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Cranial-first approach for laparoscopic extended right hemicolectomy
Kyong-Min Kang, Heung-Kwon Oh, Hong-Min Ahn, Tae-Gyun Lee, Hye-Rim Shin, Mi-Jeong Choi, Duck-Woo Kim, Sung-Bum Kang
Ann Coloproctol. 2024;40(3):282-284.   Published online June 19, 2024
DOI: https://doi.org/10.3393/ac.2023.00661.0094
  • 3,334 View
  • 169 Download
AbstractAbstract PDFSupplementary Material
Complete mesocolic excision and central vascular ligation with D3 lymphadenectomy are important surgical principles for improving oncological outcomes in colon cancer. The cranial-first approach is a colonic mobilization–first approach to radical right hemicolectomy, which has several advantages, including early feasibility assessment, safe dissection from surrounding organs, preestablished inferior margin of lymph node dissection, and revelation of the tangible anatomy of the tributaries of the gastrocolic trunk. This video demonstrates the cranial-first approach to radical right hemicolectomy in a 66-year-old man with locally advanced cecal cancer.
Case Report
Rare disease & stoma
A small, low-grade rectal neuroendocrine tumor with lateral pelvic lymph node metastasis: a case report
Seonhui Shin, Young-In Maeng, Seyun Jung, Chun-Seok Yang
Ann Coloproctol. 2022;38(4):327-331.   Published online March 7, 2022
DOI: https://doi.org/10.3393/ac.2021.00899.0128
  • 3,619 View
  • 172 Download
  • 4 Web of Science
  • 7 Citations
AbstractAbstract PDF
Rectal neuroendocrine tumors (NETs) are typically small lesions that are confined to the submucosa and have favorable behavior at the time of diagnosis. Local endoscopic or surgical resection is recommended because lymph node metastasis is very rare. In this report, we present the case of a 36-year-old male presenting with an incidentally found rectal mass during screening colonoscopy. Pathologic examination of the primary tumor revealed a 9-mm grade 1 NET with submucosal invasion and no significant aggressive factors except for central ulceration. However, radiologic studies revealed a suspected 2.6-cm mesorectal lymph node metastasis and multiple left internal iliac lymph node metastases. We performed laparoscopic intersphincteric resection with left lateral pelvic lymph node dissection. The final pathologic report revealed a metastatic lymph node with low grade, low mitotic count, and low Ki-67 index. We describe an overview of lymph node metastasis of rectal NETs focusing on lateral pelvic lymph node metastasis.

Citations

Citations to this article as recorded by  
  • Risk factors for and prognostic impact of lateral pelvic lymph node metastasis in patients with rectal neuroendocrine tumors: a single-center retrospective analysis of 214 cases with radical resection
    Tsubasa Sakurai, Y. Hiyoshi, N. Daitoku, S. Matsui, T. Mukai, T. Nagasaki, T. Yamaguchi, T. Akiyoshi, H. Kawachi, Y. Fukunaga
    Surgery Today.2025; 55(2): 144.     CrossRef
  • Construction and evaluation of the prediction model for advanced disease in well-differentiated colorectal neuroendocrine neoplasms less than 2 cm in diameter
    Hongda Yin, Yanan Chen, Wei Zhao, Fuqiang Zhao, Zhijun Huang, Aimin Yue, Zhijie Wang
    Heliyon.2025; 11(1): e41197.     CrossRef
  • Primary small rectal neuroendocrine tumor with pelvic lateral lymph nodes metastasis: A case report and review of literature
    Lihong Li, Ziyue Chen, Dajian Zhu, Qianbao Lv, Tianpeng Zhang, Jinsong Lai
    International Journal of Surgery Case Reports.2025; 127: 110963.     CrossRef
  • Risk factors for lateral pelvic lymph node metastasis in patients with rectal neuroendocrine tumors: a systematic review and meta-analysis
    Ziyue Chen, Dajian Zhu
    Frontiers in Oncology.2025;[Epub]     CrossRef
  • Successfully Resected Isolated Lateral Lymph Node Recurrence in a Patient with T1 Lower Rectal Cancer: Case Report and Literature Review
    Kazuma Rifu, Koji Koinuma, Hisanaga Horie, Katsusuke Mori, Daishi Naoi, Mineyuki Tojo, Yuko Homma, Satoshi Murahashi, Atsushi Kihara, Toshiki Mimura, Joji Kitayama, Naohiro Sata
    Journal of the Anus, Rectum and Colon.2024; 8(3): 259.     CrossRef
  • Clinical application of endoscopic ultrasonography in the management of rectal neuroendocrine tumors
    Soo-Young Na, Seong Jung Kim, Hyoun Woo Kang
    International Journal of Gastrointestinal Intervention.2023; 12(3): 105.     CrossRef
  • Multiple rectal neuroendocrine tumors: An analysis of 15 cases and literature review
    Shu Pang, Ye Zong, Kun Zhang, Haiying Zhao, Yongjun Wang, Junxiong Wang, Chuntao Liu, Yongdong Wu, Peng Li
    Frontiers in Oncology.2022;[Epub]     CrossRef
Reviews
Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer
Surgical Treatment of Low-Lying Rectal Cancer: Updates
Cristopher Varela, Nam Kyu Kim
Ann Coloproctol. 2021;37(6):395-424.   Published online December 22, 2021
DOI: https://doi.org/10.3393/ac.2021.00927.0132
  • 7,995 View
