Annals of Coloproctology

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Original Article

ERAS

Early urinary catheter removal in patients undergoing rectal cancer surgery: a randomized controlled trial on silodosin versus no pharmacological treatment on urinary function in the early postoperative period: Žilvinas Gricius, Justas Kuliavas, Eugenijus Stratilatovas, Bronius Buckus, Audrius Dulskas; Ann Coloproctol. 2025;41(3):239-245. Published online June 20, 2025; DOI: https://doi.org/10.3393/ac.2024.00703.0100

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Purpose
This study aimed to evaluate the efficacy of the α1 adrenergic receptor antagonist silodosin in preventing lower urinary tract symptoms after rectal cancer surgery.
Methods
We conducted a 2-arm, double-blind, single-center randomized controlled trial. The study included 150 patients with rectal cancer who underwent radical surgery between 2019 and 2022. On the first postoperative day, the urinary catheter was removed for all patients. Of these, 100 patients were administered silodosin, while 50 patients (control group) receive placebo (glucose tablet). Urinary dysfunction (urinary retention, infection, dysuria) and other complications were monitored.
Results
Among the 150 patients, 84 (56.0%) were male and 66 (44.0%) were female. Surgical procedures included abdominoperineal resection in 33 patients, partial mesorectal excision in 45, and total mesorectal excision in 72. A laparoscopic approach was used in 69 patients, while the remaining 81 underwent open surgery. Urinary tract symptoms developed in 10 patients (6.7%): 7 (7.0%) in the silodosin group and 3 (6.0%) in the control group (P=0.92). In the silodosin group, there was 1 case (1.0%) of urinary retention, 3 cases (3.0%) of urinary tract infection, and 3 cases (3.0%) of dysuria. In the control group, there was 1 case (2.0%) each of urinary retention, urinary tract infection, and dysuria (all P=0.92).
Conclusion
Early urinary catheter removal on the first postoperative day was safe in both groups. The use of the oral α-antagonist silodosin did not provide additional benefits in preventing lower urinary tract symptoms in patients undergoing rectal cancer surgery. Trial registration: ClinicalTrials.gov identifier: NCT03607370

Citations

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Less is more: simplifying patient-centered cancer care
In Ja Park
Annals of Coloproctology.2025; 41(3): 173. CrossRef

Video

Minimally invasive surgery

Robotic abdominoperineal resection, bilateral robotic groin node dissection and simultaneous perineal gracilis flap reconstruction for locally advanced node-positive anal squamous cell carcinoma: Mohammed Ali, Melanie Holzgang, Vivekanandan Kumar, Dhalia Masud, Sandeep Kapur, Ahmed El-Hadi, Dolly Dowsett, Irshad Shaikh; Ann Coloproctol. 2024;40(6):613-615. Published online December 2, 2024; DOI: https://doi.org/10.3393/ac.2023.00801.0114

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Review

Colorectal cancer

Dissection layer selection based on an understanding of pelvic fascial anatomy in transanal total mesorectal excision: Daichi Kitaguchi, Masaaki Ito; Ann Coloproctol. 2024;40(4):375-383. Published online August 30, 2024; DOI: https://doi.org/10.3393/ac.2024.00178.0025

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Abstract PDF

This study aimed to review the historical transition of rectal cancer surgery and recent evidence regarding transanal total mesorectal excision (TaTME). Additionally, it outlined the anatomical landmarks and technical considerations essential for successful TaTME. Anatomical studies and surgical techniques were analyzed to identify key landmarks and procedural steps crucial for TaTME. TaTME offers improved visibility and maneuverability even in the deep and narrow pelvis and is expected to contribute to tumor radical cure rates. By securing the circumferential resection margin and distal margin while preserving pelvic autonomic nerve function, TaTME holds promise for maintaining postoperative urinary and sexual functions. Key anatomical landmarks include the endopelvic fascia posteriorly, the S4-pelvic splanchnic nerve laterally, and the prostate or posterior vaginal wall anteriorly. Selecting the appropriate dissection layer based on tumor depth and ensuring precise incision of the tendinous arch of the pelvic fascia contributes to successful TaTME outcomes. TaTME represents a significant advancement in rectal cancer surgery, offering improved outcomes through meticulous attention to anatomical detail and precise dissection techniques. Understanding the historical context of rectal cancer surgery alongside recent evidence on TaTME is essential for optimizing patient outcomes and expanding the safe implementation of this innovative approach.

