Annals of Coloproctology

Case Report

Colorectal cancer

Treatment of side limb full-thickness prolapse of the side-to-end coloanal anastomosis following intersphincteric resection: a case report and review of literature: Guglielmo Niccolò Piozzi, Krunal Khobragade, Seon Hui Shin, Jeong Min Choo, Seon Hahn Kim; Ann Coloproctol. 2024;40(Suppl 1):S38-S43. Published online February 8, 2023; DOI: https://doi.org/10.3393/ac.2022.00829.0118

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Intersphincteric resection (ISR) with coloanal anastomosis is an oncologically safe anus-preserving technique for very low-lying rectal cancers. Most studies focused on oncological and functional outcomes of ISR with very few evaluating long-term postoperative anorectal complications. Full-thickness prolapse of the neorectum is a relatively rare complication. This report presents the case of a 70-year-old woman presenting with full-thickness prolapse of the side limb of the side-to-end coloanal anastomosis occurring 2 weeks after the stoma closure and 2 months after a robotic partial ISR performed with the Da Vinci single-port platform. The anastomosis was revised through resection of the side limb and conversion of the side-to-end anastomosis into an end-to-end handsewn anastomosis with interrupted stitches. This study describes the first case of full-thickness prolapse of the side limb of the side-to-end handsewn coloanal anastomosis following ISR. Moreover, a revision of all reported cases of post-ISR full-thickness and mucosal prolapse was performed.

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International standardization and optimization group for intersphincteric resection (ISOG‐ISR): modified Delphi consensus on anatomy, definition, indication, surgical technique, specimen description and functional outcome
Guglielmo Niccolò Piozzi, Krunal Khobragade, Vusal Aliyev, Oktar Asoglu, Paolo Pietro Bianchi, Vlad‐Olimpiu Butiurca, William Tzu‐Liang Chen, Ju Yong Cheong, Gyu‐Seog Choi, Andrea Coratti, Quentin Denost, Yosuke Fukunaga, Emre Gorgun, Francesco Guerra, Ma
Colorectal Disease.2023; 25(9): 1896. CrossRef

Review

Malignant disease, Rectal cancer ,Functional outcomes,Colorectal cancer,Minimally invasive surgery

Robotic Intersphincteric Resection for Low Rectal Cancer: Technical Controversies and a Systematic Review on the Perioperative, Oncological, and Functional Outcomes: Guglielmo Niccolò Piozzi, Seon Hahn Kim; Ann Coloproctol. 2021;37(6):351-367. Published online November 17, 2021; DOI: https://doi.org/10.3393/ac.2021.00836.0119

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Abstract PDF

Intersphincteric resection (ISR) is the ultimate anus-sparing technique for low rectal cancer and is considered an oncologically safe alternative to abdominoperineal resection. The application of the robotic approach to ISR (RISR) has been described by few specialized surgical teams with several differences regarding approach and technique. This review aims to discuss the technical aspects of RISR by evaluating point by point each surgical controversy. Moreover, a systematic review was performed to report the perioperative, oncological, and functional outcomes of RISR. Postoperative morbidities after RISR are acceptable. RISR allows adequate surgical margins and adequate oncological outcomes. RISR may result in severe bowel and genitourinary dysfunction affecting the quality of life in a portion of patients.

