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Malignant disease,Colorectal cancer,Epidemiology & etiology
Clinicopathologic characteristics of early-onset colorectal cancer
Kui Seon Park, Young Ki Hong, Yoon Jung Choi, Jung Gu Kang
Ann Coloproctol. 2022;38(5):362-369.   Published online March 11, 2022
DOI: https://doi.org/10.3393/ac.2021.00976.0139
  • 5,040 View
  • 186 Download
  • 12 Web of Science
  • 14 Citations
AbstractAbstract PDF
Purpose
The aim of this study was to analysis of the clinicopathological characteristics and prognosis of colorectal cancer (CRC) under the age of 50 years.
Methods
Between January 2009 and December 2018, 1,126 primary CRC patients were included from National Health Insurance Service Ilsan Hospital. The patients were divided into group 1 (n=111, ≤50 years) and group 2 (n=1,015, >50 years). The clinicopathologic features and prognostic outcomes were compared. In addition, to analyze whether there were any differences of those characteristics in 3 groups, patients aged under 50 years were divided into their 20s, 30s, and 40s.
Results
Group 1 had a slightly higher distribution in the left colon and rectum, lower T stage I and higher T stage IV rate, and a significantly higher distribution in stage N2 than group 2 (30.6%:16.3%, P<0.001). Poor histological differentiation of tumors was significantly high in group 1 (P=0.003). The 5-year survival rate for those in their 30s (69.2%) and 40s (91.6%) was higher than those in their 20s who died immediately after surgery (P<0.001). The 5-year disease-free survival rate was also confirmed to be meaningful for each age group, with 0% in their 20s, 53.8% in their 30s, 79.2% in their 40s (P<0.001).
Conclusion
Although the age was not an independent prognostic factor for overall survival in this study, the early onset group of CRCs is more advanced at the time of diagnosis and has a more aggressive histologic type.

