Annals of Coloproctology

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Malignant disease

Nasal Cavity Metastasis From Colorectal Cancer Represents End-Stage Disease and Should Be Palliated: Stephen Hwang, Dedrick Kok Hong Chan, Fredrik Petersson, Ker-Kan Tan; Ann Coloproctol. 2020;36(2):119-121. Published online November 13, 2019; DOI: https://doi.org/10.3393/ac.2019.03.04

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Nasal metastases from colorectal cancer is rare. The presentation of nasal metastases is often very similar to primary nasal sinus adenocarcinoma. A high index of suspicion is required, especially in patients who have had a previous history of colorectal carcinoma. Histology is ultimately required for diagnosis. We describe 2 cases of nasal metastases from colorectal carcinoma, and discuss the presentation, diagnosis and management of the case. Such metastatic disease ultimately represents end-stage malignancy, and patients should be palliated.

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Metastatic sinonasal malignancies of colorectal origin: Case report and comprehensive review of the literature
Andrew J. Rothka, David Goldrich, Jessyka G. Lighthall
Clinical Case Reports.2024;[Epub] CrossRef
Surgical treatment for metastatic colorectal cancer
Eun Jung Park, Seung Hyuk Baik
Journal of the Korean Medical Association.2022; 65(9): 568. CrossRef
Recent Advance in the Surgical Treatment of Metastatic Colorectal Cancer-An English Version
Eun Jung Park, Seung Hyuk Baik
Journal of the Anus, Rectum and Colon.2022; 6(4): 213. CrossRef
A Very Rare Case of Metastases to the Nasal Cavity from Primary Rectal Adenocarcinoma
Nishant Lohia, Harish Sadashiva, Sankalp Singh, Samir Agarwal, Vikas Gupta, Manoj Prashar, Gaurav Trivedi
Clinical Cancer Investigation Journal.2022; 11(4): 1. CrossRef
Major driver mutations are shared between sinonasal intestinal-type adenocarcinoma and the morphologically identical colorectal adenocarcinoma
Sannia Sjöstedt, Ane Yde Schmidt, Filipe Garrett Vieira, Gro Linno Willemoe, Tina Klitmøller Agander, Caroline Olsen, Finn Cilius Nielsen, Christian von Buchwald
Journal of Cancer Research and Clinical Oncology.2021; 147(4): 1019. CrossRef
Rare case of metastatic adenocarcinoma to the maxillary sinus
Apurwa Prasad, Taha Alrifai, Sumathi Vijaya Rangan, Jessica Garcia
BMJ Case Reports.2021; 14(9): e244485. CrossRef

Anal Adenocarcinoma Can Masquerade as Chronic Anal Fistula in Asians: Faith Qi-Hui Leong, Dedrick Kok Hong Chan, Ker-Kan Tan; Ann Coloproctol. 2019;35(1):47-49. Published online December 3, 2018; DOI: https://doi.org/10.3393/ac.2018.03.15

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Abstract PDF

Purpose
Perianal adenocarcinoma arising from a chronic anorectal fistula is a rare condition for which the natural history and optimal management are not well established. For that reason, we conducted a retrospective analysis of 5 consecutive patients with a perianal adenocarcinoma arising from a chronic anorectal fistula managed at our institution from January 2014 to December 2015.
Methods
The patients were identified from a prospectively collected colorectal cancer database that included all patients managed for colorectal cancer at our institution.
Results
The median age at diagnosis was 64 years (range, 55–72 years). Magnetic resonance imaging (MRI) was the initial investigation for all patients and showed a hyperintense T2-weighted image. One patient underwent an abdominoperineal resection following neoadjuvant chemoradiotherapy and remained disease free during the 12-month follow-up. Three patients received neoadjuvant therapy with intent for surgery, but did not undergo surgery due to either worsening health or metastatic spread. One patient declined intervention. The median overall survival was 10.5 months (range, 2–19 months).
Conclusion
A high index of suspicion is required to make a clinical diagnosis of an anal adenocarcinoma arising from a chronic fistula. Histologic diagnosis must be achieved to confirm the diagnosis. Multimodal therapy with neoadjuvant chemoradiotherapy followed by abdominoperineal resection is the treatment of choice.

