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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
  • 454 View
  • 24 Download
AbstractAbstract 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.
Minimally invasive surgery
Propensity score–matched comparison of robot-assisted rectal cancer surgery using hinotori and da Vinci
Hidetoshi Katsuno, Koji Morohara, Tomoyoshi Endo, Kenji Kikuchi, Kenichi Nakamura, Kazuhiro Matsuo, Takahiko Higashiguchi, Tetsuya Koide, Hiromi Kanai, Satoshi Arakawa, Tsunekazu Hanai, Zenichi Morise
Ann Coloproctol. 2025;41(4):310-318.   Published online August 25, 2025
DOI: https://doi.org/10.3393/ac.2025.00136.0019
  • 2,681 View
  • 45 Download
  • 1 Web of Science
  • 1 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Purpose
The hinotori Surgical Robot System (hereafter “hinotori”) is a novel platform for robot-assisted surgery, while the da Vinci Surgical System (“da Vinci”) remains the field standard. This study compared short-term surgical outcomes of rectal cancer surgery between these systems using propensity score–matched analysis.
Methods
A retrospective analysis was conducted of 209 consecutive patients who underwent robot-assisted surgery with the da Vinci and 58 patients with the hinotori system. After 2:1 propensity score matching, 108 da Vinci and 54 hinotori cases were included. Surgical outcomes, including operative time, blood loss, postoperative complications, length of hospital stay, and pathological findings, were compared.
Results
After matching, the baseline demographics were well balanced between groups. The hinotori system was associated with significantly longer operative time (266 minutes vs. 227 minutes, P=0.014) and console time (156 minutes vs. 110 minutes, P=0.001). However, estimated blood loss and postoperative complication rate did not differ significantly. Pathological findings, including the number of lymph nodes retrieved and the incidence of positive surgical margins, were comparable between systems.
Conclusion
In rectal surgery, the hinotori system demonstrates comparable short-term safety outcomes to da Vinci. Despite longer operative times and limited integrated instrumentation, hinotori‐assisted procedures may be feasible in selected patients. Further research should address long-term oncological outcomes and strategies to improve procedural efficiency.

Citations

Citations to this article as recorded by  
  • Racing toward the future of robot-assisted rectal cancer surgery: a comparative study of hinotori and da Vinci
    Sung Uk Bae
    Annals of Coloproctology.2025; 41(4): 259.     CrossRef
CRC
Impact of iron-deficiency anemia on short-term outcomes after resection of colorectal cancer liver metastasis: a US National (Nationwide) Inpatient Sample (NIS) analysis
Ko-Chao Lee, Yu-Li Su, Kuen-Lin Wu, Kung-Chuan Cheng, Ling-Chiao Song, Chien-En Tang, Hong-Hwa Chen, Kuan-Chih Chung
Ann Coloproctol. 2025;41(2):119-126.   Published online April 24, 2025
DOI: https://doi.org/10.3393/ac.2024.00591.0084
  • 3,752 View
  • 91 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDFSupplementary Material
Purpose
Colorectal cancer (CRC) often spreads to the liver, necessitating surgical treatment for CRC liver metastasis (CRLM). Iron-deficiency anemia is common in CRC patients and is associated with fatigue and weakness. This study investigated the effects of iron-deficiency anemia on the outcomes of surgical resection of CRLM.
Methods
This population-based, retrospective study evaluated data from adults ≥20 years old with CRLM who underwent hepatic resection. All patient data were extracted from the 2005–2018 US National (Nationwide) Inpatient Sample (NIS) database. The outcome measures were in-hospital outcomes including 30-day mortality, unfavorable discharge, and prolonged length of hospital stay (LOS), and short-term complications such as bleeding and infection. Associations between iron-deficiency anemia and outcomes were determined using logistic regression analysis.
Results
Data from 7,749 patients (representing 37,923 persons in the United States after weighting) were analyzed. Multivariable analysis revealed that iron-deficiency anemia was significantly associated with an increased risk of prolonged LOS (adjusted odds ratio [aOR], 2.76; 95% confidence interval [CI], 2.30–3.30), unfavorable discharge (aOR, 2.42; 95% CI, 1.83–3.19), bleeding (aOR, 5.05; 95% CI, 2.92–8.74), sepsis (aOR, 1.60; 95% CI, 1.04–2.46), pneumonia (aOR, 2.54; 95% CI, 1.72–3.74), and acute kidney injury (aOR, 1.71; 95% CI, 1.24–2.35). Subgroup analyses revealed consistent associations between iron-deficiency anemia and prolonged LOS across age, sex, and obesity status categories.
Conclusion
In patients undergoing hepatic resection for CRLM, iron-deficiency anemia is an independent risk factor for prolonged LOS, unfavorable discharge, and several critical postoperative complications. These findings underscore the need for proactive anemia management to optimize surgical outcomes.

Citations

Citations to this article as recorded by  
  • A commentary on “Individualized blood pressure regulation and acute kidney injury in older patients having major abdominal surgery: a pilot randomized trial”
    Fu-Shan Xue, Dan-Feng Wang, Xiao-Chun Zheng
    International Journal of Surgery.2025; 111(12): 9993.     CrossRef
Anorectal benign disease
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, Luana Passariello, Pasquale Talento, Giovanna Ioia, Corrado Rispoli, Mariano Fortunato Armellino, Vincenzo Bottino, Adolfo Renzi, Carlo Bartone, Luigi Monaco, Paolino Mauro, Stefano Picardi, Maria Paola Menna, Elisa Palladino, Mario Massimo Mensorio, Vinicio Mosca, Claudio Gambardella, Luigi Brusciano, Ludovico Docimo
Ann Coloproctol. 2024;40(6):602-609.   Published online December 30, 2024
DOI: https://doi.org/10.3393/ac.2024.00570.0081
  • 6,596 View
  • 116 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDF
Purpose
Postoperative pain is a major concern for patients undergoing ultrasound scalpel-assisted hemorrhoidectomy, potentially exacerbated by delayed wound healing. This study aimed to evaluate the impact of an intimate cleansing gel containing chlorhexidine, hyaluronic acid, and other anti-inflammatory agents (Antroclean Fisioderm) on postoperative pain, itching, and wound healing in patients who had undergone this procedure.
Methods
This multicenter observational case-control study involved a cohort of consecutive adult patients who underwent hemorrhoidectomy using an ultrasound device. The study compared 2 different postoperative wound management strategies over 1 month after surgery: washing with warm water twice per day (control group) versus a 2-minute topical application of intimate cleansing gel (Antroclean Fisioderm) followed by a warm water wash (intervention group).
Results
The median postoperative pain score was significantly lower in the intervention group than in the control group at each follow-up point (P<0.01). The percentage of patients reporting anal itching was also significantly lower in the intervention group than in the control group at each follow-up point (P<0.01). All patients in the intervention group achieved complete wound healing 4 weeks after surgery, compared to 88 (82%) in the control group (P<0.01). No adverse events were reported.
Conclusion
The topical application of intimate cleansing gel (Antroclean Fisioderm) twice daily for 1 month following ultrasound scalpel-assisted hemorrhoidectomy appears to be associated with faster healing, reduced pain, decreased itching, and improved quality of life, without any adverse effects. Further larger and prospective randomized trials are recommended to confirm these findings.

Citations

Citations to this article as recorded by  
  • Enhancing Proctological Outcomes: The Role of Hyaluronic Acid in Hemorrhoid Care – An Innovative Adjunct to Surgery
    Riddhi Upadhyay, Akshat Vadaliya, Haryax V. Pathak, Soham Upadhyay
    Journal of Coloproctology.2025; 45(03): 001.     CrossRef
ERAS
Impact of an Enhanced Recovery After Surgery (ERAS) program on the management of complications after laparoscopic or robotic colectomy for cancer
Victoria Weets, Hélène Meillat, Jacques Emmanuel Saadoun, Marie Dazza, Cécile de Chaisemartin, Bernard Lelong
Ann Coloproctol. 2024;40(5):440-450.   Published online September 20, 2024
DOI: https://doi.org/10.3393/ac.2023.00850.0121
  • 10,171 View
  • 228 Download
  • 3 Web of Science
  • 4 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Purpose
Enhanced Recovery After Surgery (ERAS) reduces postoperative complications (POCs) after colorectal surgery; however, its impact on the management of POCs remains unclear. This study compared the diagnosis and management of POCs before and after implementing our ERAS protocol after laparoscopic or robotic colectomy for cancer and examined the short- and mid-term oncologic impacts.
Methods
This single-center, retrospective study evaluated all consecutive patients who underwent laparoscopic or robotic colectomy for cancer between 2012 and 2021, focusing on the incidence of POCs within 90 days. We compared outcomes before (standard group) and after (ERAS group) the implementation of our ERAS protocol in January 2016.
Results
Significantly fewer patients in the ERAS group developed POCs (standard vs. ERAS, 136 of 380 patients [35.8%] vs.136 of 660 patients [20.6%]; P<0.01). The ERAS group had a significantly shorter mean total length of stay after POCs (13.1 days vs. 11.4 days, P=0.04), and the rates of life-threatening complications (6.7% vs. 0.7%) and 1-year mortality (7.4% vs. 1.5%) were significantly lower in the ERAS group than in the standard group. Among patients with anastomotic complications, laparoscopic reoperation was significantly more common in the ERAS group than in the standard group (8.3% vs. 75.0%, P<0.01). Among patients with postoperative ileus, the diagnosis and recovery times were significantly shorter in the ERAS group than in the standard group, resulting in a shorter total length of stay (13.5 days vs. 10 days, P<0.01).
Conclusion
The implementation of an ERAS protocol did not eliminate all POCs, but it did accelerate their diagnosis and management and improved patient outcomes.

