Annals of Coloproctology

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Original Article

Anorectal physiology & pelvic floor disorder

Laparoscopic ventral mesh rectopexy with and without transverse perineal support using biological mesh for rectal prolapse and perineal descent: postoperative course and functional outcomes: Maria Clelia Gervasi, Giorgio Brancato, Lorenzo Crepaz, Ahmad Tfaily, Alberto Di Leo; Ann Coloproctol. 2025;41(5):453-461. Published online October 28, 2025; DOI: https://doi.org/10.3393/ac.2025.00080.0011

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Abstract PDF Supplementary Material: Purpose
Laparoscopic ventral mesh rectopexy (LVMR) is effective for the treatment of rectal prolapse. However, descending perineal syndrome may impair the outcomes of LVMR. The aim of this study was to assess the safety and functional outcomes of LVMR performed with and without transverse perineal support (TPS).
Methods
This was a retrospective study of 143 consecutive female patients treated with LVMR with or without TPS between 2018 and 2022. Patients with rectal prolapse and perineal descent who underwent surgery were included. Obstructed defecation syndrome and fecal incontinence were evaluated using the Cleveland Constipation Score (Wexner score) and St. Mark’s Incontinence Score, respectively. Perineal descent was defined using defecography. Biological meshes were utilized in all cases.
Results
No significant differences were recorded between with- and without-TPS groups at baseline. TPS was performed in 110 patients (76.9%). Surgical morbidity was higher in the with-TPS group (12.7% vs. 0%, P=0.047), primarily due to seroma formation. Almost all complications were mild (Clavien-Dindo grades I–II). In both groups, digital aid for defecation (P<0.001), prolonged straining (P=0.004), and hematochezia (P<0.001) nearly disappeared postoperatively, though constipation and laxative/enema use persisted in 22.4%. Fecal incontinence significantly decreased from 43.4% to 11.2% (P<0.001). TPS appears to have a potentially favorable effect in reducing the constipation score. Both constipation and incontinence scores remained low up to 24 months after surgery. Operative time was significantly longer in the LVMR with-TPS group (P<0.001).
Conclusion
LVMR with TPS appears safe and feasible. TPS may provide better surgical outcomes compared to LVMR alone for patients with symptomatic rectoceles and descending perineum syndrome.

Review

Colorectal cancer

The role of lateral pelvic lymph node dissection in advanced rectal cancer: a review of current evidence and outcomes: Gyu-Seog Choi, Hye Jin Kim; Ann Coloproctol. 2024;40(4):363-374. Published online August 30, 2024; DOI: https://doi.org/10.3393/ac.2024.00521.0074

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9 Web of Science
12 Citations

Abstract PDF

Metastatic lateral pelvic lymph nodes (LPNs) in rectal cancer significantly impact the prognosis and treatment strategies. Western practices emphasize neoadjuvant chemoradiotherapy (CRT), whereas Eastern approaches often rely on LPN dissection (LPND). This review examines the evolving role of LPND in the context of modern treatments, including total neoadjuvant therapy (TNT), and the impact of CRT on the management of clinically suspicious LPNs. We comprehensively reviewed the key literature comparing the outcomes of LPND versus preoperative CRT for rectal cancer, focusing on recent advancements and ongoing debates. Key studies, including the JCOG0212 trial and recent multicenter trials, were analyzed to assess the efficacy of LPND, particularly in conjunction with preoperative CRT or TNT. Current evidence indicates that LPND can reduce local recurrence rates compared to total mesorectal excision alone in patients not receiving radiation therapy. However, the benefit of LPND in the context of neoadjuvant CRT is influenced by the size and pretreatment characteristics of LPNs. While CRT can effectively control smaller metastatic LPNs, larger or clinically suspicious LPNs may require LPND for optimal outcomes. Advances in surgical techniques, such as robotic-assisted LPND, offer potential benefits but also present challenges and complications. The role of TNT in controlling metastatic LPNs and improving patient outcomes is emerging but remains underexplored. The decision to perform LPND should be individualized based on patient-specific factors, including LPN size, response to neoadjuvant treatment, and surgeon expertise. Future research should focus on optimizing treatment protocols and further evaluating the role of TNT in managing metastatic LPNs.

Citations

Citations to this article as recorded by

Who is a candidate at the initial presentation? Prediction of positive lateral lymph node and survival after dissection
Y. Lee
Techniques in Coloproctology.2025;[Epub] CrossRef
The oncologic benefits of lateral lymph node dissection after neoadjuvant therapy – local control or survival?
T. Sammour
Techniques in Coloproctology.2025;[Epub] CrossRef
Laparoscopic Versus Robotic Lateral Pelvic Lymph Node Dissection in Locally‐Advanced Rectal Cancer: A Cohort Study Comparing Perioperative Morbidity and Short‐Term Oncological Outcomes
Joseph Mathew, Yogesh Kisan Bansod, Nishant Yadav, Janesh Murugan, Kovvuru Bhaskar Reddy, Mufaddal Kazi, Ashwin DeSouza, Avanish Saklani
Cancer Reports.2025;[Epub] CrossRef
Robotic-assisted colorectal surgery in colorectal cancer management: a narrative review of clinical efficacy and multidisciplinary integration
Engeng Chen, Li Chen, Wei Zhang
Frontiers in Oncology.2025;[Epub] CrossRef
Cirugía por cáncer de recto más allá del mesorrecto: indicaciones, preparación límites y resultados
Blas Flor-Lorente, Mario Javier de Miguel Valencia
Cirugía Española.2025; 103(9): 800202. CrossRef
Surgery for rectal cancer beyond the mesorectum: Indications, preparation, limits, and results
Blas Flor-Lorente, Mario J. de Miguel-Valencia
Cirugía Española (English Edition).2025; 103(9): 800202. CrossRef
Cancer-associated fibroblasts enhance colorectal cancer lymphatic metastasis via CLEC11A/LGR5-mediated WNT pathway activation
Chuhan Zhang, Teng Pan, Yuyuan Zhang, Yushuai Wu, Anning Zuo, Shutong Liu, Yuhao Ba, Benyu Liu, Shuaixi Yang, Yukang Chen, Hui Xu, Peng Luo, Quan Cheng, Siyuan Weng, Long Liu, Xing Zhou, Jingyuan Ning, Xinwei Han, Jinhai Deng, Zaoqu Liu
Journal of Clinical Investigation.2025;[Epub] CrossRef
Robotic lateral pelvic lymphadenectomy for rectal cancer—A video vignette
D. Castrodá, M. Paniagua, L. Pérez Corbal, L. Otalora, R. Oubiña, A. Parajó
Colorectal Disease.2025;[Epub] CrossRef
Learning curve for lateral lymph node dissection in rectal cancer – a systematic review of literature
D. Kehagias, L. Baldari, E. Cassinotti, L. Boni, C. Lampropoulos, I. Kehagias
Techniques in Coloproctology.2025;[Epub] CrossRef
Pelvic Neuroanatomy in Colorectal Surgery: Advances in Nerve Preservation for Optimized Functional Outcomes
Asim M. Almughamsi, Yasir Hassan Elhassan
Surgeries.2025; 6(4): 94. CrossRef
Targeting lateral pelvic lymph nodes in rectal cancer: response to neoadjuvant therapy and artificial intelligence driven clinical decision support
Ruiqing Liu, Yun Lu, Luca Stocchi
Intelligent Medicine.2025;[Epub] CrossRef
From the Editor: Uniting expertise, a new era of global collaboration in coloproctology
In Ja Park
Annals of Coloproctology.2024; 40(4): 285. CrossRef

Original Articles

Translational/basic research

Exfoliate cancer cell analysis in rectal cancer surgery: comparison of laparoscopic and transanal total mesorectal excision, a pilot study: Kiho You, Jung-Ah Hwang, Dae Kyung Sohn, Dong Woon Lee, Sung Sil Park, Kyung Su Han, Chang Won Hong, Bun Kim, Byung Chang Kim, Sung Chan Park, Jae Hwan Oh; Ann Coloproctol. 2023;39(6):502-512. Published online December 26, 2023; DOI: https://doi.org/10.3393/ac.2023.00479.0068

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Graphical Abstract Abstract PDF Supplementary Material: Purpose
Minimally invasive surgery (MIS) is currently the standard treatment for rectal cancer. However, its limitations include complications and incomplete total mesorectal resection (TME) due to anatomical features and technical difficulties. Transanal TME (TaTME) has been practiced since 2010 to improve this, but there is a risk of local recurrence and intra-abdominal contamination. We aimed to analyze samples obtained through lavage to compare laparoscopic TME (LapTME) and TaTME.
Methods
From June 2020 to January 2021, 20 patients with rectal cancer undergoing MIS were consecutively and prospectively recruited. Samples were collected at the start of surgery, immediately after TME, and after irrigation. The samples were analyzed for carcinoembryonic antigen (CEA) and cytokeratin 20 (CK20) through a quantitative real-time polymerase chain reaction. The primary outcome was to compare the detected amounts of CEA and CK20 immediately after TME between the surgical methods.
Results
Among the 20 patients, 13 underwent LapTME and 7 underwent TaTME. Tumor location was lower in TaTME (7.3 cm vs. 4.6 cm, P=0.012), and negative mesorectal fascia (MRF) was more in LapTME (76.9% vs. 28.6%, P=0.044). CEA and CK20 levels were high in 3 patients (42.9%) only in TaTME. There was 1 case of T4 with incomplete purse-string suture and 1 case of positive MRF with dissection failure. All patients were followed up for an average of 32.5 months without local recurrence.
Conclusion
CEA and CK20 levels were high only in TaTME and were related to tumor factors or intraoperative events. However, whether the detection amount is clinically related to local recurrence remains unclear.

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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1 Web of Science
2 Citations

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

Colorectal cancer

Recurrence following transanal total mesorectal excision for rectal cancer: a monocentric retrospective series of technically difficult cases: Jonathan Frigault, Geneviève Morin, Sébastien Drolet, Philippe Bouchard, Alexandre Bouchard, Thanh-Quan Philips Ngo, François Letarte; Ann Coloproctol. 2023;39(4):332-341. Published online November 14, 2022; DOI: https://doi.org/10.3393/ac.2022.00178.0025

4,472 View
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Abstract PDF: Purpose
Transanal total mesorectal excision (TaTME) has been proposed to overcome surgical difficulties encountered during rectal resection, especially for patients having high body mass index or low rectal cancer. The aim of this study was to evaluate oncologic outcomes following TaTME.
Methods
This retrospective study included all consecutive patients with rectal cancer who had a TaTME from 2013 to 2019. The main outcome was the incidence of locoregional recurrence by the end of the follow-up period.
Results
Among a total of 81 patients, 96.3% were male, and their mean age was 63±9 years. The mean body mass index was 30.3±5.7 kg/m2, and the median distance from tumor to anal verge was 5.0 cm (interquartile range [IQR], 4.0–6.0 cm). Most patients had a low anterior resection performed (n=80, 98.8%) with a diverting ileostomy (n=64, 79.0%). Distal and circumferential resection margins were positive in 2.5% and 6.2% of patients, respectively. Total mesorectal excision was complete or near complete in 95.1% of patients. A successful resection was achieved in 72 patients (88.9%). After a median follow-up of 27.5 months (IQR, 16.7–48.1 months), 4 patients (4.9%) experienced locoregional recurrence. Anastomotic leaks were observed in 21 patients (25.9%). At the end of the follow-up, 69 patients (85.2%) were stoma-free.
Conclusion
TaTME was associated with acceptable oncological outcomes, including low locoregional recurrence rates in selected patients with low rectal cancer. Although associated with a high incidence of postoperative morbidities, the use of TaTME enabled a high rate of successful sphincter-saving procedures in selected patients who posed a technical challenge.

Anorectal benign disease

Garg scoring system to predict long-term healing in cryptoglandular anal fistulas: a prospective validation study: Sushil Dawka, Vipul D. Yagnik, Baljit Kaur, Geetha R. Menon, Pankaj Garg; Ann Coloproctol. 2024;40(5):490-497. Published online October 11, 2022; DOI: https://doi.org/10.3393/ac.2022.00346.0049

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6 Web of Science
6 Citations

Abstract PDF

Purpose
Complex anal fistulas can recur after clinical healing, even after a long interval which leads to significant anxiety. Also, ascertaining the efficacy of any new treatment procedure becomes difficult and takes several years. We prospectively analyzed the validity of Garg scoring system (GSS) to predict long-term fistula healing.
Methods
In patients operated for cryptoglandular anal fistulas, magnetic resonance imaging was performed preoperatively and at 3 months postoperatively to assess fistula healing. Scores as per the GSS were calculated for each patient at 3 months postoperatively and correlated with long-term healing to check the accuracy of the scoring system.
Results
Fifty-seven patients were enrolled, but 50 were finally included (7 were excluded). These 50 patients (age, 41.2±12.4 years; 46 men) were followed up for 12 to 20 months (median, 17 months). Forty-seven patients (94.0%) had complex fistulas, 28 (56.0%) had recurrent fistulas, 48 (96.0%) had multiple tracts, 20 (40.0%) had horseshoe tracts, 15 (32.0%) had associated abscesses, 5 (10.0%) were suprasphincteric, and 8 (16.0%) were supralevator fistulas. The GSS could accurately predict long-term healing (high positive predictive value, 31 of 31 [100%]) but was not very accurate in predicting nonhealing (negative predictive value, 15 of 19 [78.9%]). The sensitivity in predicting healing was 31 of 35 (88.6%).
Conclusion
GSS accurately predicts long-term fistula with a high positive predictive value (100%) but is less accurate in predicting nonhealing. This scoring system can help allay anxiety in patients and facilitate the early validation of innovative procedures for anal fistulas.

Citations

Citations to this article as recorded by

External validation of the modified Parks classification of cryptoglandular anal fistula to predict failure of healing: the protocol for a retrospective analysis
Alireza Teymouri, Amir Keshvari, Faezeh Khorasanizadeh, Alireza Kazemeini, Behnam Behboudi, Mohammad Sadegh Fazeli, Mohammad Reza Keramati, Ali Ashjaei, Seyed Mohsen Ahmadi Tafti, Amirhosein Naseri
International Journal of Surgery Protocols.2025; 29(3): 118. CrossRef
Recent Advances in the Understanding and Management of Anal Fistula from India
Vipul D. Yagnik, Sandeep Kumar, Anshul Thakur, Kaushik Bhattacharya, Sushil Dawka, Pankaj Garg
Indian Journal of Surgery.2024; 86(6): 1105. CrossRef
Rectovaginal Fistulas Not Involving the Rectovaginal Septum Should Be Treated Like Anal Fistulas: A New Concept and Proposal for a Reclassification of Rectovaginal Fistulas
Pankaj Garg, Laxmikant Ladukar, Vipul Yagnik, Kaushik Bhattacharya, Gurleen Kaur
Clinical and Experimental Gastroenterology.2024; Volume 17: 97. CrossRef
Recent advances in the diagnosis and treatment of complex anal fistula
Pankaj Garg, Kaushik Bhattacharya, Vipul D. Yagnik, G. Mahak
Annals of Coloproctology.2024; 40(4): 321. CrossRef
Predictors of outcome in cryptoglandular anal fistula according to magnetic resonance imaging: A systematic review
Alireza Teymouri, Amir Keshvari, Ali Ashjaei, Seyed Mohsen Ahmadi Tafti, Faeze Salahshour, Faezeh Khorasanizadeh, Amirhosein Naseri
Health Science Reports.2023;[Epub] CrossRef
Pankaj Garg: A Community Doctor to a Master Innovator to a Global Icon
David N. Armstrong, Iwona Sudoł-Szopińska, Vincent de Parades, Francesco Litta, Manuel Limbert, Khaw C. W. James
Global Journal of Medical, Pharmaceutical, and Biomedical Update.2023; 18: 16. CrossRef

Incidence of anal fistula after pyogenic perianal abscess drainage in Kingdom of Bahrain: Zahra Abdulla Isa Yusuf Hasan, Bayan Mohamed, Rawaa AlSayegh, Raed AlMarzooq; Ann Coloproctol. 2023;39(1):27-31. Published online August 9, 2021; DOI: https://doi.org/10.3393/ac.2020.00962.0137

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199 Download
5 Web of Science
5 Citations

Abstract PDF

Purpose
Perianal fistula is one of the most common anorectal diseases in adult patients, especially men. A relationship between pyogenic perianal abscess and fistula formation is established in multiple domains. This is the first exploration of such association among patients in the country as no related study has been published in Bahrain. We expect this study to be a foundation for future protocols and evidence-based practice.
Methods
A retrospective study was conducted in Salmaniya Medical Complex of Bahrain. A total of 109 patients with a diagnosis of anal abscess were included between 2015 and 2018. Data were collected from the electronic files database used in Salmaniya Medical Complex (iSeha) as well as phone calls to the patients. Collected data were analyzed using statistical software.
Results
The most predominant presentation of perianal abscess was pain. Over 50% of abscesses were classified as perianal (56.9%) and among those, left-sided abscesses were more common, followed by right-, posterior-, and anterior-sited, respectively. No recurrence of abscess was recorded among 80% of patients. A fistula developed following abscess drainage in 33.9% of patients. Most fistulas (37.8%) were diagnosed within 6 months or less from abscess drainage. Posterior fistulas were the most common, followed by anterior and left-sided fistulas.
Conclusion
The incidence of anal fistula in Bahrain after perianal abscess was 33.9%. Most of the patients who developed a fistula following pyogenic abscess drainage were males and above the age of 40 years. The most common site for fistula was posterior.

