Annals of Coloproctology

Original Articles

Incisional hernia risk in intracorporeal anastomosis with Pfannenstiel incision versus extracorporeal anastomosis with midline incision for laparoscopic right hemicolectomy: a multicenter comparison: Francesco Saverio Lucido, Giusiana Nesta, Luigi Brusciano, Claudio Gambardella, Francesco Pizza, Giuseppe Scognamiglio, Gianmattia del Genio, Salvatore Tolone, Federico Maria Mongardini, Massimo Mongardini, Ludovico Docimo, Simona Parisi; Received September 29, 2024 Accepted January 20, 2025 Published online June 18, 2025; DOI: https://doi.org/10.3393/ac.2024.00682.0097 [Epub ahead of print]

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Abstract PDF: Purpose
Laparoscopic right hemicolectomy can be performed via intracorporeal ileocolic anastomosis (ICA) or extracorporeal ileocolic anastomosis (ECA). Prior studies have emphasized ICA’s advantages in hospital stay and postoperative pain. This multicenter study aimed to compare the 2-year incidence of incisional hernia between ICA (using a suprapubic Pfannenstiel incision) and ECA (using a pararectal incision) and assess perioperative outcomes.
Methods
We retrospectively analyzed patients undergoing laparoscopic right hemicolectomy between 2019 and 2020, divided into 2 groups: ICA with a Pfannenstiel incision and ECA with a pararectal incision.
Results
The mean operative time was longer in the ICA group (190 minutes vs. 170 minutes, P=0.004). Despite requiring advanced surgical skills and prolonged operative time, ICA was associated with superior short-term outcomes and a significantly lower incisional hernia rate compared to ECA (1.2% vs. 14.7%, P=0.044) at 24-month follow-up.
Conclusion
ICA is linked to longer operative times, but shorter hospital stays, fewer wound complications, and reduced incisional hernia rates compared to ECA.

Improved outcomes with cyanoacrylate glue for ileocolic anastomosis in right colectomy: a multicenter study: Daniela Rega, Ernesto De Giulio, Raffaele De Luca, Andrea Muratore, Marco Milone, Giuseppe Sica, Paolo Millo, Carmela Cervone, Nicola Cillara, Patrizia Marsanic, Brunella Maria Pirozzi, Valeria Grazia Malagnino, Pietro Anoldo, Marcello Calabrò, Giovanni De Palma, Michele Simone, Paolo Delrio; Received December 3, 2024 Accepted February 9, 2025 Published online June 4, 2025; DOI: https://doi.org/10.3393/ac.2024.00899.0128 [Epub ahead of print]

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Abstract PDF: Purpose
Anastomotic leaks (AL) remain a major complication following right colectomy for colon cancer. This multicenter, prospective, observational study evaluated the efficacy of Glubran 2, a cyanoacrylate-based sealant, in reducing the incidence of AL by reinforcing ileocolic anastomoses.
Methods
The study enrolled 380 patients undergoing right colectomy for colon cancer across 7 Italian hospitals. Glubran 2 was applied to reinforce ileocolic anastomoses. The primary endpoint was a 50% reduction in AL incidence from a baseline of 6.18% within 10 days after surgery. Secondary endpoints included examining the correlation between AL and preexisting risk factors and determining the rate of anastomotic bleeding. Statistical analyses employed binomial tests and logistic regression.
Results
The AL rate was reduced to 1.85% compared to the reference rate of 6.18% (P<0.01). Glubran 2 exhibited a protective effect even in patients with preexisting risk factors such as smoking, diabetes, or prior surgeries; none of these factors was significantly associated with AL (P>0.05). Surgical technique (P=0.687), anastomosis technique (P=0.998), and anastomosis type (P=0.998) did not influence AL rates. Operation time was similar across groups (P=0.613), and anastomotic bleeding occurred in 1.3% of cases, with no association with AL (P=0.989).
Conclusion
Glubran 2 was safely applied to ileocolic anastomoses, significantly reducing AL rates and potentially providing a protective effect even in patients with known risk factors. Its hemostatic and bacteriostatic properties support improved postoperative outcomes, highlighting its potential as an effective adjunct in colorectal surgery. Further studies are warranted to confirm these findings and explore broader applications.

