Annals of Coloproctology

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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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.

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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

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.

Citations

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The Clinical Utility of Anorectal Manometry: A Review of Current Practices
Eleanor Aubrey Belilos, Zoë Post, Sierra Anderson, Mark DeMeo
Gastro Hep Advances.2025; 4(2): 100562. CrossRef
Exploring Health-Related Quality of Life in Patients with Anal Fistulas: A Comprehensive Study
Tudor Mateescu, Lazar Fulger, Durganjali Tummala, Aditya Nelluri, Manaswini Kakarla, Lavinia Stelea, Catalin Dumitru, George Noditi, Amadeus Dobrescu, Cristian Paleru, Ana-Olivia Toma
Life.2023; 13(10): 2008. CrossRef
Lower Fistula Recurrence with Pulling Seton: A Retrospective Cohort Study
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.

Citations

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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
Clinical Gastroenterology and Hepatology.2024;[Epub] CrossRef
Reduced expression of alanyl aminopeptidase is a robust biomarker of non‐familial adenomatous polyposis and non‐hereditary nonpolyposis colorectal cancer syndrome early‐onset colorectal cancer
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
Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef
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, 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, 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

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.

Citations

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Impact of visceral fat area on short-term outcomes in robotic surgery for mid and low rectal cancer
Shuai Zhao, Yue Ma, Ruiqi Li, Jiajie Zhou, Longhe Sun, Qiannan Sun, Wei Wang, Daorong Wang
Journal of Robotic Surgery.2024;[Epub] CrossRef
Does the visceral fat area impact the histopathology specimen metrics after total mesorectal excision for distal rectal cancer?
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
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
Visceral obesity and anastomotic leakage rates in colorectal cancer: a systematic review and meta-analysis
Linchong Yu, Wenjiang Wu, Shijun Xia, Yue Li, Zhigang Xu
Frontiers in Oncology.2023;[Epub] CrossRef
Research Progress in the Application of Visceral Fat in Gastric Cancer
桂芳崔
Advances in Clinical Medicine.2023; 13(12): 20585. CrossRef
Impact of Preoperative Visceral Fat Area Measured by Bioelectrical Impedance Analysis on Clinical and Oncologic Outcomes of Colorectal Cancer
Kyeong Eui Kim, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Nutrients.2022; 14(19): 3971. CrossRef
Computed Tomography Assessment of Fat Distribution and Staple-Line Leak Risk After Sleeve Gastrectomy
Martin Gaillard, Antonio Esposito, Panagiotis Lainas, Pauline Cerbelaud, Cosmin Sebastian Voican, Rodi Courie, Pierre Chague, Gabriel Perlemuter, Laurence Rocher, Ibrahim Dagher, Hadrien Tranchart
Obesity Surgery.2021; 31(5): 2011. CrossRef
Visceral Fat and Anastomotic Leakage After Colon Cancer Resection
Wouter M. Verduin, Anne-Loes K. Warps, Rick van den Helder, Hieronymus J. Doodeman, Alexander P.J. Houdijk
Diseases of the Colon & Rectum.2021; 64(2): 163. CrossRef
Visceral obesity is associated with lower stage colon tumors in males without survival advantage
Ana Silva, Francisco Gomes, Sofia S. Pereira, Mariana P. Monteiro, António Araújo, Gil Faria
Surgical Oncology.2021; 37: 101606. CrossRef
The Relationship Between Colorectal Cancer and Abdominal Adipose Tissue Distribution
Fatma Esra BAHADIR ÜLGER, Ümit AKYÜZ
Journal of Contemporary Medicine.2021; 11(3): 288. CrossRef
Impact of subcutaneous and visceral fat adiposity in patients with colorectal cancer
Jin-Mok Kim, Eric Chung, Eun-Suk Cho, Jae-Hoon Lee, Su-Jin Shin, Hye Sun Lee, Eun Jung Park, Seung Hyuk Baik, Kang Young Lee, Jeonghyun Kang
Clinical Nutrition.2021; 40(11): 5631. CrossRef
Impact of Visceral Fat Area Measured by Bioelectrical Impedance Analysis on Clinico-Pathologic Outcomes of Colorectal Surgery
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
Impact of adiposity on staging and prognosis of colorectal cancer
Ana Silva, Gil Faria, António Araújo, Mariana P. Monteiro
Critical Reviews in Oncology/Hematology.2020; 145: 102857. CrossRef
Impact of visceral obesity and sarcobesity on surgical outcomes and recovery after laparoscopic resection for colorectal cancer
C. Pedrazzani, C. Conti, G.A. Zamboni, M. Chincarini, G. Turri, A. Valdegamberi, A. Guglielmi
Clinical Nutrition.2020; 39(12): 3763. CrossRef
Which obesity-associated parameters can better reflect the risk of the occurrence of the anastomotic leakage?
Zeyang Chen, Jiejin Yang, Zining Liu, Yuyang Zhang, Jiali Sun, Pengyuan Wang
Scandinavian Journal of Gastroenterology.2020; 55(4): 466. CrossRef
BMI May Be a Prognostic Factor for Local Advanced Rectal Cancer Patients Treated with Long-Term Neoadjuvant Chemoradiotherapy