Citations

Citations to this article as recorded by  
  • Multiethnic Trends in Early Onset Colorectal Cancer
    Michelle Nagata, Kohei Miyagi, Brenda Y. Hernandez, Scott K. Kuwada
    Cancers.2024; 16(2): 398.     CrossRef
  • Surgical and survival outcomes of early‐onset colorectal cancer patients: a single‐centre descriptive Australian study
    Celine Garrett, Daniel Steffens, Michael Solomon, Cherry Koh
    ANZ Journal of Surgery.2024; 94(9): 1584.     CrossRef
  • Global epidemiology of early‐onset upper gastrointestinal cancer: trend from the Global Burden of Disease Study 2019
    Pojsakorn Danpanichkul, Thanida Auttapracha, Siwanart Kongarin, Ben Ponvilawan, Daniel M. Simadibrata, Kwanjit Duangsonk, Supitchaya Jaruvattanadilok, Sakditad Saowapa, Kanokphong Suparan, Rashid N. Lui, Suthat Liangpunsakul, Michael B. Wallace, Karn Wija
    Journal of Gastroenterology and Hepatology.2024; 39(9): 1856.     CrossRef
  • Early onset metastatic colorectal cancer in Australia
    A. Jalali, S. Smith, G. Kim, H. Wong, M. Lee, J. Yeung, M. Loft, R. Wong, J.D. Shapiro, S. Kosmider, J. Tie, S. Ananda, B. Ma, M. Burge, R. Jennens, B. Lee, J. Johns, L. Lim, A. Dean, L. Nott, P. Gibbs
    Cancer Treatment and Research Communications.2024; 40: 100827.     CrossRef
  • The prognostic significance of clinicopathological characteristics in early-onset versus late-onset colorectal cancer liver metastases
    Yi-Tong Li, Xiang-Yu Wang, Bo Zhang, Bao-Rui Tao, Zhen-Mei Chen, Xiao-Chen Ma, Jia-Hao Han, Chong Zhang, Rui Zhang, Jin-Hong Chen
    International Journal of Colorectal Disease.2023;[Epub]     CrossRef
  • Clinical implication of tissue carcinoembryonic antigen expression in association with serum carcinoembryonic antigen in colorectal cancer
    Abdulmohsin Fawzi Aldilaijan, Young Il Kim, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Jihun Kim, Jun-Soo Ro, Jin Cheon Kim
    Scientific Reports.2023;[Epub]     CrossRef
  • Patients younger than 40 years with colorectal cancer have a similar prognosis to older patients
    Tomoki Abe, Takeru Matsuda, Ryuichiro Sawada, Hiroshi Hasegawa, Kimihiro Yamashita, Takashi Kato, Hitoshi Harada, Naoki Urakawa, Hironobu Goto, Shingo Kanaji, Taro Oshikiri, Yoshihiro Kakeji
    International Journal of Colorectal Disease.2023;[Epub]     CrossRef
  • Clinical and pathological characteristics of early-onset colorectal cancer in South Korea
    Su Bee Park, Jin Young Yoon, Min Seob Kwak, Jae Myung Cha
    Saudi Journal of Gastroenterology.2023; 29(6): 358.     CrossRef
  • Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
    Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
    Cancers.2023; 15(20): 5098.     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
  • Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
    Gyoung Tae Noh
    The Ewha Medical Journal.2023;[Epub]     CrossRef
  • Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus R0 resection for resectable colorectal cancer with peritoneal metastases and low peritoneal cancer index scores: A collaborative observational study from Korea and Japan
    Daichi Kitaguchi, Eun Jung Park, Seung Hyuk Baik, Shoma Sasaki, Yuichiro Tsukada, Masaaki Ito
    International Journal of Surgery.2023;[Epub]     CrossRef
  • Is the oncological impact of vascular invasion more important in right colon cancer?
    Gyung Mo Son
    Journal of Minimally Invasive Surgery.2022; 25(2): 49.     CrossRef
  • Different Oncologic Outcomes in Early-Onset and Late-Onset Sporadic Colorectal Cancer: A Regression Analysis on 2073 Patients
    Caterina Foppa, Annalisa Maroli, Sara Lauricella, Antonio Luberto, Carlotta La Raja, Francesca Bunino, Michele Carvello, Matteo Sacchi, Francesca De Lucia, Giuseppe Clerico, Marco Montorsi, Antonino Spinelli
    Cancers.2022; 14(24): 6239.     CrossRef
Malignant disease,Prognosis and adjuvant therapy
Analysis of the Incidence and Clinical Features of Colorectal Nonadenocarcinoma in Korea: A National Cancer Registry-Based Study
Soomin Nam, Dongwook Kim, Kyuwon Jung, Yoon Jung Choi, Jung Gu Kang
Ann Coloproctol. 2020;36(6):390-397.   Published online May 15, 2020
DOI: https://doi.org/10.3393/ac.2020.05.03.2
  • 3,260 View
  • 109 Download
  • 10 Web of Science
  • 10 Citations
AbstractAbstract PDF
Purpose
Although most colorectal malignancies are adenocarcinomas from mucosa, various types of malignant and benign tumors can develop. Due to extremely low incidence, little research has been conducted. The purpose was to assess incidence and compare it according to demographic factors.
Methods
Data from the Korea National Cancer Registry from 2007 to 2016 were used. The crude incidence, age-standard incidence rate (ASR) of colorectal nonadenocarcinomas were calculated.
Results
Over 11 years, there were 267,142 patients with colorectal malignancies. The patients of 14,495 (5.43%) were diagnosed with nonadenocarcinoma. The ASR was 2.52 per 100,000 in men and 1.56 in women. Lesions were classified according to histologic categories; neuroendocrine tumor (NET) was the most common malignancy (10,919 [75.33%]). Nonadenocarcinoma was the most common in 40s and 50s (40 to 49 years, 3,530 [24.35%]; 50 to 59 years, 3,991 [27.53%]). Lymphoma was high (54.46%) in patients in teenagers. Proportion of NET decreased with age and that of carcinoma increased with age. Carcinoma, sarcoma, and lymphoma were more common among men and melanoma was more common among women. The most common site was the rectum (11,066 [76.34%]). Lymphoma occurred more frequently in proximal colon. Melanoma, gastrointestinal stromal tumor, and NET occurred mostly in rectum. A total of 10,155 patients (70.06%) were classified as having localized disease.
Conclusion
This study is meaningful as it is the first study to examine incidence of colorectal nonadenocarcinoma. Differences in incidence of different lesions based on demographic factors were identified. This study will play a role in cancer prevention and diagnosis projects.

