cancer Following Chemoradiotherapy With Endoscopy and Magnetic Resonance Imaging: Hye Mi Ko, Yo Han Choi, Jeong Eun Lee, Kyung Ha Lee, Ji Yeon Kim, Jin Soo Kim; Ann Coloproctol. 2019;35(4):202-208. Published online August 31, 2019; DOI: https://doi.org/10.3393/ac.2018.10.15

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18 Web of Science
18 Citations

Abstract PDF

Purpose
The response to neoadjuvant chemoradiotherapy (CRT) for rectal cancer can be assessed using digital rectal examination, endoscopy and magnetic resonance imaging (MRI). Precise assessment of clinical complete response (CR) after CRT is essential when deciding between optimizing surgery or organ-preserving treatment. The objectives of this study were to correlate the CR finding in endoscopy and MRI with pathologic CR and to determine the appropriate approach for combining endoscopy and MRI to predict the pathologic CR in patients with rectal cancer after neoadjuvant CRT.
Methods
This retrospective cohort study included 102 patients with rectal cancer who underwent endoscopy and MRI at 2–4 weeks after CRT. We assigned a confidence level (1–4) for the endoscopic and MRI assessments. Accuracy, sensitivity, and specificity were analyzed based on the endoscopy, MRI, and combination method findings. Diagnostic modalities were compared using the likelihood ratios.
Results
Of 102 patients, 17 (16.7%) had a CR. The accuracy, sensitivity, and specificity for the prediction CR of endoscopy with biopsy were 85.3%, 52.9%, and 91.8%, while those of MRI were 91.2%, 70.6%, and 95.3%, and those of combined endoscopy and MRI were 89.2%, 52.9%, and 96.5%, respectively. No significant differences were noted in the sensitivity and specificity of any each modality. The prediction rate for CR of the combination method was 92.6% after the posttest probability test.
Conclusion
Our study demonstrated that combining the interpretation of endoscopy with biopsy and MRI could provide a good prediction rate for CR in patients with rectal cancer after CRT.