Citations

Citations to this article as recorded by

Risk factors for perianal abscess recurrence after incision and drainage: a review of the literature
Kheira Gabsi
International Surgery Journal.2025; 12(2): 255. CrossRef
A Review of the Anatomy of Anal Glands Relevant to Cryptoglandular Fistulas; Are We on the Right Track?
James Church
ANZ Journal of Surgery.2025; 95(11): 2355. CrossRef
Anal Cryptoglandular Suppuration
Oladapo Akinmoladun, Quinton M. Hatch
Surgical Clinics of North America.2024; 104(3): 491. CrossRef
Proposal for a new classification of anorectal abscesses based on clinical characteristics and postoperative recurrence
Shan-Zhong Chen, Kui-Jun Sun, Yi-Fan Gu, Hong-Yuan Zhao, Dong Wang, Yun-Fang Shi, Ren-Jie Shi
World Journal of Gastrointestinal Surgery.2024; 16(11): 3425. CrossRef
Research Progress on Diagnosis and Surgical Treatment of Perianal Deep Space Abscess
永罡秦
Advances in Clinical Medicine.2023; 13(01): 180. CrossRef

Case Report

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

Late Recurrence in a Rectal Cancer Patient Who Underwent Preoperative Chemoradiotherapy Followed by Local Excision: A Case Report: Jin Soo Han, Seok-Byung Lim, Jin-hong Park, Yong Sang Hong; Ann Coloproctol. 2021;37(Suppl 1):S24-S27. Published online July 27, 2021; DOI: https://doi.org/10.3393/ac.2020.00073.0010

4,365 View
57 Download
2 Web of Science
2 Citations

Abstract PDF

Some patients who have undergone preoperative chemoradiotherapy (CRT) following surgery have been diagnosed with late recurrence more than 5 years after treatment, raising questions about the possible benefit extending surveillance beyond the recommended 5 years. In 2011, a 71-year-old male patient was diagnosed with T3N+ low-lying rectal cancer located 3 cm from the anal verge before undergoing long-course preoperative CRT. After CRT, the patient was reexamined and diagnosed with ycT1–2N0 lesion, so local excision (LE) was performed. The patient underwent intensive surveillance for up to 5 years, and no evidence of recurrence was found. At 74 months after surgery, the patient was hospitalized for a hematochezia, and local recurrence at the excision site and peritoneal seeding nodules were identified. Considering the late recurrence in this patient, it might be necessary to long-term follow-up beyond 5 years in patients with preoperative CRT followed by LE.

Citations

Citations to this article as recorded by

Effects of clinical information on the treatment decisions for good responders to neoadjuvant chemoradiotherapy among rectal cancer patients
Eon Bin Kim, In Ja Park, Hwa Jung Kim, Jong Keon Jang, Seong Ho Park, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu
Annals of Coloproctology.2025; 41(5): 473. CrossRef
Coccygodynia in a Long-Term Cancer Survivor Diagnosed with Metastatic Cancer: A Case Report
Jung Hyun Park, Seong Jin Park, Dulee Kim, Jae Hoo Park, So Young Kwon
Medicina.2024; 60(8): 1365. CrossRef

Original Articles

Malignant disease,Prognosis

Recurrence after endoscopic resection of small rectal neuroendocrine tumors: a retrospective cohort study: Sukit Pattarajierapan, Supakij Khomvilai; Ann Coloproctol. 2022;38(3):216-222. Published online July 20, 2021; DOI: https://doi.org/10.3393/ac.2021.00017.0002

9,304 View
199 Download
3 Web of Science
3 Citations

Abstract PDF

Purpose
According to the European Neuroendocrine Tumor Society consensus guidelines, rectal neuroendocrine tumors (NETs) up to 10 mm in size and without poor prognostic factors could be safely removed with endoscopic resection, suggesting omitting surveillance colonoscopy after complete resection. However, the benefit of surveillance colonoscopy is still unknown. In this study, we aimed to report the outcomes after endoscopic resection of small rectal NETs using our surveillance protocol.
Methods
This retrospective cohort study included patients who underwent endoscopic resection for rectal NETs sized up to 10 mm from January 2013 to December 2019 at our center. We excluded patients without surveillance colonoscopy and those lost to follow-up. We strictly performed surveillance colonoscopy 1 year after endoscopic resection, and every 2 to 3 years thereafter. The primary outcomes were tumor recurrence and occurrence of metachronous tumors during followup.
Results
Of the 54 patients who underwent endoscopic resection for rectal NETs during the study period, 46 were enrolled in this study. The complete resection rates by endoscopic mucosal resection, precutting endoscopic mucosal resection, and endoscopic submucosal dissection were 92.3% (12 of 13), 100% (21 of 21), and 100% (12 of 12), respectively. There was no local or distant recurrence during the median follow-up of 39 months. However, we found that 8.7% (4 of 46) of patients developed metachronous NETs. All metachronous lesions were treated with precutting endoscopic mucosal resection.
Conclusion
Surveillance colonoscopy is reasonable after endoscopic resection of small rectal NETs for timely detection and treatment of metachronous lesions. However, larger collaborative studies are needed to influence the guidelines.

Citations

Citations to this article as recorded by

Linked color imaging for detection and characterization of gastrointestinal neuroendocrine tumors
Xin Pu, Yang Xu, Xueting Zhang, Zijin Yin, Yan Liu, Min Min
BMC Gastroenterology.2025;[Epub] CrossRef
Comparison of the efficacy of endoscopic submucosal dissection and transanal endoscopic microsurgery in the treatment of rectal neuroendocrine tumors ≤ 2 cm
Rui Jin, Xiaoyin Bai, Tianming Xu, Xi Wu, Qipu Wang, Jingnan Li
Frontiers in Endocrinology.2023;[Epub] CrossRef
Current status of the role of endoscopy in evaluation and management of gastrointestinal and pancreatic neuroendocrine tumors
Zaheer Nabi, Sundeep Lakhtakia, D. Nageshwar Reddy
Indian Journal of Gastroenterology.2023; 42(2): 158. CrossRef

Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer

Comparison of the oncological outcomes of stenting as a bridge to surgery and surgery alone in stages II to III obstructive colorectal cancer: a retrospective study: Hiroaki Uehara, Toshiyuki Yamazaki, Akira Iwaya, Hitoshi Kameyama, Masaru Komatsu, Motoharu Hirai; Ann Coloproctol. 2022;38(3):235-243. Published online July 13, 2021; DOI: https://doi.org/10.3393/ac.2020.01067.0152

8,037 View
222 Download
8 Web of Science
12 Citations

Graphical Abstract Abstract PDF

Purpose
We evaluated the oncological outcomes of bridge to surgery (BTS) using stent compared with surgery alone for obstructive colorectal cancer.
Methods
Consecutive patients who underwent curative resection for stages II to III obstructive colorectal cancer at our institution from January 2009 to March 2020, were registered retrospectively and divided into 43 patients in the BTS group and 65 patients in the surgery alone group. We compared the surgical and oncological outcomes between the 2 groups.
Results
Stent-related perforation did not occur. One patient in whom the stent placement was unsuccessful underwent emergency surgery with poor decompression (clinical success rate, 97.7%). The pathological characteristics were not significantly different between the groups. The following surgical outcomes in the BTS group were superior to those in the surgery alone group; nonemergency surgery (P<0.001), surgical approach (P=0.006), and length of hospital stay (P=0.020). The median follow-up time was 44.9 months (range, 1.1–126.5 months). The 3-year relapse-free survival rates were 68.4% and 58.2% (P=0.411), and the overall survival rates were 78.3% and 88.2% (P=0.255) in the surgery alone and BTS groups, respectively. The 3-year locoregional recurrence rates were 10.2% and 8.0% (P=0.948), and distant metastatic recurrence rates were 13.3% and 30.4% (P=0.035) in the surgery alone and BTS groups, respectively.
Conclusion
This study revealed that BTS with stent may be associated with a higher frequency of distant metastatic recurrence. Stent for stages II to III obstructive colorectal cancer potentially worsens oncological outcomes.

Citations

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Controversial issues of colon stenting in case of tumor obstructive intestinal obstruction: surgical and oncological aspects
S.A. Aliyev, E.S. Aliyev, T.K. Aliyev
Endoscopic Surgery.2025; 31(2): 65. CrossRef
Transforming outcomes: the pivotal role of self-expanding metal stents in right- and left-sided malignant colorectal obstructions-bridge to surgery: a comprehensive review and meta-analysis
Sheza Malik, Priyadarshini Loganathan, Hajra Khan, Abul Hasan Shadali, Pradeep Yarra, Saurabh Chandan, Babu P. Mohan, Douglas G. Adler, Shivangi Kothari
Clinical Endoscopy.2025; 58(2): 240. CrossRef
A rare case of massive colonic distention secondary to undiagnosed colon adenocarcinoma
Chloe Lahoud, Toni Habib, Michel Al Achkar, Tyler Grantham, Nissar Ahmed
Medical Reports.2025; 12: 100207. CrossRef
Recurrence Rates and Postoperative Complications Following Colorectal Cancer Surgery: A 5-Year Study at a Tertiary Care Hospital in Peshawar
Tilal Ahmed Raza, Hussain Jan Abbasi, Farrukh Ozair, Hajra Imtiaz
Pakistan Journal of Health Sciences.2025; : 120. CrossRef
Complete Obstruction, a Real Risk Factor: A Comprehensive Study on Obstruction in Stage IIA Colon Cancer With Propensity Score Matching Analysis
Soo Young Oh, Chan Wook Kim, Seonok Kim, Min Hyun Kim, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Clinical Colorectal Cancer.2024; 23(2): 135. CrossRef
Can we use colon stenting in accelerated recovery programs for surgical treatment colon cancer complicated by obstructive intestinal obstruction? A literature review
Saday A. Aliyev, Emil S. Aliyev
Russian Journal of Oncology.2024; 29(2): 130. CrossRef
Oncologic impact of colonic stents for obstructive left-sided colon cancer
Hideyuki Suzuki, Shingo Tsujinaka, Yoshihiro Sato, Tomoya Miura, Chikashi Shibata
World Journal of Clinical Oncology.2023; 14(1): 1. CrossRef
5-year oncological outcomes in left-sided malignant colonic obstruction: stent as bridge to surgery
Noura S Alhassan, Sulaiman A AlShammari, Razan N AlRabah, Amirah M AlZahrani, Maha-Hamadien Abdulla, Thamer A Bin Traiki, Ahmad M Zubaidi, Omar A Al-Obeed, Khayal A Alkhayal
BMC Gastroenterology.2023;[Epub] CrossRef
Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef
Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
Ji-Hyun Seo, In-Ja Park
Cancers.2023; 15(21): 5211. CrossRef
Recurrence Patterns and Risk Factors after Curative Resection for Colorectal Cancer: Insights for Postoperative Surveillance Strategies
Hyo Seon Ryu, Jin Kim, Ye Ryung Park, Eun Hae Cho, Jeong Min Choo, Ji-Seon Kim, Se-Jin Baek, Jung-Myun Kwak
Cancers.2023; 15(24): 5791. CrossRef
Colonic stent for bridge to surgery for acute left-sided malignant colonic obstruction: A review of the literature after 2020
Margherita Binetti, Augusto Lauro, Valeria Tonini
World Journal of Clinical Oncology.2022; 13(12): 957. CrossRef

Benign proctology,Complication,Biomarker & risk factor

Longer prolapsed rectum length increases recurrence risk after Delorme’s procedure: Taro Tanabe, Emi Yamaguchi, Takuya Nakada, Risa Nishio, Kinya Okamoto, Tetsuo Yamana; Ann Coloproctol. 2022;38(4):314-318. Published online July 13, 2021; DOI: https://doi.org/10.3393/ac.2020.01032.0147

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Abstract PDF

Purpose
Risk factors for recurrence of rectal prolapse after surgery remain unclear. Delorme’s procedure is often selected for relatively small-sized rectal prolapse, but there are few reports discussing the association between prolapsed rectum length and prolapse recurrence after Delorme’s procedure. We hypothesized that patients with longer rectal prolapses are at a higher risk of recurrence after Delorme’s procedure.
Methods
The study population comprised patients with rectal prolapse who underwent Delorme’s procedure between January 2014 and December 2019 at Tokyo Yamate Medical Center. We extracted data on patient age, sex, body mass index, previous history of anal surgery, previous history of surgery for rectal prolapse, and length of prolapse, to identify risk factors for prolapse recurrence.
Results
Altogether, 96 patients were eligible for analysis. The median length of the prolapsed rectum was 3.0 cm (range, 1.0–6.6 cm). Twenty-four patients (25.0%) experienced recurrence after Delorme’s procedure after a median of 7.5 months (interquartile range, 3.2–20.9 months). Multivariate analysis revealed that longer prolapsed rectum length increased the risk of recurrence after Delorme’s procedure (hazard ratio, 6.28; 95% confidence interval, 1.83–21.50; P<0.001).
Conclusion
The length of the prolapsed rectum should be measured before Delorme’s procedure for rectal prolapse, because length is associated with a risk of recurrence after the surgery.

Citations

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Surgical approaches for complete rectal prolapse
Long Wu, Huan Wu, Song Mu, Xiao-Yun Li, Yun-Huan Zhen, Hai-Yang Li
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Tratamiento quirúrgico del prolapso rectal completo del adulto
C. Korkmaz, G. Meurette
EMC - Técnicas Quirúrgicas - Aparato Digestivo.2024; 40(1): 1. CrossRef
Trattamento chirurgico del prolasso rettale completo dell’adulto
C. Korkmaz, G. Meurette
EMC - Tecniche Chirurgiche Addominale.2024; 30(1): 1. CrossRef
The Predictive Risk Factor of Postoperative Recurrence Following Altemeier's and Delorme's Procedures for Full-thickness Rectal Prolapse: An Analysis of 127 Japanese Patients in a Single Institution
Yasuyuki Miura, Kimihiko Funahashi, Akiharu Kurihara, Satoru Kagami, Takayuki Suzuki, Kimihiko Yoshida, Mitsunori Ushigome, Tomoaki Kaneko
Journal of the Anus, Rectum and Colon.2024; 8(3): 171. CrossRef
Modified Altemeier Procedure as Management for Incarcerated Rectal Prolapse in a Young Healthy Male Patient: A Case Report and Literature Review
Leenah Abdulgader, Ebtesam Al-Najjar, Bayan Khasawneh, Abdullah Esmail
Medicina.2024; 60(11): 1872. CrossRef
Traitement chirurgical du prolapsus rectal complet de l’adulte
C. Korkmaz, G. Meurette
EMC - Techniques chirurgicales - Appareil digestif.2023; 40(4): 1. CrossRef

Malignant disease, Rectal cancer,Prognosis and adjuvant therapy

Beware of Early Relapse in Rectal Cancer Patients Treated With Preoperative Chemoradiotherapy: Seul Gi Oh, In Ja Park, Ji-hyun Seo, Young Il Kim, Seok-Byung Lim, Chan Wook Kim, Yong Sik Yoon, Jong Lyul Lee, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2020;36(6):382-389. Published online June 17, 2020; DOI: https://doi.org/10.3393/ac.2020.06.11

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7 Citations

Abstract PDF

Purpose
Recurrence patterns in rectal cancer patients treated with preoperative chemoradiotherapy (PCRT) are needed to evaluate for establishing tailored surveillance protocol.
Methods
This study included 2,215 patients with locally-advanced mid and low rectal cancer treated with radical resection between January 2005 and December 2012. Recurrence was evaluated according to receipt of PCRT; PCRT group (n = 1,258) and no-PCRT group (n = 957). Early recurrence occurred within 1 year of surgery and late recurrence after 3 years. The median follow-up duration was 65.7 ± 29 months.
Results
The overall recurrence rate was similar between the PCRT and no-PCRT group (25.8% vs. 24.9%, P = 0.622). The most common initial recurrence site was the lungs in both groups (50.6% vs. 49.6%, P = 0.864), followed by the liver, which was more common in the no-PCRT group (22.5% vs. 33.6%, P = 0.004). Most of the recurrence occurred within 3 years after surgery in both groups (85.3% vs. 85.8%, P = 0.862). Early recurrence was more common in the PCRT group than in the no-PCRT group (43.1% vs. 32.4%, P = 0.020). Recurrence within the first 6 months after surgery was significantly higher in the PCRT group than in the no-PCRT group (18.8% vs. 7.6%, P = 0.003). Lung (n = 27, 44.3%) and liver (n = 22, 36.1%) were the frequent the first relapsed site within 6 months after surgery in PCRT group.
Conclusion
Early recurrence within the first 1 year after surgery was more common in patients treated with PCRT. This difference would be considered for surveillance protocols and need to be evaluated in further studies.

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In Ja Park
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The watch-and-wait strategy versus radical resection for rectal cancer patients with a good response (≤ycT2) after neoadjuvant chemoradiotherapy
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Optimal Postoperative Surveillance Strategies for Colorectal Cancer: A Retrospective Observational Study
Min-Young Park, In-Ja Park, Hyo-Seon Ryu, Jay Jung, Min-Sung Kim, Seok-Byung Lim, Chang-Sik Yu, Jin-Cheon Kim
Cancers.2021; 13(14): 3502. CrossRef
Comparison between Local Excision and Radical Resection for the Treatment of Rectal Cancer in ypT0-1 Patients: An Analysis of the Clinicopathological Factors and Survival Rates
Soo Young Oh, In Ja Park, Young IL Kim, Jong-Lyul Lee, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Cancers.2021; 13(19): 4823. CrossRef
Shifting Treatment Strategies to Prevent Early Relapse of Locally Advanced Rectal Cancer After Preoperative Chemoradiotherapy
Eun Jung Park
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Case Report

Benign proctology

Combined Fistulotomy and Contralateral Anal Internal Sphincterotomy for Recurrent and Complex Anal Fistula to Prevent Recurrence: Adeodatus Yuda Handaya, Aditya Rifqi Fauzi; Ann Coloproctol. 2020;36(2):122-127. Published online March 17, 2020; DOI: https://doi.org/10.3393/ac.2018.11.19

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3 Citations

Abstract PDF

The ideal intervention in the treatment of perianal fistula prevents the onset of infection to speed healing and prevent fistula recurrence while maintaining the function of the anal sphincter. Currently, there is no consensus on the best recommended surgical technique for perianal fistula management. Several studies have shown that fistulotomy was an easy and safe procedure for treatment of perianal fistula. Lateral internal sphincterotomy is the usual procedure performed on an anal fissure to decrease the anal sphincter tone. This study reports a combination of fistulotomy and contralateral internal sphincterotomy procedures for recurrent and complex perianal fistula to prevent recurrence. Here, we report 5 cases of recurrent and complex perianal fistula. The combination of fistulotomy and contralateral internal sphincterotomy is a relatively easy and safe procedure for complex perianal fistulae. In our cases, we found neither recurrence nor postoperative anal incontinence.