Citations

Citations to this article as recorded by  
  • Risk Factor Analysis of Lymph Node Metastasis for Rectal Neuroendocrine Tumors: Who Needs a Radical Resection in Rectal Neuroendocrine Tumors Sized 1–2 cm?
    Jin Sun Choi, Min Jung Kim, Rumi Shin, Ji Won Park, Seung Chul Heo, Seung-Yong Jeong, Kyu Joo Park, Seung-Bum Ryoo
    Annals of Surgical Oncology.2024;[Epub]     CrossRef
  • Assessing risk stratification in long-term outcomes of rectal neuroendocrine tumors following endoscopic resection: a multicenter retrospective study
    Hyun Jin Lee, Yun Seo, Chang Kyo Oh, Ji Min Lee, Hyun Ho Choi, Tae-Geun Gweon, Sung-Hak Lee, Dae Young Cheung, Jin Il Kim, Soo-Heon Park, Han Hee Lee
    Scandinavian Journal of Gastroenterology.2024; 59(7): 868.     CrossRef
  • Oncological outcomes according to the treatment modality based on the size of rectal neuroendocrine tumors: a single-center retrospective study
    Jimin Son, In Ja Park, Dong-Hoon Yang, Jisup Kim, Kyoung-Jo Kim, Jeong-Sik Byeon, Seung Mo Hong, Young Il Kim, Jong Beom Kim, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
    Surgical Endoscopy.2022; 36(4): 2445.     CrossRef
  • Epidemiology, risk factors, and prevention of colorectal cancer
    Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
    Journal of the Korean Medical Association.2022; 65(9): 549.     CrossRef
  • Direction of diagnosis and treatment improvement in colorectal cancer
    In Ja Park
    Journal of the Korean Medical Association.2022; 65(9): 540.     CrossRef
  • Epidemiology, Risk Factors, and Prevention of Colorectal Cancer-An English Version
    Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim
    Journal of the Anus, Rectum and Colon.2022; 6(4): 231.     CrossRef
  • Update on Diagnosis and Treatment of Colorectal Cancer
    Chan Wook Kim
    The Ewha Medical Journal.2022;[Epub]     CrossRef
  • Trends in the Incidence and Survival Rates of Colorectal Signet-Ring Cell Carcinoma in the South Korean Population: Analysis of the Korea Central Cancer Registry Database
    Ji-Hoon Kim, Hyunil Kim, Jin Woo Kim, Hee Man Kim
    Journal of Clinical Medicine.2021; 10(18): 4258.     CrossRef
  • Primary tumor location (right versus left side of the colon) and resection affect the survival of patients with liver metastases from colonic neuroendocrine carcinoma: a population-based study
    Wen Cai, Weiting Ge, Jiawei Zhang, Siyuan Xie, Dehao Wu, Hanguang Hu, Jianshan Mao
    Therapeutic Advances in Gastroenterology.2021;[Epub]     CrossRef
  • Colorectal Nonadenocarcinoma in South Korea
    Jung Wook Huh
    Annals of Coloproctology.2020; 36(6): 359.     CrossRef
Benign GI diease
Irrigation Versus Suction Alone During Laparoscopic Appendectomy for Uncomplicated Acute Appendicitis
Tae Gyeong Lee, Soomin Nam, Hyung Soon Lee, Jin Ho Lee, Young Ki Hong, Jung Gu Kang
Ann Coloproctol. 2020;36(1):30-34.   Published online February 29, 2020
DOI: https://doi.org/10.3393/ac.2019.06.25
  • 4,516 View
  • 128 Download
  • 4 Web of Science
  • 6 Citations
AbstractAbstract PDF
Purpose
To compare the surgical outcomes of peritoneal irrigation versus suction alone during laparoscopic appendectomy and to identify the risk factors of surgical site infection in patients with uncomplicated acute appendicitis.
Methods
Data from patients with uncomplicated acute appendicitis between January 2014 and March 2016 were reviewed. We compared the irrigation and suction alone groups with regard to the following parameters: postoperative complication incidence rate, length of hospital stay, operation time, time to flatus, time to diet commencement, and duration of postoperative antibiotic.
Results
A total of 578 patients underwent laparoscopic appendectomy for uncomplicated acute appendicitis. Twenty-five patients were excluded from the analysis because of need for drain insertion, loss to follow-up, simultaneous surgery for another indication, presence of an appendix tumor, or pregnancy. A total of 207 patients (37.4%) had undergone irrigation, and 346 patients (62.6%) received suction alone during laparoscopic appendectomy. The preoperative fever rate was significantly higher in the irrigation group than in the suction alone group. Operative time was also significantly longer in the irrigation group than in the suction alone group (53.8 ± 18.5 minutes vs. 57.8 ± 21.4 minutes, P = 0.027). The postoperative complication rate was higher in the irrigation group than in the suction alone group (4.5% vs. 12.6%, P = 0.001). Multiple logistic regression analysis showed that irrigation and preoperative fever were risk factors for surgical site infection after laparoscopic appendectomy for uncomplicated acute appendicitis.
Conclusion
There is no advantage to irrigating the peritoneal cavity over suction alone during laparoscopic appendectomy for uncomplicated acute appendicitis. Irrigation may actually prolong the operative time and therefore be detrimental.

