Annals of Coloproctology

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Original Articles

Complications

Efficacy and safety of novel alginate-based sealants (SEAL-G and SEAL-G MIST) in reducing anastomotic leakage following colorectal anastomosis: a prospective multicenter study: Moshe Kamar, Fahim Kanani, Antonio Spinelli, David Jayne, Lior Segev, Matt Tutton, Isacco Montroni, Hagit Tulchinsky, Mordechai Shimonov, Ron Lavy, Oded Zmora; Ann Coloproctol. 2025;41(5):424-433. Published online October 23, 2025; DOI: https://doi.org/10.3393/ac.2025.00297.0042

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Purpose
This study aimed to evaluate the efficacy, usability, and safety of the novel alginate-based sealants SEAL-G and SEAL-G MIST in reducing anastomotic leakage after colorectal resection.
Methods
This prospective, multicenter study enrolled 160 patients undergoing elective colonic resection with primary anastomosis at 8 centers. SEAL-G was applied in open procedures (n=33), and SEAL-G MIST was used for minimally invasive procedures (n=127), with both sealants applied circumferentially to the anastomotic site. The primary endpoints included the rate of anastomotic coverage and the incidence of leakage within 30 days, classified according to the International Study Group of Rectal Cancer (ISGRC) criteria.
Results
The overall anastomotic leak rate was 3.1% (5 of 160), with only 1 patient (0.6%) experiencing a grade C leak that required reoperation. Four patients (2.5%) developed grade A or B leaks, all of which were managed conservatively. Complete circumferential sealant coverage was achieved in 93.1% of cases. The overall leak rates were 6.1 percent and 2.4 percent, respectively. However, statistical analysis did not show a significant difference. Mean hospital stay was significantly shorter after laparoscopic surgery compared to open surgery (5.1±2.8 days vs. 8.4±5.5 days, P<0.001).
Conclusion
Alginate-based sealants show promise in reducing the severity of anastomotic leaks and in supporting anastomotic healing, demonstrating high technical success and low complication rates. Trial registration: ClinicalTrials.gov identifier: NCT04532515

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Long-Term Safety and Efficacy of Alginate-Based Serosal Reinforcement (SEAL-G/SEAL-G MIST) Following Colorectal Anastomosis: A Multicenter, Comparative and Retrospective Cohort Study
Fahim Kanani, Antonino Spinelli, Mordechai Shimonov, Husam Zbede, Nouha Hinnawi, Ron Lavy, Oded Zmora, Moshe Kamar
Journal of Clinical Medicine.2026; 15(4): 1448. CrossRef

Malignant disease, Functional outcomes

Safety and Efficacy of Single-Port Laparoscopic Ileostomy in Palliative Settings: Seng-Muk Kang, Jung Rae Cho, Heung-Kwon Oh, Eun-Ju Lee, Min Hyun Kim, Duck-Woo Kim, Sung-Bum Kang; Ann Coloproctol. 2020;36(1):17-21. Published online February 29, 2020; DOI: https://doi.org/10.3393/ac.2019.04.25

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Abstract PDF

Purpose
Single-port laparoscopic techniques can be optimized with confined incisions. This approach has an intraoperative advantage of excellent visualization of the correct intestinal segment for exteriorization, along with direct visual control of the extraction to avoid twisting. However, only a few studies have verified the efficacy of the technique. Thus, this study assessed the results of single-port laparoscopic stoma creation for fecal diversion, specifically focusing on feasibility, safety, and efficacy.
Methods
Patients who underwent single-incision enterostomy performed by a single surgeon were included. Data on demographics, indications for and chosen procedure, and operation results were retrospectively collected and analyzed.
Results
Between April 2015 and January 2018, a total of 13 patients (8 males, 5 females) with a mean age of 57.7 years (range, 41–83 years) underwent single-port ileostomy creation. The most common reason for diversion was palliative ileostomy for colon obstruction or fistula from peritoneal malignancy (n = 12), followed by colonic fistula with necrotizing pancreatitis (n = 1). There were no cases of conversion to open or multiport laparoscopic surgery. The mean operative time was 54 minutes (range, 37–118 minutes), and the median length of hospital stay was 8 days (range, 2–211 days). A postoperative complication, aspiration pneumonia, was documented in 1 patient and treated conservatively. The mean duration of bowel movement was 0.7 days (range, 0–4 days). All stomas had good function, and there was no 30-day mortality.
Conclusion
Single-port laparoscopic ileostomy in patients with a palliative setting could be a safe and feasible option for fecal diversion.

