Annals of Coloproctology

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Original Articles

Minimally invasive surgery

Interim analysis of short-term outcomes between robotic and laparoscopic surgery for colon cancer: results from the ESSIMIC trial: Marco Milone, Sara Vertaldi, Pietro Anoldo, Simona Borin, Graziano Ceccarelli, Anna D’Amore, Maurizio Degiuli, Paolo Delrio, Uberto Romario Fumagalli, Mario Guerrieri, Michele Manigrasso, Monica Ortenzi, Ugo Pace, Felice Pirozzi, Lucia Puca, Wanda Petz, Rossella Reddavid, Daniela Rega, Fabio Rondelli, Antonio Sciuto, Giovanni Domenico De Palma; Ann Coloproctol. 2026;42(1):86-93. Published online February 23, 2026; DOI: https://doi.org/10.3393/ac.2025.00339.0048

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Graphical Abstract Abstract PDF Supplementary Material: Purpose
This study aimed to determine whether the benefits of robotic surgery can be applied to the treatment of colon cancer by evaluating short-term outcomes of robotic versus laparoscopic colonic resection.
Methods
This interim analysis of an interventional multicenter randomized trial was conducted to compare outcomes of robotic and laparoscopic colorectal surgery performed between January 2017 and December 2019. The study specifically assessed short-term outcomes in patients undergoing laparoscopic or robotic right or left colectomy for cancer. In addition, all short-term outcomes were evaluated in separate subgroups of right and left colonic resections through prespecified subgroup analyses.
Results
A total of 323 patients were analyzed, of whom 142 underwent robotic-assisted surgery and 181 underwent laparoscopic surgery. Overall, 109 complications (33.7%) occurred in the short-term period, 41 (28.9%) in the robotic group and 68 (37.6%) in the laparoscopic group, with no differences between groups in intraoperative or postoperative complications. However, grade III complications were significantly more frequent in the laparoscopic group, with 17 cases (9.4%) compared to 5 cases (3.5%) in the robotic group. Oncological radicality was similar between groups. Functional recovery after surgery was superior in the robotic group, as reflected by a shorter time to mobilization (17.5±10.2 hours vs. 21.1±11.5 hours). In the right colectomy subgroup, rates of grade III complications (1.9% vs. 11.7%) and lymph nodes retrieved (20.3±10.3 vs. 20.2±6.4) favored robotic surgery. In the left colon cancer subgroup, functional recovery was also improved with robotic surgery (44.3±22.2 hours vs. 61.1±31.1 hours, as measured by the composite recovery outcome).
Conclusion
Robotic surgery is associated with fewer severe complications and improved postoperative recovery following colonic resections. Trial registration: ClinicalTrials.gov identifier: NCT02871960

Complications

Muscle loss phenotype predicts poor postoperative outcomes of colorectal cancer in US inpatients: a population-based analysis: Ko-Chao Lee, Sin-Ei Juang, Kuen-Lin Wu, Kung-Chuan Cheng, Ling-Chiao Song, Chien-En Tang, Hong-Hwa Chen, Kuan-Chih Chung; Ann Coloproctol. 2025;41(5):443-452. Published online October 24, 2025; DOI: https://doi.org/10.3393/ac.2025.00129.0018

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Abstract PDF Supplementary Material: Purpose
Muscle loss may lead to reduced therapy tolerance and survival. We aimed to assess whether colorectal cancer (CRC) patients with a muscle loss phenotype experience worse outcomes.
Methods
Data were extracted from the US Nationwide Inpatient Sample for hospitalized patients aged ≥20 years who underwent surgical resection for colorectal cancer (CRC) between 2005 and 2018. CRC and muscle loss phenotypes were identified using validated International Classification of Diseases (ICD) diagnosis and procedure codes. Propensity score matching was performed to balance characteristics. Regression analyses determined associations between muscle loss and in-hospital outcomes.
Results
A total of 209,171 patients were included, with a mean age of 67.9 years; 7.1% exhibited muscle loss phenotype. After matching, 60,295 patients remained in the sample. After adjustment, patients with muscle loss had significantly increased risks of postoperative complications (adjusted odds ratio [aOR], 2.99; 95% confidence interval [CI], 2.85–3.15), unfavorable discharge (aOR, 2.42; 95% CI, 2.30–2.53), prolonged length of stay (aOR, 4.34; 95% CI, 4.13–4.55), and higher total hospital costs (adjusted β, 70.86; 95% CI, 67.11–74.61) compared to patients without muscle loss. When stratified by age (≥65 years), results remained consistent. Among complications, muscle loss phenotype was most strongly associated with shock, sepsis, and respiratory failure.
Conclusion
Muscle loss phenotype among patients with CRC is strongly associated with poor postoperative outcomes, including higher complication rates, longer stays, and increased costs. These findings highlight the importance of preoperative muscle loss assessments and the necessity for targeted interventions.

Anorectal benign disease

Long-term outcomes of intramural rectal botulinum toxin injections for urge fecal incontinence: a salvage therapy for sacral neuromodulation nonresponders?: Philippe Onana Ndong, Véronique Vitton; Ann Coloproctol. 2025;41(5):417-423. Published online October 23, 2025; DOI: https://doi.org/10.3393/ac.2025.00332.0047

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Graphical Abstract Abstract PDF: Purpose
Sacral neuromodulation (SNM) failure in fecal incontinence (FI) management represents a therapeutic challenge, often leading to more invasive, less accepted alternatives with inconsistent efficacy. In this context, intramural rectal botulinum toxin A (BoNT-A) injection has recently emerged as a promising minimally invasive alternative for urge FI. This study aimed to evaluate the effectiveness of intramural rectal BoNT-A injections in the challenging subgroup of SNM nonresponders.
Methods
This retrospective, single-center study included patients with urge FI who underwent intramural rectal BoNT-A injections after SNM failure, between February 2018 and September 2024. The procedure involved endoscopic injection of 200 units of BoNT-A at 10 circumferential sites in the rectal wall. Treatment efficacy was assessed using the Cleveland Clinic Fecal Incontinence Score (CCFIS) and a visual analog scale (VAS) for symptom severity.
Results
Fifteen female patients met the inclusion criteria, with a median follow-up of 22.5 months (range, 4.4–103.2 months). Patients received a median of 2 injections, with a median reinjection interval of 9.8 months. CCFIS scores demonstrated significant improvement (median, 15 [range, 8–20] vs. 8 [range, 0–20]; P=0.001), as did VAS symptom scores (median, 4 [range, 0–5] vs. 2 [range, 0–5]; P=0.001). No adverse events were reported.
Conclusion
This study provides long-term evidence supporting intramural rectal BoNT-A injections as an effective option for managing urge FI, including as salvage therapy in SNM nonresponders. Further studies are necessary to confirm these findings and define the optimal role of BoNT-A within the therapeutic algorithm for urge FI.

Complications

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

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

Citations

Citations to this article as recorded by

Bowel Preparation for Colorectal Surgery: Evolution, Evidence, and Contemporary Practice
Rajendran Theakarajan, Subramanian Ashuvanth, Govindarajan Rajagopalan
Indian Journal of Colo-Rectal Surgery.2026; 9(1): 7. CrossRef
Oral antibiotics alone for bowel preparation in colorectal surgery: time to rethink tradition?
Soo Young Lee
Annals of Coloproctology.2025; 41(5): 367. CrossRef

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

CRC

Impact of iron-deficiency anemia on short-term outcomes after resection of colorectal cancer liver metastasis: a US National (Nationwide) Inpatient Sample (NIS) analysis: Ko-Chao Lee, Yu-Li Su, Kuen-Lin Wu, Kung-Chuan Cheng, Ling-Chiao Song, Chien-En Tang, Hong-Hwa Chen, Kuan-Chih Chung; Ann Coloproctol. 2025;41(2):119-126. Published online April 24, 2025; DOI: https://doi.org/10.3393/ac.2024.00591.0084

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Abstract PDF Supplementary Material

Purpose
Colorectal cancer (CRC) often spreads to the liver, necessitating surgical treatment for CRC liver metastasis (CRLM). Iron-deficiency anemia is common in CRC patients and is associated with fatigue and weakness. This study investigated the effects of iron-deficiency anemia on the outcomes of surgical resection of CRLM.
Methods
This population-based, retrospective study evaluated data from adults ≥20 years old with CRLM who underwent hepatic resection. All patient data were extracted from the 2005–2018 US National (Nationwide) Inpatient Sample (NIS) database. The outcome measures were in-hospital outcomes including 30-day mortality, unfavorable discharge, and prolonged length of hospital stay (LOS), and short-term complications such as bleeding and infection. Associations between iron-deficiency anemia and outcomes were determined using logistic regression analysis.
Results
Data from 7,749 patients (representing 37,923 persons in the United States after weighting) were analyzed. Multivariable analysis revealed that iron-deficiency anemia was significantly associated with an increased risk of prolonged LOS (adjusted odds ratio [aOR], 2.76; 95% confidence interval [CI], 2.30–3.30), unfavorable discharge (aOR, 2.42; 95% CI, 1.83–3.19), bleeding (aOR, 5.05; 95% CI, 2.92–8.74), sepsis (aOR, 1.60; 95% CI, 1.04–2.46), pneumonia (aOR, 2.54; 95% CI, 1.72–3.74), and acute kidney injury (aOR, 1.71; 95% CI, 1.24–2.35). Subgroup analyses revealed consistent associations between iron-deficiency anemia and prolonged LOS across age, sex, and obesity status categories.
Conclusion
In patients undergoing hepatic resection for CRLM, iron-deficiency anemia is an independent risk factor for prolonged LOS, unfavorable discharge, and several critical postoperative complications. These findings underscore the need for proactive anemia management to optimize surgical outcomes.

Citations

Citations to this article as recorded by

A commentary on “Individualized blood pressure regulation and acute kidney injury in older patients having major abdominal surgery: a pilot randomized trial”
Fu-Shan Xue, Dan-Feng Wang, Xiao-Chun Zheng
International Journal of Surgery.2025; 111(12): 9993. CrossRef

ERAS

Effect of continuous wound infiltration on patients using intravenous patient-controlled analgesia for pain management after reduced-port laparoscopic colorectal surgery: Hyeon Deok Choi, Sung Uk Bae; Ann Coloproctol. 2024;40(6):564-572. Published online November 22, 2024; DOI: https://doi.org/10.3393/ac.2023.00143.0020

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Graphical Abstract Abstract PDF

Purpose
Continuous wound infiltration (CWI) has been introduced as a component of multimodal analgesia to counteract the adverse effects of the most frequently used opioids. Advantages of reduced-port laparoscopic surgery (RPLS) include cosmetic benefits and decreased postoperative pain. We aimed to investigate the effect of CWI in patients using intravenous (IV) patient-controlled analgesia (PCA) for pain management after RPLS for colorectal cancer.
Methods
This retrospective study included 25 patients who received both CWI (0.5% ropivacaine infused over 72 hours) and IV PCA (fentanyl citrate) and 52 patients who received IV PCA alone. The primary endpoint was pain scores on postoperative days (PODs) 0, 1, and 2. Univariate and multivariate analyses were conducted to determine the factors affecting the pain score on POD 0.
Results
On POD 0, the mean numeric rating scale score was significantly lower in the CWI group than in the control group (3.2±0.8 vs. 3.7±0.9, P=0.042). However, the scores were comparable between the groups during the rest of the period. Within 24 hours of surgery, the CWI group consumed fewer opioids (0.7±0.9 vs. 1.3±1.1, P=0.018) and more nonsteroidal anti-inflammatory drugs (2.0±1.4 vs. 1.3±1.4, P=0.046) than the control group. Time to removal of IV PCA was significantly longer in the CWI group than in the control group (4.4±1.6 days vs. 3.4±1.0 days, P=0.016).
Conclusion
CWI with ropivacaine and IV PCA was more effective than IV PCA alone in controlling postoperative pain within 24 hours of surgery, and opioid use could be reduced further.

Citations

Citations to this article as recorded by

Optimizing postoperative pain management in minimally invasive colorectal surgery
Soo Young Lee
Annals of Coloproctology.2024; 40(6): 525. CrossRef

Case Report

Anorectal benign disease

Chronic fistula in ano associated with adenocarcinoma: a case report with a review of the literature: Nalini Kanta Ghosh, Ashok Kumar; Ann Coloproctol. 2024;40(Suppl 1):S1-S5. Published online May 16, 2024; DOI: https://doi.org/10.3393/ac.2022.00752.0107

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Abstract PDF

The malignant transformation of chronic fistula in ano is rare, accounting for 3% to 11% of all anal canal malignancies. It results from long-standing inflammation and chronic irritation. No guidelines are available for the management of these cases. We herein present a case report of a 55-year-old man who presented with a history of constipation, perianal pain, and discharging fistula in ano of 4-year duration and underwent fistula surgery with recurrence. Biopsy of the fistulous tract revealed adenocarcinoma. He received neoadjuvant chemoradiotherapy, followed by abdominoperineal excision including excision of the fistulous tract. After 18 months of follow-up, he is free of recurrence. We present this case with a review of the literature, highlighting the management strategies.

Citations

Citations to this article as recorded by

A Long-standing Perianal Fistula Hiding an Adenocarcinoma: A Case Report
I-Wei Lin, Ying-Wen Su, Ching-Heng Ting, Ming-Jen Chen
Journal of Cancer Research and Practice.2026;[Epub] CrossRef

Original Articles

Colorectal cancer

Long-term clinical outcomes after high and low ligations with lymph node dissection around the root of the inferior mesenteric artery in patients with rectal cancer: Min Wan Lee, Sung Sil Park, Kiho You, Dong Eun Lee, Dong Woon Lee, Sung Chan Park, Kyung Su Han, Dae Kyung Sohn, Chang Won Hong, Bun Kim, Byung Chang Kim, Hee Jin Chang, Dae Yong Kim, Jae Hwan Oh; Ann Coloproctol. 2024;40(1):62-73. Published online February 26, 2024; DOI: https://doi.org/10.3393/ac.2023.00094.0013

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Graphical Abstract Abstract PDF

Purpose
This study aimed to evaluate the long-term clinical outcomes based on the ligation level of the inferior mesenteric artery (IMA) in patients with rectal cancer.
Methods
This was a retrospective analysis of a prospectively collected database that included all patients who underwent elective low anterior resection for rectal cancer between January 2013 and December 2019. The clinical outcomes included oncological outcomes, postoperative complications, and functional outcomes. The oncological outcomes included overall survival (OS) and relapse-free survival (RFS). The functional outcomes, including defecatory and urogenital functions, were analyzed using the Fecal Incontinence Severity Index, International Prostate Symptom Score, and International Index of Erectile Function questionnaires.
Results
In total, 545 patients were included in the analysis. Of these, 244 patients underwent high ligation (HL), whereas 301 underwent low ligation (LL). The tumor size was larger in the HL group than in the LL group. The number of harvested lymph nodes (LNs) was higher in the HL group than in the LL group. There were no significant differences in complication rates and recurrence patterns between the groups. There were no significant differences in 5-year RFS and OS between the groups. Cox regression analysis revealed that the ligation level (HL vs. LL) was not a significant risk factor for oncological outcomes. Regarding functional outcomes, the LL group showed a significant recovery in defecatory function 1 year postoperatively compared with the HL group.
Conclusion
LL with LNs dissection around the root of the IMA might not affect the oncologic outcomes comparing to HL; however, it has minimal benefit for defecatory function.

Citations

Citations to this article as recorded by

Left colic artery–preserving radical rectal cancer surgery: a literature review
Xiyin Yang, Yuanshui Sun, Qiang Hu
Frontiers in Surgery.2026;[Epub] CrossRef
Meeting report on the 8th Asian Science Editors’ Conference and Workshop 2024
Eun Jung Park
Science Editing.2025; 12(1): 66. CrossRef
Early detection of anastomotic leakage in colon cancer surgery: the role of early warning score and C-reactive protein
Gyung Mo Son
Annals of Coloproctology.2024; 40(5): 415. CrossRef

Colorectal cancer

Computed tomography–assessed presarcopenia and clinical outcomes after laparoscopic surgery for rectal cancer: Ji Hyeong Song, Rak Kyun Oh, Jeong Eun Lee, Kyung Ha Lee, Ji Yeon Kim, Jin Soo Kim; Ann Coloproctol. 2023;39(6):513-520. Published online December 12, 2023; DOI: https://doi.org/10.3393/ac.2023.00031.0004

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Abstract PDF

Purpose
Previous studies have reported that presarcopenia negatively affects rectal cancer treatment. However, most studies have analyzed patients including majority of open surgery, and the association between presarcopenia and clinical outcomes after laparoscopic rectal cancer surgery remains unclear. This study aimed to evaluate the impact of presarcopenia on the clinical and oncological outcomes after laparoscopic rectal cancer surgery.
Methods
Three hundred and one patients undergoing laparoscopic rectal cancer surgery between December 2009 and May 2016 were enrolled. Body composition was assessed using computed tomography by measuring the muscle and fat areas at the third lumbar (L3) vertebra. The L3 skeletal muscle area was used to calculate the skeletal muscle index and evaluate presarcopenia.
Results
Presarcopenia was more common in older ( ≥ 70 years, P = 0.008) or female patients (P = 0.045). Patients with presarcopenia had decreased skeletal muscle area (P < 0.001), lower hemoglobin level (P = 0.034), longer time to first flatus (P < 0.001), and more frequent surgical site infection (P = 0.001). However, survival rates were not significantly different between those with and without presarcopenia.
Conclusion
Computed tomography-assessed presarcopenia was associated with delayed functional recovery and increased surgical site infection, although it was not revealed as a prognostic factor for oncological outcomes.