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Comparison of loose combined cutting seton and traditional cutting seton for high anal fistula: a meta-analysis
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Review

A Review of the Role of Carcinoembryonic Antigen in Clinical Practice: Claire Hall, Louise Clarke, Atanu Pal, Pamela Buchwald, Tim Eglinton, Chris Wakeman, Frank Frizelle; Ann Coloproctol. 2019;35(6):294-305. Published online December 31, 2019; DOI: https://doi.org/10.3393/ac.2019.11.13

28,905 View
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175 Citations

Abstract PDF

Carcinoembryonic antigen (CEA) is not normally produced in significant quantities after birth but is elevated in colorectal cancer. The aim of this review was to define the current role of CEA and how best to investigate patients with elevated CEA levels. A systematic review of CEA was performed, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were identified from PubMed, Cochrane library, and controlled trials registers. We identified 2,712 papers of which 34 were relevant. Analysis of these papers found higher preoperative CEA levels were associated with advanced or metastatic disease and thus poorer prognosis. Postoperatively, failure of CEA to return to normal was found to be indicative of residual or recurrent disease. However, measurement of CEA levels alone was not sufficient to improve survival rates. Two algorithms are proposed to guide investigation of patients with elevated CEA: one for patients with elevated CEA after CRC resection, and another for patients with de novo elevated CEA. CEA measurement has an important role in the investigation, management and follow-up of patients with colorectal cancer.

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Original Articles

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

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Abstract 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.

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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
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Oncologic Outcomes of Postoperative Chemoradiotherapy Versus Chemotherapy Alone in Stage II and III Upper Rectal Cancer: Ji Eun Yoon, Soo Young Lee, Han Duk Kwak, Seung Seop Yeom, Chang Hyun Kim, Jae Kyun Joo, Hyeong Rok Kim, Young Jin Kim; Ann Coloproctol. 2019;35(3):137-143. Published online June 30, 2019; DOI: https://doi.org/10.3393/ac.2018.09.28

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Abstract PDF

Purpose
The aim of this study was to assess oncological outcomes of postoperative radiotherapy plus chemotherapy (CRT) versus chemotherapy alone (CTx) in stage II or III upper rectal cancer patients who underwent curative surgery.
Methods
We retrospectively reviewed 263 consecutive patients with pathologic stage II or III upper rectal cancer who underwent primary curative resection with postoperative CRT or CTx from January 2008 to December 2014 at Chonnam National University Hwasun Hospital. Multivariate and propensity score matching analyses were used to reduce selection bias.
Results
Median follow-up was 48.1 months for the entire cohort and 53.5 months for the matched cohort. In subgroup analysis of the propensity score matched cohort, the 3-year local recurrence-free survival was 94.1% (95% confidence interval [CI], 87.8%–100%) in the CRT group and 90.1% (95% CI, 82.8%–97.9%) in the CTx group (P = 0.370). No significant difference in disease-free survival was observed according to treatment type. On multivariate analysis, circumferential resection margin involvement (hazard ratio [HR], 2.386; 95% CI, 1.190–7.599; P = 0.032), N stage (HR, 6.262; 95% CI, 1.843–21.278, P = 0.003), and T stage (HR, 5.896, 95% CI, 1.298–6.780, P = 0.021) were identified as independent risk factors for local recurrence of tumors of the upper rectum.
Conclusion
Omission of radiotherapy in an adjuvant treatment setting may not jeopardize oncologic outcomes in stages II and III upper rectal cancer.

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Efficacies of radiotherapy in rectal cancer patients treated with total mesorectal excision or other types of surgery: an updated meta-analysis
Wenshu Wang, Runyuan Zhao, Xi Liang, Manjun Liu, Haiyan Bai, Jianli Ge, Binxi Yao, Zheng Zhi, Jianming He
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Transanal Hemorrhoidal Dearterialization With Doppler Arterial Identification Versus Classic Hemorrhoidectomy: A Retrospective Analysis of 270 Patients: Vincenzo Consalvo, Francesca D’Auria, Vincenzo Salsano; Ann Coloproctol. 2019;35(3):118-122. Published online May 31, 2019; DOI: https://doi.org/10.3393/ac.2017.09.04

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Abstract PDF

Purpose
Despite the minimally invasive nature of transanal hemorrhoidal dearterialization (THD) with Doppler arterial identification procedures, hemorrhoidectomy is still considered the gold standard procedure for hemorrhoidal disease. However, the classical techniques of hemorrhoidectomy have a high rate of postoperative complications. The main purpose of this study is to demonstrate the efficacy and complications of these techniques used for grades II and III hemorrhoids.
Methods
A retrospective (case-control) study was carried out from January 2009 to May 2014, and all patients undergoing surgical procedures for hemorrhoidal disease in two French clinics were considered. Application of inclusion and exclusion criteria identified 270 eligible patients (163 undergoing Doppler THD and 107 treated with Milligan Morgan hemorrhoidectomy). Statistical analysis was calculated considering immediate postoperative complications, functional results, chronic complications, and recurrences.
Results
Analysis of primary outcomes showed a significant difference between the 2 groups concerning postoperative pain, which had a lower rate in THD (P = 0.0001) and in postoperative bleeding (P = 0.02) than hemorrhoidectomy. However, long-term follow-up at three years showed a superior rate of recurrence in the THD group (P = 0.009).
Conclusion
The THD technique is a safe and effective procedure for grades II and III hemorrhoids, has lower rates of post-operative pain and bleeding, and allows faster hospital discharge; however, it also shows a higher rate of recurrence at three years of follow-up.

Citations

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Milligan–Morgan hemorrhoidectomy combined with rubber band ligation and polidocanol foam sclerotherapy for the management of grade III/IV hemorrhoids: a retrospective study
Qing Long, Yong Wen, Jun Li
BMC Gastroenterology.2025;[Epub] CrossRef
Transanal Hemorrhoidal Dearterialization With Mucopexy Versus Vessel-Sealing Device Hemorrhoidectomy for Grade III to IV Hemorrhoids: Long-term Outcomes From the THDLIGA Randomized Controlled Trial
Loris Trenti, Sebastiano Biondo, Eloy Espin-Basany, Oriana Barrios, Jose L. Sanchez-Garcia, • Aitor Landaluce-Olavarria, Elena Bermejo-Marcos, • Maria T. Garcia-Martinez, David Alias Jimenez, Fernando Jimenez, Adolfo Alonso, Maria B. Manso, Esther Kreisle
Diseases of the Colon & Rectum.2023; 66(8): e818. CrossRef
Excisional Hemorrhoidectomy Versus Dearterialization With Mucopexy for the Treatment of Grade III Hemorrhoidal Disease: The EMODART3 Multicenter Study
Antonio Giuliani, Lucia Romano, Stefano Necozione, Vincenza Cofini, Giada Di Donato, Mario Schietroma, Francesco Carlei
Diseases of the Colon & Rectum.2023; 66(12): e1254. CrossRef
CLINICAL AND MORPHOLOGICAL EVALUATION OF THE EFFECTIVENESS OF USING RADIO WAVE AND HIGH-FREQUENCY ELECTROSURGERY TECHNOLOGIES FOR THE TREATMENT OF COMBINED ANORECTAL DISEASES
V. V. Balytskyy, M. P. Zakharash, O. G. Kuryk
World of Medicine and Biology.2022; 18(80): 19. CrossRef
Linear Pinched Hemorrhoidectomy: A Retrospective Observational Study (An Innovative, Simplified Hemorrhoidectomy)
Akiharu Kurihara, Yu Yoshino, Yu Sakai, Yasuyuki Miura, Satoru Kagami, Tomoaki Kaneko, Mitsunori Ushigome, Hiroyuki Shiokawa, Hironori Kaneko, Kimihiko Funahashi
Journal of the Anus, Rectum and Colon.2021; 5(3): 261. CrossRef
Haemorrhoidal artery ligation with and without Doppler guidance in the treatment of haemorrhoidal disease: a single-centre randomized study
P. V. Tsarkov, M. A. Popovtsev, Yu. S. Medkova, A. V. Alekberzade, N. N. Krylov
Sechenov Medical Journal.2021; 12(3): 47. CrossRef
Hemorrhoidal artery ligation without Doppler navigation in surgical treatment of hemorrhoidal disease
M.A. Popovtsev, A.V. Alekberzade, N.N. Krylov
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Comparison of Limberg Flap and Karydakis Flap Surgery for the Treatment of Patients With Pilonidal Sinus Disease: A Single-Blinded Parallel Randomized Study: Mina Alvandipour, Mohammad Sadegh Zamani, Mojtaba Ghorbani, Jamshid Yazdani Charati, Mohammad Yasin Karami; Ann Coloproctol. 2019;35(6):313-318. Published online May 22, 2019; DOI: https://doi.org/10.3393/ac.2018.09.27

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Abstract PDF

Purpose
Pilonidal sinus disease is a common condition, which mostly affects young men. While various surgical techniques have been introduced for treating intergluteal pilonidal disease (IPD), controversies still exist regarding the best surgical approach. The purpose of this study was to compare the efficiency and the short-term outcomes of Limberg flap and Karydakis flap surgeries for the treatments of patients with IPD.
Methods
A total of 80 patients with IPD who had underwent either Karydakis flap (KF group: n = 37) or Limberg flap (LF group: n = 27) surgery between January 2015 and January 2016 at Imam Khomeini Hospital of Sari in the North of Iran were recruited for inclusion in this randomized, single-blind study.
Results
Compared to the KF group, the LF group showed faster complete wound healing, longer duration of surgery and hospital stay, larger wound size, and shorter period of incapacity for work. The overall patient satisfaction in the LF group was significantly higher than that in the KF group. The visual analogue scale score of pain was lower in the LF group than in the KF group. Also, the overall frequency of postoperative complications was higher in the KF group than in the LF group. Recurrence was reported in one patient from the KF group.
Conclusion
Given the lower rate of postoperative complications and greater cosmetic satisfaction of patients, the Limberg flap procedure should be selected, instead of the Karydakis flap procedure, as the standard technique for treating patients with IPD.

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Dakshay A. Chordia, A. P. Prem, Jameel Akhter, M. Muralidharan, A. Sathishkumar
Indian Journal of Colo-Rectal Surgery.2023; 6(1): 4. CrossRef
Analysis of the Outcomes of a New Method for Plastic Surgery for Postoperative Wound Of Sacrococcygeal Region after Excision of the Pilonidal Cyst: Randomized Trial.
E. N. Shubrov, A. G. Baryshev, K. V. Triandafilov, V. A. Aladina, V. V. Fedyushkin, R. K. Amirova
Kuban Scientific Medical Bulletin.2022; 29(5): 80. CrossRef
Effectiveness and Feasibility of Limberg and Karydakis Flap in Recurrent and Complicated Pilonidal Sinus Disease
Amr Abdel Hameed Elhiny, Doaa Ali Saad, Mohamed Sadek Farahat
Indian Journal of Surgery.2021; 83(1): 55. CrossRef
S3-Leitlinie: Sinus pilonidalis. 2. revidierte Fassung 2020
A. Ommer, I. Iesalnieks, D. Doll
coloproctology.2021; 43(S1): 25. CrossRef
Pilonoidal Sinüs Tedavisinde Modifiye Limberg Flep Uygulaması Sonuçları
Nizamettin KUTLUER, Nurullah AKSOY
Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi.2021; 16(1): 68. CrossRef
Pilonidal Sinus Disease: An Analysis of the Factors Affecting Recurrence
Murat Kanlioz, Uğur Ekici, Faik Tatli, Turgay Karatas
Advances in Skin & Wound Care.2021; 34(2): 81. CrossRef
Karydakis procedure versus Limberg flap for treatment of pilonidal sinus: an updated meta-analysis of randomized controlled trials
Sameh Hany Emile, Sualeh Muslim Khan, Samer Hani Barsom, Steven D Wexner
International Journal of Colorectal Disease.2021; 36(7): 1421. CrossRef
Evaluation of comma-shaped incision with a sacral flap in surgical treatment of pilonidal sinus
MinaR.A.R. El Nahal, MohammedY.F. Aly, RagaiS Hanna, GamalA Makhlouf, GamalA Hameed Ahmed
Journal of Current Medical Research and Practice.2020; 5(1): 46. CrossRef
Surgical procedures in the pilonidal sinus disease: a systematic review and network meta-analysis
Siwei Bi, Kaibo Sun, Shanshan Chen, Jun Gu
Scientific Reports.2020;[Epub] CrossRef
An effective minimal invasive method in pilonidal sinus surgery: Sinusotomy
Önder KARABAY
Archives of Clinical and Experimental Medicine.2019; 4(3): 138. CrossRef

Female Sex and Right-Sided Tumor Location Are Poor Prognostic Factors for Patients With Stage III Colon Cancer After a Curative Resection: Jung Ho Park, Hyoung-Chul Park, Sung Chan Park, Jae Hwan Oh, Duck-Woo Kim, Sung-Bum Kang, Seung Chul Heo, Min Jung Kim, Ji Won Park, Seung-Yong Jeong, Kyu Joo Park, for the Seoul Colorectal Group (SECOG); Ann Coloproctol. 2018;34(6):286-291. Published online December 31, 2018; DOI: https://doi.org/10.3393/ac.2018.10.29

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Abstract PDF

Purpose
Stage-IIIC colon cancer is an advanced disease; however, its oncologic outcomes and prognostic factors remain unclear. In this study, we aimed to determine the predictors of disease-free survival (DFS) in patients with stage-IIIC colon cancer.
Methods
From a multicenter database, we retrospectively enrolled 611 patients (355 men and 256 women) who had undergone a potentially curative resection for a stage-IIIC colon adenocarcinoma between 2003 and 2011. The primary end-point was the 5-year DFS.
Results
The median age was 62 years; 213 and 398 patients had right-sided colon cancer (RCC) and left-sided colon cancer (LCC), respectively. The 5-year DFS in all patients was 52.0%; median follow-up time was 35 months (range, 1–134 months). A multivariate Cox regression revealed that female sex (hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.19–1.90; P < 0.01), right-sided tumor location (HR, 1.65; 95% CI, 1.29–2.11; P < 0.01), lymphatic invasion (HR, 1.52; 95% CI, 1.08–2.15; P < 0.01) and a high (≥0.4) metastatic lymph node ratio (HR, 3.72; 95% CI, 2.63–5.24; P < 0.01) were independent predictors of worse 5-year DFS. Female patients with RCC were 1.79 fold more likely to experience recurrence than male patients with LCC.
Conclusion
Female sex and right-sided tumor location are associated with higher tumor recurrence rates in patients with stage-IIIC colon cancers. Aggressive treatment and close surveillance should be planned for patients in these groups.

Citations

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Development and external validation of a nomogram predicting overall survival after curative resection of colon cancer
Shuanhu Wang, Yakui Liu, Yi Shi, Jiajia Guan, Mulin Liu, Wenbin Wang
Journal of International Medical Research.2021;[Epub] CrossRef

Clinical Etiology of Hypermetabolic Pelvic Lesions in Postoperative Positron Emission Tomography/Computed Tomography for Patients With Rectal and Sigmoid Cancer: Yun Hee Kang, Eunji Han, Geon Park; Ann Coloproctol. 2018;34(2):78-82. Published online April 30, 2018; DOI: https://doi.org/10.3393/ac.2017.09.21

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Abstract PDF

Purpose
The purpose of this study was to present various clinical etiologies of hypermetabolic pelvic lesions on postoperative positron emission tomography/computed tomography (PET/CT) images for patients with rectal and sigmoid cancer.
Methods
Postoperative PET/CT images for patients with rectal and sigmoid cancer were retrospectively reviewed to identify hypermetabolic pelvic lesions. Positive findings were detected in 70 PET/CT images from 45 patients; 2 patients who were lost to follow-up were excluded. All PET findings were analyzed in comparison with contrast-enhanced CT.
Results
A total of 43 patients were classified into 2 groups: patients with a malignancy including local recurrence (n = 30) and patients with other benign lesions (n = 13). Malignant lesions such as a local recurrent tumor, peritoneal carcinomatosis, and incidental uterine malignancy, as well as various benign lesions such as an anastomotic sinus, fistula, abscess, reactive lymph node, and normal ovary, were observed.
Conclusion
PET/CT performed during postoperative surveillance of rectal and sigmoid colon cancer showed increased fluorodeoxyglucose uptake not only in local recurrence, but also in benign pelvic etiologies. Therefore, physicians need to be cautious about the broad clinical spectrum of hypermetabolic pelvic lesions when interpreting images.

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Diagnostic and prognostic value of quantitative 18F-FDG PET/CT metabolic parameters combined with clinical indicators in patients with locally recurrent rectal cancer
Junjie Li, Yin Zhou, Liu Liu, Hua Pang
Abdominal Radiology.2025; 50(11): 5135. CrossRef
Variants and Pitfalls in PET/CT Imaging of Gastrointestinal Cancers
Vetri Sudar Jayaprakasam, Viktoriya Paroder, Heiko Schöder
Seminars in Nuclear Medicine.2021; 51(5): 485. CrossRef

Transanal Endoscopic Microsurgery for Patients With Rectal Tumors: A Single Institution's Experience: Audrius Dulskas, Alfredas Kilius, Kestutis Petrulis, Narimantas E. Samalavicius; Ann Coloproctol. 2017;33(1):23-27. Published online February 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.1.23

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Abstract PDF

Purpose

The purpose of this study was to look at our complication rates and recurrence rates, as well as the need for further radical surgery, in treating patients with benign and early malignant rectal tumors by using transanal endoscopic microsurgery (TEM).

Methods

Our study included 130 patients who had undergone TEM for rectal adenomas and early rectal cancer from December 2009 to December 2015 at the Department of Surgical Oncology, National Cancer Institute, Lithuania. Patients underwent digital and endoscopic evaluation with multiple biopsies. For preoperative staging, pelvic magnetic resonance imaging or endorectal ultrasound was performed. We recorded the demographics, operative details, final pathologies, postoperative lengths of hospital stay, postoperative complications, and recurrences.