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Single port–assisted diverting ileostomy formation for anastomotic leakage after low anterior resection
Kyong-Min Kang, Heung-Kwon Oh, Hong-min Ahn, Hye-Rim Shin, Min-Hyeong Jo, Mi-Jeong Choi, Duck-Woo Kim, Sung-Bum Kang
Journal of Minimally Invasive Surgery.2025; 28(1): 47. CrossRef
Comparison between liquid skin adhesive and wound closure strip for skin closure after subcuticular suturing in single-port laparoscopic appendectomy: a single-center retrospective study in Korea
Kyeong Eui Kim, Yu Ra Jeon, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Journal of Minimally Invasive Surgery.2024; 27(1): 14. CrossRef

Safety of Early Chemotherapy after a Laparoscopic Colorectal Cancer Resection: A Case-Control Study.: Shin, Seung Ho , Lee, Sun Il , Choi, Dong Jin , Woo, Si Uk , Kim, Jin , Min, Byung Wook , Moon, Hong Young , Kim, Seon Hahn; J Korean Soc Coloproctol. 2009;25(6):429-436.; DOI: https://doi.org/10.3393/jksc.2009.25.6.429

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Abstract PDF: PURPOSE
Since micrometastasis is generally inhibited by primary cancer, surgical ablation of the tumor may stimulate the growth of residual cancer cells, if they exist. This supports the importance of early administration of postoperative chemotherapy. METHODS: We reviewed the cases of patients who underwent a laparoscopic resection and then received chemotherapy (5 fluorouracil+leucovorin or FOLFOX4) between September 2006 and May 2008. The chemotherapy was scheduled on the 7th or the 8th postoperative day, but was postponed when a final pathologic report was delayed or patients were discharged early. The safety of chemotherapy was evaluated in two ways. Early safety, such as the presence of surgical complications and medical toxicity, was prospectively assessed just before the beginning of the second cycle of chemotherapy. Late safety, such as medical toxicity, was retrospectively estimated from the 2nd to the last cycle. These safeties were compared between the two groups: the early chemotherapy group (n=50) for which chemotherapy started on the 7th or 8th postoperative day as scheduled and the delayed chemotherapy group (n=31) for which chemotherapy started after the 14th postoperative day.
RESULTS
Patient demographics were not different between the two groups. With regards to early safety, no differences in surgical complications existed between the two groups. In medical toxicities, there were no differences, except for a higher rate of nausea in the early chemotherapy group (20 percent vs. 10 percent, P=0.01). With regards to late safety, the two groups were not different in the development of medical toxicities. CONCLUSION: Because nausea is an easily controllable toxicity, we conclude that chemotherapy is safely started on the 7th or the 8th day after a laparoscopic colorectal cancer resection.

