Annals of Coloproctology

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Original Articles

Surgical management of retrorectal tumors: a single-center 12 years’ experience: Amirhosein Naseri, Behnam Behboudi, Ali Faryabi, Seyed Mohsen Ahmadi Tafti, Amirsina Sharifi, Mohammad Reza Keramati, Mohammad Sadegh Fazeli, Amir Keshvari, Mehdi Zeinalizadeh, Reza Akbari Asbagh, Niloufar Hoorshad, Alireza Kazemeini; Received April 26, 2022 Accepted June 23, 2022 Published online October 11, 2022; DOI: https://doi.org/10.3393/ac.2022.00297.0042 [Epub ahead of print]

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Purpose
Retrorectal tumors (RTs) are rare tumors that arise in the space between the mesorectum and the pelvic wall and often originate in embryonic tissues. The primary treatment for these tumors is complete excision surgery, and choosing the best surgical approach is very important.
Methods
In this study, we retrospectively collected the data of 15 patients with RTs who underwent surgery in Imam Khomeini Hospital (Tehran, Iran) for 12 years to share our experiences of patients’ treatment and compare different surgical approaches.
Results
A total of 5 tumors were malignant, 10 were benign, and most of the tumors were congenital. Malignant tumors were seen in older patients. Three surgical procedures were performed on patients. Three patients underwent abdominal approach surgery, and 8 patients underwent posterior surgery. A combined surgical approach was performed on 4 patients. Two patients underwent laparoscopic surgery. The abdominal approach had the least long-term complication, and the combined approach had the most complications; laparoscopic surgery reduced the length of hospital stay and complications after surgery.
Conclusion
A multidisciplinary team collaboration using magnetic resonance imaging details is necessary to determine a surgical treatment approach. It could reduce the need for a preoperative biopsy. However, every approach has its advantages and disadvantages, and individualized treatment is the key.

Citations

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Tailgut Cyst—Gynecologist’s Pitfall: Literature Review and Case Report
Andrei Mihai Malutan, Viorela-Elena Suciu, Florin Laurentiu Ignat, Doru Diculescu, Razvan Ciortea, Emil-Claudiu Boțan, Carmen Elena Bucuri, Maria Patricia Roman, Ionel Nati, Cristina Ormindean, Dan Mihu
Diagnostics.2025; 15(1): 108. CrossRef
Presacral Neuroendocrine Tumor Treated With a Combined Robotic Dissection and Kraske Procedure: A Case Report
Cesar A Barros de Sousa, Steven J Capece, Mikhail I Rakhmanine, John S Park
Cureus.2025;[Epub] CrossRef

Malignant disease, Rectal cancer, Functional outcomes

Introduction of a handmade vacuum-assisted sponge drain for the treatment of anastomotic leakage after low anterior rectal resection: Amir Keshvari, Abolfazl Badripour, Mohammad Reza Keramati, Alireza Kazemeini, Behnam Behboudi, Mohammad Sadegh Fazeli, Ehsan Rahimpour, Parisa Ghaffari, Seyed Mohsen Ahmadi Tafti; Ann Coloproctol. 2022;38(3):230-234. Published online June 10, 2021; DOI: https://doi.org/10.3393/ac.2021.00059.0008

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4 Web of Science
5 Citations

Abstract PDF

Purpose
Anastomotic leakage, a known major postoperative complication, potentially leads to readmission, reoperation, and increased mortality rates in patients, such as rectal cancer patients following a low anterior resection (LAR). Currently, vacuum-assisted closure, as featured by B-Braun (B-Braun Medical B.V.), is already being used for the treatment of gastrointestinal leakages and fistulas. The main aim of this study was to introduce a novel method for creating a vacuum-assisted drain for the treatment of anastomotic leakage after LAR.
Methods
All 10 patients, who underwent LAR surgery from 2018 to 2019, were diagnosed with anastomotic leakage and had received neoadjuvant chemotherapy prior to surgery. Therefore, patients were treated with a handmade vacuum-assisted drain and were revisited every 5 to 7 days for further evaluations and drain replacement until leakage resolution. Physical features of cavity, time of diagnose, and duration of treatment were analyzed correspondingly. The handmade vacuum-assisted sponge drain was prepared for each patient in each session of follow-up.
Results
Eight out of 10 patients experienced complete closure of the defect. The mean delay time from the day of operation to the diagnosis of anastomotic leakage was 61.0±80.4 days while the mean time for leakage closure was 117.6±68.3 days. Eventually, 7 cases underwent ileostomy reversal with no complications during a 3-month follow-up.
Conclusion
In this study, we evaluated the healing process of anastomotic leakage after the usage of a handmade vacuum-assisted sponge drain in a case series method. In our trial, we provided an innovative cost-benefit method easily applicable in the operating room.