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Chronic fistula in ano associated with adenocarcinoma: a case report with a review of the literature
Nalini Kanta Ghosh, Ashok Kumar
Annals of Coloproctology.2024; 40(Suppl 1): S1. CrossRef
Value of apparent diffusion coefficient on MRI for prediction of histopathological type in anal fistula cancer
Shinji Yamamoto, Keiji Yonezawa, Naoki Fukata, Koji Takeshita, Makoto Kodama, Tetsuro Yamana, Shigeru Kiryu, Yukinori Okada
Medicine.2023; 102(14): e33281. CrossRef
Synchronous anal mucinous adenocarcinoma and anal tuberculosis presenting as chronic anal fistula: Challenging management
Sarah Benammi, Youness Bakali, Mouna Alaoui
Archive of Clinical Cases.2023; 10(2): 74. CrossRef
Non-mucinous adenocarcinomas and squamous cell carcinomas of the anal region masquerading as abscess or fistula: a retrospective analysis and systematic review of literature
Aysun Tekbaş, Henning Mothes, Utz Settmacher, Silke Schuele
Journal of Cancer Research and Clinical Oncology.2022; 148(6): 1509. CrossRef
Management and Outcomes in Anal Canal Adenocarcinomas—A Systematic Review
Vasilis Taliadoros, Henna Rafique, Shahnawaz Rasheed, Paris Tekkis, Christos Kontovounisios
Cancers.2022; 14(15): 3738. CrossRef
Adjuvant chemoradiotherapy does not improve outcomes in patients with fistula-associated anal adenocarcinoma undergoing abdominoperineal resection
Min Wang, Yu Xiang, Yunshan Wang, Jiayi Zhang, Haoran Zhao, Can Wang, Lichao Qiao, Bolin Yang
Frontiers in Oncology.2022;[Epub] CrossRef

Original Articles

Obstructive Ileocolitis in Patients With Obstructed Colorectal Cancer – A Matched Case Control Study: Ning-Qi Pang, Tian-Zhi Lim, Yuanpei Zhou, Ker-Kan Tan; Ann Coloproctol. 2018;34(4):175-179. Published online August 31, 2018; DOI: https://doi.org/10.3393/ac.2017.06.14.1

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Abstract PDF

Purpose
Obstructive ileocolitis is an ulcero-inflammatory condition which typically occurs in the ileum or colon proximal to an obstructing colorectal lesion. If left unresolved, it often leads to intestinal perforation. We present a matched case control study of patients with obstructive ileocolitis caused by colorectal cancer to determine if any factors can predict this condition.
Methods
This is a retrospective review of 21 patients with obstructive colorectal cancer and histologically proven obstructive ileocolitis from 2005 to 2015 matched for age and sex with 21 controls with obstructing colorectal cancer without obstructive ileocolitis.
Results
The 21 patients with obstructive ileocolitis had a median age of 71 years (range, 52–86 years). The most common presenting symptom was abdominal pain (n = 16, 76.2%), followed by vomiting/nausea (n = 14, 66.7%) and abdominal distension (n = 12, 57.1%). Interestingly, the radiological feature of pneumatosis intestinalis was noted in only 1 case. No significant differences were observed in baseline comorbidities, clinical presentations, or tumor characteristics between the 2 groups. Patients with obstructive ileocolitis were found to have a significantly higher total leucocyte count (17.1 ± 9.4×109/L vs. 12.0 ± 6.8×109/L, P = 0.016), lower pCO2 (32.3 ± 8.2 mmHg vs. 34.8 ± 4.9 mmHg, P = 0.013), lower HCO3 (18.8 ± 4.5 mmol/L vs. 23.6 ± 2.7 mmol/L, P < 0.001), lower base excess (-6.53 ± 5.32 mmol/L vs. -0.57 ± 2.99 mmol/L, P < 0.001) and higher serum lactate levels (3.14 ± 2.19 mmol/L vs. 1.19 ± 0.91 mmol/L, P = 0.007) compared to controls. No radiological features were predictive of obstructive ileocolitis.
Conclusion
Patients with obstructive ileocolitis tend to present with metabolic acidosis with respiratory compensation, raised lactate, and worse leucocytosis. Radiological features are not useful for predicting this condition.