Citations

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From the Editor: Uniting expertise, a new era of global collaboration in coloproctology
In Ja Park
Annals of Coloproctology.2024; 40(4): 285. CrossRef
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

Technical Note

Technical tips

Introduction of extraperitoneal tunneling method: a way to secure the drain tube in the pelvic cavity after proctectomy: Sung Il Kang, Sohyun Kim, Jae Hwang Kim; Ann Coloproctol. 2024;40(2):182-185. Published online March 25, 2024; DOI: https://doi.org/10.3393/ac.2023.00073.0010

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Abstract PDF: The effectiveness of closed drainage tube insertion after low anterior resection has been controversial. We believe that drain tube displacement, which occurs up to 35% in real clinical practice, reduces the effectiveness of the drain tube. We report in this video a simple way to secure the drain tube in the pelvic cavity after low anterior resection and introduce a case that used the drain fixation method and treated anastomotic leakage without interventional procedure.

Original Articles

Colorectal cancer

Partial mesorectal excision can be a primary option for middle rectal cancer: a propensity score–matched retrospective analysis: Ee Jin Kim, Chan Wook Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2024;40(3):253-267. Published online March 31, 2023; DOI: https://doi.org/10.3393/ac.2022.00689.0098

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Abstract PDF

Purpose
Although partial mesorectal excision (PME) and total mesorectal excision (TME) is primarily indicated for the upper and lower rectal cancer, respectively, few studies have evaluated whether PME or TME is more optimal for middle rectal cancer.
Methods
This study included 671 patients with middle and upper rectal cancer who underwent robot-assisted PME or TME. The 2 groups were optimized by propensity score matching of sex, age, clinical stage, tumor location, and neoadjuvant treatment.
Results
Complete mesorectal excision was achieved in 617 of 671 patients (92.0%), without showing a difference between the PME and TME groups. Local recurrence rate (5.3% vs. 4.3%, P>0.999) and systemic recurrence rate (8.5% vs. 16.0%, P=0.181) also did not differ between the 2 groups, in patients with middle and upper rectal cancer. The 5-year disease-free survival (81.4% vs. 74.0%, P=0.537) and overall survival (88.0% vs. 81.1%, P=0.847) also did not differ between the PME and TME groups, confined to middle rectal cancer. Moreover, 5-year recurrence and survival rates were not affected by distal resection margins of 2 cm (P=0.112) to 4 cm (P>0.999), regardless of pathological stages. Postoperative complication rate was higher in the TME than in the PME group (21.4% vs. 14.5%, P=0.027). Incontinence was independently associated with TME (odds ratio [OR], 2.009; 95% confidence interval, 1.015–3.975; P=0.045), along with older age (OR, 4.366, P<0.001) and prolonged operation time (OR, 2.196; P=0.500).
Conclusion
PME can be primarily recommended for patients with middle rectal cancer with lower margin of >5 cm from the anal verge.

Citations

Citations to this article as recorded by

Review of definition and treatment of upper rectal cancer
Elias Karam, Fabien Fredon, Yassine Eid, Olivier Muller, Marie Besson, Nicolas Michot, Urs Giger-Pabst, Arnaud Alves, Mehdi Ouaissi
Surgical Oncology.2024; 57: 102145. CrossRef
Tumour-specific mesorectal excision for rectal cancer: Systematic review and meta-analysis of oncological and functional outcomes
Fabio Carbone, Wanda Petz, Simona Borin, Emilio Bertani, Stefano de Pascale, Maria Giulia Zampino, Uberto Fumagalli Romario
European Journal of Surgical Oncology.2023; 49(11): 107069. CrossRef

