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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
  • 586 View
  • 24 Download
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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
  • 3,370 View
  • 169 Download
AbstractAbstract PDFSupplementary 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
  • 1,508 View
  • 99 Download
AbstractAbstract 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
  • 2,601 View
  • 106 Download
AbstractAbstract PDFSupplementary 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
  • 3,229 View
  • 209 Download
  • 3 Web of Science
  • 3 Citations
AbstractAbstract 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  
  • 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
  • 4,777 View
  • 162 Download
  • 2 Web of Science
  • 3 Citations
AbstractAbstract 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  
  • 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
  • Is it possible to use colon stenting as part of the implementation of the early rehabilitation after surgery concept in the surgical treatment of patients with colon cancer complicated by obstructive intestinal obstruction? Review
    Saday A. Aliyev, Emil S. Aliyev
    Russian Journal of Oncology.2024;[Epub]     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
  • 3,701 View
  • 165 Download
  • 7 Web of Science
  • 6 Citations
AbstractAbstract 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  
  • 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
  • 5,717 View
  • 277 Download
  • 19 Web of Science
  • 23 Citations
AbstractAbstract 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
    In Ja Park
    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
  • 5,222 View
  • 99 Download
AbstractAbstract 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
  • 7,601 View
  • 154 Download
  • 5 Web of Science
  • 5 Citations
AbstractAbstract 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

Citations to this article as recorded by  
  • 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
  • 3,806 View
  • 140 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract 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

Citations to this article as recorded by  
  • 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
  • 3,554 View
  • 138 Download
  • 8 Web of Science
  • 8 Citations
AbstractAbstract 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
  • 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
  • 4,687 View
  • 156 Download
  • 11 Web of Science
  • 11 Citations
AbstractAbstract 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

Citations to this article as recorded by  
  • 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
Benign GI diease,Benign diesease & IBD,Rare disease & stoma
Geographical Variation in the Use of Diverting Loop Ileostomy in Australia and New Zealand Colorectal Surgeons
David A. Clark, Bree Stephensen, Aleksandra Edmundson, Daniel Steffens, Michael Solomon
Ann Coloproctol. 2021;37(5):337-345.   Published online September 18, 2020
DOI: https://doi.org/10.3393/ac.2020.09.14.1
  • 3,420 View
  • 70 Download
  • 7 Web of Science
  • 8 Citations
AbstractAbstract PDF
Purpose
Anastomotic leak (AL) after a low pelvic anastomosis is a devastating complication, with short- and long-term morbidity and increased mortality. Surgeons may employ various adjuncts in an attempt to reduce AL rates or mitigate their impact. These include the use of temporary diverting ileostomy (TDI), transanal or rectal tubes and pelvic drains. This questionnaire evaluates the preferences and routine use of these adjuncts in Australasian colorectal surgeons.
Methods
A cross-sectional survey was administered to Australian and New Zealand colorectal surgeons on September 20, 2018. The study survey consisted of 15 questions exploring basic demographics and the number of rectal resections and ileal pouches performed in 12 months, along with the surgeon’s preference for the use of diverting stomas, rectal tubes, and pelvic drains.
Results
There were 90 respondents to the survey (31.6%). Surgeons in Western Australia (71.4%) were more likely to use a mandatory TDI in colorectal extraperitoneal anastomoses than surgeons in Queensland (14.3%). South Australian surgeons are more likely to employ a mandatory TDI (100%) for ileal pouches than Queensland surgeons (42.9%). Rectal tubes are not commonly utilized (40.0% never use them), and pelvic drains are (45.6% in all cases). Surgeons consider a median AL rate of 15% was felt to justify the use of a TDI in low pelvic anastomoses and a median AL rate of 10% for ileal pouches
Conclusion
There is considerable geographical variation in colorectal surgical practice throughout Australia and New Zealand. While surgeons interrogate the same literature, there are presumably other factors that see translation into variations in clinical practice.