Hengchang Liu, Ran Wei, Chunxiang Li, Zhixun Zhao, Xu Guan, Ming Yang, Zheng Liu, Xishan Wang, Zheng Jiang
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
Assessment of Computed Tomography (CT)-Defined Muscle and Adipose Tissue Features in Relation to Short-Term Outcomes After Elective Surgery for Colorectal Cancer: A Multicenter Approach
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
Annals of Coloproctology.2016; 32(1): 3. CrossRef

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.

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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
Is There Still a Role for Video-Assisted Laparoscopic Gastric Banding in Severe Obesity?
Nicola Zampieri, Roberto Castellani, Lorenzo Francia
Bariatric Surgical Practice and Patient Care.2016; 11(1): 25. CrossRef
Laparoscopic sigmoid colectomy: Are all laparoscopic techniques created equal?
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
Preoperative prediction of conversion from laparoscopic rectal resection to open surgery: a clinical study of conversion scoring of laparoscopic rectal resection to open surgery
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

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.

Citations

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Comparison of Operative Time Between Robotic and Laparoscopic Low Anterior Resection for Rectal Cancer:A Systematic Review and Meta-Analysis
Zhen Chen, Hua Yu, Huaping Wu, Pingxi Wang, Fanwei Zeng
Surgical Innovation.2023; 30(3): 390. CrossRef
Comparison of robotic right colectomy and laparoscopic right colectomy: a systematic review and meta-analysis
Jianchun Zheng, Shuai Zhao, Wei Chen, Ming Zhang, Jianxiang Wu
Techniques in Coloproctology.2023; 27(7): 521. CrossRef
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Giuseppe Palomba, Vincenza Paola Dinuzzi, Marianna Capuano, Pietro Anoldo, Marco Milone, Giovanni Domenico De Palma, Giovanni Aprea
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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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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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Abstract PDF

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.

Citations

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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
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Ik Yong Kim
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Young Wan Kim, Ik Yong Kim
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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
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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
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The prognostic impact of the number of lymph nodes retrieved after neoadjuvant chemoradiotherapy with mesorectal excision for rectal cancer
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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.

Multicenter Study

Factors Influenceing the Oncologic Results after Abdominoperineal Resection: Does the Introduction of Laparoscopic Procedures Influence the Oncologic Results?.: Heo, Youn Jung , Cho, Hyeon Min , Kim, Jun Gi , Won, Yong Sung , Jun, Kyong Hwa , Chin, Hyung Min , Park, Woo Bae , Chun, Chung Soo; J Korean Soc Coloproctol. 2004;20(5):311-318.