Citations

Citations to this article as recorded by

Exploring potential predictors of low muscle mass and muscle loss in adults with cancer: A scoping review
Annie R. Curtis, Carla M. Prado, Liliana Orellana, Robin M. Daly, Judy Bauer, Linda Denehy, Lara Edbrooke, Brenton J. Baguley, Laura Alston, Nicholas Hardcastle, Jenelle Loeliger, Louise Moodie, Sharad Sharma, Nicole Kiss
Clinical Nutrition.2026; 56: 106531. CrossRef
Long-term outcomes in elderly colorectal cancer patients with presarcopenia: a single center retrospective cohort study
Kil-yong Lee, Jaeim Lee, Seong Taek Oh
BMC Geriatrics.2026;[Epub] CrossRef
Stress response, complications, and postoperative recovery in patients with hepatocellular carcinoma and comorbid anxiety/depression undergoing ultrasound-guided intervention
Shuang Xu, Liu-Wei Hao, Xia Li, Xiao-Ning Zhou
World Journal of Psychiatry.2025;[Epub] CrossRef

Anorectal physioloy

Risk factors associated with low anterior resection syndrome: a cross-sectional study: See Liang Lim, Wan Zainira Wan Zain, Zalina Zahari, Andee Dzulkarnaen Zakaria, Mohd Nizam Md Hashim, Michael Pak-Kai Wong, Zaidi Zakaria, Rosnelifaizur Ramely, Ahmad Shanwani Mohamed Sidek; Ann Coloproctol. 2023;39(5):427-434. Published online June 3, 2022; DOI: https://doi.org/10.3393/ac.2022.00227.0032

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Graphical Abstract Abstract PDF Supplementary Material

Purpose
Oncological outcomes following rectal cancer surgery have improved significantly over recent decades with lower recurrences and longer overall survival. However, many of the patients experienced low anterior resection syndrome (LARS). This study identified the prevalence and risk factors associated with the development of LARS.
Methods
This cross-sectional study involved patients who were diagnosed with rectal cancer and had undergone sphincter-preserving low anterior resection from January 2011 to December 2020. Upon clinic follow-up, patients were asked to complete an interviewed based questionnaire (LARS score) designed to assess bowel dysfunction after rectal cancer surgery.
Results
Out of 76 patients, 25 patients (32.9%) had major LARS, 10 patients (13.2%) had minor LARS, and 41 patients (53.9%) had no LARS. The height of tumor from anal verge showed an association with the development of major LARS (P=0.039). Those patients with less than 8 cm tumor from anal verge had an increased risk of LARS by 3 times compared to those with 8 cm and above (adjusted odds ratio, 3.11; 95% confidence interval, 1.06–9.13).
Conclusion
Results from our study show that low tumor height was a significant risk factor that has a negative impact on bowel function after surgery. The high prevalence of LARS emphasizes the need for study regarding risk factors and the importance of understanding the pathophysiology of LARS, in order for us to improve patient bowel function and quality of life after rectal cancer surgery.

Citations

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Score assessment and treatment in patients presenting with low anterior resection syndrome after sphincter-sparing rectal cancer surgery
R. Sguinzi, J. Fiechter, L. Bafumi, B. Gremaud, B. Geng, P. Janiak, L. Bühler, B. Egger
International Journal of Colorectal Disease.2025;[Epub] CrossRef
A randomized controlled trial of a digital lifestyle intervention involving postoperative patients with colorectal cancer
Young Il Kim, In Ja Park, Jun-Soo Ro, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Yura Lee, Yae Won Tak, Seockhoon Chung, Kyung Won Kim, Yousun Ko, Sung-Cheol Yun, Min-Woo Jo, Jong Won Lee
npj Digital Medicine.2025;[Epub] CrossRef
Impact of low anterior resection syndrome after rectal surgery on sleep quality
Akira Toyoshima, Toshihiro Nishizawa, Osamu Toyoshima, Ryuji Akai, Manabu Kaneko, Shin Sasaki
Surgery Today.2025; 55(12): 1868. CrossRef
Evaluation of the utility of a nomogram for predicting lymph node metastasis in T1 colorectal cancer in shared decision-making in clinical practice: a survey-based study
Hyeon Seung Kim, Kyung Su Han, Min Wan Lee, Dae Kyung Sohn, Chang Won Hong, Dong Woon Lee, Kiho You, Sung Chan Park, Byung Chang Kim, Bun Kim, Jae Hwan Oh
Annals of Coloproctology.2025; 41(4): 303. 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
Beyond survival: a comprehensive review of quality of life in rectal cancer patients
Won Beom Jung
Annals of Coloproctology.2024; 40(6): 527. CrossRef
Organ preservation for early rectal cancer using preoperative chemoradiotherapy
Gyung Mo Son
Annals of Coloproctology.2023; 39(3): 191. CrossRef
Low anterior resection syndrome: is it predictable?
Dong Hyun Kang
Annals of Coloproctology.2023; 39(5): 373. CrossRef

Colorectal cancer

Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer: Jung Tak Son, Yong Bog Kim, Hyung Ook Kim, Chungki Min, Yongjun Park, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim; Ann Coloproctol. 2023;39(3):260-266. Published online May 25, 2022; DOI: https://doi.org/10.3393/ac.2022.00101.0014

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Abstract PDF

Purpose
Surgical management of obstructive left colon cancer (OLCC) is still a matter of debate. The classic Hartmann procedure (HP) has a disadvantage that requires a second major operation. Subtotal colectomy/total abdominal colectomy (STC/TC) with ileosigmoid or ileorectal anastomosis is proposed as an alternative procedure to avoid stoma and anastomotic leakage. However, doubts about morbidity and functional outcome and lack of long-term outcomes have made surgeons hesitate to perform this procedure. Therefore, this trial was designed to provide data for morbidity, functional outcomes, and long-term outcomes of STC/TC.
Methods
This study retrospectively analyzed consecutive cases of OLCC that were treated by STC/TC between January 2000 and November 2020 at a single tertiary referral center. Perioperative outcomes and long-term outcomes of STC/TC were analyzed.
Results
Twenty-five descending colon cancer (45.5%) and 30 sigmoid colon cancer cases (54.5%) were enrolled in this study. Postoperative complications occurred in 12 patients. The majority complication was postoperative ileus (10 of 12). Anastomotic leakage and perioperative mortality were not observed. At 6 to 12 weeks after the surgery, the median frequency of defecation was twice per day (interquartile range, 1–3 times per day). Eight patients (14.5%) required medication during this period, but only 3 of 8 patients required medication after 1 year. The 3-year disease-free survival was 72.7% and 3-year overall survival was 86.7%.
Conclusion
The risk of anastomotic leakage is low after STC/TC. Functional and long-term outcomes are also acceptable. Therefore, STC/TC for OLCC is a safe, 1-stage procedure that does not require diverting stoma.

Citations

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Controversial issues of colon stenting in case of tumor obstructive intestinal obstruction: surgical and oncological aspects
S.A. Aliyev, E.S. Aliyev, T.K. Aliyev
Endoscopic Surgery.2025; 31(2): 65. CrossRef
The Safety of Primary Anastomosis Without Protective Stoma in Emergency Left Colon Surgery: A Meta-Analysis
Zhiyan Wang, Wentao Sheng, Senjie Dai, Xuanzhou Li, Guojian Lin, Xiaohong Kang
Journal of Investigative Surgery.2025;[Epub] CrossRef
Ileus After Colectomy in the Modern Era: A Population-Based Analysis
Grace M. Crouch, Samantha Hendren, Kara K. Brockhaus, Wenjing Weng, Jami L. Boyd, Cheryl Rocker, Robert K. Cleary
Diseases of the Colon & Rectum.2025; 68(8): 1001. CrossRef
Influence of the type of anatomic resection on anastomotic leak after surgery for colon cancer
Suat Chin Ng, Andrew McCombie, Frank Frizelle, Tim Eglinton
ANZ Journal of Surgery.2024; 94(3): 424. CrossRef
Complete Obstruction, a Real Risk Factor: A Comprehensive Study on Obstruction in Stage IIA Colon Cancer With Propensity Score Matching Analysis
Soo Young Oh, Chan Wook Kim, Seonok Kim, Min Hyun Kim, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Clinical Colorectal Cancer.2024; 23(2): 135. CrossRef
Can we use colon stenting in accelerated recovery programs for surgical treatment colon cancer complicated by obstructive intestinal obstruction? A literature review
Saday A. Aliyev, Emil S. Aliyev
Russian Journal of Oncology.2024; 29(2): 130. CrossRef

Malignant disease, Rectal cancer,Prognosis

Initial local excision for clinical T1 rectal cancer showed comparable overall survival despite high local recurrence rate: a propensity-matched analysis: Jong Hee Hyun, Mohamed K. Alhanafy, Hyoung-Chul Park, Su Min Park, Sung-Chan Park, Dae Kyung Sohn, Duck-Woo Kim, Sung-Bum Kang, Seung-Yong Jeong, Kyu Joo Park, Jae Hwan Oh, on behalf of the Seoul Colorectal Research Group (SECOG); Ann Coloproctol. 2022;38(2):166-175. Published online October 6, 2021; DOI: https://doi.org/10.3393/ac.2021.00479.0068

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Abstract PDF

Purpose
Local excision (LE) is an alternative initial treatment for clinical T1 rectal cancer, and has avoided potential morbidity. This study aimed to evaluate the clinical outcomes of LE compared with total mesorectal excision (TME) for clinical T1 rectal cancer.
Methods
Between January 2000 and December 2011, we retrospectively reviewed from multicenter data in patients with clinically suspected T1 rectal cancer treated with either LE or TME. Of 1,071 patients, 106 were treated with LE and 965 were treated with TME. The data were analyzed using propensity score matching, with each group comprising 91 patients.
Results
After propensity score matching, the median follow-up time was 60.8 months (range, 0.6–150.6 months). After adjustment for the necessary variables, patients who underwent LE showed a significantly higher local recurrence rate than did those who underwent TME; however, there were no differences in disease-free survival and overall survival. In the multivariate analysis, age (hazard ratio [HR], 9.620; 95% confidence interval [CI], 3.415–27.098; P<0.001) and angiolymphatic invasion (HR, 3.63; 95% confidence interval, 1.33–9.89; P=0.012) were independently associated with overall survival. However, LE was neither associated with overall survival nor disease-free survival.
Conclusion
LE for clinical T1 rectal cancer yielded a higher local recurrence rate than did TME. Nevertheless, LE provided comparable overall survival rate and can be proposed as an optional treatment in terms of organ-preserving strategies.

Citations

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Performance reporting design in artificial intelligence studies using image-based TNM staging and prognostic parameters in rectal cancer: a systematic review
Minsung Kim, Taeyong Park, Bo Young Oh, Min Jeong Kim, Bum-Joo Cho, Il Tae Son
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Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
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Survival prognostic in different age groups of patients undergoing local versus radical excision for rectal cancer: a study based on the SEER database
Jinghui Li, Liang Wen, Yongli Ma, Guosheng Zhang, Ping Wang, Chengzhi Huang, Xueqing Yao
Updates in Surgery.2024; 76(3): 975. 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
Organ preservation for early rectal cancer using preoperative chemoradiotherapy
Gyung Mo Son
Annals of Coloproctology.2023; 39(3): 191. CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han
The Ewha Medical Journal.2023;[Epub] CrossRef
Multidisciplinary treatment strategy for early rectal cancer
Gyung Mo Son, In Young Lee, Sung Hwan Cho, Byung-Soo Park, Hyun Sung Kim, Su Bum Park, Hyung Wook Kim, Sang Bo Oh, Tae Un Kim, Dong Hoon Shin
Precision and Future Medicine.2022; 6(1): 32. CrossRef
The risk-benefit trade-off in local excision of early rectal cancer
Chang Hyun Kim
Annals of Coloproctology.2022; 38(2): 95. CrossRef
Applications of propensity score matching: a case series of articles published in Annals of Coloproctology
Hwa Jung Kim
Annals of Coloproctology.2022; 38(6): 398. CrossRef

Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Minimally invasive surgery

Should transanal total mesorectal excision be implemented in medium-sized colorectal unit? technical and oncological outcome: Man-fung Ho, Dennis Chung-Kei Ng, Janet Fung-yee Lee, Simon Siu-man Ng; Ann Coloproctol. 2022;38(3):207-215. Published online July 28, 2021; DOI: https://doi.org/10.3393/ac.2020.00941.0134

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Abstract PDF

Purpose
This study was performed to evaluate the outcome of implementation of transanal total mesorectal excision (TaTME) for low rectal cancer in a regional hospital and in comparison to laparoscopic (Lap) TME.
Methods
Consecutive patients with low rectal cancer of which the lowest border of the tumour was located beween 1 and 5 cm from the puborectalis who underwent TME at North District Hospital between January 2013 and December 2019 were included. Clinical, operative, and pathologic outcomes were compared between Lap TME and TaTME. The primary end point was complication profile.
Results
Thirty-five patients underwent Lap TME and 45 patients underwent TaTME for low rectal cancer. The conversion rate of the TaTME group was significantly lower than that of the Lap TME group (4.4% vs. 20%, P=0.029), but the operating time was longer (259 minutes vs. 219 minutes, P=0.009). The tumour location was significantly lower in the TaTME group, but the distal resection margins were adequate and not different between both groups. The TaTME group had higher incidence rates of prolonged ileus and urinary tract infection, but the other complications were similar between the two groups. The resection margin positivity rates of the TaTME and Lap TME groups were 2.2% and 5.7%, respectively (P=0.670). At a median follow up of 39 months, no abnormal early recurrence was detected.
Conclusion
It is technically feasible and oncologically safe to perform TaTME in a medium-volume colorectal unit. Patients with difficult pelvic anatomy can benefit by reducing the risk of conversion and margin positivity rate.

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The Korean Rectal Cancer Multidisciplinary Committee Clinical Practice Guidelines for Rectal Cancer version 2.0
Hyo Seon Ryu, Hyun Jung Kim, Dong Hyun Kang, Yoo-Kang Kwak, Han Deok Kwak, Yoon-Hye Kwon, Dalyon Kim, Baek-Hui Kim, Jae Hyun Kim, Ji Hun Kim, Jin Won Kim, Tae Hyung Kim, Hae Young Kim, Soo Min Nam, Gyoung Tae Noh, Jun Woo Bong, Nak Song Sung, Seon Hui Shi
Annals of Coloproctology.2026; 42(1): 4. CrossRef
Transanal versus transabdominal total mesorectal excision for rectal cancer in minimally invasive surgery: meta-analysis
Chun-Kai Liao, Yen-Lin Yu, Ya-Ting Kuo, Yu-Jen Hsu, Yih-Jong Chern, Yueh-Chen Lin, Pao-Shiu Hsieh, Jeng-Fu You, Jy-Ming Chiang
BJS Open.2025;[Epub] CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
Ji-Hyun Seo, In-Ja Park
Cancers.2023; 15(21): 5211. CrossRef

Benign proctology,Surgical technique

Hemorrhoidectomy versus rubber band ligation in grade III hemorrhoidal disease: a large retrospective cohort study with long-term follow-up: Lisette Dekker, Michiel T.J. Bak, Willem A. Bemelman, Richelle J.F. Felt-Bersma, Ingrid J.M. Han-Geurts; Ann Coloproctol. 2022;38(2):146-152. Published online July 27, 2021; DOI: https://doi.org/10.3393/ac.2020.01011.0144

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Abstract PDF

Purpose
Standard therapy for grade III hemorrhoids is rubber band ligation (RBL) and hemorrhoidectomy. The long-term clinical and patient-reported outcomes of these treatments in a tertiary referral center for proctology were evaluated.
Methods
A retrospective analysis was performed in all patients with grade III hemorrhoids who were treated between January 2013 and August 2018. Medical history, symptoms, reinterventions, complications, and patient-reported outcome measurements (PROM) were retrieved from individual electronic patient files, which were prospectively entered as standard questionnaires in our clinic.
Results
Overall, 327 patients (163 males) were treated by either RBL (n=182) or hemorrhoidectomy (n=145). The median follow-up was 44 months. The severity of symptoms and patient preference led to the treatment of choice. The most commonly experienced symptoms were prolapse (83.2%) and blood loss (69.7%). Hemorrhoidectomy was effective in 95.9% of the cases as a single procedure, while a single RBL procedure was only effective in 51.6%. In the RBL group, 34.6% received a second RBL session. Complications were not significantly different, 11 (7.6%) after hemorrhoidectomy versus 6 (3.3%) after RBL. However, 4 fistulas developed after hemorrhoidectomy and none after RBL (P<0.05). The pre-procedure PROM score was higher in the hemorrhoidectomy group whereas the post-procedure PROM score did not significantly differ between the groups.
Conclusion
Treatment of grade III hemorrhoids usually requires more than one session RBL whereas 1-time hemorrhoidectomy suffices. Complications were more common after hemorrhoidectomy. The patient-related outcome did not differ between procedures.

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Hämorrhoidalleiden und stadienabhängige Behandlung (inklusive Analprolaps)
Oliver Schwandner
Die Chirurgie.2025; 96(9): 709. CrossRef
Cost-Effectiveness of Rubber Band Ligation Versus Hemorrhoidectomy for the Treatment of Grade III Hemorrhoids: Analysis Using Evidence From the HOLLAND Randomized Controlled Trial
Justin Y. van Oostendorp, Lisette Dekker, Susan van Dieren, Ruben Veldkamp, Willem A. Bemelman, Ingrid J.M. Han-Geurts
Diseases of the Colon & Rectum.2025; 68(9): 1100. 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
Ten-year multicentric retrospective analysis regarding postoperative complications and impact of comorbidities in hemorrhoidal surgery with literature review
Cosmin Moldovan, Elena Rusu, Daniel Cochior, Madalina Elena Toba, Horia Mocanu, Razvan Adam, Mirela Rimbu, Adrian Ghenea, Florin Savulescu, Daniela Godoroja, Florin Botea
World Journal of Clinical Cases.2023; 11(2): 366. CrossRef

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

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

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Abstract PDF

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

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Does transanal total mesorectal excision (taTME) result in better quality of life and functional outcomes than traditional TME does? A retrospective propensity score-adjusted cohort study
Yanic Ammann, Marie Klein, Lukas Marti, Rene Warschkow, Lennard Ströse, Moritz Sparn, Tarkan Jäger, Stephan Bischofberger, Walter Brunner
Langenbeck's Archives of Surgery.2025;[Epub] CrossRef
Anorectal and urogenital functional outcome after robotic and transanal total mesorectal excision for rectal cancer: a propensity score-matched analysis
Pak Chiu Wong, Felix Che Lok Chow, Wai Lun Law, Chi Chung Foo
Techniques in Coloproctology.2025;[Epub] CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Beyond survival: a comprehensive review of quality of life in rectal cancer patients
Won Beom Jung
Annals of Coloproctology.2024; 40(6): 527. CrossRef
Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
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Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han
The Ewha Medical Journal.2023;[Epub] CrossRef
Quality of life and functional outcomes after transanal total mesorectal excision for rectal cancer—results from the implementation period in Denmark
M. X. Bjoern, F. B. Clausen, M. Seiersen, O. Bulut, F. Bech-Knudsen, J. E. Jansen, I. Gögenur, M. F. Klein
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Gyung Mo Son, In Young Lee, Mi Sook Yun, Jung-Hea Youn, Hong Min An, Kyung Hee Kim, Seung Mi Yeo, Bokyung Ku, Myeong Suk Kwon, Kun Hyung Kim
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Cristopher Varela, Nam Kyu Kim
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Benign proctology

Long-term outcomes after anal fistula surgery: results from two university hospitals in Thailand: Weeraput Chadbunchachai, Varut Lohsiriwat, Krisada Paonariang; Ann Coloproctol. 2022;38(2):133-140. Published online June 7, 2021; DOI: https://doi.org/10.3393/ac.2021.01.06

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Abstract PDF

Purpose
This study aimed to evaluate long-term outcomes after anal fistula surgery from university hospitals in Thailand.
Methods
A prospectively collected database of patients with cryptoglandular anal fistula undergoing surgery from 2011 to 2017 in 2 university hospitals was reviewed. Outcomes were treatment failure (persistent or recurrent fistula), fecal continence status, and chronic postsurgical pain.
Results
This study included 247 patients; 178 (72.1%) with new anal fistula and 69 (27.9%) with recurrent fistula. One hundred twenty-one patients (49.0%) had complex fistula; 53 semi-horseshoe (21.5%), 41 high transsphincteric (16.6%), 24 horseshoe (9.7%), and 3 suprasphincteric (1.2%). Ligation of intersphincteric fistula tract (LIFT) was the most common operation performed (n=88, 35.6%) followed by fistulotomy (n=79, 32.0%). With a median follow-up of 23 months (interquartile range, 12–45 months), there were 18 persistent fistulas (7.3%) and 33 recurrent fistulae (13.4%)—accounting for 20.6% overall failure. All recurrence occurred within 24 months postoperatively. Complex fistula was the only significant predictor for recurrent fistula with a hazard ratio of 4.81 (95% confidence interval, 1.82–12.71). There was no significant difference in healing rates of complex fistulas among seton staged fistulotomy (85.0%), endorectal advancement flap (72.7%), and LIFT (65.9%) (P=0.239). Four patients (1.6%) experienced chronic postsurgical pain. Seventeen patients (6.9%) reported worse fecal continence.
Conclusion
Overall failure for anal fistula surgery was 20.6%. Complex fistula was the only predictor for recurrent fistula. At least 2-year period of follow-up is suggested for detecting recurrent diseases and assessing patient-reported outcomes such as chronic pain and continence status.