Technical Note

Technical tips

A unique surgical approach to the management of life-threatening, obscure lower gastrointestinal bleeding: Nelson Chen, Tessa Daly, Neil Strugnell, Russell Hodgson, David Bird; Ann Coloproctol. 2024;40(5):515-518. Published online October 17, 2024; DOI: https://doi.org/10.3393/ac.2024.00101.0014

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Video

Video clip

Cranial-first approach for laparoscopic extended right hemicolectomy: Kyong-Min Kang, Heung-Kwon Oh, Hong-Min Ahn, Tae-Gyun Lee, Hye-Rim Shin, Mi-Jeong Choi, Duck-Woo Kim, Sung-Bum Kang; Ann Coloproctol. 2024;40(3):282-284. Published online June 19, 2024; DOI: https://doi.org/10.3393/ac.2023.00661.0094

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Abstract PDF Supplementary Material: Complete mesocolic excision and central vascular ligation with D3 lymphadenectomy are important surgical principles for improving oncological outcomes in colon cancer. The cranial-first approach is a colonic mobilization–first approach to radical right hemicolectomy, which has several advantages, including early feasibility assessment, safe dissection from surrounding organs, preestablished inferior margin of lymph node dissection, and revelation of the tangible anatomy of the tributaries of the gastrocolic trunk. This video demonstrates the cranial-first approach to radical right hemicolectomy in a 66-year-old man with locally advanced cecal cancer.

Case Report

Benign bowel disease

Colonic duplication in an adult with chronic constipation: a case report and review of its surgical management: Muhammad Ash-Shafhawi Adznan, Hizami Amin Tai, Aras Emre Canda, Nevra Elmas, Mustafa Cem Terzi; Ann Coloproctol. 2024;40(Suppl 1):S6-S10. Published online May 16, 2024; DOI: https://doi.org/10.3393/ac.2022.01081.0154

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Abstract PDF: One of the possible causes of chronic constipation is colonic duplication. Although seldom asymptomatic, its diagnosis is important due to the risk of malignancy that it carries. We present a case of a young female patient with long-standing constipation who was referred to Kolorektal Cerrahi Clinic (Izmir, Turkey) after scans revealed tubular type of colonic duplication. We successfully performed a laparoscopic total colectomy, and she recovered well. Identifying the type of duplication is important to ensure adequate resection and treatment. A proper workup, including carcinoembryonic antigen levels, must be done as well. Multiple surgical techniques and procedures have been introduced for this condition, but resection of the duplicated colon with its native lumen should be the management of choice, especially in tubular type of duplications such as in our case. In centers where laparoscopic services are available, laparoscopy could be a better option, as it provides multiple benefits of minimally invasive surgery. Attention should also be paid to anatomical details during surgery to ensure better results and outcomes.

Video

Video clip

Robotic total colectomy and ileorectal anastomosis: Jonathan Yu Jin Chua, Nan Zun Teo, James Chi-Yong Ngu; Ann Coloproctol. 2024;40(2):186-187. Published online April 22, 2024; DOI: https://doi.org/10.3393/ac.2024.00066.0009

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Abstract PDF Supplementary Material: The benefits of minimally invasive approaches in colorectal surgery have been well demonstrated. However, some hesitancy remains with regards to the utilization of the robotic platform for total colectomies, mostly due to the perceived need for multiple re-dockings in multiquadrant surgery. This video aims to demonstrate how the robotic platform can be efficiently utilized in multiquadrant surgery without the need for multiple re-dockings, as well as some tips on how to overcome the potential challenges that may be encountered during this procedure.

