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Translational/basic research
The effect of tumor resection on intestinal microbiota dysbiosis in patients with right-sided colon cancer
Aldhimas Marthsyal Pratikna, M. Iqbal Rivai, Rini Suswita, Andani Eka Putra, Irwan Abdul Rachman, Avit Suchitra
Ann Coloproctol. 2025;41(1):47-56.   Published online February 26, 2025
DOI: https://doi.org/10.3393/ac.2024.00346.0049
  • 939 View
  • 105 Download
  • 1 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Purpose
This study aimed to determine the effect of tumor resection on dysbiosis of the intestinal microbiota in patients with right-sided colon cancer.
Methods
This study utilized a longitudinal design to explore the outcomes of patients diagnosed with right-sided colon cancer who underwent surgical resection at Dr. M. Djamil General Hospital from July to December 2023. We excluded patients with a documented history of comorbidities, specifically those affecting the digestive system. To compare the microbiota (genus and phylum) between patients with right-sided colon cancer and the control group, we conducted bivariate analyses using the independent t-test or Mann-Whitney test. Furthermore, we employed the dependent t-test or Wilcoxon test to assess changes in the dysbiosis of the microbiota (genus and phylum) before and after resection. A P-value of <0.05 was considered statistically significant.
Results
This study included a total of 21 patients diagnosed with right-sided colon cancer. In the control group, Bacteroidetes constituted the highest proportion of intestinal microbiota, accounting for 56.34%. Prior to tumor resection, the intestinal microbiota of patients exhibited Proteobacteria as the predominant phylum, representing 52.97%. Following tumor resection, Bacteroidetes remained the most prevalent, comprising 50.9% of the intestinal microbiota. Significant variations in the levels of Proteobacteria, Verrucomicrobia, and Cyanobacteria/Chloroplast were observed in the intestinal microbiota of patients with right-sided colorectal cancer before and after tumor excision (all P=0.001).
Conclusion
The microbiome of patients with right-sided colorectal cancer differed significantly from that of the control group. However, following tumor resection, the microbiome composition of these patients became more similar to that observed in the control group.

Citations

Citations to this article as recorded by  
  • Dynamics of the microbiota in right-sided colon cancer patients: pre- and post-tumor resection
    Youn Young Park
    Annals of Coloproctology.2025; 41(1): 1.     CrossRef
Review
Colorectal cancer
Beyond survival: a comprehensive review of quality of life in rectal cancer patients
Won Beom Jung
Ann Coloproctol. 2024;40(6):527-537.   Published online December 20, 2024
DOI: https://doi.org/10.3393/ac.2024.00745.0106
  • 1,797 View
  • 93 Download
  • 1 Web of Science
  • 2 Citations
AbstractAbstract PDF
Rectal cancer is one of the most common carcinomas and a leading cause of cancer-related mortality. Although significant advancements have been made in the treatment of rectal cancer, the deterioration of quality of life (QoL) remains a challenging issue. Various tools have been developed to assess QoL, including the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) scale, the QLQ-C30 and QLQ-CR29 by the European Organization for Research and Treatment of Cancer (EORTC), and the 36-Item Short Form Health Survey (SF-36). Factors such as the lower location of the tumor, radiation therapy, chemoradiotherapy, and chemotherapy are associated with a decline in QoL. Furthermore, anastomotic leakage following rectal cancer resection is an important risk factor affecting QoL. With the development of novel treatment approaches, including neoadjuvant therapies such as chemoradiotherapy and total neoadjuvant therapy, the rate of clinical complete remission has increased, leading to the emergence of organ-preserving strategies. Both local excision and the “watch-and-wait” approach following neoadjuvant therapy improved functional outcomes and QoL. Efforts to improve QoL after rectal cancer surgery are ongoing in surgical techniques for rectal cancer. Since QoL is determined by a complex interplay of factors, including the patient's physical condition, surgical techniques, and psychological and social elements, a comprehensive approach is necessary to understand and enhance it. This review aims to describe the methods for measuring QoL in rectal cancer patients after surgery, the key risk factors involved, and various strategies and efforts to improve QoL outcomes.