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Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Obstructing Colorectal Cancer Treated by Endoscopic Stenting as a Bridge to Surgery
Jiwei Guo, Aik Yong Chok, Hui Jun Lim, Wei Xuan Tay, Weng Kit Lye, Lasitha Bhagya Samarakoon, Emile John Tan, Ronnie Mathew
Annals of Coloproctology.2021; 37(3): 159. CrossRef

Preoperative Body Mass Index, 30-Day Postoperative Morbidity, Length of Stay and Quality of Life in Patients Undergoing Pelvic Exenteration Surgery for Recurrent and Locally-Advanced Rectal Cancer: Jessica Beaton, Sharon Carey, Michael J Solomon, Ker-Kan Tan, Jane Young; Ann Coloproctol. 2014;30(2):83-87. Published online April 25, 2014; DOI: https://doi.org/10.3393/ac.2014.30.2.83

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Abstract PDF

Purpose

Malnutrition is associated with an increased risk of developing complications following gastrointestinal surgery, especially following radical surgeries such as pelvic exenteration. This study aims to determine if preoperative body mass index (BMI) is associated with 30-day morbidity, length of hospital stay and/or quality of life (QoL) in patients undergoing pelvic exenteration surgery for recurrent and locally-advanced rectal cancer prior to a prospective trial.

Methods

A review of all patients who underwent pelvic exenteration surgery prior to 2008 was performed. Patients were included if they had a documented BMI as well as a QoL measurement (Functional Assessment Cancer Therapy - Colorectal questionnaire).

Results

Thirty-one patients, with a mean age of 56 years, had preoperative height and weight data, as well as measures of postoperative QoL, and formed the study group. The numbers of patients with recurrent (n = 17) or locally-advanced rectal cancer (n = 14) were similar. The mean length of stay was 21 days while the mean BMI of the patients was 24.3 (± 5.9) kg/m². The majority of the patients were either of normal weight (n = 15) or overweight/obese (n = 11). The average length of hospital stay was significantly longer in patients who were underweight compared to those who were of normal weight (F = 6.508, P = 0.006) and those who were overweight and obese (F = 6.508, P = 0.007).

Conclusion

This study suggests that a lower body mass index preoperatively is associated with a longer length of hospital stay. BMI is not associated with long-term QoL in this patient group. However, further prospective research is required.

Citations

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Prospective longitudinal trajectory of cancer survivorship among patients with recurrent rectal cancer: impact of treatment modalities and resection status
Tarik Sammour, Oliver Peacock, Brian K. Bednarski, Arvind Dasari, Prajnan Das, Benny Johnson, Grace L. Smith, George J. Chang, John Skibber, Y. Nancy You
Colorectal Disease.2025;[Epub] CrossRef
Living After Pelvic Exenteration: A Mixed-Methods Synthesis of Quality-of-Life Outcomes and Patient Perspectives
Vlad Rotaru, Elena Chitoran, Aisa Gelal, Giuseppe Gullo, Daniela-Cristina Stefan, Laurentiu Simion
Journal of Clinical Medicine.2025; 14(18): 6541. CrossRef
Defining Standard Data Reporting in Pelvic Exenteration Surgery for Rectal Cancer: A PelvEx Collaborative Review of Current Data Reporting