Short-term Oncologic Outcome of Curative Resection for Obstructive Colorectal Cancer Followed by Stent Insertion: Comparative Study with Non-abstructive Colorectal Cancer.: Chang, Yeon Soo , Kim, Seong Rae , Choi, Sung Il , Joo, Sun Hyung , Lee, Suk Hwan; J Korean Soc Coloproctol. 2009;25(1):41-45.; DOI: https://doi.org/10.3393/jksc.2009.25.1.41

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Abstract PDF

PURPOSE
Recently, a self-expandable metallic stent has allowed an elective single-stage resection avoiding the risk of emergency operation and stoma formation in patients with obstructive colorectal cancer (CRC). But, forceful expansion of stent may increase the possibility of tumor cell exfoliation and dissemination through bowel lumen, lymphatic and blood vessels. Aim of study is to evaluate the short-term outcome of curative resection for obstructive colorectal cancer followed by stent in terms of oncologic safety.
METHODS
Twenty-seven patients who underwent curative resection for obstructive CRC followed by stent insertion were included in 'stent group' and control group included 87 patients who underwent surgery for non-obstructive CRC. The clinicopathologic characteristics and prognosis were compared between two groups.
RESULTS
There was no significant difference in clinicopathologic characteristics between two groups. No difference was found in postoperative complications between two groups. Overall survival rate of two groups showed no statistically significant differences (P=0.1254). Stage-matched survival rates (stage II & III) were also showed no differences between two groups.
CONCLUSION
Stent insertion itself does not compromise the survival of patients with obstructive CRC. Oncologic safety of stent insertion for obstructive CRC is acceptable. A further large-scaled prospective study and long-term follow-up is necessary to evaluate the oncologic safety of stent insertion in obstructive CRC.

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Comparison of short-term outcomes after elective surgery following endoscopic stent insertion and emergency surgery for obstructive colorectal cancer
Gil Jae Lee, Hyo Jun Kim, Jeong-Heum Baek, Won-Suk Lee, Kwang An Kwon
International Journal of Surgery.2013; 11(6): 442. CrossRef
Short-Term Outcome of Curative One-Stage Laparoscopic Resection for Obstructive Left-Sided Colon Cancers Followed by Stent Insertion: Comparative Study with Non-Obstructive Left-Sided Colon Cancers
Hyun Sil Kim, Sung Geun Kim, Chang Hyuk Ahn, Won Kyung Kang, Yun Seok Lee, In Kyu Lee, Hyung-Jin Kim, Sang Cheol Lee, Hyeon Min Cho, Jong Kyung Park, Seong Taek Oh, Jun-Gi Kim
Journal of the Korean Society of Coloproctology.2009; 25(6): 417. CrossRef

Retrospective Analysis of Patients Treated with Cetuximab plus FOLFIRI for Previous Irinotecan-combined Chemotherapy in Metastatic Colorectal Cancer.: Park, Jae Woo , Moon, Sun Mi , Hwang, Dae Yong; J Korean Soc Coloproctol. 2008;24(5):345-350.; DOI: https://doi.org/10.3393/jksc.2008.24.5.345

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Abstract PDF: PURPOSE
Many reports about efficacy of cetuximab in the prolongation of survival have been published. Especially, the combination of cetuximab and FOLFIRI has a high activity even in prior irinotecan refractory metastatic colorectal cancer (mCRC). Beside small number of patients, we are trying to evaluate the efficacy and safety of cetuximab combined with FOLFIRI for patients who prior irinotecan chemotherapy had failed.
METHODS
A retrospective analysis of 26 patients treated with cetuximab with FOLFIRI from July 2006 to August 2007 was done. All patients had already been treated with FOLFIRI chemotherapy in 1st line or 2nd line regimens for mCRC. The initial dose of cetuximab was 400 mg/m2 at the 1st week, after which the dose was 250 mg/m2 weekly plus FOLFIRI biweekly. We defined 1 cycle as 8 weeks, and the responses were evaluated at week 8.
RESULTS
The median follow-up period was 6.2 (1.1~13.9) months. After 8 weeks, 50% of the patients had a partial response, and the disease control rate was 57.5%. The median time to progression was 3 months. EGFR expression and tumor response had no correlation (P=0.07). Skin reaction and tumor response (median time to progression) had a significant correlation (P= 0.022). Cetuximab did not increase the toxicity associated with FOLFIRI, except for an acneiform rash. CONCLUSIONS: Cetuximab combined with FOLFIRI chemotherapy was effective in treating mCRC patients after FOLFIRI regimen chemotherapy.

