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15 "Postoperative complications"
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Original Articles
Anorectal benign disease
Lower pain, less itching, and faster healing after ultrasound scalpel-assisted hemorrhoidectomy using an intimate cleaner containing chlorhexidine, acid hyaluronic acid, and natural anti-inflammatories: a multicenter observational case-control study
Antonio Brillantino, Luigi Marano, Maurizio Grillo, Alessio Palumbo, Fabrizio Foroni, Luciano Vicenzo, Alessio Antropoli, Michele Lanza, Maria Laura Sandoval Sotelo, Nicola Sangiuliano, Mauro Maglio, Rosanna Filosa, Lucia Abbatiello, Maria Preziosa Romano, Luana Passariello, Pasquale Talento, Giovanna Ioia, Corrado Rispoli, Mariano Fortunato Armellino, Vincenzo Bottino, Adolfo Renzi, Carlo Bartone, Luigi Monaco, Paolino Mauro, Stefano Picardi, Maria Paola Menna, Elisa Palladino, Mario Massimo Mensorio, Vinicio Mosca, Claudio Gambardella, Luigi Brusciano, Ludovico Docimo
Ann Coloproctol. 2024;40(6):602-609.   Published online December 30, 2024
DOI: https://doi.org/10.3393/ac.2024.00570.0081
  • 583 View
  • 48 Download
AbstractAbstract PDF
Purpose
Postoperative pain is a major concern for patients undergoing ultrasound scalpel-assisted hemorrhoidectomy, potentially exacerbated by delayed wound healing. This study aimed to evaluate the impact of an intimate cleansing gel containing chlorhexidine, hyaluronic acid, and other anti-inflammatory agents (Antroclean Fisioderm) on postoperative pain, itching, and wound healing in patients who had undergone this procedure.
Methods
This multicenter observational case-control study involved a cohort of consecutive adult patients who underwent hemorrhoidectomy using an ultrasound device. The study compared 2 different postoperative wound management strategies over 1 month after surgery: washing with warm water twice per day (control group) versus a 2-minute topical application of intimate cleansing gel (Antroclean Fisioderm) followed by a warm water wash (intervention group).
Results
The median postoperative pain score was significantly lower in the intervention group than in the control group at each follow-up point (P<0.01). The percentage of patients reporting anal itching was also significantly lower in the intervention group than in the control group at each follow-up point (P<0.01). All patients in the intervention group achieved complete wound healing 4 weeks after surgery, compared to 88 (82%) in the control group (P<0.01). No adverse events were reported.
Conclusion
The topical application of intimate cleansing gel (Antroclean Fisioderm) twice daily for 1 month following ultrasound scalpel-assisted hemorrhoidectomy appears to be associated with faster healing, reduced pain, decreased itching, and improved quality of life, without any adverse effects. Further larger and prospective randomized trials are recommended to confirm these findings.
ERAS
Impact of an Enhanced Recovery After Surgery (ERAS) program on the management of complications after laparoscopic or robotic colectomy for cancer
Victoria Weets, Hélène Meillat, Jacques Emmanuel Saadoun, Marie Dazza, Cécile de Chaisemartin, Bernard Lelong
Ann Coloproctol. 2024;40(5):440-450.   Published online September 20, 2024
DOI: https://doi.org/10.3393/ac.2023.00850.0121
  • 1,906 View
  • 78 Download
  • 1 Web of Science
  • 1 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Purpose
Enhanced Recovery After Surgery (ERAS) reduces postoperative complications (POCs) after colorectal surgery; however, its impact on the management of POCs remains unclear. This study compared the diagnosis and management of POCs before and after implementing our ERAS protocol after laparoscopic or robotic colectomy for cancer and examined the short- and mid-term oncologic impacts.
Methods
This single-center, retrospective study evaluated all consecutive patients who underwent laparoscopic or robotic colectomy for cancer between 2012 and 2021, focusing on the incidence of POCs within 90 days. We compared outcomes before (standard group) and after (ERAS group) the implementation of our ERAS protocol in January 2016.
Results
Significantly fewer patients in the ERAS group developed POCs (standard vs. ERAS, 136 of 380 patients [35.8%] vs.136 of 660 patients [20.6%]; P<0.01). The ERAS group had a significantly shorter mean total length of stay after POCs (13.1 days vs. 11.4 days, P=0.04), and the rates of life-threatening complications (6.7% vs. 0.7%) and 1-year mortality (7.4% vs. 1.5%) were significantly lower in the ERAS group than in the standard group. Among patients with anastomotic complications, laparoscopic reoperation was significantly more common in the ERAS group than in the standard group (8.3% vs. 75.0%, P<0.01). Among patients with postoperative ileus, the diagnosis and recovery times were significantly shorter in the ERAS group than in the standard group, resulting in a shorter total length of stay (13.5 days vs. 10 days, P<0.01).
Conclusion
The implementation of an ERAS protocol did not eliminate all POCs, but it did accelerate their diagnosis and management and improved patient outcomes.

