Annals of Coloproctology

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Minimally invasive surgery

Comparative perioperative outcomes of articulated versus conventional straight devices in laparoscopic low anterior resection: a propensity score–matched analysis: Hayoung Lee, Yong Sik Yoon, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim; Ann Coloproctol. 2025;41(5):434-442. Published online October 16, 2025; DOI: https://doi.org/10.3393/ac.2025.00227.0032

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Abstract PDF Supplementary Material: Purpose
Laparoscopic low anterior resection for rectal cancer is technically challenging due to the precision required for mesorectal excision. Articulated instruments were developed to improve precision and oncological safety over conventional instruments. This study compares their perioperative outcomes.
Methods
A retrospective cohort study of 432 patients with colorectal cancer who underwent low anterior resection between August 2022 and February 2024 applied propensity score matching to minimize selection bias. Primary endpoints were circumferential resection margin (CRM), distal resection margin (DRM), and harvested lymph nodes count. Secondary outcomes included postoperative complications.
Results
Following propensity score matching, 84 matched pairs were analyzed. Most patients achieved CRM negativity (>1 mm), with CRM ≥10 mm in 67.9% of the articulated group and 59.5% of the conventional group (P=0.613). Median (interquartile range, IQR) lymph nodes harvests were comparable (20 [14–26] vs. 18 [14–22], P=0.147). The articulated group had a significantly longer DRM (30.0 mm [IQR, 18.0–40.0 mm] vs. 24.0 mm [IQR, 12.0–34.2 mm], P=0.008) and the median operation time (111.0 minutes [IQR, 95.8–125.2 minutes] vs. 99.5 minutes [IQR, 72.0–119.8 minutes], P=0.009). Estimated blood loss, open conversion rates, and postoperative complications, including leakage (7.1% vs. 8.3%, P>0.999) and surgical site infections, (15.5% vs. 9.5%, P=0.383), showed no significant differences.
Conclusion
Articulated laparoscopic instruments demonstrated comparable safety and feasibility to conventional instruments but offered no significant clinical or oncological benefits beyond a longer DRM. Larger studies are needed to evaluate their value in laparoscopic rectal surgery.

Anorectal benign disease

Effects of clinical information on the treatment decisions for good responders to neoadjuvant chemoradiotherapy among rectal cancer patients: Eon Bin Kim, In Ja Park, Hwa Jung Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu; Ann Coloproctol. 2025;41(5):473-482. Published online July 10, 2025; DOI: https://doi.org/10.3393/ac.2024.00276.0039

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Abstract PDF Supplementary Material: Purpose
The decision for treatment after neoadjuvant chemoradiotherapy (nCRT) in rectal cancer is intricately linked to tumor response and clinical parameters. This study was designed to elucidate determinants influencing treatment decisions for good responders to nCRT, while concurrently evaluating the ramifications of modifications in magnetic resonance imaging (MRI) tumor response evaluation protocols.
Methods
A survey was constructed with 5 cases of good responder after nCRT based on the magnetic resonance–based tumor regression grade (mrTRG) criteria. A total of 35 colorectal surgeons in Korea participated in the survey via email, and they were introduced to 2 discrete MRI-based tumor response evaluation methodologies: the conventional mrTRG and an emergent complete response (CR)/non-CR classification system. Surgeons were directed to select between total mesorectal excision, local excision, or a watch and wait strategy.
Results
Treatment decisions varied significantly (P<0.01), as gradually more clinical information was provided with mrTRG. The paradigm shift from mrTRG to CR/non-CR evaluation criterion instigated the highest alteration in decision (P<0.01). Even comparing with other sets of information, decision change with different tumor response assessment (i.e., mrTRG vs. CR/non-CR) was statistically significant (P<0.01). Three particular cases consistently displayed a declining predilection for total mesorectal excision, favoring a more pronounced inclination towards watch and wait strategy or local excision. Nonetheless, the magnitude of these decisional shifts oscillated depending on the specific endoscopic imagery present.
Conclusion
Our current findings underscore the significant role of tumor response assessment methods in shaping treatment decisions for rectal cancer patients who respond well to nCRT. This highlights the need for clear and accurate tools to interpret MRI results.

