Annals of Coloproctology

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Original Articles

Complications

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

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

Citations

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

Anorectal benign disease

Examination of 93 cases of perianal warts and suggestion of a new classification: Jo Unotoro, Keigo Matsuo, Takehiro Arai, Shigeru Okada, Teruki Kawanishi, Ryoichi Ikegami, Shuzo Mori, Hiroshi Matsuno; Ann Coloproctol. 2023;39(3):242-249. Published online March 17, 2022; DOI: https://doi.org/10.3393/ac.2021.00969.0138

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Abstract PDF

Purpose
The anatomical distribution of perianal warts is associated with patient characteristics such as sexual orientation. The purpose of this study is to confirm this experiential knowledge using a quantitative classification system and analysis and to obtain findings useful for future treatment.
Methods
From January 2014 to December 2020, 93 patients with perianal warts presented to our hospital. Patients were analyzed for age, sex, lesion site, and recurrence type, among other factors. The lesion site was divided into skin (S) and anal epithelium (anoderm, A), and the number and degree of each were classified into grades 0 to 3. The higher grade between S and A determines its dominant type, such as type S (e.g., S3A1) and type A (e.g., S0A2).
Results
The average age of the patients was 39.6 years, and the percentage of patients who were not married was 54.8%. In all, 95.8% of patients were positive for low-risk human papillomavirus (HPV). Type S accounted for 80.6%, whereas type A accounted for 9.7%. Type A cases were all male and were all presumed to be men who have sex with men (MSM). This indicates that the determination of type A may be highly specific for MSM. The type at the time of recurrence was the same type at the time of the first surgery in almost all cases.
Conclusion
In cases of perianal warts, it is useful to analyze the lesion by considering the range and grade separately for daily clinical practice on proctologist.

Citations

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Clinical efficacy of CO2 laser combined with 5-aminolevulinic acid photodynamic therapy in treating periungual and plantar warts
Yuanyuan Li
American Journal of Translational Research.2024; 16(12): 7364. CrossRef

Anorectal physiology & pelvic floor disorder

Efficacy and safety of anal encirclement combining the Leeds-Keio artificial ligament with injection sclerotherapy using aluminum potassium sulfate and tannic acid in the management of rectal prolapse: a single-center observational study: Tatsuya Abe, Masao Kunimoto, Yoshikazu Hachiro, Kei Ohara, Mitsuhiro Inagaki; Ann Coloproctol. 2023;39(3):210-215. Published online November 12, 2021; DOI: https://doi.org/10.3393/ac.2021.00731.0104

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5 Citations

Abstract PDF

Purpose
Perineal procedures are an important surgical option for frail and high-risk patients with rectal prolapse. This study aimed to evaluate the efficacy and safety of combined therapy using injection sclerotherapy, with aluminum potassium sulfate and tannic acid (ALTA), and the Thiersch procedure, using the Leeds-Keio ligament (ALTA-Thiersch).
Methods
This study included 106 consecutive patients (mean age, 81.2 years) who underwent ALTA-Thiersch for rectal prolapse. The procedure was performed under caudal epidural anesthesia. ALTA was injected into the submucosa from the tip of the prolapsed rectum down to the dentate line, circumferentially, at 20 to 40 locations. The ligament tape was placed outside the external sphincter muscle and at an approximate depth of 2 cm into the middle anal canal.
Results
Of 106 patients, rectal prolapse was cured shortly after surgery in 105 patients. An additional tape was inserted in 1 patient who had persistent prolapse. Postoperative complications were observed in 27 patients (25.5%). Fecal impaction occurred in 12 patients; however, since it was temporary, no tape removal was required. Of the 12 cases in which the tape was infected or exposed, 11 required tape removal. There were 18 cases of recurrence at a mean follow-up of 22.1 months. Cumulative recurrence rates at 3 and 5 years were 21.3% and 38.6%, respectively.
Conclusion
ALTA-Thiersch is a simple and safe procedure for rectal prolapse, having reasonable outcomes. The use of the Leeds-Keio ligament for anal encircling can help compensate for the disadvantages of the Thiersch operation.

Citations

Citations to this article as recorded by

Outcomes of the Gant-Miwa-Thiersch Procedure Using the Leeds-Keio Mesh for Rectal Prolapse
Naoto Nishigori, Yoshiyuki Sasaki, Shinsaku Obara
Journal of the Anus, Rectum and Colon.2025; 9(2): 252. CrossRef
Gant-Miwa-Thiersch Procedure for Rectal Prolapse - Use of the Leeds-Keio Mesh
Naoto Nishigori, Yoshiyuki Sasaki, Shinsaku Obara
Nihon Daicho Komonbyo Gakkai Zasshi.2025; 78(10): 398. CrossRef
Tissue engineering and regenerative medicine approaches in colorectal surgery
Bigyan B. Mainali, James J. Yoo, Mitchell R. Ladd
Annals of Coloproctology.2024; 40(4): 336. CrossRef
Efficacy and Safety of a New Technique Combining Injection Sclerotherapy and External Hemorrhoidectomy for Prolapsed Hemorrhoids: A Single-center Observational Study
Tatsuya Abe, Masao Kunimoto, Yoshikazu Hachiro, Akane Ito, Kenji Watanabe, Shigenori Ota, Kei Ohara, Mitsuhiro Inagaki, Yusuke Saitoh, Masanori Murakami
Journal of the Anus, Rectum and Colon.2024; 8(4): 331. CrossRef
Simple Anal Reinforcement with Anal Encirclement Using an Artificial Ligament in Patients with fecal Incontinence: A Single-center Observational Study
Tatsuya Abe, Masao Kunimoto, Yoshikazu Hachiro, Shigenori Ota, Kei Ohara, Mitsuhiro Inagaki
Journal of the Anus, Rectum and Colon.2022; 6(3): 174. CrossRef

Benign proctology

Anal Dysplasia Among Patients With Multiple Human Papillomavirus Anal Lesions: Mosaic or Homogeneity?: Emilie Lafferre, Laurent Abramowitz, Francine Walker, Dalila Benabderrhamanne, Anne Laurain, Xavier Duval, Florence Tubach; Ann Coloproctol. 2021;37(4):212-217. Published online July 29, 2020; DOI: https://doi.org/10.3393/ac.2020.06.11.1

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Abstract PDF: Purpose
Anal dysplasia is caused by chronic infection with the human papillomavirus and exposes to the risk of anal cancer. The aim of this study was to evaluate the distribution of dysplasia anal grade among patients operated on for multiple anal condylomas with no macroscopic differences.
Methods
This is a cross-sectional study of patients operated on for multiple anal condylomas including a mapping of dysplasia by performing systematically for each patient one biopsy on visible lesion from each of the 4 quadrants on anal margin and in anal canal. All biopsies were read independently by 2 different pathologists.
Results
Among 72 patients, 60 were men and 48 were human immunodeficiency virus (HIV)-infected with a median age of 37.5 years. The proportion of high-grade squamous intraepithelial lesion (HSIL) was higher in the anal canal (41.7%) compared to the margin (20.8%) (P = 0.004). HSIL frequency did not differ according to the quadrant (anterior, posterior, right, and left) of the 2 areas. HSIL on anal canal was not associated with HSIL on anal margin and vice versa (P = 0.390). Neither age nor sex was associated to HSIL but HIV positivity increased the risk of HSIL on the anal margin (P = 0.010).
Conclusion
Anal dysplasia is heterogeneously distributed in the anal canal as well as between anal canal and anal margin. The diagnostic of the grade of dysplasia for a person should require multiple biopsies on the canal and anal margin.