Original Articles

Minimally invasive surgery

Learning curve for single-port robot-assisted colectomy: Moon Suk Choi, Seong Hyeon Yun, Sung Chul Lee, Jung Kyong Shin, Yoon Ah Park, Jungwook Huh, Yong Beom Cho, Hee Cheol Kim, Woo Yong Lee; Ann Coloproctol. 2024;40(1):44-51. Published online December 20, 2022; DOI: https://doi.org/10.3393/ac.2022.00745.0106

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Abstract PDF

Purpose
Since the introduction of robotic surgery, robots for colorectal cancer have replaced laparoscopic surgery, and a single-port robot (SPR) platform has been launched and is being used to treat patients. We analyzed the learning curve and initial complications of using an SPR platform in colorectal cancer surgery.
Methods
We reviewed 39 patients who underwent SPR colectomy from April to October 2019. All surgeries were performed by the same surgeon using an SPR device. A learning curve was generated using the cumulative sum methodology to assess changes in total operation time, docking time, and surgeon console time. We grouped the patients into 3 groups according to the time period: the first 11 were phase 1, the next 11 were phase 2, and the last 17 were phase 3.
Results
The mean age of the patients was 61.28±13.03 years, and they had a mean body mass index of 23.79±2.86 kg/m2. Among the patients, 23 (59.0%) were male, and 16 (41.0%) were female. The average operation time was 186.59±51.30 minutes, the average surgeon console time was 95.49±35.33 minutes, and the average docking time (time from skin incision to robot docking) was 14.87±10.38 minutes. The surgeon console time differed significantly among the different phases (P<0.001). Complications occurred in 8 patients: 2 ileus, 2 postoperation hemoglobin changes, 3 urinary retentions, and 1 complicated fluid collection.
Conclusion
In our experience, the learning curve for SPR colectomy was achieved after the 18th case.

Citations

Citations to this article as recorded by

A systematic review of the Da Vinci® Single-Port system (DVSP) in the context of colorectal surgery
Francesco Brucchi, Isacco Montroni, Roberto Cirocchi, Giovanni Taffurelli, Marco Vitellaro, Gianluca Mascianà, Giovanni Battista Levi Sandri, Gianlorenzo Dionigi, Sara Lauricella
International Journal of Colorectal Disease.2025;[Epub] CrossRef
Assessing the learning curve in robot-assisted intracorporeal colorectal anastomosis and transrectal extraction (NICE) procedure: from Initial Learning to Mastery
Jacques Bistre-Varon, Muhammed Elhadi, Robert Wei, Jimena Alcocer-Barrios, Ryan Gunter, Joshua Coursey, Priya Prakash, Erin McAtee, Haley Lanser, Rachel Ellsworth, Matthew Weaver, Jean-Paul LeFave, Eric M. Haas
Journal of Robotic Surgery.2025;[Epub] CrossRef
Da Vinci single-port robotic system current application and future perspective in general surgery: A scoping review
Francesco Celotto, Niccolò Ramacciotti, Alberto Mangano, Giacomo Danieli, Federico Pinto, Paula Lopez, Alvaro Ducas, Jessica Cassiani, Luca Morelli, Gaya Spolverato, Francesco Maria Bianco
Surgical Endoscopy.2024; 38(9): 4814. CrossRef
Wristed articulated instrumentation for single‐incision plus one‐port laparoscopic surgery for obstructed sigmoid colon cancer—A video vignette
Sung Uk Bae
Colorectal Disease.2024; 26(9): 1782. CrossRef
Evaluation of the da Vinci single-port system in colorectal cancer surgery: a scoping review
Arcangelo Picciariello, Alfredo Annicchiarico, Gaetano Gallo, Agnese Dezi, Ugo Grossi
Updates in Surgery.2024; 76(7): 2515. CrossRef

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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Abstract PDF

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
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

Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy: a retrospective cohort study of anastomotic complications: Jonathan Frigault, Samuel Avoine, Sébastien Drolet, François Letarte, Alexandre Bouchard, Jean-Pierre Gagné, Claude Thibault, Roger C. Grégoire, Naomee Jutras Bouthillette, Maude Gosselin, Philippe Bouchard; Ann Coloproctol. 2023;39(2):147-155. Published online March 29, 2022; DOI: https://doi.org/10.3393/ac.2021.00983.0140

