Annals of Coloproctology

Review

Benign GI diease,Benign diesease & IBD,Epidemiology & etiology

The Epidemiology and Etiology of Right-Sided Colonic Diverticulosis: A Review: Greg A. Turner, Michael J. O’Grady, Rachel V. Purcell, Frank A. Frizelle; Ann Coloproctol. 2021;37(4):196-203. Published online July 21, 2021; DOI: https://doi.org/10.3393/ac.2021.00192.0027

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Diverticulosis of the colon is a common condition in Western countries and most patients will remain asymptomatic, but some will present with symptoms of acute diverticulitis or bleeding. Our understanding of diverticulosis is evolving but is mostly derived from diverticulosis affecting the left-sided colon. In contrast, right-sided colonic diverticulosis (RCD) is more commonly seen in Asian countries but is much less common overall. Based on the marked differences in epidemiology, it is commonly thought that these are 2 distinct disease processes. A review of the literature describing the epidemiology and etiology of RCD was performed, with a comparison to the current understanding of left-sided diverticulosis. RCD is becoming increasingly common. The epidemiology of RCD shows it to be a mostly acquired condition, and not congenital as previously thought. Many factors in the etiology of RCD are similar to that seen in left-sided diverticulosis, with a few variations. It is therefore likely that most cases of RCD represent the same disease process that is seen in the left colon.

Citations

Citations to this article as recorded by

Right‐sided colonic diverticulitis. Short and long‐term surgical outcomes and 2‐year quality of life
Sara Lauricella, Francesco Brucchi, Dario Palmisano, Gianandrea Baldazzi, Luca Bottero, Diletta Cassini, Giuseppe Faillace
World Journal of Surgery.2024; 48(2): 484. CrossRef
49-jährige Patientin mit Unterbauchschmerz rechts
Achim Jatkowski, Arne Dehling, Wolfram Zoller
Zeitschrift für Gastroenterologie.2024; 62(02): 171. CrossRef
Features of colonic diverticulitis in children and adolescents: A multicenter study
Ji-Won Han, Joonhyuk Son, Chaeyoun Oh
Asian Journal of Surgery.2024; 47(5): 2195. CrossRef
Right Upper Quadrant Pain: A Rare Presentation of Diverticulitis
Rediet Tefera Atalay, Oluwapelumi Kolawole, Girma M Ayele, Abay A Gobezie, Angesom Kibreab, Miriam B Michael
Cureus.2024;[Epub] CrossRef
Colonic Diverticulosis at Colonoscopy in Africa: A Systematic Review and Meta-Analysis of Pooled Estimates
Emeka Ray-Offor, Stella-Maris Egboh, Rex F.O.A. Ijah, Sameh Hany Emile, Steven D. Wexner
Digestive Surgery.2024; 41(2): 63. CrossRef
Genetic, epigenetic and environmental factors in diverticular disease: systematic review
Hannah N Humphrey, Pauline Sibley, Eleanor T Walker, Deborah S Keller, Francesco Pata, Dale Vimalachandran, Ian R Daniels, Frank D McDermott
BJS Open.2024;[Epub] CrossRef
Beyond the Norm: Acute Multifocal Diverticulitis
Bianca Thakkar, Jasmine Tidwell, Minh Thu T. Nguyen, Gengsheng Yu, Neil Parikh
ACG Case Reports Journal.2024; 11(9): e01505. CrossRef
Right-Sided Diverticulitis: A Rare Cause of Right-Sided Abdominal Pain
Athanasios Papatriantafyllou, Paraskevi Dedopoulou, Konstantina Soukouli, Ioannis Karioris, Stylianos Tsochatzis
Cureus.2023;[Epub] CrossRef
Diverticulosis and Diverticulitis: Epidemiology, Pathophysiology, and Current Treatment Trends
Mohit Bhatia, Aastha Mattoo
Cureus.2023;[Epub] CrossRef
Diagnosis and Treatment of Colonic Diverticular Disease
You Sun Kim
The Korean Journal of Gastroenterology.2022; 79(6): 233. CrossRef
When to Perform a Colonoscopy in Diverticular Disease and Why: A Personalized Approach
Antonio Tursi, Valerio Papa, Loris Riccardo Lopetuso, Lorenzo Maria Vetrone, Antonio Gasbarrini, Alfredo Papa
Journal of Personalized Medicine.2022; 12(10): 1713. CrossRef
Right-sided colopleural fistula secondary to diverticular disease: a case report
Summer Hassan, Primal Singh
Journal of Medical Case Reports.2022;[Epub] CrossRef
Case Series of Right Colon Diverticulitis in the West: A Neglected Disease?
Lucas Faraco Sobrado, Tarsila Gomes Caldas, Carolina Graciolli Facanali, Leonardo Bustamente-Lopez, Carlos Walter Sobrado
Journal of Coloproctology.2022; 42(04): 302. CrossRef