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

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6 Citations

Abstract 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

Gut microbiome and plasma metabolome alterations in ileostomy and after closure of ileostomy
Liang Xu, Xiaolong Li, Lang Chen, Haitao Ma, Ying Wang, Wenwen Liu, Anyan Liao, Liang Tan, Xiao Gao, Weidong Xiao, Hua Yang, Guangyan Ji, Yuan Qiu, Wei-Hua Chen, Qin Liu, Song Liu, Yang Yang
Microbiology Spectrum.2025;[Epub] CrossRef
Effect of one-stitch method of temporary ileostomy on the surgical outcomes and complications after laparoscopic low anterior resection in rectal cancer patients: a propensity score matching analysis
Xin-Peng Shu, Jia-Liang Wang, Zi-Wei Li, Fei Liu, Xu-Rui Liu, Lian-Shuo Li, Yue Tong, Xiao-Yu Liu, Chun-Yi Wang, Yong Cheng, Dong Peng
European Journal of Medical Research.2025;[Epub] CrossRef
The Differences in Postoperative Nursing Between Temporary Ileostomy and Temporary Colostomy: A Retrospective Cohort Study
Mei Wang, Lihong Dai, Xia Fang, Yan Zheng, Yuanhao Shen, Yang Yu
Nursing Open.2025;[Epub] CrossRef
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

The pattern of bowel dysfunction in patients with rectal cancer following the multimodal treatment: anorectal manometric measurements at before and after chemoradiation therapy, and postoperative 1 year: Ri Na Yoo, Bong-Hyeon Kye, HyungJin Kim, Gun Kim, Hyeon-Min Cho; Ann Coloproctol. 2023;39(1):32-40. Published online March 11, 2022; DOI: https://doi.org/10.3393/ac.2021.00696.0099

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Graphical Abstract Abstract PDF

Purpose
Bowel dysfunction commonly occurs in patients with locally advanced rectal cancer treated with a multimodal approach of chemoradiation therapy (CRT) combined with sphincter-preserving rectal resection. This study investigated the decline in anorectal function using sequential anorectal manometric measurements obtained before and after the multimodal treatment as well as at a 1-year follow-up.
Methods
This was a retrospective cohort study conducted in a single center. The study population consisted of patients with locally advanced mid- to low rectal cancer who received the preoperative CRT followed by sphincter-preserving surgery from 2012 to 2016. The anorectal manometric value measured after each treatment modality was compared to demonstrate the degree of decline in anorectal function. A generalized linear model of repeated measures was performed using the manometric values measured pre- and post-CRT, and at 12 months postoperatively.
Results
Overall, 100 patients with 3 consecutive manometric data were included in the final analysis. In the overall cohort study, the mean resting and maximal squeezing pressures showed insignificant decrement post-neoadjuvant CRT. At a 1-year postoperative follow-up, the maximal squeezing pressure significantly decreased. The maximal rectal sensory threshold demonstrated significant reduction consecutively after each following treatment (P<0.001).
Conclusion
The short-term effect of neoadjuvant CRT on the anal sphincters was relatively trivial. The following sphincter-saving surgery resulted in a profound disruption of the anorectal function. Patients with rectal cancer should be consulted on the consequence of multimodal treatment.

Citations

Citations to this article as recorded by

Beyond survival: a comprehensive review of quality of life in rectal cancer patients
Won Beom Jung
Annals of Coloproctology.2024; 40(6): 527. CrossRef
Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
Annals of Surgical Treatment and Research.2023; 105(6): 341. CrossRef

Review

Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer

Surgical Treatment of Low-Lying Rectal Cancer: Updates: Cristopher Varela, Nam Kyu Kim; Ann Coloproctol. 2021;37(6):395-424. Published online December 22, 2021; DOI: https://doi.org/10.3393/ac.2021.00927.0132

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51 Citations

Abstract PDF

Despite innovative advancements, distally located rectal cancer remains a critical disease of challenging management. The crucial location of the tumor predisposes it to a circumferential resection margin (CRM) that tends to involve the anal sphincter complex and surrounding organs, with a high incidence of delayed anastomotic complications and the risk of the pelvic sidewall or rarely inguinal lymph node metastases. In this regard, colorectal surgeons should be aware of other issues beyond total mesorectal excision (TME) performance. For decades, the concept of extralevator abdominoperineal resection to avoid compromised CRM has been introduced. However, the complexity of deep pelvic dissection with poor visualization in low-lying rectal cancer has led to transanal TME. In contrast, neoadjuvant chemoradiotherapy (NCRT) has allowed for the execution of more sphincter-saving procedures without oncologic compromise. Significant tumor regression after NCRT and complete pathologic response also permit applying the watch-and-wait protocol in some cases, now with more solid evidence. This review article will introduce the current surgical treatment options, their indication and technical details, and recent oncologic and functional outcomes. Lastly, the novel characteristics of distal rectal cancer, such as pelvic sidewall and inguinal lymph node metastases, will be discussed along with its tailored and individualized treatment approach.

