Annals of Coloproctology

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Original Articles

ERAS

Safety and patient’s satisfaction of preoperative carbohydrate drink until 2 hours before colorectal cancer surgery: a single-center, prospective randomized controlled trial: Yun Min Lee, Kyeong Eui Kim, Sung Uk Bae, Seong Kyu Baek, Woon Kyung Jeong; Ann Coloproctol. 2025;41(6):519-527. Published online December 24, 2025; DOI: https://doi.org/10.3393/ac.2025.00521.0074

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Abstract PDF: Purpose
Traditionally, fasting from midnight has been a standard practice in elective surgery for reduce the risk of aspiration. However, Enhanced Recovery After Surgery (ERAS) programs recommend clear fluid intake until 2 hours before anesthesia. This study aimed to evaluate the safety and patient satisfaction of preoperative carbohydrate drink intake until 2 hours before colorectal cancer surgery.
Methods
Sixty patients who underwent colorectal cancer surgery between April 2021 and February 2023 at Keimyung University Dongsan Medical Center were enrolled. This study included 30 patients who fasted from midnight (nothing by mouth [NPO] group) and 30 patients who consumed a high concentration of complex carbohydrate fluids (New Care NO-NPO) until 2 hours before surgery (No-NPO group). Patient satisfaction was assessed using a visual analog scale. Perioperative and postoperative outcomes were compared.
Results
Basic characteristics of patients were similar for the 2 groups. The No-NPO group had a significantly higher patient satisfaction score than the NPO group (3.7 vs. 2.2, P=0.040). Scores of operative difficulty, operation time, blood loss, postoperative recovery parameters, and postoperative complication rates were similar for the 2 groups. Pathological outcomes were also comparable. No mortality occurred in either group.
Conclusion
High-concentration carbohydrate fluid intake until 2 hours before induction of anesthesia could improve patient satisfaction without increasing postoperative complications, demonstrating its safety and feasibility in colorectal cancer surgery. Trial registration CRIS (cris.nih.go.kr) identifier: KCT0011323.

Complications

Efficacy and safety of novel alginate-based sealants (SEAL-G and SEAL-G MIST) in reducing anastomotic leakage following colorectal anastomosis: a prospective multicenter study: Moshe Kamar, Fahim Kanani, Antonio Spinelli, David Jayne, Lior Segev, Matt Tutton, Isacco Montroni, Hagit Tulchinsky, Mordechai Shimonov, Ron Lavy, Oded Zmora; Ann Coloproctol. 2025;41(5):424-433. Published online October 23, 2025; DOI: https://doi.org/10.3393/ac.2025.00297.0042

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Abstract PDF Supplementary Material: Purpose
This study aimed to evaluate the efficacy, usability, and safety of the novel alginate-based sealants SEAL-G and SEAL-G MIST in reducing anastomotic leakage after colorectal resection.
Methods
This prospective, multicenter study enrolled 160 patients undergoing elective colonic resection with primary anastomosis at 8 centers. SEAL-G was applied in open procedures (n=33), and SEAL-G MIST was used for minimally invasive procedures (n=127), with both sealants applied circumferentially to the anastomotic site. The primary endpoints included the rate of anastomotic coverage and the incidence of leakage within 30 days, classified according to the International Study Group of Rectal Cancer (ISGRC) criteria.
Results
The overall anastomotic leak rate was 3.1% (5 of 160), with only 1 patient (0.6%) experiencing a grade C leak that required reoperation. Four patients (2.5%) developed grade A or B leaks, all of which were managed conservatively. Complete circumferential sealant coverage was achieved in 93.1% of cases. The overall leak rates were 6.1 percent and 2.4 percent, respectively. However, statistical analysis did not show a significant difference. Mean hospital stay was significantly shorter after laparoscopic surgery compared to open surgery (5.1±2.8 days vs. 8.4±5.5 days, P<0.001).
Conclusion
Alginate-based sealants show promise in reducing the severity of anastomotic leaks and in supporting anastomotic healing, demonstrating high technical success and low complication rates. Trial registration: ClinicalTrials.gov identifier: NCT04532515

Complications

Effect of oral antibiotic bowel preparation versus no preparation on surgical site infections in elective colorectal surgery: a randomized trial: Kavyashree Mallesh, Rajendran Theakarajan, Balasubramanian G, Prashant Penumadu, Raja Kalayarasan, Rajkumar Nagarajan; Ann Coloproctol. 2025;41(5):393-399. Published online October 20, 2025; DOI: https://doi.org/10.3393/ac.2025.00633.0090

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Purpose
Surgical site infections (SSIs) represent a significant cause of morbidity following colorectal surgery. While mechanical bowel preparation combined with oral antibiotics is known to reduce SSIs, the independent effect of oral antibiotics alone remains unclear. This study compared the efficacy of oral antibiotic bowel preparation (OABP) versus no bowel preparation (NBP) in reducing SSIs among patients undergoing elective colorectal surgery.
Methods
A prospective, randomized, double-blinded trial was performed at a tertiary care center in India. Eighty-six patients scheduled for elective colorectal surgery were randomized to receive either OABP (oral ciprofloxacin and metronidazole) or placebo, in addition to standard intravenous antibiotics. The primary outcome was the rate of SSIs. Secondary outcomes included anastomotic leak, length of hospital stay, overall morbidity, and readmission rates.
Results
Baseline characteristics were comparable between the groups. The incidence of SSI was significantly lower in the OABP group compared to the NBP group (14.0% vs. 41.9%, P<0.01). The severity of infections and postoperative complications was also reduced in the OABP group (P<0.01). Although rates of anastomotic leak, readmission, and reoperation were higher in the NBP group, these differences were not statistically significant. The mean duration of hospital stay was shorter for patients in the OABP group (8.09 days vs. 11.28 days, P<0.01). No adverse effects related to oral antibiotics were observed.
Conclusion
OABP without mechanical cleansing significantly reduces SSIs, postoperative morbidity, and length of hospital stay in elective colorectal surgery. This approach is safe and effective, offering a strategy to improve surgical outcomes.

Citations

Citations to this article as recorded by

Oral antibiotics alone for bowel preparation in colorectal surgery: time to rethink tradition?
Soo Young Lee
Annals of Coloproctology.2025; 41(5): 367. CrossRef

Minimally invasive surgery

Comparative perioperative outcomes of articulated versus conventional straight devices in laparoscopic low anterior resection: a propensity score–matched analysis: Hayoung Lee, Yong Sik Yoon, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim; Ann Coloproctol. 2025;41(5):434-442. Published online October 16, 2025; DOI: https://doi.org/10.3393/ac.2025.00227.0032

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Abstract PDF Supplementary Material: Purpose
Laparoscopic low anterior resection for rectal cancer is technically challenging due to the precision required for mesorectal excision. Articulated instruments were developed to improve precision and oncological safety over conventional instruments. This study compares their perioperative outcomes.
Methods
A retrospective cohort study of 432 patients with colorectal cancer who underwent low anterior resection between August 2022 and February 2024 applied propensity score matching to minimize selection bias. Primary endpoints were circumferential resection margin (CRM), distal resection margin (DRM), and harvested lymph nodes count. Secondary outcomes included postoperative complications.
Results
Following propensity score matching, 84 matched pairs were analyzed. Most patients achieved CRM negativity (>1 mm), with CRM ≥10 mm in 67.9% of the articulated group and 59.5% of the conventional group (P=0.613). Median (interquartile range, IQR) lymph nodes harvests were comparable (20 [14–26] vs. 18 [14–22], P=0.147). The articulated group had a significantly longer DRM (30.0 mm [IQR, 18.0–40.0 mm] vs. 24.0 mm [IQR, 12.0–34.2 mm], P=0.008) and the median operation time (111.0 minutes [IQR, 95.8–125.2 minutes] vs. 99.5 minutes [IQR, 72.0–119.8 minutes], P=0.009). Estimated blood loss, open conversion rates, and postoperative complications, including leakage (7.1% vs. 8.3%, P>0.999) and surgical site infections, (15.5% vs. 9.5%, P=0.383), showed no significant differences.
Conclusion
Articulated laparoscopic instruments demonstrated comparable safety and feasibility to conventional instruments but offered no significant clinical or oncological benefits beyond a longer DRM. Larger studies are needed to evaluate their value in laparoscopic rectal surgery.

ERAS

The efficacy of mosapride on recovery of intestinal motility after elective colorectal cancer surgery: a randomized controlled trial: Tharin Thampongsa, Bensita Saengsawang, Chairat Supsamutchai, Chumpon Wilasrusmee, Jakrapan Jirasiritham, Puvee Punmeechao, Visarat Palitnonkiat, Napaphat Poprom, Pattawia Choikrua, Pongsasit Singhathas; Ann Coloproctol. 2025;41(3):232-238. Published online June 25, 2025; DOI: https://doi.org/10.3393/ac.2024.00892.0127

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Abstract PDF Supplementary Material: Purpose
Postoperative ileus is the physiologic hypomotility of the gastrointestinal tract that occurs immediately after abdominal surgery. Mosapride citrate is known to enhance gastrointestinal motility. This study aimed to evaluate mosapride’s impact on postoperative ileus and gastrointestinal motility in patients undergoing elective colorectal surgery.
Methods
Forty-four patients with colorectal cancer undergoing surgery at Ramathibodi Hospital between July 2021 and August 2022 were randomly assigned to either a mosapride group or a control group. The mosapride group received 5 mg of mosapride via the enteric route with 50 mL of water 3 times daily, beginning on postoperative day 1, while the control group received 5 mg of a placebo with 50 mL of water on the same schedule. A single investigator, blinded to the treatment assignments in this triple-blind study, evaluated the postoperative time to the first bowel movement and passage of flatus. Secondary outcomes included the time to step diet, length of postoperative hospital stay, and adverse effects.
Results
There were 23 patients in the control group and 21 in the mosapride group. There were no significant differences in baseline patient characteristics between the 2 groups. The mosapride group demonstrated significantly shorter times to the first bowel movement (26 hours vs. 50 hours, P=0.004) and passage of flatus (40 hours vs. 70 hours, P=0.003).
Conclusion
Mosapride significantly improved the recovery of gastrointestinal motility and reduced the length of hospital stay without causing any serious adverse effects in patients undergoing elective colorectal surgery. Trial registration: ClinicalTrials.gov identifier: NCT04905147

Colorectal cancer

How appropriately can generative artificial intelligence platforms, including GPT-4, Gemini, Bing, and Wrtn, answer questions about colon cancer in the Korean language?: Sun Huh; Ann Coloproctol. 2025;41(3):190-197. Published online June 25, 2025; DOI: https://doi.org/10.3393/ac.2024.00122.0017

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Abstract PDF Supplementary Material

Purpose
This study aims to assess the performance of 4 generative artificial intelligence (AI) platforms—Gemini (formerly Bard), Bing, GPT-4, and Wrtn—in answering questions about colon cancer in the Korean language. Two main research questions guided this study. First, which AI platform provides the most accurate answers? Second, can these AI-generated answers be reliably used to educate patients and their families about colon cancer?
Methods
Ten questions selected by the author were posed to the 4 generative AI platforms on February 22, 2024. Two colorectal surgeons in Korea, each with over 20 years of clinical experience, independently evaluated the answers provided by these generative AI platforms.
Results
The generative AI platforms scored an average of 5.5 out of 10 points. Wrtn achieved the highest score at 6 points, followed by GPT-4 and Gemini, each with 5.5, and Bing, scoring 5 points. The weighted κ for inter-rater reliability was 0.597 (P<0.001). The generative AI platforms performed well in explaining the occult blood test for cancer screening, keyhole surgery, and dietary recommendations for cancer prevention. However, they demonstrated significant limitations in answering more complex topics, such as estimating survival rates following surgery, choosing targeted therapy after surgery, and accurately reporting the mortality rate due to colon cancer in Korea.
Conclusion
The findings suggest that using these generative AI platforms as educational resources for patients and their families regarding colon cancer is premature. Further training on colorectal diseases is required before these AI platforms can be considered reliable information sources for the general public in Korea.

Citations

Citations to this article as recorded by

Expert Review on the Quality of Responses to the Questions of Multiple Myeloma Patients: A Validation Study of the Medical Artificial Intelligence System “Myelobot”
Aleksander Sergeevich Luchinin, O. E. Ochirova, V. G. Potapenko, V. V. Ryabchikova
Clinical Oncohematology.2026; 19(1): 81. CrossRef
Agentic artificial intelligence is the future of cancer detection and diagnosis
Sayedur Rahman, Md. Tanzib Hosain, Nafiz Fahad, Md. Kishor Morol, Md. Jakir Hossen
Array.2026; 29: 100676. CrossRef
Role of Medical Editors in the Age of Generative Artificial Intelligence
Sun Huh
Healthcare Informatics Research.2025; 31(4): 317. CrossRef
Temporal evolution of large language models (LLMs) in oncology
Zilin Qiu, Aimin Jiang, Chang Qi, Wenyi Gan, Lingxuan Zhu, Weiming Mou, Dongqiang Zeng, Mingjia Xiao, Guangdi Chu, Shengkun Peng, Hank Z. H. Wong, Lin Zhang, Hengguo Zhang, Xinpei Deng, Quan Cheng, Bufu Tang, Yaxuan Wang, Jian Zhang, Anqi Lin, Peng Luo
Journal of Translational Medicine.2025;[Epub] CrossRef

Complications

Bedside endoscopic inspection of colorectal anastomoses in the early postoperative period: a 2-center prospective feasibility study: David J. Nijssen, Roel Hompes, Jurriaan Tuynman, Jimme K. Wiggers, Willem A. Bemelman, Saidah Sahid, James Kinross, Wytze Laméris; Ann Coloproctol. 2025;41(2):127-135. Published online April 14, 2025; DOI: https://doi.org/10.3393/ac.2024.00584.0083

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Abstract PDF

Purpose
Early diagnosis of anastomotic leakage (AL) after colorectal surgery can reduce severe postoperative morbidity and ensure successful treatment. This study evaluated the feasibility of bedside endoscopic inspection of the anastomosis early postoperatively using a point-of-care digital rectoscope.
Methods
This prospective study was conducted at 2 tertiary centers. Patients who underwent minimally invasive or open sphincter-preserving surgery with creation of a colorectal or coloanal anastomosis were included. Data were collected from December 2022 to October 2023. Bedside anastomotic inspections were performed postoperative day (POD) 3 to 5 using a point-of-care digital rectoscope. The primary outcome was feasibility, defined as adequate clinical assessment of the anastomosis during bedside inspection. Secondary outcomes included patient tolerability, efficacy compared to other diagnostic methods, and clinical outcomes during 90 days of follow-up.
Results
In total, 35 patients were included. All bedside anastomotic inspections were carried out successfully. The examination showed complete visibility of the entire anastomosis in 30 patients (85.7%), with minimal discomfort reported by 3 (8.6%). No adverse events were recorded. AL occurred in 6 patients (17.1%), with 3 cases detected during bedside inspections between POD 3 and 5. Two leaks were detected without clinical or biochemical suspicion. Three patients with negative rectoscopy between POD 3 and 5 were later diagnosed with AL: 2 by a computed tomography scan and 1 by a bedside rectoscopy.
Conclusion
Bedside inspection of rectal anastomoses early postoperatively is feasible and tolerable for patients. Routine anastomotic inspections can detect early AL even without clear clinical or biochemical signs.

Citations

Citations to this article as recorded by

Is Chronic Pelvic Sepsis Complicating Low Anterior Resection of Rectal Cancer Preventable?
Elroy Patrick Weledji
Surgeries.2026; 7(1): 9. CrossRef
Routine Endoscopic Evaluation of Colorectal Anastomoses for Early Detection of Anastomotic Leakage (REAL Study): Protocol for a Multicenter Prospective Study
David J. Nijssen, Wytze Laméris, Quentin Denost, Antonino Spinelli, Eloy Espín-Basany, James Kinross, Jurriaan Tuynman, Roel Hompes
Digestive Surgery.2025; 42(4): 185. CrossRef
Diagnostic accuracy of C-reactive protein in detecting anastomotic leakage after minimally invasive rectal cancer surgery
David J. Nijssen, Mark Broekman, Franny Rensink, Gijs Stuart, Ritch T. J. Geitenbeek, Joost Stael, Susan van Dieren, Willem A. Bemelman, Jurriaan Tuynman, Esther C. J. Consten, Roel Hompes, Wytze Laméris, G. J. D. van Acker, T. S. Aukema, H. J. Belgers, F
Surgical Endoscopy.2025;[Epub] CrossRef

Colorectal cancer

Comparison of colorectal cancer surgery patients in intensive care between rural and metropolitan hospitals in Australia: a national cohort study: Jessica A. Paynter, Zakary Doherty, Chun Hin Angus Lee, Kirby R. Qin, Janelle Brennan, David Pilcher; Ann Coloproctol. 2025;41(1):68-76. Published online January 24, 2025; DOI: https://doi.org/10.3393/ac.2024.00269.0038

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Abstract PDF Supplementary Material

Purpose
A small proportion of colorectal cancer (CRC) surgical patients will require an admission to an intensive care unit (ICU) within the early postoperative period. This study aimed to compare the characteristics and outcomes of patients admitted to an ICU following CRC surgery per hospital type (metropolitan vs. rural) over a decade in Australia.
Methods
A retrospective cohort analysis was undertaken of all adult patients admitted to a participating Australian ICUs following CRC surgery between January 2011 and December 2021. The primary outcome was in-hospital mortality.
Results
Over the 10-year period, 19,611 patients were treated in 122 metropolitan ICUs and 4,108 patients were treated in 42 rural ICUs. Rural ICUs had a lower proportion of annual admissions following CRC surgery (20 vs. 36, P<0.001). Patients admitted to a rural ICU were more likely to have undergone emergency CRC surgery compared to those admitted to a metropolitan cohort (28.5% vs. 13.8%, P<0.001). There was no difference in in-hospital mortality between metropolitan and rural hospitals (odds ratio [OR], 1.03; 95% confidence interval [CI], 0.73–1.35; P=0.500). There was a general trend for lower mortality in later years of the study with the odds of death in the final year of the study (2021) almost half that of the first study year (OR, 0.52; 95% CI, 0.34–0.80; P=0.003).
Conclusion
There was no difference between in-hospital mortality outcomes for CRC surgical patients requiring ICU admission between metropolitan and rural hospitals. These findings may contribute to discussions regarding rural scope of colorectal practice within Australia and globally.

