Annals of Coloproctology

Original Articles

Colorectal cancer

Outcomes of side-to-end versus end-to-end colorectal anastomosis in nonemergent sigmoid and rectal cancers: a randomized controlled clinical trial: Tamer A.A.M. Habeeb, Hatem Mohammad, Tamer Wasefy, Mohamed Ibrahim Mansour; Ann Coloproctol. 2023;39(3):231-241. Published online March 11, 2022; DOI: https://doi.org/10.3393/ac.2021.00906.0129

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Purpose
The outcomes of open colorectal anastomosis of side-to-end versus end-to-end in nonemergent sigmoid and rectal cancer surgery in adults were compared.
Methods
A randomized controlled trial on individuals with sigmoid and rectal cancers was conducted between September 2016 and September 2018.
Results
The mean age was 62.58±12.3 years in the side-to-end anastomotic (SEA) group and 61.03±13.98 years in the end-to-end anastomotic (EEA) group. Except for the operative time, intraoperative data revealed no significant differences between the studied groups, and the SEA group revealed that the mean anastomotic time was significantly shorter. Perioperative blood loss, length of stay, reoperation, inpatient death, infection, and bleeding were significantly associated with leakage. There is a statistically significant change regarding the range of bowel frequency in the EEA group only (P=0.04). There is a statistically significant difference regarding incontinence for flatus in the SEA group only (P≤0.001). A statistically significant change in both groups regards incontinence for liquid stools (P≤0.001) and clustering of stools (P≤0.001 and P=0.043). The quality of life in the SEA group significantly dropped at 6 months and then returned to baseline as regards to physical well-being (PWB), functional well-being (FWB), and colorectal cancer symptoms (CCS) with no difference as regards SWB and EWB, while in the EEA group, the exact change happened only as regard PWB and FWB, but SWB and CCS percentage did not return to baseline.
Conclusion
The SEA group offers a safe alternative approach to the EEA group.

Citations

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Short-term Outcomes of Linear vs. Circular Stapling for Esophagojejunostomy in Gastric Cancer: an Inverse Probability of Treatment Weighting Analysis
Yeojin Boo, Ho-Jung Shin, Jeong Ho Song, Sang-Yong Son, Hoon Hur, Sang-Uk Han
Journal of Gastric Cancer.2025;[Epub] CrossRef
Minimally invasive left colectomy with total intracorporeal anastomosis versus extracorporeal anastomosis. A single center cohort study. Stage 2b IDEAL framework for evaluating surgical innovation
Xavier Serra-Aracil, Irene Gómez-Torres, Andrea Torrecilla-Portoles, Anna Serracant-Barrera, Albert García-Nalda, Anna Pallisera-Lloveras
Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
The impact of powered circular staplers on anastomotic leak in left-sided colorectal cancer surgeries
Hayoung Lee, Yong Sik Yoon, Young Il Kim, Eun Jung Park, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim
Surgical Endoscopy.2024; 38(10): 6111. CrossRef
Is end-to-end or side-to-end anastomotic configuration associated with risk of positive intraoperative air leak test in left-sided colon and rectal resections for colon and rectal cancers?
Sami Alahmadi, David L. Berger, Christy E. Cauley, Robert N. Goldstone, William V. Kastrinakis, Marc Rubin, Hiroko Kunitake, Rocco Ricciardi, Grace C. Lee
Journal of Gastrointestinal Surgery.2024; : 101899. CrossRef
Operative time and surgical efficiency in end-to-end versus side-to-end colorectal anastomosis for rectal cancer
Asif Almas Haque, Mir Rasekh Alam Ovi, Mohammad Tanvir Jalal
International Surgery Journal.2024; 12(1): 42. CrossRef

Long-term outcomes of high-volume stapled hemorroidopexy to treat symptomatic hemorrhoidal disease: Alessandro Sturiale, Raad Dowais, Bernardina Fabiani, Claudia Menconi, Felipe Celedon Porzio, Virginia Coli, Gabriele Naldini; Ann Coloproctol. 2023;39(1):11-16. Published online July 29, 2021; DOI: https://doi.org/10.3393/ac.2020.00227.0032