Results

The average tumor size was 2.8 ± 1.5 cm (range, 0.5–8.3 cm). 102 benign (78.5%) and 28 malignant tumors (21.5%) were removed. Of the latter, 23 (82.1%) were pT1 cancers and 5 (17.9%) pT2 cancers. Of the 5 patients with pT2 cancer, 2 underwent adjuvant chemoradiotherapy, 1 underwent an abdominoperineal resection, 1 refused further treatment and 1 was lost to follow up. No intraoperative complications occurred. In 7 patients (5.4%), postoperative complications were observed: urinary retention (4 patients, 3.1%), postoperative hemorrhage (2 patients, 1.5%), and wound dehiscence (1 patient, 0.8%). All complications were treated conservatively. The mean postoperative hospital stay was 2.3 days.

Conclusion

TEM in our experience demonstrated low complication and recurrence rates. This technique is recommended for treating patients with a rectal adenoma and early rectal cancer and has good prognosis.

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TEMPOUR: A Randomized Controlled Trial Assessing Perioperative Use of an Alpha-1 Blocker to Reduce Postoperative Urinary Retention After Transanal Endoscopic Microsurgery Procedures
Thomas Couture, Claudya Morin, Janyssa Charbonneau, Émilie Papillon-Dion, Alexandre Bouchard, François Rouleau-Fournier, Philippe Bouchard, François Letarte, Alexis F. Turgeon, Sebastien Drolet
Diseases of the Colon & Rectum.2025; 68(4): 475. CrossRef
The Outcome of Local Excision of Rectal Adenomas with High-Grade Dysplasia by Transanal Endoscopic Microsurgery: A Single-Center Experience
Muhammad Khalifa, Rachel Gingold-Belfer, Nidal Issa
Journal of Clinical Medicine.2024; 13(5): 1419. CrossRef
Transanal endoscopic rectal resection: immediate and long-term results
A.A. Maslov, Yu.A. Gevorkyan, N.V. Soldatkina, A.V. Dashkov, S.I. Poluektov, V.E. Kolesnikov, D.O. Kaymakchi, A.V. Snezhko
Khirurgiya. Zhurnal im. N.I. Pirogova.2022; (1): 30. CrossRef
Complex Procedures in Transanal Endoscopic Microsurgery: Intraperitoneal Entry, Ultra Large Rectal Tumors, High Lesions, and Resection in the Anal Canal
Xavier Serra-Aracil, Victoria Lucas-Guerrero, Laura Mora-López
Clinics in Colon and Rectal Surgery.2022; 35(02): 129. CrossRef
Multidisciplinary treatment strategy for early rectal cancer
Gyung Mo Son, In Young Lee, Sung Hwan Cho, Byung-Soo Park, Hyun Sung Kim, Su Bum Park, Hyung Wook Kim, Sang Bo Oh, Tae Un Kim, Dong Hoon Shin
Precision and Future Medicine.2022; 6(1): 32. CrossRef
Is Local Resection of Anal Canal Tumors Feasible with Transanal Endoscopic Surgery?
Xavier Serra‐Aracil, Andrea Campos‐Serra, Laura Mora‐López, Sheila Serra‐Pla, Anna Pallisera‐Lloveras, Roser Flores‐Clotet, Alba Zárate‐Pinedo, Salvador Navarro‐Soto
World Journal of Surgery.2020; 44(3): 939. CrossRef
Transanal endoscopic microsurgery for a rectal polyp – a video vignette
N. E. Samalavicius, P. Kavaliauskas, A. Dulskas
Colorectal Disease.2020; 22(9): 1203. CrossRef
Endoscopic diagnosis of gastrointestinal melanoma
Sheng Wang, Siyu Sun, Xiang Liu, Nan Ge, Guoxin Wang, Jintao Guo, Wen Liu, Jinlong Hu
Scandinavian Journal of Gastroenterology.2020; 55(3): 330. CrossRef
Is Previous Transanal Endoscopic Microsurgery for Early Rectal Cancer a Risk Factor of Worse Outcome following Salvage Surgery A Case-Matched Analysis
Audrius Dulskas, Aivaras Atkociunas, Alfredas Kilius, Kestutis Petrulis, Narimantas E. Samalavicius
Visceral Medicine.2019; 35(3): 151. CrossRef
Transanal endoscopic microsurgery for rectal lesions in a specialist regional early rectal cancer centre: the Mersey experience
M. Ondhia, P. Tamvakeras, P. O'Toole, A. Montazerri, T. Andrews, C. Farrell, S. Ahmed, S. Slawik, S. Ahmed
Colorectal Disease.2019; 21(10): 1164. CrossRef
Transanal Endoscopic Microsurgery for Patients with Rare Rectal Tumors
Xin Wu, Guole Lin, Huizhong Qiu, Jiaolin Zhou
Journal of Laparoendoscopic & Advanced Surgical Techniques.2018; 28(5): 546. CrossRef
Modern management of T1 rectal cancer by transanal endoscopic microsurgery: a 10‐year single‐centre experience
H. J. S. Jones, R. Hompes, N. Mortensen, C. Cunningham
Colorectal Disease.2018; 20(7): 586. CrossRef
Transanal endoscopic microsurgery as day surgery – a single‐centre experience with 500 patients
C. J. Brown, J. Q. Gentles, T. P. Phang, A. A. Karimuddin, M. J. Raval
Colorectal Disease.2018;[Epub] CrossRef
Transanal Endoscopic Microsurgery
Byung Chun Kim
Annals of Coloproctology.2017; 33(1): 5. CrossRef
Transanal endoscopic microsurgery for giant benign rectal tumours: is large size a contraindication?
Audrius Dulskas, Alfredas Kilius, Kestutis Petrulis, Narimantas E. Samalavicius
International Journal of Colorectal Disease.2017; 32(12): 1759. CrossRef

Efficacy of Dose-Escalated Radiotherapy for Recurrent Colorectal Cancer: Sunmi Jo, Yunseon Choi, Sung-Kwang Park, Jin-Young Kim, Hyun Jung Kim, Yun-Han Lee, Won Yong Oh, Heunglae Cho, Ki Jung Ahn; Ann Coloproctol. 2016;32(2):66-72. Published online April 30, 2016; DOI: https://doi.org/10.3393/ac.2016.32.2.66

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Abstract PDF

Purpose

This study aimed to evaluate the effects of radiotherapy (RT) on progression-free survival (PFS) for patients with recurrent colorectal cancer.

Methods

We reviewed the records of 22 patients with recurrent colorectal cancer treated with RT between 2008 and 2014. The median radiation dose for recurrent disease was 57.6 Gy (range, 45–75.6 Gy). Patients were divided into 2 groups according to the type of RT: patients underwent RT without previous history of irradiation (n = 14) and those treated with secondary RT (reirradiation: n = 8) at the time of recurrence.

Results

The median follow-up period was 24.9 months (range, 4.5–66.6 months). Progression was observed in 14 patients (including 8 with loco-regional failure and 9 with distant metastases). Distant metastases were related to the RT dose (<70 Gy, P = 0.031). The 2-year loco-regional control (LRC), PFS, and overall survival (OS) rates were 74.6%, 45.1%, and 82.0%, respectively. The LRC rate was not different between the patients treated with RT for the first time and those treated with reirradiation (P = 0.101, 2-year LRC 79.5% vs. 41.7%). However, reirradiation was related to poor PFS (P = 0.022) and OS (P = 0.002). An escalated RT dose (≥70 Gy) was associated with a higher PFS (P = 0.014, 2-year PFS 63.5% vs. 20.8%).

Conclusion

Salvage RT for locally recurrent colorectal cancer can be offered when surgery is impossible. Dose-escalated RT shows a possible benefit in reducing the risk of progression.

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Carbon-ion Radiotherapy for Colorectal Cancer
Shigeru Yamada, Hirotoshi Takiyama, Yuka Isozaki, Makoto Shinoto, Hirokazu Makishima, Naoyoshi Yamamoto, Hiroshi Tsuji
Journal of the Anus, Rectum and Colon.2021; 5(2): 113. CrossRef
LncRNA TTN‐AS1/miR‐134‐5p/PAK3 axis regulates the radiosensitivity of human large intestine cancer cells through the P21 pathway and AKT/GSK‐3β/β‐catenin pathway
Zhenkui Zuo, Shuling Ji, Lulu He, Yage Zhang, Zining Peng, Jiarui Han
Cell Biology International.2020; 44(11): 2284. CrossRef
A Review on the Special Radiotherapy Techniques of Colorectal Cancer
Shing Yau Tam, Vincent W. C. Wu
Frontiers in Oncology.2019;[Epub] CrossRef
Comparison of overall survival and quality of life between patients undergoing anal reconstruction and patients undergoing traditional lower abdominal stoma after radical resection
P. Du, S.-Y. Wang, P.-F. Zheng, J. Mao, H. Hu, Z.-B. Cheng
Clinical and Translational Oncology.2019; 21(10): 1390. CrossRef
Prospective Observational Study of High-Dose Carbon-Ion Radiotherapy for Pelvic Recurrence of Rectal Cancer (GUNMA 0801)
Shintaro Shiba, Masahiko Okamoto, Hiroki Kiyohara, Tatsuya Ohno, Takuya Kaminuma, Takayuki Asao, Hitoshi Ojima, Ken Shirabe, Hiroyuki Kuwano, Takashi Nakano
Frontiers in Oncology.2019;[Epub] CrossRef
Effects of varying radiation dosages on MMP1 expression, and MMP1 knockdown on the viability and migration of SW620 cells
Fang Ju, Na Li, Wenming Wang, Haicheng Yuan
Molecular Medicine Reports.2019;[Epub] CrossRef
Dose-Escalated Radiotherapy for the Treatment of Patients With Recurrent Colorectal Cancer
Hyung Jin Kim, Seong Taek Oh
Annals of Coloproctology.2016; 32(2): 47. CrossRef

The Clinical Features and Predictive Risk Factors for Reoperation in Patients With Perianal Crohn Diseases; A Multi-Center Study of a Korean Inflammatory Bowel Disease Study Group: Jae Bum Lee, Seo-Gue Yoon, Kyu Joo Park, Kang Young Lee, Dae Dong Kim, Sang Nam Yoon, Chang Sik Yu; Ann Coloproctol. 2015;31(5):176-181. Published online October 31, 2015; DOI: https://doi.org/10.3393/ac.2015.31.5.176

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Abstract PDF

Purpose

Perianal lesions are common in Crohn disease, but their clinical course is unpredictable. Nevertheless, predicting the clinical course after surgery for perianal Crohn disease (PCD) is important because repeated operations may decrease patient's quality of life. The aim of this study was to predict the risk of reoperation in patients with PCD.

Methods

From September 1994 to February 2010, 377 patients with PCD were recruited in twelve major tertiary university-affiliated hospitals and two specialized colorectal hospitals in Korea. Data on the patient's demographics, clinical features, and surgical outcomes were analyzed.

Results

Among 377 patients, 227 patients were ultimately included in the study. Among the 227 patients, 64 patients underwent at least one reoperation. The median period of reoperation following the first perianal surgery was 94 months. Overall 3-year, 5-year, and 10-year cumulative rates of reoperation-free individuals were 68.8%, 61.2%, and 50.5%, respectively. In multivariate analysis (Cox-regression hazard model), reoperation was significantly correlated with an age of onset less than 20 years (hazard ratio [HR], 1.93; 95% confidence interval [CI], 1.07-3.48; P = 0.03), history of abdominal surgery (HR, 1.99; 95% CI, 1.08-3.64; P = 0.03), and the type of surgery. Among types of surgery, fistulotomy or fistulectomy was associated with a decreased incidence of reoperation in comparison with incision and drainage (HR, 0.19; 95% CI, 0.09-0.42; P < 0.001).

Conclusion

Young age of onset and a history of abdominal surgery were associated with a high risk of reoperation for PCD, and the risk of reoperation were relatively low in fistulotomy or fistulectomy procedures.

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A nanofiber-hydrogel composite improves tissue repair in a rat model of Crohn’s disease perianal fistulas
Ling Li, Zhi-Cheng Yao, Alyssa Parian, Yueh-Hsun Yang, Jeffrey Chao, Jason Yin, Kevan J. Salimian, Sashank K. Reddy, Atif Zaheer, Susan L. Gearhart, Hai-Quan Mao, Florin M. Selaru
Science Advances.2023;[Epub] CrossRef
Predictors of reoperation for perianal fistula in Crohn's disease
Kwangwoo Nam, Won Beom Jung, Seung Bum Lee, Jae Seung Soh, Song Soo Yang, Seok Won Jung
Journal of Digestive Diseases.2021; 22(6): 334. CrossRef
Perianal and Luminal Relapse Following Perianal Surgical Intervention in Crohn’s Disease
Feihong Deng, Pianpian Xia, Zengrong Wu, Hejun Zhou, Xuehong Wang
International Journal of General Medicine.2021; Volume 14: 3387. CrossRef
Predictors of Perianal Fistula Relapse in Crohn’s Disease
Audrey Malian, Pauline Rivière, Dominique Bouchard, François Pigot, Marianne Eléouet-Kaplan, Charlotte Favreau-Weltzer, Florian Poullenot, David Laharie
Inflammatory Bowel Diseases.2020; 26(6): 926. CrossRef
Predictors of Perianal Fistula Relapse in Crohn’s Disease
Dana J Lukin
Inflammatory Bowel Diseases.2019;[Epub] CrossRef
Management of Perianal Fistulas in Crohn’s Disease
Steffen Seyfried, Alexander Herold
Visceral Medicine.2019; 35(6): 338. CrossRef
Surgical management of fistulating perianal Crohn's disease: a UK survey
M. J. Lee, N. Heywood, P. M. Sagar, S. R. Brown, N. S. Fearnhead
Colorectal Disease.2017; 19(3): 266. CrossRef
Risk of Repeat Surgery for Perianal Crohn Disease
Doo Han Lee
Annals of Coloproctology.2015; 31(5): 169. CrossRef

Short-term Intravenous Antibiotic Treatment in Uncomplicated Diverticulitis Does Not Increase the Risk of Recurrence Compared to Long-term Treatment: Cosimo Riccardo Scarpa, Nicolas Christian Buchs, Antoine Poncet, Béatrice Konrad-Mugnier, Pascal Gervaz, Philippe Morel, Frédéric Ris; Ann Coloproctol. 2015;31(2):52-56. Published online April 30, 2015; DOI: https://doi.org/10.3393/ac.2015.31.2.52

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Abstract PDF

Purpose

This study included all patients treated at the University Hospital of Geneva for a first episode of uncomplicated diverticulitis. Risks of recurrence and treatment failure were evaluated by comparing the results between short-course and long-course intravenous (IV) antibiotic therapy groups.

Methods

The records of all patients hospitalized at our facility from January 2007 to February 2012 for a first episode of uncomplicated diverticulitis (Hinchey Ia), as confirmed by computed tomography, were prospectively collected. We published an auxiliary analysis from this registered study at Clinicaltrials.gov (identifier number: NCT01015378). Two groups of patients were considered: one received a short-course IV antibiotic arm (ceftriaxone and metronidazole) for up to 5 days (followed by 5 days of oral antibiotics); the other received a long-course IV arm between days 5 and 10. The primary outcome was the recurrence-free survival time.

Results

Follow-up was completed for 256 patients-50% men and 50% women, with a median age of 56 years (range, 24-85 years). The average follow-up was 50 months (range, 19-89 months). Of the 256 patients included in the study, 46 patients received a short-course IV antibiotic treatment and 210 received a long-course treatment. The recurrence-free survivals were very similar between the two groups, which was supported by a log rank test (P = 0.772). Four treatment failures, all in the long-course IV antibiotic treatment group, occurred.

Conclusion

Treatment of diverticulitis with a short IV antibiotic treatment is possible and does not modify the recurrence rate in patients with uncomplicated diverticulitis.