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11 Citations

Abstract PDF

Purpose
Laparoscopic right hemicolectomy (LRH) can be performed with an intracorporeal anastomosis (IA) or extracorporeal anastomosis (EA). It is not clear which technique is best. This study evaluated the impact of each anastomosis technique on perioperative safety and postoperative evolution.
Methods
We performed a retrospective study at a tertiary colorectal surgery center. All patients who had an elective LRH from 2015 to 2019 were analyzed according to the anastomosis technique used.
Results
In total, 285 patients were included in the study. IA was performed in 64 patients (22.5%). Mean operative time was longer in the patients with IA (IA, 160±31 minutes vs. EA, 138±42 minutes; P<0.001). No differences were observed in intraoperative complications, time to first bowel movement, length of stay, reoperation, or rehospitalization. Time to first flatus was longer in the patients with IA (P=0.049). At 30 days after surgery, there were no differences in the frequency of anastomotic leak (IA, 0% vs. EA, 2.3%; P=0.59), bleeding (IA, 3.1% vs. EA, 2.7%; P>0.99), or intraabdominal abscess (IA, 0% vs. EA, 0.5%; P>0.99). During follow-up, we noted more incisional hernias in patients with EA (IA, 1.6% vs. EA, 11.3%; P=0.01) and a trend toward more hernia in patients with EA in multivariate analysis (hazard ratio, 7.13; P=0.06). Anastomosis technique had no influence on recurrence.
Conclusion
For LRH, both IA and EA are safe, with a low incidence of complications when performed by experienced surgeons. IA may be associated with a lower incidence of incisional hernia.

Citations

Citations to this article as recorded by

Short-term outcomes for intracorporeal vs. extracorporeal anastomosis in laparoscopic right hemicolectomy for colonic cancer—a prospective cohort study (ICEA-study)
Emilie Schultz Hougaard, Benedicte Schelde-Olesen, Issam Al-Najami, Thomas Buchbjerg, Benjamin Schnack Brandt Rasmussen, Lasse Bugge, Thomas Kolbro, Sören Möller, Mark Bremholm Ellebæk
International Journal of Colorectal Disease.2025;[Epub] CrossRef
Intracorporeal stapled versus extracorporeal hand-sewn anastomosis in minimal-invasive right hemicolectomy with complete mesocolic excision – a retrospective single center analysis
Maximilian Brunner, Katja Bondartschuk, Axel Denz, Georg F. Weber, Robert Grützmann, Christian Krautz
Langenbeck's Archives of Surgery.2025;[Epub] CrossRef
Comparison of Robot‐Assisted and Laparoscopic Right Hemicolectomy for Right‐Sided Colon Cancer: A Report on the Short‐Term Perioperative Outcomes Using Propensity Score Matching
Shunsuke Sakuraba, Mizuki Nishiko, Shingo Yamasaki, Kazumasa Nakamura, Kohei Koido, Takeshi Oshima, Hiroyuki Hazama, Kou Ohata, Hideyuki Kanemto
Asian Journal of Endoscopic Surgery.2025;[Epub] CrossRef
Elevating surgical standards: The role of intraperitoneal isoperistaltic side-to-side anastomosis in colon cancer surgery
Sung Uk Bae
World Journal of Gastrointestinal Oncology.2025;[Epub] CrossRef
Revisiting Robotic Right Hemicolectomy: A Critical Appraisal of Perioperative Outcomes and Emerging Complications
Javed Iqbal, Brijesh Sathian, Syed Muhammad Ali
Asian Journal of Endoscopic Surgery.2025;[Epub] CrossRef
Comparison of intracorporeal and extracorporeal anastomosis in laparoscopic right colectomy: an updated meta-analysis and trial sequential analysis
Konstantinos Perivoliotis, George Tzovaras, Konstantinos Tepetes, Ioannis Baloyiannis
Updates in Surgery.2024; 76(2): 375. CrossRef
Effectiveness and safety of self-pulling and latter transection reconstruction in totally laparoscopic right hemicolectomy
Fuyu Yang, Fan He, Chenglin Tang, Defei Chen, Junjie Xiong, Yu Zou, Saed Woraikat, Kun Qian, Hui Li
Frontiers in Oncology.2024;[Epub] CrossRef
Single-Center Experiences: A Comparison of Intracorporeal and Extracorporeal Anastomosis Outcomes in Right Hemicolectomy
Audrey Kim, Munyaradzi G Nyandoro, Linda Vu, Ruben Rajan, Abraham Jacob
Cureus.2024;[Epub] CrossRef
Comparing extracorporeal, semi-extracorporeal, and intracorporeal anastomosis in laparoscopic right hemicolectomy: introducing a bridging technique for colorectal surgeons
Hye Jung Cho, Jong Woo Kim, Woo Ram Kim
Annals of Surgical Treatment and Research.2024; 107(1): 42. CrossRef
Effect of Specimen Extraction Site on Postoperative Incisional Hernia after Minimally Invasive Right Colectomy
Josh A Johnson, Andrea Mesiti, Margo Herre, Cyrus Farzaneh, Ying Li, Wini Zambare, Joseph Carmichael, Alessio Pigazzi, Mehraneh D Jafari
Journal of the American College of Surgeons.2024; 239(2): 107. CrossRef
Extracorporeal versus intracorporeal anastomosis for right colon cancer surgery
Seong Kyu Baek
Journal of Minimally Invasive Surgery.2022; 25(3): 91. CrossRef