Citations

Citations to this article as recorded by

Intensive care unit outcomes and prognostic factors of colorectal cancer
Qian Dong, Rui Xia, Xue-Zhong Xing, Chang-Song Wang, Gang Ma, Hong-Zhi Wang, Biao Zhu, Jiang-Hong Zhao, Dong-Min Zhou, Li Zhang, Ming-Guang Huang, Rong-Xi Quan, Yong Ye, Guo-Xing Zhang, Zheng-Ying Jiang, Bing Huang, Shan-Ling Xu, Yun Xiao, Lin-Lin Zhang,
World Journal of Gastrointestinal Oncology.2025;[Epub] CrossRef

Reviews

Minimally invasive surgery

Robotic colorectal surgery training: Portsmouth perspective: Guglielmo Niccolò Piozzi, Sentilnathan Subramaniam, Diana Ronconi Di Giuseppe, Rauand Duhoky, Jim S. Khan; Ann Coloproctol. 2024;40(4):350-362. Published online August 30, 2024; DOI: https://doi.org/10.3393/ac.2024.00444.0063

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This study aims to discuss the principles and pillars of robotic colorectal surgery training and share the training pathway at Portsmouth Hospitals University NHS Trust. A narrative review is presented to discuss all the relevant and critical steps in robotic surgical training. Robotic training requires a stepwise approach, including theoretical knowledge, case observation, simulation, dry lab, wet lab, tutored programs, proctoring (in person or telementoring), procedure-specific training, and follow-up. Portsmouth Colorectal has an established robotic training model with a safe stepwise approach that has been demonstrated through perioperative and oncological results. Robotic surgery training should enable a trainee to use the robotic platform safely and effectively, minimize errors, and enhance performance with improved outcomes. Portsmouth Colorectal has provided such a stepwise training program since 2015 and continues to promote and augment safe robotic training in its field. Safe and efficient training programs are essential to upholding the optimal standard of care.

Citations

Citations to this article as recorded by

Robotic-assisted colorectal surgery in colorectal cancer management: a narrative review of clinical efficacy and multidisciplinary integration
Engeng Chen, Li Chen, Wei Zhang
Frontiers in Oncology.2025;[Epub] CrossRef
Entwicklung und Implementation eines strukturierten Ausbildungsprogramms in der robotischen Chirurgie
Sarah Englert, Natascha Tschukewitsch, Alexa Wölfl, Christoph Justinger
Die Chirurgie.2025; 96(9): 765. CrossRef
The evolution of training in robotic colorectal surgery
R. Smyth, N. Francis, S. Vasudevan
Journal of Robotic Surgery.2025;[Epub] CrossRef
Evaluating the Toumai MT‑1000 for urologic surgery: a systematic review and single-arm meta-analysis with remote and on-site experiences
Chi Zhang, Jinwan Wang
Journal of Robotic Surgery.2025;[Epub] CrossRef
A systematic review of comprehensive Robotic-assisted surgical (RAS) curricula
Anna K. Kieslich, Ruari Jardine, Hussain Ibrahim, Areeg Calvert, Kenneth G. Walker, Kim A. Walker, Angus J. M. Watson
Journal of Robotic Surgery.2025;[Epub] CrossRef
From the Editor: Uniting expertise, a new era of global collaboration in coloproctology
In Ja Park
Annals of Coloproctology.2024; 40(4): 285. CrossRef

Translational/basic research

Tissue engineering and regenerative medicine approaches in colorectal surgery: Bigyan B. Mainali, James J. Yoo, Mitchell R. Ladd; Ann Coloproctol. 2024;40(4):336-349. Published online August 30, 2024; DOI: https://doi.org/10.3393/ac.2024.00437.0062

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Abstract PDF

Tissue engineering and regenerative medicine (TERM) is an emerging field that has provided new therapeutic opportunities by delivering innovative solutions. The development of nontraditional therapies for previously unsolvable diseases and conditions has brought hope and excitement to countless individuals globally. Many regenerative medicine therapies have been developed and delivered to patients clinically. The technology platforms developed in regenerative medicine have been expanded to various medical areas; however, their applications in colorectal surgery remain limited. Applying TERM technologies to engineer biological tissue and organ substitutes may address the current therapeutic challenges and overcome some complications in colorectal surgery, such as inflammatory bowel diseases, short bowel syndrome, and diseases of motility and neuromuscular function. This review provides a comprehensive overview of TERM applications in colorectal surgery, highlighting the current state of the art, including preclinical and clinical studies, current challenges, and future perspectives. This article synthesizes the latest findings, providing a valuable resource for clinicians and researchers aiming to integrate TERM into colorectal surgical practice.

Citations

Citations to this article as recorded by

Organ-on-chip platforms for nanoparticle toxicity and efficacy assessment: Advancing beyond traditional in vitro and in vivo models
Ana Regina Sampaio, Renata Faria Maia, Maria Camilla Ciardulli, Hélder A. Santos, Bruno Sarmento
Materials Today Bio.2025; 33: 102053. CrossRef
First Successful Regeneration of a Structurally Native‐Like Colon Using a Bioabsorbable Polymer Sheet
Junpei Takashima, Mitsuo Miyazawa, Masayasu Aikawa, Daisuke Fujimoto, Hirotoshi Kobayashi
Annals of Gastroenterological Surgery.2025;[Epub] CrossRef
From the Editor: Uniting expertise, a new era of global collaboration in coloproctology
In Ja Park
Annals of Coloproctology.2024; 40(4): 285. CrossRef

ERAS

Tolerance to and postoperative outcomes with early oral feeding following elective bowel surgery: a systematic review with meta-analysis: Lord Mvoula, Evelyn Irizarry; Ann Coloproctol. 2024;40(6):538-547. Published online July 31, 2024; DOI: https://doi.org/10.3393/ac.2023.00472.0067

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Purpose
Advancements in gastrointestinal surgery have directed attention toward optimizing recovery, including through the use of feeding methods that reduce prolonged postoperative hospital stays, complications, and mortality, among other undesirable outcomes. This study’s primary goals were to identify current peer-reviewed literature reporting the postoperative outcomes of elective bowel surgery and to evaluate the clinical evidence of patients’ tolerance to oral feeding following elective bowel surgery.
Methods
An exhaustive literature search was conducted via PubMed and Scopus. The search results were screened for potential articles, and articles were assessed for eligibility based on prespecified eligibility criteria. The data were synthesized, and the results were reported and discussed thematically.
Results
The database search yielded 1,667 articles, from which 18 randomized controlled trials were chosen for inclusion in this study. This study included 874 early oral feeding (EOF) patients, 865 traditional oral feeding patients, and 91 patients whose postoperative care was unspecified. Data synthesis was done, and meta-analyses were conducted. The results showed that EOF patients required a significantly shorter time to tolerate a solid diet and had shorter hospital stays. In addition, bowel function was restored earlier in EOF groups.
Conclusion
The results show good tolerance to EOF, shorter hospitalizations, and faster restoration of bowel function, suggesting that EOF after elective bowel surgery is relatively safe. However, further studies with similar baseline conditions should be conducted to verify these results.

Citations

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Outcomes of patients with cancer receiving early feeding following gastric, small intestinal or colorectal surgery
Thuy Tran, Bach Hoang, Tien Nguyen, Huong Le
World Academy of Sciences Journal.2025; 7(6): 1. CrossRef
Perioperative nutrition practices in gastrointestinal cancer surgery: A nationwide survey among German surgical departments
Rahel Maria Strobel, Katharina Beyer, Johannes Christian Lauscher, Marc Martignoni, Christoph Reißfelder, Tim Vilz, Arved Weimann, Maria Wobith
Langenbeck's Archives of Surgery.2025;[Epub] CrossRef

Technical Notes

Can the Heald anal stent help to reduce anastomotic or rectal stump leak in elective and emergency colorectal surgery? A single-center experience: Michael Jones, Brendan Moran, Richard John Heald, John Bunni; Ann Coloproctol. 2024;40(1):82-85. Published online February 26, 2024; DOI: https://doi.org/10.3393/ac.2023.00038.0005

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Anastomotic and rectal stump leaks are feared complications of colorectal surgery. Diverting stomas are commonly used to protect low rectal anastomoses but can have adverse effects. Studies have reported favorable outcomes for transanal drainage devices instead of diverting stomas. We describe our use of the Heald anal stent and its potential impact in reducing anastomotic or rectal stump leak after elective or emergency colorectal surgery. We performed a single-center retrospective analysis of patients in whom a Heald anal stent had been used to “protect” a colorectal anastomosis or a rectal stump, in an elective or emergency context, for benign and malignant pathology. Intraoperative and postoperative outcomes were reviewed using clinical and radiological records. The Heald anal stent was used in 93 patients over 4 years. Forty-six cases (49%) had a colorectal anastomosis, and 47 (51%) had an end stoma with a rectal stump. No anastomotic or rectal stump leaks were recorded. We recommend the Heald anal stent as a simple and affordable adjunct that may decrease anastomotic and rectal stump leak by reducing intraluminal pressure through drainage of fluid and gas.

Citations

Citations to this article as recorded by

Techniques in coloproctology – controversies in coloproctology resection: rectopexy is an underutilised procedure in the management of both symptomatic high-grade internal and external rectal prolapse
J. Bunni, E. D. Courtney
Techniques in Coloproctology.2026;[Epub] CrossRef

Minimally invasive surgery

Robotic natural orifice specimen extraction surgery (NOSES) for anterior resection: Toan Duc Pham, Tomas Larach, Bushra Othman, Amrish Rajkomar, Alexander G. Heriot, Satish K. Warrier, Philip Smart; Ann Coloproctol. 2023;39(6):526-530. Published online December 19, 2023; DOI: https://doi.org/10.3393/ac.2022.00458.0065

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Minimally invasive colorectal surgery is currently well-accepted, with open techniques being reserved for very difficult cases. Laparoscopic colectomy has been proven to have lower mortality, complication, and ostomy rates; a shorter median length of stay; and lower overall costs when compared to its open counterpart. This trend is seen in both benign and malignant indications. Natural orifice specimen extraction surgery (NOSES) in colorectal surgery was first described in the early 1990s. Three recent meta-analyses comparing transabdominal extraction against NOSES concluded that NOSES was superior in terms of overall postoperative complications, recovery of gastrointestinal function, postoperative pain, aesthetics, and hospital stay. However, NOSES was associated with a longer operative time. Herein, we present our technique of robotic NOSES anterior resection using the da Vinci Xi platform in diverticular disease and sigmoid colon cancers.

Citations

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Laparoscopic natural orifice specimen extraction for diverticular disease: a systematic review
Jasmine Mui, Mina Sarofim, Ernest Cheng, Andrew Gilmore
Surgical Endoscopy.2025; 39(5): 3049. CrossRef
Current Application Status and Innovative Development of Surgical Robot
Aimin Jiang, Zhao Tang, Hanzhong Zhang, Jinxin Li, Jialin Meng, Ying Liu, Yu Fang, Juan Lu, Xu Zhang, Le Qu, Anqi Lin, Linhui Wang
Med Research.2025; 1(3): 378. CrossRef
Precision and Power: A Comprehensive Review of Exploring the Role of Laser Treatment in Hemorrhoidal Management
Dheeraj Surya, Pankaj Gharde
Cureus.2024;[Epub] CrossRef
Beyond survival: a comprehensive review of quality of life in rectal cancer patients
Won Beom Jung
Annals of Coloproctology.2024; 40(6): 527. CrossRef

Reviews

Colorectal cancer

Essential anatomy for lateral lymph node dissection: Yuichiro Yokoyama, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Hiroyuki Matsuzaki, Shinya Abe, Yuzo Nagai, Yuichiro Yoshioka, Takahide Shinagawa, Hirofumi Sonoda, Daisuke Hojo, Soichiro Ishihara; Ann Coloproctol. 2023;39(6):457-466. Published online December 8, 2023; DOI: https://doi.org/10.3393/ac.2023.00164.0023

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6 Web of Science
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Abstract PDF

In Western countries, the gold-standard therapeutic strategy for rectal cancer is preoperative chemoradiotherapy (CRT) following total mesorectal excision (TME), without lateral lymph node dissection (LLND). However, preoperative CRT has recently been reported to be insufficient to control lateral lymph node recurrence in cases of enlarged lateral lymph nodes before CRT, and LLND is considered necessary in such cases. We performed a literature review on aspects of pelvic anatomy associated with rectal surgery and LLND, and then combined this information with our experience and knowledge of pelvic anatomy. In this review, drawing upon research using a 3-dimensional anatomical model and actual operative views, we aimed to clarify the essential anatomy for LLND. The LLND procedure was developed in Asian countries and can now be safely performed in terms of functional preservation. Nonetheless, the longer operative time, hemorrhage, and higher complication rates with TME accompanied by LLND than with TME alone indicate that LLND is still a challenging procedure. Laparoscopic or robotic LLND has been shown to be useful and is widely performed; however, without a sufficient understanding of anatomical landmarks, misrecognition of vessels and nerves often occurs. To perform safe and accurate LLND, understanding the landmarks of LLND is essential.

Citations

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da Vinci robotic-assisted micro-space dissection and autonomic nerve network preservation technique in the total mesorectal excision procedure for rectal cancer: a single-center, retrospective, observational, real-world study
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Benign bowel disease

Multimodal prerehabilitation for elderly patients with sarcopenia in colorectal surgery: Jingting Wu, Hannah Chi, Shawn Kok, Jason M.W. Chua, Xi-Xiao Huang, Shipin Zhang, Shimin Mah, Li-Xin Foo, Hui-Yee Peh, Hui-Bing Lee, Phoebe Tay, Cherie Tong, Jasmine Ladlad, Cheryl H.M. Tan, Nathanelle Khoo, Darius Aw, Cheryl X.Z. Chong, Leonard M.L. Ho, Sharmini S. Sivarajah, Jialin Ng, Winson J.H. Tan, Fung-Joon Foo, Bin-Tean Teh, Frederick H. Koh; Ann Coloproctol. 2024;40(1):3-12. Published online March 31, 2023; DOI: https://doi.org/10.3393/ac.2022.01207.0172

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Abstract PDF

Sarcopenia, which is characterized by progressive and generalized loss of skeletal muscle mass and strength, has been well described to be associated with numerous poor postoperative outcomes, such as increased perioperative mortality, postoperative sepsis, prolonged length of stay, increased cost of care, decreased functional outcome, and poorer oncological outcomes in cancer surgery. Multimodal prehabilitation, as a concept that involves boosting and optimizing the preoperative condition of a patient prior to the upcoming stressors of a surgical procedure, has the purported benefits of reversing the effects of sarcopenia, shortening hospitalization, improving the rate of return to bowel activity, reducing the costs of hospitalization, and improving quality of life. This review aims to present the current literature surrounding the concept of sarcopenia, its implications pertaining to colorectal cancer and surgery, a summary of studied multimodal prehabilitation interventions, and potential future advances in the management of sarcopenia.

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С. Р. Підручна, А. С. Сверстюк, Т. Я. Ярошенко, Л. М. Палиця, А. Є. Мудра, І. П. Кузьмак, Н. Я. Летняк, О. А. Багрій-Заяць
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Optimal anastomotic technique in rectal surgery to prevent anastomotic leakage: Daichi Kitaguchi, Masaaki Ito; Ann Coloproctol. 2023;39(2):97-105. Published online January 3, 2023; DOI: https://doi.org/10.3393/ac.2022.00787.0112

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Abstract PDF

Complications after colorectal surgery remain inevitable, and anastomotic leakage is one of the most severe and potentially fatal complications. Generally, anastomotic leakage is associated with severe peritonitis, the need for emergency reoperation, and an increased mortality rate. Additionally, particularly after rectal cancer surgery, it has a negative impact on long-term outcomes, including postoperative anorectal function, local recurrence, and survival. To prevent anastomotic leakage, understanding the characteristics of each anastomotic technique and establishing a stable anastomotic procedure are important. Transanal total mesorectal excision (TaTME) is a relatively new advanced surgical access technique for pelvic dissection and facilitates different anastomotic techniques without the need for transabdominal rectal transection. Especially, stapled anastomosis in TaTME, also known as double purse-string circular stapled anastomosis or the single stapling technique (SST), has gained much attention as an alternative to the conventional double stapling technique (DST). In this article, we describe the DST, SST, and hand-sewn anastomosis as anastomotic techniques after rectal surgery, focusing mainly on the differences between conventional anastomotic techniques and SST in TaTME. Furthermore, the blood flow evaluation method for the reconstructive colon before anastomosis, which is extremely important in anastomotic leakage prevention regardless of the anastomotic type, is also described.

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Yingjun Liu, Bing Han, Weifeng Xu, Youcai Wang, Mingke Huo, Jianwei Wang, Hongli Wang, Zhi Li
Surgery.2026; 190: 109829. CrossRef
Optimizing outcomes in anastomotic recurrence of rectal cancer: Efficacy of transanal total mesorectal excision
Mengqin Yu, Ximo Xu, Hao Zhong, Duohuo Shu, Naijipu Abuduaini, Jingyi Liu, Zhenfeng Huang, Haiqin Song, Sen Zhang, Xiao Yang, Zhenghao Cai, Gaojian Cao, Jianwen Li, Bo Feng
Current Problems in Surgery.2025; 66: 101748. CrossRef
Sphincter-preserving surgical techniques in low rectal cancer management: A systematic review of contemporary evidence
Song Wang, A-Jian Li, Hui-Hong Jiang, Yin Lin, Hai-Bo Ding
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
The robotic intracorporeal single-stapled anastomosis (RiSSA) technique in robotic left-sided colorectal resection: a technical note
Chih-Chien Wu, Yung-Lin Tan, Chao-Wen Hsu, Hsin-Ping Tseng, Danilo Miskovic, Shih-Feng Huang
Annals of Coloproctology.2025; 41(4): 357. CrossRef
Achieving the perfect end-to-end single-stapled anastomosis in low anterior resection for rectal cancer: technical aspects
Cherylin Wan Pei Fu
Annals of Coloproctology.2025; 41(4): 361. CrossRef
Comparative perioperative outcomes of articulated versus conventional straight devices in laparoscopic low anterior resection: a propensity score–matched analysis
Hayoung Lee, Yong Sik Yoon, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim
Annals of Coloproctology.2025; 41(5): 434. CrossRef
Dissection layer selection based on an understanding of pelvic fascial anatomy in transanal total mesorectal excision
Daichi Kitaguchi, Masaaki Ito
Annals of Coloproctology.2024; 40(4): 375. CrossRef
Successful Clinical Avoidance of Colorectal Anastomotic Leakage through Local Decontamination
Gerhard Ernst Steyer, Markus Puchinger, Johann Pfeifer
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Gyung Mo Son
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Colorectal cancer

Outcomes of redo for failed colorectal or coloanal anastomoses: a systematic review and meta-analysis: Ricardo Purchio Galletti, Gabriel Andrade Agareno, Lucas de Abreu Sesconetto, Rafael Benjamim Rosa da Silva, Rafael Vaz Pandini, Lucas Soares Gerbasi, Victor Edmond Seid, Sérgio Eduardo Alonso Araujo, Francisco Tustumi; Ann Coloproctol. 2023;39(5):375-384. Published online December 20, 2022; DOI: https://doi.org/10.3393/ac.2022.00605.0086

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Abstract PDF Supplementary Material

Purpose
This study aimed to review the outcomes of redo procedures for failed colorectal or coloanal anastomoses.
Methods
A systematic review was performed using the PubMed, Embase, Cochrane, and LILACS databases. The inclusion criteria were adult patients undergoing colectomy with primary colorectal or coloanal anastomosis and studies that assessed the postoperative results. The protocol is registered in PROSPERO (No. CRD42021267715).
Results
Eleven articles met the eligibility criteria and were selected. The studied population size ranged from 7 to 78 patients. The overall mortality rate was 0% (95% confidence interval [CI], 0%–0.01%). The postoperative complication rate was 40% (95% CI, 40%–50%). The length of hospital stay was 13.68 days (95% CI, 11.3–16.06 days). After redo surgery, 82% of the patients were free of stoma (95% CI, 75%–90%), and 24% of patients (95% CI, 0%–39%) had fecal incontinence. Neoadjuvant chemoradiotherapy (P=0.002) was associated with a lower probability of being free of stoma in meta-regression.
Conclusion
Redo colorectal and coloanal anastomoses are strategies to restore colonic continuity. The decision to perform a redo operation should be based on a proper evaluation of the morbidity and mortality risks, the probability of remaining free of stoma, the quality of life, and a functional assessment.