Citations

Citations to this article as recorded by  
  • Meeting report on the 8th Asian Science Editors’ Conference and Workshop 2024
    Eun Jung Park
    Science Editing.2025; 12(1): 66.     CrossRef
  • Editorial: Organ preservation for rectal cancer patients
    Ionut Negoi, John R. T. Monson, Leonardo Bustamante-Lopez, Zoe Garoufalia, Vito D'Andrea, Sameh Hany Emile
    Frontiers in Surgery.2025;[Epub]     CrossRef
Original Articles
Anorectal benign disease
Long-term outcomes of sacral neuromodulation for low anterior resection syndrome after rectal cancer surgery
Mario J. de Miguel Valencia, Gabriel Marin, Ana Acevedo, Ana Hernando, Alfonso Álvarez, Fabiola Oteiza, Mario J. de Miguel Velasco
Ann Coloproctol. 2024;40(3):234-244.   Published online June 25, 2024
DOI: https://doi.org/10.3393/ac.2023.00542.0077
  • 2,884 View
  • 210 Download
AbstractAbstract PDF
Purpose
This study assessed the long-term outcomes and quality of life in patients who underwent sacral neuromodulation (SNM) due to low anterior resection syndrome (LARS).
Methods
This single-center retrospective study, conducted from 2005 to 2021, included 30 patients (21 men; median age, 70 years) who had undergone total mesorectal excision with stoma closure and had no recurrence at inclusion. All patients were diagnosed with LARS refractory to conservative treatment. We evaluated clinical and quality-of-life outcomes after SNM through a stool diary, Wexner score, LARS score, the Fecal Incontinence Quality of Life (FIQL) questionnaire, and EuroQol-5D (EQ-5D) questionnaire.
Results
Peripheral nerve stimulation was successful in all but one patient. Of the 29 patients who underwent percutaneous nerve evaluation, 17 (58.62%) responded well to SNM and received permanent implants. The median follow-up period was 48 months (range, 18–153 months). The number of days per week with fecal incontinence episodes decreased from a median of 7 (range, 2–7) to 0.38 (range, 0–1). The median number of bowel movements recorded in patient diaries fell from 5 (range, 4–12) to 2 (range, 1–6). The median Wexner score decreased from 18 (range, 13–20) to 6 (range, 0–16), while the LARS score declined from 38.5 (range, 37–42) to 19 (range, 4–28). The FIQL and EQ-5D questionnaires demonstrated enhanced quality of life.
Conclusion
SNM may benefit patients diagnosed with LARS following rectal cancer surgery when conservative options have failed, and the treatment outcomes may possess long-term sustainability.
Colorectal cancer
Long-term bowel functional outcomes following anal sphincter-preserving surgery for upper and middle rectal cancer: a single-center longitudinal study
Ahmad Sakr, Seung Yoon Yang, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim
Ann Coloproctol. 2024;40(1):27-35.   Published online February 28, 2024
DOI: https://doi.org/10.3393/ac.2022.01067.0152
  • 2,406 View
  • 190 Download
  • 2 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
Despite advances in neoadjuvant chemoradiotherapy and anal sphincter-preserving surgery for rectal cancer, bowel dysfunction is still unavoidable and negatively affects patients’ quality of life. In this longitudinal study, we aimed to investigate the changes in bowel function with follow-up time and the effect of neoadjuvant chemoradiotherapy on bowel function following low anterior resection for rectal cancer.
Methods
In this study, 171 patients with upper or middle rectal cancer who underwent low anterior resection between 2012 and 2018 were included. Bowel function was assessed longitudinally with Memorial Sloan Kettering Cancer Center Bowel Function Instrument and Wexner scores every 6 months after restoration of bowel continuity. Patients with at least 2 follow-up visits were included.
Results
Overall, 100 patients received neoadjuvant chemoradiotherapy. Urgency, soilage, and fecal incontinence were noted within 24 months in the patients treated with neoadjuvant chemoradiotherapy. After 2 years of follow-up, significant bowel dysfunction and fecal incontinence were observed in the neoadjuvant chemoradiotherapy group. Low tumor level and neoadjuvant chemoradiotherapy were associated with delayed bowel dysfunction.
Conclusion
Neoadjuvant chemoradiotherapy in combination with low tumor level was significantly associated with delayed bowel dysfunction even after 2 years of follow-up. Therefore, careful selection and discussion with patients are paramount.

Citations

Citations to this article as recorded by  
  • Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-Center Retrospective Analysis
    Jae Seung Kim, Jaram Lee, Hyeung-min Park, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
    Cancers.2024; 16(24): 4280.     CrossRef
  • Beyond survival: a comprehensive review of quality of life in rectal cancer patients
    Won Beom Jung
    Annals of Coloproctology.2024; 40(6): 527.     CrossRef
Colorectal cancer
Impact of consolidation chemotherapy in poor responders to neoadjuvant radiation therapy: magnetic resonance imaging–based clinical-radiological correlation in high-risk rectal cancers
Swapnil Patel, Suman Ankathi, Purvi Haria, Mufaddal Kazi, Ashwin L. Desouza, Avanish Saklani
Ann Coloproctol. 2023;39(6):474-483.   Published online December 21, 2023
DOI: https://doi.org/10.3393/ac.2023.00080.0011
  • 2,265 View
  • 105 Download
  • 2 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
The current study was conducted to examine the role of consolidation chemotherapy after neoadjuvant radiation therapy (NART) in decreasing the involvement of the mesorectal fascia (MRF) in high-risk locally advanced rectal cancers (LARCs).
Methods
In total, 46 patients who received consolidation chemotherapy after NART due to persistent MRF involvement were identified from a database. A team of 2 radiologists, blinded to the clinical data, studied sequential magnetic resonance imaging (MRI) scans to assess the tumor response and then predict a surgical plan. This prediction was then correlated with the actual procedure conducted as well as histopathological details to assess the impact of consolidation chemotherapy.
Results
The comparison of MRI-based parameters of sequential images showed significant downstaging of T2 signal intensity, tumor height, MRF involvement, diffusion restriction, and N category between sequential MRIs (P < 0.05). However, clinically relevant downstaging (standardized mean difference, > 0.3) was observed for only T2 signal intensity and diffusion restriction on diffusion-weighted imaging. No clinically relevant changes occurred in the remaining parameters; thus, no change was noted in the extent of surgery predicted by MRI. Weak agreement (Cohen κ coefficient, 0.375) and correlation (Spearman rank coefficient, 0.231) were found between MRI-predicted surgery and the actual procedure performed. The comparison of MRI-based and pathological tumor response grading also showed a poor correlation.
Conclusion
Evidence is lacking regarding the use of consolidation chemotherapy in reducing MRF involvement in LARCs. The benefit of additional chemotherapy after NART in decreasing the extent of planned surgery by reducing margin involvement requires prospective research.