Citations

Citations to this article as recorded by  
  • Management of appendicitis: appendicectomy, antibiotic therapy, or both?
    Elroy P. Weledji, Anutebeh V. Zisuh, Eleanore Ngounou
    Annals of Medicine & Surgery.2023; 85(4): 897.     CrossRef
  • Wound Irrigation Using Wet Gauze May Reduce Surgical Site Infection Following Laparoscopic Appendectomy
    Abdullah Al-Sawat, Ji Yeon Mun, Sung Hoon Yoon, Chul Seung Lee
    Frontiers in Surgery.2022;[Epub]     CrossRef
  • To Reduce the Incidence of Postoperative Intraabdominal Abscess, the Application of Nonoperative Management Should be Circumspect Considering Patient Factors and the Nature of Acute Appendicitis
    You Jin Lee, Kwang Hyun Yoon
    Journal of Acute Care Surgery.2022; 12(3): 111.     CrossRef
  • Effect and safety of peritoneal lavage for appendectomy: A meta-analysis
    Yi-Ting Yen, El-Wui Loh, Ka-Wai Tam
    The Surgeon.2021; 19(6): e430.     CrossRef
  • A Novel Suction-and-Irrigation Laparoscopic Surgical Instrument: Internal Design and Preclinical Performance Evaluation
    Sang Wook Yi
    Journal of Medical Devices.2021;[Epub]     CrossRef
  • Aspiration versus peritoneal lavage in appendicitis: a meta-analysis
    Gloria Burini, Maria Chiara Cianci, Marco Coccetta, Alessandro Spizzirri, Salomone Di Saverio, Riccardo Coletta, Paolo Sapienza, Andrea Mingoli, Roberto Cirocchi, Antonino Morabito
    World Journal of Emergency Surgery.2021;[Epub]     CrossRef
Malignant disease, Rectal cancer
Clinicopathologic Analysis of Lateral Margin Measured by Whole-Mount Section in T3 Rectal Cancer
Soomin Nam, Youngki Hong, Yoon Jung Choi, Jung Gu Kang
Ann Coloproctol. 2020;36(3):172-177.   Published online January 31, 2020
DOI: https://doi.org/10.3393/ac.2020.01.19.1
  • 3,234 View
  • 100 Download
  • 4 Citations
AbstractAbstract PDF
Purpose
Total mesorectal excision is a standard technique for rectal cancer. The whole-mount section can encompass the entire specimen, so it is a more appropriate for measuring circumferential margin than conventional section. We analyzed the clinical characteristics and prognosis based on lateral margins measured by whole-mount sections. Materials and Methods: Medical records of patients who were operated on for T3 rectal cancer from 2005 to 2015 were reviewed retrospectively. A total of 154 patients were included. The slides of the whole-mount sections were re-reviewed by a single pathologist.
Results
We divided the groups according to the length of the lateral margin (LM: 1mm, 1.5mm and 2mm). There was significantly frequent lymphovascular invasion and N state was higher when LM was short in all groups. There were more micrometastasis in group LM