Citations

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Rectal Eversion as an Anus-sparing Technique in Laparoscopic Low Anterior Resection With Double Stapling Anastomosis: Long-term Functional Results
Servet Karagul, Serdar Senol, Oktay Karakose, Huseyin Eken, Cuneyt Kayaalp
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2025;[Epub] CrossRef
The Review of Modified Intersphincteric Resection in the Treatment of Ultra-Low Rectal Cancer
Danni Li, Xi Xiong, Pan Diao, Jitao Hu, Wenbo Niu, Guiying Wang, Baokun Li
Current Treatment Options in Oncology.2025; 26(2): 84. CrossRef
Robotic surgery for bowel endometriosis: a multidisciplinary management of a complex entity
G. N. Piozzi, V. Burea, R. Duhoky, S. Stefan, C. So, D. Wilby, D. Tsepov, J. S. Khan
Techniques in Coloproctology.2024;[Epub] 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
Robotic beyond total mesorectal excision for locally advanced rectal cancers: Perioperative and oncological outcomes from a multicentre case series
Jim S. Khan, Guglielmo Niccolò Piozzi, Philippe Rouanet, Avanish Saklani, Volkan Ozben, Paul Neary, Peter Coyne, Seon Hahn Kim, Julio Garcia-Aguilar
European Journal of Surgical Oncology.2024; 50(6): 108308. CrossRef
Treatment of side limb full-thickness prolapse of the side-to-end coloanal anastomosis following intersphincteric resection: a case report and review of literature
Guglielmo Niccolò Piozzi, Krunal Khobragade, Seon Hui Shin, Jeong Min Choo, Seon Hahn Kim
Annals of Coloproctology.2024; 40(Suppl 1): S38. CrossRef
Robotic approach to colonic resection: For some or for all patients?
Sentilnathan Subramaniam, Guglielmo Niccolò Piozzi, Seon‐Hahn Kim, Jim S. Khan
Colorectal Disease.2024; 26(7): 1447. CrossRef
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Chenxiong Zhang, Hao Tan, Han Xu, Jiaming Ding
International Journal of Surgery.2024; 110(10): 6282. CrossRef
The Impact of a Modular Robotic Total Mesorectal Excision Training Program on Perioperative and Oncological Outcomes in Robotic Rectal Cancer Surgery
Samuel Stefan, Guglielmo Niccolò Piozzi, Patricia Tejedor, Christopher C.L. Liao, Anwar Ahmad, Nasir Z. Ahmad, Syed A.H. Naqvi, Richard J. Heald, Jim S. Khan
Diseases of the Colon & Rectum.2024; 67(11): 1485. CrossRef
Robotic surgery versus laparoscopic surgery for rectal cancer: a comparative study on surgical safety and functional outcomes
Li TengTeng, Fu HaiXiao, Fu Wei, Zhang Xuan
ANZ Journal of Surgery.2024;[Epub] CrossRef
Suitable T stage for cryosurgery to spare the anus in patients with low rectal cancer
Xuejun Jiang, Zujin Ji, Xinyi Lei, Cui Liu, Fangjun Yuan
Cryobiology.2023; 111: 121. CrossRef
Morbidity and oncological outcomes after intersphincteric resection of the rectum for low-lying rectal cancer: experience of a single center in a lower-middle-income country
Antoinette Afua Asiedua Bediako-Bowan, Narious Naalane, Jonathan C. B. Dakubo
BMC Surgery.2023;[Epub] CrossRef
Robotic male and laparoscopic female sphincter-preserving total mesorectal excision of mid-low rectal cancer share similar specimen quality, complication rates and long-term oncological outcomes
Vusal Aliyev, Guglielmo Niccolò Piozzi, Elnur Huseynov, Teuta Zoto Mustafayev, Vildan Kayku, Suha Goksel, Oktar Asoglu
Journal of Robotic Surgery.2023; 17(4): 1637. CrossRef
International standardization and optimization group for intersphincteric resection (ISOG‐ISR): modified Delphi consensus on anatomy, definition, indication, surgical technique, specimen description and functional outcome
Guglielmo Niccolò Piozzi, Krunal Khobragade, Vusal Aliyev, Oktar Asoglu, Paolo Pietro Bianchi, Vlad‐Olimpiu Butiurca, William Tzu‐Liang Chen, Ju Yong Cheong, Gyu‐Seog Choi, Andrea Coratti, Quentin Denost, Yosuke Fukunaga, Emre Gorgun, Francesco Guerra, Ma
Colorectal Disease.2023; 25(9): 1896. CrossRef
International Society of University Colon and Rectal Surgeons survey of surgeons’ preference on rectal cancer treatment
Audrius Dulskas, Philip F. Caushaj, Domas Grigoravicius, Liu Zheng, Richard Fortunato, Joseph W. Nunoo-Mensah, Narimantas E. Samalavicius
Annals of Coloproctology.2023; 39(4): 307. CrossRef
Short-term outcomes of da Vinci SP versus Xi for colon cancer surgery: a propensity-score matching analysis of multicenter cohorts
Jin-Min Jung, Young Il Kim, Yong Sik Yoon, Songsoo Yang, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Journal of Robotic Surgery.2023; 17(6): 2911. CrossRef
Low anterior resection syndrome: is it predictable?
Dong Hyun Kang
Annals of Coloproctology.2023; 39(5): 373. CrossRef
Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef
Robotic and laparoscopic sphincter-saving resections have similar peri-operative, oncological and functional outcomes in female patients with rectal cancer
Vusal Aliyev, Guglielmo Niccolò Piozzi, Niyaz Shadmanov, Koray Guven, Barıs Bakır, Suha Goksel, Oktar Asoglu
Updates in Surgery.2023; 75(8): 2201. CrossRef
Development of robotic surgical devices and its application in colorectal surgery
Kamil Erozkan, Emre Gorgun
Mini-invasive Surgery.2023;[Epub] 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
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Robotic Anterior Resection for Rectosigmoid Colon Cancer using Single Port Access
Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
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Gyoung Tae Noh
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Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer
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Youngbae Jeon, Eun Jung Park
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Jeonghee Han
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Clinical Implication of Lateral Pelvic Lymph Node Metastasis in Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy
In Ja Park
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Current status of robotic surgery for colorectal cancer: A review
Won Beom Jung
International Journal of Gastrointestinal Intervention.2022; 11(2): 56. CrossRef
Current status and role of robotic approach in patients with low-lying rectal cancer
Hyo Seon Ryu, Jin Kim
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Robotic vs. laparoscopic intersphincteric resection for low rectal cancer: a case matched study reporting a median of 7-year long-term oncological and functional outcomes
Vusal Aliyev, Guglielmo Niccolò Piozzi, Alisina Bulut, Koray Guven, Baris Bakir, Sezer Saglam, Suha Goksel, Oktar Asoglu
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Clinical Case Reports.2022;[Epub] CrossRef
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Current Status and Future of Robotic Surgery for Colorectal Cancer-An English Version
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Update on Diagnosis and Treatment of Colorectal Cancer
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Original Articles

Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer,Epidemiology & etiology

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; Ann Coloproctol. 2022;38(3):244-252. Published online November 4, 2021; DOI: https://doi.org/10.3393/ac.2021.00619.0088

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Graphical Abstract Abstract PDF

Purpose
Colorectal cancer (CRC) occurs in all age groups, and the application of treatment may vary according to age. The study was designed to identify the characteristics of CRC by age.
Methods
A total of 4,326 patients undergoing primary resection for CRC from September 2006 to July 2019 were reviewed. Patient and tumor characteristics, operative and postoperative data, and oncologic outcome were compared
Results
Patients aged 60 to 69 years comprised the largest age group (29.7%), followed by those aged 50 to 59 and 70 to 79 (24.5% and 23.9%, respectively). Rectal cancer was common in all age groups, but right-sided colon cancer tended to be more frequent in older patients. In very elderly patients, there were significant numbers of emergency surgeries, and the frequencies of open surgery and permanent stoma were greater. In contrast, total abdominal colectomy or total proctocolectomy was performed frequently in patients in their teens and twenties. The elderly patients showed more advanced tumor stages and postoperative ileus. The incidence of adjuvant treatment was low in elderly patients, who also had shorter follow-up periods. Overall survival was reduced in older patients with stages 0 to 3 CRC (P<0.001), but disease-free survival did not differ by age (P=0.391).
Conclusion
CRC screening at an earlier age than is currently undertaken may be necessary in Korea. In addition, improved surgical and oncological outcomes can be achieved through active treatment of the growing number of elderly CRC patients.

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
Comparison of body composition changes and nutritional status after surgery between older Japanese patients with upper and lower gastrointestinal cancer
Eiko Takano, Tsukasa Aritake, Kakeru Hashimoto, Yumi Suzuki, Yuichi Kitagawa, Ken Fujishiro, Yasuji Kawabata, Shinichirou Kobayashi, Izumi Kondo
The Journal of Aging Research & Lifestyle.2025; 14: 100006. CrossRef
Influence of additional prophylactic oral antibiotics during mechanical bowel preparation on surgical site infection in patients receiving colorectal surgery
Hayoung Lee, Jong Lyul Lee, Ji Sung Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok‐Byung Lim
World Journal of Surgery.2024; 48(6): 1534. CrossRef
Effects of the Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls score on postoperative clinical outcomes following colorectal cancer surgery: a retrospective study
Young Jae Kim, Sung Uk Bae, Kyeong Eui Kim, Woon Kyung Jeong, Seong Kyu Baek
European Journal of Clinical Nutrition.2024;[Epub] 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
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
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] 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
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
Tailoring strategies for colorectal cancer screening and treatment based on age in colorectal cancer patients
Eun Jung Park
Annals of Coloproctology.2022; 38(3): 181. 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