Review

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

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, On behalf of The Korean Laparoscopic Colorectal Surgery Study Group; Ann Coloproctol. 2021;37(6):434-444. Published online December 8, 2021; DOI: https://doi.org/10.3393/ac.2021.00955.0136

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Abstract PDF

Colon cancer treatment is on the way to evolution over several decades. The minimally invasive surgery has improved postoperative short-term outcomes. Adjuvant chemotherapy has prolonged the survival of advanced colon cancer patients. Hohenberger proposed the noble concept of complete mesocolic excision (CME) which consists of 3 components: plane surgery, sufficient longitudinal bowel resection, and central vascular ligation (CVL). Mesocolic plane surgery shares the same surgical principle of total mesorectal excision, which is maintaining the intact mesothelial envelope. However, there remain debates about the extent of bowel resection and the level of CVL for maximizing lymph node dissection. There is no solid clinical evidence for the oncological necessity and benefit of extended radical dissection in right hemicolectomy. CME with CVL based on open surgery has been adopted in laparoscopic surgery. So, it is also necessary to look at how the CME could be transformed and successfully implanted in the laparoscopic era. Recent rapid advances in surgical technology and cancer biology are preparing for fundamental changes in cancer surgery. In this study, we reviewed the history, oncological necessity, and compatibility of CME for the right hemicolectomy in the laparoscopic era and outline the new perspectives on the evolution of cancer surgery.