Benign GI diease

Routine Intraoperative Bacterial Culture May Be Needed in Complicated Appendicitis: Jung Tack Son, Gue Chun Lee, Hyung Ook Kim, Taewoon Kim, Donghyoun Lee, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim, Ho-Kyung Chun; Ann Coloproctol. 2020;36(3):155-162. Published online June 30, 2020; DOI: https://doi.org/10.3393/ac.2019.11.04.1

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11 Web of Science
13 Citations

Abstract PDF

Purpose
Choosing the appropriate antibiotic is important for treatment of complicated appendicitis. However, increasing multidrug resistant bacteria have been a serious problem for successful treatment. This study was designed to identify bacteria isolated from patients with complicated appendicitis and reveal their susceptibilities for antibiotics and their relationship with patient clinical course.
Methods
This study included patients diagnosed with complicated appendicitis and examined the bacterial cultures and antimicrobial susceptibilities of the isolates. Data were retrospectively collected from medical records of Kangbuk Samsung Hospital from January 2008 to February 2018.
Results
The common bacterial species cultured in complicated appendicitis were as follows: Escherichia coli (n=113, 48.9%), Streptococcus spp. (n=29, 12.6%), Pseudomonas spp. (n=23, 10.0%), Bacteriodes spp. (n=22, 9.5%), Klebsiella (n=11, 4.8%), and Enterococcus spp. (n=8, 3.5%). In antibiotics susceptibility testing, the positive rate of extended-spectrum beta lactamase (ESBL) was 9.1% (21 of 231). The resistance rate to carbapenem was 1.7% (4 of 231), while that to vancomycin was 0.4% (1 of 231). E. coli was 16.8% ESBL positive (19 of 113) and had 22.1% and 19.5% resistance rates to cefotaxime and ceftazidime, respectively. Inappropriate empirical antibiotic treatment (IEAT) occurred in 55 cases (31.8%) and was significantly related with organ/space surgical site infection (SSI) (7 of 55, P=0.005).
Conclusion
The rate of antibiotic resistance organisms was high in community-acquired complicated appendicitis in Koreans. Additionally, IEAT in complicated appendicitis may lead to increased rates of SSI. Routine intraoperative culture in patients with complicated appendicitis may be an effective strategy for appropriate antibiotic regimen.

Citations

Citations to this article as recorded by

Optimizing Antibiotic Management for Adult Patients Presenting with Acute Perforated Appendicitis: A Quality Improvement Study
Carlos Gallego-Navarro, Jason Beckermann, Maria E. Linnaus, Hayden J. Swartz, Shelby Stewart, Justin M. York, Ryan R. Gassner, Christopher A. Kasal, Annaliese G. Seidel, Corey J. Wachter, Kirstin J. Kooda, Jennifer R. Rich, Mark D. Sawyer
Surgical Infections.2025; 26(3): 143. CrossRef
A Prospective Analysis of the Burden of Multi-Drug-Resistant Pathogens in Acute Appendicitis and Their Implication for Clinical Management
Faruk Koca, Sara Fatima Faqar-Uz-Zaman, Claudia Reinheimer, Michael Hogardt, Volkhard A. J. Kempf, Paul Ziegler, Andreas A. Schnitzbauer, Armin Wiegering, Wolf Otto Bechstein, Patrizia Malkomes
Antibiotics.2025; 14(4): 378. CrossRef
Culture-based bacterial evaluation of the appendix lumen and antibiotic susceptibility of acute appendicitis in Japan: A single-center retrospective analysis
Hiroe Kitahara, Yonfan Park, Kai Seharada, Masaki Yoshimura, Akira Horiuchi, Yukihiko Karasawa
Medicine.2024; 103(29): e39037. CrossRef
Do Cultures From Percutaneously Drained Intra-abdominal Abscesses Change Treatment? A Retrospective Review
Andrew C. Esposito, Yuqi Zhang, Nupur Nagarkatti, William D. Laird, Nathan A. Coppersmith, Vikram Reddy, Ira Leeds, Anne Mongiu, Walter Longo, Ritche M. Hao, Haddon Pantel
Diseases of the Colon & Rectum.2023; 66(3): 451. CrossRef
Bacterial pathogens in pediatric appendicitis: a comprehensive retrospective study
Julia Felber, Benedikt Gross, Arend Rahrisch, Eric Waltersbacher, Evelyn Trips, Percy Schröttner, Guido Fitze, Jurek Schultz
Frontiers in Cellular and Infection Microbiology.2023;[Epub] CrossRef
An Update on Acute Appendicitis in Lebanon: Insights From a Single-Center Retrospective Study
Nagham Bazzi, Samer Dbouk, Ahmad Rached, Sadek Jaber, Hala Bazzi, Manal Jrad, Mariam Bazzi
Cureus.2023;[Epub] CrossRef
Bacterial peritonitis in paediatric appendicitis; microbial epidemiology and antimicrobial management
Keir Bhaskar, Simon Clarke, Luke S. P. Moore, Stephen Hughes
Annals of Clinical Microbiology and Antimicrobials.2023;[Epub] CrossRef
Aerobic Intraoperative Abdominal Cavity Culture Modifies Antibiotic Therapy and Reduces the Risk of Surgical Site Infection in Complicated Appendicitis with Peritonitis
Víctor Manuel Quintero-Riaza, Romario Chancí-Drago, Natalia Guzmán-Arango, Pablo Posada-Moreno, Tatiana López-Sandoval, Isabel Cristina Ramírez-Sánchez, Johanna Marcela Vanegas-Munera
Journal of Gastrointestinal Surgery.2023; 27(11): 2563. CrossRef
Does the Covid-19 pandemic have an effect on wound culture in patients undergoing appendectomy? A Case Control Study
Hacı BOLAT, Tuğba AVAN MUTLU
Journal of Contemporary Medicine.2022; 12(2): 332. CrossRef
Are We Hitting the Target?
Julia Elrod, Fatima Yarmal, Christoph Mohr, Martin Dennebaum, Michael Boettcher, Deirdre Vincent, Konrad Reinshagen, Ingo Koenigs
Pediatric Infectious Disease Journal.2022; 41(6): 460. CrossRef
Is Routine Intra-operative Gram Stain, Culture, and Sensitivity during an Appendectomy is Effective in Decreasing the Rate of Post-operative Infective Complications?
Muqdad Fuad, Ahmed Modher, Mohammed Habash
Open Access Macedonian Journal of Medical Sciences.2022; 10(B): 868. CrossRef
Die Bedeutung mikrobiologischer Ergebnisse für die Therapie der komplizierten Appendizitis – eine monozentrische Fall-Kontroll-Studie
F-X. Anzinger, K. Rothe, S. Reischl, C. Stöss, A. Novotny, D. Wilhelm, H. Friess, P-A. Neumann
Die Chirurgie.2022; 93(10): 986. CrossRef
Implications of bacteriological study in complicated and uncomplicated acute appendicitis
Sorin Cimpean, Alberto Gonzalez Barranquero, Ion Surdeanu, Benjamin Cadiere, Guy-Bernard Cadiere
Annals of Coloproctology.2022;[Epub] CrossRef