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Abstract PDF: PURPOSE
Although indications for abdominoperineal resection (APR) are decreasing due to the widespread of sphincter-saving procedures, APR is still the mainstay in the treatment of rectal cancer. The purpose of this study is to demonstrate the appropriateness of laparoscopic APR in terms of oncologic parameters.
METHODS
From January 1984 to December 2003, 110 patients with a rectal adenocarcinoma who underwent APR were involved in this study. The data were grouped according to five main items: 1) patient demographic data, 2) operative procedure, 3) gross tumor findings, 4) pathologic tumor findings, and 5) perioperative treatment. Each item was subdivided by factors that could influence the oncologic results, and univariate analyses were performed. Thereafter, a multivariate analysis was performed with those factors considered statistically significant.
RESULTS
The mean follow-up period was 106.01+/-9.98 months, the local recurrence rate was 23.6%, and distant metastasis rate was 31.8%. The five-year survival rate was 58.1%, and the ten-year survival rate was 51.1%. Multivariate analysis after univariate analyses showed that independent prognostic factors influencing local recurrence were preoperative CEA level, T-stage, and preoperative radiation therapy. Factors influencing distant metastasis were preoperative CEA level, N-stage, and preoperative radiation therapy. Univariate analysis showed that the laparoscopic approach was beneficial in terms of local recurrence; however, with the multivariate analysis, this was not statistically evident. Prognostic factors influencing long-term survival in the multivariate analysis were preoperative CEA level, stage, and perineural invasion.
CONCLUSIONS
Laparoscopic APR was not significantly different from an open procedure in terms of oncologic outcomes. In the near future, a randomized prospective multicenter trial should tell us which approach is more beneficial.

Original Articles

Laparoscopic Resection of Colon Cancer: Early Oncologic Outcomes.: Joh, Yong Geul , Kim, Seon Hahn , Hahn, Koo Yong , Lee, Dong Keun; J Korean Soc Coloproctol. 2004;20(5):289-295.

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Abstract PDF: PURPOSE
The aim of this study was to evaluate the interim oncologic outcome following a laparoscopic resection of colon cancer.
METHODS
Prospectively collected data was obtained on 119 patients (M:F=60:59, mean age=56 years) undergoing a laparoscopic colon-cancer resection between January 2001 and May 2004. Fifty-nine tumors were in the sigmoid, 17 in the right colon, 15 in the transverse colon, 12 in the hepatic flexure, 12 in the left colon, 10 in the cecum, and 4 in the splenic flexure.
RESULTS
The operative procedures included 51 sigmoidectomies, 48 right colectomies, 15 left colectomies, 3 transverse colectomies, and 2 total abdominal colectomies. The mean operative time was 186 minutes. The mean blood loss was 91 ml. Conversion to an open procedure was not required. TNM stages were 0 in 11 patients, I in 19, II in 55, III in 30, and IV in 4. The portion of T3 plus T4 was 73%. The mean number of resected lymph nodes was 27. The mean proximal and distal margins were 14 cm and 12 cm. The overall morbidity rate was 26% (15 wound seromas/ abscesses, 5 chylous leaks, 3 perianastomotic inflammations, 2 ileus, 2 intraabdominal bleedings, 1 anastomotic leak, 1 anastomotic obstruction, 1 intractable hiccup, 1 fungal peritonitis). There were no operative mortalities. The mean hospital stay was 10 days. Ninety eight patients were followed-up longer than 6 months (median 19 months, range 6~0 months) after the curative resection. Distant metastases occurred in 3 stage-IIIB and 3 stage-IIIC patients (6%): liver (2), liver & peritoneum (1), lung (1), paraaortic and iliac lymph nodes (1), and peritoneum (1). The mean time to recurrence was 10.3 months after the operation There were no local or port-site recurrences.
CONCLUSIONS
In this study, Laparoscopic resections of colon cancer provided an acceptable morbidity rate and satisfactory early oncologic outcomes. Long-term follow-up is mandatory and ongoing.

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 .

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