Citations

Citations to this article as recorded by  
  • Survival benefit of adjuvant chemotherapy in high-risk patients with colon cancer regardless of microsatellite instability
    Sung Uk Bae, Jong Lyul Lee, Chun-Seok Yang, Eun Jung Park, Soo Yeun Park, Chang Woo Kim, Woong Bae Ji, Gyung Mo Son, Yoon Dae Han, So Hyun Kim, Min Sung Kim, Youn Young Park, Kyung Ha Lee, Chang Hyun Kim, Gi Won Ha, JaeIm Lee, Kyeong Eui Kim, Woon Kyung J
    European Journal of Surgical Oncology.2025; 51(6): 109674.     CrossRef
  • The conundrum of total neoadjuvant therapy in rectal cancer
    Devesh S. Ballal, Tejas P. Vispute, Avanish P. Saklani
    Colorectal Disease.2024; 26(5): 1068.     CrossRef
Case Report
Colorectal cancer
Treatment of side limb full-thickness prolapse of the side-to-end coloanal anastomosis following intersphincteric resection: a case report and review of literature
Guglielmo Niccolò Piozzi, Krunal Khobragade, Seon Hui Shin, Jeong Min Choo, Seon Hahn Kim
Ann Coloproctol. 2024;40(Suppl 1):S38-S43.   Published online February 8, 2023
DOI: https://doi.org/10.3393/ac.2022.00829.0118
  • 2,630 View
  • 101 Download
  • 1 Citations
AbstractAbstract PDF
Intersphincteric resection (ISR) with coloanal anastomosis is an oncologically safe anus-preserving technique for very low-lying rectal cancers. Most studies focused on oncological and functional outcomes of ISR with very few evaluating long-term postoperative anorectal complications. Full-thickness prolapse of the neorectum is a relatively rare complication. This report presents the case of a 70-year-old woman presenting with full-thickness prolapse of the side limb of the side-to-end coloanal anastomosis occurring 2 weeks after the stoma closure and 2 months after a robotic partial ISR performed with the Da Vinci single-port platform. The anastomosis was revised through resection of the side limb and conversion of the side-to-end anastomosis into an end-to-end handsewn anastomosis with interrupted stitches. This study describes the first case of full-thickness prolapse of the side limb of the side-to-end handsewn coloanal anastomosis following ISR. Moreover, a revision of all reported cases of post-ISR full-thickness and mucosal prolapse was performed.

Citations

Citations to this article as recorded by  
  • International standardization and optimization group for intersphincteric resection (ISOG‐ISR): modified Delphi consensus on anatomy, definition, indication, surgical technique, specimen description and functional outcome
    Guglielmo Niccolò Piozzi, Krunal Khobragade, Vusal Aliyev, Oktar Asoglu, Paolo Pietro Bianchi, Vlad‐Olimpiu Butiurca, William Tzu‐Liang Chen, Ju Yong Cheong, Gyu‐Seog Choi, Andrea Coratti, Quentin Denost, Yosuke Fukunaga, Emre Gorgun, Francesco Guerra, Ma
    Colorectal Disease.2023; 25(9): 1896.     CrossRef
Original Articles
Colorectal cancer
Validation of the Vietnamese version of the low anterior resection syndrome score questionnaire
Tuong-Anh Mai-Phan, Vu Quang Pham
Ann Coloproctol. 2024;40(6):588-593.   Published online November 25, 2022
DOI: https://doi.org/10.3393/ac.2022.00514.0073
  • 3,175 View
  • 75 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDFSupplementary Material
Purpose
The aim of this study was to validate the low anterior resection syndrome (LARS) score questionnaire in the Vietnamese language among Vietnamese patients who underwent sphincter-preserving surgery for rectal cancer.
Methods
The LARS score questionnaire was translated from English into Vietnamese and then back-translated as recommended internationally. From January 2018 to December 2020, 93 patients who underwent sphincter-preserving surgery completed the Vietnamese version of the LARS score questionnaire together with an anchored question assessing the influence of bowel function on quality of life. To validate test-retest reliability, patients were requested to answer the LARS score questionnaire twice.
Results
Ninety-three patients completed the LARS score questionnaire, of whom 89 responded twice. The patients who responded twice were included in the analysis of test-retest reliability. Fifty-eight patients had a “major” LARS score. The LARS score was able to discriminate between patients who were obese and those who were not (P<0.001) and between the LAR and AR procedures (P<0.001). Age and sex were not associated with higher LARS scores (P=0.975). There was a perfect fit between the quality of life category question and the LARS score in 56.2% of cases, and a moderate fit was found in 42.7% of cases, showing reasonable convergent validity. The test-retest reliability of 89 patients showed a high intraclass correlation coefficient.
Conclusion
The Vietnamese version of the LARS score questionnaire is a valid tool for measuring LARS.

Citations

Citations to this article as recorded by  
  • Major Low Anterior Resection Syndrome (LARS) and Quality of Life in Patients With Low Rectal Cancer: A Preoperative Survey Using LARS Score and European Organisation for Research and Treatment of Cancer’s 30-Item Core Quality of Life Questionnaire
    Ly Huu Phu, Ho Tat Bang, Nguyen Viet Binh, Hoang Danh Tan, Ung Van Viet, Nguyen Trung Tin
    Cureus.2023;[Epub]     CrossRef
Anorectal physioloy
Risk factors associated with low anterior resection syndrome: a cross-sectional study
See Liang Lim, Wan Zainira Wan Zain, Zalina Zahari, Andee Dzulkarnaen Zakaria, Mohd Nizam Md Hashim, Michael Pak-Kai Wong, Zaidi Zakaria, Rosnelifaizur Ramely, Ahmad Shanwani Mohamed Sidek
Ann Coloproctol. 2023;39(5):427-434.   Published online June 3, 2022
DOI: https://doi.org/10.3393/ac.2022.00227.0032
  • 5,449 View
  • 175 Download
  • 6 Web of Science
  • 4 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Purpose
Oncological outcomes following rectal cancer surgery have improved significantly over recent decades with lower recurrences and longer overall survival. However, many of the patients experienced low anterior resection syndrome (LARS). This study identified the prevalence and risk factors associated with the development of LARS.
Methods
This cross-sectional study involved patients who were diagnosed with rectal cancer and had undergone sphincter-preserving low anterior resection from January 2011 to December 2020. Upon clinic follow-up, patients were asked to complete an interviewed based questionnaire (LARS score) designed to assess bowel dysfunction after rectal cancer surgery.
Results
Out of 76 patients, 25 patients (32.9%) had major LARS, 10 patients (13.2%) had minor LARS, and 41 patients (53.9%) had no LARS. The height of tumor from anal verge showed an association with the development of major LARS (P=0.039). Those patients with less than 8 cm tumor from anal verge had an increased risk of LARS by 3 times compared to those with 8 cm and above (adjusted odds ratio, 3.11; 95% confidence interval, 1.06–9.13).
Conclusion
Results from our study show that low tumor height was a significant risk factor that has a negative impact on bowel function after surgery. The high prevalence of LARS emphasizes the need for study regarding risk factors and the importance of understanding the pathophysiology of LARS, in order for us to improve patient bowel function and quality of life after rectal cancer surgery.

