Annals of Coloproctology

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Case Report

Colorectal cancer

Neuroendocrine carcinoma associated with chronic ulcerative colitis: a case report and review of the literature: Yumi Yokota, Hiroyuki Anzai, Yuzo Nagai, Hirofumi Sonoda, Takahide Shinagawa, Yuichiro Yoshioka, Shinya Abe, Yuichiro Yokoyama, Hiroyuki Matsuzaki, Shigenobu Emoto, Koji Murono, Kazuhito Sasaki, Hiroaki Nozawa, Tetsuo Ushiku, Soichiro Ishihara; Ann Coloproctol. 2024;40(Suppl 1):S32-S37. Published online April 19, 2023; DOI: https://doi.org/10.3393/ac.2022.00801.0114

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Abstract PDF: Adenocarcinoma is a common histological type of ulcerative colitis-associated cancer (UCAC), whereas neuroendocrine carcinoma (NEC) is extremely rare. UCAC is generally diagnosed at an advanced stage, even with regular surveillance colonoscopy. A 41-year-old man with a 17-year history of UC began receiving surveillance colonoscopy at the age of 37 years; 2 years later, dysplasia was detected in the sigmoid colon, and he underwent colonoscopy every 3 to 6 months. Approximately 1.5 years thereafter, a flat adenocarcinoma lesion occurred in the rectum. Flat lesions with high-grade dysplasia were found in the sigmoid colon and surrounding area. The patient underwent laparoscopic total proctocolectomy and ileal pouch-anal anastomosis with ileostomy. Adenocarcinoma was diagnosed in the sigmoid colon and NEC in the rectum. One year postoperation, recurrence or metastasis was not evident. Regular surveillance colonoscopy is important in patients with long-term UC. A histological examination of UCAC might demonstrate NEC.

Review

Inflammatory bowel diseases

Colorectal surgical management of colitis induced by vasculitis in the absence of inflammatory bowel disease: a case report and literature review: Jessica A. Paynter, Kirby R. Qin, Georgia Seamer, Ruchira Fernando, Janelle Brennan, Chun Hin Angus Lee; Ann Coloproctol. 2023;39(3):193-203. Published online November 16, 2022; DOI: https://doi.org/10.3393/ac.2022.00584.0083

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Abstract PDF

Colitis caused by vasculitis is a rare and poorly understood pathology. Little evidence exists on its clinical presentation, path to diagnosis, and surgical management. In this report, we present a case report and literature review. A healthy 20-year-old male patient presented with hemorrhagic colitis requiring total colectomy with end ileostomy. Pathological examination showed pancolitis with multiple ulcers, transmural inflammation, hemorrhage, and microvascular thrombosis. Extensive serological testing revealed elevated cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA) and eosinophilia, leading to a diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA) and vasculitis-induced colitis. A literature review was subsequently conducted. Nineteen studies were found documenting vasculitis-induced colitis in the absence of inflammatory bowel disease (IBD). Systemic signs of vasculitis, hemorrhagic colitis, and progression to fulminant colitis were present. Of all patients, 40.0% required colorectal surgery and 62.5% of those patients received a stoma; 25% underwent emergency surgery following failed immunosuppression. All cases relied on clinical correlation with serology and/or histopathology to reach a final diagnosis. We report a case of vasculitis-induced colitis caused by c-ANCA−positive EGPA. The review shows that vasculitis-induced colitis without IBD is an important differential that clinicians should be aware of in patients presenting with colitis.

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Systemic Lupus Erythematosus Vasculitis Causing Perforation Peritonitis in Miliary Tuberculosis: A Disease in Disguise
Soumyajit Jana, Monika Gureh, Ankur Cheleng, Ayush Vardhan
Cureus.2025;[Epub] CrossRef

Original Articles

Translational/basic research

Effects of angiotensin peptides on colonic motility in rats: Gi Won Ha, Jong Hun Kim, Suhn Hee Kim; Ann Coloproctol. 2023;39(3):267-274. Published online March 30, 2022; DOI: https://doi.org/10.3393/ac.2022.00087.0012

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Abstract PDF

Purpose
Renin-angiotensin system (RAS) is involved in the pathophysiology of colonic inflammation. The aim of this study was to investigate whether small angiotensins (Angs) peptides play a role in the regulation of colonic motility and their roles are modulated in colitis.
Methods
Experimental colitis was induced by an intake of 5% dextran sulfate sodium (DSS) dissolved in tap water for 7 days in Sprague-Dawley rats. After sacrifice, plasma hormone concentrations and messenger RNAs (mRNAs) for RAS were measured. Functional analysis of colonic motility in response to Angs peptides was performed using Taenia coli.
Results
DSS-treated colon showed an increased necrosis with massive infiltration of inflammatory cells. The mRNA level of colonic angiotensin II receptor type 2 (AT2R) in DSS-treated rats was higher than that in control rats whereas the mRNA levels of angiotensin II converting enzyme (ACE), ACE2, AT1R, AT4R, and Mars receptor were not different from those in control rats. Ang III, Ang IV, and Ang-(1-9) (1, 3 μM) increased the frequency of basal colonic motility. Ang-(1-7) did not cause any significant changes in frequency and amplitude of basal motility. The order of potency for an increased frequency of basal motility seems to be Ang II>>Ang IV>Ang III=Ang-(1-9). The increased frequency of basal motility by Ang-(1-9) but not Ang IV was significantly enhanced in DSS-treated rat colon.
Conclusion
In conclusion, these data suggest that small Angs peptides are partly involved in the pathophysiological regulation of colonic motility in experimental colitis.

