Annals of Coloproctology

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Original Articles

Colorectal cancer

Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer: Jung Tak Son, Yong Bog Kim, Hyung Ook Kim, Chungki Min, Yongjun Park, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim; Ann Coloproctol. 2023;39(3):260-266. Published online May 25, 2022; DOI: https://doi.org/10.3393/ac.2022.00101.0014

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4 Web of Science
6 Citations

Purpose
Surgical management of obstructive left colon cancer (OLCC) is still a matter of debate. The classic Hartmann procedure (HP) has a disadvantage that requires a second major operation. Subtotal colectomy/total abdominal colectomy (STC/TC) with ileosigmoid or ileorectal anastomosis is proposed as an alternative procedure to avoid stoma and anastomotic leakage. However, doubts about morbidity and functional outcome and lack of long-term outcomes have made surgeons hesitate to perform this procedure. Therefore, this trial was designed to provide data for morbidity, functional outcomes, and long-term outcomes of STC/TC.
Methods
This study retrospectively analyzed consecutive cases of OLCC that were treated by STC/TC between January 2000 and November 2020 at a single tertiary referral center. Perioperative outcomes and long-term outcomes of STC/TC were analyzed.
Results
Twenty-five descending colon cancer (45.5%) and 30 sigmoid colon cancer cases (54.5%) were enrolled in this study. Postoperative complications occurred in 12 patients. The majority complication was postoperative ileus (10 of 12). Anastomotic leakage and perioperative mortality were not observed. At 6 to 12 weeks after the surgery, the median frequency of defecation was twice per day (interquartile range, 1–3 times per day). Eight patients (14.5%) required medication during this period, but only 3 of 8 patients required medication after 1 year. The 3-year disease-free survival was 72.7% and 3-year overall survival was 86.7%.
Conclusion
The risk of anastomotic leakage is low after STC/TC. Functional and long-term outcomes are also acceptable. Therefore, STC/TC for OLCC is a safe, 1-stage procedure that does not require diverting stoma.

Citations

Citations to this article as recorded by

Controversial issues of colon stenting in case of tumor obstructive intestinal obstruction: surgical and oncological aspects
S.A. Aliyev, E.S. Aliyev, T.K. Aliyev
Endoscopic Surgery.2025; 31(2): 65. CrossRef
The Safety of Primary Anastomosis Without Protective Stoma in Emergency Left Colon Surgery: A Meta-Analysis
Zhiyan Wang, Wentao Sheng, Senjie Dai, Xuanzhou Li, Guojian Lin, Xiaohong Kang
Journal of Investigative Surgery.2025;[Epub] CrossRef
Ileus After Colectomy in the Modern Era: A Population-Based Analysis
Grace M. Crouch, Samantha Hendren, Kara K. Brockhaus, Wenjing Weng, Jami L. Boyd, Cheryl Rocker, Robert K. Cleary
Diseases of the Colon & Rectum.2025; 68(8): 1001. CrossRef
Influence of the type of anatomic resection on anastomotic leak after surgery for colon cancer
Suat Chin Ng, Andrew McCombie, Frank Frizelle, Tim Eglinton
ANZ Journal of Surgery.2024; 94(3): 424. CrossRef
Complete Obstruction, a Real Risk Factor: A Comprehensive Study on Obstruction in Stage IIA Colon Cancer With Propensity Score Matching Analysis
Soo Young Oh, Chan Wook Kim, Seonok Kim, Min Hyun Kim, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Clinical Colorectal Cancer.2024; 23(2): 135. CrossRef
Can we use colon stenting in accelerated recovery programs for surgical treatment colon cancer complicated by obstructive intestinal obstruction? A literature review
Saday A. Aliyev, Emil S. Aliyev
Russian Journal of Oncology.2024; 29(2): 130. CrossRef