Citations

Citations to this article as recorded by

Optimal extent of lymph node dissection in clinical early-stage right colon cancer: a retrospective analysis
Hyeung-min Park, Jaram Lee, Soo Young Lee, Suk Hee Heo, Yong Yeon Jeong, Hyeong Rok Kim, Chang Hyun Kim
Annals of Surgical Treatment and Research.2025; 108(1): 49. CrossRef
Laparoscopic right hemicolectomy: a SICE (Società Italiana di Chirurgia Endoscopica e Nuove tecnologie) network prospective study on the approach to right colon lymphadenectomy in Italy: is there a standard?—CoDIG 2 (ColonDx Italian Group)
G. Anania, M. Chiozza, A. Campagnaro, F. Bagolini, G. Resta, D. Azzolina, G. Silecchia, R. Cirocchi, A. Agrusa, D. Cuccurullo, M. Guerrieri, V. Adamo, M. Ammendola, P. Angelini, M. Annecchiarico, G. Aprea, F. Autori, G. Baldazzi, A. Balla, G. Baronio, G.
Surgical Endoscopy.2024; 38(3): 1432. CrossRef
Retrocaecal, supracolic and medial dissection (the RESUME approach) as an optimal surgical procedure for right‐sided colon cancer—A Video Vignette
Hong‐min Ahn, Min Hyeong Jo, Mi Jeong Choi, Heung‐Kwon Oh, Duck‐Woo Kim, Sung‐Bum Kang
Colorectal Disease.2024; 26(7): 1480. CrossRef
Surgical treatment of right colon cancer
A. A. Nevolskikh, V. A. Avdeenko, I. P. Reznik, T. P. Pochuev, R. F. Zibirov, S. A. Ivanov, A. D. Kaprin
Siberian journal of oncology.2024; 23(3): 133. 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
Robotic-Assisted Laparoscopic Complete Mesocolic Excision
Inci Sahin, Bilgi Baca
Digestive Disease Interventions.2023; 07(01): 024. CrossRef
A comparison of the efficacy and safety of natural orifice specimen extraction and conventional laparoscopic surgery in patients with sigmoid colon/high rectal cancer
Qiang He, Jing Huang, Liyun Niu, Chunbao Zhai
Journal of Surgical Oncology.2023; 127(7): 1160. CrossRef
Effect of intracorporeal anastomosis on postoperative ileus after laparoscopic right colectomy
Sangwoo Kim, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek, Young-Gil Son
Annals of Surgical Treatment and Research.2023; 104(3): 156. CrossRef
Surgical and oncological outcomes of laparoscopic right hemicolectomy (D3 + CME) for colon cancer: A prospective single-center cohort study
Xiaolin Wu, Yixin Tong, Daxing Xie, Haijie Li, Jie Shen, Jianping Gong
Surgical Endoscopy.2023; 37(8): 6107. CrossRef
Incidence and survival of adenocarcinoma with mixed subtypes in patients with colorectal cancer
Fan Zhang, Boqi Xu, Yao Peng, Zhongqi Mao, Shan Tong
International Journal of Colorectal Disease.2023;[Epub] 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
Early-Onset Colon Cancer: A Narrative Review of Its Pathogenesis, Clinical Presentation, Treatment, and Prognosis
Elvina C Lingas
Cureus.2023;[Epub] 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
Ausmaß und Technik der chirurgischen Resektion beim Kolonkarzinom
Christoph Holmer
coloproctology.2022; 44(3): 149. CrossRef
Letter to the Editor Reply: ‘Mesocolon Excision in Right Colon Cancer: Is it a Real Oncological Procedure or a Mere Surgical Act?’
Tamara Díaz Vico, Luis Joaquín García Flórez
Annals of Surgical Oncology.2022; 29(9): 5855. CrossRef
Medical disease and ambulatory surgery, new insights in patient selection based on medical disease
Thomas Fuchs-Buder, Jacob Rosenberg
Current Opinion in Anaesthesiology.2022; 35(3): 385. 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
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
Multidisciplinary treatment strategy for early colon cancer
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Korean Medical Association.2022; 65(9): 558. CrossRef
Direction of diagnosis and treatment improvement in colorectal cancer
In Ja Park
Journal of the Korean Medical Association.2022; 65(9): 540. CrossRef
Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 203. CrossRef
Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
It Is a Pleasure to Announce the Issue Titled “Master Class 2021” in Annals of Coloproctology
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Annals of Coloproctology.2021; 37(6): 349. CrossRef

Case Report

Benign bowel disease

A case report of impacted fecalith within mucosal pouch: an unusual cause of colocolic intussusception: Douglas Greer, Adrian Fernandez; Ann Coloproctol. 2024;40(Suppl 1):S15-S17. Published online November 18, 2021; DOI: https://doi.org/10.3393/ac.2021.00724.0103

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Abstract PDF: Intussusception involving the colon is unusual in adults and when present is managed with resection due to the risk of malignancy. We present an unusual case where the intussusceptum was impacted stool in a mucosal pouch in the transverse colon. The patient presented with bleeding per rectum and abdominal pain and was found to have a colocolic intussusception on computed tomography. Colonoscopy showed an ulcerated mass in the transverse colon. A laparoscopic right hemicolectomy was performed. Histopathology demonstrated known chronic lymphocytic leukemia, but not solid malignancy. A large fecalith impacted within a mucosal pouch had acted as the lead point. This represents a highly unusual but benign cause of intussusception.