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Systematic-Narrative Hybrid Literature Review: Crosstalk between Gastrointestinal Renin–Angiotensin and Dopaminergic Systems in the Regulation of Intestinal Permeability by Tight Junctions
Nadia Khan, Magdalena Kurnik-Łucka, Gniewomir Latacz, Krzysztof Gil
International Journal of Molecular Sciences.2024; 25(10): 5566. CrossRef

The albumin to globulin ratio is associated with clinical outcome in Japanese patients with ulcerative colitis: Sen Yagi, Shinya Furukawa, Kana Shiraishi, Teruki Miyake, Kazuhiro Tange, Yu Hashimoto, Shogo Kitahata, Tomoe Kawamura, Tomoyuki Ninomiya, Kenichirou Mori, Seiyuu Suzuki, Naozumi Shibata, Hidehiro Murakami, Katsuhisa Ohashi, Aki Hasebe, Hideomi Tomida, Yasunori Yamamoto, Eiji Takeshita, Yoshio Ikeda, Yoichi Hiasa; Ann Coloproctol. 2023;39(2):155-163. Published online March 30, 2022; DOI: https://doi.org/10.3393/ac.2021.01032.0147

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5 Web of Science
6 Citations

Abstract PDF

Purpose
The albumin to globulin ratio (AGR) is a recognized chronic inflammation marker. No evidence regarding the relationship between AGR level and ulcerative colitis (UC) exists. The aim of this study was to evaluate the association between AGR and clinical outcomes among Japanese subjects with UC.
Methods
The study subjects consisted of 273 Japanese individuals with UC. AGR was divided into 4 categories (low, moderate, high, and very high). The definition of complete mucosal healing (MH) was based on the Mayo endoscopic subscore of 0. Clinical remission (CR) was defined as no rectal bleeding and no abnormally high stool frequency (<3 times per day).
Results
The percentage of MH was 26.4%. High AGR and very high AGR were significantly positively correlated with CR (adjusted odds ratio [OR], 5.85; 95% confidence interval [CI], 2.52–14.18 and adjusted OR, 4.97; 95% CI, 2.14–12.04) and complete MH (adjusted OR, 4.03; 95% CI, 1.56–11.51 and adjusted OR, 5.22; 95% CI, 1.97–14.89), respectively after adjustment for confounding factors (P for trend=0.001). Only in the low C-reactive protein (CRP) group (≤0.1 mg/dL), very high AGR was significantly positively correlated with complete MH but not CR (adjusted OR, 4.38; 95% CI, 1.06–21.77; P for trend=0.017). In the high CRP group, no correlation between AGR and complete MH was found.
Conclusion
Among Japanese patients with UC, AGR may be independently positively correlated with complete MH. In particular, among UC patients with low CRP, AGR might be a useful complementary marker for complete MH.

Citations

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Albumin: Bountiful Arrow in the Quiver of Liver and Its Significance in Physiology
Ananda Baral
Livers.2025; 5(2): 27. CrossRef
Prognostic impact of preoperative nutritional and immune inflammatory parameters on liver cancer
Sung Uk Bae
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Progress in Biomarkers of Inflammatory Bowel Disease
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Advances in Clinical Medicine.2024; 14(03): 1418. CrossRef
Clinical utility of C‐reactive protein‐to‐albumin ratio in the management of patients with inflammatory bowel disease
Anke L Nguyen, Claudia Brick, David Liu, David J Gibson, Peter R Gibson, Miles P Sparrow
JGH Open.2024;[Epub] CrossRef
Association between Mucosal Healing and Lipid Profiles in Patients with Ulcerative Colitis: A Cross-Sectional Study
Sen Yagi, Shinya Furukawa, Teruki Miyake, Kana Shiraishi, Kazuhiro Tange, Yu Hashimoto, Shogo Kitahata, Tomoyuki Ninomiya, Seiyuu Suzuki, Naozumi Shibata, Hidehiro Murakami, Katsuhisa Ohashi, Hideomi Tomida, Yasunori Yamamoto, Eiji Takeshita, Yoshio Ikeda
Digestion.2023; 104(2): 129. CrossRef
Current and emerging biomarkers for ulcerative colitis
Jan K. Nowak, Rahul Kalla, Jack Satsangi
Expert Review of Molecular Diagnostics.2023; 23(12): 1107. CrossRef

Case Report

Benign bowel disease

Recurrent perianal abscess in a patient with Hermansky-Pudlak syndrome–associated granulomatous colitis: a case report: Ahmet Omak, Tevfik Kıvılcım Uprak, Wafi Attaallah; Ann Coloproctol. 2024;40(Suppl 1):S11-S14. Published online November 19, 2021; DOI: https://doi.org/10.3393/ac.2021.00437.0062

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Abstract PDF: Hermansky-Pudlak syndrome (HPS) is a rare genetic disease consisting of the triad of oculocutaneous albinism, bleeding diathesis, and pigmented reticuloendothelial cells. In HPS patients’ granulomatous colitis could be an additional feature and perianal abscess could be seen in such patients. We report a patient with HPS-associated granulomatous colitis, refractory to medical treatment, and perianal involvement. Patients with HPS-associated granulomatous colitis and perianal involvement may require multiple surgical interventions and there is no consensus yet for treatment in such patients.