Citations

Citations to this article as recorded by

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
Assessment of the efficacy of Handmade Vacuum-Assisted Sponge Drain for Treatment of Anastomotic leakage after Low Anterior Rectal Resection
Amir Keshvari, Leila mollamohammadi, Mohammad Reza Keramati, Behnam Behboudi, Mohammad Sadegh Fazeli, Alireza Kazemeini, Amirhossein Naseri, Elnaz Shahmohammadi, Laleh Foroutani, Aryan Ayati, Amirhossein Tayebi, Zahra Sajjadian, Alireza Hadizadeh, Seyed-M
Updates in Surgery.2023; 75(4): 847. CrossRef
Endoscopic vacuum therapy and early surgical closure after pelvic anastomotic leak: meta-analysis of bowel continuity rates
F. Borja de Lacy, Kevin Talboom, Sapho X. Roodbeen, Robin Blok, Anna Curell, Pieter J. Tanis, Wilhelmus A. Bemelman, Roel Hompes
British Journal of Surgery.2022;[Epub] CrossRef
Outpatient closure in a late colo-cutaneous postoperative anastomotic leak managed with EVAC in Bucaramanga, Colombia. Case report.
Jairo Enrique Mendoza Saavedra, Cesar Andrés Torres Carrillo, Gloria Liliana Mendoza Valbuena
International Journal of Surgery Case Reports.2022; 100: 107737. CrossRef
Neoadjuvant chemoradiotherapy determines the prognostic impact of anastomotic leakage in advanced rectal cancer
Bo Young Oh, Yoon Ah Park, Jung Wook Huh, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee
Annals of Surgical Treatment and Research.2022; 103(4): 235. CrossRef

Case Report

Proper Management for Morbid Iatrogenic Retroperitoneal Barium Insufflation: Jalal Vahedian-Ardakani, Shahram Nazerani, Amir Saraee, Ali Sarmast, Ehsan Saraee, Mohammad Reza Keramati; Ann Coloproctol. 2014;30(6):285-289. Published online December 31, 2014; DOI: https://doi.org/10.3393/ac.2014.30.6.285

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2 Web of Science
3 Citations

Abstract PDF

A barium enema is a diagnostic and therapeutic procedure commonly used for colon and rectum problems. Rectal perforation with extensive intra- and/or extraperitoneal spillage of barium is a devastating complication of a barium enema that leads to a significant increase in patient mortality. Due to the low number of reported cases in recent scientific literature and the lack of experience with the management of these cases, we would like to present our treatment approach to a rare case of retroperitoneal contamination with barium, followed by its intraperitoneal involvement during a diagnostic barium enema. Our experience with long-term management of the patient and the good outcome will be depicted in this paper.

Citations

Citations to this article as recorded by

Perforation of barium sulfate enterography in an infant: A case report
Yixing Lu, Lixian Mo, Junhong Chen, Wei Peng
Medicine.2024; 103(17): e37926. CrossRef
A Case of Sigmoid Colon Perforation Caused by Barium that was Treated by Laparoscopic Surgery
Shoichiro HARA, Junichi HAMADA, Kenichi TAKEMOTO, Kei NAITO, Toshiya OCHIAI, Eigo OTSUJI
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2024; 85(4): 546. CrossRef
Barium sulfate

Reactions Weekly.2015; 1549(1): 45. CrossRef

Original Article

Delorme's Procedure: An Effective Treatment for a Full-Thickness Rectal Prolapse in Young Patients: Mohammad Sadegh Fazeli, Ali Reza Kazemeini, Amir Keshvari, Mohammad Reza Keramati; Ann Coloproctol. 2013;29(2):60-65. Published online April 30, 2013; DOI: https://doi.org/10.3393/ac.2013.29.2.60

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17 Citations

Abstract PDF

Purpose

Delorme's procedure is infrequently applied in young adults because of its assumed higher recurrence rate. The aim of this prospective study was to assess the efficacy of the Delorme's technique in younger adults.

Methods

Fifty-two consecutive patients were entered in our study. We followed patients for at least 30 months. Their complaints and clinical exam results were noted.

Results

Our study included 52 patients (mean age, 38.44 years; standard deviation, 13.7 years). Of the included patients, 41 (78.8%) were younger than 50 years of age, and 11 (21.1%) were older than 50 years of age. No postoperative mortalities or major complications were noted. Minor complications were seen in 5 patients (9.6%) after surgery. The mean hospital stay was 2.5 days. In the younger group (age ≤50 years), fecal incontinence was improved in 92.3% (12 out of 13 with previous incontinence) of the patients, and recurrence was seen in 9.75% (4 patients). In the older group (age >50 years), fecal incontinence was improved in 20% (1 out of 5 with previous incontinence) of the patients, and recurrence was seen in 18.2% (2 patients). In 50% of the patients with a previous recurrence (3 out of 6 patients) following Delorme's procedure as a secondary procedure, recurrence was observed.

Conclusion

Delorme's procedure, especially in younger patients, is a relatively safe and effective treatment and should not be restricted to older frail patients. This procedure may not be suitable for recurrent cases.