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

Oncologic Outcomes and Safety after Tumor-specific Mesorectal Excision for Resectable Rectal Cancer: A Single Institution's Experience with 1,276 Patients with Rectal Cancer.: Kim, Nam Kyu , Min, Byung Soh , Kim, Jin Soo , Hur, Hyuk , Lee, Kang Young , Sohn, Seung Kook , Cho, Chang Hwan; J Korean Soc Coloproctol. 2008;24(2):121-133.; DOI: https://doi.org/10.3393/jksc.2008.24.2.121

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Abstract PDF

PURPOSE
The purpose of this work was to review the oncologic outcomes and the operative safety of a tumor- specific mesorectal excision (TSME) for resectable rectal cancer. The risk factors for recurrence and survival were analyzed, and the changes in the sphincter-preserving rate with time were analyzed. METHODS: A total of 1,276 patients with rectal cancer who underwent curative surgery between 1989 and 2003 were analyzed retrospectively. The enrolled patients were registered in the Colorectal Cancer Database and were followed prospectively. RESULTS: The pathologic stages were stage I in 330 (25.9%), II in 403 (31.6%), and III in 543 (42.6%). Postoperative complications developed in 263 patients (20.6%). The rates of anal sphincter preservation were 32.6% between 1989 and 1993, 56.8% between 1994 and 1998, and 69.4 % between 1999 and 2003. With a mean follow-up of 69.4 months, the overall local recurrence (LR) rate was 5.4%. The 5-year LR rates were 3.8% in stage I, 4.7% in stage II, and 8.4% in stage III (P=0.016). A multivariate analysis revealed that the risk factors affecting LR were pN (0.005) and preoperatively increased serum CEA (P=0.008). The 5-year cancer-specific survival rates were 93.8% in stage I, 84.5% in stage II, and 64.5% in stage III (P=0.021). A multivariate analysis revealed that the factors affecting cancer-specific survival were pN (P=0.012) and circumferential resection margin (P<0.001).
CONCLUSIONS
TSME for resectable rectal cancer showed acceptable operative morbidity and excellent oncologic outcomes. The trend toward sphincter preservation was obvious, and the shortening of the distal resection margin without deteriorating the oncologic outcomes was one of the major enabling factors.

Citations

Citations to this article as recorded by

Essential knowledge and technical tips for total mesorectal excision and related procedures for rectal cancer
Min Soo Cho, Hyeon Woo Bae, Nam Kyu Kim
Annals of Coloproctology.2024; 40(4): 384. CrossRef
The feasibility of laparoscopic TSME preserving the left colic artery and superior rectal artery for upper rectal cancer
Chi Zhang, Hao-tang Wei, Wenqing Hu, Yueming Sun, Qinyuan Zhang, Masanobu Abe, Zhuoran Du, Yingying Xu, Liang Zong, Xiang Hu
World Journal of Surgical Oncology.2020;[Epub] CrossRef
Biofeedback Therapy After Sphincter-Preservation Surgery for the Treatment of Rectal Cancer
Ik Yong Kim
Annals of Coloproctology.2015; 31(4): 119. CrossRef
Sexual Function After a Proctectomy for the Treatment of Rectal Cancer
Young Wan Kim, Ik Yong Kim
Annals of Coloproctology.2014; 30(5): 205. 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
Long-term Outcomes of Laparoscopic Surgery for Colorectal Cancer
Jeong-Eun Lee, Yong-Geul Joh, Sang-hwa Yoo, Geu-Young Jeong, Sung-Han Kim, Choon-Sik Chung, Dong-Gun Lee, Seon Hahn Kim
Journal of the Korean Society of Coloproctology.2011; 27(2): 64. CrossRef
The prognostic impact of the number of lymph nodes retrieved after neoadjuvant chemoradiotherapy with mesorectal excision for rectal cancer
Young‐Wan Kim, Nam‐Kyu Kim, Byung‐Soh Min, Kang‐Young Lee, Seung‐Kook Sohn, Chang‐Hwan Cho, Hoguen Kim, Ki‐Chang Keum, Jung‐Bai Ahn
Journal of Surgical Oncology.2009; 100(1): 1. CrossRef
The Influence of the Number of Retrieved Lymph Nodes on Staging and Survival in Patients With Stage II and III Rectal Cancer Undergoing Tumor-Specific Mesorectal Excision
Young-Wan Kim, Nam-Kyu Kim, Byung-Soh Min, Kang-Young Lee, Seung-Kook Sohn, Chang-Hwan Cho
Annals of Surgery.2009; 249(6): 965. CrossRef
Intersphincteric Resection and Coloanal Anstomosis for Very Low Lying Rectal Cancer
Jin Soo Kim, Cho Rok Lee, Nam Kyu Kim, Hyuk Hur, Byung Soh Min, Joong Bae Ahn, Ki Chang Keum
Journal of the Korean Surgical Society.2009; 76(1): 28. CrossRef
Rectal Cancer: Function-preserving Surgery
Nam-Kyu Kim
Journal of the Korean Society of Coloproctology.2008; 24(5): 394. CrossRef