Original Articles

Malignant disease,Colorectal cancer,Benign diesease & IBD,Biomarker & risk factor

Molecular characterization of dysplasia-initiated colorectal cancer with assessing matched tumor and dysplasia samples: Sungwon Jung, Jong Lyul Lee, Tae Won Kim, Jongmin Lee, Yong Sik Yoon, Kil Yeon Lee, Ki-hwan Song, Chang Sik Yu, Yong Beom Cho; Ann Coloproctol. 2022;38(1):72-81. Published online November 17, 2021; DOI: https://doi.org/10.3393/ac.2021.00290.0041

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2 Web of Science
2 Citations

Abstract PDF

Purpose
Ulcerative colitis (UC) is known to have an association with the increased risk of colorectal cancer (CRC), and UC-associated CRC does not follow the typical progress pattern of adenoma-carcinoma. The aim of this study is to investigate molecular characteristics of UC-associated CRC and further our understanding of the association between UC and CRC.
Methods
From 5 patients with UC-associated CRC, matched normal, dysplasia, and tumor specimens were obtained from formalin-fixed paraffin-embedded (FFPE) samples for analysis. Genomic DNA was extracted and whole exome sequencing was conducted to identify somatic variations in dysplasia and tumor samples. Statistical analysis was performed to identify somatic variations with significantly higher frequencies in dysplasia-initiated tumors, and their relevant functions were investigated.
Results
Total of 104 tumor mutation genes were identified with higher mutation frequencies in dysplasia-initiated tumors. Four of the 5 dysplasia-initiated tumors (80.0%) have TP53 mutations with frequent stop-gain mutations that were originated from matched dysplasia. APC and KRAS are known to be frequently mutated in general CRC, while none of the 5 patients have APC or KRAS mutation in their dysplasia and tumor samples. Glycoproteins including mucins were also frequently mutated in dysplasia-initiated tumors.
Conclusion
UC-associated CRC tumors have distinct mutational characteristics compared to typical adenoma-carcinoma tumors and may have different cancer-driving molecular mechanisms that are initiated from earlier dysplasia status.

Citations

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Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef
Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus R0 resection for resectable colorectal cancer with peritoneal metastases and low peritoneal cancer index scores: A collaborative observational study from Korea and Japan
Daichi Kitaguchi, Eun Jung Park, Seung Hyuk Baik, Shoma Sasaki, Yuichiro Tsukada, Masaaki Ito
International Journal of Surgery.2023;[Epub] CrossRef

Benign GI diease, IBD, Inflammatory bowel disease,Benign diesease & IBD

Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: An Australian Institution’s Experience: Ming Han Lim, Anton R. Lord, Lisa A. Simms, Katherine Hanigan, Aleksandra Edmundson, Matthew J.F.X. Rickard, Russell Stitz, David A. Clark, Graham L. Radford-Smith; Ann Coloproctol. 2021;37(5):318-325. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.08.26

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12 Web of Science
13 Citations

Abstract PDF

Purpose
We report outcomes and evaluate patient factors and the impact of surgical evolution on outcomes in consecutive ulcerative colitis patients who had restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) at an Australian institution over 26 years.
Methods
Data including clinical characteristics, preoperative medical therapy, and surgical outcomes were collected. We divided eligible patients into 3 period arms (period 1, 1990 to 1999; period 2, 2000 to 2009; period 3, 2010 to 2016). Outcomes of interest were IPAA leak and pouch failure.
Results
A total of 212 patients were included. Median follow-up was 50 (interquartile range, 17 to 120) months. Rates of early and late complications were 34.9% and 52.0%, respectively. Early complications included wound infection (9.4%), pelvic sepsis (8.0%), and small bowel obstruction (6.6%) while late complications included small bowel obstruction (18.9%), anal stenosis (16.8%), and pouch fistula (13.3%). Overall, IPAA leak rate was 6.1% and pouch failure rate was 4.8%. Eighty-three patients (42.3%) experienced pouchitis. Over time, we observed an increase in patient exposure to thiopurine (P=0.0025), cyclosporin (P=0.0002), and anti-tumor necrosis factor (P<0.00001) coupled with a shift to laparoscopic technique (P<0.00001), stapled IPAA (P<0.00001), J pouch configuration (P<0.00001), a modified 2-stage procedure (P=0.00012), and a decline in defunctioning ileostomy rate at time of IPAA (P=0.00002). Apart from pouchitis, there was no significant difference in surgical and chronic inflammatory pouch outcomes with time.
Conclusion
Despite greater patient exposure to immunomodulatory and biologic therapy before surgery coupled with a significant change in surgical techniques, surgical and chronic inflammatory pouch outcome rates have remained stable.

Citations

Citations to this article as recorded by

The prevalence of pouch fistulas in ulcerative colitis following restorative proctocolectomy: a systematic review and meta-analysis
Sheng Wei Lo, Ishaan Dharia, Danujan Sriranganathan, Maia Kayal, Edward L. Barnes, Jonathan P. Segal
Intestinal Research.2025; 23(1): 56. CrossRef
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
Surgical outcomes in ileal Crohn's disease complicated by ileosigmoid fistula
Ashley Jenkin, Aleksandra Edmundson, David Clark
ANZ Journal of Surgery.2024; 94(9): 1563. CrossRef
The Role of Minimally Invasive Surgery in the Management of Inflammatory Bowel Disease: Current Trends and Future Directions
Sanskruti Rathod , Nishant Kumar, German D Matiz, Sheryl Biju, Peter Girgis, Nagma Sabu, Hassan Mumtaz, Ali Haider
Cureus.2024;[Epub] CrossRef
Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: Predictors of Early and Late Complications
Yajnadatta Sarangi, Ashok Kumar, Somanath Malage, Nalinikanta Ghosh, Rahul Rahul, Ashish Singh, Supriya Sharma, Rajneesh K Singh, Anu Behari, Ashok Kumar
Cureus.2024;[Epub] CrossRef
Management and Outcomes of Ileal Pouch-Urethral Fistulas
João Pedro Emrich Accioly, Mariana Maspero, Hanson Zhao, Roger K. Khouri Jr., Olga Lavryk, Kenneth W. Angermeier, Tracy Hull, Hadley M. Wood
Urology.2023; 172: 213. CrossRef
Ileo-Anal Pouch Anastomosis and New Remedial Approaches for Ulcerative Colitis: A Review Article
Abhijeet Jankar, Tripti Shrivastava
Cureus.2023;[Epub] CrossRef
Review of long‐term complications and functional outcomes of ileoanal pouch procedures in patients with inflammatory bowel disease
Yusuf Hassan, William R. Connell, Alisha Rawal, Emily K. Wright
ANZ Journal of Surgery.2023; 93(6): 1503. CrossRef
Population outcomes, trends and the future of pouch surgery for ulcerative colitis: a 19‐year New South Wales data linkage study
Hugh L. Giddings, Kheng‐Seong Ng, Michael J. Solomon, Daniel Steffens, Joe Van Buskirk, Jane Young
ANZ Journal of Surgery.2023; 93(11): 2686. CrossRef
Ileoanal pouch cancers in ulcerative colitis and familial adenomatous polyposis: A systematic review and meta-analysis
Danujan Sriranganathan, Danilo Vinci, Gianluca Pellino, Jonathan P. Segal
Digestive and Liver Disease.2022; 54(10): 1328. CrossRef
Evolving Experimental Platforms to Evaluate Ulcerative Colitis
Tiffany T. Sharma, Rebecca R. Rabizadeh, Vibhav S. Prabhakar, Matthew I. Bury, Arun K. Sharma
Advanced Biology.2022;[Epub] 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
Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: An Australian Institution’s Experience
Ming Han Lim, Anton R. Lord, Lisa A. Simms, Katherine Hanigan, Aleksandra Edmundson, Matthew J.F.X. Rickard, Russell Stitz, David A. Clark, Graham L. Radford-Smith
Annals of Coloproctology.2021; 37(5): 318. CrossRef