Citations

Citations to this article as recorded by  
  • Less is more: simplifying patient-centered cancer care
    In Ja Park
    Annals of Coloproctology.2025; 41(3): 173.     CrossRef
  • Research Progress on the Application of ERAS Concept in the Perioperative Period of Colorectal Cancer Patients
    梦云 孙
    Advances in Clinical Medicine.2025; 15(08): 1208.     CrossRef
  • Can Surgical Approach and Postoperative Factors Impact Survival in Rectal Cancer? Robotic Versus Laparoscopic Insights
    Ahmed Abdelsamad, Seyidali Mirzazada, Karsten Ridwelski, Mohamad Nour Nasif, Florian Gebauer
    Cancer Medicine.2025;[Epub]     CrossRef
  • Optimizing postoperative pain management in minimally invasive colorectal surgery
    Soo Young Lee
    Annals of Coloproctology.2024; 40(6): 525.     CrossRef
Anorectal benign disease
Immediate sphincter repair following fistulotomy for anal fistula: does it impact the healing rate and septic complications?
Maher A. Abbas, Anna T. Tsay, Mohammad Abbass
Ann Coloproctol. 2024;40(3):217-224.   Published online June 28, 2024
DOI: https://doi.org/10.3393/ac.2022.01144.0163
  • 11,642 View
  • 285 Download
  • 4 Web of Science
  • 6 Citations
AbstractAbstract PDF
Purpose
Fistulotomy is considered the most effective treatment for anal fistula; however, it carries a risk of incontinence. Sphincteroplasty in the setting of fistulotomy is not standard practice due to concerns regarding healing and potential infectious complications. We aimed to compare the outcomes of patients who underwent fistulotomy with primary sphincteroplasty to those who did not undergo repair.
Methods
This was a retrospective review of consecutive patients who underwent fistulotomy for cryptoglandular anal fistula. All operations were performed by one colorectal surgeon. Sphincteroplasty was performed for patients perceived to be at higher risk for continence disturbance. The main outcome measures were the healing rate and postoperative septic complications.
Results
In total, 152 patients were analyzed. Group A (fistulotomy with sphincteroplasty) consisted of 45 patients and group B (fistulotomy alone) included 107 patients. Both groups were similar in age (P=0.16) and sex (P=0.20). Group A had higher proportions of multiple fistulas (26.7% vs. 6.5%, P<0.01) and complex fistulas (mid to high transsphincteric, 37.8% vs. 10.3%; P<0.01) than group B. The median follow-up time was 8 weeks. The overall healing rate was similar in both groups (93.3% vs. 90.6%, P=0.76). No significant difference between the 2 groups was noted in septic complications (6.7% vs. 3.7%, P=0.42).
Conclusion
Fistulotomy with primary sphincter repair demonstrated a comparable healing rate to fistulotomy alone, without an increased risk of postoperative septic complications. Further prospective randomized studies are needed to confirm these findings and to explore the functional outcomes of patients who undergo sphincteroplasty.

Citations

Citations to this article as recorded by  
  • Is Primary Opening of Fistula-in-Ano Always at Dentate Line: Correlation Between MRI and Operative Findings in 379 Patients
    Pankaj Garg, Gabriele Naldini, Vincent De Parades, Petr Tsarkov, Vipul Yagnik, Kaushik Bhattacharya, Baljit Kaur, G Mahak
    Clinical and Experimental Gastroenterology.2025; Volume 18: 121.     CrossRef
  • Clinical outcome of fistulectomy with partial sphincter preservation in complex fistula-in-ano in a tertiary hospital of Bangladesh
    Jalal Ahmed, M. Meher Ullah, Asif Aman, Satya Ranjan Mondal, Sabrina Akhter Qurashi, Golam Mustafa, Ahsan Habib, Imtiaz Faruk
    International Surgery Journal.2025; 12(7): 1131.     CrossRef
  • Sequential Surgical Management of a Recurrent Complex Transsphincteric Anal Fistula With Sphincter Disruption: A Case Report
    Diego Pérez-Valdez, Alfredo Sinahi Abarca-Magallón, Samuel Hernández-Alvarado, Daniel Castañeda-Rodríguez, Daniel Alejandro Valdivieso-Siguenza
    Cureus.2025;[Epub]     CrossRef
  • Enhanced surgical management of complex anal fistulas via integrated traditional Chinese medicine: A retrospective cohort study
    Ji-Feng Liu, Yu Wang, Xue-Song Peng, Qing-Long Li
    World Journal of Gastrointestinal Surgery.2025;[Epub]     CrossRef
  • Efficacy of recombinant bovine basic fibroblast growth factor gel combined with compound polymyxin B ointment on wound healing after fistulotomy
    Qing Long, Yan Li
    Medicine.2025; 104(50): e46473.     CrossRef
  • Achieving a high cure rate in complex anal fistulas: understanding the conceptual role of the Garg cardinal principles
    Pankaj Garg, Nicola Clemente, James C. W. Khaw
    Annals of Coloproctology.2024; 40(5): 521.     CrossRef
Colorectal cancer
Long-term bowel functional outcomes following anal sphincter-preserving surgery for upper and middle rectal cancer: a single-center longitudinal study
Ahmad Sakr, Seung Yoon Yang, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim
Ann Coloproctol. 2024;40(1):27-35.   Published online February 28, 2024
DOI: https://doi.org/10.3393/ac.2022.01067.0152
  • 5,429 View
  • 207 Download
  • 3 Web of Science
  • 3 Citations
AbstractAbstract PDF
Purpose
Despite advances in neoadjuvant chemoradiotherapy and anal sphincter-preserving surgery for rectal cancer, bowel dysfunction is still unavoidable and negatively affects patients’ quality of life. In this longitudinal study, we aimed to investigate the changes in bowel function with follow-up time and the effect of neoadjuvant chemoradiotherapy on bowel function following low anterior resection for rectal cancer.
Methods
In this study, 171 patients with upper or middle rectal cancer who underwent low anterior resection between 2012 and 2018 were included. Bowel function was assessed longitudinally with Memorial Sloan Kettering Cancer Center Bowel Function Instrument and Wexner scores every 6 months after restoration of bowel continuity. Patients with at least 2 follow-up visits were included.
Results
Overall, 100 patients received neoadjuvant chemoradiotherapy. Urgency, soilage, and fecal incontinence were noted within 24 months in the patients treated with neoadjuvant chemoradiotherapy. After 2 years of follow-up, significant bowel dysfunction and fecal incontinence were observed in the neoadjuvant chemoradiotherapy group. Low tumor level and neoadjuvant chemoradiotherapy were associated with delayed bowel dysfunction.
Conclusion
Neoadjuvant chemoradiotherapy in combination with low tumor level was significantly associated with delayed bowel dysfunction even after 2 years of follow-up. Therefore, careful selection and discussion with patients are paramount.

Citations

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  • Funktionelle Folgen von Radiotherapie, Chemotherapie und Operation bei der Behandlung des Rektumkarzinoms
    Philipp Rhode, Matthias Mehdorn, Undine Gabriele Lange, Sebastian Murad Rabe, Johannes Quart, Robert Nowotny, Patrick Sven Plum, Stefan Niebisch, Sigmar Stelzner
    Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie.2025; 150(04): 353.     CrossRef
  • Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-Center Retrospective Analysis
    Jae Seung Kim, Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
    Cancers.2024; 16(24): 4280.     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
Technical Note
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
  • 4,206 View
  • 214 Download
  • 1 Citations
AbstractAbstract PDF
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

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  • 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
Original Articles
Stoma
Protective loop ileostomy or colostomy? A risk evaluation of all common complications
Yi-Wen Yang, Sheng-Chieh Huang, Hou-Hsuan Cheng, Shih-Ching Chang, Jeng-Kai Jiang, Huann-Sheng Wang, Chun-Chi Lin, Hung-Hsin Lin, Yuan-Tzu Lan
Ann Coloproctol. 2024;40(6):580-587.   Published online January 27, 2023
DOI: https://doi.org/10.3393/ac.2022.00710.0101
  • 9,944 View
  • 284 Download
  • 5 Web of Science
  • 7 Citations
AbstractAbstract PDF
Purpose
Protective ileostomy and colostomy are performed in patients undergoing low anterior resection with a high leakage risk. We aimed to compare surgical, medical, and daily care complications between these 2 ostomies in order to make individual choice.
Methods
Patients who underwent low anterior resection for rectal tumors with protective stomas between January 2011 and September 2018 were enrolled. Stoma-related complications were prospectively recorded by wound, ostomy, and continence nurses. The cancer stage and treatment data were obtained from the Taiwan Cancer Database of our Big Data Center. Other demographic data were collected retrospectively from medical notes. The complications after stoma creation and after the stoma reversal were compared.
Results
There were 176 patients with protective colostomy and 234 with protective ileostomy. Protective ileostomy had higher proportions of high output from the stoma for 2 consecutive days than protective colostomy (11.1% vs. 0%, P<0.001). Protective colostomy resulted in more stoma retraction than protective ileostomy (21.6% vs. 9.4%, P=0.001). Female, open operation, ileostomy, and carrying stoma more than 4 months were also significantly associated with a higher risk of stoma-related complications during diversion. For stoma retraction, the multivariate analysis revealed that female (odds ratio [OR], 4.00; 95% confidence interval [CI], 2.13–7.69; P<0.001) and long diversion duration (≥4 months; OR, 2.33; 95% CI, 1.22–4.43; P=0.010) were independent risk factors, but ileostomy was an independent favorable factor (OR, 0.40; 95% CI, 0.22–0.72; P=0.003). The incidence of complication after stoma reversal did not differ between colostomy group and ileostomy group (24.3% vs. 20.9%, P=0.542).
Conclusion
We suggest avoiding colostomy in patients who are female and potential prolonged diversion when stoma retraction is a concern. Otherwise, ileostomy should be avoided for patients with impaired renal function. Wise selection and flexibility are more important than using one type of stoma routinely.