  • 345 Download
  • 37 Web of Science
  • 42 Citations
AbstractAbstract PDF
Despite innovative advancements, distally located rectal cancer remains a critical disease of challenging management. The crucial location of the tumor predisposes it to a circumferential resection margin (CRM) that tends to involve the anal sphincter complex and surrounding organs, with a high incidence of delayed anastomotic complications and the risk of the pelvic sidewall or rarely inguinal lymph node metastases. In this regard, colorectal surgeons should be aware of other issues beyond total mesorectal excision (TME) performance. For decades, the concept of extralevator abdominoperineal resection to avoid compromised CRM has been introduced. However, the complexity of deep pelvic dissection with poor visualization in low-lying rectal cancer has led to transanal TME. In contrast, neoadjuvant chemoradiotherapy (NCRT) has allowed for the execution of more sphincter-saving procedures without oncologic compromise. Significant tumor regression after NCRT and complete pathologic response also permit applying the watch-and-wait protocol in some cases, now with more solid evidence. This review article will introduce the current surgical treatment options, their indication and technical details, and recent oncologic and functional outcomes. Lastly, the novel characteristics of distal rectal cancer, such as pelvic sidewall and inguinal lymph node metastases, will be discussed along with its tailored and individualized treatment approach.

Citations

Citations to this article as recorded by  
  • Oncologic impact of technical difficulties during the early experience with laparoscopic surgery for colorectal cancer: long-term follow-up results of a prospective cohort study
    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
    Current Problems in Surgery.2025; 63: 101694.     CrossRef
  • Comparative efficacy analysis of laparoscopic-assisted transanal total mesorectal excision vs laparoscopic transanal mesorectal excision for low-lying rectal cancer
    Feng Lu, Shu-Guang Tan, Juan Zuo, Hai-Hua Jiang, Jian-Hua Wang, Yu-Ping Jiang
    World Journal of Gastrointestinal Surgery.2025;[Epub]     CrossRef
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    Chih-Kai Huang, Chi-Hsiu Shih, Yung-Shuo Kao
    Current Oncology Reports.2024; 26(2): 181.     CrossRef
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    Chungyeop Lee, In Ja Park
    The World Journal of Men's Health.2024; 42(2): 304.     CrossRef
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    Jasper Max Gebhardt, Neno Werner, Andrea Stroux, Frank Förster, Ioannis Pozios, Claudia Seifarth, Christian Schineis, Benjamin Weixler, Katharina Beyer, Johannes Christian Lauscher
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    Islam Abdelkhalek, Galal AbuElnagah, Tarek Elfayoumi, Ahmed shoukry Hafez, Mohamed Asal
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    Inkeon Yeo, Myung-Won Yoo, Seong Jin Park, Sung Kyoung Moon
    Journal of the Korean Society of Radiology.2024; 85(4): 727.     CrossRef
  • Complications Rate and Related Factors After Laparoscopic Sphincter-Preserving Total Mesorectal Excision for Low Rectal Cancer: A Single-Center Study in Vietnam
    Ly Huu Phu, Ho Tat Bang, Ung Van Viet, Hoang Danh Tan, Nguyen Trung Tin
    Cureus.2024;[Epub]     CrossRef
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    Youn Young Park, Nam Kyu Kim
    Annals of Gastroenterological Surgery.2024; 8(5): 761.     CrossRef
  • Personalized Decisional Algorithms for Soft Tissue Defect Reconstruction after Abdominoperineal Resection for Low-Lying Rectal Cancers
    Dan Cristian Moraru, Mihaela Pertea, Stefana Luca, Valentin Bejan, Andrian Panuta, Raluca Tatar, Dan Mircea Enescu, Dragos Viorel Scripcariu, Viorel Scripcariu
    Current Oncology.2024; 31(6): 3253.     CrossRef
  • Comparative analysis of organ preservation attempt and radical surgery in clinical T2N0 mid to low rectal cancer
    Hyeung-min Park, Jaram Lee, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
    International Journal of Colorectal Disease.2024;[Epub]     CrossRef
  • Essential knowledge and technical tips for total mesorectal excision and related procedures for rectal cancer
    Min Soo Cho, Hyeon Woo Bae, Nam Kyu Kim
    Annals of Coloproctology.2024; 40(4): 384.     CrossRef
  • The role of robotic-assisted surgery in the management of rectal cancer: a systematic review and meta-analysis
    Chenxiong Zhang, Hao Tan, Han Xu, Jiaming Ding
    International Journal of Surgery.2024; 110(10): 6282.     CrossRef
  • Endoscopic submucosal dissection for superficial ultra-low rectal tumors: outcomes and predictive factors for procedure difficulty
    Yinxin Wu
    American Journal of Cancer Research.2024; 14(12): 5784.     CrossRef
  • Pathologic Implications of Magnetic Resonance Imaging-detected Extramural Venous Invasion of Rectal Cancer