Citations

Citations to this article as recorded by

Implementation of Organ Preservation for Locally Advanced Rectal Cancer in Canada: A National Survey of Clinical Practice
Megan Delisle, Victoria Ivankovic, Doris Goubran, Eliane Yvonne Paglicauan, Mariam Alsobaei, Nicole Alcasid, Mary Farnand, Kristopher Dennis
Current Oncology.2025; 32(6): 341. CrossRef
Validierung künstlicher Intelligenz für die Klassifizierung von Mastdarmkrebs während endoskopischer Chirurgie
Felix Aigner, David Duller, Christoph Skias, Gabriele Moitzi, Martin Mitteregger
coloproctology.2025; 47(5): 340. CrossRef
Assessing Endoscopic Response in Locally Advanced Rectal Cancer Treated with Total Neoadjuvant Therapy: Development and Validation of a Highly Accurate Convolutional Neural Network
Hannah Williams, Hannah M. Thompson, Christina Lee, Aneesh Rangnekar, Jorge T. Gomez, Maria Widmar, Iris H. Wei, Emmanouil P. Pappou, Garrett M. Nash, Martin R. Weiser, Philip B. Paty, J. Joshua Smith, Harini Veeraraghavan, Julio Garcia-Aguilar
Annals of Surgical Oncology.2024; 31(10): 6443. CrossRef
Transanal endoscopic microsurgery after radiation or chemoradiation therapy for rectal cancer — peculiarities and results
A А. Nevolskikh, A. R. Brodskiy, V. A. Avdeenko, T. P. Pochuev, Yu. Yu. Mihaleva, T. P. Berezovskaya, R. F. Zibirov, S. A. Myalina, I. A. Orehov, L. O. Petrov, S. A. Ivanov, A. D. Kaprin
Koloproktologia.2024; 23(1): 82. CrossRef
Nonoperative management of rectal cancer
Hannah Williams, Christina Lee, Julio Garcia-Aguilar
Frontiers in Oncology.2024;[Epub] CrossRef
Diagnostic performance of MRI and endoscopy for assessing complete response in rectal cancer after neoadjuvant chemoradiotherapy: a systematic review of the literature
Nicolai Egholt Munk, Peter Bondeven, Bodil Ginnerup Pedersen
Acta Radiologica.2023; 64(1): 20. CrossRef
Correlation of Tumor Response Between Flexible Sigmoidoscopy and Magnetic Resonance Imaging in Patients Undergoing Neoadjuvant Therapy for Locally Advanced Rectal Cancer: A Retrospective Review
Maria A. Rojas, Jose Cataneo, Marianne Gagnon-Konamna, Daniel J. Borsuk, Angela J. Jarzabek, Slawomir J. Marecik, John J. Park, Kunal Kochar
The American Surgeon™.2023; 89(6): 2595. CrossRef
Endoscopy and MRI for restaging early rectal cancer after neoadjuvant treatment
Rutger C. H. Stijns, Jeroen Leijtens, Eelco de Graaf, Simon P. Bach, Geerard Beets, Andre J. A. Bremers, Regina G. H. Beets‐Tan, Johannes H. W. de Wilt
Colorectal Disease.2023; 25(2): 211. CrossRef
Deep learning of endoscopic features for the assessment of neoadjuvant therapy response in locally advanced rectal cancer
Anqi Wang, Jieli Zhou, Gang Wang, Beibei Zhang, Hongyi Xin, Haiyang Zhou
Asian Journal of Surgery.2023; 46(9): 3568. CrossRef
MRI Evaluation of Complete and Near-Complete Response after Neoadjuvant Therapy in Patients with Locally Advanced Rectal Cancer
Anca-Raluca Popita, Cosmin Lisencu, Adriana Rusu, Cristian Popita, Calin Cainap, Alexandru Irimie, Liliana Resiga, Alina Munteanu, Zsolt Fekete, Radu Badea
Diagnostics.2022; 12(4): 921. CrossRef
Watch and wait strategies for rectal cancer: A systematic review
In Ja Park
Precision and Future Medicine.2022; 6(2): 91. CrossRef
Early conformational changes at tumour bed and long term response after neoadjuvant therapy in locally-advanced rectal cancer
Inês Santiago, Maria-João Barata, Nuno Figueiredo, Oriol Parés, Celso Matos
European Journal of Radiology.2021; 140: 109742. CrossRef
Improvement in the Assessment of Response to Preoperative Chemoradiotherapy for Rectal Cancer Using Magnetic Resonance Imaging and a Multigene Biomarker
Eunhae Cho, Sung Woo Jung, In Ja Park, Jong Keon Jang, Seong Ho Park, Seung-Mo Hong, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Cancers.2021; 13(14): 3480. CrossRef
High-Resolution T2-Weighted MRI to Evaluate Rectal Cancer: Why Variations Matter
Kirsten L Gormly
Korean Journal of Radiology.2021; 22(9): 1475. CrossRef
Comparison between Local Excision and Radical Resection for the Treatment of Rectal Cancer in ypT0-1 Patients: An Analysis of the Clinicopathological Factors and Survival Rates
Soo Young Oh, In Ja Park, Young IL Kim, Jong-Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Cancers.2021; 13(19): 4823. CrossRef
MRI T2-weighted sequences-based texture analysis (TA) as a predictor of response to neoadjuvant chemo-radiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC)
Filippo Crimì, Giulia Capelli, Gaya Spolverato, Quoc Riccardo Bao, Anna Florio, Sebastiano Milite Rossi, Diego Cecchin, Laura Albertoni, Cristina Campi, Salvatore Pucciarelli, Roberto Stramare
La radiologia medica.2020; 125(12): 1216. CrossRef
MRI Assessment of Complete Response to Preoperative Chemoradiation Therapy for Rectal Cancer: 2020 Guide for Practice from the Korean Society of Abdominal Radiology
Seong Ho Park, Seung Hyun Cho, Sang Hyun Choi, Jong Keon Jang, Min Ju Kim, Seung Ho Kim, Joon Seok Lim, Sung Kyoung Moon, Ji Hoon Park, Nieun Seo
Korean Journal of Radiology.2020; 21(7): 812. CrossRef
Watch and wait approach in rectal cancer: Current controversies and future directions
Fernando López-Campos, Margarita Martín-Martín, Roberto Fornell-Pérez, Juan Carlos García-Pérez, Javier Die-Trill, Raquel Fuentes-Mateos, Sergio López-Durán, José Domínguez-Rullán, Reyes Ferreiro, Alejandro Riquelme-Oliveira, Asunción Hervás-Morón, Felipe
World Journal of Gastroenterology.2020; 26(29): 4218. CrossRef

Comparison of Long-term Clinical Outcomes according to the Change in the Rectocele Depth between Transanal and Transvaginal Repairs for a Symptomatic Rectocele: Choon Sik Chung, Sang Hwa Yu, Jeong Eun Lee, Dong Keun Lee; J Korean Soc Coloproctol. 2012;28(3):140-144. Published online June 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.3.140

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13 Citations

Abstract PDF

Purpose

This study was aimed to compare the results of a transanal repair with those of a transvaginal levatorplasty and to determine the long-term clinical outcomes according to the change in the depth of the rectocele after the procedure.

Methods

Of 50 women who underwent a rectocele repair from March 2005 to February 2007, 26 women (group A) received a transanal repair, and 24 (group B) received a transvaginal repair with or without levatorplasty. At 12 months after the procedures, 45 (group A/B, 22/23 women) among the 50 women completed physiologic studies, including anal manometry and defecography, and clinical-outcome measurements. The variations of the clinical outcomes with changes in the depth of the rectocele were also evaluated in 42 women (group A/B, 20/22) at the median follow-up of 50 months.