Citations

Citations to this article as recorded by  
  • Comparative analysis of organ preservation attempt and radical surgery in clinical T2N0 mid to low rectal cancer
    Hyeung-min Park, Jaram Lee, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim
    International Journal of Colorectal Disease.2024;[Epub]     CrossRef
  • Beyond survival: a comprehensive review of quality of life in rectal cancer patients
    Won Beom Jung
    Annals of Coloproctology.2024; 40(6): 527.     CrossRef
  • Organ preservation for early rectal cancer using preoperative chemoradiotherapy
    Gyung Mo Son
    Annals of Coloproctology.2023; 39(3): 191.     CrossRef
  • Low anterior resection syndrome: is it predictable?
    Dong Hyun Kang
    Annals of Coloproctology.2023; 39(5): 373.     CrossRef
Anorectal physioloy
Validation of low anterior resection syndrome score in Brazil with Portuguese
Kelly C.L.R. Buzatti, Andy Petroianu, Søren Laurberg, Rodrigo G. Silva, Beatriz D.S. Rodrigues, Peter Christensen, Antonio Lacerda-Filho, Therese Juul
Ann Coloproctol. 2023;39(5):402-409.   Published online May 13, 2022
DOI: https://doi.org/10.3393/ac.2022.00136.0019
  • 4,493 View
  • 126 Download
  • 4 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
This study was performed to investigate the convergent validity, discriminative validity, and reliability of the Brazilian version of the low anterior resection syndrome (LARS) score in a population with low educational and socioeconomic levels.
Methods
The LARS score was translated into the Portuguese language by forward- and back-translation procedures. In total, 127 patients from a public hospital in Brazil completed the questionnaires. The convergent validity was tested by comparing the LARS score with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core Module 30 (QLQ-C30) and with patients’ self-reported quality of life. For the discriminative validity, we tested the ability of the score to differentiate among subgroups of patients regarding neoadjuvant radiotherapy, type of surgery, and tumor distance from the anal verge. The test-retest reliability was investigated in a subgroup of 36 patients who responded to the survey twice in 2 weeks.
Results
The LARS score demonstrated a strong correlation with 5 of 6 items from the EORTC QLQ-C30 (P<0.05) and good concordance with patients’ self-reported quality of life (95.3%), confirming the convergent validity. The score was able to discriminate between subgroups of patients with different clinical characteristics related to LARS (P<0.001). The agreement between the test and retest showed that 86.1% of the patients remained in the same LARS category, and there was no significant difference between the LARS score numerical values (P=0.80), indicating good reliability overall.
Conclusion
The Brazilian version of the LARS score is a valid and reliable instrument to assess postoperative bowel function in a population with low educational and socioeconomic levels.

Citations

Citations to this article as recorded by  
  • Validation of the Vietnamese version of the low anterior resection syndrome score questionnaire
    Tuong-Anh Mai-Phan, Vu Quang Pham
    Annals of Coloproctology.2024; 40(6): 588.     CrossRef
  • Beyond survival: a comprehensive review of quality of life in rectal cancer patients
    Won Beom Jung
    Annals of Coloproctology.2024; 40(6): 527.     CrossRef
Review
Malignant disease, Rectal cancer ,Functional outcomes,Colorectal cancer,Minimally invasive surgery
Robotic Intersphincteric Resection for Low Rectal Cancer: Technical Controversies and a Systematic Review on the Perioperative, Oncological, and Functional Outcomes
Guglielmo Niccolò Piozzi, Seon Hahn Kim
Ann Coloproctol. 2021;37(6):351-367.   Published online November 17, 2021
DOI: https://doi.org/10.3393/ac.2021.00836.0119
  • 6,940 View
  • 204 Download
  • 42 Web of Science
  • 42 Citations
AbstractAbstract PDF
Intersphincteric resection (ISR) is the ultimate anus-sparing technique for low rectal cancer and is considered an oncologically safe alternative to abdominoperineal resection. The application of the robotic approach to ISR (RISR) has been described by few specialized surgical teams with several differences regarding approach and technique. This review aims to discuss the technical aspects of RISR by evaluating point by point each surgical controversy. Moreover, a systematic review was performed to report the perioperative, oncological, and functional outcomes of RISR. Postoperative morbidities after RISR are acceptable. RISR allows adequate surgical margins and adequate oncological outcomes. RISR may result in severe bowel and genitourinary dysfunction affecting the quality of life in a portion of patients.