Citations

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Italian guidelines for the diagnosis and management of colonic diverticulosis and diverticular disease
Marilia Carabotti, Costantino Sgamato, Antonio Amato, Benedetta Beltrame, Gian Andrea Binda, Bastianello Germanà, Gioacchino Leandro, Luigi Pasquale, Sergio Peralta, Maria Teresa Viggiani, Carola Severi, Bruno Annibale, Rosario Cuomo
Digestive and Liver Disease.2024; 56(12): 1989. CrossRef
Konservative Therapie der Divertikulitis
Stephan K. Böhm
coloproctology.2023; 45(3): 163. CrossRef
Diagnostic Imaging and Medical Management of Acute Left-Sided Colonic Diverticulitis
Ethan M. Balk, Gaelen P. Adam, Monika Reddy Bhuma, Kristin J. Konnyu, Ian J. Saldanha, Michael D. Beland, Nishit Shah
Annals of Internal Medicine.2022; 175(3): 379. CrossRef
Diagnosis and Management of Acute Left-Sided Colonic Diverticulitis: A Clinical Guideline From the American College of Physicians
Amir Qaseem, Itziar Etxeandia-Ikobaltzeta, Jennifer S. Lin, Nick Fitterman, Tatyana Shamliyan, Timothy J. Wilt
Annals of Internal Medicine.2022; 175(3): 399. CrossRef
S3-Leitlinie Divertikelkrankheit/Divertikulitis – Gemeinsame Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV)
Ludger Leifeld, Christoph-Thomas Germer, Stephan Böhm, Franz Ludwig Dumoulin, Thomas Frieling, Martin Kreis, Alexander Meining, Joachim Labenz, Johan Friso Lock, Jörg-Peter Ritz, Andreas Schreyer, Wolfgang Kruis
Zeitschrift für Gastroenterologie.2022; 60(04): 613. CrossRef
Recurrence of Uncomplicated Diverticulitis: A Meta-Analysis
Guhyun Kang, Soomin Son, Young-Min Shin, Jung-Soo Pyo
Medicina.2022; 58(6): 758. CrossRef
German guideline diverticular disease/diverticulitis
Wolfgang Kruis, Christoph‐Thomas Germer, Stephan Böhm, Franz Ludwig Dumoulin, Thomas Frieling, Jochen Hampe, Jutta Keller, Martin E. Kreis, Alexander Meining, Joachim Labenz, Johann F. Lock, Jörg Peter Ritz, Andreas G. Schreyer, Ludger Leifeld
United European Gastroenterology Journal.2022; 10(9): 940. CrossRef
Treatment with Ceftriaxone in Complicated Diverticulitis Increases the Incidence of Intra-Abdominal Enterococcus faecium Detection
Julius Pochhammer, Axel Kramer, Matthias Orth, Michael Schäffer, Jan Henrik Beckmann
Surgical Infections.2021; 22(5): 543. CrossRef
Risk factors for recurrence after acute colonic diverticulitis: a systematic review
Line Hupfeld, Jakob Burcharth, Hans-Christian Pommergaard, Jacob Rosenberg
International Journal of Colorectal Disease.2017; 32(5): 611. CrossRef
Acute colonic diverticulitis: an update on clinical classification and management with MDCT correlation
Maxime Barat, Anthony Dohan, Karine Pautrat, Mourad Boudiaf, Raphael Dautry, Youcef Guerrache, Marc Pocard, Christine Hoeffel, Clarisse Eveno, Philippe Soyer
Abdominal Radiology.2016; 41(9): 1842. CrossRef
The Wind of Change: Uncomplicated Diverticulitis
Hungdai Kim
Annals of Coloproctology.2015; 31(2): 43. CrossRef
Intermittent bacteremia detected in an asymptomatic apheresis platelet donor with repeat positive culture for Escherichia coli: a case report
Sandra Ramirez‐Arcos, Ted Alport, Mindy Goldman
Transfusion.2015; 55(11): 2606. CrossRef

Association Between a Close Distal Resection Margin and Recurrence After a Sphincter-Saving Resection for T3 Mid- or Low-Rectal Cancer Without Radiotherapy: Jae Woong Han, Min Jae Lee, Ha Kyung Park, Jae Ho Shin, Min Sung An, Tae Kwun Ha, Kwang Hee Kim, Ki Beom Bae, Tae Hyun Kim, Chang Soo Choi, Sang Hoon Oh, Min Kyung Oh, Mi Seon Kang, Kwan Hee Hong; Ann Coloproctol. 2013;29(6):231-237. Published online December 31, 2013; DOI: https://doi.org/10.3393/ac.2013.29.6.231

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Abstract PDF

Purpose

To maintain the patient's quality of life, surgeons strive to preserve the sphincter during rectal cancer surgery. This study evaluated the oncologic safety of a sphincter-saving resection with a distal resection margin (DRM) <1 cm without radiotherapy in T3, mid- or low-rectal cancer.

Methods

This retrospective study enrolled 327 patients who underwent a sphincter-saving resection for proven T3 rectal cancer located <10 cm from the anal verge and without radiotherapy between January 1995 and December 2011. The oncologic outcomes included the 5-year cancer-specific survival, the local recurrence, and the systemic recurrence rates.

Results

In groups A (DRM ≤1 cm) and B (DRM >1 cm), the 5-year cancer-specific survival rates were 81.57% and 80.03% (P = 0.8543), the 5-year local recurrence rates were 6.69% and 9.52% (P = 0.3981), and the 5-year systemic recurrence rates were 19.46% and 23.11% (P = 0.5750), respectively.

Conclusion

This study showed that the close DRM itself should not be a contraindication for a sphincter-saving resection for T3 mid- or low-rectal cancer without radiotherapy. However, a prospective randomized controlled trial including the effect of adjuvant therapy will be needed.

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Islam H. Metwally, Mohammad Zuhdy, Omar Hamdy, Ahmed M. Fareed, Saleh S. Elbalka
Indian Journal of Surgical Oncology.2022; 13(4): 750. CrossRef
Association of levels of metabolites with the safe margin of rectal cancer surgery: a metabolomics study
Shaopeng Zhang, Guoqiang Pan, Zhifeng Liu, Yuan Kong, Daguang Wang
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Noortje Pleunis, Maria E.J. Leermakers, Anneke A. van der Wurff, Paul J.J.M. Klinkhamer, Nicole P.M. Ezendam, Dorry Boll, Joanne A. de Hullu, Johanna M.A. Pijnenborg
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SooYoon Sung, Sung Hwan Kim, Joo Hwan Lee, Taek Keun Nam, Songmi Jeong, Hong Seok Jang, Jin Ho Song, Jeong Won Lee, Jung Min Bae, Jong Hoon Lee
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Safe Distal Resection Margin in Patients With T3 Mid and Distal Rectal Cancer Who Underwent a Sphincter-Saving Resection Without Preoperative Radiotherapy
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Annals of Coloproctology.2013; 29(6): 219. CrossRef

Diagnostic Accuracy of Elevated Serum Carcinoembryonic Antigen for Recurrence in Postoperative Stage II Colorectal Cancer Patients: Comparison With Stage III: Ho Seung Kim, Min Ro Lee; Ann Coloproctol. 2013;29(4):155-159. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.155

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Abstract PDF

Purpose

Elevated levels of serum carcinoembryonic antigen (CEA) following a curative resection of colorectal cancer (CRC) indicate recurrence; however, the levels of CEA may be elevated above the normal limit without recurrence. The aim of this study is to analyze the diagnostic accuracy of elevated serum CEA for predicting recurrence in postoperative stage II and stage III CRC patients.

Methods

A total of 336 stage II and stage III CRC patients who underwent a curative resection between January 2005 and October 2009 were enrolled. Sensitivities, specificities, positive predictive values (PPVs), negative predictive values (NPVs), likelihood ratios and post-test probabilities of recurrence associated with elevated CEA were analyzed and compared.

Results

The median follow-up duration was 45 months (36 to 134 months). Twenty-seven of 189 stage II patients (14.3%) and 52 of 147 stage III patients (35.4%) developed recurrence during the follow-up period. Sensitivities, specificities, PPVs, and NPVs of elevated CEA were 37.0%, 91.4%, 41.7%, and 89.7%, respectively, in stage II patients and 46.2%, 90.5%, 72.7%, and 75.4% in stage III patients. Post-test probabilities of recurrence associated with elevated CEA were 41.8% in stage II patients and 71.9% in stage III patients.

Conclusion

The predictive performance of the probability of recurrence associated with elevated serum CEA after a curative resection in stage II CRC patients is lower than that in stage III CRC patients.

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Validation of Assaying Carcinoembryonic Antigen in Human Serum by Using Immunomagnetic Reduction
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The diagnostic accuracy of carcinoembryonic antigen to detect colorectal cancer recurrence – A systematic review
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Blood CEA levels for detecting recurrent colorectal cancer
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Serum Carcinoembryonic Antigen for Recurrence in Colorectal Cancer Patients
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Case Report

Intramural Recurrence Without Mucosal Lesions After an Endoscopic Mucosal Resection for Early Colorectal Cancer: Min Sung Kim, Nam Kyu Kim, Ji Hye Park; Ann Coloproctol. 2013;29(3):126-129. Published online June 30, 2013; DOI: https://doi.org/10.3393/ac.2013.29.3.126

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Abstract PDF

Advances in endoscopic instruments and techniques have enabled increased detection and removal of early colorectal cancer (ECC), which is defined as a tumor whose invasion is limited to the mucosa or submucosa. Some cases can be treated by endoscopic mucosal resection (EMR). However, local recurrence frequently occurs after an EMR for ECC. The recurrence pattern is usually intramural recurrence with a mucosal lesion at the EMR's site. We report the cases of two patients with intramural recurrence without mucosal lesions after an EMR for ECC. These cases indicate that a local recurrence after an EMR for ECC can appear as an intramural recurrence without mucosal lesions at a previous EMR site or another site, although this presentation is very unusual.

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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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Growth-inhibition of S180 residual-tumor by combination of cyclophosphamide and chitosan oligosaccharides in vivo
Xingchen Zhai, Shoujun Yuan, Xin Yang, Pan Zou, Yong Shao, A.M. Abd El-Aty, Ahmet Hacımüftüoğlu, Jing Wang
Life Sciences.2018; 202: 21. CrossRef
Handling and Pathology Reporting of Gastrointestinal Endoscopic Mucosal Resection
Bita Geramizadeh, David A. Owen
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Feasibility of mesorectal vascular invasion in predicting early distant metastasis in patients with stage T3 rectal cancer based on rectal MRI
Young Chul Kim, Jai Keun Kim, Myeong-Jin Kim, Jei Hee Lee, Young Bae Kim, Sung Jae Shin
European Radiology.2016; 26(2): 297. CrossRef
Antitumor Effects of Orally and Intraperitoneally Administered Chitosan Oligosaccharides (COSs) on S180‐Bearing/Residual Mouse
Pan Zou, Xin Yang, Yanxin Zhang, Pengfei Du, Shoujun Yuan, Dexuan Yang, Jing Wang
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Re-evaluation of indications and outcomes of endoscopic excision procedures for colorectal tumors: a review
S. Cai, Y. Zhong, P. Zhou, J. Xu, L. Yao
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Anticancer activity of tuftsin-derived T peptide in postoperative residual tumors
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Anti-Cancer Drugs.2014; 25(8): 857. CrossRef

Original Articles

Delorme's Procedure: An Effective Treatment for a Full-Thickness Rectal Prolapse in Young Patients: Mohammad Sadegh Fazeli, Ali Reza Kazemeini, Amir Keshvari, Mohammad Reza Keramati; Ann Coloproctol. 2013;29(2):60-65. Published online April 30, 2013; DOI: https://doi.org/10.3393/ac.2013.29.2.60

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Abstract PDF

Purpose

Delorme's procedure is infrequently applied in young adults because of its assumed higher recurrence rate. The aim of this prospective study was to assess the efficacy of the Delorme's technique in younger adults.

Methods

Fifty-two consecutive patients were entered in our study. We followed patients for at least 30 months. Their complaints and clinical exam results were noted.

Results

Our study included 52 patients (mean age, 38.44 years; standard deviation, 13.7 years). Of the included patients, 41 (78.8%) were younger than 50 years of age, and 11 (21.1%) were older than 50 years of age. No postoperative mortalities or major complications were noted. Minor complications were seen in 5 patients (9.6%) after surgery. The mean hospital stay was 2.5 days. In the younger group (age ≤50 years), fecal incontinence was improved in 92.3% (12 out of 13 with previous incontinence) of the patients, and recurrence was seen in 9.75% (4 patients). In the older group (age >50 years), fecal incontinence was improved in 20% (1 out of 5 with previous incontinence) of the patients, and recurrence was seen in 18.2% (2 patients). In 50% of the patients with a previous recurrence (3 out of 6 patients) following Delorme's procedure as a secondary procedure, recurrence was observed.

Conclusion

Delorme's procedure, especially in younger patients, is a relatively safe and effective treatment and should not be restricted to older frail patients. This procedure may not be suitable for recurrent cases.

Citations

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Henry H. Chill, Alireza Hadizadeh, Angela Leffelman, Claudia Paya Ten, Cecilia Chang, Roger P. Goldberg, Ghazaleh Rostaminia
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Henry H. Chill, Sonia Gilani, Alireza Hadizadeh, Cecilia Chang, Nani P. Moss, Roger P. Goldberg, Ghazaleh Rostaminia
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Alessandro Sturiale, Lisa Fralleone, Bernardina Fabiani, Claudia Menconi, Vittorio d'Adamo, Gabriele Naldini
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Delorme's procedure for urgent rectal prolapse – A video vignette
A. Teresa Calderón Duque, Esther María Cano Pecharromán, Javier Broekhuizen Benítez, Laura Arriero Ollero, Lourdes Gómez Ruiz, Tomas Balsa Marín
Colorectal Disease.2023; 25(3): 513. CrossRef
External rectal prolapse: more than meets the eye
M. Yiasemidou, C. Yates, E. Cooper, R. Goldacre, I. Lindsey
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Delorme’s vs. Altemeier’s in the management of rectal procidentia: systematic review and meta-analysis
Pratik Bhattacharya, Mohammad Iqbal Hussain, Shafquat Zaman, Sophie Randle, Yousaf Tanveer, Nameer Faiz, Diwakar Ryali Sarma, Rajeev Peravali
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
What are the surgical options for recurrent rectal prolapse – retrospective single-center experience
Tomasz Kościński, Krzysztof Szmyt
Polish Journal of Surgery.2023; 96(1): 22. CrossRef
Trends in the surgical management of rectal prolapse: An Asian experience
Yvonne Ying‐Ru Ng, Emile John Kwong Wei Tan, Cherylin Wan Pei Fu
Asian Journal of Endoscopic Surgery.2022; 15(1): 110. CrossRef
Longer prolapsed rectum length increases recurrence risk after Delorme’s procedure
Taro Tanabe, Emi Yamaguchi, Takuya Nakada, Risa Nishio, Kinya Okamoto, Tetsuo Yamana
Annals of Coloproctology.2022; 38(4): 314. CrossRef
Surgical Treatment of Full-Thickness Rectal Prolapse (FTRP): a Case Series Analysis
Przemysław Ciesielski, Magdalena Szczotko, Małgorzata Kołodziejczak
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Eloy Maldonado Marcos, Pere Planellas Giné, Júlia Gil Garcia, Ramon Farrés Coll, Antoni Codina Cazador
Cirugía Española.2021; 99(5): 389. CrossRef
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Eloy Maldonado Marcos, Pere Planellas Giné, Júlia Gil Garcia, Ramon Farrés Coll, Antoni Codina Cazador
Cirugía Española (English Edition).2021; 99(5): 389. CrossRef
Laparoscopic ventral mesh rectopexy vs Delorme's operation in management of complete rectal prolapse: a prospective randomized study
S. H. Emile, H. Elbanna, M. Youssef, W. Thabet, W. Omar, A. Elshobaky, T. M. Abd El‐Hamed, M. Farid
Colorectal Disease.2017; 19(1): 50. CrossRef
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Scott R. Steele, Madhulika G. Varma, David Prichard, Adil E. Bharucha, Sarah A. Vogler, Askin Erdogan, Satish S.C. Rao, Ann C. Lowry, Erin O. Lange, Glen M. Hall, Joshua I.S. Bleier, Anthony J. Senagore, Justin Maykel, Sook Y. Chan, Ian M. Paquette, Marie
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A. Hotouras, Y. Ribas, S. Zakeri, C. Bhan, S. D. Wexner, C. L. Chan, J. Murphy
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Association of Immune Status with Recurrent Anal Condylomata in Human Immunodeficiency Virus-Positive Patients: Ji Hyun Sung, Eun Jung Ahn, Heung-Kwon Oh, Sei Hyeog Park; J Korean Soc Coloproctol. 2012;28(6):294-298. Published online December 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.6.294

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Abstract PDF

Purpose

An anal condyloma is a proliferative disease of the genital epithelium caused by the human papillomavirus. This condition is most commonly seen in male homosexuals and is frequently recurrent. Some reports have suggested that immunosuppression is a risk factor for recurrence of a condyloma. Thus, we investigated the risk factors for a recurrent anal condyloma in human immunodeficiency virus (HIV)-positive patients.

Methods

We retrospectively analyzed 85 consecutive patients who were diagnosed with and underwent surgery for an anal condyloma from January 2007 to December 2011. Outcomes were analyzed based clinical and immunologic data.

Results

Recurrent anal condylomata were found in 25 patients (29.4%). Ten cases (40.0%) were within postoperative 3 months. At postoperative 6 months, the CD4 lymphocyte count in the recurrent group was lower than it was in the nonrecurrent group (P = 0.023).

Conclusion

CD4-mediated immunosuppression is a risk factor for recurrent anal condylomata in HIV-positive patients.

Citations

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Effectiveness of physically ablative and pharmacological treatments for anal condyloma in HIV-infected men
Sandra Vela, Sebastian Videla, Arelly Ornelas, Boris Revollo, Bonaventura Clotet, Guillem Sirera, Marta Piñol, Francesc García-Cuyás, Magdalena Grce
PLOS ONE.2018; 13(8): e0199033. CrossRef
Efficacy of fulguration combined with imiquimod cream on condyloma acuminatum, and the effect on immune functions and serums levels of IL-2 and IL-10
Quan Chen, Ridong Yang, Aili Gao, Daoqing Zhong, Huilan Zhu
Experimental and Therapeutic Medicine.2017; 14(1): 131. CrossRef
Association of HIV Infection With Anal and Penile Low-Risk Human Papillomavirus Infections Among Men Who Have Sex With Men in Amsterdam
Camiel A.H. Welling, Sofie H. Mooij, Marianne A.B. van der Sande, Martijn S. van Rooijen, Wilma F. Vermeulen-Oost, Audrey J. King, Arne van Eeden, Daniëlle A.M. Heideman, Ineke G. Stolte, Maarten F. Schim van der Loeff
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Condylomes anaux dégénérés. A propos de 13 cas
R. Lalej, S. Nadir, W. Hliwa, F. Haddad, W. Badre, A. Bellabah, R. Alaoui
Journal Africain d'Hépato-Gastroentérologie.2013; 7(4): 196. CrossRef

Review

Pelvic Exenteration: Surgical Approaches: Jin Kim; J Korean Soc Coloproctol. 2012;28(6):286-293. Published online December 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.6.286

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Abstract PDF

Although the incidence of local recurrence after curative resection of rectal cancer has decreased due to the understanding of the anatomy of pelvic structures and the adoption of total mesorectal excision, local recurrence in the pelvis still remains a significant and troublesome complication. While surgery for recurrent rectal cancer may offer a chance for a cure, conservative management, including radiation and chemotherapy, remain widely accepted courses of treatment. Recent improvement in imaging modalities, perioperative care, and surgical techniques, including bone resection and wound coverage, have allowed for reductions in operative mortality, though postoperative morbidity still remains high. In this review, the techniques, including surgical approaches, employed for management of locally recurrent rectal cancer are highlighted.