Results

On the defecographic findings, the postoperative depth of the rectocele decreased significantly in both groups (group A vs. B, 1.91 ± 0.20 vs. 2.25 ± 0.46, P = 0.040). At 12 months after surgery, 17 women in each group (group A/B, 77/75%) reported improvement of their symptoms. However, only 11 and 13 women (group A/B, 55/59%) of groups A and B, respectively, maintained their improvement at the median follow-up of 50 months. Better results were reported in patients with a greater change in the depth of their rectocele (≥4 cm) after the procedure (P = 0.001)

Conclusion

In both procedures, clinical outcomes might become progressively worse as the length of the follow-up is increased.

Citations

Citations to this article as recorded by

Outcomes of laparoscopic ventral mesh rectopexy versus trans-vaginal repair in management of anterior rectocele, a randomized controlled trial
A. Sanad, A. Sakr, H. Elfeki, W. Omar, W. Thabet, E. Fouda, E. Abdallah, S. A. Elbaz
Techniques in Coloproctology.2025;[Epub] CrossRef
Tratamiento quirúrgico de los prolapsos genitales por vía vaginal
T. Thubert, M. Degez, C. Cardaillac, R. De Tayrac, M. Cosson
EMC - Urología.2024; 56(4): 1. CrossRef
Traitement chirurgical des prolapsus génitaux par voie vaginale
T. Thubert, M. Degez, C. Cardaillac, R. De Tayrac, M. Cosson
EMC - Techniques Chirurgicales - Urologie.2024; 41(3): 1. CrossRef
Laparoscopic or transanal repair of rectocele? Comparison of a reduction in rectocele size
Akira Tsunoda, Tomoko Takahashi, Satoshi Matsuda, Hiroshi Kusanagi
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Prise en charge chirurgicale de la rectocele – mise au point
M. Aubert, D. Mege, R. Le Huu Nho, G. Meurette, I. Sielezneff
Journal de Chirurgie Viscérale.2021; 158(2): 157. CrossRef
Surgical management of the rectocele – An update
M. Aubert, D. Mege, R. Le Huu Nho, G. Meurette, I. Sielezneff
Journal of Visceral Surgery.2021; 158(2): 145. CrossRef
ACG Clinical Guidelines: Management of Benign Anorectal Disorders
Arnold Wald, Adil E. Bharucha, Berkeley Limketkai, Allison Malcolm, Jose M. Remes-Troche, William E. Whitehead, Massarat Zutshi
American Journal of Gastroenterology.2021; 116(10): 1987. CrossRef
Early and late effects of the sequential transfixed stich technique for the treatment of the symptomatic rectocele without rectal mucosa prolapse
Fabio Gaj, Ivano Biviano, Antonello Trecca, Quirino Lai, Jacopo Andreuccetti
Minerva Chirurgica.2020;[Epub] CrossRef
Absence of a rectocele may be correlated with reduced internal anal sphincter function in patients with rectal intussusception and fecal incontinence
Akira Tsunoda, Tomoko Takahashi, Hiroshi Kusanagi
International Journal of Colorectal Disease.2019; 34(10): 1681. CrossRef
Trattamento chirurgico del rettocele
G. Meurette, A. Vénara, P.-A. Lehur
EMC - Tecniche Chirurgiche Addominale.2018; 24(1): 1. CrossRef
Tratamiento quirúrgico de los rectoceles
G. Meurette, A. Vénara, P.-A. Lehur
EMC - Técnicas Quirúrgicas - Aparato Digestivo.2018; 34(1): 1. CrossRef
Surgery for constipation: systematic review and practice recommendations
U. Grossi, E. J. Horrocks, J. Mason, C. H. Knowles, A. B. Williams
Colorectal Disease.2017; 19(S3): 73. CrossRef
Traitement chirurgical des rectocèles
G. Meurette, A. Vénara, P.-A. Lehur
EMC - Techniques chirurgicales - Appareil digestif.2017; 34(4): 1. CrossRef

Long-term Outcomes of Laparoscopic Surgery for Colorectal Cancer: Jeong-Eun Lee, Yong-Geul Joh, Sang-hwa Yoo, Geu-Young Jeong, Sung-Han Kim, Choon-Sik Chung, Dong-Gun Lee, Seon Hahn Kim; J Korean Soc Coloproctol. 2011;27(2):64-70. Published online April 30, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.2.64

6,585 View
52 Download
13 Citations

Abstract PDF

Purpose

The long-term results of a laparoscopic resection for colorectal cancer have been reported in several studies, but reports on the results of laparoscopic surgery for rectal cancer are limited. We investigated the long-term outcomes, including the five-year overall survival, disease-free survival and recurrence rate, after a laparoscopic resection for colorectal cancer.