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Abdominoperineal pull-through with delayed coloanal anastomosis for pelvic anastomotic failure—a systematic review
T. J. K. Tan, S.-M. Ng, T. S. Q. Lee, E. K.-W. Tan, I. Seow-En
Techniques in Coloproctology.2025;[Epub] CrossRef
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Sergio Eduardo Alonso Araujo, Francisco Tustumi, Ana Sarah Portilho, Lucas de Araujo Horcel, Victor Edmond Seid
Colorectal Disease.2023; 25(11): 2284. CrossRef

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

Surgical management of retrorectal tumors: a single-center 12 years’ experience: Amirhosein Naseri, Behnam Behboudi, Ali Faryabi, Seyed Mohsen Ahmadi Tafti, Amirsina Sharifi, Mohammad Reza Keramati, Mohammad Sadegh Fazeli, Amir Keshvari, Mehdi Zeinalizadeh, Reza Akbari Asbagh, Niloufar Hoorshad, Alireza Kazemeini; Received April 26, 2022 Accepted June 23, 2022 Published online October 11, 2022; DOI: https://doi.org/10.3393/ac.2022.00297.0042 [Epub ahead of print]

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Abstract PDF

Purpose
Retrorectal tumors (RTs) are rare tumors that arise in the space between the mesorectum and the pelvic wall and often originate in embryonic tissues. The primary treatment for these tumors is complete excision surgery, and choosing the best surgical approach is very important.
Methods
In this study, we retrospectively collected the data of 15 patients with RTs who underwent surgery in Imam Khomeini Hospital (Tehran, Iran) for 12 years to share our experiences of patients’ treatment and compare different surgical approaches.
Results
A total of 5 tumors were malignant, 10 were benign, and most of the tumors were congenital. Malignant tumors were seen in older patients. Three surgical procedures were performed on patients. Three patients underwent abdominal approach surgery, and 8 patients underwent posterior surgery. A combined surgical approach was performed on 4 patients. Two patients underwent laparoscopic surgery. The abdominal approach had the least long-term complication, and the combined approach had the most complications; laparoscopic surgery reduced the length of hospital stay and complications after surgery.
Conclusion
A multidisciplinary team collaboration using magnetic resonance imaging details is necessary to determine a surgical treatment approach. It could reduce the need for a preoperative biopsy. However, every approach has its advantages and disadvantages, and individualized treatment is the key.

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Andrei Mihai Malutan, Viorela-Elena Suciu, Florin Laurentiu Ignat, Doru Diculescu, Razvan Ciortea, Emil-Claudiu Boțan, Carmen Elena Bucuri, Maria Patricia Roman, Ionel Nati, Cristina Ormindean, Dan Mihu
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Murat Sen, Ozgen Isik
Diseases of the Colon & Rectum.2025; 68(12): e1941. CrossRef

Anorectal benign disease

Simple mucopexy and hemorrhoidal arterial ligation with and without Doppler guide: a randomized clinical trial for short-term outcome: Mahdi Alemrajabi, Abolfazl Akbari, Sara Sohrabi, Mohammad Rezazadehkermani, Mohammad Moradi, Shahram Agah, Mohsen Masoodi; Ann Coloproctol. 2023;39(4):351-356. Published online May 16, 2022; DOI: https://doi.org/10.3393/ac.2022.00017.0002

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Abstract PDF

Purpose
Hemorrhoids are the most common benign anorectal diseases. Mucopexy strengthens the anal canal mucosa, which can be performed alone or in combination with Doppler-guided hemorrhoidal artery ligation (DG-HAL). In this study, we compared the postoperative complications between simple mucopexy plus HAL with and without a Doppler guide.
Methods
This study was performed as a single-blinded randomized clinical trial. Patients referred to a tertiary colorectal referral clinic with grades 3 and 4 hemorrhoids who were candidates for surgical intervention entered the study. Thirty-six patients were randomly divided into 2 groups. Group A including 18 patients underwent mucopexy and DG-HAL and the other 18 patients (group B) underwent standard mucopexy and HAL without a Doppler guide. Postoperative pain score and the duration of oral analgesic consumption were recorded. Additionally, postoperative symptoms and complications were recorded and compared between the 2 methods.
Results
There was no significant difference between the 2 groups in terms of pain score and the duration of postoperative analgesic consumption as well as the incidence of postoperative complications. Besides, the primary grade of hemorrhoids was not significantly associated with recurrence, but there was a significant association between body mass index and Wexner score (WS) with recurrence. The mean WS of patients showed a significant decrease in both groups postoperatively. However, the rate of WS reduction was not remarkably different between the 2 groups.
Conclusion
Simple mucopexy with blind HAL (without Doppler guide) might be considered for the treatment of grades 3 and 4 hemorrhoids effectively.

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Comparison of “Mucopexy with Haemorrhoidal Artery Ligation with Open Hemorrhoidectomy in Terms of Effectiveness and Outcome
Muhammad Asad, Kiran Rehman, Muhammad Ismail Seerat, Maryam Iftikhar, Bilal Ahmed, Adil Hameed, Sufyan Rauf
Pakistan Journal of Health Sciences.2025; : 191. CrossRef
Latest Research Trends on the Management of Hemorrhoids
Sung Il Kang
Journal of the Anus, Rectum and Colon.2025; 9(2): 179. CrossRef
Evaluation of Doppler-guided Hemorrhoid Artery Ligation and Recto anal Repair Procedure: A Single-center Analysis in Indonesia
Amanda Putri Halim, Livia Taniwangsa, Joanna A. Kosasih, Anthony Berlim Lioe
Indian Journal of Colo-Rectal Surgery.2025; 8(1): 9. CrossRef
Haemorrhoidal artery ligation: Is Doppler guidance useful? A systematic review and meta‐analysis of randomized controlled trials
Roberta Tutino, Arcangelo Picciariello, Mauro Santarelli, Veronica De Simone, Pierluigi Lobascio, Gianfranco Cocorullo, Marco Massani, Giusi Graziano, Giulio Aniello Santoro, Gaetano Gallo
Colorectal Disease.2025;[Epub] CrossRef
Defining recurrence in haemorrhoidal disease and comparing Doppler systems: Are we evaluating Doppler fairly
Ugo Grossi, Pasquale Giordano
Colorectal Disease.2025;[Epub] CrossRef
Doppler-Guided Versus Digitally Guided Transanal Hemorrhoidal Dearterialization: A Systematic Review and Meta-Analysis
Marília Cardoso Massoni, Felipe Santos Marimpietri, Paulo André Lago Silva, Glicia Estevam de Abreu
Journal of Coloproctology.2025; 45(03): 001. CrossRef
The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease
Antonio Brillantino, Adolfo Renzi, Pasquale Talento, Luigi Brusciano, Luigi Marano, Maurizio Grillo, Mauro Natale Maglio, Fabrizio Foroni, Alessio Palumbo, Maria Laura Sandoval Sotelo, Luciano Vicenzo, Michele Lanza, Giovanna Frezza, Massimo Antropoli, Cl
Annals of Coloproctology.2024; 40(4): 287. CrossRef
Conventional Excisional Haemorrhoidectomy versus Transanal Haemorrhoidal Dearterialization for Haemorrhoids: A Systematic Review and Meta-Analysis
Juliana Jee, Lauren Vourneen O’Connell, Ishapreet Kaur, Shaheel Mohammad Sahebally
Digestive Surgery.2024; 41(4): 204. CrossRef
Haemorrhoid artery ligation – recto anal repair (HAL‐RAR) blind versus Doppler: a systematic review and meta‐analysis
Amos Nepacina Liew, Jason Wang, Michelle Zhiyun Chen, Yeng Kwang Tay, Joseph C.H. Kong
ANZ Journal of Surgery.2024; 94(11): 2053. CrossRef
Lower pain, less itching, and faster healing after ultrasound scalpel-assisted hemorrhoidectomy using an intimate cleaner containing chlorhexidine, acid hyaluronic acid, and natural anti-inflammatories: a multicenter observational case-control study
Antonio Brillantino, Luigi Marano, Maurizio Grillo, Alessio Palumbo, Fabrizio Foroni, Luciano Vicenzo, Alessio Antropoli, Michele Lanza, Maria Laura Sandoval Sotelo, Nicola Sangiuliano, Mauro Maglio, Rosanna Filosa, Lucia Abbatiello, Maria Preziosa Romano
Annals of Coloproctology.2024; 40(6): 602. CrossRef
Picking Up the Threads: Long-Term Outcomes of the Sutured Haemorrhoidopexy: A Retrospective Single-Centre Cohort Study
Sara Z. Kuiper, Kayleigh A. M. Van Dam, Merel L. Kimman, Litza Mitalas, Paula G. M. Koot, Jarno Melenhorst, Sander M. J. Van Kuijk, Carmen D. Dirksen, Stephanie O. Breukink
Journal of Clinical Medicine.2023; 12(1): 391. CrossRef

Anorectal physioloy

Validation of low anterior resection syndrome score in Brazil with Portuguese: Kelly C.L.R. Buzatti, Andy Petroianu, Søren Laurberg, Rodrigo G. Silva, Beatriz D.S. Rodrigues, Peter Christensen, Antonio Lacerda-Filho, Therese Juul; Ann Coloproctol. 2023;39(5):402-409. Published online May 13, 2022; DOI: https://doi.org/10.3393/ac.2022.00136.0019

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3 Citations

Abstract PDF

Purpose
This study was performed to investigate the convergent validity, discriminative validity, and reliability of the Brazilian version of the low anterior resection syndrome (LARS) score in a population with low educational and socioeconomic levels.
Methods
The LARS score was translated into the Portuguese language by forward- and back-translation procedures. In total, 127 patients from a public hospital in Brazil completed the questionnaires. The convergent validity was tested by comparing the LARS score with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core Module 30 (QLQ-C30) and with patients’ self-reported quality of life. For the discriminative validity, we tested the ability of the score to differentiate among subgroups of patients regarding neoadjuvant radiotherapy, type of surgery, and tumor distance from the anal verge. The test-retest reliability was investigated in a subgroup of 36 patients who responded to the survey twice in 2 weeks.
Results
The LARS score demonstrated a strong correlation with 5 of 6 items from the EORTC QLQ-C30 (P<0.05) and good concordance with patients’ self-reported quality of life (95.3%), confirming the convergent validity. The score was able to discriminate between subgroups of patients with different clinical characteristics related to LARS (P<0.001). The agreement between the test and retest showed that 86.1% of the patients remained in the same LARS category, and there was no significant difference between the LARS score numerical values (P=0.80), indicating good reliability overall.
Conclusion
The Brazilian version of the LARS score is a valid and reliable instrument to assess postoperative bowel function in a population with low educational and socioeconomic levels.

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Effects of low anterior resection syndrome after colorectal cancer resections on health-related quality of life: a systematic review and meta-analysis
S. Shojaei-Zarghani, K. Gorgi, A. Bananzadeh, A. R. Safarpour, S. V. Hosseini
Techniques in Coloproctology.2025;[Epub] CrossRef
Validation of the Vietnamese version of the low anterior resection syndrome score questionnaire
Tuong-Anh Mai-Phan, Vu Quang Pham
Annals of Coloproctology.2024; 40(6): 588. CrossRef
Beyond survival: a comprehensive review of quality of life in rectal cancer patients
Won Beom Jung
Annals of Coloproctology.2024; 40(6): 527. CrossRef

Minimally invasive surgery,Surgical technique

The impact of assistants’ reverse alignment surgical skill proficiency on laparoscopic colorectal surgery: Seunghun Lee; Ann Coloproctol. 2022;38(6):432-441. Published online January 20, 2022; DOI: https://doi.org/10.3393/ac.2021.00689.0098

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Graphical Abstract Abstract PDF

Purpose
We aimed to investigate the difference in the surgical outcome based on whether the assistant overcame the mirror image in laparoscopic colorectal surgery.
Methods
Three hundred patients who underwent laparoscopic colorectal surgery performed by single operator were divided into 2 groups. Based on the assistants’ experience, patients who underwent surgery involving 1 of 6 residents with an experience of fewer than 30 surgeries each were classified into group 1. Patients who underwent surgery involving a single fellow as an assistant with an experience of over 1,000 surgeries were classified into group 2. According to the type of surgery, patients were divided into left and right colon resection groups and the surgical outcome of groups 1 and 2 was investigated.
Results
Group 2 exhibited shorter operation time, less bleeding, shorter postoperative hospital stay, lower open conversion, and anastomotic leakage rate than group 1. In right colon resection, the operation time was shorter in group 2. In left colon resection, group 2 exhibited shorter operation time, less bleeding, shorter postoperative hospital stay, and lower anastomotic leakage rate. In the multivariate analysis, the assistant was a factor affecting the operation time in the entire surgery.
Conclusion
Assistants’ reverse alignment surgical skill proficiency was a factor affecting the operation time.

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The Impact of the First Assistant’s Experience on the Perioperative Outcome of Patients Undergoing Laparoscopic Hysterectomies for Benign Diseases: A Retrospective Analysis
Sangam Jha, Vikas Chandra Jha, Sharda Jha, Jafeesha B. Singh
Journal of Gynecologic Surgery.2025; 41(4): 164. CrossRef
Design of Automatic Tool Replacement Mechanism for Laparoscopic Surgical Robot Arm for Solo Surgery
Daehwan Ko, Yeonkyoung Kim, Hongseok Lim, Sungmin Kim
The International Journal of Medical Robotics and Computer Assisted Surgery.2025;[Epub] CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Can assistants’ skills be used to improve colorectal cancer surgery outcomes in a way similar to the “butterfly effect”?
Je-Ho Jang
Annals of Coloproctology.2022; 38(6): 391. CrossRef

Benign GI diease,Benign diesease & IBD,Complication,Surgical technique

Efficacy and Safety of Endoscopic Clipping for Acute Anastomotic Bleeding After Colorectal Surgery: Ryun Kyong Ha, Kyung Su Han, Sung Sil Park, Dae Kyung Sohn, Chang Won Hong, Byung Chang Kim, Bun Kim; Ann Coloproctol. 2022;38(3):262-265. Published online October 26, 2021; DOI: https://doi.org/10.3393/ac.2021.00297.0042

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Abstract PDF

Purpose
Anastomotic bleeding after colorectal surgery is a rare, mostly self-limiting, postoperative complication that could lead to a life-threatening condition. Therefore, prompt management is required. This study aimed to evaluate the efficacy and safety of endoscopic clipping for acute anastomotic bleeding after colorectal surgery.
Methods
We retrospectively reviewed the data of patients pathologically diagnosed with colorectal cancer at National Cancer Center, Korea from January 2018 to November 2020, which presented with anastomotic bleeding within the first postoperative week and were endoscopically managed with clips.
Results
Nine patients had anastomotic bleeding, underwent endoscopic management, and, therefore, were included in this study. All patients underwent laparoscopic (low/ultralow) anterior resection with mechanical double-stapled anastomosis. Anastomotic bleeding was successfully managed through a colonoscopy with clips on the first trial in all patients. Hypovolemic shock occurred in one patient, following anastomotic breakdown.
Conclusion
Endoscopic clipping seems to be an effective and safe treatment for anastomotic bleeding with minimal physiologic stress, easy accessibility, and scarce postoperative complications. However, a surgical backup should always be considered for massive bleeding.

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Multidisciplinary management of a patient with vesicosigmoid fistula and multisystem diseases undergoing stoma reversal: a case report
Jian Yang, Li Zhang, Ke Zeng
BMC Surgery.2026;[Epub] CrossRef
Post-Surgical Imaging Assessment in Rectal Cancer: Normal Findings and Complications
Federica De Muzio, Roberta Fusco, Carmen Cutolo, Giuliana Giacobbe, Federico Bruno, Pierpaolo Palumbo, Ginevra Danti, Giulia Grazzini, Federica Flammia, Alessandra Borgheresi, Andrea Agostini, Francesca Grassi, Andrea Giovagnoni, Vittorio Miele, Antonio B
Journal of Clinical Medicine.2023; 12(4): 1489. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef

Anorectal benign disease

Radical surgical management of perianal giant condyloma acuminatum of Buschke and Löwenstein: long-term results of 11 cases: Alp Yildiz, Sezai Leventoglu, Aybala Yildiz, Arda Inan, Bedrettin Bulent Mentes; Ann Coloproctol. 2023;39(3):204-209. Published online August 23, 2021; DOI: https://doi.org/10.3393/ac.2021.00080.0011

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5 Citations

Abstract PDF

Purpose
Perianal Buschke-Löwenstein tumor (BLT) is characterized by an exophytic cauliflower-like mass surrounding the perianal region. Its tendency to infiltrate the adjacent tissues, its massiveness, and its high recurrence rate cause difficulties in treatment. The aim of this study is to report our strategy with wide local excision and flap reconstruction for BLT.
Methods
From November 2002 to June 2019, 11 patients (9 men) with a mean age of 33.45 years (range, 19–54 years) were operated on for BLT. All patients underwent wide local excision and V-Y flap reconstruction, supplemented with other flaps whenever needed. No additional modalities were used.
Results
Two patients had a history of anal intercourse while all patients were human immunodeficiency virus-negative. The mean tumor length was 15.54 ± 1.34 cm (range, 10–26 cm). Human papillomavirus 6 was the most common type identified. Partial wound dehiscence developed in 3 patients, while anal stenosis, mucosal ectropion, or local recurrence was not observed during the mean follow-up period of 50.45 ± 1.75 months (range, 10–196 months).
Conclusion
In patients with perianal BLT, wide local excision and flap reconstruction result in a high healing rate without significant complications.