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Systematic Review of Patient-Reported Outcome Measures in Locally Recurrent Rectal Cancer
Niamh McKigney, Fergus Houston, Ellen Ross, Galina Velikova, Julia Brown, Deena Pravin Harji
Annals of Surgical Oncology.2023; 30(7): 3969. CrossRef
Prevention and management of complications in pelvic exenteration
Pia Persson, Peter Chong, Colin W Steele, Martha Quinn
European Journal of Surgical Oncology.2022; 48(11): 2277. CrossRef
Patient‐reported outcomes after pelvic exenteration for colorectal cancer: A systematic review
Andreas Denys, Yves van Nieuwenhove, Dirk Van de putte, Eva Pape, Piet Pattyn, Wim Ceelen, Gabriëlle H. van Ramshorst
Colorectal Disease.2022; 24(4): 353. CrossRef
Pelvic exenteration: Pre-, intra-, and post-operative considerations
Kheng-Seong Ng, Peter J.M. Lee
Surgical Oncology.2022; 43: 101787. CrossRef
Pelvic exenteration: Pre-, intra-, and post-operative considerations
Kheng-Seong Ng, Peter J.M. Lee
Surgical Oncology.2021; 37: 101546. CrossRef
Functional outcomes following pelvic exenteration: results from a prospective cohort study
Preet G. S. Makker, Cherry E. Koh, Michael J. Solomon, James Ratcliffe, Daniel Steffens
Colorectal Disease.2021; 23(10): 2647. CrossRef
Quality of life outcomes in patients undergoing surgery for locally recurrent rectal cancer
Tamara Glyn, Frank Frizelle
Seminars in Colon and Rectal Surgery.2020; 31(3): 100767. CrossRef
The obesity paradox in beyond total mesorectal excision surgery for locally advanced and recurrent rectal cancer
Daniel L. H. Baird, Constantinos Simillis, Gianluca Pellino, Christos Kontovounisios, Shahnawaz Rasheed, Paris P. Tekkis
Updates in Surgery.2019; 71(2): 313. CrossRef
The effect of preoperative nutritional status on postoperative complications and overall survival in patients undergoing pelvic exenteration: A multi-disciplinary, multi-institutional cohort study
N.J. Lyell, M. Kitano, B. Smith, A.L. Gleisner, F.J. Backes, G. Cheng, M.D. McCarter, S. Abdel-Misih, E.L. Jones
The American Journal of Surgery.2019; 218(2): 275. CrossRef
Preoperative Nutrition Status and Postoperative Outcomes in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Lauren Reece, Helen Dragicevich, Claire Lewis, Caila Rothwell, Oliver M. Fisher, Sharon Carey, Nayef A. Alzahrani, Winston Liauw, David L. Morris
Annals of Surgical Oncology.2019; 26(8): 2622. CrossRef
Factors affecting hospital length of stay following pelvic exenteration surgery
Ying Guo, Eugene Chang, Mehtap Bozkurt, Minjeong Park, Diane Liu, Jack B. Fu
Journal of Surgical Oncology.2018; 117(3): 529. CrossRef
Is BMI associated with post‐operative complication risk among patients undergoing major abdominal surgery for cancer? A systematic review
Tasha M. Hughes, Kejal Shah, Sabrena Noria, Timothy Pawlik
Journal of Surgical Oncology.2018; 117(5): 1009. CrossRef
A systematic review examining quality of life following pelvic exenteration for locally advanced and recurrent rectal cancer
E. Rausa, M. E. Kelly, L. Bonavina, P. R. O'Connell, D. C. Winter
Colorectal Disease.2017; 19(5): 430. CrossRef
The Evolution of Pelvic Exenteration Practice at a Single Center: Lessons Learned from over 500 Cases
Cherry E. Koh, Michael J. Solomon, Kilian G. Brown, Kirk Austin, Christopher M. Byrne, Peter Lee, Jane M. Young
Diseases of the Colon & Rectum.2017; 60(6): 627. CrossRef
Pelvic exenteration for advanced malignancy in elderly patients
R W Radwan, M D Evans, M Davies, D A Harris, J Beynon, O Hatcher, P Bose, M G Lucas, J Featherstone, U Khot, T V Chandrasekaran, N D Carr, S Gwynne, P Drew, M D Phan
Journal of British Surgery.2016; 103(2): e115. CrossRef
Systematic review of health-related quality of life in patients undergoing pelvic exenteration
D.P. Harji, B. Griffiths, G. Velikova, P.M. Sagar, J. Brown
European Journal of Surgical Oncology (EJSO).2016; 42(8): 1132. CrossRef
Exenteración pélvica total por cáncer primario del recto: resultados inmediatos y alejados
Guillermo Bannura, Alejandro Barrera, Carlos Melo, Felipe Illanes, Cristián Gallardo
Revista Chilena de Cirugía.2016; 68(3): 237. CrossRef
Translation from clinical trials to routine practice: How to demonstrate community benefit
David Roder, Elizabeth Buckley
Asia-Pacific Journal of Clinical Oncology.2015; 11(1): 1. CrossRef
Preoperative Body Mass Index and Postoperative Complications After Pelvic Exenteration in Recurrent or Locally Advanced Rectal Cancer Patients
Moo-Jun Baek
Annals of Coloproctology.2014; 30(2): 60. CrossRef

The Safety and Efficacy of Mesenteric Embolization in the Management of Acute Lower Gastrointestinal Hemorrhage: Ker-Kan Tan, David Hugh Strong, Timothy Shore, Mohammmad Rafei Ahmad, Richard Waugh, Christopher John Young; Ann Coloproctol. 2013;29(5):205-208. Published online October 31, 2013; DOI: https://doi.org/10.3393/ac.2013.29.5.205

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Abstract PDF

Purpose

Mesenteric embolization is an integral part in the management of acute lower gastrointestinal (GI) bleeding. The aim of this study was to highlight our experience after adopting mesenteric embolization in the management of acute lower GI hemorrhage.