Benign GI diease,Benign diesease & IBD,Complication

High Compliance With Surgical Site Infection (SSI) Prevention Bundle Reduces Incisional SSI After Colorectal Surgery: Varut Lohsiriwat; Ann Coloproctol. 2021;37(3):146-152. Published online May 15, 2020; DOI: https://doi.org/10.3393/ac.2020.04.10.2

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Abstract PDF

Purpose
This study aimed to evaluate association between compliance with surgical site infection (SSI) prevention bundle and the development of superficial or deep incisional SSI following colorectal surgery and to evaluate the impact of incisional SSI on surgical outcomes.
Methods
A prospectively collected database of consecutive patients undergoing elective colectomy and/or proctectomy from 2011 to 2019 in a university hospital was reviewed. The association between compliance with Thailand’s SSI Prevention Bundle (10 level-1A interventions) and the incidence of incisional SSI was determined. Surgical outcomes were compared between those with incisional SSI and those without.
Results
This study included 600 patients with a median age of 64 years (range, 18–102 years). Some 126 patients (21.0%) had stoma formation and 52 (8.7%) underwent laparoscopy. The incidence of incisional SSI was 5.5% (n = 33; 32 superficial incisional SSI and 1 deep incisional SSI). Higher compliance with care bundle tended to decrease incisional SSI (P = 0.20). In multivariate analysis, compliance of 70% or more was the only dependent factor for reducing incisional SSI (odds ratio, 0.39; 95% confidence interval, 0.15 to 0.99; P = 0.047). None of individual interventions were significantly associated with a lower probability of incisional SSI. Compared with counterparts, patients with incisional SSI had a 2-day longer length of postoperative stay (6 day vs. 4 day, P < 0.001) but comparable time for gastrointestinal recovery and similar rate of 30-day mortality or readmission.
Conclusion
High compliance with SSI prevention bundle (especially ≥ 70%) reduced incisional SSI after colorectal surgery.

Citations

Citations to this article as recorded by

Surgical site infection prevention care bundles in colorectal surgery: a scoping review
T. Cunha, S. Miguel, J. Maciel, C. Zagalo, P. Alves
Journal of Hospital Infection.2025; 155: 221. CrossRef
Empowering patients through a perioperative prevention bundle to reduce surgical site infections in colorectal surgery
Vladimir Nikolic, Ljiljana Markovic-Denic, Stefan Kmezic, Aleksandar Radovanovic, Djordje Nektarijevic, Jelena Djokic-Kovac, Djordje Knezevic, Andrija Antic
American Journal of Infection Control.2025; 53(7): 753. CrossRef
The Impact of Patients’ Engagement in the Prevention of Surgical Site Infections: A Systematic Review
Ashraf A'aqoulah, Munirah Alomran, Nuha Alhumaid, Ashraf El-Metwally, Farah Kalmey
Infection and Drug Resistance.2025; Volume 18: 5761. CrossRef
Systematic review and meta-analysis of outcomes associated with incisional and organ/space surgical site infections in abdominal surgery patients
Shalini Elangovan, Shravya Murali, Amudha Aravindhan, Choon Sheong Seow, Nicholas Graves
Antimicrobial Resistance & Infection Control.2025;[Epub] CrossRef
Surgical Site Infection Prevention Using “Strike Teams”: The Experience of an Academic Colorectal Surgical Department
Buddhi Hatharaliyadda, Michelle Schmitz, Anne Mork, Fauzia Osman, Charles Heise, Nasia Safdar, Aurora Pop-Vicas
Journal for Healthcare Quality.2024; 46(1): 22. CrossRef
Interventions to reduce surgical site infection following elective colorectal surgery: protocol for a systematic review with narrative synthesis and GRADE recommendations
Harry Dean, Ioanna Drami, Amira Shamsiddinova, Eman Alkizwini, James Kinross, Ana Wilson, Phil Tozer, Carolynne Vaizey
Journal of Surgical Protocols and Research Methodologies.2024;[Epub] CrossRef
Effect of a colorectal bundle in an entire healthcare region in Switzerland: results from a prospective cohort study (EvaCol study)
Benjamin Wiesler, Robert Rosenberg, Raffaele Galli, Jürg Metzger, Mathias Worni, Mark Henschel, Mark Hartel, Christian Nebiker, Carsten T. Viehl, Alexandra Müller, Lukas Eisner, Martina Pabst, Urs Zingg, Daniel Stimpfle, Beat P. Müller, Markus von Flüe, R
International Journal of Surgery.2024; 110(12): 7763. CrossRef
Information technologies for supporting prevention, diagnosis and management of surgical site infections in trauma and orthopedic patients
Anton G. Nazarenko, Elena B. Kleimenova, Mikhail A. Dronov, Dmitry S. Gorbatyuk, Nodari M. Kakabadze, Archil V. Tsiskarashvili, Natalia P. Gerasimova, Ekaterina S. Yurchenkova, Liubov P. Yashina
N.N. Priorov Journal of Traumatology and Orthopedics.2024; 31(4): 467. CrossRef
Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and the Society of American Gastrointestinal and Endoscopic Surgeons
Jennifer L. Irani, Traci L. Hedrick, Timothy E. Miller, Lawrence Lee, Emily Steinhagen, Benjamin D. Shogan, Joel E. Goldberg, Daniel L. Feingold, Amy L. Lightner, Ian M. Paquette
Diseases of the Colon & Rectum.2023; 66(1): 15. CrossRef
Clinical practice guidelines for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons and the Society of American Gastrointestinal and Endoscopic Surgeons
Jennifer L. Irani, Traci L. Hedrick, Timothy E. Miller, Lawrence Lee, Emily Steinhagen, Benjamin D. Shogan, Joel E. Goldberg, Daniel L. Feingold, Amy L. Lightner, Ian M. Paquette
Surgical Endoscopy.2023; 37(1): 5. CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
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Strategies to Reduce Post-Hemorrhoidectomy Pain: A Systematic Review
Varut Lohsiriwat, Romyen Jitmungngan
Medicina.2022; 58(3): 418. CrossRef
Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] CrossRef