    Hyun Gu Lee, Chan Wook Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
    Clinical Colorectal Cancer.2023; 22(1): 129.     CrossRef
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    Sung Uk Bae, Cristopher Varela, Manar Nassr, Nam Kyu Kim
    Diseases of the Colon & Rectum.2023;[Epub]     CrossRef
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    Gyung Mo Son
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  • The Safe Values of Quantitative Perfusion Parameters of ICG Angiography Based on Tissue Oxygenation of Hyperspectral Imaging for Laparoscopic Colorectal Surgery: A Prospective Observational Study
    Gyung Son, Armaan Nazir, Mi Yun, In Lee, Sun Im, Jae Kwak, Sang-Ho Park, Kwang-Ryul Baek, Ines Gockel
    Biomedicines.2023; 11(7): 2029.     CrossRef
  • International Society of University Colon and Rectal Surgeons survey of surgeons’ preference on rectal cancer treatment
    Audrius Dulskas, Philip F. Caushaj, Domas Grigoravicius, Liu Zheng, Richard Fortunato, Joseph W. Nunoo-Mensah, Narimantas E. Samalavicius
    Annals of Coloproctology.2023; 39(4): 307.     CrossRef
  • Clinical Significance of Combining Preoperative and Postoperative Albumin-Bilirubin Score in Colorectal Cancer
    Doyoun Kim, Jae-Hoon Lee, Eun-Suk Cho, Su-Jin Shin, Hye Sun Lee, Hwa-Hee Koh, Kang Young Lee, Jeonghyun Kang
    Cancer Research and Treatment.2023; 55(4): 1261.     CrossRef
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    Ji-Hyun Seo, In-Ja Park
    Cancers.2023; 15(21): 5211.     CrossRef
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    Dong Hyun Kang
    Annals of Coloproctology.2023; 39(5): 373.     CrossRef
  • Beyond the Horizon: Unveiling the Frontiers of Rectal Cancer Research and Treatment
    Reda H Mithany, M Hasaan Shahid, Shenouda Abdallah, Mark Abdelmaseeh, Mina Manasseh, Farid Gerges, Andrew Wanees, Mohamed S Mohamed, Mina W Hakim, Samana Aslam, Nesma Daniel
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    Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
    Annals of Surgical Treatment and Research.2023; 105(6): 341.     CrossRef
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    Youngbae Jeon, Eun Jung Park
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    Jeonghee Han
    The Ewha Medical Journal.2023;[Epub]     CrossRef
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    Hyun Gu Lee
    The Ewha Medical Journal.2023;[Epub]     CrossRef
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    Gyoung Tae Noh
    The Ewha Medical Journal.2023;[Epub]     CrossRef
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    In Ja Park
    The Ewha Medical Journal.2023;[Epub]     CrossRef
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    Maurice Vuattoux, Soleen Stocker-Ghafoor, Hatice Bunea, Christoph Kettelhack, Andreas Wicki, Frank B. Zimmermann
    InFo Hämatologie + Onkologie.2022; 25(3): 44.     CrossRef
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    Hyo Seon Ryu, Jin Kim
    Annals of Surgical Treatment and Research.2022; 103(1): 1.     CrossRef
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    Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
    Journal of the Korean Medical Association.2022; 65(9): 558.     CrossRef
  • Direction of diagnosis and treatment improvement in colorectal cancer
    In Ja Park
    Journal of the Korean Medical Association.2022; 65(9): 540.     CrossRef
  • Robotic surgery for colorectal cancer
    Sung Uk Bae
    Journal of the Korean Medical Association.2022; 65(9): 577.     CrossRef
  • Current Status and Future of Robotic Surgery for Colorectal Cancer-An English Version
    Sung Uk Bae
    Journal of the Anus, Rectum and Colon.2022; 6(4): 221.     CrossRef
  • Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
    Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
    Journal of the Anus, Rectum and Colon.2022; 6(4): 203.     CrossRef
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    Seung Mi Yeo, Gyung Mo Son
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    Young Il Kim
    The Ewha Medical Journal.2022;[Epub]     CrossRef
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    Chan Wook Kim
    The Ewha Medical Journal.2022;[Epub]     CrossRef
  • The watch-and-wait strategy versus radical resection for rectal cancer patients with a good response (≤ycT2) after neoadjuvant chemoradiotherapy
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    Annals of Surgical Treatment and Research.2022; 103(6): 350.     CrossRef
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    In Ja Park
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Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer,Minimally invasive surgery,Surgical technique
Is Laparoscopic Complete Mesocolic Excision and Central Vascular Ligation Really Necessary for All Patients With Right-Sided Colon Cancer?