Citations

Citations to this article as recorded by  
  • Gut microbiome and plasma metabolome alterations in ileostomy and after closure of ileostomy
    Liang Xu, Xiaolong Li, Lang Chen, Haitao Ma, Ying Wang, Wenwen Liu, Anyan Liao, Liang Tan, Xiao Gao, Weidong Xiao, Hua Yang, Guangyan Ji, Yuan Qiu, Wei-Hua Chen, Qin Liu, Song Liu, Yang Yang
    Microbiology Spectrum.2025;[Epub]     CrossRef
  • Effect of one-stitch method of temporary ileostomy on the surgical outcomes and complications after laparoscopic low anterior resection in rectal cancer patients: a propensity score matching analysis
    Xin-Peng Shu, Jia-Liang Wang, Zi-Wei Li, Fei Liu, Xu-Rui Liu, Lian-Shuo Li, Yue Tong, Xiao-Yu Liu, Chun-Yi Wang, Yong Cheng, Dong Peng
    European Journal of Medical Research.2025;[Epub]     CrossRef
  • The Differences in Postoperative Nursing Between Temporary Ileostomy and Temporary Colostomy: A Retrospective Cohort Study
    Mei Wang, Lihong Dai, Xia Fang, Yan Zheng, Yuanhao Shen, Yang Yu
    Nursing Open.2025;[Epub]     CrossRef
  • Preventive intestinal stoma: ileostomy, colostomy. Which option is safer? (meta-analysis and systematic review)
    Yu. A. Elfimova, R. I. Fayzulin, S. V. Chernyshov, E. G. Rybakov
    Koloproktologia.2025; 24(4): 152.     CrossRef
  • Uso de ileostomía derivativa en cáncer de ovario. Revisión de la literatura
    Franco Rafael Ruiz-Echeverría, Pedro Hernando Calderón-Quiroz, Juliana Rendón-Hernández
    Revista Colombiana de Cirugía.2024;[Epub]     CrossRef
  • Meta-analysis: loop ileostomy versus colostomy to prevent complications of anterior resection for rectal cancer
    Shilai Yang, Gang Tang, Yudi Zhang, Zhengqiang Wei, Donglin Du
    International Journal of Colorectal Disease.2024;[Epub]     CrossRef
  • The Role of Colon in Isolated Intestinal Transplantation: Description of 4 Cases
    Pierpaolo Di Cocco, Giulia Bencini, Alessandro Martinino, Egor Petrochenkov, Stepan Akshelyan, Kentaro Yoshikawa, Mario Spaggiari, Jorge Almario-Alvarez, Ivo Tzvetanov, Enrico Benedetti, Gaetano Gallo
    International Journal of Surgical Oncology.2024;[Epub]     CrossRef
Anorectal benign disease
The importance of compression time in stapled hemorrhoidopexy: is patience a virtue?
Byung Eun Yoo, Wook Ho Kang, Yong Teak Ko, Young Chan Lee, Cheong Ho Lim
Ann Coloproctol. 2024;40(2):176-181.   Published online December 20, 2022
DOI: https://doi.org/10.3393/ac.2022.00556.0079
  • 4,086 View
  • 149 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDF
Purpose
The aim of this study was to evaluate whether longer compression time before firing the stapler reduced the postoperative complications related to staple line formation in stapled hemorrhoidopexy.
Methods
This retrospective case-control study was conducted at a colorectal-anal specialty hospital. Consecutive patients with grades III and IV hemorrhoids who underwent stapled hemorrhoidopexy between January 2016 and November 2019 were included. According to the compression time, patients were assigned to the long compression time group (2 minutes) or the typical compression time group (30 seconds). The primary outcome measure was incidence of staple line complications such as dehiscence, bleeding, and stenosis.
Results
A total of 348 patients treated with stapled hemorrhoidopexy were evaluated. Seventy-three and 275 patients were included in the long compression time group and the typical compression time group, respectively. No significant differences were observed in patient characteristics between the groups. However, additional procedures were performed more frequently in the typical compression time group (78.1% vs. 92.0%, P=0.001). Bleeding occurred more frequently in the typical compression time group (1.4% vs. 8.4%, P=0.030). The rates of dehiscence and stenosis were not significantly different between the groups. Fecal urgency developed more frequently in the typical compression time group (0% vs. 5.1%, P=0.040). In logistic regression analysis, typical compression time (30 seconds) was the only risk factor for bleeding (odds ratio, 8.496; P=0.040).
Conclusion
Longer compression time was associated with a decreased incidence of postoperative bleeding after stapled hemorrhoidopexy.

Citations

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  • Latest Research Trends on the Management of Hemorrhoids
    Sung Il Kang
    Journal of the Anus, Rectum and Colon.2025; 9(2): 179.     CrossRef
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]
  • 6,603 View
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  • 3 Citations
AbstractAbstract 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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  • Tailgut Cyst—Gynecologist’s Pitfall: Literature Review and Case Report
    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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    Cesar A Barros de Sousa, Steven J Capece, Mikhail I Rakhmanine, John S Park
    Cureus.2025;[Epub]     CrossRef
  • Kraske Procedure: Oldie but Goodie
    Murat Sen, Ozgen Isik
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Malignant disease,Colorectal cancer,Complication,Biomarker & risk factor
Presepsin (soluble CD14 subtype) as a risk factor for the development of infectious and inflammatory complications in operated colorectal cancer patients
Kayrat Shakeyev, Yermek Turgunov, Alina Ogizbayeva, Olga Avdiyenko, Miras Mugazov, Sofiko Grigolashvili, Ilya Azizov
Ann Coloproctol. 2022;38(6):442-448.   Published online April 4, 2022
DOI: https://doi.org/10.3393/ac.2022.00115.0016
  • 5,399 View
  • 139 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDF
Purpose
In this pilot study the dynamic of presepsin (soluble CD14 subtype, sCD14-ST) in blood serum was assessed as a possible risk factor for the development of systemic inflammatory response syndrome (SIRS) and infectious and inflammatory complications in operated colorectal cancer patients.
Methods
To determine sCD14-ST by enzyme-linked immunosorbent assay method venous blood was taken 1 hour before surgery and 72 hours after it (3rd day). The presence of SIRS and organ dysfunctions (ODs) according to the Sequential Organ Failure Assessment scale were assessed.
Results
Thiry-six patients with colorectal cancer were enrolled in the study. sCD14-ST level before surgery was 269.8±103.1 pg/mL (interquartile range [IQR], 196.7–327.1 pg/mL). Despite the presepsin level on the 3rd day being higher (291.1±136.5 pg/mL; IQR, 181.2–395.5 pg/mL), there was no statistical significance in its dynamics (P=0.437). sCD14-ST value both before surgery and on the 3rd day after it was significantly higher in patients with bowel obstruction (P=0.038 and P=0.007). sCD14-ST level before surgery above 330 pg/mL showed an increase in the probability of complications, SIRS, and OD (odds ratio [OR], 5.5; 95% confidence interval [CI], 1.1–28.2; OR, 7.0; 95% CI, 1.3–36.7; and OR, 13.0; 95% CI, 1.1–147.8; respectively). Patients with OD had higher levels on the 3rd day after surgery (P=0.049).
Conclusion
sCD14-ST level in operated colorectal cancer patients was much higher if they were admitted with complication like bowel obstruction. Higher preoperative levels of sCD14-ST increase the probability of postoperative complications, SIRS, and OD. Therefore, further studies with large sample size are needed.

Citations

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  • Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
    Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
    Cancers.2023; 15(20): 5098.     CrossRef
Risk factors for prolonged hospitalization and delayed treatment completion after laparoscopic appendectomy in patients with uncomplicated acute appendicitis
Jiyoung Shin, Myong Hoon Ihn, Kyung Sik Kim, Sang Hyun Kim, Jihyoun Lee, Sangchul Yun, Sung Woo Cho
Ann Coloproctol. 2023;39(1):50-58.   Published online November 18, 2021
DOI: https://doi.org/10.3393/ac.2021.00773.0110
  • 7,374 View
  • 172 Download
  • 3 Web of Science
  • 4 Citations
AbstractAbstract PDFSupplementary Material
Purpose
We sought to identify the risk factors for prolonged hospitalization and delayed treatment completion after laparoscopic appendectomy in patients with uncomplicated acute appendicitis.
Methods
The study retrospectively analyzed 497 patients who underwent laparoscopic appendectomies for uncomplicated appendicitis between January 2018 and December 2020. The patients were divided into an early discharge group (≤2 days) and a late discharge group (>2 days) based on the length of hospital stay (LOS). The patients were also divided into uneventful and complicated groups according to the need for additional treatment after standard follow-up.
Results
Thirty-seven patients (7.4%) were included in the late discharge group. The mean LOS of the late discharge groups was 3.9 days. There were significant differences according to age, preoperative C-reactive protein (CRP), and operative time between the 2 groups. Only operative time was significantly associated with prolonged LOS in multivariate analysis. Thirty-five patients (7.0%) were included in the complicated group. The mean duration of treatment in the uneventful and complicated groups was 7.4 and 25.3 days, respectively. Significant differences existed between the uneventful and complicated groups in preoperative body temperature, preoperative CRP levels, maximal appendix diameter, and the presence of appendicoliths. In multivariate analysis, preoperative CRP levels and maximal appendix diameter were independent predictors of delayed treatment completion.
Conclusion
Shorter operative time is desirable to ensure minimal hospital stay in patients with uncomplicated appendicitis. Further efforts are needed to ensure that patients with uncomplicated appendicitis do not experience delayed treatment completion after laparoscopic appendectomies.