Malignant disease,Epidemiology & etiology

Colorectal cancer mortality trends in the era of cancer survivorship in Korea: 2000–2020: Min Hyun Kim, Sanghee Park, Nari Yi, Bobae Kang, In Ja Park; Ann Coloproctol. 2022;38(5):343-352. Published online October 28, 2022; DOI: https://doi.org/10.3393/ac.2022.00535.0076

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23 Web of Science
23 Citations

Graphical Abstract Abstract PDF Supplementary Material

Purpose
Korea has implemented an early screening for colorectal cancer since 2004. However, it is not known whether this has translated into improved survival over the years.
Methods
We acquired colorectal cancer mortality data from the Cause of Death Statistics in Korea from 2000 to 2020. We characterized the data into year of death, cancer-specific loci, and age group. We analyzed age-standardized mortality rates (ASMR) according to year of death, age group, and primary location to find trends in colorectal cancer mortality over a 20-year period.
Results
The crude mortality rate of colorectal cancer increased from 8.78 per 100,000 in 2000 to 17.27 per 100,000 in 2020. The second decade was slower in increments compared to the first decade. ASMR showed a decrease over the second decade after an initial increase in the first decade. The decrease was primarily from the lowering of ASMR for rectosigmoid cancers. Age group analysis showed a lowering of ASMR mainly in the 45–59-year, 60–74-year, and ≥ 75-year age groups; however, 0–29-year and 30–44-year age groups showed generally unchanged ASMR over the total period.
Conclusion
After a brief incline of age-specific mortality of colorectal cancers during the early 2000s, colorectal cancer mortality has gradually been decreasing in the past decade. This was mainly due to decreased mortalities in rectosigmoid colon cancers especially in the age groups that were the target of early screening.