Clinical Outcomes of Ileostomy Closure According to Timing During Adjuvant Chemotherapy After Rectal Cancer Surgery: Yoo Jin Choi, Jung-Myun Kwak, Neul Ha, Tae Hoon Lee, Se Jin Baek, Jin Kim, Seon Hahn Kim; Ann Coloproctol. 2019;35(4):187-193. Published online August 31, 2019; DOI: https://doi.org/10.3393/ac.2018.10.18.1

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Abstract PDF

Purpose
No guidelines exist detailing when to implement a temporary ileostomy closure in the setting of adjuvant chemotherapy following sphincter-saving surgery for rectal cancer. The aim of this study was to evaluate the clinical and oncological outcomes of ileostomy closure during adjuvant chemotherapy in patients with curative resection of rectal cancer.
Methods
This retrospective study investigated 220 patients with rectal cancer undergoing sphincter-saving surgery with protective loop ileostomy from January 2007 to August 2016. Patients were divided into 2 groups: group 1 (n = 161) who underwent stoma closure during adjuvant chemotherapy and group 2 (n = 59) who underwent stoma closure after adjuvant chemotherapy.
Results
No significant differences were observed in operative time, blood loss, postoperative hospital stay, or postoperative complications in ileostomy closure between the 2 groups. No difference in overall survival (P = 0.959) or disease-free survival (P = 0.114) was observed between the 2 groups.
Conclusion
Ileostomy closure during adjuvant chemotherapy was clinically safe, and interruption of chemotherapy due to ileostomy closure did not change oncologic outcomes.

Citations

Citations to this article as recorded by

Clinical Outcomes of Ileostomy Closure during versus after Adjuvant Chemotherapy in Patients with Rectal Cancer
Fan He, Fuyu Yang, Chenglin Tang, Defei Chen, Dongqin Zhao, Junjie Xiong, Yu Zou, Guoquan Huang, Kun Qian, Masanao Nakamura
Canadian Journal of Gastroenterology and Hepatology.2024; 2024: 1. CrossRef
Prophylactic effect of retromuscular mesh placement during loop ileostomy closure on incisional hernia incidence—a multicentre randomised patient- and observer-blind trial (P.E.L.I.O.N trial)
Sven Müller, Dirk Weyhe, Florian Herrle, Philipp Horvath, Robert Bachmann, Viktor von Ehrlich-Treuenstätt, Patrick Heger, Nadir Nasir, Christina Klose, Alexander Ritz, Anja Sander, Erich Grohmann, Colette Dörr-Harim, André L. Mihaljevic
Trials.2023;[Epub] CrossRef
Impact of chemotherapy on surgical outcomes in ileostomy reversal: a propensity score matching study from a single centre
H.-H. Cheng, Y.-C. Shao, C.-Y. Lin, T.-W. Chiang, M.-C. Chen, T.-Y. Chiu, Y.-L. Huang, C.-C. Chen, C.-P. Chen, F.-F. Chiang
Techniques in Coloproctology.2023; 27(12): 1227. CrossRef
Comparison of clinical outcomes of stoma reversal during versus after chemotherapy for rectal cancer patients
Kun-Yu Tsai, Jeng-Fu You, Shu-Huan Huang, Tzong-yun Tsai, Pao-Shiu Hsieh, Cheng-Chou Lai, Wen-Sy Tsai, Hsin-Yuan Hung
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
Early versus late closure of temporary ileostomy after rectal cancer surgery: a meta-analysis
Li Wang, Xinling Chen, Chen Liao, Qian Wu, Hongliang Luo, Fengming Yi, Yiping Wei, Wenxiong Zhang
Surgery Today.2021; 51(4): 463. CrossRef
Low albumin level and longer interval to closure increase the early complications after ileostomy closure
HyungJoo Baik, Ki Beom Bae
Asian Journal of Surgery.2021; 44(1): 352. CrossRef
Does the timing of protective ileostomy closure post-low anterior resection have an impact on the outcome? A retrospective study
Fozan Sauri, Ahmad Sakr, Ho Seung Kim, Mohammed Alessa, Radwan Torky, Eman Zakarneh, Seung Yoon Yang, Nam Kyu Kim
Asian Journal of Surgery.2021; 44(1): 374. CrossRef
Impact of a defunctioning ileostomy and time to stoma closure on bowel function after low anterior resection for rectal cancer: a systematic review and meta-analysis
I. Vogel, N. Reeves, P. J. Tanis, W. A. Bemelman, J. Torkington, R. Hompes, J. A. Cornish
Techniques in Coloproctology.2021; 25(7): 751. CrossRef
Clinical Outcomes of Ileostomy Closure before Adjuvant Chemotherapy after Rectal Cancer Surgery: An Observational Study from a Chinese Center
Zhen Sun, Yufeng Zhao, Lu Liu, Jichao Qin, Zhongguang Luo
Gastroenterology Research and Practice.2021; 2021: 1. CrossRef
Delayed ileostomy closure increases the odds of Clostridium difficile infection
Simon J. G. Richards, Dilshan K. Udayasiri, Ian T. Jones, Ian A. Hastie, Raaj Chandra, Jacob J. McCormick, Timothy J. Chittleborough, David J. Read, Ian P. Hayes
Colorectal Disease.2021; 23(12): 3213. CrossRef
The effect of ileostomy closure timing on low anterior resection syndrome in patient who underwent low anterior resection for rectal cancer
Hemn Hussain Kaka Ali, Qalandar Hussein Abdulkarim, Karzan Seerwan, Barham M. M .Salih, Omar H Ghalib Hawramy, Dara Ahmed Mohammed, Syamand Orhaman Ahmed
Kurdistan Journal of Applied Research.2021; : 126. CrossRef
Assessment of the risk of permanent stoma after low anterior resection in rectal cancer patients
Marcin Zeman, Marek Czarnecki, Andrzej Chmielarz, Adam Idasiak, Maciej Grajek, Agnieszka Czarniecka
World Journal of Surgical Oncology.2020;[Epub] CrossRef