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Abstract PDF

Purpose
The study aimed to assess the long-term results of the stapled hemorrhoidopexy (SH) using high-volume devices equipped with innovative technology, evaluating recurrence rate, complications rate, and patients’ satisfaction.
Methods
All the patients who underwent SH using high-volume devices (TST Starr plus, Touchstone International Medical Science Corp., Ltd.) for II to IV symptomatic hemorrhoidal disease from November 2012 to December 2014 were enrolled. Between December 2019 and January 2020, all of them were phone called to come to undergo a proctological reevaluation and asked to fill some questionnaires about hemorrhoidal prolapse recurrence, symptoms recurrence, and surgery satisfaction.
Results
Fifty-nine patients with a mean age of 47 years completely answered the questionnaires. Twenty-two of them accepted to come to undergo a proctological reevaluation while 27 preferred to answer only by phone due to their referred wellbeing. The median follow-up was 70.5 months (range, 60–84 months). The recurrence rate was 5.1% with a mean satisfaction level after surgery was 9.1 (range, 0–10) and 84.7% of patients whose satisfaction scored ≥8. The mean value of Cleveland Global Quality of Life assessment was 0.79 (range, 0.71–0.93). There were no cases of new onset of impaired anal continence after surgery.
Conclusion
The new generation high-volume devices to perform SH resulted to be safe and effective for II to IV degree hemorrhoidal prolapse leading to a lower long-term recurrence rate with an evident reduction of postoperative complications in comparison with the low-volume SH.

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A Comparative Analysis of Gastrointestinal Recovery and Pain Management Outcomes in Stapled Versus Open Hemorrhoidectomy: A Meta-Analysis
Sadaf Khalid, Zameer Hussain Laghari, Muhammad Kashif Rafiq, Ghashia Khan, Hiba Manzoor, Pavisankar Biju Seena, Saud Hussain, Fahmida Khatoon, Farook Ayyub Kantharia, Sana Farook Kantharia
Cureus.2025;[Epub] CrossRef
A comparative study on efficacy and safety of modified partial stapled hemorrhoidopexy versus conventional hemorrhoidectomy: a prospective randomized controlled trial
Tae Gyu Kim, Chul Seung Lee, Dong Geun Lee, Choon Sik Chung, Seung Han Kim, Sang Hwa Yu, Jeong Eun Lee, Gwan Cheol Lee, Dong Woo Kang, Jeong Sub Kim, Gyu Young Jeong
Annals of Coloproctology.2025; 41(2): 145. CrossRef
Stapler Hemorrhoidopexy—Tips and Tricks
Devender Singh, Niharika Grover, Yashwant Rathore, Piyush Ranjan, Sunil Chumber
Videoscopy.2025; 35(1): 1. CrossRef
The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease
Antonio Brillantino, Adolfo Renzi, Pasquale Talento, Luigi Brusciano, Luigi Marano, Maurizio Grillo, Mauro Natale Maglio, Fabrizio Foroni, Alessio Palumbo, Maria Laura Sandoval Sotelo, Luciano Vicenzo, Michele Lanza, Giovanna Frezza, Massimo Antropoli, Cl
Annals of Coloproctology.2024; 40(4): 287. CrossRef
Lower pain, less itching, and faster healing after ultrasound scalpel-assisted hemorrhoidectomy using an intimate cleaner containing chlorhexidine, acid hyaluronic acid, and natural anti-inflammatories: a multicenter observational case-control study
Antonio Brillantino, Luigi Marano, Maurizio Grillo, Alessio Palumbo, Fabrizio Foroni, Luciano Vicenzo, Alessio Antropoli, Michele Lanza, Maria Laura Sandoval Sotelo, Nicola Sangiuliano, Mauro Maglio, Rosanna Filosa, Lucia Abbatiello, Maria Preziosa Romano
Annals of Coloproctology.2024; 40(6): 602. CrossRef
Evaluation of Clinical Manifestations of Hemorrhoidal Disease, Carried Out Surgeries and Prolapsed Anorectal Tissues: Associations with ABO Blood Groups of Patients
Inese Fišere, Valērija Groma, Šimons Svirskis, Estere Strautmane, Andris Gardovskis
Journal of Clinical Medicine.2023; 12(15): 5119. CrossRef
Stapled Transanal Rectal Resection (Starr) in the Treatment of Obstructed Defecation: A Systematic Review
Lorenzo Ripamonti, Angelo Guttadauro, Giulia Lo Bianco, Maria Rennis, Matteo Maternini, Gerardo Cioffi, Marco Chiarelli, Matilde De Simone, Ugo Cioffi, Francesco Gabrielli
Frontiers in Surgery.2022;[Epub] CrossRef
Indications, Feasibility, and Safety of TST STARR Plus Stapler for Degree III Hemorrhoids: A Retrospective Study of 125 Hemorrhoids Patients
Jun Wei, Xufeng Ding, Jie Jiang, Lijiang Ji, Hua Huang
Frontiers in Surgery.2022;[Epub] CrossRef