Citations

Citations to this article as recorded by

Immunological changes and recovery-related factors in older patients with colon cancer: A pilot trial
Byeo Lee Lim, Young Il Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Yousun Ko, Kyung Won Kim, In Ja Park
Journal of Geriatric Oncology.2025; 16(3): 102200. CrossRef
Oncologic outcomes of surgically treated colorectal cancer in octogenarians: a comparative study using inverse probability of treatment weighting (IPTW)
Soo Young Oh, Jung Yun Park, Kwan Mo Yang, Seong-A Jeong, Yong Jae Kwon, Yun Tae Jung, Chung Hyeun Ma, Keong Won Yun, Kwang Hyun Yoon, Jae Young Kwak, Chang Sik Yu
BMC Gastroenterology.2025;[Epub] CrossRef
Oncologic outcomes and associated factors of colon cancer patients aged 70 years and older
Byeo Lee Lim, In Ja Park, Jun-Soo Ro, Young Il Kim, Seok-Byung Lim, Chang Sik Yu
Annals of Coloproctology.2025; 41(3): 198. CrossRef
Older Age Threshold for Oxaliplatin Benefit in Stage II to III Colorectal Cancer
Jun Woo Bong, Hwamin Lee, Seogsong Jeong, Sanghee Kang
JAMA Network Open.2025; 8(8): e2525660. CrossRef
Primary tumor resection vs. self-expandable metallic stent in unresectable obstructive stage IV colorectal cancer: a comparative outcome study
Chang Hyun Kim, Jae Kyun Ju, Jaram Lee, Hyeung-min Park, Soo Young Lee, Hyeong Rok Kim, Young Eun Joo, Sung Bum Cho
Annals of Surgical Treatment and Research.2025; 109(2): 89. CrossRef
Evaluation of the utility of a nomogram for predicting lymph node metastasis in T1 colorectal cancer in shared decision-making in clinical practice: a survey-based study
Hyeon Seung Kim, Kyung Su Han, Min Wan Lee, Dae Kyung Sohn, Chang Won Hong, Dong Woon Lee, Kiho You, Sung Chan Park, Byung Chang Kim, Bun Kim, Jae Hwan Oh
Annals of Coloproctology.2025; 41(4): 303. CrossRef
Performance reporting design in artificial intelligence studies using image-based TNM staging and prognostic parameters in rectal cancer: a systematic review
Minsung Kim, Taeyong Park, Bo Young Oh, Min Jeong Kim, Bum-Joo Cho, Il Tae Son
Annals of Coloproctology.2024; 40(1): 13. CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
In-Hospital Mortality and Associated Factors among Colorectal Cancer Patients in Germany
Karel Kostev, Sarah Krieg, Andreas Krieg, Tom Luedde, Sven H. Loosen, Christoph Roderburg
Cancers.2024; 16(6): 1219. CrossRef
Effect of Fluorescence Lymph Node Mapping on Improving Diagnostic Values of CT D3 Lymph Node Staging for Right-Sided Colon Cancer
Gyung Mo Son, Tae Un Kim, Mi Sook Yun, ChangYeop Kim, In Young Lee, Su Bum Park, Dong-Hoon Shin, Gi Won Ha
Cancers.2024; 16(20): 3496. CrossRef
Gochujang suppresses cell survival and changes reactive oxygen species metabolism in colorectal cancer cells
Eun-Bi Seo, So-Min Oh, Anna Han
Food & Nutrition Research.2024;[Epub] CrossRef
Optimal Indocyanine Green Dosage for Repetitive Angiography for Laparoscopic Colorectal Surgery
Gyung Mo Son, Sang-Ho Park, Nam Su Kim, Mi Sook Yun, In Young Lee, Myeong-Sook Kwon, Tae Kyun Kim, Eun Hwa Lee, Eun Jung Hwang, Kwang-Ryul Baek
Medicina.2024; 60(12): 1966. CrossRef
Beyond survival: a comprehensive review of quality of life in rectal cancer patients
Won Beom Jung
Annals of Coloproctology.2024; 40(6): 527. 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
Development and validation of nomogram models to predict radiotherapy or chemotherapy benefit in stage III/IV gastric adenocarcinoma with surgery
Xiangqing Ren, Tian Huang, Xiaolong Tang, Qian Ma, Ya Zheng, Zenan Hu, Yuping Wang, Yongning Zhou
Frontiers in Oncology.2023;[Epub] CrossRef
Prognostic prediction of colorectal cancer using the C-reactive protein to albumin ratio: the importance of inflammatory biomarkers and their association with long-term outcomes
Chul Seung Lee
Annals of Coloproctology.2023; 39(4): 287. 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
National cancer screening program for colorectal cancer in Korea
Seung Min Baik, Ryung-Ah Lee
Annals of Surgical Treatment and Research.2023; 105(6): 333. CrossRef
Recurrence Patterns and Risk Factors after Curative Resection for Colorectal Cancer: Insights for Postoperative Surveillance Strategies
Hyo Seon Ryu, Jin Kim, Ye Ryung Park, Eun Hae Cho, Jeong Min Choo, Ji-Seon Kim, Se-Jin Baek, Jung-Myun Kwak
Cancers.2023; 15(24): 5791. CrossRef
Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer
In Ja Park
The Ewha Medical Journal.2023;[Epub] CrossRef
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han
The Ewha Medical Journal.2023;[Epub] CrossRef
Inflammatory Response Markers as Predictors of Colorectal Cancer Prognosis
Minsung Kim, Il Tae Son, Bo Young Oh
The Ewha Medical Journal.2023;[Epub] CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef

Benign GI diease

Surgical Management of Sigmoid Volvulus: A Multicenter Observational Study: Keunchul Lee, Heung-Kwon Oh, Jung Rae Cho, Minhyun Kim, Duck-Woo Kim, Sung-Bum Kang, Hyung-Jin Kim, Hyoung-Chul Park, Rumi Shin, Seung Chul Heo, Seung-Bum Ryoo, Kyu Joo Park, Seoul Colorectal Research Group (SECOG); Ann Coloproctol. 2020;36(6):403-408. Published online December 31, 2020; DOI: https://doi.org/10.3393/ac.2020.03.23

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17 Web of Science
14 Citations

Abstract PDF

Purpose
This study aimed to evaluate real-world clinical outcomes from surgically treated patients for sigmoid volvulus.
Methods
Five tertiary centers participated in this retrospective study with data collected from October 2003 through September 2018, including demographic information, preoperative clinical data, and information on laparoscopic/open and elective/emergency procedures. Outcome measurements included operation time, postoperative hospitalization, and postoperative morbidity.
Results
Among 74 patients, sigmoidectomy was the most common procedure (n = 46), followed by Hartmann’s procedure (n = 23), and subtotal colectomy (n = 5). Emergency surgery was performed in 35 cases (47.3%). Of the 35 emergency patients, 34 cases (97.1%) underwent open surgery, and a stoma was established for 26 patients (74.3%). Elective surgery was performed in 39 cases (52.7%), including 21 open procedures (53.8%), and 18 laparoscopic surgeries (46.2%). Median laparoscopic operation time was 180 minutes, while median open surgery time was 130 minutes (P < 0.001). Median postoperative hospitalization was 11 days for laparoscopy and 12 days for open surgery. There were 20 postoperative complications (27.0%), and all were resolved with conservative management. Emergency surgery cases had a higher complication rate than elective surgery cases (40.0% vs. 15.4%, P = 0.034).
Conclusion
Relative to elective surgery, emergency surgery had a higher rate of postoperative complications, open surgery, and stoma formation. As such, elective laparoscopic surgery after successful sigmoidoscopic decompression may be the optimal clinical option.