Case Report

Malignant disease,Colorectal cancer

Synchronous Quadruple Colon Cancer With Two Lesions Previously Obscured by Ischemic Colitis, Plus Bladder Cancer and Thymoma: A Case Report: Byung-Soo Park, Sung Hwan Cho, Su Jin Kim, Tae Un Kim, Dong Il Kim, Gyung Mo Son, Hyun Sung Kim; Ann Coloproctol. 2021;37(Suppl 1):S44-S47. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.06.18

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Abstract PDF

Synchronous quadruple colorectal cancer (CRC) is extremely rare without genetic alterations. We present a case of synchronous quadruple CRC with 2 lesions previously obscured by ischemic colitis. A 73-year-old woman was admitted to our emergency department. An abdominal computed tomography revealed ischemic colitis and irregular wall thickening of the sigmoid colon and sigmoid-descending junction, suspicious of 2 colon cancers. A colonoscopy examination revealed a fungating mass 20 cm from the anal verge, as well as ischemic colitis spanning the mucosa from the sigmoid colon to the transverse colon. The patient underwent laparoscopic Hartmann procedure. Pathologic examination confirmed both lesions as adenocarcinomas with microsatellite stable. Seven months postoperatively, instead of a laparoscopic Hartmann reversal, a laparoscopic total colectomy was performed due to the continued presence of severe ischemic colitis. The pathologic report suggested the presence of 2 distinct invasive adenocarcinomas in the descending colon without genetic alterations such as microsatellite instability.

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Shunhua Tian, Feng Wu, Fan Yang, Guilin Min, Hongliu Chen
Journal of Surgical Case Reports.2024;[Epub] CrossRef
Could cytology supplant frozen section for intraoperative evaluation of thoracic lesions? A single institutional experience in a developing country
Zuhal Kuş Silav, Cansu Sönmez, Bülent Aydemir, Mehmet Yıldırım, Tamer Okay, Fügen Vardar Aker
Diagnostic Cytopathology.2023; 51(2): 123. CrossRef
Three colonic cancers, two sites of complete occlusion, one patient: A case report
Eric Bergeron, Thibaut Maniere, Xuan Vien Do, Michael Bensoussan, Eric De Broux
World Journal of Gastrointestinal Surgery.2021; 13(9): 1095. CrossRef

Original Articles

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

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4 Web of Science
3 Citations

Abstract 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

Current Status and Trends in Inflammatory Bowel Disease Surgery in Korea: Analysis of Data in a Nationwide Registry: Se-Jin Baek, Kil Yeon Lee, Ki Hwan Song, Chang Sik Yu, for the Inflammatory Bowel Disease (IBD) Study Group of the Korean Society of Coloproctology; Ann Coloproctol. 2018;34(6):299-305. Published online December 31, 2018; DOI: https://doi.org/10.3393/ac.2018.07.21

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17 Web of Science
16 Citations

Abstract PDF

Purpose
Inflammatory bowel disease (IBD) in Korea has been increasing in recent years, but accurate statistics about operations for IBD are lacking. The purpose of this study was to investigate the trends and current status of IBD surgeries in Korea.
Methods
Using a national database from the Korea Health Insurance Review and Assessment Service, we analyzed data from patients who underwent surgery for Crohn disease and ulcerative colitis from January 2009 to October 2016. Results: The mean number of patients who underwent surgery for Crohn disease was 791.8 per year. Colorectal surgery, small bowel surgery, and anal surgery were performed fairly often (31.2%, 29.4%, 39.4%, respectively), and laparoscopic surgery continued to increase, recently exceeding 30%. About 50% of Crohn patients used biologics before and after surgery, and those patients also underwent a relatively high rate of anal surgeries (44.2%). The mean number of patients who underwent surgery for ulcerative colitis was 247.6 per year. Colorectal surgery accounted for more than half of all operations, and laparoscopic surgery has been increasing rapidly, having been performed in about 60% of patients in recent years. The incidence of colorectal cancer in patients with ulcerative colitis was very high and increased rapidly during the study period, reaching about 80%.
Conclusion
The number of patients undergoing laparoscopic surgery for IBD in Korea has increased significantly. Biologics are actively used by patients with Crohn disease, with a high proportion of anal surgeries required. Many of the surgical indications for ulcerative colitis have shifted into colorectal cancer.