Case Report

Colorectal cancer

Experience of surgical treatment in a granular cell tumor in the ascending colon: a case report: In-Kyeong Kim, Young-Tae Ju, Han-Gil Kim, Jin-Kwon Lee, Dong-Chul Kim, Jae-Myung Kim, Jin Kyu Cho, Ji-Ho Park, Ju-Yeon Kim, Chi-Young Jeong, Soon-Chan Hong, Seung-Jin Kwag; Ann Coloproctol. 2023;39(3):275-279. Published online July 6, 2021; DOI: https://doi.org/10.3393/ac.2020.00836.0119

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Abstract PDF: We report a case about successful surgical treatment of a granular cell tumor in the ascending colon. A 36-year-old man underwent screening colonoscopy. An endoscopic examination revealed a 10-mm yellowish and hemispheric mass in the ascending colon, and lower endoscopic ultrasonography revealed a hypoechoic-to-isoechoic mass invaded the submucosal layer. The mass was suspected to be a colonic carcinoid tumor. Based on the preoperative evaluation, endoscopic complete resection was considered difficult. Therefore, the lesion was removed via laparoscopic right hemicolectomy. Histological examination revealed that the tumor consisted of nests of polygonal cells with abundant granular eosinophilic cytoplasm. Immunohistochemical staining revealed diffuse positivity for S100 and CD68. Therefore, the tumor was diagnosed as a granular cell tumor. We suggest that surgical resection should be considered if it is located in the thin-walled ascending colon prone to perforation, difficult to rule out malignant tumor due to submucosal invasion, or to remove endoscopically.

Original Articles

Malignant disease,Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer,Minimally invasive surgery

Laparoscopy offers better clinical outcomes and long-term survival in patients with right colon cancer: experience from national cancer center: Muhammad Fahd Shah, Awais Naeem, Ihtisham ul Haq, Shehryar Riaz, Osama Shakeel, Sofoklis Panteleimonitis, Shahid Khattak, Aamir Ali Syed, Amjad Parvaiz; Ann Coloproctol. 2022;38(3):223-229. Published online June 24, 2021; DOI: https://doi.org/10.3393/ac.2021.00045.0006

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Abstract PDF

Purpose
Laparoscopic approach to colonic tumor requires skill set and resources to be established as routine standard of care in most centers around the world. It presents particular challenge in country like Pakistan due to economic constrain and lack of teaching and training opportunities available for surgeons to be trained to deliver such service. The aim of this study is to look into changing practice of our institution from conventional approach of open to laparoscopic surgery for right colon cancer.
Methods
Consecutive patients between January 2010 to December 2018 who presented to Shaukat Khanum Memorial Cancer Hospital and Research Centre with diagnosis of right colon (cecum, ascending and transverse colon) adenocarcinoma and underwent surgical resections were included in this study.
Results
A total of 230 patients with adenocarcinoma of the right colon underwent curative resections during the study period. Of these, 141 patients (61.3%) underwent laparoscopic surgery while open resection was performed in 89 patients (38.7%). Five-year disease-free survival (DFS) of patients with American Joint Committee on Cancer (AJCC) stage III (80.9% vs. 54.8%, P = 0.021) was significantly better if these patients underwent laparoscopic surgery while a trend toward better DFS (96.7% vs. 84.1%, P = 0.111) was also observed in AJCC stage II patients, although this difference was not significant.
Conclusion
This study demonstrates the adoption of a laparoscopic approach for right colon cancer over 10 years. With a standardized approach and using the principle of oncological surgery, we incorporated this in our minimally invasive surgery practice at our institution.