Gyung Mo Son, In Young Lee, Yoon Suk Lee, Bong-Hyeon Kye, Hyeon-Min Cho, Je-Ho Jang, Chang-Nam Kim, Kil Yeon Lee, Suk-Hwan Lee, Jun-Gi Kim, On behalf of The Korean Laparoscopic Colorectal Surgery Study Group
Ann Coloproctol. 2021;37(6):434-444.   Published online December 8, 2021
DOI: https://doi.org/10.3393/ac.2021.00955.0136
  • 5,678 View
  • 277 Download
  • 19 Web of Science
  • 23 Citations
AbstractAbstract PDF
Colon cancer treatment is on the way to evolution over several decades. The minimally invasive surgery has improved postoperative short-term outcomes. Adjuvant chemotherapy has prolonged the survival of advanced colon cancer patients. Hohenberger proposed the noble concept of complete mesocolic excision (CME) which consists of 3 components: plane surgery, sufficient longitudinal bowel resection, and central vascular ligation (CVL). Mesocolic plane surgery shares the same surgical principle of total mesorectal excision, which is maintaining the intact mesothelial envelope. However, there remain debates about the extent of bowel resection and the level of CVL for maximizing lymph node dissection. There is no solid clinical evidence for the oncological necessity and benefit of extended radical dissection in right hemicolectomy. CME with CVL based on open surgery has been adopted in laparoscopic surgery. So, it is also necessary to look at how the CME could be transformed and successfully implanted in the laparoscopic era. Recent rapid advances in surgical technology and cancer biology are preparing for fundamental changes in cancer surgery. In this study, we reviewed the history, oncological necessity, and compatibility of CME for the right hemicolectomy in the laparoscopic era and outline the new perspectives on the evolution of cancer surgery.

Citations

Citations to this article as recorded by  
  • Optimal extent of lymph node dissection in clinical early-stage right colon cancer: a retrospective analysis
    Hyeung-min Park, Jaram Lee, Soo Young Lee, Suk Hee Heo, Yong Yeon Jeong, Hyeong Rok Kim, Chang Hyun Kim
    Annals of Surgical Treatment and Research.2025; 108(1): 49.     CrossRef
  • Laparoscopic right hemicolectomy: a SICE (Società Italiana di Chirurgia Endoscopica e Nuove tecnologie) network prospective study on the approach to right colon lymphadenectomy in Italy: is there a standard?—CoDIG 2 (ColonDx Italian Group)
    G. Anania, M. Chiozza, A. Campagnaro, F. Bagolini, G. Resta, D. Azzolina, G. Silecchia, R. Cirocchi, A. Agrusa, D. Cuccurullo, M. Guerrieri, V. Adamo, M. Ammendola, P. Angelini, M. Annecchiarico, G. Aprea, F. Autori, G. Baldazzi, A. Balla, G. Baronio, G.