Original Article

Influence of colonic mesenteric area on the number of lymph node retrieval for colon cancer: a prospective cohort study: Nadir Adnan Hacım, Ahmet Akbaş, Yigit Ulgen, Talar Vartanoglu Aktokmakyan, Serhat Meric, Merve Tokocin, Onder Karabay, Yuksel Altinel; Ann Coloproctol. 2023;39(1):77-84. Published online September 16, 2021; DOI: https://doi.org/10.3393/ac.2021.00444.0063

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Abstract PDF

Purpose
The minimum harvested 12 lymph nodes (LNs) is regarded as the limit for accurate staging of nodal status in colorectal cancer patients. Besides the association of the lengths of resected intestinal segments and vascular pedicles, the mesocolic mesenteric area’s impact on LN count has not been studied. We aimed to evaluate the associations between metric variables, including the mesocolic mesentery area on the nodal harvest.
Methods
All consecutive patients who underwent elective colectomy with a curative intention for colon adenocarcinoma were prospectively included. The metric variables included the lengths of resected intestinal segments, vascular pedicle, and colonic mesenteric area. The variables influencing the LN count and the correlation between the total LN count and the specimens’ relevant metric measurements were analyzed.
Results
There were 46 patients with a median age of 64 years. The median count for total LNs was 22, and the LN positivity was 59.2%. There was an inadequate LN yield (<12) in 3 patients (6.1%). No significant associations were found between the adequacy of nodal harvest and the demographic, clinical, and tumoral features (P>0.05). There were significant positive correlations between total LN number and length of vascular pedicle and mesenteric area (r=0.576, P<0.001 and r=0.566, P<0.001).
Conclusion
The length of the vascular pedicle and mesenteric area were significantly correlated with total LN counts. Although there was no significant impact on the length of resected segments, the colonic mesenteric area can be used alone as a measure for the assessment of the nodal yield in colon cancer.

Citations

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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
The Relationship Between the Resected Colon Length and the Number of Lymph Nodes in Colorectal Cancer: A Retrospective Cohort Study
Ulaş Karabay, Latif Yılmaz, Alper Aytekin, Aziz Bulut
European Journal of Therapeutics.2023; 29(4): 731. CrossRef
Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 203. 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

Case Report

Multivisceral resection for colonic splenic flexure malakoplakia: a case report of a minimally invasive approach: Andrés Ramiro Lanza Díaz, Santiago Gallardo Pezet, Osvaldo Soto González, Montserrat Guraieb Trueba, Ivan Azael Martínez Alonso, Mario Alberto López Ramirez; Ann Coloproctol. 2023;39(2):178-182. Published online July 21, 2021; DOI: https://doi.org/10.3393/ac.2021.00178.0025

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146 Download
1 Web of Science
1 Citations

Abstract PDF

Malakoplakia is a rare granulomatous inflammatory disorder. Its diagnosis depends on histopathological findings; however, high-quality literature regarding proper medical/surgical treatment is lacking. A 38-year-old diabetic female patient was admitted to the emergency room with a history of lower gastrointestinal hemorrhage. Colonoscopy revealed a lesion in the descending colon, and abdominal computed tomography revealed a splenic flexure mass involving the lower pole of the spleen and upper pole of the left kidney. Biopsies confirmed the diagnosis of malakoplakia. After completing antibiotic treatment, a restaging computed tomography revealed a discrete mass increase; hence, the patient underwent laparoscopic en bloc colectomy and partial nephrectomy. Postoperatively, the patient developed a pancreatic fistula, which was successfully treated with percutaneous drainage and antibiotics. The presence of pathognomonic Michaelis-Gutmann inclusions on histopathology is frequently reported as the key to diagnosing malakoplakia. Herein, we present a successful, minimally invasive surgical treatment for colonic malakoplakia.

Citations

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A Surgical Challenge Generated by Colonic Malakoplakia in Disguise as a Locally Advanced Colonic Malignancy—A Case Report
Cristina Șerban, Alexandra Toma, Dragoș Cristian Voicu, Constantin Popazu, Dorel Firescu, George Țocu, Raul Mihailov, Laura Rebegea
Medicina.2023; 59(1): 156. CrossRef

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

4,117 View
146 Download
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8 Citations

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

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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
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
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