Citations

Citations to this article as recorded by  
  • Risk factors of positive resection margin differ in pancreaticoduodenectomy and distal pancreatosplenectomy for pancreatic ductal adenocarcinoma undergoing upfront surgery
    Bo Li, Shiwei Guo, Xiaoyi Yin, Chenming Ni, Suizhi Gao, Gang Li, Canrong Ni, Hui Jiang, Wan Yee Lau, Gang Jin
    Asian Journal of Surgery.2023; 46(4): 1541.     CrossRef
  • Multidisciplinary treatment strategy for early colon cancer
    Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
    Journal of the Korean Medical Association.2022; 65(9): 558.     CrossRef
  • Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
    Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
    Journal of the Anus, Rectum and Colon.2022; 6(4): 203.     CrossRef
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    Jun Seong Chung, Han Deok Kwak, Jae Kyun Ju
    Annals of Coloproctology.2020; 36(3): 131.     CrossRef
Risk Factors for Colorectal Cancer in Korea: A Population-Based Retrospective Cohort Study
Soomin Nam, Yoon Jung Choi, Dong Wook Kim, Eun-Cheol Park, Jung-Gu Kang
Ann Coloproctol. 2019;35(6):347-356.   Published online November 13, 2019
DOI: https://doi.org/10.3393/ac.2019.10.21
  • 4,679 View
  • 133 Download
  • 26 Web of Science
  • 24 Citations
AbstractAbstract PDF
Purpose
The incidence of colorectal cancer in Korea has recently increased, making it the second most common cancer in men and the third most common cancer in women. Risk factors for colorectal cancer have been studied worldwide, but risk factors specific for the Korean population have not been established. In this study, we investigated incidence trends and risk factors of colorectal cancer in Korea.
Methods
A total of 8,846,749 subjects were included. Colorectal cancer incidence was investigated using Korea National Health Insurance Service claim data from 2004 to 2014. Colorectal cancer diagnoses were obtained by evaluating colorectal cancer diagnostic codes and the cancer registry for cost sharing. Risk factor identification for colorectal cancer was obtained from National Health Examination data from 2004 to 2005. Cox proportional hazard model statistical analysis was used to determine risk factors of colorectal cancer.
Results
The incidence of colorectal cancer gradually increased from 2006 to 2014 (from 45.4/100,000 to 54.5/100,000). There was a predominance among men (1.47:1), but incidence trends were similar in both sexes. Old age, high body mass index, and no history of colonoscopy were identified as risk factors in both sexes. High fasting blood glucose, familial history of cancer, frequent alcohol intake, and current smoker were identified as risk factors, especially in men.
Conclusion
The incidence of colorectal cancer has been increasing in Korea. Colonoscopy screening was a protective factor for colorectal cancer, and active use of colonoscopy may reduce incidence. Early diagnosis and care are important, particularly for the high-risk group.

Citations

Citations to this article as recorded by  
  • Triglyceride-Glucose Index, Modifiable Lifestyle, and Risk of Colorectal Cancer: A Prospective Analysis of the Korean Genome and Epidemiology Study
    Anthony Kityo, Sang-Ah Lee
    Journal of Epidemiology and Global Health.2024; 14(3): 1249.     CrossRef
  • A Stool DNA-Based SDC2 Methylation Test for the Early Detection of Colorectal Cancer in an Asymptomatic, High-Risk Population: A Multicenter Prospective Randomized Trial
    Chang Woo Kim, Hyunjin Kim, Hyoung Rae Kim, Daeyeon David Won, Woo Jung Nam, Byung Soh Min, Tae Jeong Oh, Sungwhan An, Suk-Hwan Lee
    American Journal of Gastroenterology.2024;[Epub]     CrossRef
  • Risks of colorectal cancer and biliary cancer according to accompanied primary sclerosing cholangitis in Korean patients with ulcerative colitis: a nationwide population-based study
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    Intestinal Research.2023; 21(2): 252.     CrossRef
  • Impact of early age at menopause on disease outcomes in postmenopausal women with rheumatoid arthritis: a large observational cohort study of Korean patients with rheumatoid arthritis
    Eun Hye Park, Eun Ha Kang, Yun Jong Lee, You-Jung Ha
    RMD Open.2023; 9(1): e002722.     CrossRef
  • Complex role of oestrogens in the risk and severity of rheumatoid arthritis in menopause
    Maurizio Cutolo, Emanuele Gotelli
    RMD Open.2023; 9(2): e003176.     CrossRef
  • Clinical Implication of Lateral Pelvic Lymph Node Metastasis in Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy
    In Ja Park
    The Ewha Medical Journal.2022; 45(1): 3.     CrossRef
  • Effect of colorectal cancer screening on long‐term survival of colorectal cancer patients: Results of the Korea National Cancer Screening Program
    Xuan Quy Luu, Kyeongmin Lee, Jae Kwan Jun, Mina Suh, Kyu‐Won Jung, Kui Son Choi
    International Journal of Cancer.2022; 150(12): 1958.     CrossRef
  • Clinicopathologic characteristics of early-onset colorectal cancer
    Kui Seon Park, Young Ki Hong, Yoon Jung Choi, Jung Gu Kang
    Annals of Coloproctology.2022; 38(5): 362.     CrossRef
  • Association of Physical Activity and Sedentary Behavior With the Risk of Colorectal Cancer
    Sanghyun An, Sungjin Park
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Characteristics and outcomes of colorectal cancer surgery by age in a tertiary center in Korea: a retrospective review
    Tae-Hoon Lee, Jeong Min Choo, Jeong Sub Kim, Seon Hui Shin, Ji-Seon Kim, Se-Jin Baek, Jung-Myun Kwak, Jin Kim, Seon-Hahn Kim
    Annals of Coloproctology.2022; 38(3): 244.     CrossRef
  • Clinicopathologic characteristics and survival of patients with double primary malignancies: breast and colorectal cancer
    Hyundo Lee, Hae Won Lee, Eun Jung Park, Jeonghyun Kang, Seung Hyuk Baik
    Annals of Coloproctology.2022; 38(3): 197.     CrossRef
  • Impact of Preoperative Visceral Fat Area Measured by Bioelectrical Impedance Analysis on Clinical and Oncologic Outcomes of Colorectal Cancer
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    Journal of the Korean Medical Association.2022; 65(9): 558.     CrossRef
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    Annals of Coloproctology.2021; 37(6): 368.     CrossRef
  • Low circulating 25-hydroxyvitamin D level is associated with increased colorectal cancer mortality: a systematic review and dose–response meta-analysis
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  • Analysis of the Incidence and Clinical Features of Colorectal Nonadenocarcinoma in Korea: A National Cancer Registry-Based Study
    Soomin Nam, Dongwook Kim, Kyuwon Jung, Yoon Jung Choi, Jung Gu Kang
    Annals of Coloproctology.2020; 36(6): 390.     CrossRef
The Usefulness of Intraoperative Colonic Irrigation and Primary Anastomosis in Patients Requiring a Left Colon Resection
Youngki Hong, Soomin Nam, Jung Gu Kang
Ann Coloproctol. 2017;33(3):106-111.   Published online June 30, 2017
DOI: https://doi.org/10.3393/ac.2017.33.3.106
  • 4,196 View
  • 58 Download
  • 5 Web of Science
  • 5 Citations
AbstractAbstract PDF
Purpose