The Early Experience of Laparoscopic Sigmoid Colon and Rectal Cancer Resection.: Park, Jung Kyu , Park, Joon Beom , Seong, Seung Hoon , Kim, Ik Yong , Kim, Dae Sung; J Korean Soc Coloproctol. 2007;23(1):41-45.; DOI: https://doi.org/10.3393/jksc.2007.23.1.41

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PURPOSE
The aim of this study is to assess the pathologic surgical outcome and short-term outcome of a laparoscopic colorectal resection at an early time on the learning curve in comparison with open surgery.
METHODS
Retrospectively collected data were obtained on 49 patients who underrent a laparoscopic sigmoid colon and rectal cancer resection between May 2001 and January 2006. The compared factors were the clinicopathologic characteristics, the operation time, the postoperative recovery, and complications.
RESULTS
There were no significant differences in age, sex, TNM stage, and tumor size between the laparoscopic and open-surgery groups. The operation time was significantly longer in the laparoscopic group (291.4 vs. 201.9 min P < 0.001). In the view point of postoperative recovery, the laparoscopic group showed a significant advantage in the passage of flatus. There were no significant differences in harvested LNs, proximal margin, and distal margin between the two groups. The complication rate was not significantly different, but anastomotic leakage was higher in the laparoscopic group (16.7% vs. 2%, P=0.02).
CONCLUSIONS
There were no significant differences in harvested LNs, proximal margin, and distal margin between the two groups, but anastomotic leakage was higher in the laparoscopic group.

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Short-Term Outcome of Curative One-Stage Laparoscopic Resection for Obstructive Left-Sided Colon Cancers Followed by Stent Insertion: Comparative Study with Non-Obstructive Left-Sided Colon Cancers
Hyun Sil Kim, Sung Geun Kim, Chang Hyuk Ahn, Won Kyung Kang, Yun Seok Lee, In Kyu Lee, Hyung-Jin Kim, Sang Cheol Lee, Hyeon Min Cho, Jong Kyung Park, Seong Taek Oh, Jun-Gi Kim
Journal of the Korean Society of Coloproctology.2009; 25(6): 417. CrossRef

Oncological Safety of Flexible Rectal Stent Insertion in Obstructive Colorectal Cancer: Short Term Result.: Kim, Jong Hyun , Lee, Doo Seok , Choi, Sung Il , Lee, Woo Yong , Choo, Sung Wook , Do, Young Soo , Chun, Ho Kyung; J Korean Soc Coloproctol. 2002;18(6):397-401.

