Annals of Coloproctology

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Original Articles

Malignant disease, Functional outcomes

Safety and Efficacy of Single-Port Laparoscopic Ileostomy in Palliative Settings: Seng-Muk Kang, Jung Rae Cho, Heung-Kwon Oh, Eun-Ju Lee, Min Hyun Kim, Duck-Woo Kim, Sung-Bum Kang; Ann Coloproctol. 2020;36(1):17-21. Published online February 29, 2020; DOI: https://doi.org/10.3393/ac.2019.04.25

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Purpose
Single-port laparoscopic techniques can be optimized with confined incisions. This approach has an intraoperative advantage of excellent visualization of the correct intestinal segment for exteriorization, along with direct visual control of the extraction to avoid twisting. However, only a few studies have verified the efficacy of the technique. Thus, this study assessed the results of single-port laparoscopic stoma creation for fecal diversion, specifically focusing on feasibility, safety, and efficacy.
Methods
Patients who underwent single-incision enterostomy performed by a single surgeon were included. Data on demographics, indications for and chosen procedure, and operation results were retrospectively collected and analyzed.
Results
Between April 2015 and January 2018, a total of 13 patients (8 males, 5 females) with a mean age of 57.7 years (range, 41–83 years) underwent single-port ileostomy creation. The most common reason for diversion was palliative ileostomy for colon obstruction or fistula from peritoneal malignancy (n = 12), followed by colonic fistula with necrotizing pancreatitis (n = 1). There were no cases of conversion to open or multiport laparoscopic surgery. The mean operative time was 54 minutes (range, 37–118 minutes), and the median length of hospital stay was 8 days (range, 2–211 days). A postoperative complication, aspiration pneumonia, was documented in 1 patient and treated conservatively. The mean duration of bowel movement was 0.7 days (range, 0–4 days). All stomas had good function, and there was no 30-day mortality.
Conclusion
Single-port laparoscopic ileostomy in patients with a palliative setting could be a safe and feasible option for fecal diversion.

Citations

Citations to this article as recorded by

Single port–assisted diverting ileostomy formation for anastomotic leakage after low anterior resection
Kyong-Min Kang, Heung-Kwon Oh, Hong-min Ahn, Hye-Rim Shin, Min-Hyeong Jo, Mi-Jeong Choi, Duck-Woo Kim, Sung-Bum Kang
Journal of Minimally Invasive Surgery.2025; 28(1): 47. CrossRef
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

Prognostic Implications of Primary Tumor Resection in Stage IVB Colorectal Cancer in Elderly Patients: Heui-June Ahn, Ho-Suk Oh, Yongchel Ahn, Sang Jin Lee, Hyun Joong Kim, Moon Ho Kim, Dae-Woon Eom, Jae Young Kwak, Myoung Sik Han, Jae Seok Song; Ann Coloproctol. 2014;30(4):175-181. Published online August 26, 2014; DOI: https://doi.org/10.3393/ac.2014.30.4.175

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10 Web of Science
10 Citations

Abstract PDF

Purpose

The aim of this study was to identify prognostic factors in stage IVB colorectal cancer in elderly patients, focusing on the influence of treatment modalities, including palliative chemotherapy and primary tumor resection.

Methods

A cohort of 64 patients aged over 65 years who presented with stage IVB colorectal cancer at the Gangneung Asan Hospital between July 1, 2001, and December 31, 2009, was analyzed. Demographics, tumor location, tumor grade, performance status, levels of carcinoembryonic antigen (CEA), level of aspartate aminotransferase (AST), and distant metastatic site at diagnosis were analyzed. Using the treatment histories, we analyzed the prognostic implications of palliative chemotherapy and surgical resection of the primary tumor retrospectively.

Results

The cohort consisted of 30 male (46.9%) and 34 female patients (53.1%); the median age was 76.5 years. Primary tumor resection was done on 28 patients (43.8%); 36 patients (56.2%) were categorized in the nonresection group. The median survival times were 12.43 months in the resection group and 3.58 months in the nonresection group (P < 0.001). Gender, level of CEA, level of AST, Eastern Cooperative Oncology Group performance status, tumor location, and presence of liver metastasis also showed significant differences in overall survival. On multivariate analysis, male gender, higher level of CEA, higher AST level, and no primary tumor resection were independent poor prognostic factors. In particular, nonresection of the primary tumor was the most potent/poor prognostic factor in the elderly-patient study group (P = 0.001; 95% confidence interval, 2.33 to 21.99; hazard ratio, 7.16).