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
Colorectal cancer
Long-term bowel functional outcomes following anal sphincter-preserving surgery for upper and middle rectal cancer: a single-center longitudinal study
Ahmad Sakr, Seung Yoon Yang, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim
Ann Coloproctol. 2024;40(1):27-35.   Published online February 28, 2024
DOI: https://doi.org/10.3393/ac.2022.01067.0152
  • 1,951 View
  • 176 Download
  • 2 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
Despite advances in neoadjuvant chemoradiotherapy and anal sphincter-preserving surgery for rectal cancer, bowel dysfunction is still unavoidable and negatively affects patients’ quality of life. In this longitudinal study, we aimed to investigate the changes in bowel function with follow-up time and the effect of neoadjuvant chemoradiotherapy on bowel function following low anterior resection for rectal cancer.
Methods
In this study, 171 patients with upper or middle rectal cancer who underwent low anterior resection between 2012 and 2018 were included. Bowel function was assessed longitudinally with Memorial Sloan Kettering Cancer Center Bowel Function Instrument and Wexner scores every 6 months after restoration of bowel continuity. Patients with at least 2 follow-up visits were included.
Results
Overall, 100 patients received neoadjuvant chemoradiotherapy. Urgency, soilage, and fecal incontinence were noted within 24 months in the patients treated with neoadjuvant chemoradiotherapy. After 2 years of follow-up, significant bowel dysfunction and fecal incontinence were observed in the neoadjuvant chemoradiotherapy group. Low tumor level and neoadjuvant chemoradiotherapy were associated with delayed bowel dysfunction.
Conclusion
Neoadjuvant chemoradiotherapy in combination with low tumor level was significantly associated with delayed bowel dysfunction even after 2 years of follow-up. Therefore, careful selection and discussion with patients are paramount.

Citations

Citations to this article as recorded by  
  • Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-Center Retrospective Analysis
    Jae Seung Kim, Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
    Cancers.2024; 16(24): 4280.     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
Technical Note
Can the Heald anal stent help to reduce anastomotic or rectal stump leak in elective and emergency colorectal surgery? A single-center experience
Michael Jones, Brendan Moran, Richard John Heald, John Bunni
Ann Coloproctol. 2024;40(1):82-85.   Published online February 26, 2024
DOI: https://doi.org/10.3393/ac.2023.00038.0005
  • 2,303 View
  • 190 Download
AbstractAbstract PDF
Anastomotic and rectal stump leaks are feared complications of colorectal surgery. Diverting stomas are commonly used to protect low rectal anastomoses but can have adverse effects. Studies have reported favorable outcomes for transanal drainage devices instead of diverting stomas. We describe our use of the Heald anal stent and its potential impact in reducing anastomotic or rectal stump leak after elective or emergency colorectal surgery. We performed a single-center retrospective analysis of patients in whom a Heald anal stent had been used to “protect” a colorectal anastomosis or a rectal stump, in an elective or emergency context, for benign and malignant pathology. Intraoperative and postoperative outcomes were reviewed using clinical and radiological records. The Heald anal stent was used in 93 patients over 4 years. Forty-six cases (49%) had a colorectal anastomosis, and 47 (51%) had an end stoma with a rectal stump. No anastomotic or rectal stump leaks were recorded. We recommend the Heald anal stent as a simple and affordable adjunct that may decrease anastomotic and rectal stump leak by reducing intraluminal pressure through drainage of fluid and gas.
Original Articles
Stoma
Protective loop ileostomy or colostomy? A risk evaluation of all common complications
Yi-Wen Yang, Sheng-Chieh Huang, Hou-Hsuan Cheng, Shih-Ching Chang, Jeng-Kai Jiang, Huann-Sheng Wang, Chun-Chi Lin, Hung-Hsin Lin, Yuan-Tzu Lan
Ann Coloproctol. 2024;40(6):580-587.   Published online January 27, 2023
DOI: https://doi.org/10.3393/ac.2022.00710.0101
  • 3,581 View
  • 194 Download
  • 2 Web of Science
  • 3 Citations
AbstractAbstract PDF
Purpose
Protective ileostomy and colostomy are performed in patients undergoing low anterior resection with a high leakage risk. We aimed to compare surgical, medical, and daily care complications between these 2 ostomies in order to make individual choice.
Methods
Patients who underwent low anterior resection for rectal tumors with protective stomas between January 2011 and September 2018 were enrolled. Stoma-related complications were prospectively recorded by wound, ostomy, and continence nurses. The cancer stage and treatment data were obtained from the Taiwan Cancer Database of our Big Data Center. Other demographic data were collected retrospectively from medical notes. The complications after stoma creation and after the stoma reversal were compared.
Results
There were 176 patients with protective colostomy and 234 with protective ileostomy. Protective ileostomy had higher proportions of high output from the stoma for 2 consecutive days than protective colostomy (11.1% vs. 0%, P<0.001). Protective colostomy resulted in more stoma retraction than protective ileostomy (21.6% vs. 9.4%, P=0.001). Female, open operation, ileostomy, and carrying stoma more than 4 months were also significantly associated with a higher risk of stoma-related complications during diversion. For stoma retraction, the multivariate analysis revealed that female (odds ratio [OR], 4.00; 95% confidence interval [CI], 2.13–7.69; P<0.001) and long diversion duration (≥4 months; OR, 2.33; 95% CI, 1.22–4.43; P=0.010) were independent risk factors, but ileostomy was an independent favorable factor (OR, 0.40; 95% CI, 0.22–0.72; P=0.003). The incidence of complication after stoma reversal did not differ between colostomy group and ileostomy group (24.3% vs. 20.9%, P=0.542).
Conclusion
We suggest avoiding colostomy in patients who are female and potential prolonged diversion when stoma retraction is a concern. Otherwise, ileostomy should be avoided for patients with impaired renal function. Wise selection and flexibility are more important than using one type of stoma routinely.