Citations

Citations to this article as recorded by

Mesopexy instead of colectomy successfully treated an elderly patient with sigmoid volvulus, a case report
Jin Qian, Shu-Qing Hua
Asian Journal of Surgery.2025; 48(2): 1441. CrossRef
Outcomes for sigmoid volvulus managed with and without early definitive surgery: 20‐year experience in a tertiary referral centre
Shriranshini Satheakeerthy, Priscilla Leow, Benjamin Hall, Damien Ah Yen, Jesse Fischer
ANZ Journal of Surgery.2024; 94(1-2): 169. CrossRef
Patience is key: Association of surgical timing with clinical outcomes in elderly patients with sigmoid volvulus
Suzanne C. Arnold, Wardah Rafaqat, May Abiad, Emanuele Lagazzi, Anne H. Hoekman, Vahe S. Panossian, Ikemsinachi C. Nzenwa, Charudutt N. Paranjape, George C. Velmahos, Haytham M.A. Kaafarani, John O. Hwabejire
The American Journal of Surgery.2024; 232: 81. CrossRef
Epidemiology and age-related trends in surgical outcomes for sigmoid volvulus: a 17-year analysis
Lukas Schabl, Stefan D. Holubar, Kamil Erozkan, Ali Alipouriani, Himani Sancheti, Scott R. Steele, Hermann Kessler
Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
Unveiling a Coalescing Catastrophe: Pre-pyloric Perforation Co-existing With Sigmoid Volvulus in a Middle-Aged Patient
Mihir Patil, Pankaj Gharde
Cureus.2024;[Epub] CrossRef
Navigating Abdominal Volvulus: A Comprehensive Review of Management Strategies
Simran Chauhan, Raju K Shinde, Yashraj Jain
Cureus.2024;[Epub] CrossRef
Laparoscopic redo surgery for sigmoid volvulus following laparoscopic sigmoidectomy
Hideyuki Masui, Kenji Kawada, Susumu Inamoto, Toshiaki Wada, Yoshiharu Sakai, Kazutaka Obama
Surgical Case Reports.2024;[Epub] CrossRef
Sigmoid volvulus as a rare cause of intestinal obstruction in the pediatric population: case series and literature review
Isabel C. Brito Rojas, Mayra A. Hernández Peñuela, Vanessa Medina Gaviria, Martin La Rotta, John M. Escobar Echeverri
International Journal of Surgery Open.2024; 62(2): 149. CrossRef
Metachronous volvulus of the descending colon after resection of the sigmoid volvulus; a case report
Molla Asnake Kebede, Sisay Mengistu Mohammed, Yilkal Teshome Numaro, Yohanes Yoseph Mesfine, Adugnaw Bogale Worku, Anteneh Messele Birhanu
International Journal of Surgery Case Reports.2024; 123: 110212. CrossRef
Left iliac fossa sigmoidectomy with mechanical anastomosis in the management of uncomplicated sigmoid volvulus: an observational study at Principal Hospital of Dakar, Senegal
Eugene Gaudens Prosper Amaye Dieme, Birame Ndiaye, Magatte Faye, Samba Tiapato Faye, Moustapha Diop, Madawas Mboup, Ibrahima Sall, Oumar Fall, Alamasso Sow
The Pan African Medical Journal.2024;[Epub] CrossRef
Bowel Preparation Before Nonelective Sigmoidectomy for Sigmoid Volvulus: Highly Beneficial but Vastly Underused
Natalie Schudrowitz, C Patrick Shahan, Tovah Moss, John E Scarborough
Journal of the American College of Surgeons.2023; 236(4): 649. CrossRef
Perioperative Adverse Outcome and Its Predictors After Emergency Laparotomy Among Sigmoid Volvulus Patients: Retrospective Follow-Up Study
Tilahun Deresse, Esubalew Tesfahun, Zenebe Gebreegziabher, Mandante Bogale, Dawit Alemayehu, Megbar Dessalegn, Tewodros Kifleyohans, George Eskandar
Open Access Emergency Medicine.2023; Volume 15: 383. CrossRef
Colonic pseudo-obstruction in a patient with dyssynergic defecation: A case report
Yejun Jeong, Yongjae Kim, Wonhyun Kim, Seoyeon Park, Su-Jin Shin, Eun Jung Park
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Comments on “Surgical Management of Sigmoid Volvulus: A Multicenter Observational Study”
Sabri Selcuk Atamanalp
Annals of Coloproctology.2021; 37(2): 73. CrossRef

Malignant disease, Functional outcomes

Safety and Efficacy of Single-Port Laparoscopic Ileostomy in Palliative Settings: Seng-Muk Kang, Jung Rae Cho, Heung-Kwon Oh, Eun-Ju Lee, Min Hyun Kim, Duck-Woo Kim, Sung-Bum Kang; Ann Coloproctol. 2020;36(1):17-21. Published online February 29, 2020; DOI: https://doi.org/10.3393/ac.2019.04.25

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1 Web of Science
2 Citations

Abstract PDF

Purpose
Single-port laparoscopic techniques can be optimized with confined incisions. This approach has an intraoperative advantage of excellent visualization of the correct intestinal segment for exteriorization, along with direct visual control of the extraction to avoid twisting. However, only a few studies have verified the efficacy of the technique. Thus, this study assessed the results of single-port laparoscopic stoma creation for fecal diversion, specifically focusing on feasibility, safety, and efficacy.
Methods
Patients who underwent single-incision enterostomy performed by a single surgeon were included. Data on demographics, indications for and chosen procedure, and operation results were retrospectively collected and analyzed.
Results
Between April 2015 and January 2018, a total of 13 patients (8 males, 5 females) with a mean age of 57.7 years (range, 41–83 years) underwent single-port ileostomy creation. The most common reason for diversion was palliative ileostomy for colon obstruction or fistula from peritoneal malignancy (n = 12), followed by colonic fistula with necrotizing pancreatitis (n = 1). There were no cases of conversion to open or multiport laparoscopic surgery. The mean operative time was 54 minutes (range, 37–118 minutes), and the median length of hospital stay was 8 days (range, 2–211 days). A postoperative complication, aspiration pneumonia, was documented in 1 patient and treated conservatively. The mean duration of bowel movement was 0.7 days (range, 0–4 days). All stomas had good function, and there was no 30-day mortality.
Conclusion
Single-port laparoscopic ileostomy in patients with a palliative setting could be a safe and feasible option for fecal diversion.