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Abstract PDF: PURPOSE
Flexible rectal stent for obstructive colorectal cancer has an advantage of elective one stage operation after decompression. But, forceful expansion of stent may increase the possibility of tumor cell dissemination through lymph nodes and blood vessels. We studied the oncological safety of stent insertion in obstructive colorectal cancer.
METHODS
From June 1996 to August 2001, the patients with stent insertion for obstructive colorectal cancer at Samsung Medical Center were retrospectively evaluated. Seventy- one patients had stent insertion for palliation or curative resection. Among these patients 15 patients underwent curative surgery after stent insertion (stent group). During the same period 25 patients underwent multi-staged operation after the decompressing colostomy or Hartman operation. (staged operation group). Statistical methods such as Fisher's exact test, 2-test, Kaplan-Meier method were used.
RESULTS
There was no significant difference between two groups in terms of age, gender, tumor location, and stage. The median follow-up period was 21 months in stent insertion group and 29 months in staged operation group. Overall recurrence rate was 33.3% in stent insertion group and 32.0% in staged operation group. The 5-year survival rate in stent insertion group was higher than in staged operation group (75.8% vs. 48.3%). But there was no statistical significance (P>0.05 ). Disease free survival was 22.4 (6~51) months in stent insertion group and 27.8 (5~71) months in staged operation group. There was no significant difference either.
CONCLUSIONS
There was no significant difference between two groups in survival rate, recurrence rate in short term result. Flexible rectal stent insertion can be considered as oncologically safe and useful treatment of obstructive colorectal cancer. But we think long term follow up and much more cases will be necessary to make a conclusion more definitively.

Safety and Feasibility of Laparoscopic Low Anterior Resection in Early Learning Curve.: Kang, Jeong Hyun , Park, Yoon Ah , Baik, Seung Hyuk , Lee, Kang Young , Kim, Nam Kyu , Sohn, Seung Kook , Cho, Chang Hwan; J Korean Soc Coloproctol. 2005;21(6):396-400.

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Abstract PDF: PURPOSE
After the final report of Clinical Outcomes of Surgical Therapy (COST) study group, the application of laparoscopic surgery in colon cancer a spread widely. However, laparoscopic surgery in the rectum is still regarded as a complicated procedure to start due to technical difficulties and a steep learning curve. The aim of this study was to show the safety and technical feasibility of a laparoscopic low anterior resection at an early time on the learning curve in comparison with open low anterior resection.
METHODS
The learning curves of one colorectal surgeon in open and laparoscopic low anterior resections were retrospectively compared. The compared factors were clinicopathologic characteristics, operation time, and the factors associated with postoperative recovery, morbidity and mortality.
RESULTS
There were no significant differences in age or sex between two groups. The operation time was significantly longer in the laparoscopy group (P<0.001) In the view point of postoperative recovery, the laparoscopy group showed significant advantages in hospital stay (P<0.001), the passage of flatus (P<0.001), the number of analgesics used (P=0.03), and the removal of foley catheter (P=0.001). There were no conversions in the laparoscopy group, and the complication rate was lower in the laparoscopy group (10.7% vs. 17.6%). There was no postoperative mortality in either group.
CONCLUSIONS
Even though the operation time was significantly longer in the laparoscopy group, a laparoscopic low anterior resection appears to have some benefits in postoperative recovery and morbidity. In terms of surgical outcomes, a laparoscopic low anterior resection can be performed safely even in early times on the learning curve.

Review

Current Status of Laparoscopic Colectomy for Colon Cancer.: Lee, Woo Yong; J Korean Soc Coloproctol. 2005;21(2):112-119.