Citations

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  • Association between preoperative neutrophil-to-lymphocyte ratio and length of stay in pediatric patients undergoing laparoscopic appendectomy: a retrospective cohort study
    Ming Liu, Yunpeng Gou, Ping Yang
    BMC Pediatrics.2025;[Epub]     CrossRef
  • Comparative Outcomes of Immediate and Delayed Wound Closure Techniques in Appendectomies for Gangrenous Appendicitis
    Anzar Usman, Esha Akbar, Aliha Mukhtar, Iqra Nasir, Usama Rehman, Adil Iqbal, Muhammad Umar Umar
    DEVELOPMENTAL MEDICO-LIFE-SCIENCES.2024; 1(3): 18.     CrossRef
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    Ming Liu, Ping Yang, Yunpeng Gou
    Frontiers in Pediatrics.2024;[Epub]     CrossRef
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    Ming Liu, Ping Yang, Yunpeng Gou, Qiang Chen, Dong Xu
    Frontiers in Pediatrics.2024;[Epub]     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
  • 6,816 View
  • 170 Download
  • 4 Web of Science
  • 4 Citations
AbstractAbstract 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.

Citations

Citations to this article as recorded by  
  • 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
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    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
Review
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
  • 11,840 View
  • 373 Download
  • 26 Web of Science
  • 32 Citations
AbstractAbstract 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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Case Report
Benign GI diease,Complication
Transmural Mesh Migration From the Abdominal Wall to the Rectum After Hernia Repair Using a Prolene Mesh: A Case Report
Yujin Lee, Byung-Noe Bae
Ann Coloproctol. 2021;37(Suppl 1):S28-S33.   Published online May 15, 2020
DOI: https://doi.org/10.3393/ac.2020.04.19
  • 7,019 View
  • 93 Download
  • 7 Web of Science
  • 8 Citations
AbstractAbstract PDF
Mesh erosion or migration is a rare and late complication after hernia repair. Its incidence is increasing as the utilization of prosthetic mesh gains popularity for abdominal hernia repair. However, mesh migration is exceedingly rare and its clinical presentation is atypical and diverse. Therefore, the management of mesh migration should be individualized to each patient. This research reports the case of a 94-year-old man with transmural migration of Prolene mesh (Ethicon) from the abdominal wall to the rectum 14 years after incisional hernia repair. He presented with only chronic abdominal pain and constipation. Migration of the mesh and a fistula between the right abdominal wall and transverse colon was observed on computed tomography. The mesh was evacuated manually from the anus without any sequelae. These findings made this case atypical, since complete transluminal migration of mesh is exceedingly rare and mesh erosion or migration requires surgical treatment in many cases.

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  • Clinical Insights and Brief Research Report on Mesh Erosion Into Bowel Following Hernia Repair: A Single-Centre Series of Eight Cases
    Vidit Dholakia, Suvendu Sekhar Jena, Amitabh Yadav, Samiran Nundy
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    Yuan Zhang, Jun Peng, Xingui Wu, Dingjiao Zhu, Yaozhi Chen
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Original Articles
Benign proctology,Functional outcome
The Long-term Effect of Standardized Anal Dilatation for Chronic Anal Fissure on Anal Continence
Ilia Pinsk, David Czeiger, Daria Lichtman, Avraham Reshef
Ann Coloproctol. 2021;37(2):115-119.   Published online March 16, 2020
DOI: https://doi.org/10.3393/ac.2020.03.16
  • 11,578 View
  • 217 Download
  • 8 Web of Science
  • 10 Citations
AbstractAbstract PDF
Purpose
For the past several decades, internal anal sphincterotomy has generally been considered to be the standard operation for an anal fissure. However, wound complications inherent in this operation forced surgeons to look for an alternative form of treatment. The aim of our study was to evaluate the long-term outcome of anal dilatation for chronic anal fissure, especially possible negative impact on anal sphincter function.
Methods
The study was approved by the local Institutional Review Board and given a waiver of written consent. A phone call survey was undertaken among a group of consecutive patients who had an anal dilatation by standardized technique for chronic anal fissure for the period between 2000 and 2016. The survey included medical, obstetrical and surgical-related data, Wexner fecal incontinence score, recurrence of the anal fissure, and the need for additional medical intervention. Five hundred 48 patients were identified after limitations of age, concomitant pathology, and procedures that were applied to the hospital computerized database. Eighty-five patients (group A) agreed to participate in the survey and 463 patients did not.
Results
There were no differences between groups in demographic information and medical records data; therefore, group A may well represent a satisfactory sample of the whole group. The interval between the procedure and the survey was 6.8 ± 2.7 years. The Wexner incontinence score was 0 in 94% of patients.
Conclusion
Anal dilatation, performed in a systematic and standardized way, has a successful outcome with no complications and has no clear long-term negative impact on anal sphincter function.

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Malignant disease, Functional outcomes
Safety and Efficacy of Single-Port Laparoscopic Ileostomy in Palliative Settings
Seng-Muk Kang, Jung Rae Cho, Heung-Kwon Oh, Eun-Ju Lee, Min Hyun Kim, Duck-Woo Kim, Sung-Bum Kang
Ann Coloproctol. 2020;36(1):17-21.   Published online February 29, 2020
DOI: https://doi.org/10.3393/ac.2019.04.25
  • 5,512 View
  • 80 Download
  • 1 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
Single-port laparoscopic techniques can be optimized with confined incisions. This approach has an intraoperative advantage of excellent visualization of the correct intestinal segment for exteriorization, along with direct visual control of the extraction to avoid twisting. However, only a few studies have verified the efficacy of the technique. Thus, this study assessed the results of single-port laparoscopic stoma creation for fecal diversion, specifically focusing on feasibility, safety, and efficacy.
Methods
Patients who underwent single-incision enterostomy performed by a single surgeon were included. Data on demographics, indications for and chosen procedure, and operation results were retrospectively collected and analyzed.
Results
Between April 2015 and January 2018, a total of 13 patients (8 males, 5 females) with a mean age of 57.7 years (range, 41–83 years) underwent single-port ileostomy creation. The most common reason for diversion was palliative ileostomy for colon obstruction or fistula from peritoneal malignancy (n = 12), followed by colonic fistula with necrotizing pancreatitis (n = 1). There were no cases of conversion to open or multiport laparoscopic surgery. The mean operative time was 54 minutes (range, 37–118 minutes), and the median length of hospital stay was 8 days (range, 2–211 days). A postoperative complication, aspiration pneumonia, was documented in 1 patient and treated conservatively. The mean duration of bowel movement was 0.7 days (range, 0–4 days). All stomas had good function, and there was no 30-day mortality.
Conclusion
Single-port laparoscopic ileostomy in patients with a palliative setting could be a safe and feasible option for fecal diversion.

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  • Single port–assisted diverting ileostomy formation for anastomotic leakage after low anterior resection
    Kyong-Min Kang, Heung-Kwon Oh, Hong-min Ahn, Hye-Rim Shin, Min-Hyeong Jo, Mi-Jeong Choi, Duck-Woo Kim, Sung-Bum Kang
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    Kyeong Eui Kim, Yu Ra Jeon, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
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Short-term Outcomes After Upfront Chemotherapy Followed by Curative Surgery in Metastatic Colon Cancer: A Comparison With Upfront Surgery Patients
Myung Hyun Han, Youn Young Park, Shiva Pratap, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim
Ann Coloproctol. 2019;35(6):327-334.   Published online December 31, 2019
DOI: https://doi.org/10.3393/ac.2019.03.04.1
  • 4,852 View
  • 71 Download
  • 2 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
Upfront systemic chemotherapy with target agents has been recommended for patients with stage IV colon cancer. Some with partial response are considered for curative resection. There is high risk of developing postoperative complications following upfront systemic chemotherapy. We aimed to evaluate short-term perioperative outcomes of curative surgery after upfront chemotherapy in comparison with upfront surgery in patients with metastatic colon cancer.
Methods
Between January 2010 and October 2015, 146 patients (80 in the surgery first group, 66 in the upfront chemotherapy group) who underwent surgical resection before or after systemic chemotherapy for metastatic colon cancer were included in the present study. All decisions for treatment were made through a multidisciplinary team. Postoperative clinical outcomes and complications were analyzed to compare the groups.
Results
There was no difference between the 2 groups in terms of postoperative clinical outcomes. Overall complication rates were not different between the groups (surgery first group: 46.3% vs. upfront chemotherapy group: 60.6%; P = 0.084). When classified according to the Clavien-Dindo method, there was no difference between the 2 groups in terms of major complications (grade 3 or more) (surgery first group: 18.9% vs. upfront chemotherapy group: 27.5%; P = 0.374).
Conclusion
There was no significant increase in major postoperative complications in metastatic colon cancer patients who received upfront chemotherapy followed by curative surgery. Careful patient selection and treatment planning are important.