Review

Benign GI diease,Epidemiology & etiology

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

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Abstract PDF

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

Citations

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General Principles of Preoperative Risk Mitigation
Sarah Atoui, A. Sender Liberman
Clinics in Colon and Rectal Surgery.2025;[Epub] CrossRef
Advanced Protocols for Preoperative Colon Preparation: Enhancing Outcomes in Colorectal Surgery
Marian Cerny, Ľudovít Danihel, Milan Schnorrer, Stefan Durdik
Polish Journal of Surgery.2025; 97(5): 1. CrossRef
Feasibility of the ERAS (Enhanced Recovery After Surgery) Protocol in Patients Undergoing Gastrointestinal Cancer Surgeries in a Tertiary Care Hospital—A Prospective Interventional Study
Surya Theja, Seema Mishra, Sandeep Bhoriwal, Rakesh Garg, Sachidanand Jee Bharati, Vinod Kumar, Nishkarsh Gupta, Saurabh Vig, Sunil Kumar, S. V. S. Deo, Sushma Bhatnagar
Indian Journal of Surgical Oncology.2024; 15(2): 304. CrossRef
Influence of additional prophylactic oral antibiotics during mechanical bowel preparation on surgical site infection in patients receiving colorectal surgery
Hayoung Lee, Jong Lyul Lee, Ji Sung Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok‐Byung Lim
World Journal of Surgery.2024; 48(6): 1534. CrossRef
The Impact of Surgical Bowel Preparation on the Microbiome in Colon and Rectal Surgery
Lauren Weaver, Alexander Troester, Cyrus Jahansouz
Antibiotics.2024; 13(7): 580. CrossRef
Pre-Operative Mechanical Bowel Preparation Does Not Affect the Impact of Anastomosis Leakage in Left-Side Colorectal Surgery—A Single Center Observational Study
Ludovít Danihel, Marian Cerny, Ivor Dropco, Petra Zrnikova, Milan Schnorrer, Marek Smolar, Miloslav Misanik, Stefan Durdik
Life.2024; 14(9): 1092. CrossRef
Bowel cleansing, dysbiosis, and postoperative infection: the dots are starting to connect
John C Alverdy
British Journal of Surgery.2024;[Epub] CrossRef
A prospective, randomized assessment of a novel, local antibiotic releasing platform for the prevention of superficial and deep surgical site infections
O. Zmora, Y. Stark, O. Belotserkovsky, M. Reichert, G. A. Kozloski, N. Wasserberg, H. Tulchinsky, L. Segev, A. J. Senagore, N. Emanuel
Techniques in Coloproctology.2023; 27(3): 209. CrossRef
Bacterial Decontamination: Bowel Preparation and Chlorhexidine Bathing
Yadin Bornstein, Elizabeth C. Wick
Clinics in Colon and Rectal Surgery.2023; 36(03): 201. CrossRef
Effect of non-mechanical bowel preparation on postoperative gastrointestinal recovery following surgery on malignant gynecological tumors: A randomized controlled trial
Shan-shan Wang, Hong-yan Xu, Xing-xia Li, Su-wen Feng
European Journal of Oncology Nursing.2023; 64: 102320. 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
The Impact of the Enhanced Recovery After Surgery (ERAS) Protocol on Colorectal Surgery in a Portuguese Tertiary Hospital
Catarina Lopes, Mariana Vaz Gomes, Manuel Rosete, Ana Almeida, Luisa Isabel Silva, José Guilherme Tralhão
Acta Médica Portuguesa.2022; 36(4): 254. CrossRef

Case Reports

Benign GI diease,Benign diesease & IBD,Complication

Clostridium difficile Infection After Ileostomy Reversal: Ho Seung Kim, Jae Hyun Kang, Han-gil Kim, Young Hun Kim, Hyeonwoo Bae, Nam Kyu Kim; Ann Coloproctol. 2021;37(Suppl 1):S4-S6. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.09.24

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129 Download
2 Web of Science
2 Citations

Abstract PDF

Clostridium difficile infection (CDI) after ileostomy reversal is rare, with few reports available in the available literature describing this condition. The diagnosis of CDI after ileostomy reversal is challenging because symptoms such as diarrhea observed in these patients can occur frequently after surgery. However, CDI can be fatal, so early diagnosis and prompt treatment are important. We discuss 2 patients with positive C. difficile toxin assay results on stool cultures performed after ileostomy reversal. Clinical progression differed between these patients: one patient who presented with severe CDI and shock was successfully treated following a prolonged intensive care unit stay for the management of vital signs and underwent hemodialysis, while another patient showed symptoms of mild colitis but we could not confirm whether diarrhea was associated with CDI or with the usual postoperative state. To our knowledge, these represent 2 of just a few cases reported in the literature describing CDI after ileostomy reversal.

Citations

Citations to this article as recorded by

Influence of additional prophylactic oral antibiotics during mechanical bowel preparation on surgical site infection in patients receiving colorectal surgery
Hayoung Lee, Jong Lyul Lee, Ji Sung Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok‐Byung Lim
World Journal of Surgery.2024; 48(6): 1534. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef

Benign proctology,Rare disease & stoma

Extraperitoneal Spread of Anorectal Abscess: A Case Report and Literature Review: Papadopoulos S. Konstantinos, Dimopoulos Andreas, Kordeni Kleoniki, Filis Dimitrios; Ann Coloproctol. 2021;37(Suppl 1):S11-S14. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2020.01.20

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149 Download
4 Web of Science
6 Citations

Abstract PDF

Supralevator abscess is a rare form of anorectal disease responsible for very rare but morbid manifestations, one of which is superior spread through fascial planes. We present a rare case of a spreading anorectal abscess in a patient who presented with only diffuse abdominal pain, and we review similar cases in the literature according to anatomical considerations, presentation, diagnostic procedures, and treatment options. We identified 7 previously reported cases of spreading anorectal abscesses. Most abscesses had a horseshoe morphology, and all patients presented or developed abdominal pain. All patients had perianal swelling and pain. Five out of 7 patients were previously mistreated. Only 2 abscesses spread through both the pre- and retroperitoneal planes. Abdominal pain is a dominant feature of extraperitoneal inflammation originating from anorectal abscesses. The absence of perianal signs is rare, and proper inspection of the patient along with the medical history can lead to quicker diagnosis and decisive treatment.

Citations

Citations to this article as recorded by

Fused Ischiorectal Phlegmon with Pre- and Retroperitoneal Extension: Case Report and Narrative Literature Review
Laurențiu Augustus Barbu, Liviu Vasile, Liliana Cercelaru, Ionică-Daniel Vîlcea, Valeriu Șurlin, Stelian-Stefaniță Mogoantă, Gabriel Florin Răzvan Mogoș, Tiberiu Stefăniță Țenea Cojan, Nicolae-Dragoș Mărgăritescu
Journal of Clinical Medicine.2025; 14(14): 4959. CrossRef
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Kalyani Dnyaneshwar Aher, Minakshi Gadhire, Naman Jain, Prafulla Salunkhe
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Original Articles

Effect of Hyperoxygenation During Surgery on Surgical Site Infection in Colorectal Surgery: Mina Alvandipour, Farzad Mokhtari-Esbuie, Afshin Gholipour Baradari, Abolfazl Firouzian, Mehdi Rezaie; Ann Coloproctol. 2019;35(1):9-14. Published online February 28, 2019; DOI: https://doi.org/10.3393/ac.2018.01.16

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Abstract PDF

Purpose
Despite the use of different surgical methods, surgical site infection is still an important cause of mortality and morbidity in patients and imposes a considerable cost on the healthcare system. Administration of supplemental oxygen during surgery has been reported to reduce surgical site infection (SSI); however, that result is still controversial. This study was performed to evaluate the effect of hyperoxygenation during colorectal surgery on the incidence of wound infection.
Methods
This study was a prospective double-blind case-control study. The main aim of the study was to evaluate the effect of hyperoxygenation during colorectal surgery on the incidence of SSI. Also, secondary outcomes, such as atelectasis, pneumonia, respiratory failure, length of hospital stay, and required hospitalization in the intensive care unit were evaluated.
Results
SSI was recorded in 2 patients (2 of 40, 5%) in the hyperoxygenation group (FiO2 80%) and 6 patients (6 of 40, 15%) in the control group (FiO2 30%) (P < 0.05). Time of hospitalization was 6 ± 6.4 days in the hyperoxygenation group and 9.2 ± 2.4 days in the control group (P < 0.05).
Conclusion
This study showed a positive effect of hyperoxygenation in reducing SSI in colorectal surgery, especially surgery in an emergency setting. When the low risk, low cost, and effectiveness of this method in patients undergoing a laparotomy are considered, it is recommended for all patients undergoing colorectal surgery.