Citations

Citations to this article as recorded by  
  • Rectal Eversion as an Anus-sparing Technique in Laparoscopic Low Anterior Resection With Double Stapling Anastomosis: Long-term Functional Results
    Servet Karagul, Serdar Senol, Oktay Karakose, Huseyin Eken, Cuneyt Kayaalp
    Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2025;[Epub]     CrossRef
  • Robotic surgery versus laparoscopic surgery for rectal cancer: a comparative study on surgical safety and functional outcomes
    Li TengTeng, Fu HaiXiao, Fu Wei, Zhang Xuan
    ANZ Journal of Surgery.2025; 95(1-2): 156.     CrossRef
  • The Review of Modified Intersphincteric Resection in the Treatment of Ultra-Low Rectal Cancer
    Danni Li, Xi Xiong, Pan Diao, Jitao Hu, Wenbo Niu, Guiying Wang, Baokun Li
    Current Treatment Options in Oncology.2025; 26(2): 84.     CrossRef
  • Long-term functional and prognostic outcomes of robotic intersphincteric resection for treating low rectal cancer: a single-center retrospective study
    Yang Bo, Wang Yigao, Zheng Mingye, Jian Zhao, Yongxiang Li
    International Journal of Colorectal Disease.2025;[Epub]     CrossRef
  • Comparison of laparoscopic versus robot-assisted sugery for rectal cancer after neo-adjuvant therapy: a large volume single center experience
    Heyuan Zhu, Jingyu Zou, Hongfeng Pan, Ying Huang, Pan Chi
    BMC Surgery.2025;[Epub]     CrossRef
  • Robotic surgery for bowel endometriosis: a multidisciplinary management of a complex entity
    G. N. Piozzi, V. Burea, R. Duhoky, S. Stefan, C. So, D. Wilby, D. Tsepov, J. S. Khan
    Techniques in Coloproctology.2024;[Epub]     CrossRef
  • Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
    Chungyeop Lee, In Ja Park
    The World Journal of Men's Health.2024; 42(2): 304.     CrossRef
  • Robotic beyond total mesorectal excision for locally advanced rectal cancers: Perioperative and oncological outcomes from a multicentre case series
    Jim S. Khan, Guglielmo Niccolò Piozzi, Philippe Rouanet, Avanish Saklani, Volkan Ozben, Paul Neary, Peter Coyne, Seon Hahn Kim, Julio Garcia-Aguilar
    European Journal of Surgical Oncology.2024; 50(6): 108308.     CrossRef
  • Treatment of side limb full-thickness prolapse of the side-to-end coloanal anastomosis following intersphincteric resection: a case report and review of literature
    Guglielmo Niccolò Piozzi, Krunal Khobragade, Seon Hui Shin, Jeong Min Choo, Seon Hahn Kim
    Annals of Coloproctology.2024; 40(Suppl 1): S38.     CrossRef
  • Robotic approach to colonic resection: For some or for all patients?
    Sentilnathan Subramaniam, Guglielmo Niccolò Piozzi, Seon‐Hahn Kim, Jim S. Khan
    Colorectal Disease.2024; 26(7): 1447.     CrossRef
  • The role of robotic-assisted surgery in the management of rectal cancer: a systematic review and meta-analysis
    Chenxiong Zhang, Hao Tan, Han Xu, Jiaming Ding
    International Journal of Surgery.2024; 110(10): 6282.     CrossRef
  • The Impact of a Modular Robotic Total Mesorectal Excision Training Program on Perioperative and Oncological Outcomes in Robotic Rectal Cancer Surgery
    Samuel Stefan, Guglielmo Niccolò Piozzi, Patricia Tejedor, Christopher C.L. Liao, Anwar Ahmad, Nasir Z. Ahmad, Syed A.H. Naqvi, Richard J. Heald, Jim S. Khan
    Diseases of the Colon & Rectum.2024; 67(11): 1485.     CrossRef
  • Suitable T stage for cryosurgery to spare the anus in patients with low rectal cancer
    Xuejun Jiang, Zujin Ji, Xinyi Lei, Cui Liu, Fangjun Yuan
    Cryobiology.2023; 111: 121.     CrossRef
  • Morbidity and oncological outcomes after intersphincteric resection of the rectum for low-lying rectal cancer: experience of a single center in a lower-middle-income country
    Antoinette Afua Asiedua Bediako-Bowan, Narious Naalane, Jonathan C. B. Dakubo
    BMC Surgery.2023;[Epub]     CrossRef
  • Robotic male and laparoscopic female sphincter-preserving total mesorectal excision of mid-low rectal cancer share similar specimen quality, complication rates and long-term oncological outcomes
    Vusal Aliyev, Guglielmo Niccolò Piozzi, Elnur Huseynov, Teuta Zoto Mustafayev, Vildan Kayku, Suha Goksel, Oktar Asoglu
    Journal of Robotic Surgery.2023; 17(4): 1637.     CrossRef
  • International standardization and optimization group for intersphincteric resection (ISOG‐ISR): modified Delphi consensus on anatomy, definition, indication, surgical technique, specimen description and functional outcome
    Guglielmo Niccolò Piozzi, Krunal Khobragade, Vusal Aliyev, Oktar Asoglu, Paolo Pietro Bianchi, Vlad‐Olimpiu Butiurca, William Tzu‐Liang Chen, Ju Yong Cheong, Gyu‐Seog Choi, Andrea Coratti, Quentin Denost, Yosuke Fukunaga, Emre Gorgun, Francesco Guerra, Ma
    Colorectal Disease.2023; 25(9): 1896.     CrossRef
  • International Society of University Colon and Rectal Surgeons survey of surgeons’ preference on rectal cancer treatment
    Audrius Dulskas, Philip F. Caushaj, Domas Grigoravicius, Liu Zheng, Richard Fortunato, Joseph W. Nunoo-Mensah, Narimantas E. Samalavicius
    Annals of Coloproctology.2023; 39(4): 307.     CrossRef
  • Short-term outcomes of da Vinci SP versus Xi for colon cancer surgery: a propensity-score matching analysis of multicenter cohorts
    Jin-Min Jung, Young Il Kim, Yong Sik Yoon, Songsoo Yang, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
    Journal of Robotic Surgery.2023; 17(6): 2911.     CrossRef
  • Low anterior resection syndrome: is it predictable?
    Dong Hyun Kang
    Annals of Coloproctology.2023; 39(5): 373.     CrossRef
  • Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
    Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
    Annals of Surgical Treatment and Research.2023; 105(5): 252.     CrossRef
  • Robotic and laparoscopic sphincter-saving resections have similar peri-operative, oncological and functional outcomes in female patients with rectal cancer
    Vusal Aliyev, Guglielmo Niccolò Piozzi, Niyaz Shadmanov, Koray Guven, Barıs Bakır, Suha Goksel, Oktar Asoglu
    Updates in Surgery.2023; 75(8): 2201.     CrossRef
  • Development of robotic surgical devices and its application in colorectal surgery
    Kamil Erozkan, Emre Gorgun
    Mini-invasive Surgery.2023;[Epub]     CrossRef
  • Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration
    Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
    Annals of Surgical Treatment and Research.2023; 105(6): 341.     CrossRef
  • Robotic Anterior Resection for Rectosigmoid Colon Cancer using Single Port Access
    Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
    Diseases of the Colon & Rectum.2023;[Epub]     CrossRef
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    Hyun Gu Lee
    The Ewha Medical Journal.2023;[Epub]     CrossRef
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    Gyoung Tae Noh
    The Ewha Medical Journal.2023;[Epub]     CrossRef
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    In Ja Park
    The Ewha Medical Journal.2023;[Epub]     CrossRef
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    Youngbae Jeon, Eun Jung Park
    The Ewha Medical Journal.2023;[Epub]     CrossRef
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    Jeonghee Han
    The Ewha Medical Journal.2023;[Epub]     CrossRef
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    In Ja Park
    The Ewha Medical Journal.2022; 45(1): 3.     CrossRef
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    Won Beom Jung
    International Journal of Gastrointestinal Intervention.2022; 11(2): 56.     CrossRef
  • Current status and role of robotic approach in patients with low-lying rectal cancer
    Hyo Seon Ryu, Jin Kim
    Annals of Surgical Treatment and Research.2022; 103(1): 1.     CrossRef
  • Robotic vs. laparoscopic intersphincteric resection for low rectal cancer: a case matched study reporting a median of 7-year long-term oncological and functional outcomes
    Vusal Aliyev, Guglielmo Niccolò Piozzi, Alisina Bulut, Koray Guven, Baris Bakir, Sezer Saglam, Suha Goksel, Oktar Asoglu
    Updates in Surgery.2022; 74(6): 1851.     CrossRef
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    Clinical Case Reports.2022;[Epub]     CrossRef
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    Sung Uk Bae
    Journal of the Korean Medical Association.2022; 65(9): 577.     CrossRef
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    In Ja Park
    Journal of the Korean Medical Association.2022; 65(9): 540.     CrossRef
  • Current Status and Future of Robotic Surgery for Colorectal Cancer-An English Version
    Sung Uk Bae
    Journal of the Anus, Rectum and Colon.2022; 6(4): 221.     CrossRef
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    Chan Wook Kim
    The Ewha Medical Journal.2022;[Epub]     CrossRef
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    Seung Mi Yeo, Gyung Mo Son
    The Ewha Medical Journal.2022;[Epub]     CrossRef
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    Chungyeop Lee, Jong Lyul Lee
    The Ewha Medical Journal.2022;[Epub]     CrossRef
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    Young Il Kim
    The Ewha Medical Journal.2022;[Epub]     CrossRef
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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
  • 6,663 View
  • 188 Download
  • 2 Web of Science
  • 2 Citations
AbstractAbstract 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  
  • 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, Rectal cancer, Functional outcomes,Colorectal cancer
The Effect of Anastomotic Leakage on the Incidence and Severity of Low Anterior Resection Syndrome in Patients Undergoing Proctectomy: A Propensity Score Matching Analysis
Sungjin Kim, Sung Il Kang, So Hyun Kim, Jae-Hwang Kim
Ann Coloproctol. 2021;37(5):281-290.   Published online June 7, 2021
DOI: https://doi.org/10.3393/ac.2021.03.15
  • 4,347 View
  • 70 Download
  • 19 Web of Science
  • 20 Citations
AbstractAbstract PDF
Purpose
Proctectomy for the treatment of rectal cancer results in inevitable changes to bowel habits. Symptoms such as fecal incontinence, constipation, and tenesmus are collectively referred to as low anterior resection syndrome (LARS). Among the several risk factors that cause LARS, anastomotic leakage (AL) is a strong risk factor for permanent stoma formation. Therefore, the purpose of this study was to investigate the relationship between the severity of LARS and AL in patients with rectal cancer based on the LARS score and the Memorial Sloan Kettering Cancer Center (MSKCC) defecation symptom questionnaires.
Methods
We retrospectively analyzed patients who underwent low anterior resection for rectal cancer since January 2010. Patients who completed the questionnaire were classified into the AL group and control group based on medical and imaging records. Major LARS and MSKCC scores were analyzed as primary endpoints.
Results
Among the 179 patients included in this study, 37 were classified into the AL group. After propensity score matching, there were significant differences in the ratio of major LARS and MSKCC scores of the control group and AL group (ratio of major LARS: 11.1% and 37.8%, P<0.001; MSKCC score: 67.29±10.4 and 56.49±7.2, respectively, P<0.001). Univariate and multivariate analyses revealed that AL was an independent factor for major LARS occurrence and MSKCC score.
Conclusion
This study showed that AL was a significant factor in the occurrence of major LARS and defecation symptoms after proctectomy.

