Annals of Coloproctology

Display

Sort by :

Original Articles

Anorectal benign disease

Cryotherapy reduces pain post-hemorrhoidectomy (CYPHER): a randomized, controlled, superiority trial of intra-anal ice after surgery for grade III hemorrhoids: Isaac Seow-En, Lionel Raphael Hui Chen, Yun Zhao, Yvonne Ying-Ru Ng, Emile Kwong-Wei Tan; Ann Coloproctol. 2025;41(6):537-544. Published online December 24, 2025; DOI: https://doi.org/10.3393/ac.2025.00549.0078

2,491 View
83 Download

Abstract PDF Supplementary Material: Purpose
We aimed to determine whether intra-anal cryotherapy reduces postoperative pain in patients undergoing hemorrhoidectomy.
Methods
This randomized controlled trial was conducted from January 2023 to August 2024. Patients with symptomatic grade III hemorrhoids were randomized 1:1 to receive either 1 minute of intra-anal cryotherapy or standard postoperative care. Because cryotherapy was applied before reversal of general anesthesia, patients were blinded to treatment allocation. The primary outcome was pain at rest on postoperative day (POD) 1. Secondary outcomes included pain after defecation, time to return to work or non-work activities, 30-day complications, and compliance with analgesia. Pain was measured using the visual analog scale.
Results
A total of 50 patients were randomized (25 per group). All 50 were included in the analysis. Baseline clinicodemographic characteristics were comparable between groups. The primary outcome, POD 1 pain at rest, did not demonstrate superiority of cryotherapy compared with standard care (median 3.0 vs. 4.0, P=0.062). However, the POD 1 pain score after defecation was significantly lower with cryotherapy than without (3.0 vs. 4.0, P=0.046). On POD 2, median pain scores at rest and after defecation were both significantly lower in the cryotherapy cohort (at rest: 2.0 vs. 4.0, P=0.043; after defecation: 2.0 vs. 5.0, P=0.001).
Conclusion
Intra-anal cryotherapy significantly reduces pain after defecation in the early postoperative period following surgery for grade III hemorrhoids. Its therapeutic efficacy, ease of application, and safety support consideration for routine use. Trial registration ClinicalTrials.gov identifier: NCT06005727

ERAS

The efficacy of mosapride on recovery of intestinal motility after elective colorectal cancer surgery: a randomized controlled trial: Tharin Thampongsa, Bensita Saengsawang, Chairat Supsamutchai, Chumpon Wilasrusmee, Jakrapan Jirasiritham, Puvee Punmeechao, Visarat Palitnonkiat, Napaphat Poprom, Pattawia Choikrua, Pongsasit Singhathas; Ann Coloproctol. 2025;41(3):232-238. Published online June 25, 2025; DOI: https://doi.org/10.3393/ac.2024.00892.0127

8,692 View
1,074 Download
1 Web of Science
1 Citations

Abstract PDF Supplementary Material

Purpose
Postoperative ileus is the physiologic hypomotility of the gastrointestinal tract that occurs immediately after abdominal surgery. Mosapride citrate is known to enhance gastrointestinal motility. This study aimed to evaluate mosapride’s impact on postoperative ileus and gastrointestinal motility in patients undergoing elective colorectal surgery.
Methods
Forty-four patients with colorectal cancer undergoing surgery at Ramathibodi Hospital between July 2021 and August 2022 were randomly assigned to either a mosapride group or a control group. The mosapride group received 5 mg of mosapride via the enteric route with 50 mL of water 3 times daily, beginning on postoperative day 1, while the control group received 5 mg of a placebo with 50 mL of water on the same schedule. A single investigator, blinded to the treatment assignments in this triple-blind study, evaluated the postoperative time to the first bowel movement and passage of flatus. Secondary outcomes included the time to step diet, length of postoperative hospital stay, and adverse effects.
Results
There were 23 patients in the control group and 21 in the mosapride group. There were no significant differences in baseline patient characteristics between the 2 groups. The mosapride group demonstrated significantly shorter times to the first bowel movement (26 hours vs. 50 hours, P=0.004) and passage of flatus (40 hours vs. 70 hours, P=0.003).
Conclusion
Mosapride significantly improved the recovery of gastrointestinal motility and reduced the length of hospital stay without causing any serious adverse effects in patients undergoing elective colorectal surgery. Trial registration: ClinicalTrials.gov identifier: NCT04905147

Citations

Citations to this article as recorded by

Mosapride versus Metoclopramide in Critically Ill Patients with Enteral Feeding Intolerance: A Randomized, Double-Blinded Comparison
Eman Mohamed Elmokadem, Dina Khaled Abou El Fadl, Ahmed Bassiouny, Amir Hanna Samy, Nouran Omar El Said
Drug Design, Development and Therapy.2026; Volume 20: 1. CrossRef

Anorectal benign disease

A comparative study on efficacy and safety of modified partial stapled hemorrhoidopexy versus conventional hemorrhoidectomy: a prospective randomized controlled trial: Tae Gyu Kim, Chul Seung Lee, Dong Geun Lee, Choon Sik Chung, Seung Han Kim, Sang Hwa Yu, Jeong Eun Lee, Gwan Cheol Lee, Dong Woo Kang, Jeong Sub Kim, Gyu Young Jeong; Ann Coloproctol. 2025;41(2):145-153. Published online April 28, 2025; DOI: https://doi.org/10.3393/ac.2024.00535.0076