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Eleanor Aubrey Belilos, Zoë Post, Sierra Anderson, Mark DeMeo
Gastro Hep Advances.2025; 4(2): 100562. CrossRef
Mucosal advancement flap versus ligation of the inter-sphincteric fistula tract for management of trans-sphincteric perianal fistulas in the elderly: a retrospective study
Tamer A. A. M. Habeeb, Massimo Chiaretti, Igor A. Kryvoruchko, Antonio Pesce, Aristotelis Kechagias, Abd Al-Kareem Elias, Abdelmonem A. M. Adam, Mohamed A. Gadallah, Saad Mohamed Ali Ahmed, Ahmed Khyrallh, Mohammed H. Alsayed, Esmail Tharwat Kamel Awad, M
International Journal of Colorectal Disease.2025;[Epub] CrossRef
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Semra Demirli Atici, Nurhilal KIZILTOPRAK, Yasemin Yildirim
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Tudor Mateescu, Lazar Fulger, Durganjali Tummala, Aditya Nelluri, Manaswini Kakarla, Lavinia Stelea, Catalin Dumitru, George Noditi, Amadeus Dobrescu, Cristian Paleru, Ana-Olivia Toma
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Ahmad Izadpanah, Ali Reza Safarpour, Mohammad Rezazadehkermani, Ali Zahedian, Reza Barati-Boldaji
Shiraz E-Medical Journal.2022;[Epub] CrossRef

Malignant disease, Rectal cancer,Colorectal cancer,Epidemiology & etiology

Clinicopathological Characteristics and Surgical Outcomes of Crohn Disease-Associated Colorectal Malignancy: Yoo Na Lee, Jong Lyul Lee, Chang Sik Yu, Jong Beom Kim, Seok-Byung Lim, In Ja Park, Young Sik Yoon, Chan Wook Kim, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park, Jin Cheon Kim; Ann Coloproctol. 2021;37(2):101-108. Published online April 30, 2021; DOI: https://doi.org/10.3393/ac.2020.11.02

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Abstract PDF Supplementary Material

Purpose
Carcinoma arising from Crohn disease (CD) is rare, and there is no clear guidance on how to properly screen for at-risk patients and choose appropriate care. This study aimed to evaluate the clinicopathological characteristics, treatment, and oncologic outcomes of CD patients diagnosed with colorectal cancer (CRC).
Methods
Using medical records, we retrospectively enrolled a single-center cohort of 823 patients who underwent abdominal surgery for CD between January 2006 and December 2015. CD-associated CRC patients included those with adenocarcinoma, lymphoma, or neuroendocrine tumors of the colon and rectum.
Results
Nineteen patients (2.3%) underwent abdominal surgery to treat CD-associated CRC. The mean duration of CD in the CD-associated CRC group was significantly longer than that in the benign CD group (124.7 ± 77.7 months vs. 68.9 ± 60.2 months, P = 0.006). The CD-associated CRC group included a higher proportion of patients with a history of perianal disease (73.7% vs. 50.2%, P = 0.035) and colonic location (47.4% vs. 6.5%, P = 0.001). Among 19 CD-associated CRC patients, 17 (89.5%) were diagnosed with adenocarcinoma, and of the 17 cases, 15 (88.2%) were rectal adenocarcinoma. On multivariable analyses for developing CRC, only colonic location was a risk factor (relative risk, 7.735; 95% confidence interval, 2.862–20.903; P = 0.001).
Conclusion
Colorectal malignancy is rare among CD patients, even among patients who undergo abdominal surgery. Rectal adenocarcinoma accounted for most of the CRC, and colonic location was a risk factor for developing CRC.

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Perianal fistulizing Crohn’s disease associated malignancy: a multi-institutional study of histology, clinical features and outcomes
Pooja Navale, Paula Toro, Shaomin Hu, Kwun Wah Wen, Xiaoyan Liao, Dongwei Zhang, Lindsay Alpert, Xiuli Liu
Pathology.2026;[Epub] CrossRef
Perianal Fistulizing Crohn’s Disease–Associated Anorectal and Fistula Cancers: Systematic Review and Expert Consensus
Serre-Yu Wong, Cathy Rowan, Elvira Diaz Brockmans, Cindy C.Y. Law, Elisabeth Giselbrecht, Celina Ang, Sergey Khaitov, David Sachar, Alexandros D. Polydorides, Leon Shin-han Winata, Bram Verstockt, Antonino Spinelli, David T. Rubin, Parakkal Deepak, Dermot
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Ye Jin Ha, Yun Jae Shin, Ka Hee Tak, Jong Lyul Park, Jeong Hwan Kim, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seon Young Kim, Jin Cheon Kim
Cancer Medicine.2023; 12(8): 10091. CrossRef
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Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef
Pretreatment inflammatory markers predicting treatment outcomes in colorectal cancer
Sanghyun An, Hongjin Shim, Kwangmin Kim, Bora Kim, Hui-Jae Bang, Hyejin Do, Hyang-Rae Lee, Youngwan Kim
Annals of Coloproctology.2022; 38(2): 97. CrossRef

Benign GI diease,Surgical technique

Laparoscopic Hartmann’s Reversal: Application of a Single-Port Approach Through the Colostomy Site: Byung Mo Kang, Chang Woo Kim, Suk-Hwan Lee; Ann Coloproctol. 2021;37(1):29-34. Published online December 4, 2020; DOI: https://doi.org/10.3393/ac.2020.09.21

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Abstract PDF

Purpose
Recently, laparoscopic reversal of Hartmann’s colostomy was performed with favorable outcomes by many surgeons. We partially applied the concepts of single-port laparoscopic procedure through the colostomy site to remove intraperitoneal adhesion during initial step of the laparoscopic Hartmann’s reversal. This study aimed to evaluate the feasibility and safety of the laparoscopic reversal of Hartmann’s colostomy with the application of single-port laparoscopic techniques through the colostomy site.
Methods
From October 2008 to November 2018, the laparoscopic Hartmann’s reversal was attempted in 20 patients. After colostomy take-downs, the single-port device was installed at the colostomy site and the single-port laparoscopic procedure was performed to remove intraperitoneal adhesions to provide space for additional trocars. After additional trocars were inserted, the descending colon and rectal stump were mobilized, and the colorectal anastomosis was completed. We retrospectively reviewed the medical records and analyzed the data to identify the perioperative complication rates as the primary outcome.
Results
Of the 20 patients, 3 patients (15.0%) had open conversions due to severe adhesions. Intraoperative small bowel injuries occurred in 2 patients (10.0%) and these were repaired through the colostomy site. Postoperative complications developed in 4 patients (20.0%) and were managed with medical treatments or wound closures under local anesthesia.
Conclusion
The single-port laparoscopic procedure through the colostomy site is sufficiently safe in order to complete the Hartmann’s reversal. We recommend that the colostomy site should be used as the access route into the abdominal cavity for the Hartmann’s reversal.

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Single‐port laparoscopic reversal of Hartmann's procedure through the colostomy site: technical aspects and early postoperative outcomes
Ahmet Akmercan, Tayfun Akmercan, Tevfik Kıvılcım Uprak
ANZ Journal of Surgery.2025; 95(1-2): 151. CrossRef
Handmade Single-Port Laparoscopic Hartmann’s Stoma Reversal Procedure
Ahmet Akmercan, Ali Hajali, Tevfik Kıvılcım Uprak
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Kyeong Eui Kim, Yu Ra Jeon, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
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Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Laparoskopische Kontinuitätswiederherstellung nach der Hartmann-Operation
Andreas Türler, Nicola Cerasani, Haug-Lambert Loriz, Xenia Kemper, Moritz Weckbecker, Maike Derenbach, Anna Krappitz
coloproctology.2022; 44(1): 35. CrossRef

Benign GI diease, Inflammatory bowel disease

Clinical Characteristics and Postoperative Outcomes of Patients Presenting With Upper Gastrointestinal Tract Crohn Disease: Joon Suk Moon, Jong Lyul Lee, Chang Sik Yu, Seok-Byung Lim, In Ja Park, Yong Sik Yoon, Chan Wook Kim, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park, Hassan Abdullah Alsaleem, Jin Cheon Kim; Ann Coloproctol. 2020;36(4):243-248. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.10.16.1

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Abstract PDF

Purpose
Upper gastrointestinal (GI) tract involvement in Crohn disease (CD) is rare and effectiveness of surgical treatment is limited. The aim of this study was to evaluate characteristics and surgical outcomes of upper GI CD.
Methods
Medical records of 811 patients who underwent intestinal surgery for CD between January 2006 and December 2015 at a single institution were reviewed. Upper GI CD was defined by involvement of the stomach to the fourth portion of duodenum, with or without concomitant small/large bowel CD involvement according to a modification of the Montreal classification.
Results
We identified 24 patients (21 males, 3 females) who underwent surgery for upper GI CD. The mean age at diagnosis was 27 ± 12 years, the mean age at surgery was 33 ± 11 years, and the mean duration of CD was 73.6 ± 56.6 months. Fifteen patients (62.5%) had history of previous perianal surgery. Ten patients (41.7%) had duodenal or gastric stricture and 14 patients (58.3%) had penetrating fistula; patients with fistula were significantly more likely to develop complications (57.1% vs. 20.0%, P = 0.035). One patient with stricture had surgical recurrence. In seven patients with fistula, fistula was related to previous anastomosis. Patients with fistula had significantly longer hospital stays than those with stricture (16 days vs. 11 days, P = 0.01).
Conclusion
Upper GI CD is rare among CD types (2.96%). In patients with upper GI CD, penetrating fistula was associated with longer hospital stay and more complications.

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Definitions, diagnosis, management, and outcomes of upper gastrointestinal Crohn's disease: an international, expert RAND/UCLA appropriateness study
Nathaniel A Cohen, Dominik Bettenworth, Neta Sror, Raneem Khedraki, Qijun Yang, Maria T Abreu, Raja Atreya, Badr Al-Bawardy, Susan J Connor, Geert D'Haens, Iris Dotan, Axel Dignass, Sara El Ouali, Brian Feagan, Roger Feakins, Richard Gearry, Ilyssa O Gord
The Lancet Gastroenterology & Hepatology.2026; 11(3): 243. CrossRef
Diagnosis and Management of Upper Gastrointestinal Involvement in Adult Patients With Crohn’s Disease: A Systematic Review
Nathaniel A. Cohen, Neta Sror, Maliha Naseer, Dominik Bettenworth, Cathy Lu, Raneem Khedraki, Maria T. Abreu, Raja Atreya, Badr Al-Bawardy, Susan J. Connor, Geert d’Haens, Iris Dotan, Axel Dignass, Sara El Ouali, Brian Feagan, Roger Feakins, Richard Gearr
Clinical Gastroenterology and Hepatology.2025;[Epub] CrossRef
Upper Gastrointestinal Crohn’s Disease: Shedding Light on the Obscure L4 Classification Meaning
Francesca Lusetti, Cristina Bezzio, Alice De Bernardi, Michele Puricelli, Gianpiero Manes, Simone Saibeni
Journal of Clinical Medicine.2025; 14(22): 8260. CrossRef
Update S2k-Guideline Helicobacter pylori and gastroduodenal ulcer disease of the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS)
Wolfgang Fischbach, Jan Bornschein, Jörg C. Hoffmann, Sibylle Koletzko, Alexander Link, Lukas Macke, Peter Malfertheiner, Kerstin Schütte, Dieter-Michael Selgrad, Sebastian Suerbaum, Christian Schulz
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A systematic review and meta‐analysis of prevalence and clinical features of upper gastrointestinal (UGI) tract Crohn's disease in adults compared to non‐UGI types
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Ranjit Pelia, Suresh Venkateswaran, Jason D. Matthews, Yael Haberman, David J. Cutler, Jeffrey S. Hyams, Lee A. Denson, Subra Kugathasan
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Soo Yeun Park
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Benign GI diease, Inflammatory bowel disease

Short-term Outcomes of Elective 2-Stage Restorative Proctocolectomy for Ulcerative Colitis in Korea: Does Laparoscopy Have Benefits?: Jun Woo Bong, Yong Sik Yoon, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2020;36(1):41-47. Published online February 29, 2020; DOI: https://doi.org/10.3393/ac.2019.03.29

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Abstract PDF

Purpose
This study aimed to compare the short-term outcomes of the open and laparoscopic approaches to 2-stage restorative proctocolectomy (RPC) for Korean patients with ulcerative colitis (UC).
Methods
We retrospectively analyzed the medical records of 73 patients with UC who underwent elective RPC between 2009 and 2016. Patient characteristics, operative details, and postoperative complications within 30 days were compared between the open and laparoscopic groups.
Results
There were 26 cases (36%) in the laparoscopic group, which had a lower mean body mass index (P = 0.025), faster mean time to recovery of bowel function (P = 0.004), less intraoperative blood loss (P = 0.004), and less pain on the first and seventh postoperative days (P = 0.029 and P = 0.027, respectively) compared to open group. There were no deaths, and the overall complication rate was 43.8%. There was no between-group difference in the overall complication rate; however, postoperative ileus was more frequent in the open group (27.7% vs. 7.7%, P = 0.043). Current smoking (odds ratio [OR], 44.4; P = 0.003) and open surgery (OR, 5.4; P = 0.014) were the independent risk factors for postoperative complications after RPC.
Conclusion
Laparoscopic RPC was associated with acceptable morbidity and faster recovery than the open approach. The laparoscopic approach is a feasible and safe option for surgical treatment for UC in selective cases.

Citations

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Patient-reported Outcome Measures in Ileoanal Pouch Surgery: a Systematic Review
Zakary Ismail Warsop, Carlo Alberto Manzo, Natalie Yu, Bilal Yusuf, Christos Kontovounisios, Valerio Celentano
Journal of Crohn's and Colitis.2024; 18(3): 479. CrossRef
Creation of an institutional preoperative checklist to support clinical risk assessment in patients with ulcerative colitis (UC) considering ileoanal pouch surgery
Bruno Augusto Alves Martins, Amira Shamsiddinova, Manal Mubarak Alquaimi, Guy Worley, Phil Tozer, Kapil Sahnan, Zarah Perry-Woodford, Ailsa Hart, Naila Arebi, Manmeet Matharoo, Janindra Warusavitarne, Omar Faiz
Frontline Gastroenterology.2024; 15(3): 203. CrossRef
Benefits of Elective Laparoscopic 2-Stage Restorative Proctocolectomy for Ulcerative Colitis in Korea
Sun Min Park, Won-Kyung Kang
Annals of Coloproctology.2020; 36(1): 3. CrossRef

Malignant disease

Thirty-Day Readmission After Elective Colorectal Surgery for Colon Cancer: A Single-Center Cohort Study: Jun Seong Chung, Han Deok Kwak, Jae Kyun Ju; Ann Coloproctol. 2020;36(3):186-191. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2019.11.04

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Abstract PDF

Purpose
There is a concern that enhanced recovery after surgery may affect other proposed quality measures, including the rate of readmission due to early discharge. We examine the 30-day readmission rate, risk factors associated with readmission after elective colorectal surgery for colon cancer, causes of readmission, disease-free survival (DFS), and overall survival (OS) in a single institution.
Methods
We retrospectively investigated 292 patients who underwent elective colorectal surgery for colon cancer between 2010 and 2015. Baseline data including age, sex, body mass index, American Society of Anesthesiologists physical status classification, preoperative comorbidities, previous operation history, TNM stage, surgical approach, operation time, gas passage time, and length of hospital stay were obtained. Univariate and multivariate logistic regression analyses were performed to identify risk factors associated with 30-day readmission.
Results
A total of 229 patients who underwent elective colorectal surgery were enrolled. Twenty-four patients were readmitted 30 days after discharge. The most common readmission diagnoses were wound bleeding or surgical site infection. Multivariate analysis indicated that patients who had preoperative hepatic disease were at the highest risk of readmission (odds ratio [OR], 8.98; 95% confidence interval [CI], 7.35–10.61). Survival outcomes were significantly better in the nonreadmitted group (OS, P=0.00; DFS, P=0.04).
Conclusion
This study identified that preoperative comorbidities including hepatic and pulmonary diseases were associated with higher readmission rates after elective colorectal surgery. Moreover, the most common cause of readmission in patients who underwent elective colorectal surgery was wound bleeding or surgical site infection.