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  • The effect of robotic surgery on low anterior resection syndrome in patients with lower rectal cancer: a propensity score-matched analysis
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    Chungyeop Lee, In Ja Park
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    Balázs Bánky, András Fülöp, Viktória Bencze, Lóránd Lakatos, Petra Rozman, Attila Szijártó
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    Gyung Mo Son
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  • The Diagnosis and Evolution of Patients with LARS Syndrome: A Five-Year Retrospective Study from a Single Surgery Unit
    Cosmin Vasile Obleagă, Sergiu Marian Cazacu, Tiberiu Ștefăniță Țenea Cojan, Cecil Sorin Mirea, Dan Nicolae Florescu, Cristian Constantin, Mircea-Sebastian Șerbănescu, Mirela Marinela Florescu, Liliana Streba, Dragoș Marian Popescu, Ionică Daniel Vîlcea, M
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    Angelina Di Re, Salam Tooza, Jason Diab, Charbel Karam, Mina Sarofim, Kevin Ooi, Catherine Turner, Daniel Kozman, David Blomberg, Matthew Morgan
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    Jing Su, Qianhui Liu, Dagui Zhou, Xiaofeng Yang, Guiru Jia, Lijun Huang, Xiao Tang, Jiafeng Fang
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    Dong Hyun Kang
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    Kelly C.L.R. Buzatti, Andy Petroianu, Søren Laurberg, Rodrigo G. Silva, Beatriz D.S. Rodrigues, Peter Christensen, Antonio Lacerda-Filho, Therese Juul
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    Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
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    Jeonghee Han
    The Ewha Medical Journal.2023;[Epub]     CrossRef
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    Gyoung Tae Noh
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    Hyun Gu Lee
    The Ewha Medical Journal.2023;[Epub]     CrossRef
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    N. J. O’Sullivan, H. C. Temperley, T. S. Nugent, E. Z. Low, D. O. Kavanagh, J. O. Larkin, B. J. Mehigan, P. H. McCormick, M. E. Kelly
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    Mingfang Yan, Zhenmeng Lin, Zhiying Wu, Huizhe Zheng, Meiqin Shi
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    M. M. Ahmed, K. A. M. El Naggar, M. F. Abadir, W. Abbas, E. M. Abdel Hamid, Ajaya Kumar Singh
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    The Ewha Medical Journal.2022;[Epub]     CrossRef
  • The watch-and-wait strategy versus radical resection for rectal cancer patients with a good response (≤ycT2) after neoadjuvant chemoradiotherapy
    Chungyeop Lee, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
    Annals of Surgical Treatment and Research.2022; 103(6): 350.     CrossRef
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    Eun Jung Park, Seung Hyuk Baik
    Precision and Future Medicine.2021; 5(4): 164.     CrossRef
Case Reports
Malignant disease, Rectal cancer,Colorectal cancer,Complication
Neorectal Mucosal Prolapse After Intersphincteric Resection for Low-Lying Rectal Cancer: A Case Report
Mohammed Alessa, Hyeon Woo Bae, Homoud Alawfi, Ahmad Sakr, Fozan Sauri, Nam Kyu Kim
Ann Coloproctol. 2021;37(Suppl 1):S15-S17.   Published online April 22, 2021
DOI: https://doi.org/10.3393/ac.2020.02.22
  • 3,396 View
  • 88 Download
  • 6 Web of Science
  • 7 Citations
AbstractAbstract PDF
Radical resection for low rectal cancer is the mainstay among the treatment modalities. Intersphincteric resection (ISR) is considered a relatively new but effective surgical treatment for low-lying rectal tumor. As the sphincter preserving techniques get popularized, we notice uncommon complication associated with it in the form of rectal mucosal prolapse. We presented 2 rare cases that developed neorectal mucosa prolapse after ISR a complication following low rectal cancer surgery. Although ISR is a safe and effective surgical technique for low rectal cancer, it should be considered to correct modifiable possible risk factors. Also, Delorme procedure is good option for management of neorectal mucosal prolapse.