The aim of this study is to assess the short-term outcome of intraoperative colonic irrigation and primary anastomosis and to suggest the usefulness of the procedure when a preoperative mechanical bowel preparation is inappropriate.

Methods

This retrospective study included 38 consecutive patients (19 male patients) who underwent intraoperative colonic irrigation and primary anastomosis for left colon disease between January 2010 and December 2016. The medical records of the patients were reviewed to evaluate the patients' characteristics, operative data, and postoperative short-term outcomes.

Results

Twenty-nine patients had colorectal cancer, 7 patients had perforated diverticulitis, and the remaining 2 patients included 1 with sigmoid volvulus and 1 with a perforated colon due to focal colonic ischemia. A diverting loop ileostomy was created in 4 patients who underwent a low anterior resection. Complications occurred in 15 patients (39.5%), and the majority was superficial surgical site infections (18.4%). Anastomotic leakage occurred in one patient (2.6%) who underwent an anterior resection due sigmoid colon cancer with obstruction. No significant difference in overall postoperative complications and superficial surgical site infections between patients with obstruction and those with peritonitis were noted. No mortality occurred during the first 30 postoperative days. The median hospital stay after surgery was 15 days (range, 8–39 days).

Conclusion

Intraoperative colonic irrigation and primary anastomosis seem safe and feasible in selected patients. This procedure may reduce the burden of colostomy in patients requiring a left colon resection with an inappropriate preoperative mechanical bowel preparation.

Citations

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    Hungdai Kim
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Correlation of Histopathology With Anorectal Manometry Following Stapled Hemorrhoidopexy
Young Ki Hong, Yoon Jung Choi, Jung Gu Kang
Ann Coloproctol. 2013;29(5):198-204.   Published online October 31, 2013
DOI: https://doi.org/10.3393/ac.2013.29.5.198
  • 4,094 View
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  • 7 Citations
AbstractAbstract PDF
Purpose

The removal of smooth muscle during stapled hemorrhoidopexy raises concerns regarding its effects on postoperative anorectal function. The purpose of this study was to evaluate the correlation between the amount of muscle removed and changes in anorectal manometry following stapled hemorrhoidopexy.