Citations

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Effects of high vs. low perioperative inspired oxygen fraction on length of hospital stay and postoperative complications: a systematic review, meta-analysis, and trial sequential analysis
Mimi WU, Lanlan CHANG, Leying SUN, Zhao DAI, Jinhua BO, Xin XU
Minerva Anestesiologica.2025;[Epub] CrossRef
Perioperative oxygen therapy: an overview of systematic reviews and meta-analyses
Adel Elfeky, Yen-Fu Chen, Amy Grove, Keith Couper, Rachel Court, Sara Tomassini, Anna Wilson, Amy Hooper, Alexandra Buckle, Sharvari Vadeyar, Marion Thompson, Olalekan Uthman, Joyce Yeung
British Journal of Anaesthesia.2025;[Epub] CrossRef
Perioperative Low Fraction of Inspired Oxygen Reduces Postoperative Atelectasis in Abdominal Surgery Patients: A Systematic Review and Meta-Analysis
勇肖
Advances in Clinical Medicine.2025; 15(08): 1883. CrossRef
Perioperative oxygen therapy in patients undergoing surgical procedures: an overview of systematic reviews and meta-analyses
Adel Elfeky, Yen-Fu Chen, Amy Grove, Keith Couper, Rachel Court, Sara Tomassini, Anna Wilson, Amy Hooper, Alexandra Buckle, Sharvari Vadeyar, Marion Thompson, Olalekan Uthman, Joyce Yeung
Health Technology Assessment.2025; : 1. CrossRef
Risk Factors for Postoperative Infections Following Appendectomy of Complicated Appendicitis: A Meta-analysis and Retrospective Single-institutional Study
Katherine Cironi, Aaron L. Albuck, Bryant McLafferty, Alison K. Mortemore, Christina McCarthy, Mohammad Hussein, Peter P. Issa, Tyler Metz, Marcela Herrera, Eman Toraih, Sharven Taghavi, Emad Kandil, Jacquelyn Turner
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2024; 34(1): 20. CrossRef
Vermeidung postoperativer Wundinfektionen
Pernilla V. Conrad, Thomas Becker, Julius Pochhammer, Axel Kramer
Im OP.2024; 14(05): 236. CrossRef
The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for Preventing Surgical Site Infection
Benjamin D. Shogan, Jon D. Vogel, Bradley R. Davis, Deborah S. Keller, Jennifer M. Ayscue, Lindsey E. Goldstein, Daniel L. Feingold, Amy L. Lightner, Ian M. Paquette
Diseases of the Colon & Rectum.2024; 67(11): 1368. CrossRef
Updated meta-analysis on intraoperative inspired fraction of oxygen and the risk of surgical site infection in adults undergoing general and regional anesthesia
Yoann El Maleh, Charlotte Fasquel, Christophe Quesnel, Marc Garnier
Scientific Reports.2023;[Epub] CrossRef
Vermeidung postoperativer Wundinfektionen
Pernilla V. Stropnicky, Thomas Becker, Julius Pochhammer, Axel Kramer
Allgemein- und Viszeralchirurgie up2date.2023; 17(04): 301. CrossRef
The effect of high perioperative inspiratory oxygen fraction for abdominal surgery on surgical site infection: a systematic review and meta-analysis
Jae Hee Kuh, Woo-Seok Jung, Leerang Lim, Hae Kyung Yoo, Jae-Woo Ju, Ho-Jin Lee, Won Ho Kim
Scientific Reports.2023;[Epub] CrossRef
Differences in clinical and cost-effectiveness between cefmetazole and flomoxef for the prevention of surgical site infection in elective colorectal surgery: A single-center, retrospective cohort study
Yuya Urano, Shunichi Saito, Takafumi Machimoto, Yukio Tsugihashi, Hiroyasu Ishimaru, Hiroyuki Akebo, Ryuichi Sada
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Mallory A Rowley, Kometh Thawanyarat, Jennifer K Shah, Lawrence Cai, Elizabeth Turner, Oscar J Manrique, Brian Thornton, Rahim Nazerali
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Maria Høybye, Peter C. Lind, Mathias J. Holmberg, Maria Bolther, Marie K. Jessen, Mikael F. Vallentin, Frederik B. Hansen, Johanne M. Holst, Andreas Magnussen, Niklas S. Hansen, Cecilie M. Johannsen, Johannes Enevoldsen, Thomas H. Jensen, Lara L. Roessler
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Johanne M. Holst, Maibritt P. Klitholm, Jeppe Henriksen, Mikael F. Vallentin, Marie K. Jessen, Maria Bolther, Mathias J. Holmberg, Maria Høybye, Peter Carøe Lind, Asger Granfeldt, Lars W. Andersen
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Gearóid Mc Geehan, Itoro M. Edelduok, Magda Bucholc, Angus Watson, Zsolt Bodnar, Alison Johnston, Michael Sugrue
Life.2021; 11(2): 138. CrossRef

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

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Abstract 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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Complicated diverticulitis: Diagnostic precision and surgical solutions in a patient with chronic kidney disease
Sharon L. Hsieh, Nathaniel Grabill, Mena Louis, Bradley Kuhn
Radiology Case Reports.2025; 20(1): 346. CrossRef
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
Annals of Plastic Surgery.2024; 92(1S): S33. CrossRef
TIMING OF THE STOMA REVERSAL, WHAT IS THE SAFE PERIOD?: A RETROSPECTIVE OBSERVATIONAL STUDY
GIRIDHAR ASHWATH, ESHWAR KATHIRESAN MANASIJAN, ANTHONY P ROZARIO
Asian Journal of Pharmaceutical and Clinical Research.2024; : 181. CrossRef
Diverting ileostomy in benign colorectal surgery: the real clinical cost analysis
F. Ascari, G. Barugola, G. Ruffo
Updates in Surgery.2024; 76(5): 1761. CrossRef
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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Surgical Site Infection After Stoma Reversal: A Comparison Between Linear and Purse-String Closure
Muhammad Awais Khan, Khurram Niaz, Shahzeb Asghar, Maaz A Yusufi, Mohtamam Nazir, Syed Muhammad Ali, Aryan Ahmed, Akeel Ahamed Salahudeen, Talha Kareem
Cureus.2023;[Epub] CrossRef
Factors Predicting the Reversal of Hartmann’s Procedure
Ömer Yalkın, Fatih Altıntoprak, Mustafa Yener Uzunoğlu, Yasin Alper Yıldız, Muhammet Burak Kamburoğlu, Necattin Fırat, Fehmi Çelebi, Mihajlo Jakovljevic
BioMed Research International.2022;[Epub] CrossRef

Purse-String Versus Linear Conventional Skin Wound Closure of an Ileostomy: A Randomized Clinical Trial: Mina Alvandipour, Babak Gharedaghi, Hamed Khodabakhsh, Mohammad Yasin Karami; Ann Coloproctol. 2016;32(4):144-149. Published online August 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.4.144

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23 Citations

Abstract PDF

Purpose

Infection is one of the most frequent complications that can occur after ileostomy closure. The incidence of wound infection depends on the skin closure technique, but there is no agreement on the perfect closure method for an ileostomy wound. The aim of this study was to evaluate the incidence of infection, the patient's approval, and the patient's pain between purse-string closure (PSC) and the usual linear closure (LC) of a stoma wound.