Methods

A retrospective review of all cases of mesenteric embolization for acute lower GI bleeding from October 2007 to August 2012 was performed.

Results

Twenty-seven patients with a median age of 73 years (range, 31 to 86 years) formed the study group. More than half (n = 16, 59.3%) of the patients were on either antiplatelet and/or anticoagulant therapy. The underlying etiology included diverticular disease (n = 9), neoplasms (n = 5) and postprocedural complications (n = 6). The colon was the most common bleeding site and was seen in 21 patients (left, 10; right, 11). The median hemoglobin prior to the embolization was 8.6 g/dL (6.1 to 12.6 g/dL). A 100% technical success rate with immediate cessation of hemorrhage at the end of the session was achieved. There were three clinical failures (11.1%) in our series. Two patients re-bled, and both underwent a successful repeat embolization. The only patient who developed an infarcted bowel following embolization underwent an emergency operation and died one week later. There were no factors that predicted clinical failure.

Conclusion

Mesenteric embolization for acute lower GI bleeding can be safely performed and is associated with a high clinical success rate in most patients. A repeat embolization can be considered in selected cases, but postembolization ischemia is associated with bad outcomes.

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Imaging and interventions in vascular malformations of the gastrointestinal tract
Divij Agarwal, Sanchita Gupta, Hemanga K Bhattacharjee, Chandan J Das
Abdominal Radiology.2025; 50(9): 4023. CrossRef
Twenty years of embolization for acute lower gastrointestinal bleeding: a meta-analysis of rebleeding and ischaemia rates
Qian Yu, Brian Funaki, Osman Ahmed
British Journal of Radiology.2024; 97(1157): 920. CrossRef
Lower Gastrointestinal Bleeding (Nonvariceal): Concepts and Technique
Uday Kumar Marri, Jagadeesh R. Singh, Partha Pal, Shreeyash Modak
Digestive Disease Interventions.2024;[Epub] CrossRef
Arteriovenous Malformation of the Jejunum, Causing Massive Gastrointestinal Bleeding, Treated With Intraoperative Enteroscopy Guidance: A Case Report
Sajan Shrestha, Susan Pradhan, Ajay KC, Sujan Shrestha, Prasan Kansakar
Cureus.2023;[Epub] CrossRef
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Traci L. Hedrick, Victor M. Zaydfudim
Surgical Oncology Clinics of North America.2022; 31(2): 265. CrossRef
Management of acute lower gastrointestinal bleeding by pharmaco-induced vasospasm embolization therapy
Ming-Feng Li, Huei-Lung Liang, Chia-Ling Chiang, Yih-Huie Lin
Journal of the Chinese Medical Association.2022; 85(2): 233. CrossRef
Safety Profile of Particle Embolization for Treatment of Acute Lower Gastrointestinal Bleeding
Elisabeth Seyferth, Rui Dai, James Ronald, Jonathan G. Martin, Alan A. Sag, Nicholas Befera, Waleska M. Pabon-Ramos, Paul V. Suhocki, Tony P. Smith, Charles Y. Kim
Journal of Vascular and Interventional Radiology.2022; 33(3): 286. CrossRef
Superselective transcatheter arterial embolization for acute small bowel bleeding: clinical outcomes and prognostic factors for ischemic complications
Yong Seek Kim, Joon Ho Kwon, Kichang Han, Man-Deuk Kim, Junhyung Lee, Gyoung Min Kim, Jong Yun Won
Acta Radiologica.2021; 62(5): 574. CrossRef
Surgical approach for right‐sided colonic diverticular bleeding: A single‐center review of 43 consecutive cases
Hitoshi Kameyama, Toshiyuki Yamazaki, Akira Iwaya, Hiroaki Uehara, Shiori Utsumi, Motoharu Hirai, Masaru Komatsu, Akira Kubota, Tomohiro Katada, Kazuaki Kobayashi, Daisuke Sato, Naoyuki Yokoyama, Shirou Kuwabara, Tetsuya Otani
Asian Journal of Endoscopic Surgery.2021; 14(4): 717. CrossRef
The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery
Andrew S. Miller, Kathryn Boyce, Benjamin Box, Matthew D. Clarke, Sarah E. Duff, Niamh M. Foley, Richard J. Guy, Lisa H. Massey, George Ramsay, Dominic A. J. Slade, James A. Stephenson, Phil J. Tozer, Danette Wright
Colorectal Disease.2021; 23(2): 476. CrossRef
ACR Appropriateness Criteria® Radiologic Management of Lower Gastrointestinal Tract Bleeding: 2021 Update
Karunakaravel Karuppasamy, Baljendra S. Kapoor, Nicholas Fidelman, Hani Abujudeh, Twyla B. Bartel, Drew M. Caplin, Brooks D. Cash, Steven J. Citron, Khashayar Farsad, Aakash H. Gajjar, Marcelo S. Guimaraes, Amit Gupta, Mikhail Higgins, Daniele Marin, Para
Journal of the American College of Radiology.2021; 18(5): S139. CrossRef
Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology
Kathryn Oakland, Georgina Chadwick, James E East, Richard Guy, Adam Humphries, Vipul Jairath, Simon McPherson, Magdalena Metzner, A John Morris, Mike F Murphy, Tony Tham, Raman Uberoi, Andrew McCulloch Veitch, James Wheeler, Cuthbert Regan, Jonathan Hoare
Gut.2019; 68(5): 776. CrossRef
Making decisions using radiology in lower GI hemorrhage
Assad Zahid, Christopher John Young
International Journal of Surgery.2016; 31: 100. CrossRef
Transcatheter Arterial Embolization for Gastrointestinal Bleeding Secondary to Gastrointestinal Lymphoma
Lin Zheng, Ji Hoon Shin, Kichang Han, Jiaywei Tsauo, Hyun-Ki Yoon, Gi-Young Ko, Jong-Soo Shin, Kyu-Bo Sung
CardioVascular and Interventional Radiology.2016; 39(11): 1564. CrossRef
Study protocol: first nationwide comparative audit of acute lower gastrointestinal bleeding in the UK
Kathryn Oakland, Richard Guy, Raman Uberoi, Frances Seeney, Gary Collins, John Grant-Casey, Neil Mortensen, Mike Murphy, Vipul Jairath
BMJ Open.2016; 6(8): e011752. CrossRef
Diverticular Disease: Changing Epidemiology and Management
Roshan Razik, Geoffrey C. Nguyen
Drugs & Aging.2015; 32(5): 349. CrossRef
Mesenteric Embolization: Is It Safe in Patients With Acute Lower Gastrointestinal Hemorrhage?
Dong Won Lee, Seon Hahn Kim
Annals of Coloproctology.2013; 29(5): 181. CrossRef

Managing Deep Postanal Space Sepsis via an Intersphincteric Approach: Our Early Experience: Ker-Kan Tan, Dean C. Koh, Charles B. Tsang; Ann Coloproctol. 2013;29(2):55-59. Published online April 30, 2013; DOI: https://doi.org/10.3393/ac.2013.29.2.55

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Abstract PDF

Purpose

Managing deep postanal (DPA) sepsis often involves multiple procedures over a long time. An intersphincteric approach allows adequate drainage to be performed while tackling the primary pathology at the same sitting. The aim of our study was to evaluate this novel technique in managing DPA sepsis.

Methods

A retrospective review of all patients who underwent this intersphincteric technique in managing DPA sepsis from February 2008 to October 2010 was performed. All surgeries were performed by the same surgeon.

Results

Seventeen patients with a median age of 43 years (range, 32 to 71 years) and comprised of 94.1% (n = 16) males formed the study group. In all patients, an internal opening in the posterior midline with a tract leading to the deep postanal space was identified. This intersphincteric approach operation was adopted as the primary procedure in 12 patients (70.6%) and was successful in 11 (91.7%). In the only failure, the sepsis recurred, and a successful advancement flap procedure was eventually performed. Five other patients (29.4%) underwent this same procedure as a secondary procedure after an initial drainage operation. Only one was successful. In the remaining four patients, one had a recurrent abscess that required drainage while the other three patients had a tract between the internal opening and the intersphincteric incision. They subsequently underwent a drainage procedure with seton insertion and advancement flap procedures.