Citations

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The impact of advanced medical therapies on time to resection and colorectal cancer outcomes in ulcerative colitis patients undergoing colectomy
Eva Visser, Antonio Luberto, Lianne Heuthorst, Roel Hompes, Séverine Vermeire, Geert R D’Haens, Willem A Bemelman, André D’Hoore, Gabriele Bislenghi, Christianne J Buskens
Journal of Crohn's and Colitis.2025;[Epub] CrossRef
Clinical Significance of Prognostic Nutrition Index in Patients with Crohn’s Disease after Primary Bowel Resection
Hyeon Woo Bae, Yong Joon Lee, Min Young Park, Seung Yoon Yang, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Jae Hee Cheon, Joseph C. Carmichael, Byung Soh Min
Yonsei Medical Journal.2024; 65(7): 380. CrossRef
The Hydrophobic Amino Acid-Rich Fish Collagen Peptide Ameliorates Dextran Sulfate Sodium-Induced Ulcerative Colitis in Mice via Repairing the Intestinal Barrier, Regulating Intestinal Flora and AA Metabolism
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Journal of Agricultural and Food Chemistry.2024; 72(46): 25690. CrossRef
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Lianne Heuthorst, Houda Harbech, Harmanna J. Snijder, Aart Mookhoek, Geert R. D'Haens, Séverine Vermeire, André D'Hoore, Willem A. Bemelman, Christianne J. Buskens
American Journal of Gastroenterology.2023; 118(5): 848. CrossRef
Optimal surgical management of duodenal fistula in Crohn’s disease: a Korean multicenter cohort study
Soo Young Oh, Young Il Kim, Yong Sik Yoon, Min Soo Cho, Min Young Park, Seung-Bum Ryoo, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Molecular characterization of dysplasia-initiated colorectal cancer with assessing matched tumor and dysplasia samples
Sungwon Jung, Jong Lyul Lee, Tae Won Kim, Jongmin Lee, Yong Sik Yoon, Kil Yeon Lee, Ki-hwan Song, Chang Sik Yu, Yong Beom Cho
Annals of Coloproctology.2022; 38(1): 72. CrossRef
New insights on the surgical management of ulcerative colitis in the 21st century
Paulo G Kotze, Lianne Heuthorst, Amy L Lightner, Aderson O M C Damião, Willem A Bemelman
The Lancet Gastroenterology & Hepatology.2022; 7(7): 679. CrossRef
Surgical management of Crohn’s disease: a state of the art review
Elise Maria Meima - van Praag, Christianne Johanna Buskens, Roel Hompes, Wilhelmus Adrianus Bemelman
International Journal of Colorectal Disease.2021; 36(6): 1133. CrossRef
Surgical options for perianal fistula in patients with Crohn's disease: A comparison of seton placement, fistulotomy, and stem cell therapy
Min Young Park, Yong Sik Yoon, Hyoung Eun Kim, Jong Lyul Lee, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Asian Journal of Surgery.2021; 44(11): 1383. CrossRef
Improving the care of inflammatory bowel disease (IBD) patients: perspectives and strategies for IBD center management
Jihye Park, Sinyoung Park, Shin Ae Lee, Soo Jung Park, Jae Hee Cheon
The Korean Journal of Internal Medicine.2021; 36(5): 1040. CrossRef
Short-term and long-term outcomes of laparoscopic vs open ileocolic resection in patients with Crohn's disease: Propensity-score matching analysis
Shin Jeong Pak, Young Il Kim, Yong Sik Yoon, Jong Lyul Lee, Jung Bok Lee, Chang Sik Yu
World Journal of Gastroenterology.2021; 27(41): 7159. CrossRef
Effect of Age on the Initiation of Biologic Agent Therapy in Patients With Inflammatory Bowel Disease: Korean Common Data Model Cohort Study
Youn I Choi, Yoon Jae Kim, Jun-Won Chung, Kyoung Oh Kim, Hakki Kim, Rae Woong Park, Dong Kyun Park
JMIR Medical Informatics.2020; 8(4): e15124. CrossRef
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Soo Yeun Park
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Joon Suk Moon, Jong Lyul Lee, Chang Sik Yu, Seok-Byung Lim, In Ja Park, Yong Sik Yoon, Chan Wook Kim, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park, Hassan Abdullah Alsaleem, Jin Cheon Kim
Annals of Coloproctology.2020; 36(4): 243. CrossRef
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Hee Man Kim, Jin Woo Kim, Hyun-Soo Kim, Joo Sung Kim, You Sun Kim, Jae Hee Cheon, Won Ho Kim, Byong Duk Ye, Won Moon, Sung Hee Jung, Young-Ho Kim, Dong Soo Han
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What Are the Major Changes in Korean Inflammatory Bowel Disease Surgery?
Chang-Nam Kim
Annals of Coloproctology.2018; 34(6): 277. CrossRef

Obstructive Ileocolitis in Patients With Obstructed Colorectal Cancer – A Matched Case Control Study: Ning-Qi Pang, Tian-Zhi Lim, Yuanpei Zhou, Ker-Kan Tan; Ann Coloproctol. 2018;34(4):175-179. Published online August 31, 2018; DOI: https://doi.org/10.3393/ac.2017.06.14.1