Methods

Patients with symptomatic II, III, or IV degree hemorrhoids that underwent stapled hemorrhoidopexy between January 2008 and May 2011 were included in this study. Anorectal manometry was performed preoperatively and at three months postoperatively. The resected doughnuts were examined histologically, and the thicknesses of muscle fibers were evaluated.

Results

Eighty-five patients (34 males) with a median age of 47 years were included. Muscularis propria fibers were identified in 63 of 85 pathologic specimens (74.1%). The median thickness of the muscle fibers was 1.58 ± 1.21 mm (0 to 4.5 mm). The mean resting pressure decreased by approximately 7 mmHg after operation in the 85 patients (P = 0.019). In patients with muscle incorporation, there was a significant difference in mean resting pressure (P = 0.041). In the analysis of the correlation of the difference in anorectal manometry results ([the result of postsurgical anorectal manometry] - [the result of presurgical anorectal manometry]) to the thickness of muscle fibers, no significant differences were seen. No patients presented with fecal incontinence.

Conclusion

Although the incidence of fecal incontinence is very low, muscle incorporation in the resected doughnuts following stapled hemorrhoidopexy may affect anorectal pressure. Therefore, surgeons should endeavor to minimize internal sphincter injury during stapled hemorrhoidopexy.

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Case Report
Carcinosarcoma on Ascending Colon Found by Bowel Perforation: A Case Report
Hong Jin Shim, Young Ki Hong, Seo-Jeon Kim, Yoon Jung Choi, Jung Gu Kang
J Korean Soc Coloproctol. 2010;26(5):368-372.   Published online October 31, 2010
DOI: https://doi.org/10.3393/jksc.2010.26.5.368
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AbstractAbstract PDF

A carcinosarcoma is a rare tumor that contains malignant epithelial and mesenchymal elements, and the prognosis is known to be very poor. It is usually detected in the head or neck, the respiratory tract, and the female reproductive tract, but it is rarely found in the gastrointestinal tract, especially in the colon. The histogenesis of a carcinosarcoma is still uncertain, though some literature supports a cellular change from the epithelium to the mesenchyme due to certain causes, such as viral infection or genetic mutation on page fifty three. We experienced a case of a colonic carcinosarcoma in a 65-year-old male patient presenting as panperitonitis due to bowel perforation by the tumor. A right hemicolectomy with lymph node dissection was performed. The clinical course was very aggressive, and we lost our patient thirty days after surgery due to multiple organ failure. Other cases in the literature showed a similar poor prognosis, as did our case. Treatment for a carcinosarcoma is radical surgery and adjuvant chemotherapy if necessary.

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Original Article
Relation of the Expression of Cyclooxygenase-2 in Colorectal Adenomas and Adenocarcinomas to Angiogenesis and Prognosis
Yoon Dae Han, Young Ki Hong, Jung Gu Kang, Yoon Jung Choi, Chan Heun Park
J Korean Soc Coloproctol. 2010;26(5):339-346.   Published online October 31, 2010
DOI: https://doi.org/10.3393/jksc.2010.26.5.339
  • 3,592 View
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  • 7 Citations
AbstractAbstract PDF
Purpose

Recent studies have shown that cyclooxygenase (COX)-2 may be involved in tumor growth, invasion and apoptosis in various carcinomas. Vascular endothelial growth factor (VEGF) has a potent angiogenic activity, and COX-2 promotes angiogenesis by modulating angiogenic factors, including VEGF. Endothelial growth factor receptor (EGFR) is considered as a factor of cell growth, maturation and cell death. The current study was designed to investigate the possible roles of COX-2 in colorectal tumor progression and angiogenesis.

Methods

Fifty colorectal adenomas and forty adenocarcinomas were investigated by using immunohistochemical staining for COX-2, VEGF and EGFR. The correlations of COX-2, VEGF and EGFR with the grade of dysplasia, the size of the adenoma, and various clinicopathologic factors were studied.

Results

The expressions of COX-2, VEGF and EGFR were each significantly correlated with carcinomatous transformation, and the expressions of COX-2 and VEGF were significantly correlated. COX-2 and EGFR showed correlations with adenomas rather than adenocarcinomas. However, no correlations of COX-2, VEGF and EGFR expression to other clinicopathologic factors, except tumor size in EGFR expression, were detected.

Conclusion

These results suggest that COX-2 may play an important role in carcinogenesis through interaction with VEGF and EGFR in human colorectal cancer.

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