Citations

Citations to this article as recorded by

Single port–assisted diverting ileostomy formation for anastomotic leakage after low anterior resection
Kyong-Min Kang, Heung-Kwon Oh, Hong-min Ahn, Hye-Rim Shin, Min-Hyeong Jo, Mi-Jeong Choi, Duck-Woo Kim, Sung-Bum Kang
Journal of Minimally Invasive Surgery.2025; 28(1): 47. CrossRef
Comparison between liquid skin adhesive and wound closure strip for skin closure after subcuticular suturing in single-port laparoscopic appendectomy: a single-center retrospective study in Korea
Kyeong Eui Kim, Yu Ra Jeon, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Journal of Minimally Invasive Surgery.2024; 27(1): 14. CrossRef

Discrepancy of Medical Terminology Regarding Colorectal Surgery Between South and North Korea: Dayoung Ko, Heung-Kwon Oh, Jangwhan Jo, Hyun Hui Yang, Min-Hyun Kim, Myung Jo Kim, Sung Il Kang, Duck-Woo Kim, Sung-Bum Kang; Ann Coloproctol. 2018;34(5):248-252. Published online October 31, 2018; DOI: https://doi.org/10.3393/ac.2017.10.01

5,073 View
108 Download
2 Web of Science
2 Citations

Abstract PDF

Purpose
We aimed to investigate the extent of heterogeneity in medical terminology between South and North Korea by comparing medical terms related to the colorectal system.
Methods
North Korean medical terms were collected from the sections on diseases of the small intestine and colon in a surgery textbook from North Korea, and those terms were compared with their corresponding terms in a South Korean medical terminology textbook. The terms were categorized as either identical, similar, showing disparity, or not used in South Korea. In a subsection analysis, the terms were allocated to pathophysiology, diagnosis, symptoms and examination, drugs, testing, treatment, or others according to the categorization used in the textbook.
Results
We found 705 terms in the North Korean textbook, most of which were pathophysiological terms (206, 29.2%), followed by diagnostic terms (165, 23.4%) and symptom and examination terms (122, 17.3%). Treatment-, drug-, and testing-related terms constituted 15.5%, 5.8%, and 4.1% of the 705 terms, respectively. There were 331 identical terms (47.0%) and 146 similar terms (20.7%); 126 terms (17.9%) showed disparity. Another 102 terms (14.5%) were not used in South Korea. The pathophysiological terms were the least heterogeneous, with 61.2% being identical terms used in both countries. However, 26.8% of the terms in the drug category were not used in South Korea.
Conclusion
The present study showed that less than 50% of the terms for the colorectal system used in South and North Korea were identical. As the division between South and North Korea persists, the heterogeneity of medical terminology is expected to increase.

Citations

Citations to this article as recorded by

Characteristics and Distribution of Surgical Diseases in North Korean Research Papers Published between 2006 and 2017
Yo Han Lee, Namkee Oh, Hyerim Kim, Shin Ha
Journal of Korean Medical Science.2021;[Epub] CrossRef
Assessing the pharmacy students’ knowledge of common medical terms after a curricular change in Saudi Arabia
Yazed AlRuthia, Monira Alwhaibi, Haya Almalag, Hadeel Alkofide, Bander Balkhi, Amani Almejel, Fahad Alshammari, Fawaz Alharbi, Ibrahim Sales, Yousif Asiri
Saudi Pharmaceutical Journal.2020; 28(6): 763. CrossRef

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