Methods

This randomized clinical trial enrolled 66 patients who underwent a stoma closure from February 2015 to May 2015 in Sari Emam Khomeini Hospital. Patients were divided into 2 groups according to the stoma closing method: the PSC group (n = 34) and the LC group (n = 32). The incidences of infection for the 2 groups were compared, and the patients' satisfaction and pain with the stoma were determined by using a questionnaire.

Results

Infection occurred in 1 of 34 PSC patients (2.9%) and in 7 of 32 LC patients (21.8%), and this difference was statistically significant (P = 0.021). Patients in the PSC group were more satisfied with the resulting wound scar and its cosmetic appearance at one month and three months after surgery (P = 0.043).

Conclusion

After stoma closure, PSC was associated with a significantly lower incidence of wound infection and greater patient satisfaction compared to LC. However, the healing period for patients who underwent PSC was longer than it was for those who underwent LC.

Citations

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Usefulness of a negative pressure wound therapy system for stoma closure
Chisato Shirakawa, Yuzuru Sakamoto, Shinya Ueki, Hiroki Shomura, Keizo Kazui, Akinobu Taketomi
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Circular (purse-string) vs primary skin closure following stoma closure: an up-to-date systematic review and meta-analysis
F. Menegon Tasselli, F. Pata, G. Fuschillo, G. Signoriello, A. Bondurri, G. Sciaudone, F. Selvaggi, G. Pellino
Techniques in Coloproctology.2025;[Epub] CrossRef
Primary closure of ileostomy site after irrigation with betaine–polyhexanide: a case series
Henry Krasner, Abigail W Cheng, Lance Horner, Ovunc Bardakcioglu
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The Outcome of Purse-string Versus Conventional Wound Closure Techniques in Patients Undergoing Stoma Reversal: A Randomized Controlled Trial
Assad Ameer, Muhammad Bilal Mirza, Nabila Talat
Journal of Pediatric Surgery.2024; 59(6): 1186. CrossRef
Purse-string skin closure versus linear skin closure in people undergoing stoma reversal
Shahab Hajibandeh, Shahin Hajibandeh, Andrew Maw
Cochrane Database of Systematic Reviews.2024;[Epub] CrossRef
Comparison of purse-string technique vs linear suture for skin closure after ileostomy reversal. A randomized controlled trial
Filippo Carannante, Gianluca Costa, Valentina Miacci, Gianfranco Bianco, Gianluca Masciana, Sara Lauricella, Marco Caricato, Gabriella Teresa Capolupo
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Purse-string versus linear closure of the skin wound following stoma reversal: A meta-analysis with RCT and systematic review
Jinlong Luo, Dan Liu, Junmei Wu, Huaiwu Jiang, Jin Chen, Hua Yang, Lie Yang
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Short-term outcomes following purse-string versus conventional closure of ileostomy wounds in Chinese colorectal cancer patients — a single center retrospective study
Yu-Rong Jiao, Xin-Bin Zhou, Yao Ye, Qian Xiao, Xiang-Xing Kong, Ke-Feng Ding, Jun Li
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N. A. Maistrenko, A. A. Sazonov, P. N. Romashchenko, M. V. Zotov
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Sumesh Kaistha, Rajesh Panwar, Sujoy Pal, Nihar Ranjan Dash, Peush Sahni, Tushar Kanti Chattopadhyay
Surgical Infections.2023; 24(9): 797. CrossRef
Purse-string skin closure versus linear skin closure in people undergoing stoma reversal
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Cochrane Database of Systematic Reviews.2022;[Epub] CrossRef
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Shahnam Askarpour, Mehran Peyvasteh, Farbod Farhadi, Hazhir Javaherizadeh
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Nilotpal Behuria, Jayant Kumar Banerjee, Sita Ram Ghosh, Shrirang Vasant Kulkarni, Ramanathan Saranga Bharathi
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Diseases of the Colon & Rectum.2020; 63(10): 1411. CrossRef
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Emanuele Rausa, M. E. Kelly, G. Sgroi, V. Lazzari, A. Aiolfi, F. Cavalcoli, G. Bonitta, L. Bonavina
International Journal of Colorectal Disease.2019; 34(2): 209. CrossRef
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M. Gachabayov, H. Lee, A. Chudner, A. Dyatlov, N. Zhang, R. Bergamaschi
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Italian guidelines for the surgical management of enteral stomas in adults
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International Journal of Surgery.2018; 52: 208. CrossRef
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Shahab Hajibandeh, Shahin Hajibandeh, Andrew Kennedy-Dalby, Sheik Rehman, Reza Arsalani Zadeh
International Journal of Colorectal Disease.2018; 33(10): 1319. CrossRef
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D. P. O’Leary, M. Carter, D. Wijewardene, M. Burton, D. Waldron, E. Condon, J. C. Coffey, C. Peirce
Techniques in Coloproctology.2017; 21(11): 863. CrossRef

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

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16 Citations

Abstract PDF

Purpose

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

Methods

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

Results

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

Conclusion

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

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Mingyue Xu, Yuanyuan Chen, Panhua Li, Qianwen Ye, Shouhan Feng, Bing Yan
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Han Gyu Cha, Jin Geun Kwon, Hyun Ho Han, Jin Sup Eom, Eun Key Kim
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Geunhyeok Yang, Chang Woo Kim, Suk-Hwan Lee
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Bum Sik Tae, Ju Hyun Park, Jung Kwon Kim, Ja Hyeon Ku, Cheol Kwak, Hyeon Hoe Kim, Chang Wook Jeong
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Annals of Coloproctology.2015; 31(6): 211. CrossRef

Clinical Trial on the Incidence of Wound Infection and Patient Satisfaction After Stoma Closure: Comparison of Two Skin Closure Techniques: Sang Il Yoon, Sun Mi Bae, Hwan Namgung, Dong Guk Park; Ann Coloproctol. 2015;31(1):29-33. Published online February 28, 2015; DOI: https://doi.org/10.3393/ac.2015.31.1.29

7,131 View
71 Download
20 Web of Science
19 Citations

Abstract PDF

Purpose

Surgical site infection (SSI) is one of the most common complications that can occur after stoma closure. Reports have described differences in the incidence of wound infection depending on the skin closure technique, but there is no consensus on the ideal closure technique for a stoma wound. The aim of this study was to compare the incidence of SSI and the patient satisfaction between a circumferential purse-string approximation (CPA) and a primary linear closure (PC) of a stoma wound.