Citations

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  • Impact of preoperative chemotherapy on perioperative morbidity in combined resection of colon cancer and liver metastases
    Joy Z. Done, Angelos Papanikolaou, Miloslawa Stem, Shannon N. Radomski, Sophia Y. Chen, Chady Atallah, Jonathan E. Efron, Bashar Safar
    Journal of Gastrointestinal Surgery.2023; 27(11): 2380.     CrossRef
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    Young Jin Kim, Chang Hyun Kim
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Malignant disease, Prognosis and adjuvant therapy
Long-term Oncologic Outcome of Postoperative Complications After Colorectal Cancer Surgery
Chang Kyu Oh, Jung Wook Huh, You Jin Lee, Moon Suk Choi, Dae Hee Pyo, Sung Chul Lee, Seong Mun Park, Jung Kyong Shin, Yoon Ah Park, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee
Ann Coloproctol. 2020;36(4):273-280.   Published online November 13, 2019
DOI: https://doi.org/10.3393/ac.2019.10.15
  • 7,076 View
  • 172 Download
  • 23 Web of Science
  • 23 Citations
AbstractAbstract PDF
Purpose
The impact of postoperative complications on long-term oncologic outcome after radical colorectal cancer surgery is controversial. The aim of this study was to examine the risk factors and oncologic outcomes of surgery-related postoperative complication groups.
Methods
From January 2010 to December 2010, 310 patients experienced surgery-related postoperative complications after radical colorectal cancer surgery. These stage I–III patients were classified into 2 subgroups, minor (grades I, II) and major (grades III, IV) complication groups, according to extended Clavien-Dindo classification system criteria. Clinicopathologic differences between the 2 groups were analyzed to identify risk factors for major complications. The diseasefree survival rates of surgery-related postoperative complication groups were also compared.
Results
Minor and major complication groups were stratified with 194 patients (62.6%) and 116 patients (37.4%), respectively. The risk factors influencing the major complication group were pathologic N category and operative method. The prognostic factors associated with disease-free survival were preoperative perforation, perineural invasion, tumor budding, and receiving neoadjuvant therapy. With a median follow-up period of 72.2 months, the 5-year disease-free survival rates were 84.4% in the minor group and 78.5% in the major group, but there was no statistical significance between the minor and major groups (P = 0.392).
Conclusion
Advanced cancer and open surgery were identified as risk factors for increased surgery-related major complications after radical colorectal cancer surgery. However, severity of postoperative complications did not affect disease-free survival from colorectal cancer.

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    Hong-min Ahn, Tae Gyun Lee, Hye-Rim Shin, Jeehye Lee, In Jun Yang, Jung Wook Suh, Heung-Kwon Oh, Duck-Woo Kim, Sung-Bum Kang
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    Carlota Matallana, Paula Manchon-Walsh, Eloy Espín, Marta Pascual, Sebastiano Biondo, Marta Jiménez-Toscano, Josep Maria Borràs, Josep M Badia, Enric Limón, Luisa Aliste, Rebeca Font, Miguel Pera
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    Sung Uk Bae
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Transanal Hemorrhoidal Dearterialization With Doppler Arterial Identification Versus Classic Hemorrhoidectomy: A Retrospective Analysis of 270 Patients
Vincenzo Consalvo, Francesca D’Auria, Vincenzo Salsano
Ann Coloproctol. 2019;35(3):118-122.   Published online May 31, 2019
DOI: https://doi.org/10.3393/ac.2017.09.04
  • 7,554 View
  • 176 Download
  • 5 Web of Science
  • 7 Citations
AbstractAbstract PDF
Purpose
Despite the minimally invasive nature of transanal hemorrhoidal dearterialization (THD) with Doppler arterial identification procedures, hemorrhoidectomy is still considered the gold standard procedure for hemorrhoidal disease. However, the classical techniques of hemorrhoidectomy have a high rate of postoperative complications. The main purpose of this study is to demonstrate the efficacy and complications of these techniques used for grades II and III hemorrhoids.
Methods
A retrospective (case-control) study was carried out from January 2009 to May 2014, and all patients undergoing surgical procedures for hemorrhoidal disease in two French clinics were considered. Application of inclusion and exclusion criteria identified 270 eligible patients (163 undergoing Doppler THD and 107 treated with Milligan Morgan hemorrhoidectomy). Statistical analysis was calculated considering immediate postoperative complications, functional results, chronic complications, and recurrences.
Results
Analysis of primary outcomes showed a significant difference between the 2 groups concerning postoperative pain, which had a lower rate in THD (P = 0.0001) and in postoperative bleeding (P = 0.02) than hemorrhoidectomy. However, long-term follow-up at three years showed a superior rate of recurrence in the THD group (P = 0.009).
Conclusion
The THD technique is a safe and effective procedure for grades II and III hemorrhoids, has lower rates of post-operative pain and bleeding, and allows faster hospital discharge; however, it also shows a higher rate of recurrence at three years of follow-up.

Citations

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  • Milligan–Morgan hemorrhoidectomy combined with rubber band ligation and polidocanol foam sclerotherapy for the management of grade III/IV hemorrhoids: a retrospective study
    Qing Long, Yong Wen, Jun Li
    BMC Gastroenterology.2025;[Epub]     CrossRef
  • Transanal Hemorrhoidal Dearterialization With Mucopexy Versus Vessel-Sealing Device Hemorrhoidectomy for Grade III to IV Hemorrhoids: Long-term Outcomes From the THDLIGA Randomized Controlled Trial
    Loris Trenti, Sebastiano Biondo, Eloy Espin-Basany, Oriana Barrios, Jose L. Sanchez-Garcia, • Aitor Landaluce-Olavarria, Elena Bermejo-Marcos, • Maria T. Garcia-Martinez, David Alias Jimenez, Fernando Jimenez, Adolfo Alonso, Maria B. Manso, Esther Kreisle
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    Antonio Giuliani, Lucia Romano, Stefano Necozione, Vincenza Cofini, Giada Di Donato, Mario Schietroma, Francesco Carlei
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  • CLINICAL AND MORPHOLOGICAL EVALUATION OF THE EFFECTIVENESS OF USING RADIO WAVE AND HIGH-FREQUENCY ELECTROSURGERY TECHNOLOGIES FOR THE TREATMENT OF COMBINED ANORECTAL DISEASES
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    Akiharu Kurihara, Yu Yoshino, Yu Sakai, Yasuyuki Miura, Satoru Kagami, Tomoaki Kaneko, Mitsunori Ushigome, Hiroyuki Shiokawa, Hironori Kaneko, Kimihiko Funahashi
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    M.A. Popovtsev, A.V. Alekberzade, N.N. Krylov
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Postoperative Outcomes of Stoma Takedown: Results of Long-term Follow-up
Bomina Paik, Chang Woo Kim, Sun Jin Park, Kil Yeon Lee, Suk-Hwan Lee
Ann Coloproctol. 2018;34(5):266-270.   Published online October 10, 2018
DOI: https://doi.org/10.3393/ac.2017.12.13
  • 7,159 View
  • 166 Download
  • 6 Web of Science
  • 8 Citations
AbstractAbstract PDF
Purpose
Stoma takedown is a frequently performed procedure with considerable postoperative morbidities. Various skin closure techniques have been introduced to reduce surgical site infections. The aim of this study was to assess postoperative outcomes after stoma takedown during a long-term follow-up period.
Methods
Between October 2006 and December 2015, 84 consecutive patients underwent a colostomy or ileostomy takedown at our institution. Baseline characteristics and perioperative outcomes were analyzed through retrospective reviews of medical records.
Results
The proportion of male patients was 60.7%, and the mean age of the patients was 59.0 years. The overall complication rate was 28.6%, with the most common complication being prolonged ileus, followed by incisional hernia, anastomotic leakage, surgical site infection, anastomotic stenosis, and entero-cutaneous fistula. The mean follow-up period was 64.3 months. The univariate analysis revealed no risk factors related to overall complications or prolonged ileus.
Conclusion
The postoperative clinical course and long-term outcomes following stoma takedown were acceptable. Stoma takedown is a procedure that can be performed safely.

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    Sharon L. Hsieh, Nathaniel Grabill, Mena Louis, Bradley Kuhn
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  • Comparing Surgical Site Infection Rate Between Primary Closure and Rhomboid Flap After Stoma Reversal
    Che-Ming Chu, Chih-Cheng Chen, Yu-Yao Chang, Kai-Jyun Syu, Shih-Lung Lin
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    GIRIDHAR ASHWATH, ESHWAR KATHIRESAN MANASIJAN, ANTHONY P ROZARIO
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    F. Ascari, G. Barugola, G. Ruffo
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  • Laparoscopic versus open Hartmann reversal: a propensity score matching analysis
    Li Tan, Xiao-Yu Liu, Bin Zhang, Lian-Lian Wang, Zheng-Qiang Wei, Dong Peng
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  • Defunctioning stoma in anterior resection for rectal cancer does not impact anastomotic leakage: a national population-based cohort study
    Eihab Munshi, Marie-Louise Lydrup, Pamela Buchwald
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Case Report
Rhabdomyolysis Following Colonoscopy: A Case Report
Jin Yong Jeong, Kap Tae Kim, Mi Jin Kim, Yea Jeong Kim
Ann Coloproctol. 2018;34(1):52-55.   Published online February 28, 2018
DOI: https://doi.org/10.3393/ac.2018.34.1.52
  • 6,499 View
  • 83 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDF

We experienced a case of 1 patient who died from rhabdomyolysis-related complications after colonoscopy. A 60-year-old man had undergone an ‘uncomplicated’ colonoscopic polypectomy. Approximately 10 hours following this procedure, the patient complained of increasing left abdominal pain. His computed tomography image showed free gas, but his operative findings revealed no macroscopic perforation or abscess formation. Eight hours after the operation, the patient presented with myoglobulinuria, and we diagnosed the condition to be rhabdomyolysis. Based on this case, we recommend that rhabdomyolysis be added to the list of complications following a colonoscopic procedure. Moreover, for prevention and early treatment, endoscopists should be attentive to the risk factors and signs/symptoms of rhabdomyolysis.