Benign proctology,Rare disease & stoma,Surgical technique

Comparison of blowhole colostomy and loop ostomy for palliation of acute malignant colonic obstruction: Yongjun Park, Dong Uk Choi, Hyung Ook Kim, Yong Bog Kim, Chungki Min, Jung Tack Son, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim; Ann Coloproctol. 2022;38(4):319-326. Published online March 7, 2022; DOI: https://doi.org/10.3393/ac.2021.00682.0097

13,037 View
275 Download
2 Web of Science
3 Citations

Graphical Abstract Abstract PDF

Purpose
Surgery to create a stoma for decompression might be required for unresectable stage IV cancer patients with complete colonic obstruction. The aim of this study was to compare the results of blowhole colostomy with those of loop ostomy.
Methods
Palliative ileostomy or colostomy procedures performed at a single center between January 2011 and October 2020, were analyzed retrospectively. Fifty-nine patients were identified during this period. The demographic characteristics and outcomes between the blowhole colostomy group (n=24) and the loop ostomy group (n=35) were compared.
Results
The median operative time tended to be shorter in the blowhole colostomy group (52.5 minutes; interquartile range [IQR], 43–65) than in the loop ostomy group (60 minutes; IQR, 40–107), but the difference did not reach statistical significance (P=0.162). The median length of hospital stay was significantly shorter with blowhole colostomy (blowhole, 13 days [IQR, 9–23]; loop, 21 days [IQR, 14–37]; P=0.013). Mean cecum diameter was significantly larger in the blowhole group than in the loop group (8.83±1.91 cm vs. 6.78±2.36 cm, P=0.001), and the emergency operation rate was higher in the blowhole group than in the loop group (22 of 24 [91.7%] vs. 23 of 35 [65.7%], P=0.021).
Conclusion
In surgical emergencies, diverting a blowhole colostomy can be safe and effective for palliative management of colonic obstruction in patients with end-stage cancer and might reduce the operative time in emergent situations.

Citations

Citations to this article as recorded by

A Last Resort: Dacron Vascular Graft Prosthesis for Management of a Blowhole Colostomy
Brittney A. Ehrlich, Maria C. Unuvar, Justin M. Orenich, Rebecca L. Hoffman
The American Surgeon™.2025; 91(2): 303. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef
Stoma-Related Complications: A Single-Center Experience and Literature Review
Zalán Benedek, Loránd Kocsis, Orsolya Bauer, Nicolae Suciu, Sorin Sorlea, Călin Crăciun, Rareș Georgescu, Marius Florin Coroș
Journal of Interdisciplinary Medicine.2022; 7(2): 31. CrossRef

Malignant disease

Increased Risk of Neoplasms in Adult Patients Undergoing Interval Appendectomy: Jungtak Son, Yong Jun Park, Sung Ryol Lee, Hyung Ook Kim, Kyung Uk Jung; Ann Coloproctol. 2020;36(5):311-315. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2019.10.15.1

8,108 View
220 Download
12 Web of Science
12 Citations

Abstract PDF

Purpose
The low rate of recurrent appendicitis after initial nonsurgical management of complicated appendicitis supports the recently implemented strategy of omitting routine interval appendectomy. However, several reports have suggested an increased incidence rate of neoplasms in these patients. We aimed to identify the risk of neoplasms in the population undergoing interval appendectomy.
Methods
This study retrospectively analyzed consecutive cases of appendicitis that were treated surgically between January 2014 and December 2018 at a single tertiary referral center. Patients were divided into 2 groups depending on whether they underwent immediate or interval appendectomy. Demographics and perioperative clinical and pathologic parameters were analyzed.
Results
All 2,013 adults included in the study underwent surgical treatment because of an initial diagnosis of acute appendicitis. Of these, 5.5% (111 of 2,013) underwent interval appendectomy. Appendiceal neoplasm was identified on pathologic analysis in 36 cases (1.8%). The incidence of neoplasm in the interval group was 12.6% (14 of 111), which was significantly higher than that of the immediate group (1.2% [22 of 1,902], P < 0.001). Conclusion: The incidence rate of neoplasms was significantly higher in patients undergoing interval appendectomy. These findings should be considered when choosing treatment options after successful nonsurgical management of complicated appendicitis.