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Original Articles

Risk Factors for Repeat Abdominal Surgery in Korean Patients with Crohn's Disease: A Multi-Center Study of a Korean Inflammatory Bowel Disease Study Group: Kil Yeon Lee, Chang Sik Yu, Kang Young Lee, Yong Beom Cho, Kyu Joo Park, Gyu-Seog Choi, Sang Nam Yoon, Hanna Yoo; J Korean Soc Coloproctol. 2012;28(4):188-194. Published online August 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.4.188

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Abstract PDF

Purpose

The purpose of this study was to assess the risk factors for repeated abdominal surgery in Crohn's disease (CD) patients after the first abdominal surgery. Prior studies have tried to identify the risk factors for postoperative recurrence in CD patients, but the results of the studies have been inconsistent. Furthermore, few data on the risk factors for repeated abdominal surgery are available.

Methods

Clinical data on CD patients who underwent abdominal surgery from January 2000 to December 2009 were collected from seventeen university hospitals and one colorectal clinic. Data from a total of 708 patients were analyzed to find the risk factors for repeated abdominal surgery in CD patients. The mean follow-up period was 72 months.

Results

The risk of repeated abdominal surgery was 3 times higher in young patients (below 16 years old) than in older patients (odds ratio [OR], 3.056; 95% confidence interval [CI], 1.021 to 9.150); P = 0.046). Stricturing behavior at diagnosis was also a risk factor for repeated abdominal surgery (OR, 2.438; 95% CI, 1.144 to 5.196; P = 0.021). Among operative indications, only intra-abdominal abscess was associated with repeated abdominal surgery (OR, 2.393; 95% CI, 1.098 to 5.216; P = 0.028). Concerning type of operation, an ileostomy might be a risk factor for repeated abdominal surgery (OR, 11.437; 95% CI, 1.451 to 90.124; P = 0.021). Emergency surgery (OR, 4.994; 95% CI, 2.123 to 11.745; P < 0.001) and delayed diagnosis after surgery (OR, 2.339; 95% CI, 1.147 to 4.771; P = 0.019) also increased the risk of repeated abdominal surgery.

Conclusion

Young age (below 16 years), stricturing behavior, intra-abdominal abscess, emergency surgery, and delayed diagnosis after surgery were identified as possible risk factors for repeated abdominal surgery in CD patients.

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Maria Michela Chiarello, Gilda Pepe, Valeria Fico, Valentina Bianchi, Giuseppe Tropeano, Gaia Altieri, Giuseppe Brisinda
World Journal of Gastroenterology.2022; 28(18): 1902. CrossRef
Risk Factors for Postoperative Recurrence in Korean Patients with Crohn’s Disease
Sung Bae Kim, Jae Hee Cheon, Jae Jun Park, Eun Soo Kim, Seong Woo Jeon, Sung-Ae Jung, Dong Il Park, Chang Kyun Lee, Jong Pil Im, You Sun Kim, Hyun Soo Kim, Jun Lee, Chang Soo Eun, Jeong Mi Lee, Byung Ik Jang, Geom Seog Seo
Gut and Liver.2020; 14(3): 331. CrossRef
Prevalence and factors associated with re-laparotomy among patients operated in Debre-Markos referral hospital, north west Ethiopia: Retrospective cross-sectional study
Yeneabat Birhanu, Debrework Tesgera, Henok Biresaw Netsere, Nurhusien Nuru
International Journal of Africa Nursing Sciences.2020; 13: 100249. CrossRef
Comparison of missing data methods in clustered survival data using Bayesian adaptive B-Spline estimation
Hanna Yoo, Jae Won Lee
Communications for Statistical Applications and Methods.2018; 25(2): 159. CrossRef
Patients with perianal Crohn's disease have poor disease outcomes after primary bowel resection
Yoo Min Han, Ji Won Kim, Seong‐Joon Koh, Byeong Gwan Kim, Kook Lae Lee, Jong Pil Im, Joo Sung Kim, Hyun Chae Jung
Journal of Gastroenterology and Hepatology.2016; 31(8): 1436. CrossRef
The Clinical Features and Predictive Risk Factors for Reoperation in Patients With Perianal Crohn Diseases; A Multi-Center Study of a Korean Inflammatory Bowel Disease Study Group
Jae Bum Lee, Seo-Gue Yoon, Kyu Joo Park, Kang Young Lee, Dae Dong Kim, Sang Nam Yoon, Chang Sik Yu
Annals of Coloproctology.2015; 31(5): 176. CrossRef
Crohn's disease in Korea: past, present, and future
Kang-Moon Lee, Ji Min Lee
The Korean Journal of Internal Medicine.2014; 29(5): 558. CrossRef
Clinical and Endoscopic Recurrence after Surgical Resection in Patients with Crohn's Disease
Yang Woon Lee, Kang-Moon Lee, Woo Chul Chung, Chang Nyol Paik, Hea Jung Sung, You Suk Oh
Intestinal Research.2014; 12(2): 117. CrossRef

Oncologic Outcomes and Risk Factors for Recurrence after Tumor-specific Mesorectal Excision of Rectal Cancer: 782 Cases: Sam Hee Kim, Ki Beom Bae, Jung Min Kim, Jae Ho Shin, Min Sung An, Tae Geun Ha, Sung Mok Ryu, Kwang Hee Kim, Tae Hyeon Kim, Chang Soo Choi, Jin Yong Shin, Minkyung Oh, Seung Hun Baek, Kwan Hee Hong; J Korean Soc Coloproctol. 2012;28(2):100-107. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.100

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11 Citations

Abstract PDF

Purpose

The aim of this study was to analyze the oncologic outcomes and the risk factors for recurrence after a tumor-specific mesorectal excision (TSME) of resectable rectal cancer in a single institution.

Methods

A total of 782 patients who underwent a TSME for resectable rectal cancer between February 1995 and December 2005 were enrolled retrospectively. Oncologic outcomes included 5-year cancer-specific survival and its affecting factors, as well as risk factors for local and systemic recurrence.

Results

The 5-year cancer-specific survival rate was 77.53% with a mean follow-up period of 61 ± 31 months. The overall local and systemic recurrence rates were 9.2% and 21.1%, respectively. The risk factors for local recurrence were pN stage (P = 0.015), positive distal resection margin, and positive circumferential resection margin (P < 0.001). The risk factors for systemic recurrence were pN stage (P < 0.001) and preoperative carcinoembryonic antigen level (P = 0.005). The prognostic factors for cancer-specific survival were pT stage (P < 0.001), pN stage (P < 0.001), positive distal resection margin (P = 0.005), and positive circumferential resection margin (P = 0.016).

Conclusion

The oncologic outcomes in our institution after a TSME for patients with resectable rectal cancer were similar to those reported in other recent studies, and we established the risk factors that could be crucial for the planning of treatment and follow-up.

Citations

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Short-term outcomes of robotic tumor-specific mesorectal resection of rectal cancer: surgical techniques in mesorectal division using rolling division of the mesorectum
Yushi Yamakawa, Nobuhiro Haruki, Nobuo Ochi, Reo Sato, Hiroyuki Asai, Tomohiro Kako, Takumi Kato, Mitsuki Nakazawa, Shuji Takiguchi
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Current Controversies in the Management of Locally Advanced Colon Cancer
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Functional outcomes after sphincter-preserving surgeries for low-lying rectal cancer: A review
Eun Jung Park, Seung Hyuk Baik
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Locally Advanced Rectal Cancer Evaluation by Magnetic Resonance Imaging after Neoadjuvant Therapy on Decision Making: Cancer Center Experience and Literature Review
Alejandro Recio-Boiles, Hytham Hammad, Krisha Howell, Bobby T. Kalb, Valentine N. Nfonsam, Aaron J. Scott, Hani M. Babiker, Emad Elquza
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Chi Zhang, Hao-tang Wei, Wenqing Hu, Yueming Sun, Qinyuan Zhang, Masanobu Abe, Zhuoran Du, Yingying Xu, Liang Zong, Xiang Hu
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Recurrence in patients with stage I colorectal cancer
Patrick Ely Teloken, David Ransom, Ian Faragher, Ian Jones, Peter Gibbs, Cameron Platell
ANZ Journal of Surgery.2016; 86(1-2): 49. CrossRef
Current methods in the treatment of rectal cancer
L. Yu. Kazieva, E. G. Rybakov, S. I. Sevostianov
Endoskopicheskaya khirurgiya.2016; 22(4): 49. CrossRef
TRANSANAL TOTAL MESORECTAL EXCISION FOR RECTAL CANCER (review)
L. Uj. Kazieva
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Sabrina M. Ebinger, René Warschkow, Ignazio Tarantino, Bruno M. Schmied, Lukas Marti
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Michael Wilhelmsen, Thomas Kring, Lars N. Jorgensen, Mogens Rørbæk Madsen, Per Jess, Orhan Bulut, Knud Thygesen Nielsen, Claus Lindbjerg Andersen, Hans Jørgen Nielsen
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Jong Seob Park, Jung Wook Huh, Yoon Ah Park, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Ho-Kyung Chun
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Clinicopathologic Factors Affecting Recurrence after Curative Surgery for Stage I Colorectal Cancer: Min Ae Keum, Seok-Byung Lim, Sun A Kim, Yong Sik Yoon, Chan Wook Kim, Chang Sik Yu, Jin Cheon Kim; J Korean Soc Coloproctol. 2012;28(1):49-55. Published online February 29, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.1.49

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Abstract PDF

Purpose

The objective of the current study was to identify the clinicopathological risk factors affecting recurrence after a curative resection for stage I colorectal cancer.

Methods

We retrospectively studied 434 patients who underwent a curative resection for stage I colorectal cancer between January 1999 and December 2004. Postoperative oral chemotherapy was performed in 189 patients (45.3%). The following prognostic factors were correlated with recurrence: age, gender, preoperative carcinoembryonic antigen level, location of tumor, T stage, size of tumor, histologic differentiation, growth pattern, and lymphovascular invasion. The median follow-up duration was 65 months.

Results

The overall recurrence rate was 4.6% (20/434). The median time to recurrence was 33 months. Two-thirds of the recurrence occurred more than two years after surgery. Risk factors associated with recurrence were rectal cancer (P = 0.009), T2 stage (P = 0.010), and infiltrative growth pattern (P = 0.020). A Cox proportional hazards regression analysis demonstrated that the infiltrative growth pattern was an independent predictor for recurrence. Tumor cell budding was observed in all pathologic reviews with recurrence.

Conclusion

Long-term follow-up is necessary for stage I colorectal patients with high risk factors like rectal cancer, T2 stage, and infiltrative growth pattern.

Citations

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Single-incision Laparoscopic Surgery for Appendiceal Mucoceles: Safety and Feasibility in a Series of 16 Consecutive Cases: Ki Bum Park, Jun Seok Park, Gyu-Seog Choi, Hye Jin Kim, Soo Yeun Park, Jong Pil Ryuk, Won Ho Choi, You Seok Jang; J Korean Soc Coloproctol. 2011;27(6):287-292. Published online December 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.6.287

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Abstract PDF

Purpose

The aim of this study was to evaluate the technical feasibility, safety, and oncological outcomes of transumbilical single-incision laparoscopic surgery in patients with an uncomplicated appendiceal mucocele.

Methods

A review of a prospectively collected database at the Kyungpook National University Hospital from January 2006 to September 2010 revealed that a series of 16 consecutive patients underwent single-incision laparoscopic surgery (SILS) for an appendiceal mucocele. Data regarding patient demographics, operating time, conversion, surgical morbidity, lateral lymph node status, and mid-term oncologic result were analyzed.

Results

The reported series consisted of 7 women (50%) and 9 men with a mean age of 61.6 years (range, 41 to 88 years). The mean operative time was 66.8 minutes (range, 33 to 150 minutes). Perioperative mortality and morbidity were 0% and 6.2%, respectively. Recovery after the procedure was rapid, and the mean hospital stay was 6.8 days (range, 3 to 22 days). Pathology revealed 12 lesions compatible with a mucinous cystadenoma and four others compatible with benign cystic tumors. All surgical margins were clear. In one case, an extra port had to be placed, and another case required conversion from SILS to a standard open laparotomy immediately after identification of the tumor because of a micro-perforation with focal mucin collection. With a median follow-up of 28.7 months, no re-admission or tumor recurrence, such as pseudomyxoma peritonei, was noted in 14 patients.

Conclusion

A single-port laparoscopic mucocelectomy should be safe and feasible and has the advantage of being a minimally invasive approach. Prospective controlled studies comparing SILS and conventional open surgery, with long-term follow-up evaluation, are needed to confirm the author's initial experience.

Citations

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The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Appendiceal Neoplasms
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Diseases of the Colon & Rectum.2025; 68(7): 815. CrossRef
Appendiceal Mucocele - A Review of Literature with a Case Report
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IV. Les recommandations

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Case Report

Recurrent Renal Leiomyosarcoma Mimicking a Colonic Submucosal Tumor: A Case Report: Yun Jeung Kim, Hee Seok Moon, Eaum Seok Lee, Jae Kyu Sung, Hyun Yong Jeong, Ji Yeon Kim, Dae Young Kang; J Korean Soc Coloproctol. 2011;27(5):270-274. Published online October 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.5.270

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Abstract PDF

A primary leiomyosarcoma of the kidney is a rare, but highly aggressive, neoplasm, accounting for only 0.1% of all invasive renal tumors. Local or systemic recurrence is common, but a leiomyosarcoma is difficult to diagnose preoperatively. We recently encountered an interesting case of an unusual recurrence of a renal leiomyosarcoma. A 57-year-old woman visited our hospital complaining of lower abdominal pain. Four years previously, she had undergone a left nephrectomy. She had a primary leiomyosarcoma of the kidney that had been misdiagnosed as a renal cell carcinoma. Colonoscopy revealed the presence of a lesion similar to a submucosal tumor in the descending colon. Postoperative pathologic examination confirmed that the mass was a recurrent leiomyosarcoma. We report this unusual case and present a review of the literature.

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A Rare Case of Colonic Leiomyosarcoma in Association with Ulcerative Colitis
Daisuke Akutsu, Yuji Mizokami, Hideo Suzuki, Masahiko Terasaki, Toshiaki Narasaka, Tsuyoshi Kaneko, Hirofumi Matsui, Tsuyoshi Enomoto, Taiki Sato, Ichinosuke Hyodo
Internal Medicine.2016; 55(19): 2799. CrossRef

Original Articles

Surgical Treatment of a Parastomal Hernia: Seung Chul Heo, Heung-Kwon Oh, Yoon Suk Song, Mi Sun Seo, Eun Kyung Choe, Seungbum Ryoo, Kyu Joo Park; J Korean Soc Coloproctol. 2011;27(4):174-179. Published online August 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.4.174

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9 Citations

Abstract PDF

Purpose

Parastomal hernia is a major complication of an intestinal stoma. This study was performed to compare the results of various operative methods to treat parastomal hernias.

Methods

Results of surgical treatment for parastomal hernias (postoperative recurrence, complications and postoperative hospital stays) were surveyed in 39 patients over an 11-year period. The patients enrolled in this study underwent surgery by a single surgeon to exclude surgeon bias.

Results

Seventeen patients were male, and twenty-two patients were female. The mean age was 65.9 years (range, 36 to 86 years). The stomas were 35 sigmoid-end-colostomies (90%), 2 loop-colostomies (5%), and 2 double-barrel-colostomies. Over half of the hernias developed within two years after initial formation. Stoma relocation was performed in 8 patients, suture repair in 14 patients and mesh repair in 17 patients. Seven patients had recurrence of the hernia, and ten patients suffered from complications. Postoperative complications and recurrence were more frequent in stoma relocation than in suture repair and mesh repair. Emergency operations were performed in four patients (10.3%) with higher incidence of complications but not with increased risk of recurrence. Excluding emergency operations, complications of relocations were not higher than those of mesh repairs. Postoperative hospital stays were shortest in mesh repair patients.

Conclusion

In this study, mesh repair showed low recurrence and a low complication rate with shorter hospital stay than relocation methods, though these differences were not statistically significant. Further studies, including randomized trials, are necessary if more reliable data on the surgical treatment of parastomal hernias are to be obtained.

Citations

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Long-term outcomes after open parastomal hernia repair at a high-volume center
Alexis M. Holland, William R. Lorenz, Brittany S. Mead, Gregory T. Scarola, Vedra A. Augenstein, B. Todd Heniford, Monica E. Polcz
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Stoma-Related Complications: A Single-Center Experience and Literature Review
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Journal of Interdisciplinary Medicine.2022; 7(2): 31. CrossRef
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Andrew S. Miller, Kathryn Boyce, Benjamin Box, Matthew D. Clarke, Sarah E. Duff, Niamh M. Foley, Richard J. Guy, Lisa H. Massey, George Ramsay, Dominic A. J. Slade, James A. Stephenson, Phil J. Tozer, Danette Wright
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G. S. Hwang, M. H. Hanna, J. C. Carmichael, S. D. Mills, A. Pigazzi, M. J. Stamos
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J. Al Shakarchi, J. G. Williams
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A. Lampel, N. Runkel
Der Urologe.2012; 51(7): 965. CrossRef
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In Ho Song, Heon-Kyun Ha, Sang-Gi Choi, Byeong Geon Jeon, Min Jung Kim, Kyu Joo Park
Journal of the Korean Society of Coloproctology.2012; 28(6): 299. CrossRef

Effect of Diabetes Mellitus on Outcomes of Colorectal Cancer: Geum Youb Noh, Dae-Yong Hwang, Yoon Hee Choi, Yun Yong Lee; J Korean Soc Coloproctol. 2010;26(6):424-428. Published online December 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.6.424

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25 Citations

Abstract PDF

Purpose

Many studies have revealed that diabetes mellitus (DM) increases a person's lifetime risk of colorectal cancer and that DM is associated with a worse outcome of colon cancer, but this association is controversial. In this study, we intended to examine the relationship between DM and the long-term outcomes of colorectal cancer.

Methods

A retrospective analysis was conducted on 657 patients who underwent surgery due to colorectal cancer between 1997 and 2004 at Korea Cancer Center Hospital. The operations were done by a single surgeon. With a median follow-up of 4.7 years, we analyzed differences in recurrence-free survival (RFS) and overall survival (OS) between patients with DM and those without DM.