Citations

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Current Problems in Surgery.2025; 63: 101694. CrossRef
Comparative efficacy analysis of laparoscopic-assisted transanal total mesorectal excision vs laparoscopic transanal mesorectal excision for low-lying rectal cancer
Feng Lu, Shu-Guang Tan, Juan Zuo, Hai-Hua Jiang, Jian-Hua Wang, Yu-Ping Jiang
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Risk factors influencing sphincter preservation in laparoscopic radical rectal cancer surgery
Jia-Rui Liu, Jin Zhang, Xiang-Long Duan
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Clinical using of innovative biodegradable stent with extension sleeve in Ta_tme for low rectal cancer with high risk of anastomotic leakage
Rongrong Hao, Wensheng Wang, Yuanhang Ma, Jianghong Chen, Yunbo Li, Yang Yang, Dan Ma, Zhicao Zhang
Scientific Reports.2025;[Epub] CrossRef
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Engeng Chen, Li Chen, Wei Zhang
Frontiers in Oncology.2025;[Epub] CrossRef
Radiomic Features of Mesorectal Fat as Indicators of Response in Rectal Cancer Patients Undergoing Neoadjuvant Therapy
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Tomography.2025; 11(4): 44. CrossRef
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Rui Sang, Sheri Nixdorf, Tzongtyng Hung, Carl Power, Fei Deng, Thuy Anh Bui, Alexander Engel, Ewa M. Goldys, Wei Deng
eBioMedicine.2025; 116: 105724. CrossRef
MRI Monitoring of Locally Advanced Rectal Cancer in Watch and Wait Patients
Jian Zhao, Kanghua Huang, Akao Zhu, Jinghan Zhu, Yimin Fang, Xiaofeng Zhou, Hao Jiang, Li Shen, Haiyan Chen
Clinical Colorectal Cancer.2025;[Epub] CrossRef
Real‐World Long‐Term Outcomes of Operated and Non‐Operated Rectal Cancer in the Elderly: A 14‐Year Retrospective Multicentre Study
Harun Demir, Gül Kanyılmaz, İbrahim Babalıoğlu, Bedriye Doğan, Meryem Aktan, Berrin Benli Yavuz, Ayşe Sümeyye Safi
Journal of Medical Imaging and Radiation Oncology.2025;[Epub] CrossRef
Sagittal FOCUS-MUSE Diffusion-weighted Imaging MRI Improves the Accuracy of Rectal Cancer Location: A Prospective Observational Study
Jingjing Liu, Wei Sun, Shujie Zhang, Gengyun Miao, Lamei Deng, Mengsu Zeng, Liheng Liu
Academic Radiology.2025;[Epub] CrossRef
Personalized Treatment Modalities for Rectal Cancer: Advances in Neoadjuvant Treatment
Nussara Pakvisal, Leontios Pappas, Bennett A. Caughey, Rocco Ricciardi, Aparna Parikh
Journal of Clinical Medicine.2025; 14(13): 4411. CrossRef
Elderly Rectal Cancer: An Updated Review
Chih-Kai Huang, Chi-Hsiu Shih, Yung-Shuo Kao
Current Oncology Reports.2024; 26(2): 181. CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Robotic-Assisted versus Laparoscopic Surgery for Rectal Cancer: An Analysis of Clinical and Financial Outcomes from a Tertiary Referral Center
Jasper Max Gebhardt, Neno Werner, Andrea Stroux, Frank Förster, Ioannis Pozios, Claudia Seifarth, Christian Schineis, Benjamin Weixler, Katharina Beyer, Johannes Christian Lauscher
Journal of Clinical Medicine.2024; 13(6): 1795. CrossRef
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Islam Abdelkhalek, Galal AbuElnagah, Tarek Elfayoumi, Ahmed shoukry Hafez, Mohamed Asal
Alexandria Journal of Medicine.2024; 60(1): 113. CrossRef
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Inkeon Yeo, Myung-Won Yoo, Seong Jin Park, Sung Kyoung Moon
Journal of the Korean Society of Radiology.2024; 85(4): 727. CrossRef
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Ly Huu Phu, Ho Tat Bang, Ung Van Viet, Hoang Danh Tan, Nguyen Trung Tin
Cureus.2024;[Epub] CrossRef
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Annals of Gastroenterological Surgery.2024; 8(5): 761. CrossRef
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Hyeung-min Park, Jaram Lee, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
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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
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Chenxiong Zhang, Hao Tan, Han Xu, Jiaming Ding
International Journal of Surgery.2024; 110(10): 6282. CrossRef
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American Journal of Cancer Research.2024; 14(12): 5784. CrossRef
Pathologic Implications of Magnetic Resonance Imaging-detected Extramural Venous Invasion of Rectal Cancer
Hyun Gu Lee, Chan Wook Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
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In Ja Park
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Robotic surgery for colorectal cancer
Sung Uk Bae
Journal of the Korean Medical Association.2022; 65(9): 577. CrossRef
Current Status and Future of Robotic Surgery for Colorectal Cancer-An English Version
Sung Uk Bae
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Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
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Seung Mi Yeo, Gyung Mo Son
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Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
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Chan Wook Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
The watch-and-wait strategy versus radical resection for rectal cancer patients with a good response (≤ycT2) after neoadjuvant chemoradiotherapy
Chungyeop Lee, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
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It Is a Pleasure to Announce the Issue Titled “Master Class 2021” in Annals of Coloproctology
In Ja Park
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Technical Note