Citations

Citations to this article as recorded by

Incidental appendiceal neoplasms in a multicenter registry of appendicitis management
Aksel D. Laudon, Brendin R. Beaulieu-Jones, Swetha Duraiswamy, Frank F. Yang, Elizabeth Chen, Dave R. Flum, Kasey Lerner, Heather L. Evans, Lauren Thompson, Faris K. Azar, Alex Charboneau, Vlad V. Simianu, Victoria Valdes, Chaitan Narsule, Sabrina E. Sanc
Surgery.2026; 190: 109879. CrossRef
Appendiceal Tumor Prevalence in Patients With Periappendicular Abscess
Roosa Salminen, Jenny Alajääski, Tero Rautio, Saija Hurme, Pia Nordström, Elisa Mäkäräinen, Elina Lietzén, Tarja Pinta, Marie Grönroos-Korhonen, Tuomo Rantanen, Jan Andersén, Anne Mattila, Jyrki Kössi, Antti Riikola, Hannu Paajanen, Markku Matikainen, Ves
JAMA Surgery.2025; 160(5): 526. CrossRef
Acellular mucin in neoplastic and non-neoplastic conditions of the lower gastrointestinal tract
Noureldien Darwish, Lynn Guo, Eundong Park, Hwajeong Lee
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Is it Possible to Manage Appendicular Mass Without Surgery?
Muhammad Albahadili, Saif Mundher Ismael, Monaf Faik Al-Samarraee
Al-Rafidain Journal of Medical Sciences ( ISSN 2789-3219 ).2025; 9(2): 46. CrossRef
Can Appendiceal Neoplasms Be Predicted in Patients with Presumed Acute Appendicitis?
Şevki Pedük
European Journal of Therapeutics.2024; 30(2): 145. CrossRef
Beyond acute appendicitis: a single-institution experience of unexpected pathology findings after 989 consecutive emergency appendectomy
Pietro Fransvea, Caterina Puccioni, Gaia Altieri, Luca D’Agostino, Gianluca Costa, Giuseppe Tropeano, Antonio La Greca, Giuseppe Brisinda, Gabriele Sganga
Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
Exploring the mysterious mucinous appendiceal neoplasm
Erika Hissong
Seminars in Diagnostic Pathology.2024; 41(5): 222. CrossRef
High Incidence of Appendiceal Neoplasms in the Elderly: A Critical Concern for Non-Surgical Treatment
Gizem Issin, Fatih Demir, Irem Guvendir Bakkaloglu, Diren Vuslat Cagatay, Hasan Aktug Simsek, Ismail Yilmaz, Ebru Zemheri
Medical Principles and Practice.2023; 32(6): 358. CrossRef
Benign multicystic mesothelioma of appendiceal origin treated by hyperthermic intraperitoneal chemotherapy: A case report
Suk Jun Lee, Ji Hae Nahm, Jeonghyun Kang, Seung Hyuk Baik, Eun Jung Park
International Journal of Surgery Case Reports.2022; 99: 107665. CrossRef
Risk of appendiceal neoplasm after interval appendectomy for complicated appendicitis: A systematic review and meta-analysis
Roberto Peltrini, Valeria Cantoni, Roberta Green, Ruggero Lionetti, Michele D'Ambra, Carolina Bartolini, Marcello De Luca, Umberto Bracale, Alberto Cuocolo, Francesco Corcione
The Surgeon.2021; 19(6): e549. CrossRef
Interval appendicectomy for complicated appendicitis: do not let your guard down!
R Peltrini, M Podda, S Di Saverio, U Bracale, F Corcione
British Journal of Surgery.2021; 108(9): e288. CrossRef
Modern Management of the Appendix
CPT Samuel Grasso, LTC Avery Walker
Surgical Clinics of North America.2021; 101(6): 1023. CrossRef

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