Methods

Using prospectively collected data on 303 patients with colorectal cancer who underwent a laparoscopic resection between January 2001, and December 2003, we analyzed sex, age, stage, complications, hospital stay, mean operation time and blood loss. The overall survival rate, disease-free survival rate and recurrence rate were investigated for 271 patients who could be followed for more than three years.

Results

Tumor-node-metastasis (TNM) stage I cancer was present in 55 patients (18.1%), stage II in 116 patients (38.3%), stage III in 110 patients (36.3%), and stage IV in 22 patients (7.3%). The mean operative time was 200 minutes (range, 100 to 535 minutes), and the mean blood loss was 97 mL (range, 20 to 1,200 mL). The mean hospital stay was 11 days and the mean follow-up period was 54 months. The mean numbers of resected lymph nodes were 26 and 21 in the colon and the rectum, respectively, and the mean distal margins were 10 and 3 cm. The overall morbidity rate was 26.1%. The local recurrence rates were 2.2% and 4.4% in the colon and the rectum, respectively, and the distant recurrence rates were 7.8% and 22.5%. The five-year overall survival rates were 86.1% in the colon (stage I, 100%; stage II, 97.6%; stage III, 77.5%; stage IV, 16.7%) and 68.8% in the rectum (stage I, 90.2%; stage II, 84.0%; stage III, 57.6; stage IV, 13.3%). The five-year disease-free survival rates were 89.8% in the colon (stage I, 100%; stage II, 97.7%; stage III, 74.2%) and 74.5% in the rectum (stage I, 90.0%; stage II, 83.9%; stage III, 59.2%).

Conclusion

Laparoscopic surgery for colorectal cancer is a good alternative method to open surgery with tolerable oncologic long-term results.

Citations

Citations to this article as recorded by

The Determinants of Long-Term Outcomes After Colorectal Cancer Surgery: A Literature Review
Olorungbami K Anifalaje, Charles Ojo, Oluwaseyi T Balogun, Fikayo A Ayodele, Abeeb Azeez, Shirley Gabriels
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Thanh Xuân Nguyễn
Vietnam Journal of Endolaparoscopic Surgey.2024;[Epub] CrossRef
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Hữu Thịnh Nguyễn
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Functional and clinical outcomes of hand-assisted laparoscopic colorectal surgery: a single-institution experience in 255 patients
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Comparison of the clinical outcomes of laparoscopic-assisted versus open surgery for colorectal cancer
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Oncology Letters.2014; 7(4): 1213. 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
Annals of Coloproctology.2014; 30(6): 274. CrossRef
Results of laparoscopic colorectal surgery from a national training center
Rudra Krishna Maitra, Austin G. Acheson, Chris Gornall, John H. Scholefield, Julian P. Williams, Charles A. Maxwell-Armstrong
Asian Journal of Surgery.2014; 37(1): 1. CrossRef
Laparoscopic-Assisted Versus Open Surgery for Colorectal Cancer: Short- and Long-Term Outcomes Comparison
Antonio Biondi, Giuseppe Grosso, Antonio Mistretta, Stefano Marventano, Chiara Toscano, Salvatore Gruttadauria, Francesco Basile
Journal of Laparoendoscopic & Advanced Surgical Techniques.2013; 23(1): 1. CrossRef
Long-term Outcomes After Resection for Submucosal Invasive Colorectal Cancers
Hiroaki Ikematsu, Yusuke Yoda, Takahisa Matsuda, Yuichiro Yamaguchi, Kinichi Hotta, Nozomu Kobayashi, Takahiro Fujii, Yasuhiro Oono, Taku Sakamoto, Takeshi Nakajima, Madoka Takao, Tomoaki Shinohara, Yoshitaka Murakami, Takahiro Fujimori, Kazuhiro Kaneko,
Gastroenterology.2013; 144(3): 551. CrossRef
Palliative resection of the primary tumour in patients with Stage IV colorectal cancer: systematic review and meta‐analysis of the early outcome after laparoscopic and open colectomy
T. X. Yang, B. Billah, D. L. Morris, T. C. Chua
Colorectal Disease.2013;[Epub] CrossRef
Major postoperative complications and survival for colon cancer elderly patients
Giuseppe Grosso, Antonio Biondi, Stefano Marventano, Antonio Mistretta, Giorgio Calabrese, Francesco Basile
BMC Surgery.2012;[Epub] CrossRef
A rectumtumorok sebészete
Péter Metzger
Magyar Sebészet.2012; 65(3): 129. CrossRef
Oncologic Outcomes of a Laparoscopic Right Hemicolectomy for Colon Cancer: Results of a 3-Year Follow-up
Jung Hoon Cho, Dae Ro Lim, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Kang Young Lee, Nam Kyu Kim
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