Malignant disease, Rectal cancer,Minimally invasive surgery

Single-port robot-assisted abdominoperineal resection: a case review of the first four experiences: Moon Suk Choi, Seong Hyeon Yun, Jung Kyong Shin, Yoon Ah Park, Jung Wook Huh, Yong Beom Cho, Hee Cheol Kim, Woo Yong Lee; Ann Coloproctol. 2022;38(1):88-92. Published online October 18, 2021; DOI: https://doi.org/10.3393/ac.2021.00395.0056

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6 Citations

Abstract PDF

Recently, abdominoperineal resection (APR) using a robot has been demonstrated in other studies. However, there has been no report on APR for rectal cancer using the single-port robot (SPR) platform. In response to this research gap, we described the clinical experience of APR using a SPR. From April 2019 to March 2020, APR using a SPR platform was performed in a total of 4 patients. Three patients had a transumbilical approach, and 1 patient had a transstoma site approach. The average operation time was 307 minutes, and the patient docking time to the SPR platform was 133.5 minutes. There were no complications during the operation, and no laparoscopy or open conversion. No reoperation occurred within 30 days. Mild postoperative complications occurred in 2 patients. We found that APR has safety and feasibility in surgery using an SPR platform. There was no intraoperative event and severe postoperative complications.

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Chul Seung Lee, Gwan Chul Lee, Choon Sik Chung, Dong Keun Lee
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Evaluation of the da Vinci single-port system in colorectal cancer surgery: a scoping review
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H. S. Kim, B.-Y. Oh, C. Cheong, M. H. Park, S. S. Chung, R.-A. Lee, K. H. Kim, G. T. Noh
Techniques in Coloproctology.2023; 27(7): 589. CrossRef
Short-term outcomes of single-incision robotic colectomy versus conventional multiport laparoscopic colectomy for colon cancer
Ho Seung Kim, Bo-Young Oh, Soon Sup Chung, Ryung-Ah Lee, Gyoung Tae Noh
Journal of Robotic Surgery.2023; 17(5): 2351. CrossRef
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Journal of Robotic Surgery.2023; 17(6): 2911. CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef

Original Articles

Malignant disease, Rectal cancer, Functional outcomes,Colorectal cancer

The Effect of Anastomotic Leakage on the Incidence and Severity of Low Anterior Resection Syndrome in Patients Undergoing Proctectomy: A Propensity Score Matching Analysis: Sungjin Kim, Sung Il Kang, So Hyun Kim, Jae-Hwang Kim; Ann Coloproctol. 2021;37(5):281-290. Published online June 7, 2021; DOI: https://doi.org/10.3393/ac.2021.03.15