Early Systemic Failure After Preoperative Chemoradiotherapy for the Treatment of Patients With Rectal Cancer: Taesun Choi, Se-Jin Baek, Jung Myun Kwak, Jin Kim, Seon-Hahn Kim; Ann Coloproctol. 2019;35(2):94-99. Published online April 30, 2019; DOI: https://doi.org/10.3393/ac.2018.08.28

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Abstract PDF

Purpose
Distant metastasis can occur early after neoadjuvant chemoradiotherapy (CRT) in patients with rectal cancer. This study was conducted to evaluate the clinical characteristics of patients who developed early systemic failure.
Methods
The patients who underwent neoadjuvant CRT for a rectal adenocarcinoma between June 2007 and July 2015 were included in this study. Patients who developed distant metastasis within 6 months after CRT were identified. We compared short- and long-term clinicopathologic outcomes of patients in the early failure (EF) group with those of patients in the control group.
Results
Of 107 patients who underwent neoadjuvant CRT for rectal cancer, 7 developed early systemic failure. The lung was the most common metastatic site. In the EF group, preoperative carcinoembryonic antigen was higher (5 mg/mL vs. 2 mg/mL, P = 0.010), and capecitabine as a sensitizer of CRT was used more frequently (28.6% vs. 3%, P = 0.002). Of the 7 patients in the EF group, only 4 underwent a primary tumor resection (57.1%), in contrast to the 100% resection rate in the control group (P < 0.001). In terms of pathologic outcomes, ypN and TNM stages were more advanced in the EF group (P < 0.001 and P = 0.047, respectively), and numbers of positive and retrieved lymph nodes were much higher (P < 0.001 and P = 0.027, respectively).
Conclusion
Although early distant metastasis after CRT for rectal cancer is very rare, patients who developed early metastasis showed a poor nodal response with a low primary tumor resection rate and poor oncologic outcomes.

