Annals of Coloproctology

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Original Article

ERAS

Predicting venous thromboembolism and determining appropriate prophylaxis in elderly patients undergoing colorectal cancer surgery with Enhanced Recovery After Surgery (ERAS) using the adjusted Caprini score: Young Sun Choi, Hyung Jin Cho, Chul Seung Lee, Dong Geun Lee, Choon Sik Chung, Gwan Cheol Lee, Dong Woo Kang, Jeong Sub Kim, Tae Gyu Kim; Ann Coloproctol. 2025;41(4):279-286. Published online August 26, 2025; DOI: https://doi.org/10.3393/ac.2024.00857.0122

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Abstract PDF Supplementary Material: Purpose
Age and postoperative complications are known risk factors for venous thromboembolism (VTE). Minimally invasive surgery and Enhanced Recovery After Surgery (ERAS) protocol has been implemented to reduce these risks. The purpose of this study was to assess the short- and long-term effects of a VTE prophylaxis program using the Caprini score in elderly patients undergoing minimally invasive colorectal cancer surgery with the ERAS protocol.
Methods
This retrospective cross-sectional study included 1,043 colorectal cancer patients requiring surgery from January 2017 to December 2019, divided into a control group (≤75 years) and an elderly group (>75 years), with 827 and 216 patients, respectively. The primary outcome was the incidence of VTE; secondary outcome was the incidence of postoperative complications, particularly bleeding.
Results
The incidence of VTE was 1.5% in the control group and 3.7% in the elderly group (P=0.061). Five patients (0.5%) experienced symptomatic VTE, and the Caprini score for all VTE patients was ≤8 points; thus, only mechanical prophylaxis was used. In the multivariable logistic regression, the Caprini score (P=0.024) and cancer stage (P=0.004) were selected. The odds ratios (95% confidence interval) of the Caprini score and TNM staging were 1.758 (1.078–2.867) and 6.152 (2.045–26.510), respectively.
Conclusion
When the ERAS protocol was used for patients with colorectal cancer as perioperative care, the VTE risk was lower than that estimated by the Caprini score. Given that age is a recognized risk factor for major bleeding, criteria for the use of anticoagulation to prevent VTE, particularly in elderly patients, should be carefully evaluated, considering both the bleeding risks and the potential benefits of pharmacologic prophylaxis. Trial registration: Clinical Research Information Service (CRIS; cris.nih.go.kr) identifier: KCT0007804

Case Report

Metachronous carcinoma at the colostomy site after abdominoperineal resection of rectal cancer: a case report: Young Sun Choi, Kil-young Lee, Youn Young Park, Hyung Jin Kim, Jaeim Lee; Ann Coloproctol. 2023;39(2):175-177. Published online July 27, 2021; DOI: https://doi.org/10.3393/ac.2020.00185.0026

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6 Citations

Abstract PDF

Metachronous carcinoma at the colostomy site is very rare after abdominoperineal resection. A 53-year-old male patient underwent an abdominoperineal resection 6 years earlier for rectal cancer developed metachronous carcinoma at the site of stoma. A portion of the colon, including the stoma and the surrounding skin, was resected and a new stoma was created in the transverse colon. Although the occurrence of carcinoma at the stoma site is a rare condition, careful observation for the stoma and colonoscopy for surveillance are necessary.

Citations

Citations to this article as recorded by

Tumor Recurrence at the Colostomy Site: A Rare Case Report and Literature Review
Abdelhak Ettaoussi, Ilias El Azhari, Nassima Fakhiri, Abdessamad Majd, Kamal Khadija, Mounir Bouali, Abdelilah El Bakouri, Khalid Khaleq, Khalid El Hattabi
European Journal of Medical and Health Research.2025; 3(3): 215. CrossRef
A rare case of metastatic carcinoma at the colostomy site after abdominoperineal resection
Dheeraj Manne, Tirou Aroul, Robinson Smile
International Surgery Journal.2025; 12(10): 1849. CrossRef
Colostomy‐site carcinoma with primitive phenotype in a rectal cancer patient after achieving pathological complete response with neoadjuvant chemoradiotherapy
Takayuki Kodama, Maki Kanzawa, Hiroshi Hasegawa, Shuichi Tsukamoto, Mari Nishio, Manabu Shigeoka, Yu‐ichiro Koma, Tomoo Itoh, Hiroshi Yokozaki
Pathology International.2024; 74(1): 33. CrossRef
Metachronous Carcinoma at Colostomy Site Post Abdominoperineal Resection – A Rare Presentation Case Report
Muhammed Huzaifa, Ankita Singh, Vaibhav Aggarwal, Anita Dhar
Clinical Cancer Investigation Journal.2023; 12(2): 1. CrossRef
Peristomal adenocarcinoma 16 years after colorectal adenocarcinoma resection with curative intent
Kayleigh A M van Dam, Thaís T T Tweed, Bart de Vries, Henricus J Belgers
Journal of Surgical Case Reports.2023;[Epub] CrossRef
A Rare Case of Metachronous Carcinoma at the Colostomy Site Following Abdominoperineal Resection – Case Report
Naoki Todayama, Ai Hua Chang, Tomohiro Tabata
Archive of International Journal of Cancer and Allied Science.2023; 3(2): 1. CrossRef

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