Citations

Citations to this article as recorded by

Short-Term Outcomes of First 100 Laparoscopic Colorectal Surgeries at a Newly Developed Surgical Setup at Peshawar
Muhammad F Shah, Irfan Ul Islam Nasir, Riaz Ahmad, Sajjad Ahmad, Aalia Amjad, Khush Bakht Zaineb, Romana Rehman
Cureus.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
Clinical Effectiveness of Fluorescence Lymph Node Mapping Using ICG for Laparoscopic Right Hemicolectomy: A Prospective Case–Control Study
Gyung Mo Son, Mi Sook Yun, In Young Lee, Sun Bin Im, Kyung Hee Kim, Su Bum Park, Tae Un Kim, Dong-Hoon Shin, Armaan M. Nazir, Gi Won Ha
Cancers.2023; 15(20): 4927. CrossRef
Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
Ji-Hyun Seo, In-Ja Park
Cancers.2023; 15(21): 5211. 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
Ileal long-segment ischemia after the unintended ligation of variant ileal branch during laparoscopic right hemicolectomy
Gyung Mo Son, Tae Un Kim, Dong-Hoon Shin, Joo-Young Na, In Young Lee, Shin Hoo Park
Journal of Minimally Invasive Surgery.2022; 25(3): 116. CrossRef
Is Laparoscopic Complete Mesocolic Excision and Central Vascular Ligation Really Necessary for All Patients With Right-Sided Colon Cancer?
Gyung Mo Son, In Young Lee, Yoon Suk Lee, Bong-Hyeon Kye, Hyeon-Min Cho, Je-Ho Jang, Chang-Nam Kim, Kil Yeon Lee, Suk-Hwan Lee, Jun-Gi Kim
Annals of Coloproctology.2021; 37(6): 434. CrossRef

Female Sex and Right-Sided Tumor Location Are Poor Prognostic Factors for Patients With Stage III Colon Cancer After a Curative Resection: Jung Ho Park, Hyoung-Chul Park, Sung Chan Park, Jae Hwan Oh, Duck-Woo Kim, Sung-Bum Kang, Seung Chul Heo, Min Jung Kim, Ji Won Park, Seung-Yong Jeong, Kyu Joo Park, for the Seoul Colorectal Group (SECOG); Ann Coloproctol. 2018;34(6):286-291. Published online December 31, 2018; DOI: https://doi.org/10.3393/ac.2018.10.29

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Abstract PDF

Purpose
Stage-IIIC colon cancer is an advanced disease; however, its oncologic outcomes and prognostic factors remain unclear. In this study, we aimed to determine the predictors of disease-free survival (DFS) in patients with stage-IIIC colon cancer.
Methods
From a multicenter database, we retrospectively enrolled 611 patients (355 men and 256 women) who had undergone a potentially curative resection for a stage-IIIC colon adenocarcinoma between 2003 and 2011. The primary end-point was the 5-year DFS.
Results
The median age was 62 years; 213 and 398 patients had right-sided colon cancer (RCC) and left-sided colon cancer (LCC), respectively. The 5-year DFS in all patients was 52.0%; median follow-up time was 35 months (range, 1–134 months). A multivariate Cox regression revealed that female sex (hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.19–1.90; P < 0.01), right-sided tumor location (HR, 1.65; 95% CI, 1.29–2.11; P < 0.01), lymphatic invasion (HR, 1.52; 95% CI, 1.08–2.15; P < 0.01) and a high (≥0.4) metastatic lymph node ratio (HR, 3.72; 95% CI, 2.63–5.24; P < 0.01) were independent predictors of worse 5-year DFS. Female patients with RCC were 1.79 fold more likely to experience recurrence than male patients with LCC.
Conclusion
Female sex and right-sided tumor location are associated with higher tumor recurrence rates in patients with stage-IIIC colon cancers. Aggressive treatment and close surveillance should be planned for patients in these groups.

Citations

Citations to this article as recorded by

Development and external validation of a nomogram predicting overall survival after curative resection of colon cancer
Shuanhu Wang, Yakui Liu, Yi Shi, Jiajia Guan, Mulin Liu, Wenbin Wang
Journal of International Medical Research.2021;[Epub] CrossRef

Case Reports

Giant Ascending Colonic Diverticulum Presenting With Intussusception: Ho Jin Kim, Jin Ha Kim, Ok In Moon, Kyung Jong Kim; Ann Coloproctol. 2013;29(5):209-212. Published online October 31, 2013; DOI: https://doi.org/10.3393/ac.2013.29.5.209

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10 Citations

Abstract PDF

Diverticular disease of the colon is a common disease, and its incidence is increasing gradually. A giant colonic diverticulum (GCD) is a rare entity and is defined as a diverticulum greater than 4 cm in size. It mainly arises from the sigmoid colon, and possible etiology is a ball-valve mechanism permitting progressive enlargement. A plain abdominal X-ray can be helpful to make a diagnosis initially, and a barium enema and abdominal computed tomography may confirm the diagnosis. Surgical intervention is a definite treatment for a GCD. We report a case of an ascending GCD presenting with intussusception in a young adult.