Malignant disease,Colorectal cancer,Surgical technique

Comparison of Short-term Results after Laparoscopic Complete Mesocolic Excision and Standard Colectomy for Right-Sided Colon Cancer: Analysis of a Western Center Cohort: Cristian Conti, Corrado Pedrazzani, Giulia Turri, Eduardo Fernandes, Enrico Lazzarini, Raffaele De Luca, Alessandro Valdegamberi, Andrea Ruzzenente, Alfredo Guglielmi; Ann Coloproctol. 2021;37(3):166-173. Published online April 22, 2021; DOI: https://doi.org/10.3393/ac.2020.05.18

5,286 View
161 Download
11 Web of Science
11 Citations

Abstract PDF

Purpose
Laparoscopic complete mesocolic excision (CME) right colectomy is a technically demanding procedure infrequently employed in Western centers. This retrospective cohort study aims to analyze the safety of laparoscopic CME colectomy compared to standard colectomy for right-sided colon cancer in a Western series.
Methods
Prospectively collected data from 60 patients who underwent laparoscopic CME right colectomy were compared to the ones of 55 patients who underwent laparoscopic standard right colectomy.
Results
No differences in clinical characteristics were observed between the CME and standard right colectomy groups. No differences were demonstrated in terms of blood loss (P = 0.060), intraoperative complications (P = 1), conversion rate (P = 0.102), and operative time (P = 0.473). No deaths were observed in either group, while complication rate was 40.0% in the CME and 49.1% in the standard group (P = 0.353). Severe complications occurred in 10.0% vs. 9.1% (P = 0.842), redo surgery in 5.0% vs. 7.3% (P = 0.708), and unplanned readmission in 5.0% vs. 5.5% (P = 1) after CME and standard colectomy, respectively. A significant difference in favor of CME was observed in the total length of specimen (P < 0.001), proximal (P = 0.018), and distal margins (P = 0.037). The number of lymph nodes harvested was significantly higher in the CME group (27 vs. 22, P = 0.037).
Conclusion
In Western series, where patients have less favorable clinical characteristics, laparoscopic CME allows to obtain better quality surgical specimens and comparable short-term outcomes compared to standard right colectomy.

Citations

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Retrocaecal, supracolic and medial dissection (the RESUME approach) as an optimal surgical procedure for right‐sided colon cancer—A Video Vignette
Hong‐min Ahn, Min Hyeong Jo, Mi Jeong Choi, Heung‐Kwon Oh, Duck‐Woo Kim, Sung‐Bum Kang
Colorectal Disease.2024; 26(7): 1480. CrossRef
Complete mesocolic excision (CME) impacts survival only for Stage III right-sided colon cancer: a systematic review and meta-analysis
Kengo Hayashi, Roberto Passera, Chiara Meroni, Rebecca Dallorto, Chiara Marafante, Carlo Alberto Ammirati, Alberto Arezzo
Minimally Invasive Therapy & Allied Technologies.2024; 33(6): 323. 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
Robot-assisted versus laparoscopic short- and long-term outcomes in complete mesocolic excision for right-sided colonic cancer: a systematic review and meta-analysis
Pedja Cuk, Mohamad Jawhara, Issam Al-Najami, Per Helligsø, Andreas Kristian Pedersen, Mark Bremholm Ellebæk
Techniques in Coloproctology.2023; 27(3): 171. CrossRef
Influence of colonic mesenteric area on the number of lymph node retrieval for colon cancer: a prospective cohort study
Nadir Adnan Hacım, Ahmet Akbaş, Yigit Ulgen, Talar Vartanoglu Aktokmakyan, Serhat Meric, Merve Tokocin, Onder Karabay, Yuksel Altinel
Annals of Coloproctology.2023; 39(1): 77. CrossRef
Uptake of robot-assisted colon cancer surgery in the Netherlands
Marlou F. M. Sterk, Rogier M. P. H. Crolla, Mareille Verseveld, Jan Willem T. Dekker, George P. van der Schelling, Cornelis Verhoef, Pim B. Olthof
Surgical Endoscopy.2023; 37(11): 8196. 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
Direction of diagnosis and treatment improvement in colorectal cancer
In Ja Park
Journal of the Korean Medical Association.2022; 65(9): 540. CrossRef
Multidisciplinary treatment strategy for early colon cancer
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Korean Medical Association.2022; 65(9): 558. CrossRef
Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 203. CrossRef
Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] CrossRef

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