Citations

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Cost-effectiveness and readmission rates of laparoscopic vs. open surgery for colorectal cancer: evidence from the health insurance review and assessment service dataset in South Korea
Sanghyun An, Sung Eun Hong, Moo Hyun Kim, Ik Yong Kim
Frontiers in Surgery.2025;[Epub] CrossRef
Risk factors for unplanned 31-day readmission after surgery for colorectal cancer patients: a meta-analysis
Nan Qu, Tiantian Li, Lifeng Zhang, Xingyu Liu, Liping Cui
BMC Gastroenterology.2025;[Epub] CrossRef
Readmission rates following major colorectal surgery
Aoife Shorten, Matthew G. Davey, William P. Joyce
The Surgeon.2024; 22(2): 116. CrossRef
Ambulatory Robotic Colectomy: Factors Affecting and Affected by Postoperative Opioid Use
Michael M. Vu, Jace J. Franko, Anna Buzadzhi, Beau Prey, Maksim Rusev, Marta Lavery, Laila Rashidi
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2024; 34(2): 163. CrossRef
Meta-analysis of postoperative incision infection risk factors in colorectal cancer surgery
Li Jia, Huacai Zhao, Jia Liu
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The 30-day readmission rate of patients with an overlap of probable sarcopenia and malnutrition undergoing major oncological surgery
Hadassa Hillary Novaes Pereira Rodrigues, Kathyelli Thaynara Pimenta de Araujo, José Eduardo de Aguilar-Nascimento, Diana Borges Dock-Nascimento
einstein (São Paulo).2024;[Epub] CrossRef
Risk factors for early readmission to hospital in patients with malignancy-related ascites: a retrospective cohort study
Zhenhua Tian, Zhilong Huang, Yaqi Guo, Xiaolin Zhao, Luna Liu, Chunxiao Yu, Qingbo Guan
Frontiers in Oncology.2024;[Epub] CrossRef
A National Cancer Database analysis of the predictors of unplanned 30-day readmission after proctectomy for rectal adenocarcinoma: The CCF RETURN-30 Score
Sameh Hany Emile, Nir Horesh, Michael R. Freund, Zoe Garoufalia, Rachel Gefen, Emanuela Silva-Alvarenga, Steven D. Wexner
Surgery.2023; 173(2): 342. CrossRef
Data analytics and artificial intelligence in predicting length of stay, readmission, and mortality: a population-based study of surgical management of colorectal cancer
Shamsul Masum, Adrian Hopgood, Samuel Stefan, Karen Flashman, Jim Khan
Discover Oncology.2022;[Epub] CrossRef
The 30-day hospital readmission and mortality after surgery in colorectal cancer patients
Mesnad S. Alyabsi, Anwar H. Alqarni, Latifah M. Almutairi, Mohammed A. Algarni, Kanan M. Alshammari, Adel Almutairi, Nahar A. Alselaim
BMC Gastroenterology.2022;[Epub] CrossRef

Anorectal Manometry Versus Patient-Reported Outcome Measures as a Predictor of Maximal Treatment for Fecal Incontinence: Lisa Ramage, Shengyang Qiu, Zhu Yeap, Constantinos Simillis, Christos Kontovounisios, Paris Tekkis, Emile Tan; Ann Coloproctol. 2019;35(6):319-326. Published online December 31, 2019; DOI: https://doi.org/10.3393/ac.2018.10.16

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Abstract PDF

Purpose
This study aims to establish the ability of patient-reported outcome measures (PROMs) and anorectal manometry (ARM) in predicting the need for surgery in patients with fecal incontinence (FI).
Methods
Between 2008 and 2015, PROMs data, including the Birmingham Bowel and Urinary Symptoms Questionnaire (BBUSQ), Short Form 36 (SF-36), Wexner Incontinence Score and ARM results, were prospectively collected from 276 patients presenting with FI. Spearman rank was used to assess correlations between specific PROMs questions and ARM assessments of sphincter motor function. Binomial regression analyses were performed to identify factors predictive of the need for surgery. Finally, receiver operating characteristic (ROC) curve analyses were performed to establish the utility of individual ARM and PROMs variables in predicting the need for surgical intervention in patients with FI.
Results
Two hundred twenty-eight patients (82.60%) were treated conservatively while 48 (17.39%) underwent surgery. On univariate analyses, all 4 domains of the BBUSQ, all 8 domains of the SF-36, and the Wexner Incontinence Score were significant predictors of surgery. Additionally, maximum resting pressure, 5-second squeeze endurance, threshold volume, and urge volume were significant. On ROC curve analyses, the only significant ARM measurement was the 5-second squeeze endurance. PROMs, such as the incontinence domain of the BBUSQ and five of the SF-36 domains, were identified as fair discriminators of the need for surgery.
Conclusion
PROMs are reliable predictors of maximal treatment in patients with FI and can be readily used in primary care to aid surgical referrals and can be applied in hospital settings as an aid to guide surgical treatment decisions.

Citations

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Capturing Patient Reported Outcomes Following Treatment of Benign Anorectal Disease Requires Significant Surgeon Commitment: Do Surgeons Really Want to Know?
Thomas Peponis, Marc S. Rubin, Ronald Bleday, Harrison T. Hubbell, Robert N. Goldstone, Joel E. Goldberg, Khawaja F. Ahmed, Liliana G. Bordeianou
World Journal of Colorectal Surgery.2025; 14(1): 1. CrossRef
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Nicola Adanna Okeahialam, Ranee Thakar, Abdul H. Sultan
BJOG: An International Journal of Obstetrics & Gynaecology.2025; 132(12): 1802. CrossRef
Correlation of Digital Rectal Examination and Anorectal Manometry with Patient-Reported Outcomes Among Women with Fecal Incontinence
Alayne Markland, Mary Ackenbom, Uduak Andy, Ben Carper, Eric Jelovsek, Douglas Luchristt, Shawn Menefee, Rebecca Rogers, Vivian Sung, Donna Mazloomdoost, Maria Gantz
International Urogynecology Journal.2024; 35(12): 2367. CrossRef
Pelvic floor investigations for anal incontinence: Are they useful to predict outcomes from conservative treatment?
Karina Cuinas, Linda Ferrari, Carlene Igbedioh, Deepa Solanki, Andrew Williams, Alexis Schizas, Alison Hainsworth
Neurourology and Urodynamics.2023; 42(5): 1122. CrossRef
Anorectal dysfunction in multiple sclerosis patients: A pilot study on the effect of an individualized rehabilitation approach
Martina Kovari, Jan Stovicek, Jakub Novak, Michaela Havlickova, Sarka Mala, Andrew Busch, Pavel Kolar, Alena Kobesova
NeuroRehabilitation.2022; 50(1): 89. CrossRef
Postpartum fecal incontinence. State of the problem
D.R. Markaryan, A.M. Lukyanov, T.N. Garmanova, M.A. Agapov, V.A. Kubyshkin
Khirurgiya. Zhurnal im. N.I. Pirogova.2022; (6): 127. CrossRef
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Eun Jung Park, Seung Hyuk Baik
Precision and Future Medicine.2021; 5(4): 164. CrossRef
Usefulness of Patient-Reported Outcome Measures and Anorectal Physiologic Tests in Predicting Clinical Outcome for Fecal Incontinence
Chang-Nam Kim
Annals of Coloproctology.2019; 35(6): 289. CrossRef

Malignant disease, Rectal cancer

Short-term and Medium-term Outcomes of Low Midline and Low Transverse Incisions in Laparoscopic Rectal Cancer Surgery: Do Hoe Ku, Hyeon Seung Kim, Jin Yong Shin; Ann Coloproctol. 2020;36(5):304-310. Published online November 13, 2019; DOI: https://doi.org/10.3393/ac.2019.10.22

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Abstract PDF

Purpose
Limited data exist on the use of low midline and transverse incisions for specimen extraction or stoma sites in laparoscopic rectal cancer surgery (LRCS). We compared the short-term and medium-term outcomes of these incisions and assessed whether wound complications in specimen extraction sites (SES) are increased by specimen extraction through the stoma site (SESS) in LRCS.
Methods
From March 2010 to December 2017, 189 patients who underwent LRCS and specimen extraction through low abdominal incisions were divided into 2 groups: midline (n = 102) and transverse (n = 87), and perioperative outcomes were compared.
Results
The midline group showed a higher frequency of temporary stoma formation (P = 0.001) and splenic flexure mobilization (P < 0.001) than the transverse group. The overall incisional hernia and wound infection rates in the SES were 21.6% and 25.5%, respectively, in the midline group and 26.4% and 17.2%, respectively, in the transverse group (P = 0.494 and P = 0.232, respectively). In patients who underwent SESS, the incisional hernia and wound infection rates of SES after stoma closure were 39.1% and 43.5%, respectively, in the midline group, and 35.5% and 22.6%, respectively, in the transverse group (P = 0.840 and P = 0.035, respectively).
Conclusion
In terms of incisional hernia and wound infection at the SES, a low midline incision may be used as a low transverse incision in patients without temporary stoma in LRCS. However, considering the high wound complication rates after stoma closure in patients with SESS in this study, SESS should be performed with caution in LRCS.

Citations

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Comparison between liquid skin adhesive and wound closure strip for skin closure after subcuticular suturing in single-port laparoscopic appendectomy: a single-center retrospective study in Korea
Kyeong Eui Kim, Yu Ra Jeon, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Journal of Minimally Invasive Surgery.2024; 27(1): 14. CrossRef
An evidence map and synthesis review with meta-analysis on the risk of incisional hernia in colorectal surgery with standard closure
C. Stabilini, M.A. Garcia-Urena, F. Berrevoet, D. Cuccurullo, S. Capoccia Giovannini, M. Dajko, L. Rossi, K. Decaestecker, M. López Cano
Hernia.2022; 26(2): 411. CrossRef
Choice of specimen’s extraction site affects wound morbidity in laparoscopic colorectal cancer surgery
Mahmood Al Dhaheri, Mohanad Ibrahim, Omer Al-Yahri, Ibrahim Amer, Mahwish Khawar, Noof Al-Naimi, Ayman Abdelhafiz Ahmed, Mohamed Abu Nada, Amjad Parvaiz
Langenbeck's Archives of Surgery.2022; 407(8): 3561. CrossRef

Review

Reconsideration of the Safety of Laparoscopic Rectal Surgery for Cancer: Gyung Mo Son, Bong-Hyeon Kye, Min Ki Kim, Jun-Gi Kim; Ann Coloproctol. 2019;35(5):229-237. Published online October 31, 2019; DOI: https://doi.org/10.3393/ac.2019.10.16

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6 Citations

Abstract PDF

The oncological outcomes of laparoscopic rectal cancer surgery were evaluated in recent multicenter randomized clinical trials (RCTs). The MRC-CLASSIC, COLOR II, and COREAN trials found no differences in local recurrence or diseasefree survival rate between laparoscopic and open surgery. However, the noninferiority of laparoscopic surgery with respect to open surgery for rectal cancer was not established on statistical analysis in the ACOSOG Z6051 and the ALaCaRT trials. Quality of total mesorectal excision (TME) is one of the most important prognostic factors. Incomplete TME had unfavorable oncologic outcomes compared to complete TME. Although TME quality can be clearly identified on pathologic evaluation, there is controversy regarding the acceptable range of oncologically safe TME for laparoscopic surgery. It is not certain whether near-complete TME has an unfavorable oncologic impact and whether laparoscopic surgery with near-complete TME is an oncological threat. Therefore, the surgical community will be interested in the long-term outcomes and meta-analyses of ongoing large-scale RCTs. Laparoscopic rectal cancer surgery has been steadily improving its safety for oncology surgery, which has been reported consistently in various multicenter RCTs. To improve surgical quality, colorectal surgeons should choose the most appropriate surgical technique, including laparoscopic surgery.

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Why did we encounter a pCRM-positive specimen whose preoperative MRI indicates negative mesorectal fascia involvement in middle to low rectal cancer?
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Original Articles

Comparison of Delorme-Thiersch Operation Outcomes in Men and Women With Rectal Prolapse: Keehoon Hyun, Seo-Gue Yoon; Ann Coloproctol. 2019;35(5):262-267. Published online October 31, 2019; DOI: https://doi.org/10.3393/ac.2018.10.15.1

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6 Citations

Abstract PDF

Purpose
The laparoscopic rectopexy has become increasingly popular with verified stability, surgical route selection should be tailored to individual patient characteristics rather than operative risk. The perineal approach is useful in young male patients who need to preserve fertility. This study aimed to compare the characteristics of men and women who underwent Delorme-Thiersch procedures and analyze the postoperative outcomes of the perineal approach by sex.
Methods
We retrospectively reviewed the medical records of 293 patients who underwent Delorme-Thiersch operations in Seoul Song Do Colorectal Hospital between January 2011 and September 2017. Patient clinical characteristics and postoperative complications were analyzed by sex. We analyzed surgical outcomes with preoperative and 3-month postoperative incontinence questionnaires, constipation levels, and anal manometry.
Results
In this study, men with rectal prolapse were younger than women with the same condition. American Society of Anesthesiologists physical status classifications were higher in women and women had more L-spine X-ray and pudendal nerve terminal motor latency test abnormalities. Anorectal manometry pressures were higher in men. Men also had longer operation times and hospital stays and more postoperative complications (8 T ring infections, 6 patients with bleeding, 3 with strictures, 2 with severe pain, and 2 with rectal perforations). The recurrence rate was higher among women.
Conclusion
Men with rectal prolapse were younger, healthier, and had relatively better anorectal function than women. The Delorme-Thiersch operation in men promoted lower recurrence rates and was advantageous in preserving the fertility of young patients, but the incidence of complications was also higher in men. Adequate counseling and preparation for the possibility of complications are needed.

Citations

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Laparoscopic anterior and posterior rectopexy using two mesh implants for rectal prolapse in men
A.L. Goncharov, A.S. Aslanyan, M.A. Chicherina, I.I. Muratov, T.V. Khorobrykh
Pirogov Russian Journal of Surgery.2025; (10): 73. CrossRef
Assessment of Laparoscopic Posterior Mesh Rectopexy for Complete Rectal Prolapse: A Case Series with Review of Literature
Vishal Chawda, Abhijit Joshi
International Journal of Recent Surgical and Medical Sciences.2023; 09(01): 059. CrossRef
A comparative study on the surgical options for male rectal prolapse
Han Deok Kwak, Jun Seong Chung, Jae Kyun Ju
Journal of Minimal Access Surgery.2022; 18(3): 426. CrossRef
Clinical outcomes of surgical management for recurrent rectal prolapse: a multicenter retrospective study
Kwang Dae Hong, Keehoon Hyun, Jun Won Um, Seo-Gue Yoon, Do Yeon Hwang, Jaewon Shin, Dooseok Lee, Se-Jin Baek, Sanghee Kang, Byung Wook Min, Kyu Joo Park, Seung-Bum Ryoo, Heung-Kwon Oh, Min Hyun Kim, Choon Sik Chung, Yong Geul Joh
Annals of Surgical Treatment and Research.2022; 102(4): 234. CrossRef
Longer prolapsed rectum length increases recurrence risk after Delorme’s procedure
Taro Tanabe, Emi Yamaguchi, Takuya Nakada, Risa Nishio, Kinya Okamoto, Tetsuo Yamana
Annals of Coloproctology.2022; 38(4): 314. CrossRef
Perineal stapled prolapse resection in combination with Thiersch operation for relapsed rectal prolapse: a case report
Teppei Kamada, Hironori Ohdaira, Junji Takahashi, Yoshinobu Fuse, Wataru Kai, Keigo Nakashima, Yuichi Nakaseko, Norihiko Suzuki, Masashi Yoshida, Takeo Usui, Yutaka Suzuki
Surgical Case Reports.2021;[Epub] CrossRef

Oncologic Outcomes of Organ Preserving Approaches in Patients With Rectal Cancer Treated With Preoperative Chemoradiotherapy: In Ja Park, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2019;35(2):65-71. Published online April 30, 2019; DOI: https://doi.org/10.3393/ac.2019.03.17

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Abstract PDF

Purpose
We evaluated the oncologic outcomes of organ-preserving strategies in patients with rectal cancer treated with preoperative chemoradiotherapy (PCRT).
Methods
Between January 2008 and January 2013, 74 patients who underwent wait-and-watch (WW) (n = 42) and local excision (LE) (n = 32) were enrolled. Organ-preserving strategies were determined based on a combination of magnetic resonance imaging, sigmoidoscopy, and physical examination 4–6 weeks after completion of PCRT. The rectum sparing rate, 5-year recurrence-free survival (RFS), and overall survival (OS) were evaluated.
Results
The rectum was more frequently spared in the LE (100% vs. 87.5%, P = 0.018) at last follow-up. Recurrence occurred in 9 (28.1%) WW and 7 (16.7%) LE (P = 0.169). In the WW, 7 patients had only luminal regrowth and 2 had combined lung metastasis. In the LE, 2 (4.8%) had local recurrence only, 4 patients had distant metastasis, and 1 patient had local and distant metastasis. Among 13 patients who indicated salvage surgery (WW, n = 7; LE, n = 11), all in the WW received but all of LE refused salvage surgery (P = 0.048). The 5-year OS and 5-year RFS in overall patients was 92.7% and 76.9%, respectively, and were not different between WW and LE (P = 0.725, P = 0.129).
Conclusion
WW and LE were comparable in terms of 5-year OS and RFS. In the LE group, salvage treatment was performed much less among indicated patients. Therefore, methods to improve the oncologic outcomes of patients indicated for salvage treatment should be considered before local excision.

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Ke Liu, Haiquan Qian, Shensi Chen, Shengjun Zhang, Wei Zhao
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Soo Young Oh, In Ja Park, Young IL Kim, Jong-Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Cancers.2021; 13(19): 4823. CrossRef
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Eun Jung Park, Seung Hyuk Baik
Precision and Future Medicine.2021; 5(4): 164. CrossRef
The risk of distant metastases in rectal cancer managed by a watch-and-wait strategy – A systematic review and meta-analysis
Joanna Socha, Lucyna Kępka, Wojciech Michalski, Karol Paciorek, Krzysztof Bujko
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Seong Kyu Baek
Annals of Coloproctology.2019; 35(2): 51. CrossRef

Does the Different Locations of Colon Cancer Affect the Oncologic Outcome? A Propensity-Score Matched Analysis: Kwan Mo Yang, In Ja Park, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seok-Byung Lim, Na Young Kim, Shinae Hong, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2019;35(1):15-23. Published online February 28, 2019; DOI: https://doi.org/10.3393/ac.2018.07.25

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Purpose
We evaluate the prognostic value of primary tumor location for oncologic outcomes in patients with colon cancer (CC).
Methods
CC patients treated with curative surgery between 2009 and 2012 were classified into 2 groups: right-sided colon cancer (RCC) and left-sided colon cancer (LCC). Recurrence-free survival (RFS) and overall survival (OS) were examined based on tumor stage. Propensity scores were created using eight variables (age, sex, T stage, N stage, histologic grade, presence of lymphovascular invasion/perineural invasion, and microsatellite instability status).
Results
Overall, 2,329 patients were identified. The 5-year RFSs for RCC and LCC patients were 89.7% and 88.4% (P = 0.328), respectively, and their 5-year OSs were 90.9% and 93.4% (P = 0.062). Multivariate survival analyses were carried out by using the Cox regression proportional hazard model. In the unadjusted analysis, a marginal increase in overall mortality was seen in RCC patients (hazard ratio [HR], 1.297; 95% confidence interval [CI], 0.987–1.704, P = 0.062); however, after multivariable adjustment, similar OSs were observed in those patients (HR, 1.219; 95% CI, 0.91–1.633; P = 0.183). After propensity-score matching with a total of 1,560 patients, no significant difference was identified (P = 0.183). A slightly worse OS was seen for stage III RCC patients (HR, 1.561; 95% CI, 0.967–2.522; P = 0.068) than for stage III LCC patients. The 5-year OSs for patients with stage III RCC and stage III LCC were 85.5% and 90.5%, respectively (P = 0.133).
Conclusion
Although the results are inconclusive, tumor location tended to be associated with OS in CC patients with lymph node metastasis, but it was not related to oncologic outcome.