Citations

Citations to this article as recorded by

Intussusception secondary to retroflexion of a proximal jejunal diverticulum, leading to Type 3 vagal indigestion with severe hypochloraemia in an adult Simmental bull (Bos taurus)
Liam A. Wilson, Rob F. Kelly, Adrian W. Philbey
Veterinary Record Case Reports.2024;[Epub] CrossRef
A case report of impacted fecalith within mucosal pouch: an unusual cause of colocolic intussusception
Douglas Greer, Adrian Fernandez
Annals of Coloproctology.2024; 40(Suppl 1): S15. CrossRef
Popping the Balloon: A Giant Colonic Diverticulum Complicated by Bladder Neck Compression
M. C. Ripoli, A. Lauro, S. Vaccari, G. Mastrocola, A. Lanci-Lanci, V. D’Andrea, I. R. Marino, M. Cervellera, V. Tonini
Digestive Diseases and Sciences.2021; 66(1): 41. CrossRef
Laparoscopic resection of a giant colonic diverticulum – the ‘lifting balloon’ sign – a video vignette
C. Rodríguez‐Otero Luppi, M. Rodríguez Blanco, J. Bollo Rodríguez, A. Méndez, J. Merlo Más
Colorectal Disease.2019; 21(9): 1096. CrossRef
Intussusception caused by an inverted colonic diverticulum: a case report
Bei Zhang, Jiping Wang, Xiaoguang Li, Zhuo Wang, Yangjiao Zhang, Hao Yang
Journal of Medical Case Reports.2018;[Epub] CrossRef
Adult intussusception secondary to diverticular disease
Habib Syed, Labib Syed, Umesh Parampalli, Mokhtar Uheba
BMJ Case Reports.2018; : bcr-2018-226678. CrossRef
Laparoskopische Resektion eines Riesenkolondivertikels
P. J. Roch, T. Friedrich, R. Bönninghoff, D. Dinter, A. Rickert
Der Chirurg.2017; 88(8): 682. CrossRef
Giant colonic diverticulum: radiographic and MDCT characteristics
Abdel-Rauf Zeina, Ahmad Mahamid, Alicia Nachtigal, Itamar Ashkenazi, Mika Shapira-Rootman
Insights into Imaging.2015; 6(6): 659. CrossRef
Giant colonic diverticulum: Clinical presentation, diagnosis and treatment: Systematic review of 166 cases
Giuseppe Nigri
World Journal of Gastroenterology.2015; 21(1): 360. CrossRef
Giant Colonic Diverticulum: a Rare Diagnostic and Therapeutic Challenge of Diverticular Disease
Ryan Macht, Holly K. Sheldon, P. Marco Fisichella
Journal of Gastrointestinal Surgery.2015; 19(8): 1559. CrossRef

Adenosquamous Carcinoma of the Ascending Colon: A Case Report and Review of the Literature: Jae Won Choi, Hee Ug Park; Ann Coloproctol. 2013;29(2):83-86. Published online April 30, 2013; DOI: https://doi.org/10.3393/ac.2013.29.2.83

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9 Web of Science
7 Citations

Abstract PDF

An adenosquamous carcinoma is a malignancy that has both glandular and squamous histologic components. Both components are malignant and have potential to metastasize. An adenosquamous carcinoma of the large bowel is rare, and its clinicopathologic behavior is not fully understood. It is reported to be more aggressive and have a worse prognosis when it is compared with an adenocarcinoma alone. We present a case of an adenosquamous carcinoma in the ascending colon which was laparoscopically resected and followed by adjuvant chemotherapy.