Citations

Citations to this article as recorded by  
  • Feasibility of triple assessment of the anastomosis using an anastomotic checklist
    Madeleine Louise Kelly, Amy Cao, Ruben Rajan, David A Clark
    ANZ Journal of Surgery.2024; 94(10): 1812.     CrossRef
  • Predictors of pouch failure and quality of life following ileal pouch‐anal anastomosis for ulcerative colitis: a retrospective multicenter study
    Ahmet Rencuzogullari, Cihangir Akyol, Ismail Hamzaoglu, Tahsin Colak, Tayfun Karahasanoglu, Ugur Sungurtekin, Sezai Leventoglu, Ersin Ozturk, Mustafa Ali Korkut, Selman Sokmen
    ANZ Journal of Surgery.2024;[Epub]     CrossRef
  • Drain fluid amylase as a biomarker for the detection of anastomotic leakage after rectal resection without a diverting ileostomy
    David A. Clark, Aleksandra Edmundson, Daniel Steffens, Craig Harris, Andrew Stevenson, Michael Solomon
    ANZ Journal of Surgery.2022; 92(4): 813.     CrossRef
  • Surgical management and long‐term functional outcomes after anastomotic leak in patients undergoing minimally invasive restorative rectal resection and without a diverting ileostomy
    Tony McGiffin, David A. Clark, Aleks Edmundson, Daniel Steffens, Andrew Stevenson, Michael Solomon
    ANZ Journal of Surgery.2022; 92(4): 806.     CrossRef
  • Does an ileostomy cover the surgeon or the anastomosis?
    David A. Clark, Andrew Stevenson, John Lumley, Damien Petersen, Craig Harris, Daniel Steffens, Michael Solomon
    ANZ Journal of Surgery.2022; 92(1-2): 19.     CrossRef
  • Risk taking propensity: Nurse, surgeon and patient preferences for diverting ileostomy
    Ian Mackay, David A. Clark, James Nicholson, Aleks Edmundson, Daniel Steffens, Michael Solomon
    Colorectal Disease.2022; 24(9): 1073.     CrossRef
  • Multicenter Study of Drain Fluid Amylase as a Biomarker for the Detection of Anastomotic Leakage After Ileal Pouch Surgery Without a Diverting Ileostomy
    David A. Clark, • Aleksandra Edmundson, Daniel Steffens, Graham Radford-Smith, Michael Solomon
    Diseases of the Colon & Rectum.2022; 65(11): 1335.     CrossRef
  • An umbrella systematic review of drain fluid analysis in colorectal surgery for the detection of anastomotic leak: Not yet ready to translate research studies into clinical practice
    David A. Clark, Daniel Steffens, Michael Solomon
    Colorectal Disease.2021; 23(11): 2795.     CrossRef
Benign GI diease, Inflammatory bowel disease
Short-term Outcomes of Elective 2-Stage Restorative Proctocolectomy for Ulcerative Colitis in Korea: Does Laparoscopy Have Benefits?
Jun Woo Bong, Yong Sik Yoon, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Ann Coloproctol. 2020;36(1):41-47.   Published online February 29, 2020
DOI: https://doi.org/10.3393/ac.2019.03.29
  • 3,636 View
  • 85 Download
  • 4 Web of Science
  • 3 Citations
AbstractAbstract PDF
Purpose
This study aimed to compare the short-term outcomes of the open and laparoscopic approaches to 2-stage restorative proctocolectomy (RPC) for Korean patients with ulcerative colitis (UC).
Methods
We retrospectively analyzed the medical records of 73 patients with UC who underwent elective RPC between 2009 and 2016. Patient characteristics, operative details, and postoperative complications within 30 days were compared between the open and laparoscopic groups.
Results
There were 26 cases (36%) in the laparoscopic group, which had a lower mean body mass index (P = 0.025), faster mean time to recovery of bowel function (P = 0.004), less intraoperative blood loss (P = 0.004), and less pain on the first and seventh postoperative days (P = 0.029 and P = 0.027, respectively) compared to open group. There were no deaths, and the overall complication rate was 43.8%. There was no between-group difference in the overall complication rate; however, postoperative ileus was more frequent in the open group (27.7% vs. 7.7%, P = 0.043). Current smoking (odds ratio [OR], 44.4; P = 0.003) and open surgery (OR, 5.4; P = 0.014) were the independent risk factors for postoperative complications after RPC.
Conclusion
Laparoscopic RPC was associated with acceptable morbidity and faster recovery than the open approach. The laparoscopic approach is a feasible and safe option for surgical treatment for UC in selective cases.

Citations

Citations to this article as recorded by  
  • Patient-reported Outcome Measures in Ileoanal Pouch Surgery: a Systematic Review
    Zakary Ismail Warsop, Carlo Alberto Manzo, Natalie Yu, Bilal Yusuf, Christos Kontovounisios, Valerio Celentano
    Journal of Crohn's and Colitis.2024; 18(3): 479.     CrossRef
  • Creation of an institutional preoperative checklist to support clinical risk assessment in patients with ulcerative colitis (UC) considering ileoanal pouch surgery
    Bruno Augusto Alves Martins, Amira Shamsiddinova, Manal Mubarak Alquaimi, Guy Worley, Phil Tozer, Kapil Sahnan, Zarah Perry-Woodford, Ailsa Hart, Naila Arebi, Manmeet Matharoo, Janindra Warusavitarne, Omar Faiz
    Frontline Gastroenterology.2024; 15(3): 203.     CrossRef
  • Benefits of Elective Laparoscopic 2-Stage Restorative Proctocolectomy for Ulcerative Colitis in Korea
    Sun Min Park, Won-Kyung Kang
    Annals of Coloproctology.2020; 36(1): 3.     CrossRef

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