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Reviews

Differences Regarding the Molecular Features and Gut Microbiota Between Right and Left Colon Cancer: Kwangmin Kim, Ernes John T. Castro, Hongjin Shim, John Vincent G. Advincula, Young-Wan Kim; Ann Coloproctol. 2018;34(6):280-285. Published online December 31, 2018; DOI: https://doi.org/10.3393/ac.2018.12.17

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Abstract PDF

For many years, developmental and physiological differences have been known to exist between anatomic segments of the colorectum. Because of different outcomes, prognoses, and clinical responses to chemotherapy, the distinction between right colon cancer (RCC) and left colon cancer (LCC) has gained attention. Furthermore, variations in the molecular features and gut microbiota between right and LCCs have recently been a hot research topic. CpG island methylator phenotype-high, microsatellite instability-high colorectal cancers are more likely to occur on the right side whereas tumors with chromosomal instability have been detected in approximately 75% of LCC patients and 30% of RCC patients. The mutation rates of oncogenes and tumor suppressor genes also differ between RCC and LCC patients. Biofilm is more abundant in RCC patients than LLC patients, as are Prevotella, Selenomonas, and Peptostreptococcus. Conversely, Fusobacterium, Escherichia/Shigella, and Leptotrichia are more abundant in LCC patients compared to RCC patients. Distinctive characteristics are apparent in terms of molecular features and gut microbiota between right and LCC. However, how or to what extent these differences influence diverging oncologic outcomes remains unclear. Further clinical and translational studies are needed to elucidate the causative relationship between primary tumor location and prognosis.

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Intersphincteric Resection for Patients With Low-Lying Rectal Cancer: Oncological and Functional Outcomes: In Ja Park, Jin Cheon Kim; Ann Coloproctol. 2018;34(4):167-174. Published online August 31, 2018; DOI: https://doi.org/10.3393/ac.2018.08.02

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Abstract PDF

The aim of this review is to evaluate the outcomes after an intersphincteric resection (ISR) for patients with low-lying rectal cancer. Reports published in the literature regarding surgical, oncological, and functional outcomes of an ISR were reviewed. The morbidity after an ISR was 7.7%–32%, and anastomotic leakage was the most common adverse event. Local recurrence rates ranged from 0% to 12%, 5-year overall survival rates ranged from 62% to 92%, and rates of major incontinence ranged from 0% to 25.8% after an ISR. An ISR is a safe procedure for sphincter-saving rectal surgery in patients with very low rectal cancer; it does not compromise the oncological outcomes of the resection and is a valuable alternative to an abdominoperineal resection. While the functional outcomes after an ISR were found to be acceptable, the long-term functional outcome and quality of life still require careful investigation. ISRs have been performed with surgical and oncologic safety on patients with low-lying rectal cancer. However, patients must be selected very carefully for an ISR, considering the associated functional derangement and the limited extent of the resection.

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Medicina.2019; 55(12): 764. CrossRef

Original Articles

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

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Abstract PDF

Purpose

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

Methods

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

Results

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

Conclusion

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

Citations

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Effects of the COVID‐19 pandemic on short‐term postoperative outcomes for colorectal perforation: A nationwide study in Japan based on the National Clinical Database
Shimpei Ogawa, Hideki Endo, Masahiro Yoshida, Tomomitsu Tsuru, Michio Itabashi, Hiroyuki Yamamoto, Yoshihiro Kakeji, Hideki Ueno, Yuko Kitagawa, Taizo Hibi, Akinobu Taketomi, Norihiko Ikeda, Masaki Mori
Annals of Gastroenterological Surgery.2024; 8(3): 450. CrossRef
Effects of surgeon specialization on the outcome of emergency colorectal surgery
Nahar A. Alselaim, Ohood H. AlAamer, Mohammed M. Almalki, Abdualziz A. Al-osail, Sultanah F. Bin Gheshayan
Annals of Medicine & Surgery.2024; 86(12): 7010. CrossRef
Association between Intraoperative Early Warning Score and Mortality and In-Hospital Stay in Lower Gastrointestinal Spontaneous Perforation
Kazuya Takada, Yusuke Nagamine, Akira Ishii, Yan Shuo, Takumi Seike, Hanako Horikawa, Kentaro Matsumiya, Tetsuya Miyashita, Takahisa Goto, Ronald G. Pearl
Anesthesiology Research and Practice.2023; 2023: 1. CrossRef
Sigmoid colon cancer presenting as a left inguinal hernia: a case report
Mohammad E. Al Mohtasib, Mohammad N. Emar, Anan I. Al-jabari, Taima M. Aljabari, Islam H. Karajeh, Qutaiba Y. Al Jawabrah, Raghad M. Dghaish, Fahmi Jubran, Shadi Ruzayqat
Annals of Medicine & Surgery.2023; 85(11): 5653. CrossRef
Factors associated with 30-day mortality and morbidity in patients undergoing emergency colorectal surgery
Nahar A. Alselaim, Muhannad Abdulrahman Alsemari, Mesnad Alyabsi, Abrar M. Al-Mutairi
Annals of Saudi Medicine.2023; 43(6): 364. CrossRef
Efficiency of pre-operative preparation of intestines at treatment of sharp intestinal impassability tumoral genesis
H. Sh. Nazarov, Sh. К. Nazarov, N. Sh. Hasanov
Health care of Tajikistan.2022; (2): 59. CrossRef
Fluid management for critical patients undergoing urgent colectomy
Fabian Grass, Basile Pache, Fabio Butti, Josep Solà, Dieter Hahnloser, Nicolas Demartines, Martin Hübner
Journal of Evaluation in Clinical Practice.2020; 26(1): 109. CrossRef
Emergency surgery for gastrointestinal cancer: A nationwide study in Japan based on the National Clinical Database
Nobuaki Hoshino, Hideki Endo, Koya Hida, Nao Ichihara, Yoshimitsu Takahashi, Hiroshi Hasegawa, Toshimoto Kimura, Yuko Kitagawa, Yoshihiro Kakeji, Hiroaki Miyata, Takeo Nakayama, Yoshiharu Sakai
Annals of Gastroenterological Surgery.2020; 4(5): 549. CrossRef
Gestione delle complicanze infettive intra-addominali e delle peritoniti postoperatorie in chirurgia viscerale
A. Mancini, J. Abba, C. Arvieux
EMC - Tecniche Chirurgiche Addominale.2020; 26(4): 1. CrossRef
Tratamiento de las complicaciones infecciosas intraabdominales y de la peritonitis postoperatoria en cirugía visceral
A. Mancini, J. Abba, C. Arvieux
EMC - Técnicas Quirúrgicas - Aparato Digestivo.2020; 36(4): 1. CrossRef
Colonic stenting as a bridge to surgery in malignant large bowel obstruction: oncological outcomes
N. E. Donlon, M. E. Kelly, F. Narouz, P. H. McCormick, J. O. Larkin, B. J. Mehigan
International Journal of Colorectal Disease.2019; 34(4): 613. CrossRef

Does Anastomosis Configuration Influence Long-term Outcomes in Patients With Crohn Disease?: Parajuli Anuj, Yong Sik Yoon, Chang Sik Yu, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Jin Cheon Kim; Ann Coloproctol. 2017;33(5):173-177. Published online October 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.5.173

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9 Citations

Abstract PDF

Purpose

In this study, we evaluated the role of various anastomoses in surgical recurrence for patients with Crohn disease (CD).

Methods

We analyzed data retrospectively from consecutive laparotomy cases involving complicated CD between 1991 and 2008. Clinical data were compared in terms of reoperation-free survival (RFS) according to the types of anastomoses, the materials used for the anastomoses, and the operating surgeon.

Results

Of 233 patients with entero-enteric or entero-colic anastomoses, 199 (85%), 11 (5%), and 23 (10%) experienced side-to-side (SS), side-to-end (SE), and end-to-end (EE) anastomoses, respectively. The SS group had the following characteristics: more extensive bowel involvement, frequent obstruction, and greater stapler use; the SS anastomoses were also frequently made by specialized surgeons (P < 0.001–0.004). EE anastomoses were frequently made by general surgeons using a hand-sewing technique (P < 0.001). No differences in RFS were noted among the 3 groups according to the type of anastomosis and the operating surgeon. However, the hand-sewn group showed better RFS than the stapler group (P = 0.04).

Conclusion

The roles of the anastomotic configuration, the material used, and the operating surgeon were not significantly correlated with reoperations or complications in our retrospective CD cohort, irrespective of the higher risk of anastomosis site stricture for EE anastomoses.

Citations

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Anastomosis after Bowel Resection for Crohn's Disease: State of the Art Review
Carla Newton, Alessandro Fichera
Clinics in Colon and Rectal Surgery.2025; 38(02): 104. CrossRef
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Joana Roseira, Maria Manuela Estevinho, Beatriz Gros, Irene Marafini, Virginia Solitano, Paula Sousa, Cristina Carretero, Winnie Zou, Nasim Parsa, Aline Charabaty, Lumir Kunovsky
Best Practice & Research Clinical Gastroenterology.2025; 78: 102055. CrossRef
New anti-mesenteric delta-shaped stapled anastomosis: Technical report with short-term postoperative outcomes in patients with Crohn’s disease
Jong Lyul Lee, Yong Sik Yoon, Hyun Gu Lee, Young Il Kim, Min Hyun Kim, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
World Journal of Gastrointestinal Surgery.2024; 16(8): 2592. CrossRef
Results of the Eighth Scientific Workshop of ECCO: Pathophysiology and Risk Factors of Postoperative Crohn’s Disease Recurrence after an Ileocolonic Resection
Pauline Rivière, Gabriele Bislenghi, Nassim Hammoudi, Bram Verstockt, Steven Brown, Melissa Oliveira-Cunha, Willem Bemelman, Gianluca Pellino, Paulo Gustavo Kotze, Gabriele Dragoni, Mariangela Allocca, Nurulamin M Noor, Lieven Pouillon, Míriam Mañosa, Edo
Journal of Crohn's and Colitis.2023; 17(10): 1557. CrossRef
Ileocolic Resection for Crohn Disease: The Influence of Different Surgical Techniques on Perioperative Outcomes, Recurrence Rates, and Endoscopic Surveillance
Benjamin Click, Amit Merchea, Dorin T Colibaseanu, Miguel Regueiro, Francis A Farraye, Luca Stocchi
Inflammatory Bowel Diseases.2022; 28(2): 289. CrossRef
Anastomotic Techniques for Abdominal Crohn's Disease: Tricks and Tips
Marco Bertucci Zoccali, Alessandro Fichera
Journal of Laparoendoscopic & Advanced Surgical Techniques.2021; 31(8): 861. CrossRef
Short-term and long-term outcomes of laparoscopic vs open ileocolic resection in patients with Crohn's disease: Propensity-score matching analysis
Shin Jeong Pak, Young Il Kim, Yong Sik Yoon, Jong Lyul Lee, Jung Bok Lee, Chang Sik Yu
World Journal of Gastroenterology.2021; 27(41): 7159. CrossRef
The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Surgical Management of Crohn’s Disease
Amy L. Lightner, Jon D. Vogel, Joseph C. Carmichael, Deborah S. Keller, Samir A. Shah, Uma Mahadevan, Sunanda V. Kane, Ian M. Paquette, Scott R. Steele, • Daniel L. Feingold
Diseases of the Colon & Rectum.2020; 63(8): 1028. CrossRef
Correlation Between Anastomotic Configuration and Long-term Outcomes in Surgery for Crohn Disease
Jin-Su Kim, Ji-Yeon Kim
Annals of Coloproctology.2017; 33(5): 159. CrossRef

Prognostic Significance of Mucinous Histologic Subtype on Oncologic Outcomes in Patients With Colorectal Cancer: Sare Hosseini, Ali Mohammad Bananzadeh, Roham Salek, Mohammad Zare-Bandamiri, Ali Taghizadeh Kermani, Mohammad Mohammadianpanah; Ann Coloproctol. 2017;33(2):57-63. Published online April 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.2.57

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Abstract PDF

Purpose

Mucinous adenocarcinomas account for about 10% of all colorectal cancers. This study aimed to investigate the prognostic impact of mucinous histologic subtype on oncologic outcomes in patients with colorectal cancer.

Methods

This retrospective study was performed at two large tertiary university hospitals. We analyzed the characteristics, prognostic factors, and survival of patients with colorectal cancer who were treated and followed up between 2000 and 2013.

Results

Totally, 144 of 1,268 patients with a colorectal adenocarcinoma (11.4%) had mucinous histologic subtype. Statistically significant results found in this research are as follows: Mucinous histologic subtype tended to present in younger patients and to have larger tumor size, higher histologic grade, higher node stage, larger number of positive nodes, and higher rate of perineural invasion compared to nonmucinous histologic subtype. On the univariate analysis, mucinous subtype was a prognostic factor for disease-free and overall survival. On the multivariate analysis, primary tumor location, node stage and lymphatic-vascular invasion were independent prognostic factors for the local control rate. Rectal tumor location, higher disease stage, tumor grade II, and presence of lymphatic-vascular invasion had negative influences on disease-free survival, as did rectal tumor location, higher disease stage and presence of lymphatic-vascular invasion on overall survival.

Conclusion

Mucinous histologic subtype was associated with some adverse pathologic features in patients with colorectal cancer; however, it was not an independent prognostic factor for oncologic outcome.

Citations

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Comparing the Histopathologic Patterns and Survival Outcomes of Mucinous vs Non-mucinous Colorectal Adenocarcinoma: A Systematic Review and Meta-Analysis
Jane Nnanemere, Akinyele Oladimeji, Sarah Waseem, Ifelunwa M Osanakpo, Aminat D Lawal , Moses C Odoeke, Joshua T Green
Cureus.2026;[Epub] CrossRef
Association between lymphovascular invasion and lymph node metastases in colon cancer: A National Cancer Database analysis
Sameh Hany Emile, Nir Horesh, Zoe Garoufalia, Anjelli Wignakumar, Marylise Boutros, Steven D. Wexner
Colorectal Disease.2025;[Epub] CrossRef
Comprehensive Overview of Molecular, Imaging, and Therapeutic Challenges in Rectal Mucinous Adenocarcinoma
Mihaela Berar, Andra Ciocan, Emil Moiș, Luminița Furcea, Călin Popa, Răzvan Alexandru Ciocan, Florin Zaharie, Cosmin Puia, Nadim Al Hajjar, Cosmin Caraiani, Ioana Rusu, Florin Graur
International Journal of Molecular Sciences.2025; 26(2): 432. CrossRef
Clinicopathological and prognostic features of colorectal mucinous adenocarcinomas: a systematic review and meta-analysis
Xiao Wang, Haoran Wang, Haoqing He, Kai Lv, Wenguang Yuan, Jingbo Chen, Hui Yang
BMC Cancer.2024;[Epub] CrossRef
Multi gene mutation signatures in colorectal cancer patients: predict for the diagnosis, pathological classification, staging and prognosis
Yan Zhuang, Hailong Wang, Da Jiang, Ying Li, Lixia Feng, Caijuan Tian, Mingyu Pu, Xiaowei Wang, Jiangyan Zhang, Yuanjing Hu, Pengfei Liu
BMC Cancer.2021;[Epub] CrossRef
Clinicopathological Features and Survival of Signet-Ring Cell Carcinoma and Mucinous Adenocarcinoma of Right Colon, Left Colon, and Rectum
Lili Zhu, Chunrun Ling, Tao Xu, Jinglin Zhang, Yujie Zhang, Yingjie Liu, Chao Fang, Lie Yang, Wen Zhuang, Rui Wang, Jie Ping, Mojin Wang
Pathology and Oncology Research.2021;[Epub] CrossRef
Identification of Potential Biomarkers and Biological Pathways for Poor Clinical Outcome in Mucinous Colorectal Adenocarcinoma
Chang Woo Kim, Jae Myung Cha, Min Seob Kwak
Cancers.2021; 13(13): 3280. CrossRef
Clinical significance of mucinous component in colorectal adenocarcinoma: a propensity score-matched study
Chuanwang Yan, Hui Yang, Lili Chen, Ran Liu, Wei Shang, Wenguang Yuan, Fei Yang, Qing Sun, Lijian Xia
BMC Cancer.2021;[Epub] CrossRef
Incidence and prognosis of pulmonary metastasis in colorectal cancer: a population-based study
Yizhi Ge, Shijun Lei, Bo Cai, Xiang Gao, Guobin Wang, Lin Wang, Zheng Wang
International Journal of Colorectal Disease.2020; 35(2): 223. CrossRef
Association between aberrant dynein cytoplasmic�1 light intermediate chain�1 expression levels, mucins and chemosensitivity in colorectal cancer
Chun‑Chao Chang, Kuo‑Ching Chao, Chi‑Jung Huang, Chih‑Sheng Hung, Yen‑Chieh Wang
Molecular Medicine Reports.2020;[Epub] CrossRef
Clinical impact of non-predominant histopathological subtypes on the long-term prognosis of colorectal cancer patients in Japan
Heita Ozawa, Shinichi Yamauchi, Hiroki Nakanishi, Junichi Sakamoto, Shin Fujita, Kenichi Sugihara
International Journal of Colorectal Disease.2020; 35(12): 2257. CrossRef
Predictive Significance of Mucinous Histology on Pathologic Complete Response Rate Following Capecitabine-Based Neoadjuvant Chemoradiation in Rectal Cancer: a Comparative Study
Sare Hosseini, NamPhong Nguyen, Mohammad Mohammadianpanah, Sepideh Mirzaei, Ali Mohammad Bananzadeh
Journal of Gastrointestinal Cancer.2019; 50(4): 716. CrossRef
Impact of histological subtype on the prognosis of patients undergoing surgery for colon cancer
Fabio Bagante, Gaya Spolverato, Eliza Beal, Katiuscha Merath, Qinyu Chen, Ozgür Akgül, Robert A. Anders, Timothy M. Pawlik
Journal of Surgical Oncology.2018; 117(7): 1355. CrossRef
SCF/c-KIT Signaling Increased Mucin2 Production by Maintaining Atoh1 Expression in Mucinous Colorectal Adenocarcinoma
Ping Shen, Shu Yang, Haimei Sun, Guilan Li, Bo Wu, Fengqing Ji, Tingyi Sun, Deshan Zhou
International Journal of Molecular Sciences.2018; 19(5): 1541. CrossRef
Mucinous Subtype in Patients With Colorectal Cancer
Hyung Jin Kim
Annals of Coloproctology.2017; 33(2): 44. CrossRef

Management of Colonic Diverticulitis Tailored to Location and Severity: Comparison of the Right and the Left Colon: Byeoung Hoon Chung, Gi Won Ha, Min Ro Lee, Jong Hun Kim; Ann Coloproctol. 2016;32(6):228-233. Published online December 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.6.228

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24 Citations

Abstract PDF

Purpose

This study assessed optimal management of colonic diverticulitis as functions of disease location and severity and factors associated with complicated diverticulitis.