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  • Rhabdomyolysis following colorectal endoscopic submucosal dissection: A case report
    Ying Chen, Wenxuan Zhang, Junqiang Cai, Min Zhong
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Original Articles
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
  • 6,162 View
  • 60 Download
  • 14 Web of Science
  • 14 Citations
AbstractAbstract 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.

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    Nan Zun Teo, James Chi Yong Ngu
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Predictors of Morbidity and Mortality After Surgery for Intestinal Perforation
Rumi Shin, Sang Mok Lee, Beonghoon Sohn, Dong Woon Lee, Inho Song, Young Jun Chai, Hae Won Lee, Hye Seong Ahn, In Mok Jung, Jung Kee Chung, Seung Chul Heo
Ann Coloproctol. 2016;32(6):221-227.   Published online December 31, 2016
DOI: https://doi.org/10.3393/ac.2016.32.6.221
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AbstractAbstract PDF
Purpose

An intestinal perforation is a rare condition, but has a high mortality rate, even after immediate surgical intervention. The clinical predictors of postoperative morbidity and mortality are still not well established, so this study attempted to identify risk factors for postoperative morbidity and mortality after surgery for an intestinal perforation.

Methods

We retrospectively analyzed the cases of 117 patients who underwent surgery for an intestinal perforation at a single institution in Korea from November 2008 to June 2014. Factors related with postoperative mortality at 1 month and other postoperative complications were investigated.

Results

The mean age of enrolled patients was 66.0 ± 15.8 years and 66% of the patients were male. Fifteen patients (13%) died within 1 month after surgical treatment. Univariate analysis indicated that patient-related factors associated with mortality were low systolic and diastolic blood pressure, low serum albumin, low serum protein, low total cholesterol, and high blood urea nitrogen; the surgery-related factor associated with mortality was feculent ascites. Multivariate analysis using a logistic regression indicated that low systolic blood pressure and feculent ascites independently increased the risk for mortality; postoperative complications were more likely in both females and those with low estimated glomerular filtration rates and elevated serum C-reactive protein levels.

Conclusion

Various factors were associated with postoperative clinical outcomes of patients with an intestinal perforation. Morbidity and mortality following an intestinal perforation were greater in patients with unstable initial vital signs, poor nutritional status, and feculent ascites.

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Distribution and Impact of the Visceral Fat Area in Patients With Colorectal Cancer
Hyeon Yu, Yong-Geul Joh, Gyung-Mo Son, Hyun-Sung Kim, Hong-Jae Jo, Hae-Young Kim
Ann Coloproctol. 2016;32(1):20-26.   Published online February 29, 2016
DOI: https://doi.org/10.3393/ac.2016.32.1.20
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AbstractAbstract PDF
Purpose

The purposes of this study were to investigate the distribution of the visceral fat area (VFA) and general obesity and to compare visceral and general obesity as predictors of surgical outcomes of a colorectal cancer resection.

Methods

The prospectively collected data of 102 patients with preoperatively-diagnosed sigmoid colon or rectal cancer who had undergone a curative resection at Pusan National University Yangsan Hospital between April 2011 and September 2012 were reviewed retrospectively. Men with a VFA of >130 cm2 and women with a VFA of >90 cm2 were classified as obese (VFA-O, n = 22), and the remaining patients were classified as nonobese (VFA-NO, n = 80).

Results

No differences in morbidity, mortality, postoperative bowel recovery, and readmission rate after surgery were observed between the 2 groups. However, a significantly higher number of harvested lymph nodes was observed in the VFA-NO group compared with the VFA-O group (19.0 ± 1.0 vs. 13.5 ± 1.2, respectively, P = 0.001).

Conclusion

Visceral obesity has no influence on intraoperative difficulties, postoperative complications, and postoperative recovery in patients with sigmoid colon or rectal cancer.

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Case Report
Acute Cholecystitis After a Colonoscopy
Tae Ik Park, Sang Yong Lee, Jun Hee Lee, Min Cheol Kim, Bong Gap Kim, Dong Hyuk Cha
Ann Coloproctol. 2013;29(5):213-215.   Published online October 31, 2013
DOI: https://doi.org/10.3393/ac.2013.29.5.213
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AbstractAbstract PDF

Acute cholecystitis after a colonoscopy is a rare event, and only eight documented cases are reported in the literature. A 35-year-old male underwent a screening colonoscopy. There was a 5-mm sessile polyp in the sigmoid colon, which was removed by using a hot snare polypectomy. Forty-eight hours after the colonoscopy, the patient visited our emergency department with epigastric pain and fever. Based on the clinical findings, laboratory data and radiologic imaging, our diagnosis was acute cholecystitis. Because no previous cases of this type have been reported to date in Korea, we publish the details of our patients who presented with a postcolonoscopy complication diagnosed as acute cholecystitis.

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    Madalina Maria Gorgan, Ioana Grigorescu, Dan Lucian Dumitrascu
    European Journal of Case Reports in Internal Medicine.2016;[Epub]     CrossRef
Original Articles
Appendicitis during Pregnancy: The Clinical Experience of a Secondary Hospital
Soo Jung Jung, Do Kyung Lee, Jun Hyun Kim, Pil Sung Kong, Kyung Ha Kim, Sung Woo Bae
J Korean Soc Coloproctol. 2012;28(3):152-159.   Published online June 30, 2012
DOI: https://doi.org/10.3393/jksc.2012.28.3.152
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  • 22 Citations
AbstractAbstract PDF
Purpose

Appendicitis is the most common condition leading to an intra-abdominal operation for a non-obstetric problem in pregnancy. The aim of this study was to examine our experience and to analyze the clinical characteristics and the pregnancy outcomes for appendicitis during pregnancy that was reported in Korea.

Methods

We reported 25 cases of appendicitis during pregnancy that were treated at Good Moonhwa Hospital from January 2004 to March 2010. We also analyzed appendicitis during pregnancy reported in Korea between 1970 and 2008 by a review of journals.

Results

The incidence of acute appendicitis during pregnancy was one per 568 deliveries. The mean age was 27.92 years old, the gestational stage at the onset of symptoms was the first trimester in 10 patients (40%), the second trimester in 14 patients (56%), and the third trimester in 1 patient (4%). Among the 25 cases, 21 were treated with an open appendectomy and 4 with laparoscopic appendectomies. The postoperative complications were 2 wound infections and 1 spontaneous abortion.

Conclusion

Our experience demonstrated that appendectomies on pregnant patients can be successfully performed at secondary hospitals.