Methods

This prospective nonrandomized trial enrolled 48 patients who underwent a stoma closure from February 2010 to October 2013. Patients were divided into two groups according to the stoma closing technique: the CPA group (n = 34) and the PC group (n = 14). The incidences of SSI for the two groups were compared, and the patients' satisfaction with the stoma closure was determined by using a questionnaire.

Results

SSI occurred in 3 of 48 patients (6.3%) and was more frequent in the PC group than in the CPA group (3/14 [21.4%] vs. 0/34 [0%], P = 0.021). Time to complete healing after stoma closure in the CPA group was 32 days (range, 14-61 days). Patients in the CPA group were more satisfied with the resulting wound scar (P = 0.043).

Conclusion

After stoma closure, CPA was associated with a significantly lower incidence of wound infection and greater patient satisfaction compared to PC. However, with the CPA technique, the time to heal is longer than it is with PC.

Citations

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The Influence of Nutritional Assessment on the Outcome of Ostomy Takedown: Min Sang Kim, Ho Kun Kim, Dong Yi Kim, Jae Kyun Ju; J Korean Soc Coloproctol. 2012;28(3):145-151. Published online June 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.3.145

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9 Citations

Abstract PDF

Purpose

Ostomy takedown is often considered a simple procedure without intention; however, it is associated with significant morbidity. This study is designed to evaluate factors predicting postoperative complications in the ostomy takedown in view of metabolism and nutrition.

Methods

A retrospective, institutional review-board-approved study was performed to identify all patients undergoing takedown of an ostomy from 2004 to 2010.

Results

Of all patients (150), 48 patients (32%; male, 31; female, 17) had complications. Takedown of an end-type ostomy showed a high complication rate; complications occurred in 55.9% of end-type ostomies and 15.7% of loop ostomies (P < 0.001). Severe adhesion was also related to a high rate of overall complication (41.3%) (P = 0.024). In preoperative work-up, ostomy type was not significantly associated with malnutrition status. However, postoperatively severe malnutrition level (albumin <2.8 mg/dL) was statistically significant in increasing the risk of complications (72.7%, P = 0.015). In particular, a significant postoperative decrease in albumin (>1.3 mg/dL) was associated with postoperative complications, particularly surgical site infection (SSI). Marked weight loss such as body mass index downgrading may be associated with the development of complications.

Conclusion

A temporary ostomy may not essentially result in severe malnutrition. However, a postoperative significant decrease in the albumin concentration is an independent risk factor for the development of SSI and complications.

Citations

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Jianhua Zhu, Yuanjuan Shen, Juyun Li, Sainan Wang, Wenjuan Shang, Min Sun
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Nutritional and Educational Intervention to Recover a Healthy Eating Pattern Reducing Clinical Ileostomy-Related Complications
Antonio Fernández-Gálvez, Sebastián Rivera, María del Carmen Durán Ventura, Rubén Morilla Romero de la Osa
Nutrients.2022; 14(16): 3431. CrossRef
Classification of the complications of the loop-ileostomy closure procedure according to the Clavien-Dindo grading system
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Case Report

Acute Abdomen Caused by an Infected Mesenteric Cyst in the Ascending Colon: A Case Report: Eun-Ji Kim, Seung-Hyun Lee, Byung-Kwon Ahn, Sung-Uhn Baek; J Korean Soc Coloproctol. 2011;27(3):153-156. Published online June 30, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.3.153

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Abstract PDF

Mesenteric cysts are rare intra-abdominal tumors. Mesenteric cysts are usually asymptomatic and are incidentally detected during physical or radiological examination. Although uncommon, complications such as infection, bleeding, torsion, rupture and intestinal obstruction cause an acute abdomen. Spontaneous infection is a very rare complication. We present a case of infected mesenteric cysts in the ascending colon, which caused an acute abdomen. A 26-year-old woman was admitted to our hospital with acute abdominal pain. She had a painful mass in the right abdomen on physical examination. Abdominal computed tomography showed a hypodense cystic mass with septation at the mesenteric region of the ascending colon. A laparotomy revealed two cystic tumors at the mesenteric region of the ascending colon. She underwent a right hemicolectomy. The two cysts were filled with a yellowish turbid fluid. The walls of both two cysts were lined with a thin fibrotic membrane without any epithelial cell. They were diagnosed as psuedocysts with E. coli infection. Mesenferic cysts may cause life-threatening complications. Mesenteric cyst, even if it is asymptomatic and was diagnosed incidentally, should be removed completely.

Citations

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Infected Mesenteric Cysts: A Rare Cause of Abdominal Pain
Abhishek S Satpathy, Kailash C Mohapatra
Cureus.2024;[Epub] CrossRef
Inflamed Mesenteric Pseudocyst Associated with Meckel’s Diverticulitis: Cause or Consequence
Stefan Talev, Maja Avramovska, Petar Avramovski, Zorica Nikleski, Tamara Ivkovska, Biljana Taleva, Kosta Sotiroski, Vesna Siklovska, Irena Trajcevska, Aleksandra Servini
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Non-organ mesothelial cyst of the abdominal cavity. Clinical observation
I. V. Matveev, M. A. Danilov, N. S. Karnaukhov, A. V. Maksimenko, A. V. Leontiev, A. M. Valieva, V. V. Tsvirkun
Surgery and Oncology.2023; 13(3): 44. CrossRef
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Allan M. F. Kwok, Neryan A. Thomas, Stephen R. Smith
ANZ Journal of Surgery.2022; 92(4): 884. CrossRef
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Riju Ramachandran, Vaishnavi Gunasekaran, Anoop Vasudevan Pillai, Biju Chandran
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Irene Cantarero Carmona, José Fernando Trebollé, Daniel Milian García, María José Luesma Bartolomé
Annals of Medicine and Surgery.2020; 50: 28. CrossRef
Perforated Mesenteric Cyst with Sepsis and Neurological Complication in a 9 Month Old Child
Mandal KC, Saha D, Halder P, Chakraborty P, Debnath B, Mukhopadhyay B
Asploro Journal of Pediatrics and Child Health.2020; 2(1): 30. CrossRef
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Tamara G. Mullaney, Basil D'Souza
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S. K. Pattanaik
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Alireza Mohammadzadeh, Fatemeh Samiee-rad, Kamran Soleimanitadi
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Davy R. Sudiono, Joep B. Ponten, Frank M. Zijta
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Cirugía y Cirujanos (English Edition).2015; 83(4): 334. CrossRef
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Original Article

Conventional Linear versus Purse-string Skin Closure after Loop Ileostomy Reversal: Comparison of Wound Infection Rates and Operative Outcomes: Jung Ryeol Lee, Young Wan Kim, Jong Je Sung, Ok-Pyung Song, Hyung Chul Kim, Cheol-Wan Lim, Gyu-Seok Cho, Jun Chul Jung, Eung-Jin Shin; J Korean Soc Coloproctol. 2011;27(2):58-63. Published online April 30, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.2.58

9,054 View
66 Download
34 Citations

Abstract PDF

Purpose

Wound infection after an ileostomy reversal is a common problem. To reduce wound-related complications, purse-string skin closure was introduced as an alternative to conventional linear skin closure. This study is designed to compare wound infection rates and operative outcomes between linear and purse-string skin closure after a loop ileostomy reversal.