Conclusion

Managing DPA space sepsis via an intersphincteric approach is successful in 70.6% of patients. This single-staged technique allows for effective drainage of the sepsis and removal of the primary pathology in the intersphincteric space.

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Deep Postanal Abscess With Sacrococcygeal Osteomyelitis: A Case Report
Javid Ahmadov, Mustafa Anil Turhan, Ender Erguder, Sezai Leventoğlu, Bulent Mentes
Cureus.2025;[Epub] CrossRef
Is Primary Opening of Fistula-in-Ano Always at Dentate Line: Correlation Between MRI and Operative Findings in 379 Patients
Pankaj Garg, Gabriele Naldini, Vincent De Parades, Petr Tsarkov, Vipul Yagnik, Kaushik Bhattacharya, Baljit Kaur, G Mahak
Clinical and Experimental Gastroenterology.2025; Volume 18: 121. CrossRef
Process to determine the level of the primary internal opening of anal fistula on magnetic resonance imaging
Pankaj Garg, Baljit Kaur, G. Mahak
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Christianna Oikonomou, Periklis Alepas, Stelios Gavriil, Dimitrios Kalliouris, Konstantinos Manesis, Petros Bouboulis, Dimitrios Filippou, Panagiotis Skandalakis
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S. Stelzner, T. Wedel
coloproctology.2019; 41(6): 390. CrossRef
Understanding and Treating Supralevator Fistula-in-Ano: MRI Analysis of 51 Cases and a Review of Literature
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Diseases of the Colon & Rectum.2018; 61(5): 612. CrossRef
The treatment of anal fistula: secondACPGBIPosition Statement – 2018
G. Williams, A. Williams, P. Tozer, R. Phillips, A. Ahmad, D. Jayne, C. Maxwell‐Armstrong
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International Journal of Surgery.2017; 40: 130. CrossRef
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Diseases of the Colon & Rectum.2016; 59(8): 707. CrossRef
S3-Leitlinie: Analabszess
A. Ommer, A. Herold, E. Berg, St. Farke, A. Fürst, F. Hetzer, A. Köhler, S. Post, R. Ruppert, M. Sailer, T. Schiedeck, O. Schwandner, B. Strittmatter, B. H. Lenhard, W. Bader, S. Krege, H. Krammer, E. Stange
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coloproctology.2015; 37(3): 214. CrossRef
Modern management of deep post-anal space abscess and horseshoe fistulas
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Laparoscopic Versus an Open Colectomy in an Emergency Setting: A Case-Controlled Study: Frederick H. Koh, Ker-Kan Tan, Charles B. Tsang, Dean C. Koh; Ann Coloproctol. 2013;29(1):12-16. Published online February 28, 2013; DOI: https://doi.org/10.3393/ac.2013.29.1.12

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Abstract PDF

Purpose

Laparoscopy continues to be increasingly adopted for elective colorectal resections. However, its role in an emergency setting remains controversial. The aim of this study was to compare the outcomes between laparoscopic and open colectomies performed for emergency colorectal conditions.

Methods

A retrospective review of all patients who underwent emergency laparoscopic colectomies for various surgical conditions was performed. These patients were matched for age, gender, surgical diagnosis and type of surgery with patients who underwent emergency open colectomies.

Results

Twenty-three emergency laparoscopic colectomies were performed from April 2006 to October 2011 for patients with lower gastrointestinal tract bleeding (6), colonic obstruction (4) and colonic perforation (13). The hand-assisted laparoscopic technique was utilized in 15 cases (65.2%). There were 4 (17.4%) conversions to the open technique. The operative time was longer in the laparoscopic group (175 minutes vs. 145 minutes, P = 0.04), and the duration of hospitalization was shorter in the laparoscopic group (6 days vs. 7 days, P = 0.15). The overall postoperative morbidity rates were similar between the two groups (P = 0.93), with only 3 patients in each group requiring postoperative surgical intensive-care-unit stays or reoperations. There were no mortalities. The cost analysis did not demonstrate any significant differences in the procedural (P = 0.57) and the nonprocedural costs (P = 0.48) between the two groups.

Conclusion

Emergency laparoscopic colectomy in a carefully-selected patient group is safe. Although the operative times were longer, the postoperative outcomes were comparable to those of the open technique. The laparoscopic group did not incur a higher cost.

Citations

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