Citations

Citations to this article as recorded by  
  • Uso de ileostomía derivativa en cáncer de ovario. Revisión de la literatura
    Franco Rafael Ruiz-Echeverría, Pedro Hernando Calderón-Quiroz, Juliana Rendón-Hernández
    Revista Colombiana de Cirugía.2024;[Epub]     CrossRef
  • Meta-analysis: loop ileostomy versus colostomy to prevent complications of anterior resection for rectal cancer
    Shilai Yang, Gang Tang, Yudi Zhang, Zhengqiang Wei, Donglin Du
    International Journal of Colorectal Disease.2024;[Epub]     CrossRef
  • The Role of Colon in Isolated Intestinal Transplantation: Description of 4 Cases
    Pierpaolo Di Cocco, Giulia Bencini, Alessandro Martinino, Egor Petrochenkov, Stepan Akshelyan, Kentaro Yoshikawa, Mario Spaggiari, Jorge Almario-Alvarez, Ivo Tzvetanov, Enrico Benedetti, Gaetano Gallo
    International Journal of Surgical Oncology.2024;[Epub]     CrossRef
Anorectal benign disease
The importance of compression time in stapled hemorrhoidopexy: is patience a virtue?
Byung Eun Yoo, Wook Ho Kang, Yong Teak Ko, Young Chan Lee, Cheong Ho Lim
Ann Coloproctol. 2024;40(2):176-181.   Published online December 20, 2022
DOI: https://doi.org/10.3393/ac.2022.00556.0079
  • 2,409 View
  • 134 Download
  • 1 Web of Science
AbstractAbstract PDF
Purpose
The aim of this study was to evaluate whether longer compression time before firing the stapler reduced the postoperative complications related to staple line formation in stapled hemorrhoidopexy.
Methods
This retrospective case-control study was conducted at a colorectal-anal specialty hospital. Consecutive patients with grades III and IV hemorrhoids who underwent stapled hemorrhoidopexy between January 2016 and November 2019 were included. According to the compression time, patients were assigned to the long compression time group (2 minutes) or the typical compression time group (30 seconds). The primary outcome measure was incidence of staple line complications such as dehiscence, bleeding, and stenosis.
Results
A total of 348 patients treated with stapled hemorrhoidopexy were evaluated. Seventy-three and 275 patients were included in the long compression time group and the typical compression time group, respectively. No significant differences were observed in patient characteristics between the groups. However, additional procedures were performed more frequently in the typical compression time group (78.1% vs. 92.0%, P=0.001). Bleeding occurred more frequently in the typical compression time group (1.4% vs. 8.4%, P=0.030). The rates of dehiscence and stenosis were not significantly different between the groups. Fecal urgency developed more frequently in the typical compression time group (0% vs. 5.1%, P=0.040). In logistic regression analysis, typical compression time (30 seconds) was the only risk factor for bleeding (odds ratio, 8.496; P=0.040).
Conclusion
Longer compression time was associated with a decreased incidence of postoperative bleeding after stapled hemorrhoidopexy.
Risk factors for prolonged hospitalization and delayed treatment completion after laparoscopic appendectomy in patients with uncomplicated acute appendicitis
Jiyoung Shin, Myong Hoon Ihn, Kyung Sik Kim, Sang Hyun Kim, Jihyoun Lee, Sangchul Yun, Sung Woo Cho
Ann Coloproctol. 2023;39(1):50-58.   Published online November 18, 2021
DOI: https://doi.org/10.3393/ac.2021.00773.0110
  • 3,926 View
  • 154 Download
  • 2 Web of Science
  • 3 Citations
AbstractAbstract PDFSupplementary Material
Purpose
We sought to identify the risk factors for prolonged hospitalization and delayed treatment completion after laparoscopic appendectomy in patients with uncomplicated acute appendicitis.
Methods
The study retrospectively analyzed 497 patients who underwent laparoscopic appendectomies for uncomplicated appendicitis between January 2018 and December 2020. The patients were divided into an early discharge group (≤2 days) and a late discharge group (>2 days) based on the length of hospital stay (LOS). The patients were also divided into uneventful and complicated groups according to the need for additional treatment after standard follow-up.
Results
Thirty-seven patients (7.4%) were included in the late discharge group. The mean LOS of the late discharge groups was 3.9 days. There were significant differences according to age, preoperative C-reactive protein (CRP), and operative time between the 2 groups. Only operative time was significantly associated with prolonged LOS in multivariate analysis. Thirty-five patients (7.0%) were included in the complicated group. The mean duration of treatment in the uneventful and complicated groups was 7.4 and 25.3 days, respectively. Significant differences existed between the uneventful and complicated groups in preoperative body temperature, preoperative CRP levels, maximal appendix diameter, and the presence of appendicoliths. In multivariate analysis, preoperative CRP levels and maximal appendix diameter were independent predictors of delayed treatment completion.
Conclusion
Shorter operative time is desirable to ensure minimal hospital stay in patients with uncomplicated appendicitis. Further efforts are needed to ensure that patients with uncomplicated appendicitis do not experience delayed treatment completion after laparoscopic appendectomies.