Citations

Citations to this article as recorded by

Long-Term Outcomes of Transvaginal Sacrospinous Ligament Suture Rectopexy
Henry H. Chill, Alireza Hadizadeh, Angela Leffelman, Claudia Paya Ten, Cecilia Chang, Roger P. Goldberg, Ghazaleh Rostaminia
International Urogynecology Journal.2025;[Epub] CrossRef
Safety of concurrent transvaginal rectopexy at time of transvaginal apical prolapse repair: A comparative study
Henry H. Chill, Sonia Gilani, Alireza Hadizadeh, Cecilia Chang, Nani P. Moss, Roger P. Goldberg, Ghazaleh Rostaminia
European Journal of Obstetrics & Gynecology and Reproductive Biology.2025; 312: 114512. CrossRef
Management of recurrent external rectal prolapse. A single center experience
Alessandro Sturiale, Lisa Fralleone, Bernardina Fabiani, Claudia Menconi, Vittorio d'Adamo, Gabriele Naldini
Surgery Open Digestive Advance.2024; 14: 100137. CrossRef
Delorme's procedure for urgent rectal prolapse – A video vignette
A. Teresa Calderón Duque, Esther María Cano Pecharromán, Javier Broekhuizen Benítez, Laura Arriero Ollero, Lourdes Gómez Ruiz, Tomas Balsa Marín
Colorectal Disease.2023; 25(3): 513. CrossRef
External rectal prolapse: more than meets the eye
M. Yiasemidou, C. Yates, E. Cooper, R. Goldacre, I. Lindsey
Techniques in Coloproctology.2023; 27(10): 783. CrossRef
Delorme’s vs. Altemeier’s in the management of rectal procidentia: systematic review and meta-analysis
Pratik Bhattacharya, Mohammad Iqbal Hussain, Shafquat Zaman, Sophie Randle, Yousaf Tanveer, Nameer Faiz, Diwakar Ryali Sarma, Rajeev Peravali
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
What are the surgical options for recurrent rectal prolapse – retrospective single-center experience
Tomasz Kościński, Krzysztof Szmyt
Polish Journal of Surgery.2023; 96(1): 22. CrossRef
Trends in the surgical management of rectal prolapse: An Asian experience
Yvonne Ying‐Ru Ng, Emile John Kwong Wei Tan, Cherylin Wan Pei Fu
Asian Journal of Endoscopic Surgery.2022; 15(1): 110. CrossRef
Longer prolapsed rectum length increases recurrence risk after Delorme’s procedure
Taro Tanabe, Emi Yamaguchi, Takuya Nakada, Risa Nishio, Kinya Okamoto, Tetsuo Yamana
Annals of Coloproctology.2022; 38(4): 314. CrossRef
Surgical Treatment of Full-Thickness Rectal Prolapse (FTRP): a Case Series Analysis
Przemysław Ciesielski, Magdalena Szczotko, Małgorzata Kołodziejczak
Indian Journal of Surgery.2021; 83(3): 634. CrossRef
Procedimiento de Altemeier para la reparación de prolapso rectal tras resección anterior de recto interesfinteriana con escisión mesorrectal total por vía transanal
Eloy Maldonado Marcos, Pere Planellas Giné, Júlia Gil Garcia, Ramon Farrés Coll, Antoni Codina Cazador
Cirugía Española.2021; 99(5): 389. CrossRef
Altemeier procedure for rectal prolapse after intersphincteric low anterior resection with transanal total mesorectal excision
Eloy Maldonado Marcos, Pere Planellas Giné, Júlia Gil Garcia, Ramon Farrés Coll, Antoni Codina Cazador
Cirugía Española (English Edition).2021; 99(5): 389. CrossRef
Laparoscopic ventral mesh rectopexy vs Delorme's operation in management of complete rectal prolapse: a prospective randomized study
S. H. Emile, H. Elbanna, M. Youssef, W. Thabet, W. Omar, A. Elshobaky, T. M. Abd El‐Hamed, M. Farid
Colorectal Disease.2017; 19(1): 50. CrossRef
The evolution of evaluation and management of urinary or fecal incontinence and pelvic organ prolapse
Scott R. Steele, Madhulika G. Varma, David Prichard, Adil E. Bharucha, Sarah A. Vogler, Askin Erdogan, Satish S.C. Rao, Ann C. Lowry, Erin O. Lange, Glen M. Hall, Joshua I.S. Bleier, Anthony J. Senagore, Justin Maykel, Sook Y. Chan, Ian M. Paquette, Marie
Current Problems in Surgery.2015; 52(2): 17. CrossRef
Komplikationen nach Rektumprolapsoperationen
T.H.K. Schiedeck
Der Chirurg.2015; 86(8): 747. CrossRef
A systematic review of the literature on the surgical management of recurrent rectal prolapse
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Outcome of the Delorme procedure for the management of complete rectal prolapse in children
Mohamed Rabae
The Egyptian Journal of Surgery.2014; 33(4): 260. CrossRef

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