Citations

Citations to this article as recorded by

Presentation, treatment, and prognosis of colorectal adenosquamous carcinoma: A contemporary analysis of the surveillance, epidemiology, and end results database
Adil H. Khan, Xiang Gao, Paolo Goffredo, Amanda R. Kahl, Alan F. Utria, Mary E. Charlton, Sajida Ahad, Imran Hassan
The American Journal of Surgery.2022; 223(5): 957. CrossRef
PRIMARY ADENOSQUAMOUS CARCINOMA OF COLON – A RARE CASE DIAGNOSED ON HISTOPATHOLOGY
Shivani Parikh, Nisha Raval
PARIPEX INDIAN JOURNAL OF RESEARCH.2022; : 29. CrossRef
Atypical Expression of CK7 and CK20 in Adenosquamous Carcinoma, Colon—a Rare Case
Tarun Kumar, Avinash Singh, Jitendra Singh Nigam, Jagjit Kumar Pandey, Subhash Kumar
Journal of Gastrointestinal Cancer.2021; 52(2): 780. CrossRef
Adenosquamous carcinoma of the right colon: A case report and review of the literature
Omar Toumi, Badii Hamida, Manel Njima, Amal Bouchrika, Houssem Ammar, Amira Daldoul, Sonia Zaied, Sadok Ben Jabra, Rahul Gupta, Faouzi Noomen, Khadija Zouari
International Journal of Surgery Case Reports.2018; 50: 119. CrossRef
Primary Colon Adenosquamous Carcinoma in a Patient With Lynch Syndrome
Virginia E. Duncan, Shuko Harada, Todd M. Stevens
International Journal of Surgical Pathology.2016; 24(7): 653. CrossRef
Clinicopathological characteristics, diagnosis, treatment, and outcomes of primary gastric adenosquamous carcinoma
Haining Chen, Chaoyong Shen, Rui Yin, Yuan Yin, Jiaju Chen, Luyin Han, Bo Zhang, Zhixin Chen, Jiaping Chen
World Journal of Surgical Oncology.2015;[Epub] CrossRef
Adenosquamous Carcinoma in Distal Transverse Colon in a 72-Year-Old Female Patient
Kang Ryun Moon, Jong Seok Ju, Hee Seok Moon, Sun Hyung Kang, Jae Kyu Seong, Hyun Yong Jeong
Journal of the Korean Geriatrics Society.2014; 18(1): 30. CrossRef

Original Article

Clinical Analysis of Diverticulosis of the Cecum and Ascending Colon.: Kim, Gyu Yeol , Nam, Chang Woo , Ko, Byung Kyun , Cho, Hong Rae , Park, Chan Jin , Choi, Dae Hwan; J Korean Soc Coloproctol. 1998;14(3):595-604.

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Abstract PDF: BACKGROUND
Diverticulosis of the cecum and ascending colon is a rare disease in Western countries, it is more common in the Orient. Making the diagnosis preoperatively could be difficult, and the intraoperative assessment and decision of optimal treatments are difficult.
METHODS
Therefore, we reviewed the patient's charts of diverticulosis of the cecum and ascending colon at our hospital from 1992 to 1997.
RESULTS
During the past 5 years, a total of 53 cases of diverticulosis of the cecum and ascending colon had been treated at this hospital. Mean age was 41.8 years (range 20-70). The male to female ratio was 1.8 : 1. Frequent complaints were abdominal pain (46 cases, 86.8%), followed by diarrhea (5 cases, 9.3%), indigestion (4 cases, 7.5%), and bowel habits change (2 cases, 3.8%). Mean duration of illness was 3.5 days(range 24 hours~15 days). In non-surgical cases, diagnoses were established with barium enema, CT scan, or ultrasonography. The accuracy of these methods was 91%, 75%, and 25%. In surgical cases, the preoperative diagnoses were appendicitis(13 cases, 50.1%), diverticulitis (7 cases, 31.8%), and abscess (2 cases, 9.1%). Treatments of the cecum and ascending colon diverticulitis were conservative management (3 teases,58.5%) and surgical treatment (22 cases,41.5%). The operative procedures were right hemicolectomies (2 cases), ileocecal resections (2 cases), diverticulectomies (6 cases) and appendectomies only (11 cases).
CONCLUSION
These results suggest that correct diagnosis of the diverticulitis of the cecum and ascending colon made before treatment is very important because correct assessment of diverticulitis intraoperatively is difacut. Liberal use of diagnostic modalities could facilitate to make correct diagnosis to set a proper plan for treatment.

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