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21 Citations

Abstract PDF

Purpose
Proctectomy for the treatment of rectal cancer results in inevitable changes to bowel habits. Symptoms such as fecal incontinence, constipation, and tenesmus are collectively referred to as low anterior resection syndrome (LARS). Among the several risk factors that cause LARS, anastomotic leakage (AL) is a strong risk factor for permanent stoma formation. Therefore, the purpose of this study was to investigate the relationship between the severity of LARS and AL in patients with rectal cancer based on the LARS score and the Memorial Sloan Kettering Cancer Center (MSKCC) defecation symptom questionnaires.
Methods
We retrospectively analyzed patients who underwent low anterior resection for rectal cancer since January 2010. Patients who completed the questionnaire were classified into the AL group and control group based on medical and imaging records. Major LARS and MSKCC scores were analyzed as primary endpoints.
Results
Among the 179 patients included in this study, 37 were classified into the AL group. After propensity score matching, there were significant differences in the ratio of major LARS and MSKCC scores of the control group and AL group (ratio of major LARS: 11.1% and 37.8%, P<0.001; MSKCC score: 67.29±10.4 and 56.49±7.2, respectively, P<0.001). Univariate and multivariate analyses revealed that AL was an independent factor for major LARS occurrence and MSKCC score.
Conclusion
This study showed that AL was a significant factor in the occurrence of major LARS and defecation symptoms after proctectomy.

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Repeated Treatments for Chronic Colorectal and Coloanal Anastomotic Leaks are Associated With a Higher Chance of a Permanent Stoma
Justin Dourado, Sameh Hany Emile, Anjelli Wignakumar, Brett Weiss, Nir Horesh, Victoria DeTrolio, Rachel Gefen, Zoe Garoufalia, Peter Rogers, Victor Strassmann, Steven D. Wexner
The American Surgeon™.2025;[Epub] CrossRef
The effect of robotic surgery on low anterior resection syndrome in patients with lower rectal cancer: a propensity score-matched analysis
Lei Zhang, Chenhao Hu, Jiamian Zhao, Chenxi Wu, Zhe Zhang, Ruizhe Li, Ruihan Liu, Junjun She, Feiyu Shi
Surgical Endoscopy.2024; 38(4): 1912. CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Innovációk a colorectalis sebészetben
Balázs Bánky, András Fülöp, Viktória Bencze, Lóránd Lakatos, Petra Rozman, Attila Szijártó
Orvosi Hetilap.2024; 165(2): 43. CrossRef
Early detection of anastomotic leakage in colon cancer surgery: the role of early warning score and C-reactive protein
Gyung Mo Son
Annals of Coloproctology.2024; 40(5): 415. CrossRef
The Diagnosis and Evolution of Patients with LARS Syndrome: A Five-Year Retrospective Study from a Single Surgery Unit
Cosmin Vasile Obleagă, Sergiu Marian Cazacu, Tiberiu Ștefăniță Țenea Cojan, Cecil Sorin Mirea, Dan Nicolae Florescu, Cristian Constantin, Mircea-Sebastian Șerbănescu, Mirela Marinela Florescu, Liliana Streba, Dragoș Marian Popescu, Ionică Daniel Vîlcea, M
Cancers.2024; 16(24): 4175. CrossRef
Low anterior resection syndrome after radical surgical treatment of rectal cancer: interim results of a multicenter interuniversity clinical trial
A. A. Zakharenko, M. A. Belyaev, A. A. Trushin, A. A. Svechkova, I. A. Paltyshev, A. Kh. Khamid, O. A. Ten, T. V. Kupenskaya, M. V. Zavgorodnyaya, I. A. Filatova, F. Ya. Dzhafarzadeh, K. I. Vladimirova, N. M. Guseinova, L. A. Khamid, Ya. O. Baskova, Z. U.
The Scientific Notes of the Pavlov University.2024; 31(4): 55. CrossRef
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Angelina Di Re, Salam Tooza, Jason Diab, Charbel Karam, Mina Sarofim, Kevin Ooi, Catherine Turner, Daniel Kozman, David Blomberg, Matthew Morgan
Annals of Coloproctology.2023; 39(5): 395. CrossRef
The status of low anterior resection syndrome: data from a single-center in China
Jing Su, Qianhui Liu, Dagui Zhou, Xiaofeng Yang, Guiru Jia, Lijun Huang, Xiao Tang, Jiafeng Fang
BMC Surgery.2023;[Epub] CrossRef
Low anterior resection syndrome: is it predictable?
Dong Hyun Kang
Annals of Coloproctology.2023; 39(5): 373. CrossRef
Validation of low anterior resection syndrome score in Brazil with Portuguese
Kelly C.L.R. Buzatti, Andy Petroianu, Søren Laurberg, Rodrigo G. Silva, Beatriz D.S. Rodrigues, Peter Christensen, Antonio Lacerda-Filho, Therese Juul
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Jeonghee Han
The Ewha Medical Journal.2023;[Epub] CrossRef
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Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef
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N. J. O’Sullivan, H. C. Temperley, T. S. Nugent, E. Z. Low, D. O. Kavanagh, J. O. Larkin, B. J. Mehigan, P. H. McCormick, M. E. Kelly
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Mingfang Yan, Zhenmeng Lin, Zhiying Wu, Huizhe Zheng, Meiqin Shi
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The Ewha Medical Journal.2022;[Epub] CrossRef
The watch-and-wait strategy versus radical resection for rectal cancer patients with a good response (≤ycT2) after neoadjuvant chemoradiotherapy
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Clinical Outcome of a Rectovaginal Fistula in Crohn's Disease.: Chung, Choon Sik , Lee, Dong Keun , George, Bruce D , Mortensen, Neil J; J Korean Soc Coloproctol. 2007;23(1):10-15.; DOI: https://doi.org/10.3393/jksc.2007.23.1.10