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Abstract PDF

Purpose
Obstructive ileocolitis is an ulcero-inflammatory condition which typically occurs in the ileum or colon proximal to an obstructing colorectal lesion. If left unresolved, it often leads to intestinal perforation. We present a matched case control study of patients with obstructive ileocolitis caused by colorectal cancer to determine if any factors can predict this condition.
Methods
This is a retrospective review of 21 patients with obstructive colorectal cancer and histologically proven obstructive ileocolitis from 2005 to 2015 matched for age and sex with 21 controls with obstructing colorectal cancer without obstructive ileocolitis.
Results
The 21 patients with obstructive ileocolitis had a median age of 71 years (range, 52–86 years). The most common presenting symptom was abdominal pain (n = 16, 76.2%), followed by vomiting/nausea (n = 14, 66.7%) and abdominal distension (n = 12, 57.1%). Interestingly, the radiological feature of pneumatosis intestinalis was noted in only 1 case. No significant differences were observed in baseline comorbidities, clinical presentations, or tumor characteristics between the 2 groups. Patients with obstructive ileocolitis were found to have a significantly higher total leucocyte count (17.1 ± 9.4×109/L vs. 12.0 ± 6.8×109/L, P = 0.016), lower pCO2 (32.3 ± 8.2 mmHg vs. 34.8 ± 4.9 mmHg, P = 0.013), lower HCO3 (18.8 ± 4.5 mmol/L vs. 23.6 ± 2.7 mmol/L, P < 0.001), lower base excess (-6.53 ± 5.32 mmol/L vs. -0.57 ± 2.99 mmol/L, P < 0.001) and higher serum lactate levels (3.14 ± 2.19 mmol/L vs. 1.19 ± 0.91 mmol/L, P = 0.007) compared to controls. No radiological features were predictive of obstructive ileocolitis.
Conclusion
Patients with obstructive ileocolitis tend to present with metabolic acidosis with respiratory compensation, raised lactate, and worse leucocytosis. Radiological features are not useful for predicting this condition.

Citations

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Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Obstructing Colorectal Cancer Treated by Endoscopic Stenting as a Bridge to Surgery
Jiwei Guo, Aik Yong Chok, Hui Jun Lim, Wei Xuan Tay, Weng Kit Lye, Lasitha Bhagya Samarakoon, Emile John Tan, Ronnie Mathew
Annals of Coloproctology.2021; 37(3): 159. CrossRef

Clinical Characteristics and Incidence of Perianal Diseases in Patients With Ulcerative Colitis: Yong Sung Choi, Do Sun Kim, Doo Han Lee, Jae Bum Lee, Eun Jung Lee, Seong Dae Lee, Kee Ho Song, Hyung Joong Jung; Ann Coloproctol. 2018;34(3):138-143. Published online June 30, 2018; DOI: https://doi.org/10.3393/ac.2017.06.08

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23 Citations

Abstract PDF

Purpose
While perianal disease (PAD) is a characteristic of patients with Crohn disease, it has been overlooked in patients with ulcerative colitis (UC). Thus, our study aimed to analyze the incidence and the clinical features of PAD in patients with UC.
Methods
We reviewed the data on 944 patients with an initial diagnosis of UC from October 2003 to October 2015. PAD was categorized as hemorrhoids, anal fissures, abscesses, and fistulae after anoscopic examination by experienced proctologists. Data on patients’ demographics, incidence and types of PAD, medications, surgical therapies, and clinical course were analyzed.
Results
The median follow-up period was 58 months (range, 12–142 months). Of the 944 UC patients, the cumulative incidence rates of PAD were 8.1% and 16.0% at 5 and 10 years, respectively. The incidence rates of bleeding hemorrhoids, anal fissures, abscesses, and fistulae at 10 years were 6.7%, 5.3%, 2.6%, and 3.4%, respectively. The cumulative incidence rates of perianal sepsis (abscess or fistula) were 2.2% and 4.5% at 5 and 10 years, respectively. In the multivariate analyses, male sex (risk ratio [RR], 4.6; 95% confidence interval [CI], 1.7–12.5) and extensive disease (RR, 4.2; 95% CI, 1.6–10.9) were significantly associated with the development of perianal sepsis.
Conclusion
Although the clinical course of PAD in patients with UC is not serious, in clinical practice, PAD is not rare in such patients. Therefore, careful examination and appropriate management for PAD is needed if the quality of life for patients with UC is to be improved.