Conclusion

In stage IVB colorectal cancer in elderly patients, resection of the primary tumor may enhance survival.

Citations

Citations to this article as recorded by

Primary Tumor Resection for Metastatic Colorectal, Gastric and Pancreatic Cancer Patients: In Search of Scientific Evidence to Inform Clinical Practice
Valentina Fanotto, Francesca Salani, Caterina Vivaldi, Mario Scartozzi, Dario Ribero, Marco Puzzoni, Francesco Montagnani, Francesco Leone, Enrico Vasile, Maria Bencivenga, Giovanni De Manzoni, Debora Basile, Lorenzo Fornaro, Gianluca Masi, Giuseppe April
Cancers.2023; 15(3): 900. CrossRef
The association of blood biomarkers with treatment response and adverse health outcomes in older patients with solid tumors: A systematic review
Yara van Holstein, P. Janne E. van den Berkmortel, Stella Trompet, Diana van Heemst, Frederiek van den Bos, Marieke Roemeling-van Rhijn, Nienke A. de Glas, Marian Beekman, P. Eline Slagboom, Johanneke E.A. Portielje, Simon P. Mooijaart, Barbara C. van Mun
Journal of Geriatric Oncology.2023; 14(7): 101567. CrossRef
Survival for patients with metastatic colon cancer underwent cytoreductive colectomy in the era of rapid development of anticancer drugs: A real-world analysis based on updated population dataset of 2004–2018
Guangran Meng, Shengtao Yang, Feixiang Chen
Frontiers in Pharmacology.2022;[Epub] CrossRef
Can the De Ritis Ratio (AST/ALT) be used to predict colon cancer stages?
Saygın ALTINER, Enes CEBECİ, Bedri Burak SUCU, Mert ÇÖL, Ender ERGÜDER, Yılmaz ÜNAL, Salih TUNCAL, Mevlüt Recep PEKCİCİ
Ahi Evran Medical Journal.2022;[Epub] CrossRef
Provisional Clinical Opinions (PCOs) Recommended by the Surgical Treatment Working Group for Vulnerable Elderly Patients in Colorectal Cancer: Clinical Questions with Answers
Junichi Nishimura, Yoshio Yoshida, Chie Tanaka, Keiji Matsuda, Shiro Oka, Kohei Murata, Ju Mizuno, Yoichiro Yoshida
Nippon Daicho Komonbyo Gakkai Zasshi.2021; 74(7): 401. CrossRef
Sixty-Day Mortality of Patients With Metastatic Colorectal Cancer Randomized to Systemic Treatment vs Primary Tumor Resection Followed by Systemic Treatment
Dave E. W. van der Kruijssen, Sjoerd G. Elias, Geraldine R. Vink, Karlijn L. van Rooijen, Jorine ‘t Lam-Boer, Linda Mol, Cornelis J. A. Punt, Johannes H. W. de Wilt, Miriam Koopman, Gijs J.D. van Acker, Rahim Altaf, Kees van Arkel, Coen I.M. Baeten, Sandr
JAMA Surgery.2021; 156(12): 1093. CrossRef
Primary Tumor Resection in Patients with Incurable Localized or Metastatic Colorectal Cancer: A Systematic Review and Meta‐analysis
Constantinos Simillis, Eliana Kalakouti, Thalia Afxentiou, Christos Kontovounisios, Jason J. Smith, David Cunningham, Michel Adamina, Paris P. Tekkis
World Journal of Surgery.2019; 43(7): 1829. CrossRef
Meta-analysis of outcomes following resection of the primary tumour in patients presenting with metastatic colorectal cancer
U Nitsche, C Stöß, L Stecher, D Wilhelm, H Friess, G O Ceyhan
Journal of British Surgery.2018; 105(7): 784. CrossRef
A systematic analysis highlighting deficiencies in reported outcomes for patients with stage IV colorectal cancer undergoing palliative resection of the primary tumour
Deena P. Harji, Abigail Vallance, Jenny Selgimann, Simon Bach, Faheez Mohamed, Julia Brown, Nicola Fearnhead
European Journal of Surgical Oncology.2018; 44(10): 1469. CrossRef
Paradigm Shift in the Treatment of Elderly Patients With Unresectable Stage IV Colorectal Cancer
Nam Kyu Kim
Annals of Coloproctology.2014; 30(4): 155. CrossRef

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