Citations

Citations to this article as recorded by  
  • Diagnostic value of the pregnancy index for acute appendicitis in pregnant women
    Ismail Sezİklİ, Ramazan Topcu, Mehmet Berksun Tutan, Orhan Aslan, Mahmut Arif Yüksek
    Scientific Reports.2025;[Epub]     CrossRef
  • Analyzing results of diagnostics and prediction of acute appendicitis in pregnant women: approaches to solving a well-known clinical problem
    Larisa A. Logvin, Dmitry N. Popov, Elena V. Kiseleva, Andrey Yu. Korolkov, Sergey F. Bagnenko
    Pediatrician (St. Petersburg).2025; 16(1): 35.     CrossRef
  • Akut Apandisit Nedeniyle Opere Edilen Gebe Hastaların Sonuçları: 37 Vaka Serisinin Tek Merkez Deneyimi
    Felat Çiftçi, Mazlum Yavaş
    Harran Üniversitesi Tıp Fakültesi Dergisi.2024; 21(1): 36.     CrossRef
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    Anna Haataja, Hannu Kokki, Outi Uimari, Merja Kokki
    Scandinavian Journal of Surgery.2023; 112(3): 187.     CrossRef
  • PARAMETERS ASSOCIATED WITH ACUTE APPENDICITIS IN PREGNANCY
    Samet ŞAHİN, Eyüp Murat YILMAZ, Mahir KIRNAP, Ethem BİLGİÇ, Ahmet Ender DEMİRKIRAN
    SDÜ Tıp Fakültesi Dergisi.2023; 30(2): 185.     CrossRef
  • Efficacy of magnetic resonance imaging among pregnant patients diagnosed with acute abdomen in the emergency department
    Yunus YILMAZSOY, Adnan ÖZDEMİR, Serdar ARSLAN, Pelin Zeynep BEKİN SARIKAYA
    Anatolian Current Medical Journal.2023; 5(3): 187.     CrossRef
  • Laparoscopic appendectomy for acute appendicitis in pregnancy
    A.P. Ukhanov, D.V. Zakharov, S.A. Zhilin, S.V. Bolshakov, K.D. Muminov, Yu.A. Aselderov
    Pirogov Russian Journal of Surgery.2023; (9): 86.     CrossRef
  • Significance of laboratory parameters in diagnosing acute appendicitis during pregnancy
    Rıfat Peksöz, Esra Dişçi, Abdulkadir Kaya, Enes Ağırman, Ercan Korkut, Nurhak Aksungur, Necip Altundaş, Salih Kara, Sabri Selçuk Atamanalp
    ANZ Journal of Surgery.2022; 92(1-2): 121.     CrossRef
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    Steven Yale, Halil Tekiner, Eileen S Yale
    Cureus.2022;[Epub]     CrossRef
  • Evaluation of Clinical and Paraclinical Findings in Cases of Pregnancy Appendectomy in Ali Ebn-e Abitaleb Hospital Within 2015 - 2019
    Shahla Mirgaloy Bayat, Farahnaz Farzaneh, Zahra Asadi Kalameh, Najmeh Zamaniha
    Zahedan Journal of Research in Medical Sciences.2022;[Epub]     CrossRef
  • Acute Appendicitis During Pregnancy: A Case Series of 42 Pregnant Women
    Tezcan Akın, Birkan Birben, Gökhan Akkurt, Onur Karaca, Mustafa Dönmez, Sadettin Er, Mesut Tez
    Cureus.2021;[Epub]     CrossRef
  • Laparoscopic Versus Open Appendectomy for Appendicitis in Pregnancy: Systematic Review and Meta-Analysis
    Qi Zeng, Amina Aierken, Shen-Sen Gu, Gang Yao, Shadike Apaer, Nuerzhatijiang Anweier, Jing Wu, Jin-Ming Zhao, Tao Li, Tuerhongjiang Tuxun
    Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2021; 31(5): 637.     CrossRef
  • APPENDICITIS IN PREGNANCY : OUR CLINICAL EXPERIENCE AT A TERTIARY CARE CENTRE
    Anil Kumar, Rekha Rani, Hamid Wani
    GLOBAL JOURNAL FOR RESEARCH ANALYSIS.2021; : 22.     CrossRef
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    Erkan Somuncu, Emre Bozdag, inanc sarici, Adem Ozcan, Cenk Ozkan, Ceren Basaran
    Polish Journal of Surgery.2021; 94(1): 48.     CrossRef
  • Optimization of Diagnosis of Acute Appendicitis in Pregnant Women
    Aydar Mindiarovich Ziganshin, Hiwa Mohammed Hassan Karkhani, Bhawna Sharma
    Indian Journal of Surgery.2020; 82(5): 941.     CrossRef
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    A. V. Sazhin, A. I. Kirienko, M. A. Kurtser, A. G. Konoplyannikov, A. V. Panin, D. A. Son, G. D. Shulyak
    Khirurgiya. Zhurnal im. N.I. Pirogova.2019; (1): 70.     CrossRef
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    Seung Hwan Lee, Jin Young Lee, Yoon Young Choi, Jae Gil Lee
    BMC Surgery.2019;[Epub]     CrossRef
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    A. V. Sazhin, M. A. Kurtser, A. G. Konoplyannikov, G. B. Ivakhov, A. V. Panin, D. A. Son, G. D. Shulyak, Yu. A. Serebrennikova
    Khirurgiya. Zhurnal im. N.I. Pirogova.2019; (4): 15.     CrossRef
  • Outcomes after open and laparoscopic appendectomy during pregnancy: A meta-analysis
    Anastasia Prodromidou, Nikolaos Machairas, Ioannis D. Kostakis, Ernesto Molmenti, Eleftherios Spartalis, Athanasios Kakkos, Georgios T. Lainas, Georgios C. Sotiropoulos
    European Journal of Obstetrics & Gynecology and Reproductive Biology.2018; 225: 40.     CrossRef
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    Tika Ram Bhandari, Sudha Shahi, Sarita Acharya
    International Scholarly Research Notices.2017; 2017: 1.     CrossRef
  • Appendicitis in pregnancy: Difficulties in diagnosis and management. Guidance for the emergency general surgeon: A systematic review
    Arkeliana Tase, Mohamad Fathul Aizat Kamarizan, Keshav Swarnkar
    International Journal of Surgery Open.2017; 6: 5.     CrossRef
  • Maternal and Fetal Outcome in Pregnant Women with Acute Appendicitis: A Three Year Observational Study
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Postoperative Complications and Recurrence in Patients with Crohn's Disease.
Hong, Dong Hyun , Yu, Chang Sik , Kim, Dae Dong , Jung, Sang Hun , Choi, Pyong Hwa , Park, In Ja , Kim, Hee Cheol , Kim, Jin Cheon
J Korean Soc Coloproctol. 2008;24(1):13-19.
DOI: https://doi.org/10.3393/jksc.2008.24.1.13
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  • 4 Citations
AbstractAbstract PDF
PURPOSE
This study was performed to assess postoperative complications and recurrence rates and to elucidate the risk factors in Crohn's disease (CD). METHODS: A retrospective review was undertaken for patients who had undergone bowel surgery at Asan Medical Center between October 1991 and June 2006. Symptomatic recurrence was defined as the presence of symptoms related to CD that was subsequently verified by radiologic or endoscopic finding. Surgical recurrence was defined as the need for repeated surgery for enteric CD.
RESULTS
There were 160 patients with a mean follow up of 34 months (108 men and 52 women; mean age: 29.7+/-10.9). The most common indication for surgery was a complication of CD, such as intra-abdominal abscess (31.9%), intestinal obstruction (21.9%), and internal fistula (19.4%). Another frequent indication was medical intractability (23.8%). The types of surgical procedures were ileocolic resection (50.0%), small bowel resection (25.0%), total/subtotal colectomy (17.5%), and others. The cumulative symptomatic recurrences were 15.9% and 36.4% at 2 and 5 years, and the cumulative surgical recurrence was 13.6% at 5 years. The cumulative surgical recurrence was higher for stricturing-type CD than for penetrating-type CD (P=0.049). No other significant risk factor for recurrence was found in our study. Twenty patients (12.5%) had postoperative complications, such as intra-abdominal abscess, anastomosis leakage, obstruction, and wound infection. CONCLUSIONS: The postoperative complication and recurrence rates were acceptable. For stricturing-type Crohn's disease surgical recurrence is higher than penetrating type, but long-term follow up is needed to verify the risk factors for recurrence.