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Kristen M. Westfall, Ronald Charles, Emily Steinhagen
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Uchenna E Okpete, Haewon Byeon
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The bacterial composition signatures of perianal abscess and origin of infecting microbes
Song Han, Wenya Su, Kefeng Fan, Zhen Xu, Hai Xu, Mingyu Wang, Ling Li, Wenlong Shen
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Cumulative incidence and prevalence of perianal diseases in patients with inflammatory bowel disease and in the population: a nationwide Swedish study
Åsa H. Everhov, Michael Eberhardson, Jonas Söderling, Caroline Nordenvall, Jonas Halfvarson, Jonas F. Ludvigsson, Ola Olén, Pär Myrelid, Hans Strid, Henrik Hjortswang, Malin Olsson, Jonas L. Bengtsson, Marie A. Andersson, Pontus Karling, Martin Rejler, Su
Scandinavian Journal of Gastroenterology.2025; 60(4): 349. CrossRef
Analfissuren bei chronisch entzündlichen Darmerkrankungen
Emile Rijcken
coloproctology.2025;[Epub] CrossRef
Efficacy and safety of office-based procedures for hemorrhoidal disease in patients with inflammatory bowel disease
T. Carvalho, T. Leal, B. Arroja, P. Mesquita, I. Malta, T. Gago, A. R. Gonçalves, R. Coelho, S. B. Ponte, P. Salgueiro, F. Castro-Poças, A. C. Bravo, C. Gouveia, A. M. Oliveira, M. Francisco, R. Gonçalves, A. C. Caetano
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Hans Lovén, Rune Erichsen, Anders Tøttrup, Thue Bisgaard
Hernia.2025;[Epub] CrossRef
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Xuelong Zhao, Ruixue Dai, Jing Wang, Liangliang Cao, Peidong Chen, Weifeng Yao, Fangfang Cheng, Beihua Bao, Li Zhang
Journal of Pharmaceutical and Biomedical Analysis.2024; 238: 115853. CrossRef
Problem with Hookups: Perianal Fistula After Ileal Pouch-Anal Anastomosis
Arafa Djalal, Serre-Yu Wong, Jean-Frédéric Colombel, Ryan Ungaro, Maia Kayal
Digestive Diseases and Sciences.2024; 69(4): 1102. CrossRef
Diffusion-Weighted MRI in Perianal Abscess: Role and Comparison With Contrast-Enhanced MRI
Pooja Aggarwal, Rajesh Malik, Radha Sarawagi, Aman Kumar, Jitendra Sharma
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HanYu Wang, Lu Wang, XiaoYu Zeng, ShiPeng Zhang, Yong Huang, QinXiu Zhang
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XiaoYu Zeng, HanYu Wang, Ting Wu, ZiNing Zhou, JianPing Zhou, Hao Fu
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Ulcerative colitis complicated with Fournier’s gangrene: A case report
Irina Bondoc, Marius Zamfir, Mara Mardare, Andrei Văcărașu, Alin Burlacu, Leila Ali, Ariana Hudita, Bianca Galateanu, Octav Ginghină, Georgios Georgiadis, Charalampos Mamoulakis
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Zongbiao Tan, Shijie Zhu, Chuan Liu, Yang Meng, Jiao Li, Jixiang Zhang, Weiguo Dong
Journal of Clinical Medicine.2023; 12(7): 2482. CrossRef
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Catherine Le Berre, Sailish Honap, Laurent Peyrin-Biroulet
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Perianal Fistula After Ileoanal Pouch in Patients With Ulcerative Colitis: A Review of 475 Patients Operated on at a Major IBD Center
Tomas M. Heimann, Santosh Swaminathan, Gary I. Slater, Robert J. Kurtz
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Prostaglandin E‐major urinary metabolite diagnoses mucosal healing in patients with ulcerative colitis in remission phase
Toshiyuki Sakurai, Yoshihiro Akita, Haruna Miyashita, Ryosuke Miyazaki, Yuki Maruyama, Tomoko Saito, Mariko Shimada, Takuji Yamasaki, Seiji Arhihiro, Tomohiro Kato, Tomokazu Matsuura, Masahiro Ikegami, Isao Okayasu, Masayuki Saruta
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Bo Shen
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Clinical characteristics and MRI-based phenotypes of perianal abscess formation in children with fistulizing Crohn's Disease
Azadeh Tabari, Jess L. Kaplan, Susanna Y. Huh, Christopher J. Moran, Michael S. Gee
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Rohan V Yewale, Kartik Natarajan, Jeyaraj Ubal Dhus, Sarojini Ashok Parameswaran, Kallipatti Ramaswamy Palaniswamy, Doraisamy Babu Vinish, Aravindh Somasundaram, Arulraj Ramakrishnan, Sibithooran Karmegam, Ramaswamy Saraswathy Arun, Ujjani Shankaraiah Man
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A. L. Lightner, D. Kearney, D. Giugliano, T. Hull, S. Holubar, S. Shawki, S. R. Steele
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Nicholas P. McKenna, Amy L. Lightner, Elizabeth B. Habermann, Kellie L. Mathis
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Small Bowel Obstruction After Ileal Pouch-Anal Anastomosis With a Loop Ileostomy in Patients With Ulcerative Colitis: Hitoshi Kameyama, Yoshifumi Hashimoto, Yoshifumi Shimada, Saki Yamada, Ryoma Yagi, Yosuke Tajima, Takuma Okamura, Masato Nakano, Kohei Miura, Masayuki Nagahashi, Jun Sakata, Takashi Kobayashi, Shin-ichi Kosugi, Toshifumi Wakai; Ann Coloproctol. 2018;34(2):94-100. Published online April 30, 2018; DOI: https://doi.org/10.3393/ac.2017.06.14

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115 Download
11 Web of Science
10 Citations

Abstract PDF

Purpose
Small bowel obstruction (SBO) remains a common complication after pelvic or abdominal surgery. However, the risk factors for SBO in ulcerative colitis (UC) surgery are not well known. The aim of the present study was to clarify the risk factors associated with SBO after ileal pouch-anal anastomosis (IPAA) with a loop ileostomy for patients with UC.
Methods
The medical records of 96 patients who underwent IPAA for UC between 1999 and 2011 were reviewed. SBO was confirmed based on the presence of clinical symptoms and radiographic findings. The patients were divided into 2 groups: the SBO group and the non-SBO group. We also analyzed the relationship between SBO and computed tomography (CT) scan image parameters.
Results
The study included 49 male and 47 female patients. The median age was 35.5 years (range, 14–72 years). We performed a 2- or 3-stage procedure as a total proctocolectomy and IPAA for patients with UC. SBO in the pretakedown of the loop ileostomy after IPAA occurred in 22 patients (22.9%). Moreover, surgical intervention for SBO was required for 11 patients. In brief, closure of the loop ileostomy was performed earlier than expected. A multivariate logistic regression analysis revealed that the 2-stage procedure (odds ratio, 2.850; 95% confidence interval, 1.009–8.044; P = 0.048) was a significant independent risk factor associated with SBO. CT scan image parameters were not significant risk factors of SBO.
Conclusion
The present study suggests that a 2-stage procedure is a significant risk factor associated with SBO after IPAA in patients with UC.