5,702 View
132 Download
1 Citations

Abstract PDF Supplementary Material

Purpose
The long-term outcomes and efficacy of partial stapled hemorrhoidopexy (PSH) compared with those of conventional hemorrhoidectomy (CH) are not fully understood. This study aimed to introduce a modified PSH (mPSH) and compare its clinical efficacy and safety with those of CH.
Methods
A prospective randomized controlled trial was conducted. This study was performed at a single hospital and involved 6 colorectal surgeons. In total, 110 patients were enrolled between July 2019 and September 2020. Patients were randomly assigned to undergo either mPSH group (n=55) or CH group (n=55). The primary outcome was to compare postoperative average pain and postoperative peak pain using visual analog scale score between the 2 groups.
Results
The required duration of analgesia was shorter in the mPSH group than in the CH group, although the difference was not statistically significant (P=0.096). However, the laxative requirement duration (P<0.010), return to work (P<0.010), satisfaction score (P<0.010), and Vaizey score (P=0.014) were significantly better in the mPSH group. The average and peak postoperative pain scores were significantly lower in the mPSH group during the 15 days after surgery (P<0.001). The overall complication rate in both groups was 9.1%, with no significant difference between the groups (P=0.867).
Conclusion
The mPSH group demonstrated better improvement in symptoms, lower pain scores, and greater patient early satisfaction after surgery than the CH group. Therefore, this surgical technique appears to be a safe and effective alternative for CH.

Citations

Citations to this article as recorded by

Ligasure versus voyant hemorrhoidectomy: comparison of 30-day postoperative complications
Fabio MARINO, Rossella DONGHIA
Minerva Surgery.2026;[Epub] CrossRef

Benign proctology

Prospective Comparative Analysis of the Incidence of Vasovagal Reaction and the Effect of Rectal Submucosal Lidocaine Injection in Stapled Hemorrhoidopexy: A Randomized Controlled Trial: Kyung Jin Cho, Do Yeon Hwang, Hyun Joo Lee, Ki Hoon Hyun, Tae Jung Kim, Duk Hoon Park; Ann Coloproctol. 2020;36(5):344-348. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2020.02.12

6,416 View
162 Download
2 Web of Science
4 Citations

Abstract PDF

Purpose
This study was performed to evaluate the incidence of vasovagal reactions (VVRs) and the efficacy of lidocaine injection for prevention.
Methods
One hundred seventeen patients diagnosed with hemorrhoids and scheduled to undergo a stapled hemorrhoidopexy (SH) were randomly divided according to submucosal injection to the rectum: lidocaine group (n = 53, lidocaine injected just before full closure of the stapler) and control group (n = 58). Outcomes included baseline patient characteristics (American Society of Anesthesiologists physical status classification, body mass index, diabetes mellitus, hypertension, and previous VVR history), vital signs during the operation, incidence of VVRs (hypotension, bradycardia, dizziness, diaphoresis, and nausea/vomiting), and postoperative complications (pain, bleeding, and urinary retention).
Results
Baseline characteristics were similar between groups. The number of patients with lower abdominal pain after firing the stapler and incidence of dizziness were lower for the lidocaine group than for the control group (9.4% vs. 25.9%, P = 0.017; 0% vs. 8.6%, P = 0.035, respectively). However, there were no significant between-group differences in incidence of nausea and diaphoresis (0% vs. 3.4%, P = 0.172) and syncope (1.9% vs. 3.4%, P = 0.612). Fewer patients in the lidocaine group complained of postoperative pain (41.5% vs. 58.6%, P = 0.072), and these patients used analgesics less frequently than those in the control group (28.3% vs. 36.2%, P = 0.374).
Conclusion
Patients who received a submucosal lidocaine injection prior to SH experienced less lower abdominal pain and dizziness compared with those who received standard treatment. A larger, more detailed prospective study is needed for further analysis.

Citations

Citations to this article as recorded by

Reducing Pain, Spasm, and Vasovagal Syndrome in Transradial Cardiac Angiography: The Role of Lidocaine Cream and Injectable Lidocaine
Behrang Bahreini, Saeed Alipour Parsa, Vahid Eslami, Mohammad Khani, Abdolhamid Bagheri
International Journal of Cardiovascular Practice.2024;[Epub] CrossRef
PROSPECT guideline for haemorrhoid surgery
Alexis Bikfalvi, Charlotte Faes, Stephan M. Freys, Girish P. Joshi, Marc Van de Velde, Eric Albrecht
European Journal of Anaesthesiology Intensive Care.2023; 2(3): e0023. CrossRef
Treatment of Hemorrhoid in Unusual Condition-Pregnancy
Hyo Seon Ryu
The Ewha Medical Journal.2022;[Epub] CrossRef
The Effort to Reduce Vasovagal Reaction and Abdominal Pain During Stapled Hemorrhoidopexy
Hyeonseok Jeong
Annals of Coloproctology.2020; 36(5): 291. CrossRef

First
Prev
Page of 1
Next
Last

Search