Annals of Coloproctology

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Original Articles

ERAS

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

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

Benign diesease & IBD,Rare disease & stoma

Determining the etiology of small bowel obstruction in patients without intraabdominal operative history: a retrospective study: Youngjin Jang, Sung Min Jung, Tae Gil Heo, Pyong Wha Choi, Jae Il Kim, Sung-Won Jung, Heungman Jun, Yong Chan Shin, Eunhae Um; Ann Coloproctol. 2022;38(6):423-431. Published online December 8, 2021; DOI: https://doi.org/10.3393/ac.2021.00710.0101

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4 Web of Science
4 Citations

Abstract PDF Supplementary Material

Purpose
Most of the causes of small bowel obstruction (SBO) in patients without a history of abdominal surgery are unclear at initial assessment. This study was conducted to identify the etiology and clinical characteristics of SBO in virgin abdomens and discuss the proper management.
Methods
A retrospective review involving operative cases of SBO from a single institute, which had no history of abdominal surgery, was conducted between January 2010 and December 2020. Clinical information, including radiological, operative, and pathologic findings, was investigated to determine the etiology of SBO.
Results
A total of 55 patients were included in this study, with a median age of 57 years and male sex (63.6%) constituting the majority. The most frequently reported symptoms were abdominal pain and nausea or vomiting. Neoplasm as an underlying cause accounted for 34.5% of the cases, of which 25.5% were malignant cases. In patients aged ≥60 years (n=23), small bowel neoplasms were the underlying cause in 12 (52.2%), of whom 9 (39.1%) were malignant cases. Adhesions and Crohn disease were more frequent in patients aged <60 years. Coherence between preoperative computed tomography scans and intraoperative findings was found in 63.6% of the cases.
Conclusion
There were various causes of surgical cases of SBO in virgin abdomens. In older patients, hidden malignancy should be considered as a possible cause of SBO in a virgin abdomen. Patients with symptoms of recurrent bowel obstruction who have no history of prior abdominal surgery require thorough medical history and close follow-up.

Citations

Citations to this article as recorded by

Mesothelial cell responses to acute appendicitis or small bowel obstruction reactive ascites: Insights into immunoregulation of abdominal adhesion
Melissa A. Hausburg, Kaysie L. Banton, Christopher D. Cassidy, Robert M. Madayag, Carlos H. Palacio, Jason S. Williams, Raphael Bar-Or, Rebecca J. Ryznar, David Bar-Or, Eliseo A. Eugenin
PLOS ONE.2025; 20(1): e0317056. CrossRef
Spontaneous Right-Sided Diaphragmatic Hernia: A Rare Cause of Small Bowel Obstruction
Phoebe Douzenis, Ali Yasen Y Mohamedahmed, Sreekanth Sukumaran, Zbigniew Muras, Najam Husain
Cureus.2024;[Epub] CrossRef
Small bowel obstruction on food impaction after binge eating
E Van Eecke, L Crapé, I Colle
Acta Gastro Enterologica Belgica.2024; 87(3): 427. CrossRef
Colonic pseudo-obstruction in a patient with dyssynergic defecation: A case report
Yejun Jeong, Yongjae Kim, Wonhyun Kim, Seoyeon Park, Su-Jin Shin, Eun Jung Park
International Journal of Surgery Case Reports.2022; 98: 107524. CrossRef

Malignant disease, Functional outcomes,Colorectal cancer

The Relationship Between High-Output Stomas, Postoperative Ileus, and Readmission After Rectal Cancer Surgery With Diverting Ileostomy: Naa Lee, Soo Young Lee, Chang Hyun Kim, Han Deok Kwak, Jae Kyun Ju, Hyeong Rok Kim; Ann Coloproctol. 2021;37(1):44-50. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.08.03