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Unmasking the Giant Condyloma: A Case Report and Literature Review of Buschke-Löwenstein Tumor
Vasileios Tzikoulis, Anastasios Anastasiadis, Dimitrios Memmos, Stavros Tsiakaras, Ioannis Mykoniatis, Fotios Dimitriadis, Konstantinos Papathanasiou, Christos Roidos, Loukas Charalambous, Georgios Gousis, Nikolaos Tserkezis, Maria Kougioni, Dimitrios Oik
Cureus.2025;[Epub] CrossRef
An Anal Lesion in a 27-Year-Old Patient
Jérémy Baude, Hugues Mura, Alexis Lépinoy
JAMA Oncology.2024; 10(10): 1437. CrossRef
Clinicopathological Findings and Comprehensive Review of Buschke–Lowenstein Tumors Based on a Case Study
Andreea Grosu-Bularda, Cristian-Sorin Hariga, Catalina-Stefania Dumitru, Nicolae Calcaianu, Cosmin-Antoniu Creanga, Valentin Enache, Silvia-Elena Tache, Eliza-Maria Bordeanu-Diaconescu, Vladut-Alin Ratoiu, Razvan-Nicolae Teodoreanu, Ioan Lascar
Journal of Personalized Medicine.2024; 14(8): 887. CrossRef
Cirugía más inmunoterapia local en el tratamiento del tumor de Buschke-Löwenstein. A propósito de un caso
Nicole Emily Rojas Espinoza, Juan Pablo Torrico Vilte
Revista de Investigación e Información en Salud.2023; 18(44): 51. CrossRef
Surgical Management of Perianal Giant Condyloma Acuminatum of Buschke and Löwenstein: Case Presentation
Raul Mihailov, Alin Laurențiu Tatu, Elena Niculet, Iulia Olaru, Corina Manole, Florin Olaru, Oana Mariana Mihailov, Mădălin Guliciuc, Adrian Beznea, Camelia Bușilă, Iuliana Laura Candussi, Lavinia Alexandra Moroianu, Floris Cristian Stănculea
Life.2023; 13(9): 1916. CrossRef

Malignant disease,Rectal cancer

Spotlight on laparoscopy in the surgical resection of locally advanced rectal cancer: multicenter propensity score match study: Irfan Ul Islam Nasir, Muhammad Fahd Shah, Sofoklis Panteleimonitis, Nuno Figueiredo, Amjad Parvaiz; Ann Coloproctol. 2022;38(4):307-313. Published online August 11, 2021; DOI: https://doi.org/10.3393/ac.2020.01060.0151

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Graphical Abstract Abstract PDF

Purpose
This study was aimed to assess the feasibility of laparoscopic rectal surgery, comparing quality of surgical specimen, morbidity, and mortality.
Methods
Prospectively acquired data from consecutive patients undergoing laparoscopic surgery for rectal cancer, at 2 minimally invasive colorectal units, operated by the same team was included. Locally advanced rectal tumors were identified as T3B or T4 with preoperative magnetic resonance imaging scans. All the patients were operated on by the same team. The 1:1 propensity score matching was performed to create a perfect match in terms of tumor height.
Results
Total of 418 laparoscopic resections were performed, out of which 109 patients had locally advanced rectal cancer (LARC) and were propensity score matched with non-LARC (NLARC) patients. Median operation time was higher for the LARC group (270 minutes vs. 250 minutes, P=0.011). However, conversion to open surgery was done in 5 vs. 2 patients (P=0.445), reoperation in 8 vs. 7 (P=0.789), clinical anastomotic leak was found in 3 vs. 2 (P=0.670), and 30-day mortality rates was 2 vs. 1 (P>0.999) between LARC and NLARC, respectively. Readmission rate was higher in the NLARC group (33 patients vs. 19 patients, P=0.026), due to stoma-related issues. There was no statistically significant difference in the R0 resection between the 2 groups (99 patients in LARC vs. 104 patients in NLARC, P=0.284).
Conclusion
This study demonstrates that standardized approach to laparoscopy is safe and feasible in LARC. Comparable postoperative short-term clinical and pathological outcomes were seen between LARC and NLARC groups.

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Performance reporting design in artificial intelligence studies using image-based TNM staging and prognostic parameters in rectal cancer: a systematic review
Minsung Kim, Taeyong Park, Bo Young Oh, Min Jeong Kim, Bum-Joo Cho, Il Tae Son
Annals of Coloproctology.2024; 40(1): 13. CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Robotic surgery for locally advanced T4 rectal cancer: feasibility and oncological quality
Marcos Gomez Ruiz, Roberto Ballestero Diego, Patricia Tejedor, Carmen Cagigas Fernandez, Lidia Cristobal Poch, Natalia Suarez Pazos, Julio Castillo Diego
Updates in Surgery.2023; 75(3): 589. CrossRef
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han
The Ewha Medical Journal.2023;[Epub] CrossRef
Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer
In Ja Park
The Ewha Medical Journal.2023;[Epub] CrossRef
Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
Applications of propensity score matching: a case series of articles published in Annals of Coloproctology
Hwa Jung Kim
Annals of Coloproctology.2022; 38(6): 398. CrossRef

Comparison of long-term outcomes of colonic stenting as a “bridge to surgery” and emergency surgery in patients with left-sided malignant colonic obstruction: Supakij Khomvilai, Sukit Pattarajierapan; Ann Coloproctol. 2023;39(1):17-26. Published online July 29, 2021; DOI: https://doi.org/10.3393/ac.2021.00227.0032

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Abstract PDF

Purpose
Long-term oncologic outcomes of colonic stenting as a “bridge to surgery” in patients with left-sided malignant colonic obstruction (LMCO) are unclear. This study was performed to compare long-term outcomes of self-expandable metal stent (SEMS) insertion as a bridge to surgery and emergency surgery in patients with acute LMCO.
Methods
This retrospective cohort study included patients with acute LMCO who underwent SEMS insertion as a bridge to surgery or emergency surgery. The primary outcomes were 5-year disease-free survival (DFS), overall survival (OS), and recurrence rate. Survival outcomes were determined using the Kaplan-Meier method and compared using log-rank tests.
Results
There was a trend of worsening 5-year OS rate in the SEMS group compared with emergency surgery group (45% vs. 57%, P=0.07). In stage-wise subgroup analyses, a trend of deteriorating 5-year OS rate in the SEMS group with stage III (43% vs. 59%, P=0.06) was observed. The 5-year DFS and recurrence rate were not different between groups. The overall median follow-up time was 58 months. On multivariate analysis, age of ≥65 years and American Joint Committee on Cancer stage of ≥III, and synchronous metastasis were significant poor prognostic factors for OS (hazard ratio [HR], 1.709; 95% confidence interval [CI], 1.007–2.900; P=0.05/HR, 1.988; 95% CI, 1.038–3.809; P=0.04/HR, 2.146; 95% CI, 1.191–3.866; P=0.01; respectively).
Conclusion
SEMS as a bridge to surgery may have adverse oncologic outcomes. Patients in the SEMS group had a trend of worsening 5-year OS rate without higher recurrence.

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Transforming outcomes: the pivotal role of self-expanding metal stents in right- and left-sided malignant colorectal obstructions-bridge to surgery: a comprehensive review and meta-analysis
Sheza Malik, Priyadarshini Loganathan, Hajra Khan, Abul Hasan Shadali, Pradeep Yarra, Saurabh Chandan, Babu P. Mohan, Douglas G. Adler, Shivangi Kothari
Clinical Endoscopy.2025; 58(2): 240. CrossRef
Controversial issues of colon stenting in case of tumor obstructive intestinal obstruction: surgical and oncological aspects
S.A. Aliyev, E.S. Aliyev, T.K. Aliyev
Endoscopic Surgery.2025; 31(2): 65. CrossRef
Primary tumor resection vs. self-expandable metallic stent in unresectable obstructive stage IV colorectal cancer: a comparative outcome study
Chang Hyun Kim, Jae Kyun Ju, Jaram Lee, Hyeung-min Park, Soo Young Lee, Hyeong Rok Kim, Young Eun Joo, Sung Bum Cho
Annals of Surgical Treatment and Research.2025; 109(2): 89. CrossRef
Complete Obstruction, a Real Risk Factor: A Comprehensive Study on Obstruction in Stage IIA Colon Cancer With Propensity Score Matching Analysis
Soo Young Oh, Chan Wook Kim, Seonok Kim, Min Hyun Kim, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Clinical Colorectal Cancer.2024; 23(2): 135. CrossRef
Can we use colon stenting in accelerated recovery programs for surgical treatment colon cancer complicated by obstructive intestinal obstruction? A literature review
Saday A. Aliyev, Emil S. Aliyev
Russian Journal of Oncology.2024; 29(2): 130. CrossRef
Colonic stenting: is the bridge to surgery worth its cost? A cost-effectiveness analysis at a single Asian institution
Michelle Shi Qing Khoo, Frederick H. Koh, Sharmini Su Sivarajah, Leonard Ming-Li Ho, Darius Kang-Lie Aw, Cheryl Xi-Zi Chong, Fung Joon Foo, Winson Jianhong Tan
Annals of Coloproctology.2024; 40(6): 555. CrossRef
Comparison of colonic stenting and stoma creation as palliative treatment for incurable malignant colonic obstruction
Sukit Pattarajierapan, Chatiyaporn Manomayangoon, Panat Tipsuwannakul, Supakij Khomvilai
JGH Open.2022; 6(9): 630. CrossRef
Oncologic safety of colonic stenting as a bridge to surgery in left-sided malignant colonic obstruction: Current evidence and prospects
Sukit Pattarajierapan, Nattapanee Sukphol, Karuna Junmitsakul, Supakij Khomvilai
World Journal of Clinical Oncology.2022; 13(12): 943. CrossRef

Benign proctology,Complication,Biomarker & risk factor

Frequency and risk factors of severe postoperative bleeding after proctological surgery: a retrospective case-control study: Sarah Taieb, Patrick Atienza, Jean-David Zeitoun, Milad Taouk, Josée Bourguignon, Christian Thomas, Nabila Rabahi, Saliha Dahlouk, Anne-Carole Lesage, David Lobo, Isabelle Etienney; Ann Coloproctol. 2022;38(5):370-375. Published online July 27, 2021; DOI: https://doi.org/10.3393/ac.2021.00122.0017

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Abstract PDF

Purpose
The aim of this study was to assess frequency and risk factors of severe bleeding after proctological surgery requiring hemostatic surgery observed after publication of the French guidelines for anticoagulant and platelet-inhibitor treatment.
Methods
All patients who underwent proctological surgery between January 2012 and March 2017 in a referral center were included. Delay, severity of bleeding, and need for blood transfusion were recorded. Patients with severe postoperative bleeding were matched to controls at a 2:1 ratio adjusted on the operator, and the type of surgery.
Results
Among the 8,890 operated patients, 65 (0.7%) needed a postoperative hemostatic procedure in an operating room. The risk of a hemostatic surgery was significantly increased after hemorrhoidal surgery compared with other procedures (1.9% vs. 0.5%, P<10^–4) and was most frequent after Milligan-Morgan hemorrhoidectomy (2.5%). Mean bleeding time was 6.2 days and no bleeding occurred after day 15. Blood transfusion rate was 0.1%. Treatment with anticoagulants and platelet inhibitors were managed according to recommendations and did not increase the severity of bleeding. The risk of severe bleeding was significantly lower in active smokers vs. non-smokers in univariate (16.9% vs. 36.2%, P=0.007) and multivariate (odds ratio, 0.31; 95% confidence interval, 0.14–0.65) analysis whereas sex, age, and body mass were not significantly associated with bleeding.
Conclusion
Severe postoperative bleeding occurs in 0.7% of patients, but varies with type of procedure and is not affected by anticoagulant or antiplatelet treatment. These treatments given in accordance with the new guidelines do not increase the severity of postoperative bleeding.

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Efficacy of Endoscopic Evaluation and Hemostatic Intervention for Post-hemorrhoidectomy Bleeding
Katsuhisa Ohashi, Katsuhide Ohashi, Akinori Sasaki, Kazuyoshi Ota, Kazutomo Kitagawa
Journal of the Anus, Rectum and Colon.2025; 9(1): 162. CrossRef
Evaluation of Clinical Manifestations of Hemorrhoidal Disease, Carried Out Surgeries and Prolapsed Anorectal Tissues: Associations with ABO Blood Groups of Patients
Inese Fišere, Valērija Groma, Šimons Svirskis, Estere Strautmane, Andris Gardovskis
Journal of Clinical Medicine.2023; 12(15): 5119. CrossRef
Sclerobanding in the treatment of second and third degree hemorrhoidal disease in high risk patients on antiplatelet/anticoagulant therapy without suspension: a pilot study
Francesco Pata, Luigi M. Bracchitta, Bruno Nardo, Gaetano Gallo, Giancarlo D’Ambrosio, Salvatore Bracchitta
Frontiers in Surgery.2023;[Epub] CrossRef
Principles of minimize bleeding and the transfusion of blood and its components in operated patients – surgical aspects
Tomasz Banasiewicz, Waldemar Machała, Maciej Borejsza Wysocki, Maciej Lesiak, Sebastian Krych, Małgorzata Lange, Piotr Hogendorf, Adam Durczyński, Jarosław Cwaliński, Tomasz Bartkowiak, Adam Dziki, Wojciech Kielan, Stanisław Kłęk, Łukasz Krokowicz, Krzysz
Polish Journal of Surgery.2023; 95(5): 14. CrossRef

Malignant disease, Rectal cancer,Colorectal cancer,Functional outcome,Surgical technique

Oncological and functional outcomes of transanal total mesorectal excision in a teaching hospital in the Netherlands: Joost A.G. van der Heijden, Kelly G.H. van de Pas, Frank J.C. van den Broek, Francois M.H. van Dielen, Gerrit D. Slooter, Adriana J.G. Maaskant-Braat; Ann Coloproctol. 2022;38(1):28-35. Published online June 29, 2021; DOI: https://doi.org/10.3393/ac.2020.00773.0110

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Abstract PDF

Purpose
Transanal total mesorectal excision (TaTME) was developed to overcome surgical difficulties experienced in distal pelvic dissection. Concerns have been raised about potential worse postoperative functional outcomes after TaTME. Also, the oncological safety was questioned. This study aimed to describe the functional, surgical, oncological outcomes and quality of life (QoL) after TaTME.
Methods
All consecutive TaTME cases for rectal cancer without disseminated disease between December 2016 and April 2019 were included. The Wexner incontinence score, low anterior resection syndrome (LARS) score, fecal incontinence-related QoL, and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-core questionnaire and 29-item module (EORTC QLQ-C30/CR29) were collected. Kaplan-Meier analysis was used to calculate local recurrence-free survival.
Results
Thirty patients were eligible for analysis of which 23 received questionnaires. Response rate was 74%. After a median follow-up of respectively 20.0 and 23.0 months for functional and oncological outcomes, the median (interquartile range) of Wexner incontinence and LARS scores were 9.0 (7.0–12.0) and 33.1 (25.0–39.0). Major LARS was present in 73.3%. Fecal incontinence, general and colorectal-specific QoL subdomains that are associated with poor bowel function scored in line with previously reported data. The 2-year actuarial cumulative local recurrence rate was 3.7% (95% confidence interval, 2.4%–5.0%).
Conclusion
TaTME may lead to significant functional impairments. Patients should receive preoperative counseling on this topic and be fully aware of the potential consequences of their treatment. Oncological data were in line with other short- to moderate-term data and did not show alarming results.

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Does transanal total mesorectal excision (taTME) result in better quality of life and functional outcomes than traditional TME does? A retrospective propensity score-adjusted cohort study
Yanic Ammann, Marie Klein, Lukas Marti, Rene Warschkow, Lennard Ströse, Moritz Sparn, Tarkan Jäger, Stephan Bischofberger, Walter Brunner
Langenbeck's Archives of Surgery.2025;[Epub] CrossRef
Anorectal and urogenital functional outcome after robotic and transanal total mesorectal excision for rectal cancer: a propensity score-matched analysis
Pak Chiu Wong, Felix Che Lok Chow, Wai Lun Law, Chi Chung Foo
Techniques in Coloproctology.2025;[Epub] CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Beyond survival: a comprehensive review of quality of life in rectal cancer patients
Won Beom Jung
Annals of Coloproctology.2024; 40(6): 527. CrossRef
Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
Annals of Surgical Treatment and Research.2023; 105(6): 341. CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han
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Malignant disease,Prognosis and adjuvant therapy,Functional outcomes,Postoperative outcome & ERAS

The impact of variations in care and complications within a colorectal Enhanced Recovery After Surgery program on length of stay: James Wei Tatt Toh, Jack Cecire, Kerry Hitos, Karen Shedden, Fiona Gavegan, Nimalan Pathmanathan, Toufic El Khoury, Angelina Di Re, Annelise Cocco, Alex Limmer, Tom Liang, Kar Yin Fok, James Rogers, Edgardo Solis, Grahame Ctercteko; Ann Coloproctol. 2022;38(1):36-46. Published online May 6, 2021; DOI: https://doi.org/10.3393/ac.2020.11.23

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221 Download
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18 Citations

Abstract PDF Supplementary Material

Purpose
Enhanced Recovery After Surgery (ERAS) has become standard of care in colorectal surgery. However, there is not a universally accepted colorectal ERAS protocol and significant variations in care exist between institutions. The aim of this study was to examine the impact of variations in ERAS interventions and complications on length of stay (LOS).
Methods
This study was a single-center review of the first 200 consecutive patients recruited into our prospectively collected ERAS database. The primary outcome of this study was to examine the rate of compliance to ERAS interventions and the impact of these interventions on LOS. The secondary outcome was to assess the impact of complications (anastomotic leak, ileus, and surgical site infections) on LOS. ERAS interventions, rate of adherence, LOS, readmissions, morbidity, and mortality were recorded, and statistical analysis was performed.
Results
ERAS variations and complications significantly influenced patient LOS on both univariate and multivariate analysis. ERAS interventions identified as the most important strategies in reducing LOS included laparoscopic surgery, mobilization twice daily postoperative day (POD) 0 to 1, discontinuation of intravenous fluids on POD 0 to 1, upgrading to solid diet by POD 0 to 2, removal of indwelling catheter by POD 0 to 2, avoiding nasogastric tube reinsertion and removing drains early. Both major and minor complications increased LOS. Anastomotic leak and ileus were associated with the greatest increase in LOS.
Conclusion
Seven high-yield ERAS interventions reduced LOS. Major and minor complications increased LOS. Reducing variations in care and complications can improve outcomes following colorectal surgery.