Citations

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Characteristics of Patients Presented With Metastases During or After Completion of Chemoradiation Therapy for Locally Advanced Rectal Cancer: A Case Series
Radwan Torky, Mohammed Alessa, Ho Seung Kim, Ahmed Sakr, Eman Zakarneh, Fozan Sauri, Heejin Bae, Nam Kyu Kim
Annals of Coloproctology.2021; 37(3): 186. CrossRef
Challenges and shifting treatment strategies in the surgical treatment of locally advanced rectal cancer
Ho Seung Kim, Nam Kyu Kim
Annals of Gastroenterological Surgery.2020; 4(4): 379. CrossRef

Anastomotic Sinus That Developed From Leakage After a Rectal Cancer Resection: Should We Wait for Closure of the Stoma Until the Complete Resolution of the Sinus?: Chris Tae-Young Chung, Se-Jin Baek, Jung-Myun Kwak, Jin Kim, Seon-Hahn Kim; Ann Coloproctol. 2019;35(1):30-35. Published online January 25, 2019; DOI: https://doi.org/10.3393/ac.2018.08.13

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Abstract PDF

Purpose
The aims of this study were to identify the clinical characteristics of an anastomotic sinus and to assess the validity of delaying stoma closure in patients until the complete resolution of an anastomotic sinus.
Methods
The subject patients are those who had undergone a resection of rectal cancer from 2011 to 2017, who had a diversion ileostomy protectively or therapeutically and who developed a sinus as a sequelae of anastomotic leakage. The primary outcomes that were measured were the incidence, management and outcomes of an anastomotic sinus.
Results
Of the 876 patients who had undergone a low anterior resection, 14 (1.6%) were found to have had an anastomotic sinus on sigmoidoscopy or a gastrografin enema before their ileostomy closure. In the 14 patients with a sinus, 7 underwent ileostomy closure as scheduled, with a mean closure time of 4.1 months. The remaining 7 patients underwent ileostomy repair, but it was delayed until after the follow-up for the widening of the sinus opening by using digital dilation, with a mean closure time of 6.9 months. Four of those remaining seven patients underwent stoma closure even though their sinus condition had not yet been completely resolved. No pelvic septic complications occurred after closure in any of the 14 patients with an anastomotic sinus, but 2 of the 14 needed a rediversion due to a severe anastomotic stricture.
Conclusion
Patients with an anastomotic sinus who had been carefully selected underwent successful ileostomy closure without delay.

Citations

Citations to this article as recorded by

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Mohamed Rabie, Laura Parry, Iannish Sadien, Sandeep Kapur, Adam Stearns, Irshad Shaikh
ANZ Journal of Surgery.2022; 92(4): 801. CrossRef
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Peter Kienle, Jörn Richard Magdeburg
Der Chirurg.2021; 92(7): 605. CrossRef
Response to Dioscoridi et al.
G. I. Popivanov, V. M. Mutafchiyski, R. Cirocchi, S. D. Chipeva, V. V. Vasilev, K. T. Kjossev, M. S. Tabakov
Colorectal Disease.2020; 22(7): 841. CrossRef
Anastomotic Sinus Developed From Leakage in Rectal Cancer Resection: When Can We Reverse the Defunctioning Stoma?
Chang Hyun Kim
Annals of Coloproctology.2019; 35(1): 1. CrossRef

Editorial

Mesenteric Embolization: Is It Safe in Patients With Acute Lower Gastrointestinal Hemorrhage?: Dong Won Lee, Seon Hahn Kim; Ann Coloproctol. 2013;29(5):181-181. Published online October 31, 2013; DOI: https://doi.org/10.3393/ac.2013.29.5.181

2,738 View
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PDF

Original Article

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

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Abstract PDF

Purpose

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

Methods

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

Results

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

Conclusion

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

Citations

Citations to this article as recorded by

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Antonio Biondi, Giuseppe Grosso, Antonio Mistretta, Stefano Marventano, Chiara Toscano, Salvatore Gruttadauria, Francesco Basile
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Hiroaki Ikematsu, Yusuke Yoda, Takahisa Matsuda, Yuichiro Yamaguchi, Kinichi Hotta, Nozomu Kobayashi, Takahiro Fujii, Yasuhiro Oono, Taku Sakamoto, Takeshi Nakajima, Madoka Takao, Tomoaki Shinohara, Yoshitaka Murakami, Takahiro Fujimori, Kazuhiro Kaneko,
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Péter Metzger
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Oncologic Outcomes of a Laparoscopic Right Hemicolectomy for Colon Cancer: Results of a 3-Year Follow-up
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Editorial

Can Single Incision Laparoscopic Surgery be Considered Primarily for Patients with Complicated Appendicitis?: Seon Hahn Kim, Jung Myun Kwak; J Korean Soc Coloproctol. 2010;26(6):373-374. Published online December 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.6.373

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