5,194 View
171 Download
12 Web of Science
10 Citations

Abstract PDF

Purpose
This study aimed to evaluate the relationship between high-output stomas (HOSs), postoperative ileus (POI), and readmission after rectal cancer surgery with diverting ileostomy.
Methods
We included 302 patients with rectal cancer who underwent restorative resection with diverting ileostomy between January 2011 and December 2015. HOSs were defined as stomas with ≥ 2,000 mL/day output. We analyzed predictive factors for readmission of these patients.
Results
Forty-eight patients (15.9%) had HOSs during the hospital stay, and 41 patients (13.6%) experienced POI. HOSs were strongly associated with POI (45.8% vs. 7.5%, P < 0.001). The all-cause readmission rate was 16.9%, with 19 (6.3%) and 20 (6.6%) experiencing ileus and acute kidney injury, respectively. HOSs (27.1% vs. 15.0%, P = 0.040) and POI (34.1% vs. 14.2%, P = 0.002) were associated with all-cause readmission, and POI was associated with readmission with ileus (17.1% vs. 4.6%, P = 0.007). POI was an independent risk factor for all-cause readmission (adjusted odds ratio [OR], 2.640; 95% confidence interval [CI], 1.162 to 6.001; P = 0.020) and readmission with ileus (adjusted OR = 3.869; 95% CI 1.387 to 10.792; P = 0.010).
Conclusion
POI was associated with readmission, particularly for subsequent ileus, in patients with diverting ileostomy. We should make efforts to reduce POI, such as strong control of HOSs, to prevent readmission.

Citations

Citations to this article as recorded by

High output stoma after surgery for rectal cancer - a risk factor for low anterior resection syndrome?
Xuena Zhang, Qingyu Meng, Jianna Du, Zhongtao Tian, Yinju Li, Bin Yu, Wenbo Niu
BMC Gastroenterology.2025;[Epub] CrossRef
Summary of Best Evidence for the Dietary Management in Patients with High-Output Ileostomy
Ying Wang, Hua Peng, Cui Cui, Qi Zou, Mudi Yang
Journal of Multidisciplinary Healthcare.2025; Volume 18: 877. CrossRef
Elevating surgical standards: The role of intraperitoneal isoperistaltic side-to-side anastomosis in colon cancer surgery
Sung Uk Bae
World Journal of Gastrointestinal Oncology.2025;[Epub] CrossRef
Maximizing Readmission Reduction in Colon Cancer Patients
Mario Schootman, Chenghui Li, Jun Ying, Sonia T. Orcutt, Jonathan Laryea
Journal of Surgical Research.2024; 295: 587. CrossRef
Analysis of decision-making factors for defunctioning ileostomy after rectal cancer surgery and their impact on perioperative recovery: a retrospective study of 1082 patients
Xiaojiang Yi, Huaguo Yang, Hongming Li, Xiaochuang Feng, Weilin Liao, Jiaxin Lin, Zhifeng Chen, Dechang Diao, Manzhao Ouyang
Surgical Endoscopy.2024; 38(11): 6782. CrossRef
Effect of intracorporeal anastomosis on postoperative ileus after laparoscopic right colectomy
Sangwoo Kim, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek, Young-Gil Son
Annals of Surgical Treatment and Research.2023; 104(3): 156. CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Overall readmissions and readmissions related to dehydration after creation of an ileostomy: a systematic review and meta-analysis
I. Vogel, M. Shinkwin, S. L. van der Storm, J. Torkington, J. A.Cornish, P. J. Tanis, R. Hompes, W. A. Bemelman
Techniques in Coloproctology.2022; 26(5): 333. CrossRef
Postoperative paralytic ileus following debulking surgery in ovarian cancer patients
Eva K. Egger, Freya Merker, Damian J. Ralser, Milka Marinova, Tim O. Vilz, Hanno Matthaei, Tobias Hilbert, Alexander Mustea
Frontiers in Surgery.2022;[Epub] CrossRef
Obstructive and secretory complications of diverting ileostomy
Shingo Tsujinaka, Hideyuki Suzuki, Tomoya Miura, Yoshihiro Sato, Chikashi Shibata
World Journal of Gastroenterology.2022; 28(47): 6732. CrossRef

Case Report

A Case of a Mucinous Adenocarcinoma Arising from a Rectal Diverticulum: Jang Hoon Kwon, Koon Hee Han, Woo-Sung Chang, Ki-Ho Nam, Myoung Sik Han, Jae Hong Ahn, Sang Hak Han, Gab Jin Cheon; J Korean Soc Coloproctol. 2012;28(4):222-224. Published online August 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.4.222

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42 Download
7 Citations

Abstract PDF

The occurrence of an adenocarcinoma arising from a rectal diverticulum that causes mechanical ileus is very rare. Recently, we diagnosed a case of a mucinous adenocarcinoma in a rectal diverticulum after an emergent abdominal perineal resection and permanent colostomy by laparotomy. Here, we present a case report and a review of the literature.