Methods

This retrospective review analyzed 202 patients diagnosed between 2007 and 2014 at Chonbuk National University Hospital, South Korea, with colonic diverticulitis by using abdominopelvic computed tomography. Diverticulitis location was determined, and disease severity was categorized using the modified Hinchey classification.

Results

Patients included 108 males (53.5%) and 94 females (46.5%); of these, 167 patients (82.7%) were diagnosed with right-sided and 35 (17.3%) with left-sided colonic diverticulitis. Of the 167 patients with right-sided colonic diverticulitis, 12 (7.2%) had complicated and 155 (92.8%) had uncomplicated diverticulitis; of these, 157 patients (94.0%) were successfully managed conservatively. Of the 35 patients with left-sided colonic diverticulitis, 23 (65.7%) had complicated and 12 (34.3%) had uncomplicated diverticulitis; of these, 23 patients (65.7%) were managed surgically. Among patients with right-sided diverticulitis, those with complicated disease were significantly older (54.3 ± 12.7 years vs. 42.5 ± 13.4 years, P = 0.004) and more likely to be smokers (66.7% vs. 32.9%, P = 0.027) than those with uncomplicated disease. However, among patients with left-sided diverticulitis, those with complicated disease had significantly lower body mass index (BMI; 21.9 ± 4.7 kg/m² vs. 25.8 ± 4.3 kg/m², P = 0.021) than those with uncomplicated disease.

Conclusion

Conservative management may be effective in patients with right-sided diverticulitis and patients with uncomplicated left-sided colonic diverticulitis. Surgical management may be required for patients with complicated left-sided diverticulitis. Factors associated with complicated diverticulitis include older age, smoking and lower BMI.

Citations

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The outcomes of right and left complicated colonic diverticulitis
Anh Tuan Nguyen, Quang Tien Pham, Hoi Van Tran, Hoang Viet Truong, Loc Huynh Tran
Surgery Open Science.2025; 27: 31. CrossRef
Right‐sided acute diverticulitis in a North African country: Presentation and management in one surgical center
Laila Jedidi, Aymen Mabrouk, Hela Ghali, Anis Ben Dhaou, Senda Ben Lahouel, Sami Daldoul, Houyem Said Latiri, Mounir Ben Moussa
World Journal of Surgery.2024; 48(6): 1509. CrossRef
Current diagnosis and management of acute colonic diverticulitis: What you need to know
Lisa M. Kodadek, Kimberly A. Davis
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Comparison of surgical management and outcomes of acute right colic and sigmoid diverticulitis: a French national retrospective cohort study
E. Karam, C. Sabbagh, L. Beyer-Bergeot, P. Zerbib, V. Bridoux, G. Manceau, Y. Panis, E. Buscail, A. Venara, I. Khaoudy, M. Gaillard, M. Viennet, A. Thobie, B. Menahem, C. Eveno, C. Bonnel, J.-Y. Mabrut, B. Badic, C. Godet, Y. Eid, E. Duchalais, Z. Lakkis,
Techniques in Coloproctology.2024;[Epub] CrossRef
Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines
Federico Coccolini, Massimo Sartelli, Robert Sawyer, Kemal Rasa, Bruno Viaggi, Fikri Abu-Zidan, Kjetil Soreide, Timothy Hardcastle, Deepak Gupta, Cino Bendinelli, Marco Ceresoli, Vishal G. Shelat, Richard ten Broek, Gian Luca Baiocchi, Ernest E. Moore, Ib
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Diagnosis and management of acute colonic diverticulitis: results of a survey among Korean gastroenterologists
Jae Gon Lee, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Shin Hee Lee, Myung-Won You, Seong-Eun Kim
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Right-sided diverticulitis in a Western population
Adi Rov, Anat Ben-Ari, Eyal Barlev, David Pelcman, Sergio Susmalian, Haim Paran
International Journal of Colorectal Disease.2022; 37(6): 1251. CrossRef
Emergency surgery comparison of right versus left acute colonic diverticulitis: A 10-year outcome analysis
JS Tsang, Chi Chung Foo, Jeremy Yip, Hok Kwok Choi, Wai Lun Law, Oswens Siu Hung Lo
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Jordan M. Rook, Jill Q. Dworsky, Thomas Curran, Sudeep Banerjee, Mary R. Kwaan
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Elizabeth H. Wood, Michael M. Sigman, Dana M. Hayden
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Routine colonoscopy may be needed for uncomplicated acute right colonic diverticulitis
Kil-yong Lee, Jaeim Lee, Youn Young Park, Seong Taek Oh
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WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections
Massimo Sartelli, Federico Coccolini, Yoram Kluger, Ervis Agastra, Fikri M. Abu-Zidan, Ashraf El Sayed Abbas, Luca Ansaloni, Abdulrashid Kayode Adesunkanmi, Boyko Atanasov, Goran Augustin, Miklosh Bala, Oussama Baraket, Suman Baral, Walter L. Biffl, Marja
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Kil-yong Lee, Jaeim Lee, Youn Young Park, Younglim Kim, Seong Taek Oh
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Yoshihisa Fujita, Fumihiko Ishikawa, Shigeyuki Kamata
Nippon Daicho Komonbyo Gakkai Zasshi.2020; 73(6): 244. CrossRef
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S. Hajibandeh, S. Hajibandeh, N. J. Smart, A. Maw
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Long-term outcome and management of right colonic diverticulitis in western countries: Multicentric Retrospective Study
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Résultats à long terme et prise en charge des diverticulites du colon droit dans les pays occidentaux : étude rétrospective multicentrique
L. Courtot, V. Bridoux, Z. Lakkis, G. Piessen, G. Manceau, A. Mulliri, G. Meurette, A. Bouayed, A. Vénara, B. Blanc, N. Tabchouri, E. Salamé, M. Ouaïssi
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Prospective randomized clinical trial of uncomplicated right-sided colonic diverticulitis: antibiotics versus no antibiotics
Jeong Yeon Kim, Sung Gil Park, Hee Joon Kang, Young Ah Lim, Kyung Ho Pak, Tae Yoo, Won Tae Cho, Dong Woo Shin, Jong Wan Kim
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Taeyoung Yoo, Keun Ho Yang, Jungbin Kim, Inseok Park, Hyunjin Cho, Geumhee Gwak, Byung Noe Bae, Ki Hwan Kim
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Perforated diverticulitis: is the right and left difference present here too?
Nicholas Yock Teck Soh, Nan Zun Teo, Carrie Jen Hsi Tan, Shivani Rajaraman, Marianne Tsang, Calvin Jian Ming Ong, Ramesh Wijaya
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Pill Sun Paik, Jung-A Yun
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Distribution and Impact of the Visceral Fat Area in Patients With Colorectal Cancer: Hyeon Yu, Yong-Geul Joh, Gyung-Mo Son, Hyun-Sung Kim, Hong-Jae Jo, Hae-Young Kim; Ann Coloproctol. 2016;32(1):20-26. Published online February 29, 2016; DOI: https://doi.org/10.3393/ac.2016.32.1.20

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Abstract PDF

Purpose

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

Methods

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

Results

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

Conclusion

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

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Dorsa Salabat, Asma Mousavi, Shayan Shojaei, Razman Arabzadeh Bahri, Hanieh Radkhah
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Yulong Wang, Xijuan Liu, Xiao Feng, Xing Jiang, Lili Huang
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M Gachabayov, DM Felsenreich, S Bhatti, R Bergamaschi, Seon-Hahn Kim, Guglielmo Niccolo Piozzi, Rosa Jimenez-Rodriguez, Li-Jen Kuo, Tomohiro Yamaguchi, Fabio Cianchi, Oktar Asoglu, Vusal Aliyev, Dejan Ignjatovic, Yosef Nasseri, Moshe Barnajian, Dorin E. P
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Kyeong Eui Kim, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Nutrients.2022; 14(19): 3971. CrossRef
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Clinical Nutrition.2021; 40(11): 5631. CrossRef
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Kyeong Eui Kim, Woo Jin Song, Minji Seok, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Journal of Clinical Nutrition.2021; 13(1): 17. CrossRef
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Ana Silva, Gil Faria, António Araújo, Mariana P. Monteiro
Critical Reviews in Oncology/Hematology.2020; 145: 102857. CrossRef
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C. Pedrazzani, C. Conti, G.A. Zamboni, M. Chincarini, G. Turri, A. Valdegamberi, A. Guglielmi
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Zeyang Chen, Jiejin Yang, Zining Liu, Yuyang Zhang, Jiali Sun, Pengyuan Wang
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Cancer Management and Research.2020; Volume 12: 10321. CrossRef
Influence of Visceral Fat in the Outcomes of Colorectal Cancer
André Goulart, Nuno Malheiro, Hugo Rios, Nuno Sousa, Pedro Leão
Digestive Surgery.2019; 36(1): 33. CrossRef
Visceral fat area, not body mass index, predicts postoperative 30-day morbidity in patients undergoing colon resection for cancer
Benjamin A. Kuritzkes, Emmanouil P. Pappou, Ravi P. Kiran, Onur Baser, Liqiong Fan, Xiaotao Guo, Binsheng Zhao, Stuart Bentley-Hibbert
International Journal of Colorectal Disease.2018; 33(8): 1019. CrossRef
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Lisa Martin, Jessica Hopkins, Georgios Malietzis, J. T. Jenkins, Michael B. Sawyer, Ron Brisebois, Anthony MacLean, Gregg Nelson, Leah Gramlich, Vickie E. Baracos
Annals of Surgical Oncology.2018; 25(9): 2669. CrossRef
Impact of Visceral Fat Area in Colorectal Surgery
Ji Yeon Kim
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Short-term Outcomes of an Extralevator Abdominoperineal Resection in the Prone Position Compared With a Conventional Abdominoperineal Resection for Advanced Low Rectal Cancer: The Early Experience at a Single Institution: Seungwan Park, Hyuk Hur, Byung Soh Min, Nam Kyu Kim; Ann Coloproctol. 2016;32(1):12-19. Published online February 29, 2016; DOI: https://doi.org/10.3393/ac.2016.32.1.12

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10 Citations

Abstract PDF

Purpose

This study compared the perioperative and pathologic outcomes between an extralevator abdominoperineal resection (APR) in the prone position and a conventional APR.

Methods

Between September 2011 and March 2014, an extralevator APR in the prone position was performed on 13 patients with rectal cancer and a conventional APR on 26 such patients. Patients' demographics and perioperative and pathologic outcomes were obtained from the colorectal cancer database and electronic medical charts.

Results

Age and preoperative carcinoembryonic antigen (CEA) level were significantly different between the conventional and the extralevator APR in the prone position (median age, 65 years vs. 55 years [P = 0.001]; median preoperative CEA level, 4.94 ng/mL vs. 1.81 ng/mL [P = 0.011]). For perioperative outcomes, 1 (3.8%) intraoperative bowel perforation occurred in the conventional APR group and 2 (15.3%) in the extralevator APR group. In the conventional and extralevator APR groups, 12 (46.2%) and 6 patients (46.2%) had postoperative complications, and 8 (66.7%) and 2 patients (33.4%) had major complications (Clavien-Dindo III/IV), respectively. The circumferential resection margin involvement rate was higher in the extralevator APR group compared with the conventional APR group (3 of 13 [23.1%] vs. 3 of 26 [11.5%]).

Conclusion

The extralevator APR in the prone position for patients with advanced low rectal cancer has no advantages in perioperative and pathologic outcomes over a conventional APR for such patients. However, through early experience with a new surgical technique, we identified various reasons for the lack of favorable outcomes and expect sufficient experience to produce better peri- or postoperative outcomes.

Citations

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Abdominoperineal Resection in Prone Versus Supine Position: A Systematic Review and Meta-Analysis
Bernardo Fontel Pompeu, Eric Pasqualotto, Beatriz D'Andrea Pigossi, Matheus Reginato Araujo, Lucas Monteiro Delgado, Lucas Soares de Souza Pinto Guedes, Sergio Mazzola Poli de Figueiredo, Fernanda Bellotti Formiga
Journal of Laparoendoscopic & Advanced Surgical Techniques.2025; 35(3): 224. CrossRef
Management of left-sided malignant colorectal obstructions with curative intent: a network meta-analysis
Tyler McKechnie, Jeremy E. Springer, Zacharie Cloutier, Victoria Archer, Karim Alavi, Aristithes Doumouras, Dennis Hong, Cagla Eskicioglu
Surgical Endoscopy.2023; 37(6): 4159. CrossRef
Prone Versus Supine Position in Abdominoperineal Resection: Outcomes in the Laparoscopic Era
Cecilia Ferrari, Carmen Martinez Sanchez, Jesus Bollo, Pilar Hernandez, Lorena Cambeiro, Claudia Codina, Eduardo Targarona
Journal of Laparoendoscopic & Advanced Surgical Techniques.2021; 31(4): 382. CrossRef
Surgical Treatment of Low-Lying Rectal Cancer: Updates
Cristopher Varela, Nam Kyu Kim
Annals of Coloproctology.2021; 37(6): 395. CrossRef
Perioperative and oncological outcomes of abdominoperineal resection in the prone position vs the classic lithotomy position: A systematic review with meta‐analysis
Jose Wilson B. Mesquita‐Neto, Hassan Mouzaihem, Francisco Igor B. Macedo, Lance K. Heilbrun, Donald W. Weaver, Steve Kim
Journal of Surgical Oncology.2019; 119(7): 979. CrossRef
Prone Compared With Lithotomy for Abdominoperineal Resection: A Systematic Review and Meta-analysis
Tyler McKechnie, Yung Lee, Jeremy E. Springer, Aristithes G. Doumouras, Dennis Hong, Cagla Eskicioglu
Journal of Surgical Research.2019; 243: 469. CrossRef
Perineal Wound Complications After Extralevator Abdominoperineal Excision for Low Rectal Cancer
Jia Gang Han, Zhen Jun Wang, Zhi Gang Gao, Guang Hui Wei, Yong Yang, Zhi Wei Zhai, Bao Cheng Zhao, Bing Qiang Yi
Diseases of the Colon & Rectum.2019; 62(12): 1477. CrossRef
Critical and Challenging Issues in the Surgical Management of Low-Lying Rectal Cancer
Aeris Jane D. Nacion, Youn Young Park, Seung Yoon Yang, Nam Kyu Kim
Yonsei Medical Journal.2018; 59(6): 703. CrossRef
EXTRALEVATOR ABDOMINOPERINEAL EXCISION OF THE RECTUM: SHORT-TERM OUTCOMES IN COMPARISON WITH CONVENTIONAL SURGERY
R. A. Murashko, I. B. Uvarov, E. A. Ermakov, V. B. Kaushanskiy, R. V. Konkov, D. D. Sichinava, B. N. Sadikov
Koloproktologia.2017; (4): 34. CrossRef
Extralevator Abdominoperineal Resection in the Prone Position
Young Jin Kim
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Preoperative Body Mass Index, 30-Day Postoperative Morbidity, Length of Stay and Quality of Life in Patients Undergoing Pelvic Exenteration Surgery for Recurrent and Locally-Advanced Rectal Cancer: Jessica Beaton, Sharon Carey, Michael J Solomon, Ker-Kan Tan, Jane Young; Ann Coloproctol. 2014;30(2):83-87. Published online April 25, 2014; DOI: https://doi.org/10.3393/ac.2014.30.2.83

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Abstract PDF

Purpose

Malnutrition is associated with an increased risk of developing complications following gastrointestinal surgery, especially following radical surgeries such as pelvic exenteration. This study aims to determine if preoperative body mass index (BMI) is associated with 30-day morbidity, length of hospital stay and/or quality of life (QoL) in patients undergoing pelvic exenteration surgery for recurrent and locally-advanced rectal cancer prior to a prospective trial.

Methods

A review of all patients who underwent pelvic exenteration surgery prior to 2008 was performed. Patients were included if they had a documented BMI as well as a QoL measurement (Functional Assessment Cancer Therapy - Colorectal questionnaire).

Results

Thirty-one patients, with a mean age of 56 years, had preoperative height and weight data, as well as measures of postoperative QoL, and formed the study group. The numbers of patients with recurrent (n = 17) or locally-advanced rectal cancer (n = 14) were similar. The mean length of stay was 21 days while the mean BMI of the patients was 24.3 (± 5.9) kg/m². The majority of the patients were either of normal weight (n = 15) or overweight/obese (n = 11). The average length of hospital stay was significantly longer in patients who were underweight compared to those who were of normal weight (F = 6.508, P = 0.006) and those who were overweight and obese (F = 6.508, P = 0.007).

Conclusion

This study suggests that a lower body mass index preoperatively is associated with a longer length of hospital stay. BMI is not associated with long-term QoL in this patient group. However, further prospective research is required.