Citations

Citations to this article as recorded by  
  • Comparative Outcomes of Immediate and Delayed Wound Closure Techniques in Appendectomies for Gangrenous Appendicitis
    Anzar Usman, Esha Akbar, Aliha Mukhtar, Iqra Nasir, Usama Rehman, Adil Iqbal, Muhammad Rashid, Muhammad Umar
    DEVELOPMENTAL MEDICO-LIFE-SCIENCES.2024; 1(3): 35.     CrossRef
  • Non-linear association between C-reactive protein levels and length of stay in pediatric appendicitis patients undergoing laparoscopic appendectomy
    Ming Liu, Ping Yang, Yunpeng Gou
    Frontiers in Pediatrics.2024;[Epub]     CrossRef
  • Nomogram prediction model for length of hospital stay following laparoscopic appendectomy in pediatric patients: a retrospective study
    Ming Liu, Ping Yang, Yunpeng Gou, Qiang Chen, Dong Xu
    Frontiers in Pediatrics.2024;[Epub]     CrossRef
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
  • 3,918 View
  • 79 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDF
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  
  • 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
Short-term Outcomes After Upfront Chemotherapy Followed by Curative Surgery in Metastatic Colon Cancer: A Comparison With Upfront Surgery Patients
Myung Hyun Han, Youn Young Park, Shiva Pratap, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim
Ann Coloproctol. 2019;35(6):327-334.   Published online December 31, 2019
DOI: https://doi.org/10.3393/ac.2019.03.04.1
  • 3,216 View
  • 69 Download
  • 2 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
Upfront systemic chemotherapy with target agents has been recommended for patients with stage IV colon cancer. Some with partial response are considered for curative resection. There is high risk of developing postoperative complications following upfront systemic chemotherapy. We aimed to evaluate short-term perioperative outcomes of curative surgery after upfront chemotherapy in comparison with upfront surgery in patients with metastatic colon cancer.
Methods
Between January 2010 and October 2015, 146 patients (80 in the surgery first group, 66 in the upfront chemotherapy group) who underwent surgical resection before or after systemic chemotherapy for metastatic colon cancer were included in the present study. All decisions for treatment were made through a multidisciplinary team. Postoperative clinical outcomes and complications were analyzed to compare the groups.
Results
There was no difference between the 2 groups in terms of postoperative clinical outcomes. Overall complication rates were not different between the groups (surgery first group: 46.3% vs. upfront chemotherapy group: 60.6%; P = 0.084). When classified according to the Clavien-Dindo method, there was no difference between the 2 groups in terms of major complications (grade 3 or more) (surgery first group: 18.9% vs. upfront chemotherapy group: 27.5%; P = 0.374).
Conclusion
There was no significant increase in major postoperative complications in metastatic colon cancer patients who received upfront chemotherapy followed by curative surgery. Careful patient selection and treatment planning are important.

