Annals of Coloproctology

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Original Article

Anorectal benign disease

Antibiotic use during the first episode of acute perianal sepsis: a still-open question: Stanislas Blondin, David Lobo, Axel Egal, Saliha Ysmail-Dahlouk, Milad Taouk, Josée Bourguignon, David Blondeel, Isabelle Etienney; Ann Coloproctol. 2025;41(1):40-46. Published online February 3, 2025; DOI: https://doi.org/10.3393/ac.2024.00472.0067

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Abstract PDF: Purpose
The role of antibiotics in preventing fistula formation following an initial abscess remains a subject of debate. This study compared the incidence of fistula in ano in patients experiencing their first episode of acute perianal sepsis, with and without antibiotic therapy, and evaluated the prevalence of fistula in ano necessitating surgical intervention at 1 year.
Methods
This retrospective cohort study was conducted at a tertiary care hospital with a dedicated proctology department. All patients who presented to the emergency proctology unit with a first episode of acute perianal sepsis were eligible for inclusion.
Results
This study included 276 patients. At 1 year, fistula formation was identified in 65.6% of all patients, 54.0% of those who had received antibiotics, and 75.0% of those who had not (P<0.001). This finding remained significant after weighted propensity analysis (odds ratio, 0.53; 95% confidence interval, 0.31–0.92; P=0.025).
Conclusion
The rate of fistula formation was relatively high in this study. However, it was lower among patients with perianal sepsis who were treated with antibiotics, although a causal relationship could not be established. Prolonged follow-up is needed to clarify the role of antibiotic therapy in preventing or delaying fistula development in patients with acute perianal sepsis.

Case Report

Pneumoretroperitoneum and Sepsis After Transanal Endoscopic Resection of a Rectal Lateral Spreading Tumor: Bruno Augusto Alves Martins, Marcelo de Melo Andrade Coura, Romulo Medeiros de Almeida, Natascha Mourão Moreira, João Batista de Sousa, Paulo Gonçalves de Oliveira; Ann Coloproctol. 2017;33(3):115-118. Published online June 30, 2017; DOI: https://doi.org/10.3393/ac.2017.33.3.115

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3 Web of Science
5 Citations

Abstract PDF

Transanal endoscopic microsurgery is considered a safe, appropriate, and minimally invasive approach, and complications after endoscopic microsurgery are rare. We report a case of sepsis and pneumoretroperitoneum after resection of a rectal lateral spreading tumor. The patient presented with rectal mucous discharge. Colonoscopy revealed a rectal lateral spreading tumor. The patient underwent an endoscopic transanal resection of the lesion. He presented with sepsis of the abdominal focus, and imaging tests revealed pneumoretroperitoneum. A new surgical intervention was performed with a loop colostomy. Despite the existence of other reports on pneumoretroperitoneum after transanal endoscopic microsurgery, what draws attention to this case is the association with sepsis.

Citations

Citations to this article as recorded by

Massive pneumoperitoneum and subcutaneous emphysema after transanal resection of a rectal tumor: Case report and comprehensive review of the literature
P Bretcha Boix, Marie Stephanie Nunez Duarte, A Dieter, R Silver
Journal of Case Reports and Images in Surgery.2025; 11(1): 31. CrossRef
Emphysema as a complication after transanal endoscopic microsurgery (TEM) (case report and review)
E. A. Khomyakov, T. A. Eryshova, M. V. Kapitanov, S. V. Chernyshov, E. G. Rybakov
Koloproktologia.2023; 22(4): 113. CrossRef
Approach to the patient with pneumoretroperitoneum
Sumudu Welikumbura, Toan Pham, Anshini Jain, Marli Williams, Philip Smart
ANZ Journal of Surgery.2021; 91(1-2): 206. CrossRef
Penetration into free abdominal cavity during transanal endoscopic rectal resection for adenoma
Yu. A. Gevorkyan, N. V. Soldatkina, V. E. Kolesnikov, D. A. Kharagezov, A. V. Dashkov, S. I. Poluektov, N. S. Samoylenko
South Russian Journal of Cancer.2021; 2(1): 43. CrossRef
Ectopic air localizations after transanal procedures: A systematic literature review
Andrea Balla, Silvia Quaresima, Alessandro M. Paganini
International Journal of Surgery.2018; 56: 167. CrossRef

Original Article

Risk Factors of Pouch Failure after a Restorative Proctocolectomy.: Shin, Ui Sup , Yu, Chang Sik , Kim, Dae Dong , Yoon, Sang Nam , Kim, Jin Cheon; J Korean Soc Coloproctol. 2008;24(4):252-259.; DOI: https://doi.org/10.3393/jksc.2008.24.4.252

2,275 View
15 Download
1 Citations

Abstract PDF

PURPOSE
The aim of this study was to analyze the risk factors of pouch failure after a restorative proctocolectomy.
METHODS
A restorative proctocolectomy was performed in 169 patients between November 1989 and May 2007. A retrospective review was done for postoperative complications and follow-up results of pouch failure, and the risk factors of pouch failure were analyzed. Pouch failure was defined as having occurred when a permanent ileostomy was constructed, regardless of pouch removal. The median follow-up was 48 (3~155) months.
RESULTS
Among the 169 cases, 86 cases involved ulcerative colitis (UC group), 70 cases involved familial adenomatous polyposis or attenuated adenomatous polyposis coli (FAP group), and the remaining 13 involved hereditary nonpolyposis colorectal cancer or synchronous colon and rectal caner (CRC group). The sex ratios and the incidences of comorbidity were not significantly different between the groups, but the mean ages were. Complications occurred in 61 patients (36.1%): pelvic sepsis (28 cases), pouchitis (23 cases), desmoid tumor (12 cases), wound infection (10 cases), and anastomosis stricture (4 cases). The 5-year cumulative rate of pouch failure was 9.8%. Presence of a desmoid tumor, pelvic sepsis, and anastomosis stricture were risk factors of pouch failure.
CONCLUSIONS
The cumulative pouch failure rate after a restorative proctocolectomy was 9.8% for 5 years, and pouch failure was associated with the presence of a desmoid tumor, pelvic sepsis, and anastomosis stricture.

Citations

Citations to this article as recorded by

Factors affecting pouch-related outcomes after restorative proctocolectomy
Gyoung Tae Noh, Jeonghee Han, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim, Emiko Mizoguchi
PLOS ONE.2017; 12(10): e0186596. CrossRef

Case Report

Thrombophlebitis of the Inferior Mesenteric Vein.: Lee, In Kyu , Kim, Seong Ah , Lee, Yoon Suk , Oh, Seong Taek , Jeon, Hae Myung , Kim, Eung Kook , Chang, Suk Kyun , Jung, Seung Eun; J Korean Soc Coloproctol. 2005;21(5):329-332.

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16 Download

Abstract PDF: Isolated thrombophlebitis of the inferior mesenteric vein (IMV) is a rare condition, but delayed diagnosis causes severe problems and serious long-term complications. Therefore, the early diagnosis and adequate management of the underlying disease and thrombus is very important. Here, a case of a 64-year-old man with isolated IMV thrombosis on computed tomography (CT) and CT angiography due to inflammation of an abdominal organ and spell our disseminate intravascular coagulation (DIC) is reported. The patient's condition improved without complication after treatments with an anticoagulant regimen and antimicrobials. In the follow up, there was no thrombus on the CT angiograph and no sign of recurrent disease.

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