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  • Retrocaecal, supracolic and medial dissection (the RESUME approach) as an optimal surgical procedure for right‐sided colon cancer—A Video Vignette
    Hong‐min Ahn, Min Hyeong Jo, Mi Jeong Choi, Heung‐Kwon Oh, Duck‐Woo Kim, Sung‐Bum Kang
    Colorectal Disease.2024; 26(7): 1480.     CrossRef
  • Surgical treatment of right colon cancer
    A. A. Nevolskikh, V. A. Avdeenko, I. P. Reznik, T. P. Pochuev, R. F. Zibirov, S. A. Ivanov, A. D. Kaprin
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  • Effect of Fluorescence Lymph Node Mapping on Improving Diagnostic Values of CT D3 Lymph Node Staging for Right-Sided Colon Cancer
    Gyung Mo Son, Tae Un Kim, Mi Sook Yun, ChangYeop Kim, In Young Lee, Su Bum Park, Dong-Hoon Shin, Gi Won Ha
    Cancers.2024; 16(20): 3496.     CrossRef
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    Inci Sahin, Bilgi Baca
    Digestive Disease Interventions.2023; 07(01): 024.     CrossRef
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    Qiang He, Jing Huang, Liyun Niu, Chunbao Zhai
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    Christoph Holmer
    coloproctology.2022; 44(3): 149.     CrossRef
  • Letter to the Editor Reply: ‘Mesocolon Excision in Right Colon Cancer: Is it a Real Oncological Procedure or a Mere Surgical Act?’
    Tamara Díaz Vico, Luis Joaquín García Flórez
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    Thomas Fuchs-Buder, Jacob Rosenberg
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    Gyung Mo Son
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  • Ileal long-segment ischemia after the unintended ligation of variant ileal branch during laparoscopic right hemicolectomy
    Gyung Mo Son, Tae Un Kim, Dong-Hoon Shin, Joo-Young Na, In Young Lee, Shin Hoo Park
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  • Multidisciplinary treatment strategy for early colon cancer
    Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
    Journal of the Korean Medical Association.2022; 65(9): 558.     CrossRef
  • Direction of diagnosis and treatment improvement in colorectal cancer
    In Ja Park
    Journal of the Korean Medical Association.2022; 65(9): 540.     CrossRef
  • Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
    Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
    Journal of the Anus, Rectum and Colon.2022; 6(4): 203.     CrossRef
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    Young Il Kim
    The Ewha Medical Journal.2022;[Epub]     CrossRef
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    In Ja Park
    Annals of Coloproctology.2021; 37(6): 349.     CrossRef
Malignant disease, Rectal cancer,Colorectal cancer
Extended lymphadenectomy in locally advanced rectal cancers: a systematic review
Balaji Mahendran, Supriya Balasubramanya, Simone Sebastiani, Sebastian Smolarek
Ann Coloproctol. 2022;38(1):3-12.   Published online November 17, 2021
DOI: https://doi.org/10.3393/ac.2021.00703.0100
  • 3,701 View
  • 157 Download
  • 6 Web of Science
  • 5 Citations
AbstractAbstract PDF
Purpose
The surgical treatment of advanced low rectal cancer remains controversial. Extended lymphadenectomy (EL) is the preferred option in the East, especially in Japan, while neoadjuvant radiotherapy is the treatment of choice in the West. This review was undertaken to review available evidence supporting each of the therapies.
Methods
All studies looking at EL were included in this review. A comprehensive search was conducted as per PRISMA guidelines. Primary outcome was defined as 5-year overall survival, with secondary outcomes including 3-year overall survival, 3- and 5-year disease-free survival, length of operation, and number of complications.
Results
Thirty-one studies met the inclusion criteria. There was no significant publication bias. There was statistically significant difference in 5-year survival for patient who underwent EL (odds ratio, 1.34; 95 confidence interval, 0.09–0.5; P=0.006). There were no differences noted in secondary outcomes except for length of the operations.
Conclusion
There is evidence supporting EL in rectal cancer; however, it is difficult to interpret and not easily transferable to a Western population. Further research is necessary on this important topic.

Citations

Citations to this article as recorded by  
  • Performance reporting design in artificial intelligence studies using image-based TNM staging and prognostic parameters in rectal cancer: a systematic review
    Minsung Kim, Taeyong Park, Bo Young Oh, Min Jeong Kim, Bum-Joo Cho, Il Tae Son
    Annals of Coloproctology.2024; 40(1): 13.     CrossRef
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    Paweł Mroczkowski, Łukasz Dziki, Tereza Vosikova, Ronny Otto, Anna Merecz-Sadowska, Radosław Zajdel, Karolina Zajdel, Hans Lippert, Olof Jannasch
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    Youngbae Jeon, Eun Jung Park
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    Daichi Kitaguchi, Eun Jung Park, Seung Hyuk Baik, Shoma Sasaki, Yuichiro Tsukada, Masaaki Ito
    International Journal of Surgery.2023;[Epub]     CrossRef
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