Citations

Citations to this article as recorded by  
  • Impact of preoperative chemotherapy on perioperative morbidity in combined resection of colon cancer and liver metastases
    Joy Z. Done, Angelos Papanikolaou, Miloslawa Stem, Shannon N. Radomski, Sophia Y. Chen, Chady Atallah, Jonathan E. Efron, Bashar Safar
    Journal of Gastrointestinal Surgery.2023; 27(11): 2380.     CrossRef
  • Treatment for Peritoneal Metastasis of Patients With Colorectal Cancer
    Young Jin Kim, Chang Hyun Kim
    Annals of Coloproctology.2021; 37(6): 425.     CrossRef
Malignant disease, Prognosis and adjuvant therapy
Long-term Oncologic Outcome of Postoperative Complications After Colorectal Cancer Surgery
Chang Kyu Oh, Jung Wook Huh, You Jin Lee, Moon Suk Choi, Dae Hee Pyo, Sung Chul Lee, Seong Mun Park, Jung Kyong Shin, Yoon Ah Park, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee
Ann Coloproctol. 2020;36(4):273-280.   Published online November 13, 2019
DOI: https://doi.org/10.3393/ac.2019.10.15
  • 4,606 View
  • 167 Download
  • 21 Web of Science
  • 21 Citations
AbstractAbstract PDF
Purpose
The impact of postoperative complications on long-term oncologic outcome after radical colorectal cancer surgery is controversial. The aim of this study was to examine the risk factors and oncologic outcomes of surgery-related postoperative complication groups.
Methods
From January 2010 to December 2010, 310 patients experienced surgery-related postoperative complications after radical colorectal cancer surgery. These stage I–III patients were classified into 2 subgroups, minor (grades I, II) and major (grades III, IV) complication groups, according to extended Clavien-Dindo classification system criteria. Clinicopathologic differences between the 2 groups were analyzed to identify risk factors for major complications. The diseasefree survival rates of surgery-related postoperative complication groups were also compared.
Results
Minor and major complication groups were stratified with 194 patients (62.6%) and 116 patients (37.4%), respectively. The risk factors influencing the major complication group were pathologic N category and operative method. The prognostic factors associated with disease-free survival were preoperative perforation, perineural invasion, tumor budding, and receiving neoadjuvant therapy. With a median follow-up period of 72.2 months, the 5-year disease-free survival rates were 84.4% in the minor group and 78.5% in the major group, but there was no statistical significance between the minor and major groups (P = 0.392).
Conclusion
Advanced cancer and open surgery were identified as risk factors for increased surgery-related major complications after radical colorectal cancer surgery. However, severity of postoperative complications did not affect disease-free survival from colorectal cancer.