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Abstract PDF: Although laparoscopic colon resection is a widely accepted treatment for benign colon disease, many questions have been raised about its value in management of colorectal cancer. The short-term benefits of this operation, such as decreased incidence of pulmonary complications, faster return of the bowel function, decreased narcotic requirements, shortened hospital stay, and faster recovery time, are now well established. However, there are many controversies for this method as a treatment of cancer. The main issues are adequacy of oncologic resection, recurrence rates and patterns, and long-term survival. Considering the results so far reported, laparoscopic colectomy seems to be feasible and safe. Modest benefits in the quality of life are observed. Same oncologic resection can be performed laparoscopically with no adverse influence on the recurrence rate. At least, equivalent survival is obtained by laparoscopic colectomy. Even the early results of laparoscopic colectomy for cancer are encouraging, the fate of this procedure rests with the long term analysis of number of trials currently underway.

Original Articles

Comparison of Long-term Survival for Laparoscopic-assisted Surgery and Open Surgery for Right Colon Cancer: A Case-Control Study.: Choi, Seok Kyoung , Lee, Jong Ho , Choi, Gyu Seog; J Korean Soc Coloproctol. 2004;20(6):384-390.

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Abstract PDF: PURPOSE
The aim of this study was to compare the long-term oncologic outcomes of laparoscopy assisted and open surgery for patients with right colon cancer.
METHODS
From June 1996 to May 2000, 35 patients underwent curative surgery with a laparoscopic-assisted right hemicolectomy (LAC), and from among the patients who had curative open surgery, 35 patients with clinicopathologic characteristics comparable to those of the LAC group were selected and matched as a control group (OC). A comparative analysis of long-term survival and patterns of recurrence between these two groups was done.
RESULTS
There were no statistical differences in demographic, laboratory and pathologic characteristics between the two groups. The mean follow-up period was 54.5 months. The overall five-year survival was 82.9% in the LAC group and 68.6% in the OC group, but was not statistically significant (P=0.17). Interestingly, the five-year survival of patients with TNM stage III tumors was significantly higher in the LAC group (84.2%) than in the OC group (52.6%) (P=0.04). There were no port-site recurrences or operative deaths.
CONCLUSIONS
The long-term oncologic outcomes of laparoscopic surgery for right-sided colon cancer were similar to those of open surgery. Interestingly, laparoscopic surgery for stage III tumors showed better survival than open surgery. However, a more large-scaled randomized study will be needed to clarify the oncologic safety of laparoscopic surgery for colon cancer.

Laparoscopic Treatment of Colonic Injury Caused by Colonoscopy.: Lee, Sang Ho , Choi, Gyu Seog , Lee, Jong Ho; J Korean Soc Coloproctol. 2004;20(5):257-262.

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Abstract PDF: PURPOSE
Colonoscopy is a reliable and useful tool for diagnosis, surveillance and treatment of colorectal disease. In spite of its safety, in a large number of procedures, serious complications such as perforation or bleeding of the colon are rare, but inevitable. Laparoscopically, we treated patients with complications after diagnostic or therapeutic colonoscopy and evaluated the safety and the usefulness of laparoscopic treatment.
METHODS
From December 2002 to November 2003, thirteen patients were referred to us from regional colonoscopic clinics for laparoscopic surgery due to complications of colonoscopy. All patients presented radiologic intra- or retro-peritoneal free air and various degrees of clinical symptoms or signs comparable to colonic injury, such as abdominal pain and tenderness, distension, and/or fever. One patient with mild symptoms and an other colonoscopically treated were excluded for this study. Patients were followed up at least for two months after the operation.
RESULTS
Laparoscopic procedures ranged from exploration only or closure of a perforated colon to a standard operation for colorectal cancer according to the degree of injury or associated disease. The mean operative time was 102 min. Patients resumed meals at the 2nd to 4th post-operative day and were discharged 5 to 8 days after the operation. No operative complications occurred.
CONCLUSIONS
Laparoscopic surgery for complications of colonoscopy is feasible and safe and can allow an unnecessary laparotomy to be avoided. Even in patients with colonic injury due to the colonoscope and colorectal cancer together, laparoscopic surgery can be an alternative method for treatment of the disease.

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