Citations

Citations to this article as recorded by  
  • Patients with perianal Crohn's disease have poor disease outcomes after primary bowel resection
    Yoo Min Han, Ji Won Kim, Seong‐Joon Koh, Byeong Gwan Kim, Kook Lae Lee, Jong Pil Im, Joo Sung Kim, Hyun Chae Jung
    Journal of Gastroenterology and Hepatology.2016; 31(8): 1436.     CrossRef
  • Clinical and Endoscopic Recurrence after Surgical Resection in Patients with Crohn's Disease
    Yang Woon Lee, Kang-Moon Lee, Woo Chul Chung, Chang Nyol Paik, Hea Jung Sung, You Suk Oh
    Intestinal Research.2014; 12(2): 117.     CrossRef
  • The epidemiology and cost of surgical site infections in Korea: a systematic review
    Kil Yeon Lee, Kristina Coleman, Dan Paech, Sarah Norris, Jonathan T Tan
    Journal of the Korean Surgical Society.2011; 81(5): 295.     CrossRef
  • Long-term Result of Surgical Treatment for Crohn's Enteritis
    Sang-Ji Choi, Eun-Kyung Choe, Sung-Chan Park, Kyu-Joo Park
    Journal of the Korean Society of Coloproctology.2008; 24(6): 409.     CrossRef
Case Report
Laparoscopy-assisted Surgical Removal of a Retained Wireless Capsule Endoscopy: A case report.
Lee, Sang Hoon , Han, Sang Ah , Park, Chi Min , Yun, Seong Hyeon , Lee, Woo Yong , Chun, HoKyung
J Korean Soc Coloproctol. 2006;22(3):192-196.
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AbstractAbstract PDF
Occult bleeding of the gastrointestinal tract is a major cause of iron deficiency anemia. Even with endoscopic evaluation of the upper and the lower gastrointestinal tract in these patients, in 30~50% of the cases, the cause of bleeding still remains undiscovered. Wireless capsule endoscopy (WCE) is a novel method of evaluating the small bowel mucosa by using a small capsule equipped with a camera and transmission device. Complications of WCE include impaction within the gastrointestinal tract, sometimes requiring surgical removal. The authors report a case of capsule impaction in the small bowel in a patient evaluated for anemia due to occult gastrointestinal tract bleeding. The patient is a 19 year-old female with a history of anemia since age 4. The stool guaiac test was positive, but upper and lower gastrointestinal tract endoscopy showed no abnormalities, so WCE was done. A short segment of circular ulcers with lumen narrowing were seen in the distal jejunum. Seven days after ingestion of the capsule, the patient denied passage of the capsule. Small bowel enteroclysis was performed, and the capsule was seen along with a segment of lumen narrowing distal to the site of retention. Surgery was done, and upon laparoscopic examination, the entire bowel appeared normal. Retrieval of the capsule was done along with a resection of an 8 cm segment of the small bowel. Three linear ulcers were seen in the resected bowel specimen. Pathology revealed no evidence of Crohn's disease or tuberculosis. The patient is still on iron supplements, but her hemoglobin level remains stable at 11~12 g/dl.
Original Articles
Early Postoperative Complications following a Resection for Colorectal Cancer.
Park, In Ja , Kim, Hee Cheol , Yu, Chang Sik , Kim, Jin Cheon
J Korean Soc Coloproctol. 2005;21(4):213-219.
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AbstractAbstract PDF
PURPOSE
Understanding of early postoperative course is very important for planning of operation and postoperative management. However, reports regarding early postoperative complications following colorectal cancer surgery are rare. The aim of this study was to report the incidence of immediate postoperative complications associated with colorectal cancer surgery.
METHODS
This prospective study examined clinicopathological data on 869 patients who underwent a resection for colorectal cancer between November 2002 and October 2003. Patients who underwent a palliative stoma, bypass, or emergent operation were excluded. Early postoperative complications were defined as complications occurring within 30 days of surgery. The male-to-female ratio was 518:351, and the mean age was 59 (range, 18~90) years.
RESULTS
The tumor was located at right colon in 176, at left colon in 169, and at rectum in 510 patients. In 158 patients (18.2%), at least one postoperative complication occurred. The most common complication was ileus (5.5%), followed by wound complication (4.1%), the voiding disturbance (3.3%), anastomotic bleeding (1.4%), anastomotic leakage (1.1%), and bleeding (0.6%). The complication rate was 21.6% in patients with right colon cancer, 16% in those with left colon cancer, and 17.3% in those with rectal cancer. Ileus occurred on mean postoperative day 8 and required a mean of 12 days for resolution. The wound complications occurred on mean postoperative day 9 and were resolved after a mean of 10 days. Of the 8 anastomotic leakage patients, proximal stoma construction was required in 5 patients. Intra-luminal bleeding occurred most common in patients with right colon cancer. Higher frequency of postoperative complications occurred in male patients (P=0.008), patients older than 70 years (P=0.02), and patients with co-morbid medical conditions (P=0.01).
CONCLUSIONS
The overall early postoperative complication rate following colorectal cancer surgery was 18.2%. The postoperative complication rate was higher in male, elderly, and patients with co-morbid medical conditions. Our results have allowed us to identify major complications and to better understand the postoperative course in patients undergoing colorectal cancer resections.
Efficacy of Preoperative Radio-chemotherapy in Patients with Advanced Low Rectal Cancr.
Yu, Chang Sik , Kim, Jong Hoon , Lee, Je Hwan , Kim, Tae Won , Chang, Heung Moon , Namgung, Hwan , Kim, Hee Cheol , Kim, Jin Cheon
J Korean Soc Coloproctol. 2004;20(1):46-51.
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AbstractAbstract PDF
PURPOSE
This study was performed to evaluate the surgical and the oncological outcomes of preoperative radio-chemotherapy (PRCT) in patients with low rectal cancer.
METHODS
We reviewed 26 (M:F=17:9) patients who underwent PRCT between September 1999 and December 2001. Inclusion criteria were lower rectal cancer (4~5 cm from AV), more than T3 or N1 in preoperative staging using CT scan and transrectal ultrasound, and no distant metastasis. Patients received a mean of 47.3 (45.0 ~56.0) Gy of radiation therapy for 5 weeks and concomitant intravenous or oral chemotherapy using 5 FU and leucovorin. Surgery was performed in about 5~6 weeks after completion of radiotherapy. Total mesorectal excision and autonomic nerve preservation was the routine procedure. Adverse events during PRCT were assessed according to the NCI Common Toxicity Criteria (version 2.0, 1997).
RESULTS
The mean age was 49 (28~65) years old. The median follow-up period was 31 (20~44) months. The most frequent adverse event was diarrhea (8, 30.8%), followed by nausea and vomiting (5, 19.2%), dermatitis (5, 19.2%), anemia (4, 15.4%), leucopenia (2, 7.7%), and mucositis (1, 3.8%). The mean location of the tumor was elevated from 4.5 cm to 5.5 cm after PRCT. Downstaging of the tumor was identified in 69.2% of the T-level and 63.2% of the N-level. The serum CEA level was decreased from 14.5+/-5.0 ng/ml to 3.5+/-0.5 ng/ml after PRCT (P=0.034). A sphincter-saving resection (SSR) was possible in 16 cases (61.5%). The mean distal resection margin was 2.2+/-0.7 cm in SSRs. Small bowel obstruction was the most frequent complication (6 cases, 23.1%), followed by hydronephrosis 2 (7.7%), a recto-vaginal fistula (1, 3.8%), and a recto-vesical fistula (1, 3.8%). There were no mortalities. Five (19.2%) recurrences developed in distant area, one (3.8%) in a local area, and one in both a local and a distant area. The patients with N-level downstaging revealed a significantly low recurrence rate (8.3% vs. 57.1%; P=0.03).
CONCLUSIONS
PRCT can be performed with an acceptable toxicity and complication rate. It is effective in downstaging of the tumor and in increasing the sphincter-saving rate. However, a prospective, randomized, controlled trial should be performed to prove the oncological benefit.
Clinical Features of Intestinal Obstruction after Colorectal Surgery.
Kim, Yeon Sun , Yu, Chang Sik , Lee, Kang Hong , Namgung, Hwan , Kim, Hee Cheol , Kim, Jin Cheon
J Korean Soc Coloproctol. 2003;19(6):354-359.
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AbstractAbstract PDF
PURPOSE
The purposes of this study are to determine the incidence of postoperative ileus after colorectal surgery, to analyze its clinical features, and to identify the risk factors for its development.
METHODS
We reviewed the cases of 263 patients with mechanical ileus among 3,237 patients who underwent colorectal surgery in our clinic between June 1989 and December 2000.
RESULTS
A total of 263 (8.1%) patients of postoperative ileus were documented, 193 (73.4%) cases occurred during the 1st. year. Postoperative ileus is influenced by the initial site of surgery; the rectum has more impact than the colon (P=0.028). The causes of postoperative ileus were adhesion, recurrence of cancer, and parastomal hernia. Adhesion (81.1%) was the most common cause of ileus, and cancer recurrence (18.0%) was the second. However, in postoperative ileus requiring surgery, cancer recurrence increased with time (2 year: 58.1%). The cases receiving postoperative adjuvant radiation therapy presented a significant increase in the incidence of postoperative ileus (10.3% vs 6.7% P=0.01) and in the requirement for surgical treatment (4.6% vs 2.7%, P=0.04). Patients with a temporary stoma presented a significant increase in the incidence of postoperative ileus than patients with a permanent stoma (P=0.001). The frequency of prior episodes of ileus was the strongest predictor of recurrence.
CONCLUSIONS
There is a high risk of adhesion-related problems after colorectal surgery. The risk factors are associated with rectal surgery, postoperative radiation therapy, and a temporary stoma.
The Postoperative Impact of Co-morbidity in Colorectal Cancer Surgery.
Suh, Hee Seok , Lee, Kang Hong , Kim, Hee Cheol , Yu, Chang Sik , Kim, Jin Cheon
J Korean Soc Coloproctol. 2003;19(5):299-306.
  • 1,346 View
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AbstractAbstract PDF
PURPOSE
Co-morbidity is the presence of co-existing or additional diseases during the initial diagnosis. It may be used as a prognostic indicator for the postoperative outcomes in most cancers, including colorectal cancers. The impact of respective co-morbidities in colorectal cancer surgeries were evaluated to identify their outcomes regarding complications and hospital stay.
METHODS
The medical records of 2,242 colorectal cancer patients, who had had curative operations between Jan. 1997 and Dec. 2001, were reviewed to evaluate the prevalence of co-morbidities. All co-morbidities were adequately evaluated and managed preoperatively.
RESULTS
Co-morbidities were observed in 789 out of the 2,242 (35.2%) patients. Hypertension was the most frequent (340, 15.2%), with diabetes (210, 9.4%) and cardiovascular diseases (124, 5.5%) following. Early stages (0~II) were more frequently associated with co-morbidities, compared to late stages (III~IV) (P<0.001). Hypertension and cerebrovascular diseases were significantly associated with postoperative complications (P<0.05). Postoperative complications occurred in 578 out of the 2242 (25.8%) patients: e.g., ileus (10.2%), voiding difficulty (4.4%), wound problems (4.3%), etc. Pulmonary complications occurred more often in patients with cerebrovascular diseases, hypertension, and asthma. Wound complications were observed in patients with hypertension, cerebrovascular diseases, chronic obstructive pulmonary disease, and chronic renal failure (P<0.05). Patients with more than one co-morbidity were closely associated with frequent postoperative co-mplications (P<0.05). However, comorbidities did not seem to affect the duration of the postoperative hospital stay.
CONCLUSIONS
Postoperative complications frequently occur in colorectal cancer patients with specific co- morbidities, especially in those with more than one. An adequate management of the co-morbidities preoperatively leads to a good outcome.
Culture-Sensitivity Test and Infectious Complication in Perforated Appendicitis.
Yun, Seok Joo , Koh, Young Taeg , Sim, Myung Seok , Suh, Dong Youb , Park, Dong Sun
J Korean Soc Coloproctol. 2000;16(2):73-77.
  • 1,301 View
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AbstractAbstract PDF
PURPOSE
The purpose of this study was aimed to disclose main affected organisms in patients with perforated appendicitis and to analyze correlations between culture-sensitivity test and infectious complication.
METHODS
In 26 of 421 patients who had undergone appendectomy due to acute appendicitis from April 1996 to March 1999, we performed culture-sensitivity test. The clinical records of these patients were collected and reviewed about clinicopathological features and results of culture-sensitivity test, retrospectively. Culture material was collected in BBL transport media with cotton swab and cultured by MacConkey agar plate. The method of MIC by VITEK was used for sensitivity test.
RESULTS
Cultured organisms were E. coli (18 cases), Pseudomonas (4), Enterobacter (2), Enterococcus (1), and Proteus (1). In sensitivity test, sensitive antibiotics against all cultured organism were amikacin, ceftriaxone, imipenem and cefotetan. But ampicillin, sulfametoxazole/trimethoprim and piperacillin were mostly resistant. Infectious complications occurred in 11 of 26 patients (42.3%) and consisted of 9 wound infection and 2 intraabdominal abscess. Especially, 13 of 18 cases in which E. coli were isolated, were resistant to ampicillin. And they had infectious complications statistically more than those who were not resistant to ampicillin (p=0.036).
CONCLUSIONS
E. coli was a main organism in perforated appendicitis. In case of ampicillin-resistant E. coli, the patients were susceptible to infectious complication such as wound infection and intraabdominal abscess.
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