Citations

Citations to this article as recorded by  
  • Oncologic impact of technical difficulties during the early experience with laparoscopic surgery for colorectal cancer: long-term follow-up results of a prospective cohort study
    Hong-min Ahn, Tae Gyun Lee, Hye-Rim Shin, Jeehye Lee, In Jun Yang, Jung Wook Suh, Heung-Kwon Oh, Duck-Woo Kim, Sung-Bum Kang
    Current Problems in Surgery.2025; 63: 101694.     CrossRef
  • Impact of Preoperative and Intraoperative Factors on Postoperative Outcomes in Patients with Colorectal Cancer: A 10-Year Retrospective Study
    Lucian Flavius Herlo, Ioana Golu, Alexandra Herlo, Claudia Raluca Balasa Virzob, Ionescu Alin, Stela Iurciuc, Ionut Eduard Iordache, Luana Alexandrescu, Doina Ecaterina Tofolean, Raluca Dumache
    Diseases.2025; 13(1): 16.     CrossRef
  • Accelerated enhanced recovery after colon cancer surgery with discharge within one day after surgery: a systematic review
    Misha A. T. Sier, Anke H. C. Gielen, Thaís T. T. Tweed, Noémi C. van Nie, Tim Lubbers, Jan H. M. B. Stoot
    BMC Cancer.2024;[Epub]     CrossRef
  • Risk Factors of Postoperative Complication and Hospital Mortality after Colorectal Perforation Surgery
    Kensuke Kudou, Shuhei Kajiwara, Takashi Motomura, Takafumi Yukaya, Tomonori Nakanoko, Yosuke Kuroda, Masahiro Okamoto, Tadashi Koga, Yo-Ichi Yamashita
    Journal of the Anus, Rectum and Colon.2024; 8(2): 118.     CrossRef
  • Predictive value of POSSUM scoring system for postoperative complications and mortality in elderly patients with colorectal cancer
    Qiang Li, Yingjun Lu
    Technology and Health Care.2024; 32(6): 4653.     CrossRef
  • Postoperative Complications Result in Poor Oncological Outcomes: What Is the Evidence?
    Anjana Wajekar, Sohan Lal Solanki, Juan Cata, Vijaya Gottumukkala
    Current Oncology.2024; 31(8): 4632.     CrossRef
  • The role of robotic-assisted surgery in the management of rectal cancer: a systematic review and meta-analysis
    Chenxiong Zhang, Hao Tan, Han Xu, Jiaming Ding
    International Journal of Surgery.2024; 110(10): 6282.     CrossRef
  • Effect of postoperative complications on 5-year survival following laparoscopic surgery for resectable colorectal cancer: a retrospective study
    Jae Eun Lee, Kyeong Eui Kim, Woon Kyung Jeong, Seong Kyu Baek, Sung Uk Bae
    International Journal of Colorectal Disease.2024;[Epub]     CrossRef
  • Robotic versus Laparoscopic Total Mesorectal Excision Surgery in Rectal Cancer: Analysis of Medium-Term Oncological Outcomes
    Jing-jing Li, Zhi-bo Zhang, Shi-yun Xu, Cheng-ren Zhang, Xiong-fei Yang, Yao-xing Duan
    Surgical Innovation.2023; 30(1): 36.     CrossRef
  • Do postoperative infectious complications really affect long‐term survival in colorectal cancer surgery? A multicenter retrospective cohort study
    Akihisa Matsuda, Hiroshi Maruyama, Shinji Akagi, Toru Inoue, Kenichiro Uemura, Minako Kobayashi, Hisanori Shiomi, Manabu Watanabe, Hiroki Arai, Yutaka Kojima, Yusuke Mizuuchi, Hajime Yokomizo, Yuji Toiyama, Toru Miyake, Yasuyuki Yokoyama, Kei Ishimaru, Sh
    Annals of Gastroenterological Surgery.2023; 7(1): 110.     CrossRef
  • International Society of University Colon and Rectal Surgeons survey of surgeons’ preference on rectal cancer treatment
    Audrius Dulskas, Philip F. Caushaj, Domas Grigoravicius, Liu Zheng, Richard Fortunato, Joseph W. Nunoo-Mensah, Narimantas E. Samalavicius
    Annals of Coloproctology.2023; 39(4): 307.     CrossRef
  • Effect of serum lactate dehydrogenase-to-albumin ratio (LAR) on the short-term outcomes and long-term prognosis of colorectal cancer after radical surgery
    Xin-Peng Shu, Ying-Chun Xiang, Fei Liu, Yong Cheng, Wei Zhang, Dong Peng
    BMC Cancer.2023;[Epub]     CrossRef
  • Modified Clavien–Dindo–sink classification system for adolescent idiopathic scoliosis
    Ndéye F. Guissé, Joseph D. Stone, Lukas G. Keil, Tracey P. Bastrom, Mark A. Erickson, Burt Yaszay, Patrick J. Cahill, Stefan Parent, Peter G. Gabos, Peter O. Newton, Michael P. Glotzbecker, Michael P. Kelly, Joshua M. Pahys, Nicholas D. Fletcher
    Spine Deformity.2022; 10(1): 87.     CrossRef
  • Surgical site infection after laparoscopic resection of colorectal cancer is associated with compromised long-term oncological outcome
    Nana Sugamata, Takashi Okuyama, Emiko Takeshita, Haruka Oi, Yuhei Hakozaki, Shunya Miyazaki, Musashi Takada, Takashi Mitsui, Takuji Noro, Hideyuki Yoshitomi, Masatoshi Oya
    World Journal of Surgical Oncology.2022;[Epub]     CrossRef
  • Does Preoperative Waiting Time Affect the Short-Term Outcomes and Prognosis of Colorectal Cancer Patients? A Retrospective Study from the West of China
    Xiao-Yu Liu, Zi-Wei Li, Bing Kang, Yu-Xi Cheng, Wei Tao, Bin Zhang, Hua Zhang, Zheng-Qiang Wei, Dong Peng, Antonio Giovanni Solimando
    Canadian Journal of Gastroenterology and Hepatology.2022; 2022: 1.     CrossRef
  • Surgical safety in the COVID-19 era: present and future considerations
    Young Il Kim, In Ja Park
    Annals of Surgical Treatment and Research.2022; 102(6): 295.     CrossRef
  • Current status and role of robotic approach in patients with low-lying rectal cancer
    Hyo Seon Ryu, Jin Kim
    Annals of Surgical Treatment and Research.2022; 103(1): 1.     CrossRef
  • Robotic surgery for colorectal cancer
    Sung Uk Bae
    Journal of the Korean Medical Association.2022; 65(9): 577.     CrossRef
  • Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and Current Management
    Seung Mi Yeo, Gyung Mo Son
    The Ewha Medical Journal.2022;[Epub]     CrossRef
  • Current Status and Future of Robotic Surgery for Colorectal Cancer-An English Version
    Sung Uk Bae
    Journal of the Anus, Rectum and Colon.2022; 6(4): 221.     CrossRef
  • A propensity score-matched analysis of advanced energy devices and conventional monopolar device for colorectal cancer surgery: comparison of clinical and oncologic outcomes
    Woo Jin Song, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
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Postoperative Outcomes of Stoma Takedown: Results of Long-term Follow-up
Bomina Paik, Chang Woo Kim, Sun Jin Park, Kil Yeon Lee, Suk-Hwan Lee
Ann Coloproctol. 2018;34(5):266-270.   Published online October 10, 2018
DOI: https://doi.org/10.3393/ac.2017.12.13
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  • 8 Citations
AbstractAbstract PDF
Purpose
Stoma takedown is a frequently performed procedure with considerable postoperative morbidities. Various skin closure techniques have been introduced to reduce surgical site infections. The aim of this study was to assess postoperative outcomes after stoma takedown during a long-term follow-up period.
Methods
Between October 2006 and December 2015, 84 consecutive patients underwent a colostomy or ileostomy takedown at our institution. Baseline characteristics and perioperative outcomes were analyzed through retrospective reviews of medical records.
Results
The proportion of male patients was 60.7%, and the mean age of the patients was 59.0 years. The overall complication rate was 28.6%, with the most common complication being prolonged ileus, followed by incisional hernia, anastomotic leakage, surgical site infection, anastomotic stenosis, and entero-cutaneous fistula. The mean follow-up period was 64.3 months. The univariate analysis revealed no risk factors related to overall complications or prolonged ileus.
Conclusion
The postoperative clinical course and long-term outcomes following stoma takedown were acceptable. Stoma takedown is a procedure that can be performed safely.