Citations

Citations to this article as recorded by

Solitary rectal diverticulum: A rare entity mimicking contained perforation – Imaging and surgical correlation
Kassandra G. Tulenko, Samantha H. Epstein, Brett R. Kurpiel, Rachita Khot
Case Reports in Clinical Radiology.2025; 0: 1. CrossRef
A Novel Method of Treating Rectal Diverticulum Using Transanal Minimally Invasive Surgery (TAMIS)
Yui Kaneko, Neil Strugnell
World Journal of Colorectal Surgery.2024; 13(2): 46. CrossRef
A case of solitary rectal diverticulum presenting with a large retrorectal abscess
Stefanos Gorgoraptis, Sofia Xenaki, Elias Athanasakis, Anna Daskalaki, Konstantinos Lasithiotakis, Evangelia Chrysou, Emmanuel Chrysos
Annals of Medicine and Surgery.2020; 49: 57. CrossRef
Mucinous Adenocarcinoma Arising within a Colonic Diverticulum Mimicking a Diverticular Abscess: A Case Report
Goun Choi, Jiyoung Hwang, Seong Sook Hong, Jae Joon Kim, In Ho Choi
Journal of the Korean Society of Radiology.2018; 79(1): 40. CrossRef
Divertículo rectal sintomático
Alvaro Andres Gomez Venegas
Revista Colombiana de Gastroenterología.2018; 33(4): 469. CrossRef
Rectal pseudodiverticulum
Saurabh Singh, Louis Savage
BMJ Case Reports.2014; 2014: bcr2013201888. CrossRef
Rectal Diverticulum after Stapled Transanal Procedures: Surgery Encouraged
Gianluca Pellino
The American Surgeon™.2013; 79(12): 1320. CrossRef

Original Articles

The Effect of Dexpanthenol in Postoperative Patients.: Hwang, Mi Ri , Kim, Hungdai , Cho, Dong Ho , Han, Won Kon; J Korean Soc Coloproctol. 2007;23(2):71-74.; DOI: https://doi.org/10.3393/jksc.2007.23.2.71

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40 Download

Abstract PDF: PURPOSE
The purpose of this study was to compare the efficacy of dexpanthenol in postoperative patients. Dexpanthenol, the alcohol derivative of pantothenic acid, is believed to be a precursor of acetylcholine through its incorporation into coenzyme-A.
METHODS
From June 2005 to December 2005, 130 curative abdominal surgery, which were divided into a dexpanthenol group with 65 patients and a control group with 65 patients, were prospectively and randomly studied for recovery of bowel motility.
RESULTS
No significant difference was found between the two groups as to incidence of postoperative ileus (16.9% vs. 15.4%, P=0.081), the time to flatus (77.2+/-38.4 vs. 77.9+/-31.9 hours, P=0.90), the time to defecation (5.3+/-2.7 vs. 5.1+/-2.6 days, P=0.77), the time to resumption of meals (7.9+/-4.0 vs. 8.9+/-4.2 days, P=0.17), and the duration of hospital stay (16.4+/-7.8 vs. 17.9+/-11.5 days, P=0.39). CONSLUSIONS: Since no differences in the postoperative bowel motility were observed between the two groups, dexpanthenol is not recommended for general surgical use.

The Effect of Hyaluronate Membrane on Prevention of Adhesion after Rectal Cancer Surgery: a Prospective Study.: Yu, Chang Sik , Kim, Hee Cheol , Park, In Ja , Lee, Kang Hong , Kim, Jin Cheon; J Korean Soc Coloproctol. 2005;21(2):76-81.

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6 Download

Abstract PDF: PURPOSE
The aim of this study was to evaluate the efficacy of using a Hyaluronate (HA) bioresorbable membrane (SeprafilmTM, Genzyme Corp., Cambridge, MA) to prevent adhesion after rectal cancer surgery.
METHODS
We recruited 362 rectal cancer patients who underwent a curative resection between April 2001 and December 2002. We excluded patients with a previous operation history, a stoma procedure, a multivisceral resection, an extended lymphadenectomy, a total colectomy, or a pouch procedure. An adhesive ileus was defined as a symptomatic, radiological intestinal obstruction without evidence of recurrence.
RESULTS
We placed the HA membrane under the midline incision in 153 patients. There was no difference between the groups regarding demographic findings and clinicopathological findings, including locations of the tumors, surgery performed, AJCC stage, and adjuvant treatment. While only 1 (0.7%) patient of the HA group experienced an adhesive ileus, 13 (6.2%) cases of adhesion were identified in the control group (P=0.008). Every patient, except 1 in the control group, underwent conservative management.
CONCLUSIONS
A Hyaluronate membrane may be effective in preventing an adhesive ileus after rectal cancer surgery. However, a prospective, randomized, double-blind study is needed.

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