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Shingo Tsujinaka, Hideyuki Suzuki, Tomoya Miura, Yoshihiro Sato, Chikashi Shibata
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Ryo Maemoto, Shingo Tsujinaka, Yasuyuki Miyakura, Rintaro Fukuda, Nao Kakizawa, Tsutomu Takenami, Erika Machida, Nozomi Kikuchi, Rina Kanemitsu, Sawako Tamaki, Hideki Ishikawa, Toshiki Rikiyama
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RISK FACTORS FOR THE DEVELOPMENT OF COMPLICATIONS OF ILEAL POUCH IN PATIENTS WITH ULCERATIVE COLITIS
S. I. Achkasov, O. I. Sushkov, A. E. Kulikov, Sh. A. Binnatli, M. A. Nagudov, A. V. Vardanyan
Koloproktologia.2020; 19(1): 51. CrossRef
A Common Complication After an Ileal Pouch-Anal Anastomosis With a Loop Ileostomy in Patients With Ulcerative Colitis: Small Bowel Obstruction
Chang-Nam Kim
Annals of Coloproctology.2018; 34(2): 57. CrossRef
Elevated risk of stoma outlet obstruction following colorectal surgery in patients undergoing ileal pouch–anal anastomosis: a retrospective cohort study
Satoshi Okada, Keisuke Hata, Shigenobu Emoto, Koji Murono, Manabu Kaneko, Kazuhito Sasaki, Kensuke Otani, Takeshi Nishikawa, Toshiaki Tanaka, Kazushige Kawai, Hiroaki Nozawa
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Case Report

Necrotizing Fasciitis of the Thigh Secondary to Radiation Colitis in a Rectal Cancer Patient: So Hyun Park, Jung Ran Choi, Ji Young Song, Kyu Keun Kang, Woong Sun Yoo, Sung Wan Han, Choon Kwan Kim; J Korean Soc Coloproctol. 2012;28(6):325-329. Published online December 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.6.325

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Abstract PDF

Necrotizing fasciitis usually occurs after dermal injury or through hematogenous spread. To date, few cases have been reported as necrotizing fasciitis of the thigh secondary to rectal perforation in rectal cancer patients. A 66-year-old male complained of pelvic and thigh pain and subsequently developed necrotizing fasciitis in his right thigh. Four years earlier, he had undergone a low anterior resection and radiotherapy due to of rectal cancer. An ulcerative lesion had been observed around the anastomosis site during the colonoscopy that had been performed two months earlier. Pelvic computed tomography and sigmoidoscopy showed rectal perforation and presacral abscess extending to buttock and the right posterior thigh fascia. Thus, the necrotizing fasciitis was believed to have occurred because of ulcer perforation, one of the complications of chronic radiation colitis, at the anastomosis site. When a rectal-cancer patient complains of pelvic and thigh pain, the possibility of a rectal perforation should be considered.

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SuleymanUtku Celik, Rahman Senocak
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Kenneth D. Marshall, Dakota M. Williams, Bradley S. Jackson
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ベバシズマブを含む化学療法中の直腸癌患者に発症したA群β溶連菌による壊死性筋膜炎の1例(A case of group A beta streptococcal necrotizing fasciitis in a patient with rectal cancer underwent chemotherapy including bevacizumab)
三好博実 (Hiromi Miyoshi), 大下慎一郎 (Shinichiro Ohshimo), 木田佳子 (Yoshiko Kida), 山賀聡之 (Satoshi Yamaga), 太田浩平 (Kohei Ota), 津村龍 (Ryu Tsumura), 志馬伸朗 (Nobuaki Shime)
Nihon Kyukyu Igakukai Zasshi: Journal of Japanese Association for Acute Medicine.2018; 29(1): 36. CrossRef
Unusual inguinal mass
Matthew Wei, Andrew Hardley, Raaj Chandra
ANZ Journal of Surgery.2017; 87(11): 949. CrossRef
Necrotising Fascitis of the Thigh through Short External Rotator Muscles Due to an Unrecognized Perforated Rectal Cancer
Ju-Oh Kim, Hong-Man Cho, Woo-Jin Sin, Hwang-Se Bong
Hip & Pelvis.2013; 25(2): 149. CrossRef

Review

A Comprehensive Review of Inflammatory Bowel Disease Focusing on Surgical Management: Seung Hyuk Baik, Won Ho Kim; J Korean Soc Coloproctol. 2012;28(3):121-131. Published online June 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.3.121

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4 Citations

Abstract PDF

The two main diseases of inflammatory bowel disease are Crohn's disease and ulcerative colitis. The pathogenesis of inflammatory disease is that abnormal intestinal inflammations occur in genetically susceptible individuals according to various environmental factors. The consequent process results in inflammatory bowel disease. Medical treatment consists of the induction of remission in the acute phase of the disease and the maintenance of remission. Patients with Crohn's disease finally need surgical treatment in 70% of the cases. The main surgical options for Crohn's disease are divided into two surgical procedures. The first is strictureplasty, which can prevent short bowel syndrome. The second is resection of the involved intestinal segment. Simultaneous medico-surgical treatment can be a good treatment strategy. Ulcerative colitis is a diffuse nonspecific inflammatory disease that involves the colon and the rectum. Patients with ulcerative colitis need surgical treatment in 30% of the cases despite proper medical treatment. The reasons for surgical treatment are various, from life-threatening complications to growth retardation. The total proctocolectomy (TPC) with an ileal pouch anal anastomosis (IPAA) is the most common procedure for the surgical treatment of ulcerative colitis. Medical treatment for ulcerative colitis after a TPC with an IPAA is usually not necessary.

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Smiljana Spasic, Iva Brcic, Rochelle Freire, Monica T. Garcia-Buitrago, Andrew E. Rosenberg
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Journal of the Korean Society of Coloproctology.2012; 28(4): 175. CrossRef

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