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Alexandra-Eleftheria Menni, Georgios Tzikos, George Petrakis, Patroklos Goulas, Panagiotis V. Karathanasis, Stylianos Apostolidis
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Malignant disease, Functional outcomes,Colorectal cancer,Postoperative outcome & ERAS

Systematic Early Urinary Catheter Removal Integrated in the Full Enhanced Recovery After Surgery (ERAS) Protocol After Laparoscopic Mid to Lower Rectal Cancer Excision: A Feasibility Study: Hélène Meillat, Cloé Magallon, Clément Brun, Cécile de Chaisemartin, Laurence Moureau-Zabotto, Julien Bonnet, Marion Faucher, Bernard Lelong; Ann Coloproctol. 2021;37(4):204-211. Published online April 22, 2021; DOI: https://doi.org/10.3393/ac.2020.05.22

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Abstract PDF

Purpose
Enhanced Recovery After Surgery (ERAS) programs advocate early urinary catheter removal after rectal cancer surgery; however, the optimal duration remains unclear. This study assessed the feasibility of the early urinary catheter removal protocol after rectal cancer surgery within an ERAS pathway and identified predictive factors for failure of this strategy.
Methods
Between March 2017 and October 2018, all unselected and consecutive patients who underwent rectal cancer resection and benefited from our ERAS program were included. Urinary complications (infection and retention) were prospectively recorded. Success was defined as catheter removal on postoperative day (POD) 3 without urinary complications.
Results
Of 135 patients (male, 63.7%; neoadjuvant chemoradiation, 57.0%; urology history, 17.8%), 120 had early urinary catheter removal with no complications (success rate, 88.9%), 8 did not have urinary catheter removal on POD 3 due to clinical judgment or prescription error, 5 experienced a urinary tract infection, and 2 had acute urinary retention. Obesity (odds ratio [OR], 0.16; P = 0.003), American Society of Anesthesiologists physical status classification > II (OR, 0.28; P = 0.048), antiaggregant platelet medication (OR, 0.12; P < 0.001), absence of anastomosis (OR, 0.1; P = 0.003), and prolonged operative time (OR, 0.21; P = 0.020) were predictive factors for failure. Conversely, optimal compliance with the ERAS program (OR, 7.68; P < 0.001), postoperative nonsteroidal anti-inflammatory drug use (OR, 21.71; P < 0.001), and balanced intravenous fluid therapy (OR, 7.87; P = 0.001) were associated with increased strategy success.
Conclusion
Withdrawal of the urinary catheter on POD 3 was successfully achieved after laparoscopic rectal resection and can be safely implemented in the ERAS program.

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Reviews

Malignant disease

How to Prevent Anastomotic Leak in Colorectal Surgery? A Systematic Review: Mohamed Ali Chaouch, Tarek Kellil, Camillia Jeddi, Ahmed Saidani, Faouzi Chebbi, Khadija Zouari; Ann Coloproctol. 2020;36(4):213-222. Published online August 31, 2020; DOI: https://doi.org/10.3393/ac.2020.05.14.2

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32 Citations

Abstract PDF

Anastomosis leakage (AL) after colorectal surgery is an embarrassing problem. It is associated with poor consequence. This review aims to summarize published evidence on prevention of AL after colorectal surgery and provide recommendations according to the Oxford Centre for Evidence-Based Medicine. We conducted bibliographic research on January 15, 2020, of PubMed, Cochrane Library, Embase, Scopus, and Google Scholar. We retained meta-analysis, reviews, and randomized clinical trials. We concluded that mechanical bowel preparation did not reduce AL. It seems that oral antibiotic or oral antibiotic with mechanical bowel preparation could reduce the risk of AL. The surgical approach did not affect the AL rate. The low ligation of the inferior mesenteric artery could reduce the AL rate. The mechanical anastomosis is superior to handsewn anastomosis only in case of right colectomies, with similar results in rectal surgery between the 2 anastomosis techniques. In the case of right colectomies, this anastomosis could be performed intracorporeally or extracorporeally with similar outcomes. The air leak test did not reduce AL. There is no interest of external drainage in colonic surgery but drains reduced the rate of AL and rate of reoperation after low anterior resection. The transanal tube reduced the rate of AL.

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Benign GI diease,Epidemiology & etiology

A Review of Bowel Preparation Before Colorectal Surgery: Yeon Uk Ju, Byung Wook Min; Ann Coloproctol. 2021;37(2):75-84. Published online May 15, 2020; DOI: https://doi.org/10.3393/ac.2020.04.01

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307 Download
15 Web of Science
13 Citations

Abstract PDF

Infectious complications are the biggest problem during bowel surgery, and one of the approaches to minimize them is the bowel cleaning method. It was expected that bowel cleaning could facilitate bowel manipulation as well as prevent infectious complications and further reduce anastomotic leakage. In the past, with the development of antibiotics, bowel cleaning and oral antibiotics (OA) were used together. However, with the success of emergency surgery and Enhanced Recovery After Surgery, bowel cleaning was not routinely performed. Consequently, bowel cleaning using OA was gradually no longer used. Recently, there have been reports that only bowel cleaning is not helpful in reducing infectious complications such as surgical site infection (SSI) compared to OA and bowel cleaning. Accordingly, in order to reduce SSI, guidelines are changing the trend of only intestinal cleaning. However, a consistent regimen has not yet been established, and there is still controversy depending on the location of the lesion and the surgical method. Moreover, complications such as Clostridium difficile infection have not been clearly analyzed. In the present review, we considered the overall bowel preparation trends and identified the areas that require further research.

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Hayoung Lee, Jong Lyul Lee, Ji Sung Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok‐Byung Lim
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O. Zmora, Y. Stark, O. Belotserkovsky, M. Reichert, G. A. Kozloski, N. Wasserberg, H. Tulchinsky, L. Segev, A. J. Senagore, N. Emanuel
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Original Articles

Malignant disease, Functional outcomes

The Benefits of Colorectal Surgery Surveys in Australia and New Zealand: Auerilius Erastus Ricardo Hamilton, Amelia Alice Lin, Christopher John Young; Ann Coloproctol. 2020;36(2):102-111. Published online April 30, 2020; DOI: https://doi.org/10.3393/ac.2019.09.17

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64 Download
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Abstract PDF Supplementary Material

Purpose
Pertaining to the Colorectal Surgery Society of Australia and New Zealand (CSSANZ) Executive and Research Support Committee, this study aimed to assess the usefulness and outcomes of surveys sent out by the society to its members.
Methods
From 2009 to 2017, CSSANZ members received 38 surveys, most of which were distributed from within the society, and a few of which originated from other affiliated groups. Surveys were categorised by type, topics, times required for completion, delivery method, response rates, and advancement to publication.
Results
Of 38 surveys, 20 (53%) were published and 18 remain unpublished. Four surveys were distributed annually on average, with 2.2 published annually on average, with a mean impact factor of 2.41 ± 1.55. Mean time to publication was 31 ± 17 months. Surveys contributed to 13 publications (34%). The most common survey topics were rectal cancer decisionmaking, in 6 publications (16%), preoperative assessment of colorectal patients, in 5 publications (13%), and anal physiology: continence and defaecation, in 4 publications (11%). Publication of surveys was not related to the number of surveys distributed per year, the number of questions per survey, or the time required by respondents to complete the surveys.
Conclusion
Most of the CSSANZ-distributed surveys resulted in publications, and one third of the surveys contributed to higher degrees obtained by investigators. These surveys aid research into areas that are otherwise difficult to assess, often indicating areas for future research.

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Current approaches to the surgical management of Crohn’s disease in Australia and New Zealand
Sophie Zheng, Aleksandra Edmundson, David A. Clark
International Journal of Colorectal Disease.2025;[Epub] CrossRef
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Abdulhakim B Jamjoom, Abdulhadi Y Gahtani, Jude M Jamjoom, Belal M Sharab, Omar M Jamjoom, Moajeb T AlZahrani
Cureus.2024;[Epub] CrossRef
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
Annals of Coloproctology.2021; 37(5): 337. CrossRef

Malignant disease, Rectal cancer

First Feasibility Study and Short-term Outcomes of Laparoscopic-Assisted Anterior Resection in Colorectal Cancer in Malaysia: Henry Chor Lip Tan, Jih Huei Tan, Nur Akmalrudin Nur Dzainuddin, Koon Khee Chan; Ann Coloproctol. 2020;36(2):94-101. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.05.10

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Abstract PDF

Purpose
The purpose of this study was to demonstrate the feasibility and safety of laparoscopic-assisted anterior resection (LAAR) for colorectal cancer in a local Asian population.
Methods
This is a retrospective review of all patients with colorectal cancer operated from November 2017 to October 2018. Main variables of interest were demography, type and surgery, length of stay (LOS), and the involvement of proximal and distal doughnut. Postoperative complications were analysed using chi-square or Fisher exact and Mann-Whitney tests.
Results
There were 23 patients with a mean age of 62.5 ± 12.2 years. The mean time from diagnosis to surgery was 97.1 ± 154.84 days. There were 12 patients in the LAAR group and 11 in the open anterior resection (OAR) group. Duration of surgery was shorter in OAR (129.58 ± 51.38 minutes) compared to LAAR (147.91 ± 39.37 minutes). Mean LOS was shorter in the LAAR group with 5±1.5 days compared to the OAR group of 7.42 ± 4.25 days. However, there was no significant P-value for both duration of surgery (P = 0.322) or LOS (P = 0.87). A total of 3 complications were recorded after OAR and 2 after LAAR. Both groups had clear proximal and distal margins with 16 (12–18.5) harvested lymph nodes in LAAR and 18 (16–22) in OAR, which were equal (P = 0.155).
Conclusion
This study reports a shorter LOS in the minimally invasive group of 2 days with similar oncologic resection outcomes. This shows that LAAR is feasible in Malaysia and has potential outcome benefits.

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Short-Term Surgical Outcomes of Curative Colorectal Resections from an Evolving Low-Volume Cancer Center in a Tier-2 City in India
Vishnu S. Menon, Amita Sekhar Padhy, Rigved Nittala, Mounika Basani, Sidaksingh R. Arora
Indian Journal of Surgical Oncology.2025;[Epub] CrossRef
Five-year follow-up retrospective review of colorectal cancer patients in Johor Bahru
Jih Huei Tan, Hoo Zhi Ai, Keith Tan Jian Li, Lai Yong Sheng, Anoopurany Subramaniam, Aishath Rahy Abdul Latheef, Cheah Suang Yao, Kelly Loo Kai Li, Ian Chiew Juin Liang, Raymond Lim Zhun Ming, Henry Tan Chor Lip, Koon Khee Chan
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Perforated caecal carcinoma within a strangulated inguinal hernia
Wick Champ Lai, Mogaraj Sellapan, Novinth Kumar Raja Ram, Henry Tan Chor Lip
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Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and Current Management
Seung Mi Yeo, Gyung Mo Son
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Critical adjustments and trauma surgery trends in adaptation to COVID-19 pandemic in Malaysia
Henry Tan Chor Lip, Tan Jih Huei, Yuzaidi Mohamad, Rizal Imran Alwi, Tuan Nur' Azmah Tuan Mat
Chinese Journal of Traumatology.2020; 23(4): 207. CrossRef

Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer,Biomarker & risk factor

Surgical Risk and Pathological Results of Emergency Resection in the Treatment of Acutely Obstructing Colorectal Cancers: A Retrospective Cohort Study: Giovanni Domenico Tebala, Andrea Mingoli, Andrea Natili, Abdul Qayyum Khan, Gioia Brachini; Ann Coloproctol. 2021;37(1):21-28. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.03.10.1

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6 Citations

Abstract PDF

Purpose
The treatment of acutely obstructing colorectal cancers is still a matter of debate. The prevailing opinion is that an immediate resection should be performed whenever possible. This study sought to determine whether immediate resection is safe and oncologically valid.
Methods
We completed a retrospective 2-center cohort study using the medical records of patients admitted for acutely obstructing colorectal cancer under the care of the Colorectal Team, Noble’s Hospital, Isle of Man, and the Emergency Surgery Unit, Umberto I University Hospital, Rome, from March 2013 to May 2017. The primary endpoints were 90-day mortality and morbidity, reoperation rate, and length of stay. The secondary endpoints were status of margins, number of lymph nodes retrieved, and the rate of adequate nodal harvest.
Results
Sixty-three patients were retrospectively enrolled in the study. Mortality was associated with age > 80 years and Dukes B tumors. The length of hospital stay was shorter in patients who had their resection less than 24 hours from their admission, in those who had laparoscopic resection and in those with distal tumors. The number of lymph nodes retrieved and rate of R0 resections were similar to those reported in elective colorectal surgery and were greater in laparoscopic resections and in patients operated on within 24 hours, respectively.
Conclusion
Immediate resection is a safe and reliable option in patients with acutely obstructing colorectal cancer.

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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
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Hyun Gu Lee, Young IL Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
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Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
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Young Il Kim, In Ja Park
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Failure to rescue after reoperation for major complications of elective and emergency colorectal surgery: A population-based multicenter cohort study
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Surgery.2022; 172(4): 1076. CrossRef
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Benign GI diease

Early Metabolic and Inflammatory Intraperitoneal Changes After Rectum Perforation: Ioannis Oikonomakis, Tal M. Horer, Per Skoog, Kristofer F. Nilsson, Kjell Jansson; Ann Coloproctol. 2020;36(6):374-381. Published online February 25, 2020; DOI: https://doi.org/10.3393/ac.2019.09.30.1

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Abstract PDF: Purpose
Anastomotic leakage (AL) is the most dreaded complication in rectal surgery. It has a great impact on postoperative morbidity and mortality. This animal model, in which we have studied postoperative metabolic and inflammatory changes, is designed to imitate an AL.
Methods
Twelve pigs were randomized into 2 groups. In the experimental group, an iatrogenic rectal perforation was performed, with the control group having a sham operation. The 2 groups were followed for 10 hours after operation with regard to vital parameters, arterial lactate, and cytokines interleukin (IL) 1, IL6, and IL10 in the blood and intraperitoneally. Intraperitoneal microdialysis analyses of glucose, lactate, glycerol, and pyruvate were performed and the lactate/pyruvate ratio was calculated.
Results
Glucose levels were lower in the experimental group after 4 hours. After 7 hours, lactate and lactate/pyruvate ratio was higher in the experimental group. At the same time intraperitoneal cytokines IL6 and IL10 were higher in the experimental group. Blood samples showed higher IL6 after 7 hours in the experimental group. Conclusion: In this study, several significant differences between the groups in metabolic and inflammatory values were detected. Further clinical studies are recommended to evaluate the importance of intraperitoneal metabolic and inflammatory analyses as a diagnostic tool for early identification of an AL.

Original article

Defunctioning Protective Stoma Can Reduce the Rate of Anastomotic Leakage after Low Anterior Resection in Rectal Cancer Patients: Byoung Chul Lee, Seok-Byung Lim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Chang Sik Yu, Jin Cheon Kim; Received October 22, 2019 Accepted November 19, 2019 Published online January 16, 2020; DOI: https://doi.org/10.3393/ac.2019.11.19.1

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Abstract PDF

PURPOSE
This study aimed to identify risk factors for anastomotic leakage and to evaluate the impact of protective stoma on the rate of anastomotic leakage and subsequent management.
METHODS
This retrospective study analyzed data from 4,282 patients who underwent low anterior resection between 2007 and 2014. Among these, 1,367 (31.9%) underwent surgery to create protective diverting stoma and 232 (5.4%) experienced anastomotic leakage. At 6-month timepoints, data were evaluated to identify any correlation between the presence of diverting stoma and the incidence of anastomotic leakage. In addition, clinicopathological parameters were investigated to identify risk factors for anastomotic leakage.
RESULTS
Diverting stomas significantly reduced the rate of anastomotic leakage [HR 0.334, 95% CI 0.212