Citations

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Predictors of Morbidity and Mortality After Surgery for Intestinal Perforation
Rumi Shin, Sang Mok Lee, Beonghoon Sohn, Dong Woon Lee, Inho Song, Young Jun Chai, Hae Won Lee, Hye Seong Ahn, In Mok Jung, Jung Kee Chung, Seung Chul Heo
Ann Coloproctol. 2016;32(6):221-227.   Published online December 31, 2016
DOI: https://doi.org/10.3393/ac.2016.32.6.221
  • 9,373 View
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  • 36 Web of Science
  • 37 Citations
AbstractAbstract PDF
Purpose

An intestinal perforation is a rare condition, but has a high mortality rate, even after immediate surgical intervention. The clinical predictors of postoperative morbidity and mortality are still not well established, so this study attempted to identify risk factors for postoperative morbidity and mortality after surgery for an intestinal perforation.

Methods

We retrospectively analyzed the cases of 117 patients who underwent surgery for an intestinal perforation at a single institution in Korea from November 2008 to June 2014. Factors related with postoperative mortality at 1 month and other postoperative complications were investigated.

Results

The mean age of enrolled patients was 66.0 ± 15.8 years and 66% of the patients were male. Fifteen patients (13%) died within 1 month after surgical treatment. Univariate analysis indicated that patient-related factors associated with mortality were low systolic and diastolic blood pressure, low serum albumin, low serum protein, low total cholesterol, and high blood urea nitrogen; the surgery-related factor associated with mortality was feculent ascites. Multivariate analysis using a logistic regression indicated that low systolic blood pressure and feculent ascites independently increased the risk for mortality; postoperative complications were more likely in both females and those with low estimated glomerular filtration rates and elevated serum C-reactive protein levels.

Conclusion

Various factors were associated with postoperative clinical outcomes of patients with an intestinal perforation. Morbidity and mortality following an intestinal perforation were greater in patients with unstable initial vital signs, poor nutritional status, and feculent ascites.

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Appendicitis during Pregnancy: The Clinical Experience of a Secondary Hospital
Soo Jung Jung, Do Kyung Lee, Jun Hyun Kim, Pil Sung Kong, Kyung Ha Kim, Sung Woo Bae
J Korean Soc Coloproctol. 2012;28(3):152-159.   Published online June 30, 2012
DOI: https://doi.org/10.3393/jksc.2012.28.3.152
  • 3,727 View
  • 38 Download
  • 20 Citations
AbstractAbstract PDF
Purpose

Appendicitis is the most common condition leading to an intra-abdominal operation for a non-obstetric problem in pregnancy. The aim of this study was to examine our experience and to analyze the clinical characteristics and the pregnancy outcomes for appendicitis during pregnancy that was reported in Korea.

Methods

We reported 25 cases of appendicitis during pregnancy that were treated at Good Moonhwa Hospital from January 2004 to March 2010. We also analyzed appendicitis during pregnancy reported in Korea between 1970 and 2008 by a review of journals.