Citations

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Prospective longitudinal trajectory of cancer survivorship among patients with recurrent rectal cancer: impact of treatment modalities and resection status
Tarik Sammour, Oliver Peacock, Brian K. Bednarski, Arvind Dasari, Prajnan Das, Benny Johnson, Grace L. Smith, George J. Chang, John Skibber, Y. Nancy You
Colorectal Disease.2025;[Epub] CrossRef
Living After Pelvic Exenteration: A Mixed-Methods Synthesis of Quality-of-Life Outcomes and Patient Perspectives
Vlad Rotaru, Elena Chitoran, Aisa Gelal, Giuseppe Gullo, Daniela-Cristina Stefan, Laurentiu Simion
Journal of Clinical Medicine.2025; 14(18): 6541. CrossRef
Defining Standard Data Reporting in Pelvic Exenteration Surgery for Rectal Cancer: A PelvEx Collaborative Review of Current Data Reporting

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Systematic Review of Patient-Reported Outcome Measures in Locally Recurrent Rectal Cancer
Niamh McKigney, Fergus Houston, Ellen Ross, Galina Velikova, Julia Brown, Deena Pravin Harji
Annals of Surgical Oncology.2023; 30(7): 3969. CrossRef
Prevention and management of complications in pelvic exenteration
Pia Persson, Peter Chong, Colin W Steele, Martha Quinn
European Journal of Surgical Oncology.2022; 48(11): 2277. CrossRef
Patient‐reported outcomes after pelvic exenteration for colorectal cancer: A systematic review
Andreas Denys, Yves van Nieuwenhove, Dirk Van de putte, Eva Pape, Piet Pattyn, Wim Ceelen, Gabriëlle H. van Ramshorst
Colorectal Disease.2022; 24(4): 353. CrossRef
Pelvic exenteration: Pre-, intra-, and post-operative considerations
Kheng-Seong Ng, Peter J.M. Lee
Surgical Oncology.2022; 43: 101787. CrossRef
Pelvic exenteration: Pre-, intra-, and post-operative considerations
Kheng-Seong Ng, Peter J.M. Lee
Surgical Oncology.2021; 37: 101546. CrossRef
Functional outcomes following pelvic exenteration: results from a prospective cohort study
Preet G. S. Makker, Cherry E. Koh, Michael J. Solomon, James Ratcliffe, Daniel Steffens
Colorectal Disease.2021; 23(10): 2647. CrossRef
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Tamara Glyn, Frank Frizelle
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Daniel L. H. Baird, Constantinos Simillis, Gianluca Pellino, Christos Kontovounisios, Shahnawaz Rasheed, Paris P. Tekkis
Updates in Surgery.2019; 71(2): 313. CrossRef
The effect of preoperative nutritional status on postoperative complications and overall survival in patients undergoing pelvic exenteration: A multi-disciplinary, multi-institutional cohort study
N.J. Lyell, M. Kitano, B. Smith, A.L. Gleisner, F.J. Backes, G. Cheng, M.D. McCarter, S. Abdel-Misih, E.L. Jones
The American Journal of Surgery.2019; 218(2): 275. CrossRef
Preoperative Nutrition Status and Postoperative Outcomes in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Lauren Reece, Helen Dragicevich, Claire Lewis, Caila Rothwell, Oliver M. Fisher, Sharon Carey, Nayef A. Alzahrani, Winston Liauw, David L. Morris
Annals of Surgical Oncology.2019; 26(8): 2622. CrossRef
Factors affecting hospital length of stay following pelvic exenteration surgery
Ying Guo, Eugene Chang, Mehtap Bozkurt, Minjeong Park, Diane Liu, Jack B. Fu
Journal of Surgical Oncology.2018; 117(3): 529. CrossRef
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Tasha M. Hughes, Kejal Shah, Sabrena Noria, Timothy Pawlik
Journal of Surgical Oncology.2018; 117(5): 1009. CrossRef
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E. Rausa, M. E. Kelly, L. Bonavina, P. R. O'Connell, D. C. Winter
Colorectal Disease.2017; 19(5): 430. CrossRef
The Evolution of Pelvic Exenteration Practice at a Single Center: Lessons Learned from over 500 Cases
Cherry E. Koh, Michael J. Solomon, Kilian G. Brown, Kirk Austin, Christopher M. Byrne, Peter Lee, Jane M. Young
Diseases of the Colon & Rectum.2017; 60(6): 627. CrossRef
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R W Radwan, M D Evans, M Davies, D A Harris, J Beynon, O Hatcher, P Bose, M G Lucas, J Featherstone, U Khot, T V Chandrasekaran, N D Carr, S Gwynne, P Drew, M D Phan
Journal of British Surgery.2016; 103(2): e115. CrossRef
Systematic review of health-related quality of life in patients undergoing pelvic exenteration
D.P. Harji, B. Griffiths, G. Velikova, P.M. Sagar, J. Brown
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Guillermo Bannura, Alejandro Barrera, Carlos Melo, Felipe Illanes, Cristián Gallardo
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David Roder, Elizabeth Buckley
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Preoperative Body Mass Index and Postoperative Complications After Pelvic Exenteration in Recurrent or Locally Advanced Rectal Cancer Patients
Moo-Jun Baek
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Clinical Outcomes of 103 Hand-Assisted Laparoscopic Surgeries for Left-Sided Colon and Rectal Cancer: Single Institutional Review: Narimantas Evaldas Samalavicius, Rakesh Kumar Gupta, Audrius Dulskas, Darius Kazanavicius, Kestutis Petrulis, Raimundas Lunevicius; Ann Coloproctol. 2013;29(6):225-230. Published online December 31, 2013; DOI: https://doi.org/10.3393/ac.2013.29.6.225

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Abstract PDF

Purpose

The laparoscopic colectomy is avoided principally because of its technical difficulty, steep learning curve, and increased operative time. Hand-assisted laparoscopic surgery (HALS) is an alternative technique that addresses these problems while preserving the short-term benefits of a laparoscopic colectomy. Our study was aimed to describe the characteristics of patients admitted due to left-sided colon and rectal cancer for HALS.

Methods

A prospectively maintained database was used to identify patients who underwent HALS at the Institute of Oncology, Vilnius University, from July 1, 2009, to October 1, 2012.

Results

One hundred-three HALS colorectal resections were performed. The patients' mean age was 64 ± 13.4 years. There were 46 male and 57 female patients. The body mass index was 27.3 ± 5.8 kg/m². Forty-three patients (41.8%) had experienced prior abdominal surgery. The mean HALS time was 105 minutes (range, 55-85 minutes). The conversion rate was 2.7% (3/103). The median of return of gastrointestinal function was 2.5 days (range, 2.2-4.5 days). The median length of hospital stay was 9 days. The postoperative complication and mortality rates were 10.7% and 0.97%, respectively. Four incisional hernias (3.9%) were seen at a mean follow-up of 7.0 ± 3.4 months. None of the patients had a trocar or a hand-port site recurrence.

Conclusion

A HALS colorectal resection is a safe and effective technique, and it provides all the benefits of minimally invasive surgery.

Citations

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Comparative clinical efficacy of three surgical modalities for the treatment of malignant tumours of the left hemicolon
Hao Chen, Dong-Ping Han, Jian-Yang Xiong, Zhen-Sheng Li, Teng-Cheng Hu, Zheng-Rong Li, Yi Cao
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Hand Assisted Laparoscopic Surgery for Colorectal Cancer: Surgical and Oncological Outcomes from a Single Tertiary Referral Centre
Narimantas Evaldas Samalavicius, Zygimantas Kuliesius, Robertas Stasys Samalavičius, Renatas Tikuisis, Edgaras Smolskas, Zilvinas Gricius, Povilas Kavaliauskas, Audrius Dulskas
Journal of Clinical Medicine.2022; 11(13): 3781. CrossRef
Laparoscopic and Robotic Surgery for Rectal Cancer—Comparative Study Between Two Centres
Audrius Dulskas, Mahdi Albandar, Narimantas E. Samalavicius, Yoon Dae Han, Nam Kyu Kim
Indian Journal of Surgery.2021; 83(1): 48. CrossRef
Laparoscopic hand‐assisted total mesorectal excision for mid rectal cancer using the Gelport system—a video vignette
Narimantas E. Samalavicius, Vita Klimasauskiene, Audrius Dulskas
Colorectal Disease.2021; 23(4): 1018. CrossRef
Hand‐assisted laparoscopic surgery for rectal cancer – a video vignette
N. E. Samalavicius, P. Kavaliauskas, A. Dulskas
Colorectal Disease.2019; 21(11): 1336. CrossRef
High vascular ligation in left-sided colon cancer surgery is safe and adequate
Narimantas E. Samalavicius, Audrius Dulskas, Simonas Uselis, Edgaras Smolskas, Giedre Smailyte, Raimundas Lunevicius
European Surgery.2018; 50(5): 221. CrossRef
Laparoscopic colectomy in obese patients: a comparison of laparoscopic and hand-assisted laparoscopic techniques
Douglas M. Overbey, Michelle L. Cowan, Patrick W. Hosokawa, Brandon C. Chapman, Jon D. Vogel
Surgical Endoscopy.2017; 31(10): 3912. CrossRef
HAND-ASSISTED LAPAROSCOPIC SURGERY FOR THE CANCER OF THE LEFT COLON AND RECTUM - AN IDEAL OPTION OF MINIMALLY INVASIVE SURGERY? SINGLE CENTRE EXPERIENCE WITH 459 CASES
Narimantas E. Samalavicius, Zygimantas Kuliesius, Audrius Dulskas, Justas Kuliavas, Giedre Rudinskaite, Edgaras Smolskas, Afredas Kilius, Kestutis Petrulis
Koloproktologia.2017; (4): 7. CrossRef
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Nicola Zampieri, Roberto Castellani, Lorenzo Francia
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Emily F. Midura, Dennis J. Hanseman, Bradley R. Davis, Bobby L. Johnson, Joshua W. Kuethe, Janice F. Rafferty, Ian M. Paquette
Surgical Endoscopy.2016; 30(8): 3567. CrossRef
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Guang-Dong Zhang, Xu-Ting Zhi, Jian-Li Zhang, Guang-Bo Bu, Gang Ma, Kai-Lei Wang
International Journal of Colorectal Disease.2015; 30(9): 1209. CrossRef
Hand-Assisted Laparoscopic Approach in Colon Surgery
Zhobin Moghadamyeghaneh, Joseph C. Carmichael, Steven Mills, Alessio Pigazzi, Ninh T. Nguyen, Michael J. Stamos
Journal of Gastrointestinal Surgery.2015; 19(11): 2045. CrossRef
What Is the Role of Hand-Assisted Laparoscopic Surgery in the Single-Port Surgery Era?
Chang-Nam Kim
Annals of Coloproctology.2013; 29(6): 217. CrossRef

Managing Deep Postanal Space Sepsis via an Intersphincteric Approach: Our Early Experience: Ker-Kan Tan, Dean C. Koh, Charles B. Tsang; Ann Coloproctol. 2013;29(2):55-59. Published online April 30, 2013; DOI: https://doi.org/10.3393/ac.2013.29.2.55

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Abstract PDF

Purpose

Managing deep postanal (DPA) sepsis often involves multiple procedures over a long time. An intersphincteric approach allows adequate drainage to be performed while tackling the primary pathology at the same sitting. The aim of our study was to evaluate this novel technique in managing DPA sepsis.

Methods

A retrospective review of all patients who underwent this intersphincteric technique in managing DPA sepsis from February 2008 to October 2010 was performed. All surgeries were performed by the same surgeon.

Results

Seventeen patients with a median age of 43 years (range, 32 to 71 years) and comprised of 94.1% (n = 16) males formed the study group. In all patients, an internal opening in the posterior midline with a tract leading to the deep postanal space was identified. This intersphincteric approach operation was adopted as the primary procedure in 12 patients (70.6%) and was successful in 11 (91.7%). In the only failure, the sepsis recurred, and a successful advancement flap procedure was eventually performed. Five other patients (29.4%) underwent this same procedure as a secondary procedure after an initial drainage operation. Only one was successful. In the remaining four patients, one had a recurrent abscess that required drainage while the other three patients had a tract between the internal opening and the intersphincteric incision. They subsequently underwent a drainage procedure with seton insertion and advancement flap procedures.

Conclusion

Managing DPA space sepsis via an intersphincteric approach is successful in 70.6% of patients. This single-staged technique allows for effective drainage of the sepsis and removal of the primary pathology in the intersphincteric space.

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Deep Postanal Abscess With Sacrococcygeal Osteomyelitis: A Case Report
Javid Ahmadov, Mustafa Anil Turhan, Ender Erguder, Sezai Leventoğlu, Bulent Mentes
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Pankaj Garg, Gabriele Naldini, Vincent De Parades, Petr Tsarkov, Vipul Yagnik, Kaushik Bhattacharya, Baljit Kaur, G Mahak
Clinical and Experimental Gastroenterology.2025; Volume 18: 121. CrossRef
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Understanding and Treating Supralevator Fistula-in-Ano: MRI Analysis of 51 Cases and a Review of Literature
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The treatment of anal fistula: secondACPGBIPosition Statement – 2018
G. Williams, A. Williams, P. Tozer, R. Phillips, A. Ahmad, D. Jayne, C. Maxwell‐Armstrong
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Heng Zhang, Zhi-yang Zhou, Bang Hu, De-chao Liu, Hui Peng, Shang-kui Xie, Dan Su, Dong-lin Ren
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Complex Fistula-In-Ano
J. Graham Williams
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S3-Leitlinie: Analabszess
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Oncologic Outcomes and Risk Factors for Recurrence after Tumor-specific Mesorectal Excision of Rectal Cancer: 782 Cases: Sam Hee Kim, Ki Beom Bae, Jung Min Kim, Jae Ho Shin, Min Sung An, Tae Geun Ha, Sung Mok Ryu, Kwang Hee Kim, Tae Hyeon Kim, Chang Soo Choi, Jin Yong Shin, Minkyung Oh, Seung Hun Baek, Kwan Hee Hong; J Korean Soc Coloproctol. 2012;28(2):100-107. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.100

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11 Citations

Abstract PDF

Purpose

The aim of this study was to analyze the oncologic outcomes and the risk factors for recurrence after a tumor-specific mesorectal excision (TSME) of resectable rectal cancer in a single institution.

Methods

A total of 782 patients who underwent a TSME for resectable rectal cancer between February 1995 and December 2005 were enrolled retrospectively. Oncologic outcomes included 5-year cancer-specific survival and its affecting factors, as well as risk factors for local and systemic recurrence.

Results

The 5-year cancer-specific survival rate was 77.53% with a mean follow-up period of 61 ± 31 months. The overall local and systemic recurrence rates were 9.2% and 21.1%, respectively. The risk factors for local recurrence were pN stage (P = 0.015), positive distal resection margin, and positive circumferential resection margin (P < 0.001). The risk factors for systemic recurrence were pN stage (P < 0.001) and preoperative carcinoembryonic antigen level (P = 0.005). The prognostic factors for cancer-specific survival were pT stage (P < 0.001), pN stage (P < 0.001), positive distal resection margin (P = 0.005), and positive circumferential resection margin (P = 0.016).

Conclusion

The oncologic outcomes in our institution after a TSME for patients with resectable rectal cancer were similar to those reported in other recent studies, and we established the risk factors that could be crucial for the planning of treatment and follow-up.

Citations

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Comparison of Short-term Surgical Outcomes between a Robotic Colectomy and a Laparoscopic Colectomy during Early Experience: Jin Yong Shin; J Korean Soc Coloproctol. 2012;28(1):19-26. Published online February 29, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.1.19

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Abstract PDF

Purpose

Although robotic surgery was invented to overcome the technical limitations of laparoscopic surgery, the role of a robotic (procto)colectomy (RC) for the treatment of colorectal cancer compared to that of a laparoscopic (procto)colectomy (LC) was not well defined during the initial adoption periods of both procedures. This study aimed to evaluate the efficacy and the safety of a RC for the treatment of colorectal cancer by comparing the authors' initial experiences with both a RC and a LC.

Methods

The first 30 patients treated by using a RC for colorectal cancer from July 2010 to March 2011 were compared with the first 30 patients treated by using a LC for colorectal cancer from December 2006 to June 2007 by the same surgeon. Perioperative variables and short-term outcomes were analyzed. In addition, the 30 RC and the 30 LC cases involved were divided into rectal cancer (n = 17 and n = 12, respectively), left-sided colon cancer (n = 7 and n = 12, respectively) and right-sided colon cancer (n = 6 and n = 6, respectively) for subgroup analyses.

Results

The mean operating times for RC and LC were significantly different at 371.8 and 275.5 minutes, respectively, but other perioperative parameters (rates of open conversion, numbers of retrieved lymph node, estimated blood losses, times to first flatus, maximal pain scores before discharge and postoperative hospital stays) were not significantly different in the two groups. Subgroup analyses showed that the mean operative times for a robotic proctectomy and a laparoscopic proctectomy were 396.5 and 298.8 minutes, respectively (P < 0.000). Postoperative complications occurred in five patients in the RC group and in six patients in the LC group (P = 0.739).

Conclusion

Although the short-term outcomes of a RC during its initial use were better than those of a LC (with the exception of operating time), differences were not found to be significantly different. On the other hand, the longer operation time of a robotic proctectomy compared to that of a laparoscopic proctectomy during the early period may be problematic.

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Surgical Outcomes after Total Colectomy with Ileorectal Anastomosis in Patients with Medically Intractable Slow Transit Constipation: Guiyun Sohn, Chang Sik Yu, Chan Wook Kim, Jae Young Kwak, Tae Young Jang, Kyung Ho Kim, Song Soo Yang, Yong Sik Yoon, Seok-Byung Lim, Jin Cheon Kim; J Korean Soc Coloproctol. 2011;27(4):180-187. Published online August 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.4.180

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Abstract PDF

Purpose

The aim of this study was to evaluate outcomes of a total colectomy with ileorectal anastomosis in patients with slow transit constipation.

Methods

A retrospective review of 37 consecutive patients with slow transit constipation who underwent a total colectomy between 1994 and 2008 was undertaken. Preoperative and postoperative Wexner's constipation scores were collected and used to evaluate the outcomes after surgical treatment. Also patients' postoperative satisfaction scores were collected using a 4-point scale.

Results

The 37 patients consisted of 31 women and 6 men, with a median age of 41 years (range, 17 to 71 years). Pre- and post-operative Wexner's scores were collected from 33 patients (89.1%), and the mean preoperative Wexner's score was 19.3 (range, 11 to 24), which decreased to an average post-operative score of 2.3 (range, 0 to 8). Neither intraoperative complications nor postoperative mortalities were noted. Five patients (13.5%) had early postoperative complications, and the most common complication was postoperative ileus (10.8%). Seven patients (18.9%) had late postoperative complications, and postoperative ileus (10.8%) was also the most common. Twenty seven of 33 patients were satisfied with their surgical outcome (81.8%).

Conclusion

A total colectomy with ileorectal anastomosis might be an effective surgical procedure with acceptable morbidity to treat medically intractable slow transit constipation.

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Long-term Outcomes of Laparoscopic Surgery for Colorectal Cancer: Jeong-Eun Lee, Yong-Geul Joh, Sang-hwa Yoo, Geu-Young Jeong, Sung-Han Kim, Choon-Sik Chung, Dong-Gun Lee, Seon Hahn Kim; J Korean Soc Coloproctol. 2011;27(2):64-70. Published online April 30, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.2.64

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14 Citations

Abstract PDF

Purpose

The long-term results of a laparoscopic resection for colorectal cancer have been reported in several studies, but reports on the results of laparoscopic surgery for rectal cancer are limited. We investigated the long-term outcomes, including the five-year overall survival, disease-free survival and recurrence rate, after a laparoscopic resection for colorectal cancer.

Methods

Using prospectively collected data on 303 patients with colorectal cancer who underwent a laparoscopic resection between January 2001, and December 2003, we analyzed sex, age, stage, complications, hospital stay, mean operation time and blood loss. The overall survival rate, disease-free survival rate and recurrence rate were investigated for 271 patients who could be followed for more than three years.