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Application of one-stitch modified ileostomy in laparoscopic low anterior rectal resection: An open-label, randomized clinical trial
Xin Zhang, Baochuan Yang, Weishuai Song, Benjia Liang, Liangzhao Chen, Quan Yuan, Yitong Wang, Jiayi Li, Jie Liu, Jizhun Zhang
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International Journal of Colorectal Disease.2026;[Epub] CrossRef
Factors associated with leakage after reversal of protective stoma in patients with locally advanced rectal cancer following curative resection and anastomosis
Miao-Ling Tsai, Ji-Shiang Hung, John Huang, Been-Ren Lin
European Journal of Surgical Oncology.2025; 51(8): 108698. CrossRef
Risk factors influencing sphincter preservation in laparoscopic radical rectal cancer surgery
Jia-Rui Liu, Jin Zhang, Xiang-Long Duan
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Wenjing Tan, Shiyin Cai, Juanqin Wu, Wenke Wu, Shan Wang, Yaqiu Li, Lulu Liu, Liping Tang, Ying Cao
World Journal of Surgical Oncology.2025;[Epub] CrossRef
Machine learning model for prediction of permanent stoma after anterior resection of rectal cancer: A multicenter study
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Sarcopenic Obesity Is a Risk Factor for Worse Oncological Long-Term Outcome in Locally Advanced Rectal Cancer Patients: A Retrospective Single-Center Cohort Study
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Tailored Management with Highly-Selective Diversion for Low Colorectal Anastomosis: Biochemical Postoperative Follow-Up and Long-Term Results from a Single-Institution Cohort
Philippe Rouanet, Marie Selvy, Marta Jarlier, Caroline Bugnon, Guillaume Carrier, Anne Mourregot, Pierre-Emmanuel Colombo, Christophe Taoum
Annals of Surgical Oncology.2022; 29(4): 2514. CrossRef
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Peter Tschann, Markus P. Weigl, Philipp Szeverinski, Daniel Lechner, Thomas Brock, Stephanie Rauch, Jana Rossner, Helmut Eiter, Paolo N. C. Girotti, Tarkan Jäger, Jaroslav Presl, Klaus Emmanuel, Alexander De Vries, Ingmar Königsrainer, Patrick Clemens
Langenbeck's Archives of Surgery.2022; 407(7): 2945. CrossRef
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Keli Wang, Meijiao Li, Rui Liu, Yang Ji, Jin Yan
Cancer Management and Research.2022; Volume 14: 2243. CrossRef
Preoperative risk factors associated with anastomotic leakage after colectomy for colorectal cancer: a systematic review and meta-analysis
VINÍCIUS EVANGELISTA DIAS, PEDRO ALVES SOARES VAZ DE CASTRO, HOMERO TERRA PADILHA, LARA VICENTE PILLAR, LAURA BOTELHO RAMOS GODINHO, AUGUSTO CLAUDIO DE ALMEIDA TINOCO, RODRIGO DA COSTA AMIL, ALEIDA NAZARETH SOARES, GERALDO MAGELA GOMES DA CRUZ, JULIANA MA
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Xiang-nan Yu, Lu-ming Xu, Ya-wen Bin, Ye Yuan, Shao-bo Tian, Bo Cai, Kai-xiong Tao, Lin Wang, Guo-bin Wang, Zheng Wang
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Effect of pelvic drain displacement on anastomotic leakage-related morbidity after rectal cancer surgery
Ho Yung Lee, Sung Il Kang, So Hyun Kim, Jae-Hwang Kim
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Preoperative chemoradiotherapy versus surgery alone for advanced low rectal cancer: a large multicenter cohort study in Japan
Tomonori Akagi, Masafumi Inomata, Hajime Fujishima, Meiki Fukuda, Tsuyoshi Konishi, Shunsuke Tsukamoto, Fuminori Teraishi, Heita Ozawa, Keitaro Tanaka, Koya Hida, Yoshiharu Sakai, Masahiko Watanabe
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Case Report

Malignant disease,Rare disease & stoma

Extensive Resection for Treatment of Locally Advanced Primary Mucinous Adenocarcinoma Arising From Fistula-in-Ano: Jordan Au, Francis M. Hulme-Moir, Andrew Herd, Mathew A. Kozman; Ann Coloproctol. 2021;37(Suppl 1):S7-S10. Published online November 26, 2019; DOI: https://doi.org/10.3393/ac.2019.11.19

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Abstract PDF

We report a case of a 66-year-old male who presented with a locally advanced primary mucinous adenocarcinoma arising from a fistula-in-ano. The presentation was typical for perianal sepsis and fistula-in-ano with anal pain and chronic discharge. Initial treatments with fistula debridement and seton were performed. Subsequent review of histology revealed underlying adenocarcinoma, while magnetic resonance imaging (MRI) showed local invasion into the prostate. The patient received neoadjuvant chemoradiotherapy followed by pelvic exenteration to maximize the chance of achieving cure. Features of this case are discussed together with its implications, including treatment guidelines and typical MRI findings.

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Original Articles

Long-term Transanal Excision Outcomes in Patients With T1 Rectal Cancer: Comparative Analysis of Radical Resection: Yunghuyn Hwang, Yong Sik Yoon, Jun Woo Bong, Hye Yun Choi, In Ho Song, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2019;35(4):194-201. Published online August 31, 2019; DOI: https://doi.org/10.3393/ac.2018.10.18.2

7,994 View
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18 Citations

Abstract PDF

Purpose
Transanal excision (TAE) is an alternative surgical procedure for early rectal cancer. This study compared long-term TAE outcomes, in terms of survival and local recurrence (LR), with total mesorectal excision (TME) in patients with pathologically confirmed T1 rectal cancer.
Methods
T1 rectal adenocarcinoma patients who underwent surgery from 1990 to 2011 were retrospectively reviewed. Patients that were suspected to have preoperative lymph node metastasis were excluded. Demographics, recurrence, and survival were analyzed based on TAE and TME surgery.
Results
Of 268 individuals, 61 patients (26%) underwent TAE, which was characterized by proximity to the anus, submucosal invasion depth, and lesion infiltration, compared with TME patients (P < 0.001–0.033). During a median follow-up of 10.4 years, 12 patients had systemic and/or LR. Ten-year cancer-specific survival in the TAE and TME groups was not significantly different (98% vs. 100%). However, the 10-year LR rate in the TAE group was greater than that of TME group (10% vs. 0%, P < 0.001). Although 5 of the 6 TAE patients with LR underwent salvage surgery, one of the patients eventually died. The TAE surgical procedure (hazard ratio, 19.066; P = 0.007) was the only independent risk factor for LR.
Conclusion
Although long-term survival after TAE was comparable to that after TME, TAE had a greater recurrence risk than TME. Thus, TAE should only be considered as an alternative surgical option for early rectal cancer in selected patients.

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Marija Nikolić, Nemanja Trifunović, Damir Jašarović, Tanja Abazović, Milica Radivojević, Nebojša Mitrović
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Cristopher Varela, Nam Kyu Kim
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Taesung Ahn
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World Journal of Surgical Oncology.2019;[Epub] CrossRef

Discrepancy of Medical Terminology Regarding Colorectal Surgery Between South and North Korea: Dayoung Ko, Heung-Kwon Oh, Jangwhan Jo, Hyun Hui Yang, Min-Hyun Kim, Myung Jo Kim, Sung Il Kang, Duck-Woo Kim, Sung-Bum Kang; Ann Coloproctol. 2018;34(5):248-252. Published online October 31, 2018; DOI: https://doi.org/10.3393/ac.2017.10.01

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Abstract PDF

Purpose
We aimed to investigate the extent of heterogeneity in medical terminology between South and North Korea by comparing medical terms related to the colorectal system.
Methods
North Korean medical terms were collected from the sections on diseases of the small intestine and colon in a surgery textbook from North Korea, and those terms were compared with their corresponding terms in a South Korean medical terminology textbook. The terms were categorized as either identical, similar, showing disparity, or not used in South Korea. In a subsection analysis, the terms were allocated to pathophysiology, diagnosis, symptoms and examination, drugs, testing, treatment, or others according to the categorization used in the textbook.
Results
We found 705 terms in the North Korean textbook, most of which were pathophysiological terms (206, 29.2%), followed by diagnostic terms (165, 23.4%) and symptom and examination terms (122, 17.3%). Treatment-, drug-, and testing-related terms constituted 15.5%, 5.8%, and 4.1% of the 705 terms, respectively. There were 331 identical terms (47.0%) and 146 similar terms (20.7%); 126 terms (17.9%) showed disparity. Another 102 terms (14.5%) were not used in South Korea. The pathophysiological terms were the least heterogeneous, with 61.2% being identical terms used in both countries. However, 26.8% of the terms in the drug category were not used in South Korea.
Conclusion
The present study showed that less than 50% of the terms for the colorectal system used in South and North Korea were identical. As the division between South and North Korea persists, the heterogeneity of medical terminology is expected to increase.

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Characteristics and Distribution of Surgical Diseases in North Korean Research Papers Published between 2006 and 2017
Yo Han Lee, Namkee Oh, Hyerim Kim, Shin Ha
Journal of Korean Medical Science.2021;[Epub] CrossRef
Assessing the pharmacy students’ knowledge of common medical terms after a curricular change in Saudi Arabia
Yazed AlRuthia, Monira Alwhaibi, Haya Almalag, Hadeel Alkofide, Bander Balkhi, Amani Almejel, Fahad Alshammari, Fawaz Alharbi, Ibrahim Sales, Yousif Asiri
Saudi Pharmaceutical Journal.2020; 28(6): 763. CrossRef

Surgical Outcomes and Risk Factors in Patients Who Underwent Emergency Colorectal Surgery: Dai Sik Jeong, Young Hun Kim, Kyung Jong Kim; Ann Coloproctol. 2017;33(6):239-244. Published online December 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.6.239

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Abstract PDF

Purpose

Emergency colorectal surgery has high rates of complications and mortality because of incomplete bowel preparation and bacterial contamination. The authors aimed to evaluate the surgical outcomes and the risk factors for the mortality and the complication rates of patients who underwent emergency surgery to treat colorectal diseases.

Methods

This is a prospective study from January 2014 to April 2016, and the results are based on a retrospective analysis of the clinical results for patients who underwent emergency colorectal surgery at Chosun University Hospital.

Results

A total of 99 patients underwent emergency colorectal surgery during the study period. The most frequent indication of surgery was perforation (75.8%). The causes of disease were colorectal cancer (19.2%), complicated diverticulitis (21.2%), and ischemia (27.2%). There were 27 mortalities (27.3%). The major morbidity was 39.5%. Preoperative hypotension and perioperative blood transfusion were independent risk factors for both morbidity and mortality.

Conclusion

These results revealed that emergency colorectal surgeries are associated with significant morbidity and mortality. Furthermore, the independent risk factors for both morbidity and mortality in such patiients were preoperative hypotension and perioperative transfusion.

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Shimpei Ogawa, Hideki Endo, Masahiro Yoshida, Tomomitsu Tsuru, Michio Itabashi, Hiroyuki Yamamoto, Yoshihiro Kakeji, Hideki Ueno, Yuko Kitagawa, Taizo Hibi, Akinobu Taketomi, Norihiko Ikeda, Masaki Mori
Annals of Gastroenterological Surgery.2024; 8(3): 450. CrossRef
Effects of surgeon specialization on the outcome of emergency colorectal surgery
Nahar A. Alselaim, Ohood H. AlAamer, Mohammed M. Almalki, Abdualziz A. Al-osail, Sultanah F. Bin Gheshayan
Annals of Medicine & Surgery.2024; 86(12): 7010. CrossRef
Association between Intraoperative Early Warning Score and Mortality and In-Hospital Stay in Lower Gastrointestinal Spontaneous Perforation
Kazuya Takada, Yusuke Nagamine, Akira Ishii, Yan Shuo, Takumi Seike, Hanako Horikawa, Kentaro Matsumiya, Tetsuya Miyashita, Takahisa Goto, Ronald G. Pearl
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Laparoscopic and Robotic Surgeries for Patients With Colorectal Cancer Who Have Had a Previous Abdominal Surgery: Soeun Park, Jeonghyun Kang, Eun Jung Park, Seung Hyuk Baik, Kang Young Lee; Ann Coloproctol. 2017;33(5):184-191. Published online October 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.5.184

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Abstract PDF

Purpose

The impact of previous abdominal surgery (PAS) on surgical outcomes from laparoscopic and robot surgeries is inconclusive. This study aimed to investigate the impact of PAS on perioperative outcomes from laparoscopic and robotic colorectal surgeries.

Methods

From March 2007 to February 2014, a total of 612 and 238 patients underwent laparoscopic and robotic surgeries, respectively. Patients were divided into 3 groups: those who did not have a PAS (NPAS), those who had a major PAS, and those who had a minor PAS. We further divided the patients so that our final groups for analysis were: patients with NPAS (n = 478), major PAS (n = 19), and minor PAS (n = 115) in the laparoscopy group, and patients with NPAS (n = 202) and minor PAS (n = 36) in the robotic surgery group.

Results

In the laparoscopy group, no differences in the conversion rates between the 3 groups were noted (NPAS = 1.0% vs. major PAS = 0% vs. minor PAS = 1.7%, P = 0.701). In the robotic surgery group, the conversion rate did not differ between the NPAS group and the minor PAS group (1.0% vs. 2.8%, P = 0.390). Among the groups, neither the operation time, blood loss, days to soft diet, length of hospital stay, nor complication rate were affected by PAS.

Conclusion

PAS did not jeopardize the perioperative outcomes for either laparoscopic or robotic colorectal surgeries. Therefore, PAS should not be regarded as an absolute contraindication for minimally invasive colorectal surgeries.

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Robotic-assisted versus laparoscopic surgery for colorectal cancer in high-risk patients: a systematic review and meta-analysis
S. Gahunia, J. Wyatt, S. G. Powell, S. Mahdi, S. Ahmed, K. Altaf
Techniques in Coloproctology.2025;[Epub] CrossRef
Impact of previous abdominal surgery on minimally invasive radical resection of colorectal cancer: A meta-analysis
Wenjun Liu, Fan He, Defei Chen, Xiuping Zhang
European Journal of Surgical Oncology.2025; 51(10): 110259. CrossRef
Robotic-assisted radical cystoprostatectomy and intracorporeal ileal conduit formation in a patient with prior total colectomy and J-pouch
Grace S Sutherland, Jodie M McDonald, Amanda C Chung, Justin V Vass, Ahmed G Goolam, Matthew R Winter
Journal of Surgical Case Reports.2025;[Epub] CrossRef
Effect of previous abdominal surgery on robotic-assisted rectal cancer surgery
Davide Ferrari, Tommaso Violante, Himani Bhatt, Ibrahim A. Gomaa, Anne-Lise D. D’Angelo, Kellie L. Mathis, David W. Larson
Journal of Gastrointestinal Surgery.2024; 28(4): 513. CrossRef
The impact of previous abdominal surgery on colorectal cancer patients undergoing laparoscopic surgery
Xu-Rui Liu, Bing-Lan Zhang, Dong Peng, Fei Liu, Zi-Wei Li, Chun-Yi Wang
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Shoutarou Watanabe, Hiroaki Kobayashi, Nao Hiroe, Tomohiro Iwasawa, Michio Kosugi, Masayuki Shimizu, Masaru Ishida
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The risk of postoperative complications is higher in stage I-III colorectal cancer patients with previous abdominal surgery: a propensity score matching analysis
Xu-Rui Liu, Fei Liu, Zi-Wei Li, Xiao-Yu Liu, Wei Zhang, Dong Peng
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Sanghyun An, Hongjin Shim, Kwangmin Kim, Bora Kim, Hui-Jae Bang, Hyejin Do, Hyang-Rae Lee, Youngwan Kim
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Won Beom Jung
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Marco Milone, Nicola de'Angelis, Nassiba Beghdadi, Francesco Brunetti, Michele Manigrasso, Giuseppe De Simone, Giuseppe Servillo, Sara Vertaldi, Giovanni Domenico De Palma
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E. Lorenz, J. Arend, M. Franz, M. Rahimli, A. Perrakis, V. Negrini, A. A. Gumbs, R. S. Croner
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Anil Heroor, Aysha Khan, Kashish Jain, Akshay Patil, Hitesh Rajendra Singhavi
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Safety and feasibility of repeat laparoscopic colorectal resection: a matched case–control study
Alban Zarzavadjian le Bian, Laurent Genser, Christine Denet, Carlotta Ferretti, Anais Laforest, Jean-Marc Ferraz, Candice Tubbax, Philippe Wind, Brice Gayet, David Fuks
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Ching-Wen Huang, Wei-Chih Su, Tsung-Kun Chang, Cheng-Jen Ma, Tzu-Chieh Yin, Hsiang-Lin Tsai, Po-Jung Chen, Yen-Cheng Chen, Ching-Chun Li, Yi-Chien Hsieh, Jaw-Yuan Wang
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C. Clancy, M. Flanagan, M. Bughio, M. G. O'Riordain
Colorectal Disease.2019; 21(8): 972. CrossRef

The First Year After Colorectal Surgery in the Elderly: Verena N.N. Kornmann, Jeroen L.A. van Vugt, Anke B. Smits, Bert van Ramshorst, Djamila Boerma; Ann Coloproctol. 2017;33(4):134-138. Published online August 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.4.134

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Abstract PDF

Purpose

Surgery for colorectal malignancy is increasingly being performed in the elderly. Little is known about the impact of complications on late mortality. This study aimed to analyze whether a complicated postoperative course affects the 1-year survival in elderly patients.

Methods

All consecutive patients older than 75 years of age who underwent colorectal cancer surgery between January 2009 and April 2013 were included in this study. The main outcome was mortality at 1 year after surgery. Logistic regression analyses were performed to determine risk factors for a poor outcome (mortality) after survival of the early postoperative course of surgery at 1-year follow-up. Patients who died within 30 days postoperatively were excluded from analysis.

Results

The early mortality rate was 6.3% (n = 15), and 2 patients died during follow-up as a result of complications after a second surgery. A total of 223 patients survived the perioperative period and were included in this study. Twenty-two patients (9.9%) died during the first year of follow-up. Stage IV disease (P = 0.002), complications of primary surgery (P = 0.016), and comorbidity (P = 0.050) were risk factors for 1-year mortality. Intensive care unit stay, reoperation and readmission were not associated with a worse 1-year outcome.

Conclusion

Elderly patients with stage IV disease at the time of surgery, comorbidity, and postoperative complications are at risk for mortality during the first year after surgery. A patient-tailored approach with special attention to perioperative care should be considered in the elderly.