Citations

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  • Tailoring rectal cancer surgery: Surgical approaches and anatomical insights during deep pelvic dissection for optimal outcomes in low‐lying rectal cancer
    Youn Young Park, Nam Kyu Kim
    Annals of Gastroenterological Surgery.2024; 8(5): 761.     CrossRef
  • Treatment of side limb full-thickness prolapse of the side-to-end coloanal anastomosis following intersphincteric resection: a case report and review of literature
    Guglielmo Niccolò Piozzi, Krunal Khobragade, Seon Hui Shin, Jeong Min Choo, Seon Hahn Kim
    Annals of Coloproctology.2024; 40(Suppl 1): S38.     CrossRef
  • Surgical Treatment for Mucosal Prolapse after Intersphincteric Resection
    Rina Takahashi, Makoto Takahashi, Yuki Ii, Megumi Kawaguchi, Hirotaka Momose, Shunsuke Motegi, Ryoichi Tsukamoto, Yu Okazawa, Masaya Kawai, Kiichi Sugimoto, Yutaka Kojima, Kazuhiro Sakamoto
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    Kyung Uk Jung, Hyung Ook Kim, Hungdai Kim, Donghyoun Lee, Chinock Cheong
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    Toshikatsu Nitta, Masatsugu Ishii, Jun Kataoka, Sedakatsu Senpuku, Yasuhiko Ueda, Ryo Iida, Ayumi Matsutani, Takashi Ishibashi
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    Guglielmo Niccolò Piozzi, Seon Hahn Kim
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    Cristopher Varela, Nam Kyu Kim
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Malignant disease,Rare disease & stoma
Malignant Melanoma of Anorectum: Two Case Reports
Binh Van Pham, Jae Hyun Kang, Huynh Huu Phan, Min Soo Cho, Nam Kyu Kim
Ann Coloproctol. 2021;37(1):65-70.   Published online February 28, 2021
DOI: https://doi.org/10.3393/ac.2020.01.07.1
  • 9,724 View
  • 153 Download
  • 15 Web of Science
  • 12 Citations
AbstractAbstract PDF
Malignant melanoma of the anorectum is a rare disorder. Patients often present with local symptoms similar to benign diseases. The prognosis is very poor, and almost all patients die because of metastases. We report 2 female patients with unremarkable histories. Both of them received previous operations before visiting our center after they were diagnosed with anorectal malignant melanoma. One case underwent abdominoperineal resection and postoperative chemotherapy. The other had been treated with ultralow anterior resection followed by immunotherapy.