Results

Of the 657 patients, 374 (57%) were males and 67 (10%) had DM. There was no difference in age at diagnosis, sex and pathologic stage of colorectal cancer according to the presence of DM. There were no difference in the RFS and the OS of colon cancer between the patients with DM and those without DM. At 5 years, the RFS was 71.3% in diabetic patients vs. 70.4% in non-diabetic patients (P = 0.480), and the OS was 68.8% in diabetic patients vs. 75.0% in non-diabetic patients (P = 0.498). There was no difference in the median survival between the groups (9.6 years in the diabetic group vs. 10.6 years in the non-diabetic group; P = 0.495).

Conclusion

In this study, we did not find any relation between the presence of DM and either the recurrence or the survival in cases of colorectal cancer. More studies to elucidate whether the influence of DM is directly related to a higher rate of cancer recurrence or survival are needed.

Citations

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The impact of the incidence of diabetic complications on mortality in colorectal cancer patients with diabetes: A nationwide study
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Effect of diabetes mellitus comorbidity on outcomes in stages II and III colorectal cancer
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World Journal of Gastroenterology.2022; 28(19): 2148. CrossRef
Diabetes mellitus and colorectal carcinoma outcomes: a meta-analysis
Daniel J. Becker, Arjun D. Iyengar, Salman R. Punekar, Dalia Kaakour, Megan Griffin, Joseph Nicholson, Heather T. Gold
International Journal of Colorectal Disease.2020; 35(11): 1989. CrossRef
Socioclinical profile of patients seeking treatment for cancer in a Teaching hospital in east Delhi, India
Utsav Gupta, MadhuKumari Upadhyay, Rahul Sharma
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Postoperative serum carcinoembryonic antigen levels cannot predict survival in colorectal cancer patients with type II diabetes
Chih-Sheng Huang, Chin-Yau Chen, Li-Kuo Huang, Wei-Shu Wang, Shung-Haur Yang
Journal of the Chinese Medical Association.2020; 83(10): 911. CrossRef
Utility of KRAS Gene and Clinicopathological Features in the Assessment of the Risk of Type 2 Diabetes in the Etiology of Colon Cancer
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Optimal glycemic target level for colon cancer patients with diabetes
Shin Jun Lee, Jae Hyun Kim, Seun Ja Park, So Young Ock, Su Kyoung Kwon, Young Sik Choi, Bu Kyung Kim
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Bo Zhu, Xiaomei Wu, Bo Wu, Dan Pei, Lu Zhang, Lixuan Wei, Masaru Katoh
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Jingtao Li, Jixi Liu, Chun Gao, Fang Liu, Hongchuan Zhao
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Mohammad Aziz Rasouli, Ghobad Moradi, Daem Roshani, Bahram Nikkhoo, Ebrahim Ghaderi, Bahman Ghaytasi
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Abdominoperineal Resection in the Treatment of Locally-advanced Low Rectal Cancer: Is Preoperative Chemoradiation Advantageous?.: Kim, Jeong Yeon , Kim, Jin Soo , Kim, Young Wan , Hur, Hyuk , Min, Byung Soh , Kim, Nam Kyu; J Korean Soc Coloproctol. 2010;26(2):129-136.; DOI: https://doi.org/10.3393/jksc.2010.26.2.129

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Abstract PDF: PURPOSE
An abdominoperineal resection (APR) has a poor prognosis. However, limited studies about the prognostic factors in APR and the role of preoperative chemoradiotherapy (CRT) have been performed even though in rectal cancer, the application of preoperative CRT provides better local control compared to postoperative CRT. The aim of this study was to identify the prognostic factors and the impact of preoperative CRT in patients who undergo an APR.
METHODS
A retrospective analysis was conducted with a total of 133 patients who underwent an APR, cT3, cT4, or cN(+) patients, for rectal cancer between January 1995 and October 2004. Fifty-one patients treated with preoperative CRT (Group 1) were compared with 82 APR patients treated with postoperative CRT (Group 2). Oncologic outcomes were compared between the two groups, and the clinicopathologic factors affecting the treatment outcomes were evaluated.
RESULTS
The median follow-up period was 61.2 mo (range 6 to 194 mo). Circumferential margin (CRM) involvement was significantly associated with local recurrence (LR) and with disease-free survival in APR patients (P<0.001, P=0.011). The 5-yr LR rate was significantly lower in Group 1 than in Group 2 (P=0.013) in the univariate analysis, but no difference was noted in multivariate analysis (P=0.315). In Group 1, CRM involvement, tumor size, and lymph node metastasis were significantly lower than they were in Group 2 (P=0.043, P=0.003, P<0.001).
CONCLUSION
For achieving adequate oncologic outcomes in APR patients, an adequate CRM should be acquired with an optimal operation. In addition, preoperative CRT would be helpful for high-risk APR patients with a threatening CRM margin, providing the benefit of tumor downstaging.

The Influence of Age on Survival and Recurrence after a Curative Surgical Resection for Colon Cancer Patients.: Lee, Cho Rok , Kim, Young Wan , Kim, Nam Kyu , Hur, Hyuk , Min, Byung Soh , Lee, Kang Young , Sohn, Seung Kook , Cho, Chang Hwan; J Korean Soc Coloproctol. 2009;25(6):401-409.; DOI: https://doi.org/10.3393/jksc.2009.25.6.401

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Abstract PDF

PURPOSE
This study was performed to evaluate whether age was a factor associated with oncological outcome for colon cancer patients who underwent a curative surgical resection.
METHODS
A retrospective study of 2,125 colon cancer patients who underwent surgery between January 1989 to December 2004 was conducted. RESULTS: Of the 2,125 patients, 1,724 patients underwent a curative resection (R0). The patients with R0 were classified into three groups: group I (n=142) under 40 yr of age, group II (n=1,462) between 40 and 75 yr of age, and group III (n=120) over 75 yr of age. There were no significant differences in gender, tumor diameter, or postoperative complications among the groups. A history of hereditary colon cancer, advanced TNM stage (III, IV), and poorly- differentiated histology were more commonly found in group I. Adjuvant chemotherapy was administered less frequently in group III. In the survival analysis, the cancer-specific survival (CSS) and the disease-free survival (DFS) rates were not different between groups I and II. The CSS and the DFS rates of group III were significantly unfavorable compared with those of groups I and II. On the multivariate analysis, old age (group III), TNM stage, and preoperative CEA level were independent risk factors for CSS and DFS. CONCLUSION: In colon cancer patients, tailored approaches according to age, such as early screening in young adults with family history and proper patients selection for adjuvant treatment in old patients, could be needed.

Citations

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Overweight is Associated with a Favorable Survival in Patients with Colorectal Cancer: A Prospective Cohort Study in an Asian Population
Yang Won Min, Su-A Kim, Jun Hee Lee, Jin Young Kim, Dong Kyung Chang, Poong-Lyul Rhee, Jae J. Kim, Jong Chul Rhee, Young-Ho Kim
Annals of Surgical Oncology.2012; 19(11): 3460. CrossRef
Analysis of the Prognostic Effectiveness of a Multivisceral Resection for Locally Advanced Colorectal Cancer
Sejin Park, Yun Sik Lee
Journal of the Korean Society of Coloproctology.2011; 27(1): 21. CrossRef

Clinicopathologic Analysis of Gastrointestinal Stromal Tumors of the Colon and Rectum.: Choi, Sung Hoon , Kim, Seo Jeon , Choi, Yun Jung , Min, Byung So , Kim, Jin Su , Baik, Seung Hyuk , Kim, Nam Kyu , Kang, Jung Gu; J Korean Soc Coloproctol. 2009;25(5):323-333.; DOI: https://doi.org/10.3393/jksc.2009.25.5.323

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Abstract PDF

PURPOSE
This study's aim is to investigate the clinicopathologic characteristics of colorectal gastrointestinal stromal tumors (GISTs) and to evaluate the result of those tumors.
METHODS
We retrospectively reviewed 22 patients who had been diagnosed with primary colorectal GISTs and who had undergone a surgical resection between October 1996 and July 2008.
RESULTS
Colorectal GISTs accounted for 0.28% of all colorectal malignancies and 7.7% of all GISTs. Rectal GISTs (19, 86.4%) were more common than colonic GISTs (3, 13.6%). According to the National Institute of Health's (NIH) grading system, there were 1 (4.5%) very low, 5 (22.7%) low, 4 (18.2%) intermediate, and 12 (54.6%) high-risk tumors. The disease recurred in 7 patients (1 with intermediate risk and 6 with high risk). Recurrence sites were the liver (42.9%), the peritoneum (71.5%), and the lymph nodes (14.3%). Adjuvant imatinib therapy and/or radiation therapy were done for patients with microscopically positive margins of resection and high risk, of which one experienced a recurrence at 95 months after surgery. The five-year recurrence rates were 0% in the very-low-grade and low-grade groups, 33.3% in the intermediate-grade group, and 37.5% in the high-grade group. The five-year overall survival rates were 100% in the very-low-grade and low-grade groups, 66.7% in the intermediate-grade group, and 62.5% in the high-grade group.
CONCLUSION
Poor prognosis of colorectal GISTs was closely related to the tumor's histologic grade and size. Integrating surgery, molecular therapy, and radiation therapy might improve outcomes, but further study with more cases is needed.

Citations

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Transanal endoscopic microsurgery with alternative neoadjuvant imatinib for localized rectal gastrointestinal stromal tumor: a single center experience with long-term surveillance
Xueshan Bai, Weixun Zhou, Yunhao Li, Guole Lin
Surgical Endoscopy.2021; 35(7): 3607. CrossRef
Primary localized rectal/pararectal gastrointestinal stromal tumors: results of surgical and multimodal therapy from the French Sarcoma group
Thanh-Khoa Huynh, Pierre Meeus, Philippe Cassier, Olivier Bouché, Sophie Lardière-Deguelte, Antoine Adenis, Thierry André, Julien Mancini, Olivier Collard, Michael Montemurro, Emmanuelle Bompas, Maria Rios, Nicolas Isambert, Didier Cupissol, Jean-Yves Bla
BMC Cancer.2014;[Epub] CrossRef
Efficacy of Imatinib Mesylate Neoadjuvant Treatment for a Locally Advanced Rectal Gastrointestinal Stromal Tumor
Kyu Jong Yoon, Nam Kyu Kim, Kang Young Lee, Byung Soh Min, Hyuk Hur, Jeonghyun Kang, Sarah Lee
Journal of the Korean Society of Coloproctology.2011; 27(3): 147. CrossRef
Multiple Colonic Metastases from Hepatocellular Carcinoma
Gwi Hong Jeong, Byong Duk Ye, Seung Jae Myung
The Korean Journal of Gastroenterology.2011; 58(5): 288. CrossRef

Prognosis and Recurrent Patterns of Sporadic Primary Colon Cancers According to Location.: Park, Jin Seok , Yu, Chang Sik , Kim, Chan Wook , Jeong, Kwang Yong , Shin, Ui Sup , Yoon, Sang Nam , Lim, Seok Byung , Kim, Jin Cheon; J Korean Soc Coloproctol. 2009;25(4):221-226.; DOI: https://doi.org/10.3393/jksc.2009.25.4.221

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PURPOSE
We aimed to compare the prognosis and the recurrence patterns of sporadic primary colon cancers according to the location of the cancer. METHODS: One thousand four-hundred eighty-three (1,483) stage II, III colon cancer patients who had undergone a consecutive curative resection between January 1989 and December 2003 were analyzed. Hereditary, synchronous, metachronous, and recurrent colon cancers were excluded. The right colon was defined as being from the cecum to the transverse colon, and the left colon was defined as being from the splenic flexure colon to the rectosigmoid colon. The median follow-up time was 63 (3-228) mo. RESULTS: Poorly differentiated and mucinous cell type tumors were more frequent in the right colon. T3 tumors were more frequent in the right colon. Lymph-node-positive tumors were more frequent in the left colon. The recurrence rate was higher in the left colon, but the patterns of recurrence were not different according to the tumor's location. By univariate analysis, age, preoperative serum CEA level, T-stage, N-stage, lymphovascular invasion, postoperative chemotherapy, and tumor location were significant prognostic factors associated with recurrence. By multivariate analysis, sex, preoperative serum CEA level, T-stage, N-stage, postoperative chemotherapy, and tumor location were significant prognostic factors associated with recurrence. The 5-yr disease-free survival rates were 84.0% for right colon cancer and 77.1% for left colon cancer (P=0.005). The recurrence rates for cancers in the sigmoid colon and the rectosigmoid colon were higher than those for cancers in the cecum and the ascending colon. CONCLUSION: The tumor's location was an independent prognostic factor for recurrence, but the pattern of recurrence did not vary with the tumor's location.

Citations

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Survival analysis for colon subsite and rectal cancers: Experience from a single surgeon
Inhwa Lee, Seung-Hyun Baek, Hyunsung Kim, Hong-Jae Jo, Nahm-Gun Oh, Sanghwa Ko
Korean Journal of Clinical Oncology.2015; 11(2): 114. CrossRef

Oncologic Impact of Extracapsular Invasion of Nodal Metastasis in Patients with Stage III Rectal Cancer.: Li, Ki Yoon , Shin, Jin Yong , Oh, Sang Hoon , Hong, Kwan Hee; J Korean Soc Coloproctol. 2009;25(3):186-192.; DOI: https://doi.org/10.3393/jksc.2009.25.3.186

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Abstract PDF: PURPOSE
Extracapsular invasion (ECI) of nodal metastasis is reported to be a prognosticator of colorectal cancer. However, limited knowledge exists about the prognostic value of ECI in stage III rectal cancer.
METHODS
From January 1996 to June 2004, 202 stage III rectal cancer patients who underwent surgery were enrolled in this study. The patients were divided into two groups according to ECI (patients with ECI, ECIP, n=122; patients without ECI, ECIN, n=80). The potential prognostic factors were compared in a Cox model.
RESULTS
Of 916 positive nodes examined, ECI was seen in 46.7% of the positive nodes. The univariate comparison between the two groups revealed the five-year results after a median follow-up of 48.0 mo. The local control rate of ECIP did not show a significant difference from that of ECIN (77.0% vs. 85.4%, P=0.550). The disease-free survival rate and the overall survival rate differed for the two groups, with rates of 44.1% and 50.0% for ECIP and 70.4% and 63.2% for ECIN (P<0.001, P=0.049, respectively). The impact of ECI on the disease-free survival was confirmed in a Cox model. In a subgroup analysis, no significant differences in the recurrence and the survival rates were seen between the N1 ECIP and the N2 ECIN subgroups.
CONCLUSION
Although ECI is not a risk factor for survival and local relapse, ECI is a prognosticator of overall recurrence. Based on these findings, more aggressive adjuvant treatment seems to be needed for decreasing the overall recurrence in stage III rectal cancer with ECI.

Long-term Result of Surgical Treatment for Crohn's Enteritis.: Choi, Sang Ji , Choe, Eun Kyung , Park, Sung Chan , Park, Kyu Joo; J Korean Soc Coloproctol. 2008;24(6):409-416.; DOI: https://doi.org/10.3393/jksc.2008.24.6.409

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Abstract PDF: PURPOSE
We sought to determine the long-term outcome of surgical management for gastrointestinal Crohns's disease (CD) and to find out whether there is any improvement over the time period.
METHODS
We analyzed the records of the 102 patients who underwent surgery for gastrointestinal CD excluding perianal CDbetween 1978 and 2007. A cumulative surgical recurrence rate was analyzed by Kaplan-Meier plots and log-rank tests.
RESULTS
The main sites of CD were ileocecal area in 54.5%, followed by small bowel (29.7%) and large bowel (7.9%). Common indications for operation were obstruction (25.7%), diagnostic purpose (20.8%), and failure of medical treatment (12.9%). The operation performed were ileocolectomy including right hemicolectomy in 53 cases (45.3%), small bowel resection in 38 cases (31.7%), and strictureplasty 12 cases (10.0%, including 11 cases combined with bowel resection). The average follow-up period after operation was 6.4years (range: 0.5~29 yr, median: 5.3 yr). Among all patients, 22 (21.6%) underwent operations for recurrence. The re-operation rate was higher in the younger patients group (age at diagnosis less than 25 years) (34.1% vs. 12.1%, P<0.05), and in case of the patients whose length of initial intestinal resection was less than 40 cm (27.9% vs. 7.7%, P<0.05). The overall cumulative re-operation rates at 5years, 10years and 15years were 15%, 25%, and 60%, respectively.
CONCLUSIONS
Despite recent advances in medical therapy, the cumulative re-operation rate of patients operated for gastrointestinal CD remains similar to our previous report in 1997.

Case Report

Re-anastomosis above a Preceding Anastomosis Made by a Low Anterior Resection.: Shin, Milljae , Yun, Haeran , Lee, Wonseok , Yun, Seonghyeon , Lee, Wooyong , Chun, Ho Kyung; J Korean Soc Coloproctol. 2008;24(4):287-291.; DOI: https://doi.org/10.3393/jksc.2008.24.4.287

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Abstract PDF: Periodic colonoscopic checkup is needed for patients suffering from colorectal cancer, based on the property that a colorectal neoplasm often recurs synchronously or metachronously. Surgical management appropriate to the occasion should be taken in recurrent colorectal cancer. Particularly, recurring colorectal cancer closely above the prior anastomosis for a low anterior resection should be eliminated by using an abdomino-perineal resection, including the preceding anastomotic site or a new anastomotic creation. Under the latter instance, ample possibility exists for postoperative anastomotic stenosis or leakage by reason of insufficient blood supply to the segment between the earlier anastomosis and the later one. The authors report two cases of re-anastomosis for colorectal cancer just above a previous anastomosis taken by a low anterior resection for rectal cancer. In a 52-year-old male with a history of neoadjuvant concomitant chemo-radiotherapy (CCRT) and low anterior resection for rectal cancer located at 6 cm from the anal verge, a new adenocarcinoma was detected 7 cm from the previous anastomotic site and 3 cm from the anal verge. Considering anal sphincter preservation, the re-anastomosis was made at the upper part of the preceding anastomosis. The patient experienced no surgical complications, such as anastomotic stenosis or leakage and functional defecation difficulty. In another patient, a 50-year-old male with a low anterior resection and adjuvant CCRT for rectal cancer 8 cm from anal verge, a new adenocarcinoma was detected in the colon. The new adenocarcinoma was located 10 cm from the anal verge and 8 cm from the previous anastomosis. The same surgical management was applied to this case, with the same postoperative result.