Results

Tumor-node-metastasis (TNM) stage I cancer was present in 55 patients (18.1%), stage II in 116 patients (38.3%), stage III in 110 patients (36.3%), and stage IV in 22 patients (7.3%). The mean operative time was 200 minutes (range, 100 to 535 minutes), and the mean blood loss was 97 mL (range, 20 to 1,200 mL). The mean hospital stay was 11 days and the mean follow-up period was 54 months. The mean numbers of resected lymph nodes were 26 and 21 in the colon and the rectum, respectively, and the mean distal margins were 10 and 3 cm. The overall morbidity rate was 26.1%. The local recurrence rates were 2.2% and 4.4% in the colon and the rectum, respectively, and the distant recurrence rates were 7.8% and 22.5%. The five-year overall survival rates were 86.1% in the colon (stage I, 100%; stage II, 97.6%; stage III, 77.5%; stage IV, 16.7%) and 68.8% in the rectum (stage I, 90.2%; stage II, 84.0%; stage III, 57.6; stage IV, 13.3%). The five-year disease-free survival rates were 89.8% in the colon (stage I, 100%; stage II, 97.7%; stage III, 74.2%) and 74.5% in the rectum (stage I, 90.0%; stage II, 83.9%; stage III, 59.2%).

Conclusion

Laparoscopic surgery for colorectal cancer is a good alternative method to open surgery with tolerable oncologic long-term results.

Citations

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Management of Appendicitis Presenting with Abscess or Mass: Jeong-Ki Kim, Seungbum Ryoo, Heung-Kwon Oh, Ji Sun Kim, Rumi Shin, Eun Kyung Choe, Seung-Yong Jeong, Kyu Joo Park; J Korean Soc Coloproctol. 2010;26(6):413-419. Published online December 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.6.413

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Abstract PDF

Purpose

Management strategy in acute appendicitis patients initially presenting with abscess or mass is surrounded with controversy. This study was performed to identify the outcomes of management for this condition.

Methods

We retrospectively analyzed prospectively registered 76 patients (male:female = 39:37; mean age, 50.8 years) with appendicitis presenting with abscess or mass over a 9-year period at the Seoul National University Hospital. Patients were divided into three groups (emergency operation group, delayed operation group, and follow-up group), and clinical characteristics and outcomes of treatment were investigated.

Results

Twenty-eight patients (36.8%) underwent an emergency operation. Of the remaining 48 patients, 20 (41.7%) were initially treated with conservative management through the use of antibiotics only; the other 28 (58.3%) with and additional ultrasound-guided percutaneous drainage of the abscess. Twenty-six (54.2%) patients underwent planned operations after conservative management, and 22 (45.8%) were followed without surgery (median duration, 37.8 month), of which 3 (13%) underwent an appendectomy due to recurrent appendicitis (mean of 56.7 days after initial attack). There were no statistical differences in types of operation performed (appendectomy or ileocecectomy), postoperative complications, and postoperative hospital stay among the patients who underwent emergency operations, delayed operations and operations for recurrence during follow-up.

Conclusion

Although the recurrence rate was relatively low after conservative management for appendicitis patients presenting with abscess or mass, there was no difference in surgical outcome between the emergent, elective, or recurrent groups. Our results indicate that proper management of appendicitis with abscess or mass can be selected according to surgeon's preference.

Citations

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High Diagnostic Accuracy but Persistent Risk of Complicated Appendicitis: A Retrospective Analysis from Hail Province, Saudi Arabia
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Short-term Outcomes of a Laparoscopic Left Hemicolectomy for Descending Colon Cancer: Retrospective Comparison with an Open Left Hemicolectomy: Kil-Su Han, Gyu-Seog Choi, Jun-Seok Park, Hye Jin Kim, Soo Yeon Park, Soo-Han Jun; J Korean Soc Coloproctol. 2010;26(5):347-353. Published online October 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.5.347

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Abstract PDF

Purpose

Many randomized clinical trials have been performed to treat a colorectal neoplasm with the exclusion of descending colon cancer. The aim of the present study was to investigate the difference in surgical outcomes between a laparoscopic left hemicolectomy and a conventional open left hemicolectomy for descending colon cancer.

Methods

A retrospective study of ninety patients with descending colon cancer, who underwent a laparoscopic (LAP) or open left hemicolectomy (OS) between May 1998 and December 2009 at Kyungpook National University Hospital, was performed. Clinicopathological and surgical outcomes were compared between the LAP and the OS for descending colon cancer.

Results

The baseline characteristics, including age, gender, body mass index, history of prior abdominal surgical history and tumor location, were similar between the two groups. The mean operation time was 156.2 minutes for the LAP group and 223.2 minutes for the OS group (P < 0.001). Intraoperative blood loss was significantly greater in the OS group (37.5 mL vs. 80.4 mL; P = 0.039). The postoperative recovery in the LAP group was faster, as reflected by the shorter time to pass gas and the shorter hospital stay. Pathological examinations showed the surgery to be equally radical in the two groups. The median follow-up was 21 months and there were 3 distant metastases (8.5%) during follow-up in the LAP group, but no port-site or local recurrence.

Conclusion

A laparoscopic left hemicolectomy is a technically safe and feasible procedure for treating descending colon cancer. Prospective multi-center trials are necessary to establish the LAP as the standard treatment for descending colon cancer.

Citations

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Left hemicolectomy and low anterior resection in colorectal cancer patients: Knight–griffen vs. transanal purse-string suture anastomosis with no-coil placement
Michele Ammendola, Francesco Filice, Caterina Battaglia, Roberto Romano, Francesco Manti, Roberto Minici, Nicola de'Angelis, Riccardo Memeo, Domenico Laganà, Giuseppe Navarra, Severino Montemurro, Giuseppe Currò
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Long-term Result of Surgical Treatment for Crohn's Enteritis.: Choi, Sang Ji , Choe, Eun Kyung , Park, Sung Chan , Park, Kyu Joo; J Korean Soc Coloproctol. 2008;24(6):409-416.; DOI: https://doi.org/10.3393/jksc.2008.24.6.409

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Abstract PDF: PURPOSE
We sought to determine the long-term outcome of surgical management for gastrointestinal Crohns's disease (CD) and to find out whether there is any improvement over the time period.
METHODS
We analyzed the records of the 102 patients who underwent surgery for gastrointestinal CD excluding perianal CDbetween 1978 and 2007. A cumulative surgical recurrence rate was analyzed by Kaplan-Meier plots and log-rank tests.
RESULTS
The main sites of CD were ileocecal area in 54.5%, followed by small bowel (29.7%) and large bowel (7.9%). Common indications for operation were obstruction (25.7%), diagnostic purpose (20.8%), and failure of medical treatment (12.9%). The operation performed were ileocolectomy including right hemicolectomy in 53 cases (45.3%), small bowel resection in 38 cases (31.7%), and strictureplasty 12 cases (10.0%, including 11 cases combined with bowel resection). The average follow-up period after operation was 6.4years (range: 0.5~29 yr, median: 5.3 yr). Among all patients, 22 (21.6%) underwent operations for recurrence. The re-operation rate was higher in the younger patients group (age at diagnosis less than 25 years) (34.1% vs. 12.1%, P<0.05), and in case of the patients whose length of initial intestinal resection was less than 40 cm (27.9% vs. 7.7%, P<0.05). The overall cumulative re-operation rates at 5years, 10years and 15years were 15%, 25%, and 60%, respectively.
CONCLUSIONS
Despite recent advances in medical therapy, the cumulative re-operation rate of patients operated for gastrointestinal CD remains similar to our previous report in 1997.

Oncologic Outcomes and Safety after Tumor-specific Mesorectal Excision for Resectable Rectal Cancer: A Single Institution's Experience with 1,276 Patients with Rectal Cancer.: Kim, Nam Kyu , Min, Byung Soh , Kim, Jin Soo , Hur, Hyuk , Lee, Kang Young , Sohn, Seung Kook , Cho, Chang Hwan; J Korean Soc Coloproctol. 2008;24(2):121-133.; DOI: https://doi.org/10.3393/jksc.2008.24.2.121

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PURPOSE
The purpose of this work was to review the oncologic outcomes and the operative safety of a tumor- specific mesorectal excision (TSME) for resectable rectal cancer. The risk factors for recurrence and survival were analyzed, and the changes in the sphincter-preserving rate with time were analyzed. METHODS: A total of 1,276 patients with rectal cancer who underwent curative surgery between 1989 and 2003 were analyzed retrospectively. The enrolled patients were registered in the Colorectal Cancer Database and were followed prospectively. RESULTS: The pathologic stages were stage I in 330 (25.9%), II in 403 (31.6%), and III in 543 (42.6%). Postoperative complications developed in 263 patients (20.6%). The rates of anal sphincter preservation were 32.6% between 1989 and 1993, 56.8% between 1994 and 1998, and 69.4 % between 1999 and 2003. With a mean follow-up of 69.4 months, the overall local recurrence (LR) rate was 5.4%. The 5-year LR rates were 3.8% in stage I, 4.7% in stage II, and 8.4% in stage III (P=0.016). A multivariate analysis revealed that the risk factors affecting LR were pN (0.005) and preoperatively increased serum CEA (P=0.008). The 5-year cancer-specific survival rates were 93.8% in stage I, 84.5% in stage II, and 64.5% in stage III (P=0.021). A multivariate analysis revealed that the factors affecting cancer-specific survival were pN (P=0.012) and circumferential resection margin (P<0.001).
CONCLUSIONS
TSME for resectable rectal cancer showed acceptable operative morbidity and excellent oncologic outcomes. The trend toward sphincter preservation was obvious, and the shortening of the distal resection margin without deteriorating the oncologic outcomes was one of the major enabling factors.

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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 feasibility of laparoscopic TSME preserving the left colic artery and superior rectal artery for upper rectal cancer
Chi Zhang, Hao-tang Wei, Wenqing Hu, Yueming Sun, Qinyuan Zhang, Masanobu Abe, Zhuoran Du, Yingying Xu, Liang Zong, Xiang Hu
World Journal of Surgical Oncology.2020;[Epub] CrossRef
Biofeedback Therapy After Sphincter-Preservation Surgery for the Treatment of Rectal Cancer
Ik Yong Kim
Annals of Coloproctology.2015; 31(4): 119. CrossRef
Sexual Function After a Proctectomy for the Treatment of Rectal Cancer
Young Wan Kim, Ik Yong Kim
Annals of Coloproctology.2014; 30(5): 205. CrossRef
Oncologic Outcomes and Risk Factors for Recurrence after Tumor-specific Mesorectal Excision of Rectal Cancer: 782 Cases
Sam Hee Kim, Ki Beom Bae, Jung Min Kim, Jae Ho Shin, Min Sung An, Tae Geun Ha, Sung Mok Ryu, Kwang Hee Kim, Tae Hyeon Kim, Chang Soo Choi, Jin Yong Shin, Minkyung Oh, Seung Hun Baek, Kwan Hee Hong
Journal of the Korean Society of Coloproctology.2012; 28(2): 100. CrossRef
Long-term Outcomes of Laparoscopic Surgery for Colorectal Cancer
Jeong-Eun Lee, Yong-Geul Joh, Sang-hwa Yoo, Geu-Young Jeong, Sung-Han Kim, Choon-Sik Chung, Dong-Gun Lee, Seon Hahn Kim
Journal of the Korean Society of Coloproctology.2011; 27(2): 64. CrossRef
The prognostic impact of the number of lymph nodes retrieved after neoadjuvant chemoradiotherapy with mesorectal excision for rectal cancer
Young‐Wan Kim, Nam‐Kyu Kim, Byung‐Soh Min, Kang‐Young Lee, Seung‐Kook Sohn, Chang‐Hwan Cho, Hoguen Kim, Ki‐Chang Keum, Jung‐Bai Ahn
Journal of Surgical Oncology.2009; 100(1): 1. CrossRef
The Influence of the Number of Retrieved Lymph Nodes on Staging and Survival in Patients With Stage II and III Rectal Cancer Undergoing Tumor-Specific Mesorectal Excision
Young-Wan Kim, Nam-Kyu Kim, Byung-Soh Min, Kang-Young Lee, Seung-Kook Sohn, Chang-Hwan Cho
Annals of Surgery.2009; 249(6): 965. CrossRef
Intersphincteric Resection and Coloanal Anstomosis for Very Low Lying Rectal Cancer
Jin Soo Kim, Cho Rok Lee, Nam Kyu Kim, Hyuk Hur, Byung Soh Min, Joong Bae Ahn, Ki Chang Keum
Journal of the Korean Surgical Society.2009; 76(1): 28. CrossRef
Rectal Cancer: Function-preserving Surgery
Nam-Kyu Kim
Journal of the Korean Society of Coloproctology.2008; 24(5): 394. CrossRef

Oncological Safety of a Metallic Stent for a Left-sided Obstructive Colorectal Carcinoma.: Oh, Seung Yeop , Park, Seung Hyun , Lee, Kwang Jae , Kim, Jin Hong , Suh, Kwang Wook; J Korean Soc Coloproctol. 2007;23(3):180-185.; DOI: https://doi.org/10.3393/jksc.2007.23.3.180

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Abstract PDF: Purpose
There is a controversy about the treatment of left-sided obstructive colorectal cancer. Recently, experience using an expandable metallic stent for relief of the obstruction has been increasing, but its oncological safety has not been confirmed. Therefore, we designed this study to evaluate the oncological safety of a metallic stent for the treatment of left-sided obstructive colorectal cancer. Methods: Forty-six patients with left-sided obstructive colorectal cancer who underwent a curative resection from 1994 to 2004, were retrospectively evaluated. Nineteen emergency operations (1994~2003) and 27 metallic stent insertions (2000~2004) were compared based on clinicopathologic features, postoperative complications, recurrence rates, and survival rates. Results: There were no significant differences in age, location, sex, and recurrence rate between the two groups. The complication rate in the emergency group was higher than it was in the stent group, but this difference was not statistically significant (26.3% vs. 14.8%; P=0.33). The overall and the disease-free survival rates were not significantly different. Conclusions: Because there was no significant differences in survival rate and recurrence rate between the two groups, metallic stent insertion can be used safely in the preoperative treatment of obstructive left-sided colorectal cancer.

The Clinical Results of a Total Proctocolectomy with an Ileal Pouch-Anal Anastomosis: 12 Cases.: Lee, Gyoung Chun , Lee, Seung Hyun , Ahn, Byung Kwon , Baek, Sung Uhn; J Korean Soc Coloproctol. 2003;19(1):6-12.

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Abstract PDF: PURPOSE
A restorative proctocolectomy has been accepted as the operation of choice for ulcerative colitis and familial adenomatous polyposis. The purpose of this study was to assess the postoperative complications and functional outcomes following a total proctocolectomy with a J ileal pouch-anal anastomosis.
METHODS
The medical records of 12 patients who had undergone a total proctocolectomy, with a J ileal pouch-anal anastomosis, between January 1997 and June 2002, were retrospectively reviewed according to sex, age, underlying disease and postoperative complications. We evaluated the functional outcomes using medical record reviews and patients and telephone interviews.
RESULTS
Total proctocolectomy, with a J ileal pouch-anal anastomosis, were done for ulcerative colitis (n=2) and familial adenomatous polyposis (n=10). A diverting ileostomy was performed in 8 patients. Postoperative complications occurred in 7 patients (58%), intestinal obstructions in 4 and complications related with anastomosis in 3, i.e. J ileal pouch leakage (n=2) and ileal pouch-vaginal fistula (n=1). Re-operations, due to postoperative complications, were performed in 4 patients, i.e. small bowel segmental resection (n=1), adhesiolysis (n=1), diverting ileostomy (n=1) and ileal pouch resection & reconstruction (n=1). The daily median defecation frequencies were 7.7 (range 4~20) a month after the operation, 5.4 (3~12) at 2~3 months, 4.5 (3~7) at 6 months and 4.1 (3~5) at 12 months, following the operation. Two patients had gas incontinence, 1 had fluid incontinence, 4 had night soiling and 3 needed pads, but these incontinences, the need for anti-diarrhea medication and the use of pads, all improved within 6 months of the operation. Fluid incontinence and the use of pads improved within 3 months of the operation, gas incontinence and night soiling improved within 6 months of the operation. The mean length of follow-up was 30.6 months.
CONCLUSIONS
The postoperative complication rate was 58%. Thirty-three percent of patients had fecal incontinence, but all these improved within 6 months. The long- term functional outcomes, after a total proctocolectomy with J ileal pouch-anal anastomosis, were satisfactory, and the postoperative complications acceptable. The postoperative complication rates were no different between the protective diverting ileostomy and non-ileostomy .

Laparoscopic Resection of Rectal Cancer: Oncologic Results of 110 Patients with Minimum 2-year Follow-up after a Curative Resection.: Joh, Yong Geul , Kim, Seon Hahn , Hahn, Koo Yong , Yu, Sang Hwa , Chung, Choon Sik , Lee, Dong Keun; J Korean Soc Coloproctol. 2006;22(2):118-124.

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Abstract PDF: PURPOSE
This study aimed to assess the oncologic outcomes after a laparoscopic resection in rectal cancer patients with minimum 2-year follow-up.
METHODS
Among the 312 patients undergoing a laparoscopic rectal cancer resection between Jan. 2000 and Dec. 2004 at Hansol Hospital, 110 patients who had been followed-up for longer than 24 months (mean 33, range 24~56) after the curative resection were included in this study. Two patients (1.8%) received preoperative chemoradiation. Five patients (4.5%) received radiotherapy postoperatively.
RESULTS
TNM stage was 0 in 5 patients, I in 25 (22.7%), II in 35 (31.8%), and III in 45 (40.9%). The T stage was as follows; Tis:T1:T2:T3:T4=4.5%:3.6%:25.5%:40.9%:25.5%. A protective ileostomy was performed in nine patients. The mean operative time was 208 minutes, and the mean blood loss was 179 ml. The mean number of removed lymph nodes was 18, and the mean distal margin was 3.0 cm. The radial margin was positive in one case. Conversion was required in three cases (2.7%). The overall morbidity rate was 17.2%. Anastomotic leak age occurred in five patients (5.5%). There was no operative mortality. During 33 months of mean follow-up, distant metastases and local recurrence were seen in 17 (15.5%) and 5 patients (4.5%), respectively. None had port-site recurrence. For the 94 patients with rectal cancer within 12 cm from the anal verge, the rate of local recurrence was 5.3%. The overall survival rate was 88.9% at 3 years (stage 0, I: 100.0%, stage II: 100.0%, stage III: 72.6%). The disease free survival rate was 78.8% at 3 years (stage 0, I: 100.0%, stage II: 88.6%, stage III: 56.9%).
CONCLUSIONS
A laparoscopic resection of rectal cancer provides an acceptable safety profile. If the highly selective indications for radiotherapy (6.3%) and the rather high volume of advanced cancers (stage III 40.9%, T3/4 66.4%) of this study are considered, a 4.5% local recurrence rate is promising. Optimal surgery for rectal cancer by using a laparoscopic technique may reduce the need for radiotherapy.

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