Results

The incidence of acute appendicitis during pregnancy was one per 568 deliveries. The mean age was 27.92 years old, the gestational stage at the onset of symptoms was the first trimester in 10 patients (40%), the second trimester in 14 patients (56%), and the third trimester in 1 patient (4%). Among the 25 cases, 21 were treated with an open appendectomy and 4 with laparoscopic appendectomies. The postoperative complications were 2 wound infections and 1 spontaneous abortion.

Conclusion

Our experience demonstrated that appendectomies on pregnant patients can be successfully performed at secondary hospitals.

Citations

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    Samet ŞAHİN, Eyüp Murat YILMAZ, Mahir KIRNAP, Ethem BİLGİÇ, Ahmet Ender DEMİRKIRAN
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    A.P. Ukhanov, D.V. Zakharov, S.A. Zhilin, S.V. Bolshakov, K.D. Muminov, Yu.A. Aselderov
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Early Postoperative Complications following a Resection for Colorectal Cancer.
Park, In Ja , Kim, Hee Cheol , Yu, Chang Sik , Kim, Jin Cheon
J Korean Soc Coloproctol. 2005;21(4):213-219.
  • 969 View
  • 12 Download
AbstractAbstract PDF
PURPOSE
Understanding of early postoperative course is very important for planning of operation and postoperative management. However, reports regarding early postoperative complications following colorectal cancer surgery are rare. The aim of this study was to report the incidence of immediate postoperative complications associated with colorectal cancer surgery.
METHODS
This prospective study examined clinicopathological data on 869 patients who underwent a resection for colorectal cancer between November 2002 and October 2003. Patients who underwent a palliative stoma, bypass, or emergent operation were excluded. Early postoperative complications were defined as complications occurring within 30 days of surgery. The male-to-female ratio was 518:351, and the mean age was 59 (range, 18~90) years.
RESULTS
The tumor was located at right colon in 176, at left colon in 169, and at rectum in 510 patients. In 158 patients (18.2%), at least one postoperative complication occurred. The most common complication was ileus (5.5%), followed by wound complication (4.1%), the voiding disturbance (3.3%), anastomotic bleeding (1.4%), anastomotic leakage (1.1%), and bleeding (0.6%). The complication rate was 21.6% in patients with right colon cancer, 16% in those with left colon cancer, and 17.3% in those with rectal cancer. Ileus occurred on mean postoperative day 8 and required a mean of 12 days for resolution. The wound complications occurred on mean postoperative day 9 and were resolved after a mean of 10 days. Of the 8 anastomotic leakage patients, proximal stoma construction was required in 5 patients. Intra-luminal bleeding occurred most common in patients with right colon cancer. Higher frequency of postoperative complications occurred in male patients (P=0.008), patients older than 70 years (P=0.02), and patients with co-morbid medical conditions (P=0.01).
CONCLUSIONS
The overall early postoperative complication rate following colorectal cancer surgery was 18.2%. The postoperative complication rate was higher in male, elderly, and patients with co-morbid medical conditions. Our results have allowed us to identify major complications and to better understand the postoperative course in patients undergoing colorectal cancer resections.
Clinical Features of Intestinal Obstruction after Colorectal Surgery.
Kim, Yeon Sun , Yu, Chang Sik , Lee, Kang Hong , Namgung, Hwan , Kim, Hee Cheol , Kim, Jin Cheon
J Korean Soc Coloproctol. 2003;19(6):354-359.
  • 1,108 View
  • 6 Download
AbstractAbstract PDF
PURPOSE
The purposes of this study are to determine the incidence of postoperative ileus after colorectal surgery, to analyze its clinical features, and to identify the risk factors for its development.
METHODS
We reviewed the cases of 263 patients with mechanical ileus among 3,237 patients who underwent colorectal surgery in our clinic between June 1989 and December 2000.
RESULTS
A total of 263 (8.1%) patients of postoperative ileus were documented, 193 (73.4%) cases occurred during the 1st. year. Postoperative ileus is influenced by the initial site of surgery; the rectum has more impact than the colon (P=0.028). The causes of postoperative ileus were adhesion, recurrence of cancer, and parastomal hernia. Adhesion (81.1%) was the most common cause of ileus, and cancer recurrence (18.0%) was the second. However, in postoperative ileus requiring surgery, cancer recurrence increased with time (2 year: 58.1%). The cases receiving postoperative adjuvant radiation therapy presented a significant increase in the incidence of postoperative ileus (10.3% vs 6.7% P=0.01) and in the requirement for surgical treatment (4.6% vs 2.7%, P=0.04). Patients with a temporary stoma presented a significant increase in the incidence of postoperative ileus than patients with a permanent stoma (P=0.001). The frequency of prior episodes of ileus was the strongest predictor of recurrence.
CONCLUSIONS
There is a high risk of adhesion-related problems after colorectal surgery. The risk factors are associated with rectal surgery, postoperative radiation therapy, and a temporary stoma.
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