Citations

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  • A Rare Entity: Primary Malignant Melanoma of the Anorectum
    Jeongmin Choi, Jong Whan Kim
    Journal of Digestive Cancer Research.2024; 12(1): 44.     CrossRef
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    Ramazan Kozan, Ozkan Akpinar, Meral Toker
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    Nicholas L. Vitagliano, Muhammad B. Darwish, Roger W. Hsiung
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    Shamiliprabha MG, Anand CD, Supriya Verma, Nivethitha S, Jaison J John
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    Giovanni Paolino, Antonio Podo Brunetti, Carolina De Rosa, Carmen Cantisani, Franco Rongioletti, Andrea Carugno, Nicola Zerbinati, Mario Valenti, Domenico Mascagni, Giulio Tosti, Santo Raffaele Mercuri, Riccardo Pampena
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    Nawal Khan, Dondre Irving, Lynn O’Connor
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    Mohamed Mehdi Trabelsi, Neirouz Kammoun, Marwa Inoubli, Mohamed Ali Chaouch, Haifa Ben Romdhane, Wafa Koubaa, Hichem Jerraya
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Original Article
Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer
Feasibility and Outcomes of Multivisceral Resection in Locally Advanced Colorectal Cancer: Experience of a Tertiary Cancer Center in North-East India
Joydeep Purkayastha, Pritesh Rajeev Singh, Abhijit Talukdar, Gaurav Das, Jitin Yadav, Srinivas Bannoth
Ann Coloproctol. 2021;37(3):174-178.   Published online July 3, 2020
DOI: https://doi.org/10.3393/ac.2020.06.03
  • 3,776 View
  • 87 Download
  • 5 Web of Science
  • 6 Citations
AbstractAbstract PDF
Purpose
Locally advanced colorectal cancer may require an en bloc resection of surrounding organs or structures to achieve complete tumor removal. This decision must weigh the risk of complications of multivisceral resection against the potential survival benefit. The purpose of this study is to review a single-center experience of feasibility of en bloc multivisceral resections for locally advanced colorectal carcinoma and to examine the effect of surgical experience on immediate outcome and rate of R0 resections.
Methods
This is a study of 27 patients who underwent multivisceral resection for locally advanced colorectal carcinoma which was performed at our institute from January 2016 to December 2019. Among the 27 patients aged between 21 and 76 years (mean age, 48.67±7.3 years), 13 were males and 14 were females. Overall 18 patients had primary colon carcinoma and 9 had primary rectal carcinoma. All rectal cancer patients received neoadjuvant chemoradiation. All patients underwent surgery with curative intent. All patients underwent open surgery of which 66.7% underwent colectomy, 14.8% underwent anterior resection, 11.1% underwent Miles procedure, and 7.4% underwent pelvic exenteration.
Results
The mean operative time was 268.14±72.2 minutes and the median amount of blood units transfused was 2.07 units. The mean hospital stay was 13.67±3.4 days. Histologically, 44.4% of patients had well-differentiated adenocarcinoma and 55.6% had moderately differentiated adenocarcinoma. The final histopathological examinatio n revealed malignant infiltration of the adjacent organs in 19/27 patients (70.4%). Pathological complete response was seen in 2 patients. R0 resection rate achieved was 96.3%. Lymph node metastasis was seen in 66.7% of patients with colon cancer and 11.1% with rectal cancer with overall mean number of harvested lymph nodes being 12.44±3.01. Postoperative complications were identified in 7 patients (25.9%), while mortality was seen in 2 (7.4%).
Conclusion
Multivisceral resection for advanced colorectal cancer invading into the adjacent organ may be performed with acceptable morbidity and mortality.

Citations

Citations to this article as recorded by  
  • En bloc Right Hemicolectomy with Pancreaticoduodenectomy for Advanced Ascending Colon Cancer
    Hiroyuki Takeda, Tetsuo Ishizaki, Ryutaro Udo, Tomoya Tago, Kenta Kasahara, Junichi Mazaki, Keiichiro Inoue, Yuichi Nagakawa
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    Jinzhu Zhang, Jinfeng Sun, Junguang Liu, Shiwen Mei, Jichuan Quan, Gang Hu, Bo Li, Meng Zhuang, Xishan Wang, Jianqiang Tang
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    Viorel Dejeu, Paula Dejeu, Anita Muresan, Paula Bradea, Danut Dejeu
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    Jichuan Quan, Kai Zuo, Guoli Li, Junguang Liu, Shiwen Mei, Gang Hu, Wenlong Qiu, Meng Zhuang, Ling Meng, Xishan Wang, Hu Chang, Jianqiang Tang
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    Youngbae Jeon, Eun Jung Park
    The Ewha Medical Journal.2023;[Epub]     CrossRef
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    Seung Mi Yeo, Gyung Mo Son
    The Ewha Medical Journal.2022;[Epub]     CrossRef

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