Original Articles

Prognostic Significance of the Circumferential Resection Margin in Invasive T3 Rectal Cancer.: Joo, In Ho , Jin, Sang Hwa , Bae, Ki Beom , Shin, Jin Yong , Choi, Chang Soo , Choi, Su Im , Hong, Kwan Hee; J Korean Soc Coloproctol. 2008;24(4):278-286.; DOI: https://doi.org/10.3393/jksc.2008.24.4.278

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Abstract PDF

PURPOSE
Because depth of invasion by T3 rectal cancer can vary according to the extent of mesorectal invasion, the prognosis for invasive T3 rectal cancer is reported to be very different from that for minimal invasive cancer. Recently, with more emphasis on circumferential resection margin (CRM) status, the T stage, rather than the N stage, seems to be a more valuable prognostic marker in rectal cancer. Therefore, the aim of this study is to determine the prognostic significance of the CRM in invasive T3 rectal cancer.
METHODS
Through reviewing 324 consecutive patients with rectal cancer who underwent a curative resection between January 1995 and December 2002 at Busan Paik hospital, 195 patients with invasive T3 rectal cancer, who had not received preoperative neoadjuvant therapy were selected. The patients were classified into a negative CRM group (negative group, n=173) or a positive CRM group (positive group, n=22), and the patients were subgrouped according to the presence of lymph-node (LN) metastasis and CRM status as negative LN and negative CRM (L-/CM-), negative LN and positive CRM (L-/CM+), positive LN and negative CRM (L+/CM-) and positive LN and positive CRM (L+/CM+). All pathological specimens were re-reviewed by a single pathologist, and the distance between the most advanced edge and the outermost aspect of the specimen was re-measured by using a microscope. Local relapse rates, disease free survival, and overall survival were compared using the Kaplan- Meier method. Multivariate analyses to identify independent prognostic factors were performed using the logistic regression model.
RESULTS
Local recurrence rates in the positive group and the negative group were 38.6% and 15.3%, respectively (P=0.004, log-rank test). The multiple logistic regression model demonstrated positive CRM (hazard ratio 4.4, P=0.0007) and N2 nodal status (hazard ratio 2.4, P=0.02) as predictors of local recurrence. In the subgroup analysis, the overall recurrence rates and survival rates were, respectively, 12.3% and 86.5% in the L-/CM- subgroup, 53.1% and 50.3% in the L-/CM+ subgroup, 52.7% and 50.0% in the L+/ CM- subgroup, and 58.7 % and 33.8% in the L+/CM+ subgroup (log rank test for trend; P=0.0001 and P=0.0001, respectively).
CONCLUSIONS
In the event of predicted CRM involvement in invasive T3 rectal cancer, adjuvant therapy should be performed to improve local control. Also, larger prospective studies are needed to clarify the prognostic role of the CRM in invasive T3 rectal cancer because the number of cases in this study was small, especially in the number of CRM positive cases.

Citations

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Comparison of short-term oncologic outcomes following laparoscopic versus conventional open surgery for rectal cancer
Nak Jun Choi, Jong Han Yoo, Hong Tae Lee, Jae Ho Shin, Ha Kyoung Park, Min Sung An, Tae Kwun Ha, Kwang Hee Kim, Ki Beom Bae, Tae Hyun Kim, Chang Soo Choi, Sang Hoon Oh, Minkyung Oh, Kwan Hee Hong
Korean Journal of Clinical Oncology.2013; 9(1): 17. CrossRef

Colorectal Cancer Presenting as an Early Recurrence Within 1 Year after a Curative Resection.: Jung, Sang Hun , Kim, Hee Cheol , Kim, Ah Young , Choi, Pyong Wha , Park, In Ja , Yu, Chang Sik , Kim, Jin Cheon; J Korean Soc Coloproctol. 2008;24(4):265-272.; DOI: https://doi.org/10.3393/jksc.2008.24.4.265

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Abstract PDF

PURPOSE
An individualized surveillance protocol based on stratified prognostic factors is needed for the early detection of recurrent disease. The aim of this study was to determine both the clinicopathological characteristics for early-recurring colorectal cancer and the impact on survival.
METHODS
From January 1996 to September 2000, 1,504 patients with curatively resected colorectal cancer were recruited. The primary goal of this study was to evaluate the time interval until first loco-regional or distant recurrence, and the secondary goal was the last survival status. Early recurrence was defined as recurrence within the first 12 months postoperatively. Clinicopathologic data and preoperative CT records were reviewed. The follow-up period was over 48 months.
RESULTS
The 5-year recurrence rate was 25.4%, and 39.5% of these were detected within the first 12 months postoperatively. In the multivariate analysis, the independent prognostic factors for early recurrence were cell differentiation (PD/MUC/SRC), lymphovascular invasion, and absence of adjuvant chemotherapy in stage III and curatively resected colorectal cancer in stage IV. Inaccurate interpretation by a low-quality CT scan resulted in a stage III cancer being understaged preoperatively. The 5-year overall survival rate according to the recurrent time interval was significantly different (early recurrence: 7.4% vs. late recurrence: 23.6%, P<0.05). The resection rate was similar in both groups (early recurrence: 22.7% vs. late recurrence: 27.6%, P=0.392).
CONCLUSIONS
Colorectal cancer that recurred within 12 months showed more aggressive biologic behaviors and poor survival. Understaging caused by incomplete preoperative evaluation for disease extension may cause treatment failure.

Citations

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Predictive factors and the prognosis of recurrence of colorectal cancer within 2 years after curative resection
Jong Pil Ryuk, Gyu-Seog Choi, Jun Seok Park, Hye Jin Kim, Soo Yeun Park, Ghil Suk Yoon, Soo Han Jun, Yong Chul Kwon
Annals of Surgical Treatment and Research.2014; 86(3): 143. CrossRef
Advanced Neoplasm Detection and Its Associated Factors in Colonoscopic Surveillance of Endoscopically Resected Early Colorectal Cancer
Soon Ha Kwon, Jin Woo Choo, Hyun Gun Kim, Seong Ran Jeon, Byung Hoo Lee, Tae Hee Lee, Wan Jung Kim, Bong Min Ko, Jin-Oh Kim, Joo Young Cho, Joon Seong Lee, Moon Sung Lee
The Korean Journal of Gastroenterology.2013; 62(4): 219. CrossRef

Pattern of Recurrences and Metastases after a Curative Resection for Primary Colorectal Cancer.: Park, In Ja , Kim, Hee Cheol , Yu, Chang Sik , Kim, Jin Cheon; J Korean Soc Coloproctol. 2008;24(3):207-213.; DOI: https://doi.org/10.3393/jksc.2008.24.3.207

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Abstract PDF

PURPOSE
We aimed to verify the pattern of recurrences or metastases after a curative resection for primary colorectal cancer. METHODS: From the prospective colorectal cancer database of Asan Cancer Center, 2,810 paitents who underwent a curative resection for primary colon (1,295) or rectal (1,515) cancer between October 1995 and December 2003 were studied retrospectively. Patients were followed for more than three years or until disease recurrence. Risk factors considered were age, gender, site of primary tumor, stage, histologic differentiation, and lymphovascular invasion. The mean follow-up duration was 60+/-29 months. RESULTS: Overall recurrence occurred in 546 patients (19.4%). According to stage, the recurrence rates were 4.7% (20/423) in stage I, 10.8% (128/1,185) in stage II, and 33.1% (398/1,202) in stage III. More than 70% of the recurrences occurred within 2 years of surgery. The most common metastatic site was the liver in colon cancer and the lung in rectal cancer. In colon cancer, recurrence was more common in left than in right colon cancer (P=0.012). In rectal cancer, local recurrence was the most common in lower rectal cancer and was more common in patients receiving abdominoperineal resection than in those receiving a sphincter-preserving operation. The liver was the most common site of metastasis within 2 years postoperatively, but metastasis to lung was significantly increased after the second postoperative year. Factors such as sex, T category, N category, and location of the primary tumor were identified to be independent risk covariates for recurrence. CONCLUSIONS: Patterns of recurrences differed according to the characteristics of the primary tumor and varied with the follow-up period.

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Effects of High-Dose Intravenous Vitamin C on Colorectal Cancer Recurrence: The Retrospective Study by Medical Records for 23 Years
Junjung LEE, Jong Soon CHOI
Korean Journal of Health Promotion.2024; 24(3): 101. CrossRef
Clinicopathologic Factors Affecting Recurrence after Curative Surgery for Stage I Colorectal Cancer
Min Ae Keum, Seok-Byung Lim, Sun A Kim, Yong Sik Yoon, Chan Wook Kim, Chang Sik Yu, Jin Cheon Kim
Journal of the Korean Society of Coloproctology.2012; 28(1): 49. CrossRef
Oncologic Outcomes and Risk Factors for Recurrence after Tumor-specific Mesorectal Excision of Rectal Cancer: 782 Cases
Sam Hee Kim, Ki Beom Bae, Jung Min Kim, Jae Ho Shin, Min Sung An, Tae Geun Ha, Sung Mok Ryu, Kwang Hee Kim, Tae Hyeon Kim, Chang Soo Choi, Jin Yong Shin, Minkyung Oh, Seung Hun Baek, Kwan Hee Hong
Journal of the Korean Society of Coloproctology.2012; 28(2): 100. CrossRef

Patterns of Recurrence and Prognosis in Patients with Intestinal Behcet's Disease Who Underwent a Bowel Resection.: Hur, Hyuk , Min, Byung Soh , Kim, Jin Soo , Lee, Kang Young , Park, Yoon Ah , Baik, Seung Hyuk , Sohn, Seung Kook , Cho, Chang Hwan , Kim, Jae Hak , Kim, Won Ho , Kim, Nam Kyu; J Korean Soc Coloproctol. 2008;24(3):166-174.; DOI: https://doi.org/10.3393/jksc.2008.24.3.166

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Abstract PDF

PURPOSE
We aim to analyze the clinical course and the recurrence patterns after surgical treatment in patients with intestinal Behcet's disease and to determine the prognostic factors. METHODS: Thirty-eight patients with intestinal Behcet's disease who had undergone operations between 1979 and 2007 were analyzed. Clinical characteristics between the recurrent group (n=24) and the non-recurrent group (n=14) were compared. The cumulative recurrence rates were calculated by using the Kaplan-Meier method, and the results were compared by using the log-rank test. RESULTS: The median follow-up was 120 months. The median age of the 38 patients was 36.5 years, and the patients included 26 males and 12 females. Recurrences after surgical treatment were observed in 24 patients, and reoperations were performed in 21 patients. The mean age at operation was 35.7 years in the recurrent group and was less than 43.4 years in the non-recurrent group (P=0.030). Clinical subtypes of Behcet's disease (complete or incomplete vs. suspicious) and the cause of operation (presence vs. absence of a perforation or fistula) were different between the recurrent and the non-recurrent groups (P=0.048, P=0.014, respectively). The 5-year cumulative recurrence rate and reoperation rate for all patients with intestinal Behcet's disease who underwent operations were 52.7% and 36.0%, respectively the clinical subtypes and the cause of the operation were significant factors affecting the cumulative recurrence and the reoperation rates.
CONCLUSIONS
Intestinal Behcet's disease demonstrates high recurrence and reoperation rates after surgical treatment. More careful follow up is needed to these surgical patients with high risk of recurrence and reoperation.

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Short- and long-term outcomes of surgical treatment in patients with intestinal Behcet’s disease
Min Young Park, Yong Sik Yoon, Jae Ha Park, Jong Lyul Lee, Chang Sik Yu
World Journal of Gastrointestinal Surgery.2024; 16(2): 429. CrossRef
Evidence-based diagnosis and clinical practice guidelines for intestinal Behçet’s disease 2020 edited by Intractable Diseases, the Health and Labour Sciences Research Grants
Kenji Watanabe, Satoshi Tanida, Nagamu Inoue, Reiko Kunisaki, Kiyonori Kobayashi, Masakazu Nagahori, Katsuhiro Arai, Motoi Uchino, Kazutaka Koganei, Taku Kobayashi, Mitsuhiro Takeno, Fumiaki Ueno, Takayuki Matsumoto, Nobuhisa Mizuki, Yasuo Suzuki, Tadakaz
Journal of Gastroenterology.2020; 55(7): 679. CrossRef
Prognostic factors and long-term clinical outcomes for surgical patients with intestinal Behcetʼs disease
Yoon Suk Jung, Jin Young Yoon, Jin Ha Lee, Soung Min Jeon, Sung Pil Hong, Tae Il Kim, Won Ho Kim, Jae Hee Cheon
Inflammatory Bowel Diseases.2011; 17(7): 1594. CrossRef
Response Rates to Medical Treatments and Long-term Clinical Outcomes of Nonsurgical Patients With Intestinal Behçet Disease
Moon Jae Chung, Jae Hee Cheon, Seung Up Kim, Jae Jun Park, Tae Il Kim, Nam Kyu Kim, Won Ho Kim
Journal of Clinical Gastroenterology.2010; 44(6): e116. CrossRef

Postoperative Complications and Recurrence in Patients with Crohn's Disease.: Hong, Dong Hyun , Yu, Chang Sik , Kim, Dae Dong , Jung, Sang Hun , Choi, Pyong Hwa , Park, In Ja , Kim, Hee Cheol , Kim, Jin Cheon; J Korean Soc Coloproctol. 2008;24(1):13-19.; DOI: https://doi.org/10.3393/jksc.2008.24.1.13

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Abstract PDF

PURPOSE
This study was performed to assess postoperative complications and recurrence rates and to elucidate the risk factors in Crohn's disease (CD). METHODS: A retrospective review was undertaken for patients who had undergone bowel surgery at Asan Medical Center between October 1991 and June 2006. Symptomatic recurrence was defined as the presence of symptoms related to CD that was subsequently verified by radiologic or endoscopic finding. Surgical recurrence was defined as the need for repeated surgery for enteric CD.
RESULTS
There were 160 patients with a mean follow up of 34 months (108 men and 52 women; mean age: 29.7+/-10.9). The most common indication for surgery was a complication of CD, such as intra-abdominal abscess (31.9%), intestinal obstruction (21.9%), and internal fistula (19.4%). Another frequent indication was medical intractability (23.8%). The types of surgical procedures were ileocolic resection (50.0%), small bowel resection (25.0%), total/subtotal colectomy (17.5%), and others. The cumulative symptomatic recurrences were 15.9% and 36.4% at 2 and 5 years, and the cumulative surgical recurrence was 13.6% at 5 years. The cumulative surgical recurrence was higher for stricturing-type CD than for penetrating-type CD (P=0.049). No other significant risk factor for recurrence was found in our study. Twenty patients (12.5%) had postoperative complications, such as intra-abdominal abscess, anastomosis leakage, obstruction, and wound infection. CONCLUSIONS: The postoperative complication and recurrence rates were acceptable. For stricturing-type Crohn's disease surgical recurrence is higher than penetrating type, but long-term follow up is needed to verify the risk factors for recurrence.

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Patients with perianal Crohn's disease have poor disease outcomes after primary bowel resection
Yoo Min Han, Ji Won Kim, Seong‐Joon Koh, Byeong Gwan Kim, Kook Lae Lee, Jong Pil Im, Joo Sung Kim, Hyun Chae Jung
Journal of Gastroenterology and Hepatology.2016; 31(8): 1436. CrossRef
Clinical and Endoscopic Recurrence after Surgical Resection in Patients with Crohn's Disease
Yang Woon Lee, Kang-Moon Lee, Woo Chul Chung, Chang Nyol Paik, Hea Jung Sung, You Suk Oh
Intestinal Research.2014; 12(2): 117. CrossRef
The epidemiology and cost of surgical site infections in Korea: a systematic review
Kil Yeon Lee, Kristina Coleman, Dan Paech, Sarah Norris, Jonathan T Tan
Journal of the Korean Surgical Society.2011; 81(5): 295. CrossRef
Long-term Result of Surgical Treatment for Crohn's Enteritis
Sang-Ji Choi, Eun-Kyung Choe, Sung-Chan Park, Kyu-Joo Park
Journal of the Korean Society of Coloproctology.2008; 24(6): 409. CrossRef

Is a Short Distal Resection Margin of Less than One Centimeter in a Sphincter-saving Resection for Rectal Cancer Oncologically Safe?.: Cho, Min Jeong , Yu, Chang Sik , Park, In Ja , Jeong, Sang Hoon , Chae, Pheung Ha , Hong, Dong Heun , Kim, Dea Dong , Kim, Hee Cheol , Kim, Jin Cheon; J Korean Soc Coloproctol. 2007;23(6):454-459.; DOI: https://doi.org/10.3393/jksc.2007.23.6.454

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Abstract PDF: PURPOSE
Sphincter preservation is one of the main goals in the treatment of rectal cancer. The aim of this study was to evaluate the oncologic safety of a sphincter-saving resection with a distal resection margin of less than 1 cm.
METHODS
Two hundred forty-eight patients who underwent a sphincter-saving resection between June 1989 and December 2002 and who had a confirmed distal resection margin of less than 1 cm on pathologic examination were included. All patients were evaluated for local and systemic recurrences.
RESULTS
The median follow-up period was 45 (6~144) months. The mean length of distal resection margin was 0.79+/-0.26 cm. Lower rectalcancer was most common (56.5%). Forty patients (16.1%) experienced recurrence. The local recurrence rate was 3.6%, systemic recurrence rate was 11.7%, and the combined local and systemic recurrence rate was 0.4%. In systemic recurrence, the liver was the most common site, followed by the lung. Among stage II & III groups, patients who underwent adjuvant chemoradiotherapy experienced significantly lower local recurrence compared to patients in the chemotherapy-only or the no-adjuvant group (2.6%, 12.9%, 8.7%, P=0.05). The length of distal resection margin, the total mesorectal excision, the location of tumor, sex, histology, and stage were not associated with local recurrence.
CONCLUSIONS
A distal resection margin of less than 1 cm in a sphincter-saving resection showed acceptableoncologic outcomes. Adjuvant chemoradiotherapy were beneficial to reduce local recurrence in the stage II and the stage III groups.

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