Citations

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Medical versus surgical causes of death following colorectal resection: a Queensland Audit of Surgical Mortality (QASM) study
Derek Mao, Therese Rey‐Conde, John B. North, Raymond P. Lancashire, Sanjeev Naidu, Terence Chua
ANZ Journal of Surgery.2024; 94(4): 684. CrossRef
Factors associated with one-year mortality after curative surgery for primary clinical T4 and locally recurrent rectal cancer in elderly patients
Nikki C.M. van Ham, Sofie Glazemakers, Mirjam van der Ende-van Loon, Grard A.P. Nieuwenhuijzen, Harm J.T. Rutten, Jip L. Tolenaar, Anne Jacobs, Jacobus W.A. Burger, Stijn H.J. Ketelaers, Johanne G. Bloemen
European Journal of Surgical Oncology.2024; 50(6): 108259. CrossRef
Outcomes of Robot-Assisted Versus Laparoscopic Surgery for Colorectal Cancer in Adults Aged 75 Years and Older: A Propensity Score–Matched Analysis of the US Nationwide Inpatient Sample
Kuan-Chih Chung, Kuen-Lin Wu, Yu-Li Su, Kung-Chuan Cheng, Chien-En Tang, Ling-Chiao Song, Hong-Hwa Chen, Ko-Chao Lee
Diseases of the Colon & Rectum.2024; 67(9): 1121. CrossRef
Robot-assisted vs. laparoscopic right hemicolectomy in octogenarians and nonagenarians: an analysis of the US nationwide inpatient sample 2005–2018
Chien-Chang Lu, Chi-Tung Lu, Kai-Yen Chang, Wang Chun-Li, Chien-Ying Wu
Aging Clinical and Experimental Research.2024;[Epub] CrossRef
Robotic surgery in elderly patients with colorectal cancer: Review of the current literature
Nan Zun Teo, James Chi Yong Ngu
World Journal of Gastrointestinal Surgery.2023; 15(6): 1040. CrossRef
Surgical outcomes following colorectal cancer resections in patients aged 80 years and over: results from the Australia and New Zealand Binational Colorectal Cancer Audit
Andrea J. Cross, Pauline Kornfält, Jacqueline Lidin, Pamela Buchwald, Frank A. Frizelle, Timothy W. Eglinton
Colorectal Disease.2021; 23(4): 814. CrossRef
Routine postoperative intensive care unit admission after colorectal cancer surgery for the elderly patient reduces postoperative morbidity and mortality
M. Fahim, R. A. Visser, L. M. Dijksman, D. H. Biesma, P. G. Noordzij, A. B. Smits
Colorectal Disease.2020; 22(4): 408. CrossRef
When and how should surgery be performed in senior colorectal cancer patients?
S.H.J. Ketelaers, M. Fahim, H.J.T. Rutten, A.B. Smits, R.G. Orsini
European Journal of Surgical Oncology.2020; 46(3): 326. CrossRef
Surgical approach and geriatric evaluation for elderly patients with colorectal cancer
Marco Vacante, Erika Cristaldi, Francesco Basile, Antonio Maria Borzì, Antonio Biondi
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Significant improvement in postoperative and 1-year mortality after colorectal cancer surgery in recent years
S.H.J. Ketelaers, R.G. Orsini, J.W.A. Burger, G.A.P. Nieuwenhuijzen, H.J.T. Rutten
European Journal of Surgical Oncology.2019; 45(11): 2052. CrossRef
Screening and systematic follow-up for cardiopulmonary comorbidity in elective surgery for colorectal cancer: a randomised feasibility study
Hans B. Rahr, Susanna Streym, Charlotte G. Kryh-Jensen, Helene T. Hougaard, Anne S. Knudsen, Steffen H. Kristensen, Ejler Ejlersen
World Journal of Surgical Oncology.2019;[Epub] CrossRef
Robotic Versus Laparoscopic Colorectal Cancer Surgery in Elderly Patients: A Propensity Score Match Analysis
Nicola de'Angelis, Solafah Abdalla, Giorgio Bianchi, Riccardo Memeo, Cecile Charpy, Niccolo Petrucciani, Iradj Sobhani, Francesco Brunetti
Journal of Laparoendoscopic & Advanced Surgical Techniques.2018; 28(11): 1334. CrossRef
High Serum CA19-9 Concentration Predicts Poor Prognosis in Elderly Patients with Stage IV Colorectal Cancer
Eiji Hidaka, Chiyo Maeda, Kenta Nakahara, Kunihiko Wakamura, Yasuhiro Ishiyama, Shoji Shimada, Junichi Seki, Yojiro Takano, Sonoko Oae, Yuta Enami, Naruhiko Sawada, Fumio Ishida, Shin-ei Kudo
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Colorectal Cancer Surgery in Elderly Patients
Young Jin Kim
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Hand-Assisted Laparoscopic Surgery: A Versatile Tool for Colorectal Surgeons: Ju Yong Cheong, Christopher J. Young; Ann Coloproctol. 2017;33(4):125-129. Published online August 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.4.125

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Abstract PDF

Purpose

Hand-assisted laparoscopic surgery (HALS) is a minimally invasive surgical technique with the combined benefits of laparoscopic surgery while allowing the use of the surgeon's hand for better tactile control. Obesity has been associated with higher conversion rates with multiport laparoscopic surgery, but not with HALS. This study aimed to examine the versatility of HALS in various clinical contexts.

Methods

All HALSs performed at 2 major tertiary centers in Sydney were prospectively collected for retrospective analysis. Variables including age, sex, body mass index (BMI), previous surgeries, pathologies including size and T-stage, and the number of conversions to a midline laparotomy were examined.

Results

A total of 121 HALS colorectal resections were analyzed. The median age of the patients was 62 years, with 63.6% being women. Seven patients required conversion to a midline laparotomy. Of the 121 patients, 50.2% were overweight or obese, and 52.9% had undergone previous abdominal/pelvic operations. However, neither obesity nor abdominal adhesions from previous operations were an indication for conversion to an open laparotomy in any of the 7 converted patients. The presence of intra-abdominal adhesions did not impact the operative time. HALS allowed access to the entire colon and rectum and allowed resection of the bladder, uterus, and ureter, when these organs were involved.

Conclusion

HALS is a versatile, minimally invasive technique, which is independent of the patient's BMI, for performing a colorectal resection.

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Satyam K. Ghodasara, Jana K. Elsawwah, Stephanie S. Hyon, Joseph S. Flanagan, Patricia B. Stopper, Rolando H. Rolandelli, Zoltan H. Nemeth
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Stephanie S. Hyon, Jana K. Elsawwah, Rahul Narang, Patricia B. Stopper, Rolando H. Rolandelli, Zoltan H. Nemeth
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2025;[Epub] CrossRef
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Hideaki Kimura, Kenichiro Toritani, Itaru Endo
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A single centre audit: repeat pre‐operative colonoscopy
Michelle Zhiyun Chen, Hareshdeva Devan Nair, Apoorva Saboo, Sharon Chih Lin Lee, Xinchen Gu, Sheik Mohammad Azhar Auckloo, Sandeep Tamang, Sally Jiasi Chen, Ryan William Lowe, Neil Strugnell
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Limei Zhang, Xinrui Li, Yao Ning, Yufei Cai, Zhihan Lv
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Annals of Coloproctology.2017; 33(4): 119. CrossRef

Standardizing the Protocols for Enhanced Recovery From Colorectal Cancer Surgery: Are We a Step Closer to Ideal Recovery?: Mosab Shetiwy, Tamer Fady, Fayez Shahatto, Ahmed Setit; Ann Coloproctol. 2017;33(3):86-92. Published online June 30, 2017; DOI: https://doi.org/10.3393/ac.2017.33.3.86

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Abstract PDF

Purpose

Enhanced recovery protocols are being implemented into the standard of care in surgical practice. This study aimed to insert a steadfast set of elements into the perioperative care pathway to establish an improved recovery program for colorectal cancer patients.

Methods

Seventy patients planned for elective laparoscopic colorectal resection were randomized into 2 groups: conventional recovery group (n = 35) and enhanced recovery group (n = 35). The primary outcome was the length of hospital stay. Secondary outcomes included the times of removal of nasogastric tubes (NGTs), successful enteral feeding, and removal of drains, postoperative complications, intra-hospital mortality, and rate of readmission.

Results

The mean postoperative hospital stay was 4.49 ± 0.85 days vs. 13.31 ± 6.9 days (P < 0.001), the mean time of removal of NGTs was 0.77 ± 1.031 days vs. 3.26 ± 2.737 days (P < 0.001), the mean time of successful enteral feeding was 1.89 ± 1.13 days vs. 5.46 ± 1.67 days (P < 0.001), and the mean time for removal of intra-abdominal drains was 2.94 ± 1.056 days vs. 9.06 ± 3.757 days (P < 0.001) for the enhanced and the conventional groups, respectively. Complications were significantly lower among patients in the enhanced group (25.7% vs. 65.7%) (P = 0.001). The rates of readmission were similar in the 2 groups.

Conclusion

Applying definite evidence-based elements to the colorectal rehabilitation program significantly boosts the recovery pathway with favorable outcomes, including faster recovery of gastrointestinal tract functions, lower morbidities, and eventually earlier discharge from the hospital.

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Vaishnavi Kannan, Najeeb Ullah, Sunitha Geddada, Amir Ibrahiam, Zahraa Munaf Shakir Al-Qassab, Osman Ahmed, Iana Malasevskaia
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Mohey Aldien Ahmed Elamin Elnour, Radwan Alsayed Radwan Ahmed, Ahmed Elkhalifa, Mohamed Eissa Elrayah Omran, Mohamed Ibrahim Osman Hamd, Rouida Elfadil Mohamed Ahmed Aboagla
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Ahmad Y. Al-Omari, Rand A. Othman
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Khara M. Sauro, Christine Smith, Seremi Ibadin, Abigail Thomas, Heather Ganshorn, Linda Bakunda, Bishnu Bajgain, Steven P. Bisch, Gregg Nelson
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Jing-Yan Song, Jing Cao, Jian Mao, Jiang-Lian Wang
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Satish Patil, Swapnil Sharma, Sarvesh Paliwal
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Nianmei Li, Shuju Wei, Yonghua Qi, Wenjng Wei
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Aya M Riad, Aisling Barry, Stephen R Knight, Carlie J Arbaugh, Parvez D Haque, Thomas G Weiser, Ewen M Harrison
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Jignesh Patel, Timo Tolppa, Bruce M. Biccard, Brigitta Fazzini, Rashan Haniffa, Debora Marletta, Ramani Moonesinghe, Rupert Pearse, Sutharshan Vengadasalam, Timothy J. Stephens, Cecilia Vindrola‐Padros
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Mosab Shetiwy, Amr F Elalfy, Osama Eldamshety, Ramy Abbas, Mohamed Abdelkhalek
Journal of Gastrointestinal Cancer.2021; 52(3): 1010. CrossRef
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A. Venara, R. Jaouen, E. Lermite, P. Le Naoures, C. Casa, E. Mirallié, E. Duchalais, A. Hamy
World Journal of Surgery.2019; 43(1): 252. CrossRef
Is the Enhanced Recovery After Surgery (ERAS) Program Effective and Safe in Laparoscopic Colorectal Cancer Surgery? A Meta-Analysis of Randomized Controlled Trials
Xiaofei Ni, Dan Jia, Yan Chen, Lei Wang, Jian Suo
Journal of Gastrointestinal Surgery.2019; 23(7): 1502. CrossRef
The efficacy and safety of enhanced recovery after surgery (ERAS) program in laparoscopic digestive system surgery: A meta-analysis of randomized controlled trials
Xiaofei Ni, Dan Jia, Yuchen Guo, Xuan Sun, Jian Suo
International Journal of Surgery.2019; 69: 108. CrossRef
The Need for Subdividing the Enhanced Recovery Program and Evaluation Criteria After Colorectal Surgery
In Ja Park
Annals of Coloproctology.2017; 33(3): 79. CrossRef

Outcome of Colorectal Surgery in Elderly Populations: Mostafa Shalaby, Nicola Di Lorenzo, Luana Franceschilli, Federico Perrone, Giulio P. Angelucci, Silvia Quareisma, Achille L. Gaspari, Pierpaolo Sileri; Ann Coloproctol. 2016;32(4):139-143. Published online August 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.4.139

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Abstract PDF

Purpose

The aim of this study is to investigate the impact of age on short-term outcomes after colorectal surgery in terms of the 30-day postoperative morbidity and mortality rates.

Methods

The subjects for the study were patients who had undergone colorectal surgery. Patients were divided into 2 groups according to age; groups A and B patients were ≥80 and <80 years old of age, respectively. Both groups were manually matched for body mass index, American Society of Anesthesiologists score, Charlson Comorbidity Index and procedure performed.

Results

A total of 200 patients, 91 men (45.5%) and 109 women (54.5%), were included in this retrospective study. These patients were equally divided into 2 groups. The mean ages were 85 years in group A (range, 80 to 104 years) and 55.3 years in group B (range, 13 to 79 years). The overall 30-day postoperative mortality rate was 1% of total 200 patients; both of these 2 patients were in group A. However, this observation had no statistical significance. No intraoperative complications were encountered in either group. The overall 30-day postoperative morbidity rate was 27% (54 of 200) for both groups. The 30-day postoperative morbidity rates in groups A and B were 28% (28 of 100) and 26% (26 of 100), respectively. However, these differences between the groups had no statistical significance importance.

Conclusion

Age alone should not be considered to be more of a contraindication or a worse predictor than other factors for the outcome after colorectal surgery on elderly patients.

Citations

Citations to this article as recorded by

Preoperative management in octogenarian patients with rectal cancer
Arthur M. Damasceno, Rubens Kesley, Marcus Valadão, Fabrício Braga, Cristiane A. D'Almeida, Marcos B. Pitombo
Heliyon.2025; 11(1): e41469. CrossRef
Predictors of complicated course of perioperative period in patients with rectal cancer and rectosigmoid junction
E. P. Kulikov, S. A. Mertsalov, N. I. Verkin, Yu. D. Kaminskiy, I. S. Pikushin
Experimental and Clinical Gastroenterology.2023; (10): 77. CrossRef
Oncological and surgical outcomes of radical surgery in elderly colorectal cancer patients with intestinal obstruction
Qingbiao Ma, Hongyu Li, Yujuan Jiang, Yingfei Wang, Jianwei Liang
Frontiers in Surgery.2023;[Epub] CrossRef
Efficiency of pre-operative preparation of intestines at treatment of sharp intestinal impassability tumoral genesis
H. Sh. Nazarov, Sh. К. Nazarov, N. Sh. Hasanov
Health care of Tajikistan.2022; (2): 59. CrossRef
Before-and-After Study of the First Four Years of the Enhanced Recovery after Surgery (ERAS®) Programme in Older Adults Undergoing Elective Colorectal Cancer Surgery
Cristina Martínez-Escribano, Francisco Arteaga Moreno, David Cuesta Peredo, Francisco Javier Blanco Gonzalez, Juan Maria De la Cámara-de las Heras, Francisco J. Tarazona Santabalbina
International Journal of Environmental Research and Public Health.2022; 19(22): 15299. CrossRef
Perioperative score for octogenarian patients eligible for rectal cancer surgery
Arthur Mota Damasceno, Rubens Kesley, Bruno Souza Paolino, Marcelo Rubens dos Santos do Amaral, Marcos Bettini Pitombo
Journal of Surgical Oncology.2021; 124(8): 1409. CrossRef
Prehabilitation: finally utilizing frailty screening data
Francesco Carli, Amal Bessissow, Rashami Awasthi, Sender Liberman
European Journal of Surgical Oncology.2020; 46(3): 321. CrossRef
Video‐assisted anal fistula treatment for complex anal fistula: a long‐term follow‐up study
G. Giarratano, M. Shalaby, C. Toscana, P. Sileri
Colorectal Disease.2020; 22(8): 939. CrossRef
New prognostic risk score for predicting in-hospital mortality in geriatric patients undergoing colorectal cancer surgery: U.S. Nationwide Inpatient Sample analysis
Xiaohong Zhao, Yunmei Yang, Haifeng Gu, Wenjing Zhou, Qin Zhang
Journal of Geriatric Oncology.2020; 11(8): 1250. CrossRef
Impact of ASA-score, age and learning curve on early outcome in the initiation phase of an oncological robotic colorectal program
Hülya Sarikaya, Tahar Benhidjeb, Sergiu I. Iosivan, Theodoros Kolokotronis, Christine Förster, Stephan Eckert, Ludwig Wilkens, Alaa Nasser, Sebastian Rehberg, Martin Krüger, Jan Schulte am Esch
Scientific Reports.2020;[Epub] CrossRef
Prediction of overall survival following colorectal cancer surgery in elderly patients
Isaac Seow-En, Winson Jianhong Tan, Sreemanee Raaj Dorajoo, Sharon Hui Ling Soh, Yi Chye Law, Soo Yeun Park, Gyu-Seok Choi, Wah Siew Tan, Choong Leong Tang, Min Hoe Chew
World Journal of Gastrointestinal Surgery.2019; 11(5): 247. CrossRef
Health-Related Quality of Life in Older Adults with Colorectal Cancer
Evan Lapinsky, Lillian C. Man, Amy R. MacKenzie
Current Oncology Reports.2019;[Epub] CrossRef
Evaluation of short-term outcomes of laparoscopic-assisted surgery for colorectal cancer in elderly patients aged over 75 years old: a multi-institutional study (YSURG1401)
Keisuke Kazama, Toru Aoyama, Tsutomu Hayashi, Takanobu Yamada, Masakatsu Numata, Shinya Amano, Mariko Kamiya, Tsutomu Sato, Takaki Yoshikawa, Manabu Shiozawa, Takashi Oshima, Norio Yukawa, Yasushi Rino, Munetaka Masuda
BMC Surgery.2017;[Epub] CrossRef
Colorectal Surgery in Elderly Patients
Byung Chun Kim
Annals of Coloproctology.2016; 32(4): 126. CrossRef

Outcomes and Risk Factors Affecting Mortality in Patients Who Underwent Colorectal Emergency Surgery: Nam Ho Oh, Kyung Jong Kim; Ann Coloproctol. 2016;32(4):133-138. Published online August 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.4.133

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14 Web of Science
11 Citations

Abstract PDF

Purpose

Emergency colorectal surgery has a high risk of mortality and morbidity because of incomplete bowel preparation, bacterial proliferation, and contamination. In this study, we investigated the outcomes and the risk factors affecting mortality in patients who had undergone emergency surgery for the treatment of various colorectal diseases.

Methods

This study is a retrospective analysis of prospectively collected data to survey the clinical results for patients who had undergone emergency colorectal surgery from January 2014 to December 2014. We analyzed various clinicopathologic factors, which were divided into 3 categories: preoperative, intraoperative, and postoperative.

Results

A total of 50 patients had undergone emergency colorectal surgery during the time period covered by this study. Among them, 10 patients (20%) died during the postoperative period. A simple linear regression analysis showed that the risk factors for mortality were old age, preoperative hypotension, and a high American Society of Anesthesiologist (ASA) score. Moreover, a multiple linear regression analysis showed a high ASA score and preoperative hypotension to be independent risk factors.

Conclusion

In this study, emergency colorectal surgery showed a relatively high mortality rate. Furthermore, the independent risk factors for mortality were preoperative hypotension and high ASA score; thus, patients with these characteristics need to be evaluated more carefully and receive better care if the mortality rate is to be reduced.