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3 Citations

Abstract PDF

PURPOSE
The aim of this study is to analyze the outcome of a variety of treatments, including local surgical treatments, diverting stoma, and combined medical therapy, for patients with a rectovaginal fistula complicating Crohn's disease.
METHODS
Between 1994 and 2003, twenty-one patients with a rectovaginal fistula complicating Crohn's disease from a prospectively compiled 422-patient Crohn's disease database were reviewed.
RESULTS
All three patients treated by seton and fibrin glue recurred despite having relatively long tracts. Of six patients with infliximab treatment combined with a seton procedure, five patients had an improvement of their symptoms, but were not cured. Of eight patients with a transanal or endovaginal advancement flap techniques, three had successful closure, three eventually required a proctectomy, and two had a recurrent fistula without symptoms. Four (2 without any local treatments, and 2 with seton placement) of 16 patients who had a diverting stoma during treatment had successful closure. All proctectomy patients (n=8) had rectal involvement of Crohn's disease. Two patients who underwent a proctectomy with a presumptive diagnosis of ulcerative colitis and indeterminate colitis turned out to have Crohn's disease. Overall, except for the proctectomy patients, seven patients (54%) had successful closure, but six (four without symptoms, and two with symptoms) following a wide spectrum of treatments had recurrence after a mean follow-up of 44 months.
CONCLUSIONS
Combining different treatments for a rectovaginal fistula in Crohn's disease can be successful in a reasonable number of cases. The presence of uncontrolled perianal sepsis and/or complicated anorectal problems is likely to lead to a proctectomy.

Citations

Citations to this article as recorded by

Guidelines for the Management of Crohn's Disease
Byong Duk Ye, Suk-Kyun Yang, Sung Jae Shin, Kang Moon Lee, Byung Ik Jang, Jae Hee Cheon, Chang Hwan Choi, Young-Ho Kim, Heeyoung Lee
Intestinal Research.2012; 10(1): 26. CrossRef
Guidelines for the Management of Crohn's Disease
Byong Duk Ye, Suk-Kyun Yang, Sung Jae Shin, Kang Moon Lee, Byung Ik Jang, Jae Hee Cheon, Chang Hwan Choi, Young-Ho Kim, Heeyoung Lee
The Korean Journal of Gastroenterology.2012; 59(2): 141. CrossRef
Long-term results in the treatment of fistula-in-ano with fibrin glue: a prospective study
Göktürk Maralcan, İlyas Başkonuş, Avni Gökalp, Ersin Borazan, Ahmet Balk
Journal of the Korean Surgical Society.2011; 81(3): 169. CrossRef

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