Methods

Between December 2002 and October 2010, a total of 48 consecutive patients undergoing a loop ileostomy reversal were enrolled. Outcomes were compared between linear skin closure (group L, n = 30) and purse string closure (group P, n = 18). The operative technique for linear skin closure consisted of an elliptical incision around the stoma, with mobilization, and anastomosis of the ileum. The rectus fascia was repaired with interrupted sutures. Skin closure was performed with vertical mattress interrupted sutures. Purse-string skin closure consisted of a circumstomal incision around the ileostomy using the same procedures as used for the ileum. Fascial closure was identical to linear closure, but the circumstomal skin incision was approximated using a purse-string subcuticular suture (2-0 Polysorb).

Results

Between group L and P, there were no differences of age, gender, body mass index, and American Society of Anesthesiologists (ASA) scores. Original indication for ileostomy was 23 cases of malignancy (76.7%) in group L, and 13 cases of malignancy (77.2%) in group P. The median time duration from ileostomy to reversal was 4.0 months (range, 0.6 to 55.7 months) in group L and 4.1 months (range, 2.2 to 43.9 months) in group P. The median operative time was 103 minutes (range, 45 to 260 minutes) in group L and 100 minutes (range, 30 to 185 minutes) in group P. The median hospital stay was 11 days (range, 5 to 4 days) in group L and 7 days (range, 4 to 14 days) in group P (P < 0.001). Wound infection was found in 5 cases (16.7%) in group L and in one case (5.6%) in group L (P = 0.26).

Conclusion

Based on this study, purse-string skin closure after a loop ileostomy reversal showed comparable outcomes, in terms of wound infection rates, to those of linear skin closure. Thus, purse-string skin closure could be a good alternative to the conventional linear closure.

Citations

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Case Report

Ulcerofungating Rectal Mass Caused by Cytomegalovirus Infection in a Patient with AIDS.: Lee, Sang Il , Park, Jun Seok , Lee, Taek Gu , Kim, Hong Bin , Park, Young Soo , Lee, Kyung Ho , Kang, Sung Bum; J Korean Soc Coloproctol. 2007;23(4):270-273.; DOI: https://doi.org/10.3393/jksc.2007.23.4.270

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Abstract PDF: Cytomegalovirus infection is a common complication in patients suffering from advanced acquired immunodeficiency syndrome. Cytomegalovirus infections of the gastrointestinal tract in human immunodeficiency-virus-positive patients tend to manifest as ulcerative lesions rather than as mass lesions. In this study, we describe a case of a mass lesion identified as cytomegalovirus proctitis in a human immunodeficiency-virus-positive patient, which had initially been thought to have an adenocarcinoma or a lymphoma. A 60-year-old man had an ulcerofungating mass in the rectum, which was initially detected via palpation. Findings of computerized tomography indicated a malignant mass, which was enhanced in the contrast image. An additional colonoscopy and biopsy were conducted for purposes of diagnosis. The histological examination revealed characteristic inclusion bodies within the nuclei of vascular endothelial cells in the ulcer bed. Immunohistochemical staining with anti-cytomegalovirus antibody confirmed the diagnosis of cytomegalovirus infection. The patient's anorectal lesion had subsided after the initiation antiviral treatments. The diagnosis of cytomegalovirus infection in human immunodeficiency-virus- positive patients occasionally proves rather difficult. Cytomegalovirus infection had induce the formation of mass lesions in immunocompromised patients.

Original Article

Benign Anal Diseases on Patients with HIV Disease.: Hwang, Do Yeon , Lee, Joo Shil , Yoon, Seo Gue , Rhyou, Jai Hyun , Song, Seok Gyu , Lee, Jong Kyun; J Korean Soc Coloproctol. 2003;19(1):1-5.

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Abstract PDF: PURPOSE
The number of patients with HIV disease has been increasing rapidly, with anorectal discomfort being the most common complaint of these patients. However, there are no data on HIV disease relating to the benign anorectal area in Koreans.
METHODS
A retrospective chart review was performed on patients diagnosed with benign anal diseases, combined with HIV disease, between 1996 and 2001. Their clinical aspects were compared with HIV patients registered with the National Institute of Health in Korea between 1985 and 2001.
RESULTS
A total of 1,613 patients were registered, with the National Institute of Health in Korea, as having HIV disease. The ratio of sex was 7.2:1, with a male predominance. The disease was most common in the 3rd & 4th decades, with 64.2%, of the patients in this age range. As for the routes of transmission, sexual contact was the most common (96.9%), followed by blood transfusion (including blood products) (2.8%), vertical transmission (0.1%) and drug injection (0.1%). With regard to the sexual contact routes, homosexuality accounted for 28.0%. Of the cases of HIV disease presenting with a benign anal disease, 32 patients, with a sex ratio of 31:1, with an overwhelming male predominance, were selected. Twenty-six cases had been newly diagnosed at our hospital. As for the routes of the transmission, the disease had been transmitted by sexual contact in all cases. In 43.8% of these cases, the disease had been transmitted by homosexual contact, which showed a marked difference to that of the National database (P<0.05). For those associated with an anal diseases, there were 10 cases of anal fistula, 9 of perianal abscess, 7 of condyloma acuminata, 7 of anal fissure, 5 of hemorrhoids and 2 of ulceration on the lower rectum, noted.
CONCLUSIONS
Nowadays, the numbers of anorectal-disease patients with HIV are increasing in Korea. Since HIV is common in the area of benign proctology, all proctologists must consider the possibility of HIV when managing patients.

Randomized Controlled Trial

Preventive Effects for Wound Infection of Intra-incisional Metronidazole Infiltration Preoperatively in Appendectomy.: Park, Bu Il , Kim, Byung Seok , Moon, Duk Jin , Park, Ju Sub; J Korean Soc Coloproctol. 2000;16(6):356-359.

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Abstract PDF: PURPOSE
The aim of this prospective study was to evaluate the effect of metronidazole for wound infection by using intra-incisional infiltration before appendectomy.
METHODS
From January to May 2000, 176 patients with acute appendicitis received appendectomy. All patients were randomly divided into two groups. Group I (n=50) was the treatment group and group II (n=126) was the control group. After anesthesizing the patients of group I, 7.5 mg/kg of metronidazole was injected into subcutaneous tissue and muscle. All patients of group I and II were given intravenous injection of cephalosporin and intravenous or intramuscular injection of aminoglycoside.
RESULTS
In the 50 cases of group I, the rate of wound infection was 2% and the rate of wound infection in the 126 cases of group II was 4.8%. The rate of anaerobic bacteria of organisms cultured from wound of patients with infection was 0% in group I and 33% in group II. The statistical analysis using chi-square test was not significant (p=0.676) but the rate of wound infection was reduced, especially in infection caused by anaerobic bacteria.
CONCLUSIONS
The rate of wound infection was not significant statistically but it was reduced after intra-incisional infiltration of metronidazole. Therefore we suggest that this method can be one of methods that reduce the rate of wound infection after appendectomy.

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