Citations

Citations to this article as recorded by

Impact of Surgeon Specialization on Outcomes in Emergency Colorectal Surgery: A Systematic Review and Meta-analysis
Zachary Bunjo, Luke Traeger, Ishraq Murshed, Sergei Bedrikovetski, Nagendra N. Dudi-Venkata, Christopher Dobbins, Tarik Sammour
Diseases of the Colon & Rectum.2025; 68(1): 14. CrossRef
Postoperative hypotension following acute hip fracture surgery is a predictor of 30-day mortality
Neil Donald, Grace Eniola, Krisztian Deierl
The Bone & Joint Journal.2024; 106-B(2): 189. CrossRef
Emergent colectomy for colorectal cancer: A comparative analysis of open vs. minimally invasive approach
Hunter Jecius, Muhammad Khurrum, Erika Krall, Dynnika Tso, Afang Pefok, Ryan Silva, Emily Wusterbarth, Hina Arif, Mohammad Hamidi, Valentine Nfonsam
The American Journal of Surgery.2023; 225(4): 724. CrossRef
Surgical outcomes and prognostic factors associated with emergency left colonic surgery
Dauda Bawa, Yasser Mohammad Khalifa, Saleem Khan, Waddah Norah, Nibras Noman
Annals of Saudi Medicine.2023; 43(2): 97. CrossRef
Development and Evaluation of a Risk-Adjusted Measure of Intraoperative Hypotension in Patients Having Nonemergent, Noncardiac Surgery
Anna L. Christensen, Ethan Jacobs, Kamal Maheshwari, Fei Xing, Xiaohong Zhao, Samuel E. Simon, Karen B. Domino, Karen L. Posner, Alvin F. Stewart, Joseph A. Sanford, Daniel I. Sessler
Anesthesia & Analgesia.2021; 133(2): 445. CrossRef
Prediction of functional loss in emergency surgery is possible with a simple frailty screening tool
Davide Zattoni, Isacco Montroni, Nicole Marie Saur, Anna Garutti, Maria Letizia Bacchi Reggiani, Federico Ghignone, Giovanni Taffurelli, Giampaolo Ugolini
World Journal of Emergency Surgery.2021;[Epub] CrossRef
Fluid management for critical patients undergoing urgent colectomy
Fabian Grass, Basile Pache, Fabio Butti, Josep Solà, Dieter Hahnloser, Nicolas Demartines, Martin Hübner
Journal of Evaluation in Clinical Practice.2020; 26(1): 109. CrossRef
Procalcitonin as an early marker in the detection of anastomotic intestinal leak in a Universitary Hospital of Bogotá
Elkin Eduardo Benítez Navarrete, Tatiana Carolina Beltrán-García, María Fernanda Mosquera, Valeria Martinez Rojas, Daniel Alejandro Buitrago Medina, Carlos Edgar Figueroa Avendaño
Journal of Coloproctology.2020; 40(04): 376. CrossRef
Association of intra‐operative hypotension with acute kidney injury, myocardial injury and mortality in non‐cardiac surgery: A meta‐analysis
Ran An, Qian-Yun Pang, Hong‐Liang Liu
International Journal of Clinical Practice.2019;[Epub] CrossRef
Emergency Surgery Mortality (ESM) Score to Predict Mortality and Improve Patient Care in Emergency Surgery
Sirirat Tribuddharat, Thepakorn Sathitkarnmanee, Pavit Sappayanon
Anesthesiology Research and Practice.2019; 2019: 1. CrossRef
Emergent Colorectal Surgery: What Should Be Considered?
Chang-Nam Kim
Annals of Coloproctology.2016; 32(4): 124. CrossRef

Influence of Shorter Duration of Prophylactic Antibiotic Use on the Incidence of Surgical Site Infection Following Colorectal Cancer Surgery: Youn Young Park, Chang Woo Kim, Sun Jin Park, Kil Yeon Lee, Jung Joo Lee, Hye Ok Lee, Suk-Hwan Lee; Ann Coloproctol. 2015;31(6):235-242. Published online December 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.6.235

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15 Web of Science
16 Citations

Abstract PDF

Purpose

This study aimed to identify the risk factors for surgical site infections (SSIs) in patients undergoing colorectal cancer surgery and to determine whether significantly different SSI rates existed between the short prophylactic antibiotic use group (within 24 hours) and the long prophylactic antibiotic use group (beyond 24 hours).

Methods

The medical records of 327 patients who underwent colorectal resection due to colorectal cancer from January 2010 to May 2014 at a single center were retrospectively reviewed, and their characteristics as well as the surgical factors known to be risk factors for SSIs, were identified.

Results

Among the 327 patients, 45 patients (13.8%) developed SSIs. The patients were divided into two groups according to the duration of antibiotic use: group S (within 24 hours) and group L (beyond 24 hours). Of the 327 patients, 114 (34.9%) were in group S, and 213 (65.1%) were in group L. Twelve patients (10.5%) in group S developed SSIs while 33 patients (15.5%) in group L developed SSIs (P = 0.242). History of diabetes mellitus and lung disease, long operation time, and perioperative transfusion were independent risk factors for SSIs.

Conclusion

This study shows that discontinuation of prophylactic antibiotics within 24 hours after colorectal surgery has no significant influence on the incidence of SSIs. This study also showed that history of diabetes mellitus and lung disease, long operation time, and perioperative transfusion were associated with increased SSI rates.

Citations

Citations to this article as recorded by

RETRACTED: A meta‐analysis of the risk factors for surgical site infection in patients with colorectal cancer
Yani Chen, Hua Guo, Tian Gao, Jiale Yu, Yujia Wang, Haiquan Yu
International Wound Journal.2024;[Epub] CrossRef
Evaluation after implementation of chemical bowel preparation for surgical site infections in elective colorectal cancer surgery and role of antimicrobial stewardship pharmacist: Retrospective cohort study
Yasuhiro Sasaki, Akira Kurishima, Chieko Miyamoto, Kenichiro Hataji, Toru Tezuka, Hideo Katsuragawa
Journal of Pharmaceutical Health Care and Sciences.2024;[Epub] CrossRef
Antibiotic use during radical surgery in stage I-III colorectal cancer: correlation with outcomes?
Mingyue Xu, Yuanyuan Chen, Panhua Li, Qianwen Ye, Shouhan Feng, Bing Yan
BMC Cancer.2024;[Epub] CrossRef
Surgical Site Infections in Colorectal Cancer Surgeries: A Systematic Review and Meta-Analysis of the Impact of Surgical Approach and Associated Risk Factors
Valentin Calu, Catalin Piriianu, Adrian Miron, Valentin Titus Grigorean
Life.2024; 14(7): 850. CrossRef
Potent antibacterial activity in surgical wounds with local administration of D-PLEX100
Noam Emanuel, Goldi A. Kozloski, Shlomo Nedvetzki, Sefi Rosenfeld
European Journal of Pharmaceutical Sciences.2023; 188: 106504. CrossRef
Worldwide incidence of surgical site infections in general surgical patients: A systematic review and meta-analysis of 488,594 patients
Brigid M. Gillespie, Emma Harbeck, Megan Rattray, Rhea Liang, Rachel Walker, Sharon Latimer, Lukman Thalib, Annette Erichsen Andersson, Bronwyn Griffin, Robert Ware, Wendy Chaboyer
International Journal of Surgery.2021; 95: 106136. CrossRef
Risk factors for surgical site infection in patients undergoing colorectal surgery: A meta-analysis of observational studies
ZhaoHui Xu, Hui Qu, ZeZhong Gong, George Kanani, Fan Zhang, YanYing Ren, Shuai Shao, XiaoLiang Chen, Xin Chen, Zubing Mei
PLOS ONE.2021; 16(10): e0259107. CrossRef
Update on risk factors of surgical site infection in colorectal cancer: a systematic review and meta-analysis
Zhaohui Xu, Hui Qu, George Kanani, Zhong Guo, Yanying Ren, Xin Chen
International Journal of Colorectal Disease.2020; 35(12): 2147. CrossRef
Appropriate Prophylactic Antibiotic Use in Clean Wound Surgery Under Local Anesthesia
Han Gyu Cha, Jin Geun Kwon, Hyun Ho Han, Jin Sup Eom, Eun Key Kim
Journal of Korean Medical Science.2019;[Epub] CrossRef
Patterns of antibiotics and pathogens for anastomotic leakage after colorectal cancer surgery
Geunhyeok Yang, Chang Woo Kim, Suk-Hwan Lee
Korean Journal of Clinical Oncology.2019; 15(2): 79. CrossRef
Challenging surgical dogma in the management of proximal esophageal atresia with distal tracheoesophageal fistula: Outcomes from the Midwest Pediatric Surgery Consortium
Dave R. Lal, Samir K. Gadepalli, Cynthia D. Downard, Daniel J. Ostlie, Peter C. Minneci, Ruth M. Swedler, Thomas H. Chelius, Laura Cassidy, Cooper T. Rapp, Deborah Billmire, Steven Bruch, R. Carland Burns, Katherine J. Deans, Mary E. Fallat, Jason D. Fras
Journal of Pediatric Surgery.2018; 53(7): 1267. CrossRef
Comparison of intraoperative handling and wound healing between (NEOSORB® plus) and coated polyglactin 910 suture (NEOSORB®): a prospective, single-blind, randomized controlled trial
Bum Sik Tae, Ju Hyun Park, Jung Kwon Kim, Ja Hyeon Ku, Cheol Kwak, Hyeon Hoe Kim, Chang Wook Jeong
BMC Surgery.2018;[Epub] CrossRef
Impact of a change in duration of prophylactic antibiotics on infectious complications after radical cystectomy with a neobladder
Chung-Jong Kim, Kwang Hyun Kim, Wan Song, Dong Hyeon Lee, Hee Jung Choi
Medicine.2018; 97(47): e13196. CrossRef
Colorectal surgery and surgical site infection: is a change of attitude necessary?
Manuela Elia-Guedea, Elena Cordoba-Diaz de Laspra, Estibaliz Echazarreta-Gallego, María Isabel Valero-Lazaro, Jose Manuel Ramirez-Rodriguez, Vicente Aguilella-Diago
International Journal of Colorectal Disease.2017; 32(7): 967. CrossRef
Influence of a Shorter Duration of Post-Operative Antibiotic Prophylaxis on Infectious Complications in Patients Undergoing Elective Liver Resection
Masahiko Sakoda, Satoshi Iino, Yuko Mataki, Yota Kawasaki, Hiroshi Kurahara, Kosei Maemura, Shinichi Ueno, Shoji Natsugoe
Surgical Infections.2017; 18(2): 149. CrossRef
Efforts to Prevent Surgical Site Infection After Colorectal Surgery
Byung Wook Min
Annals of Coloproctology.2015; 31(6): 211. CrossRef

Assessment by Using a Water-Soluble Contrast Enema Study of Radiologic Leakage in Lower Rectal Cancer Patients With Sphincter-Saving Surgery: Seok In Seo, Jong Lyul Lee, Seong Ho Park, Hyun Kwon Ha, Jin Cheon Kim; Ann Coloproctol. 2015;31(4):131-137. Published online August 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.4.131

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11 Citations

Abstract PDF

Purpose

This study evaluated the efficacy of a water-soluble contrast enema (WCE) in predicting anastomotic healing after a low anterior resection (LAR).

Methods

Between January 2000 and March 2012, 682 consecutive patients underwent a LAR or an ultra-low anterior resection (uLAR) and were followed up for leakage. Clinical leakage was established by using physical and laboratory findings. Radiologic leakage was identified by using retrograde WCE imaging. Abnormal radiologic features on WCE were categorized into four types based on morphology: namely, dendritic, horny, saccular, and serpentine.

Results

Of the 126 patients who received a concurrent diverting stoma, only two (1.6%) suffered clinical leakage due to pelvic abscess. However, 37 patients (6.7%) in the other group suffered clinical leakage following fecal diversion (P = 0.027). Among the 163 patients who received a fecal diversion, 20 showed radiologic leakage on the first WCE (eight with and 12 without a concurrent diversion); 16 had abnormal features continuously until the final WCE while four patients healed spontaneously. Eleven of the 16 patients (69%), by their surgeon's decision, underwent a stoma restoration based on clinical findings (2/3 dendritic, 3/4 horny, 5/7 saccular, 1/2 serpentine). After stoma reversal, only 2 of the 11 (19%) complained of complications related to the rectal anastomosis.

Conclusion

WCE is helpful for detecting radiologic leakage before stoma restoration, especially in patients suffering clinical leakage after an uLAR. However, surgeons appear to opt for stoma restoration despite the persistent existence of radiologic leakage in cases with particular features on the WCE.

Citations

Citations to this article as recorded by

Preoperative anastomotic evaluation prior to ileostomy closure: A 5‐year UK survey, systematic review, and meta‐analysis
D. Atraszkiewicz, T. Shakir, C. Harrington, P. Bassett, B. Soile, H. Mukhtar
Colorectal Disease.2025;[Epub] CrossRef
Technical considerations in stoma reversal
Reece K. DeHaan, Jeremy Lipman
Seminars in Colon and Rectal Surgery.2023; 34(2): 100957. CrossRef
Pictorial review: radiological diagnosis of anastomotic leakage with water-soluble contrast enema after anterior resection of the rectum
Piero Boraschi, Gaia Tarantini, Giuseppe Mercogliano, Luigi Giugliano, Francescamaria Donati
Japanese Journal of Radiology.2022; 40(12): 1235. CrossRef
Flexible endoscopy is enough diagnostic prior to loop ileostomy reversal
S. Lindner, K. von Rudno, J. Gawlitza, J. Hardt, F. Sandra-Petrescu, S. Seyfried, P. Kienle, C. Reissfelder, A. Bogner, F. Herrle
International Journal of Colorectal Disease.2021; 36(2): 413. CrossRef
Out of the Loop: The Value of a Preoperative Loopogram for Colostomy Reversal in Trauma
Nolitha Makapi Tisetso Morare, Meshack Nkosinaye Motha, Maeyane Stephens Moeng
World Journal of Surgery.2021; 45(7): 2009. CrossRef
Less is more—the best test for anastomotic leaks in rectal cancer patients prior to ileostomy reversal
Simon Lindner, Steffen Eitelbuss, Svetlana Hetjens, Joshua Gawlitza, Julia Hardt, Steffen Seyfried, Christian Galata, Christoph Reissfelder, Flavius Sandra-Petrescu, Florian Herrle
International Journal of Colorectal Disease.2021; 36(11): 2387. CrossRef
Radiological findings in anastomotic leakage after anterior resection may predict a permanent stoma
Henrik Jutesten, Marie-Louise Lydrup, Axel Landberg, Daniel Risberg, Olle Ekberg, Sophia Zackrisson, Pamela Buchwald
Acta Radiologica Open.2020;[Epub] CrossRef
Are radiologic pouchogram and pouchoscopy useful before ileostomy closure in asymptomatic patients operated for ulcerative colitis?
Georgios Exarchos, Linda Metaxa, Antonios Gklavas, Vassilis Koutoulidis, Ioannis Papaconstantinou
European Radiology.2019; 29(4): 1754. CrossRef
Surgical specimen extraction via a prophylactic ileostomy procedure: A minimally invasive technique for laparoscopic rectal cancer surgery
Peng Wang, Jian-Wei Liang, Hai-Tao Zhou, Zheng Wang, Zhi-Xiang Zhou
World Journal of Gastroenterology.2018; 24(1): 104. CrossRef
Imaging of the Postoperative Colon
Eugene Huo, Laura Eisenmenger, Stefanie Weinstein
Radiologic Clinics of North America.2018; 56(5): 835. CrossRef
Should a Contrast Enema Be Performed Before Reversal of a Diverting Stoma in Lower Rectal Surgery?
Ji Yeon Kim
Annals of Coloproctology.2015; 31(4): 117. CrossRef

Enhancing the Enhanced Recovery Program in Colorectal Surgery - Use of Extended-Release Epidural Morphine (DepoDur®): Rajeev Peravali, Rachael Brock, Elizabeth Bright, Patricia Mills, Dawn Petty, Justin Alberts; Ann Coloproctol. 2014;30(4):186-191. Published online August 26, 2014; DOI: https://doi.org/10.3393/ac.2014.30.4.186

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12 Web of Science
12 Citations

Abstract PDF

Purpose

DepoDur® is a single-dose extended-release morphine injection into the epidural space. It is not commonly used, but has many advantages over traditional analgesic regimens. We analyzed a number of these advantages in our case series in the context of the colorectal enhanced recovery program (ERP) and aimed to show that the ERP could be further enhanced by using DepoDur®.

Methods

We conducted a prospective audit of all patients undergoing open and laparoscopic colorectal procedures where DepoDur® was used between July 2010 and April 2012. Validated pain scores were used, and primary outcome measures were resting and dynamic pain, mobilization, and need for additional analgesia.

Results

Two hundred eighty patients were included in the case series. Good pain control was seen at 24 and 48 hours. Eighty-one percent of the patients required simple analgesia alone at 24 hours, and 62% required simple analgesia (paracetamol +/- nonsteroidal anti-inflammatory drugs) alone at 48 hours. Only a minority required additional oramorph and patient-controlled analgesia at 24 and 48 hours (19% at 24 hours and 38% at 48 hours). Seventy-nine percent of the patients were mobilized at 24 hours, and 88% of the patients were mobilized at 48 hours.

Conclusion

DepoDur® is an effective alternative to conventional pain management techniques and may have a role in further enhancing the ERP.

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Soraya Babaie, Arezou Taghvimi, Joo-Hyun Hong, Hamed Hamishehkar, Seongpil An, Ki Hyun Kim
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Application of Nanocarrier in Drug development with special Emphasis on Liposomes: A Review
Anshul Sharma, Keshav Dhiman, Anshul Sharma, Kamya Goyal, Vinay Pandit, M. S. Ashawat, Shammy Jindal
Asian Journal of Pharmacy and Technology.2022; : 320. CrossRef
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Pooria Nakhaei, Ria Margiana, Dmitry O. Bokov, Walid Kamal Abdelbasset, Mohammad Amin Jadidi Kouhbanani, Rajender S. Varma, Faroogh Marofi, Mostafa Jarahian, Nasrin Beheshtkhoo
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Endogenous Opiates and Behavior: 2015
Richard J. Bodnar
Peptides.2017; 88: 126. CrossRef
Protocol for a multicentre, prospective, observational cohort study of variation in practice in perioperative analgesic strategies in elective laparoscopic colorectal surgery: the LapCoGesic Study
Phillippa Burnell, Rachael Coates, Steven Dixon, Lucy Grant, Matthew Grey, Ben Griffiths, Mike Jones, Anantha Madhavan, Iain McCallum, Ross McClean, Karen Naru, Lydia Newton, Paul O'Loughlin, Fadlo Shaban, Anisha Sukha, Sameer Somnath, Syed Shumon, Deena
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Best Practice in the Administration of Analgesia in Postoncological Surgery
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Clinical Translation of Nanomedicine
Yuanzeng Min, Joseph M. Caster, Michael J. Eblan, Andrew Z. Wang
Chemical Reviews.2015; 115(19): 11147. CrossRef
Epidural Injection of Extended-Release Morphine During Colorectal Surgery
Sung-Bum Kang
Annals of Coloproctology.2014; 30(4): 159. CrossRef

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