Clinical Study of Circular Stapler Hemorrhoidectomy.: Kang, Jung Gu , Lee, Seuk Young , Lee, Sang Hyeok; J Korean Soc Coloproctol. 2005;21(6):370-375.

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Abstract PDF: PURPOSE
A circular stapler hemorrhoidectomy is widely used to treat hemorrhoids and has the advantages of less pain and an earlier return to work compared with a conventional excisional hemorrhoidectomy. This study examined the clinical significance and efficacy of a circular stapled hemorrhoidectomy.
METHODS
One hundred eighty-six (186) patients with prolapsed hemorrhoids underwent surgery using a circular stapler. The patients' characteristics, the operation time, the postoperative course, the procedure- related factors, the pain, and the complications were analyzed. All the patients received a follow-up examination at the outpatient clinic, including the time to return to work, and the degree of satisfaction was analyzed.
RESULTS
Grade-III hemorrhoids were the most common complaint (74.1%), followed by grade-IV hemorrhoids (23.7%). Twenty-one cases (11.3%) had undergone previous anal operations: hemorrhoids, fissure, and fistula. Regarding the anesthetic method, caudal anesthesia was used in 59.7% of the cases, and spinal or saddle anesthesia was used in 39.2%. The mean operation time was 19.1 minutes (range: 8~50). The postoperative pain scores were 3.4 on the operation day, 2.1 on the postoperative 3rd day, and 0.9 on the postoperative 7th day. During the operation, a hemostatic suture was made at the suture line in 72.0% of the cases. Muscle involvement was detected at a donut specimen grossly in 9% of cases and microscopically in 48.9%. The mean thickness of muscle involvement was 2.5 mm. In the postoperative course, the time for the first bowel movement was 1.2 days, and the mean hospital stay was 2.1 days. The mean time needed for the patient to return to work was 6.2 days. The most common complication encountered was urinary problems (34.9%). The incidence of postoperative bleeding was 2.2%. Postoperative follow- up revealed one case of a hemorrhoids recurrence and one case of temporary fecal incontinence.
CONCLUSIONS
The circular stapler hemorrhoidectomy has no disadvantage in terms of operation time and operative course, and has an advantage in terms of operative pain and an earlier return to normal work without any significant or serious complications. Moreover, it has minimal long-term complications. Therefore, a circular stapler hemorrhoidectomy can be performed safely and is recommended as a useful method for treating hemorrhoids.

Surgical Management of Cecal Diverticulitis Detected during Appendectomy.: Park, Chul Woon , Kim, Bong Goo , Kim, Ki Sang , Byun, Young Hoon , Cho, Kwang Ho , Byun, Sang Hyun , Kim, Byung Ju; J Korean Soc Coloproctol. 2001;17(1):15-19.

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Abstract PDF: PURPOSE
Acute diverticulitis of the right colon is not rare in Korea and the clinical presentation is indistin guishable from acute appendicitis. Cecal diverticulitis has led to a controversy in the management of disease.
METHODS
Thirty-one cases of acute cecal diverticulitis who underwent operation for suspected acute appendicitis were reviewed retrospectively from January 1995 to December 1998.
RESULTS
There were 17 men & 14 women. Ages ranged from 9 to 69 (mean: 37.5) years. All patients presented with signs and symptoms as acute appendicitis. All patients were explored through a transverse incision in the right lower quadrant under the impression of acute appendicitis. An appendectomy and drainage was performed in 13 patients, and resection of the lesion was performed in 18 patients (12 ileocecal resection, one partial cecectomy including appendix, one partial cecectomy and an appendectomy, 4 diverticulectomy and appendectomy), depending on the location of diverticulitis, severity of inflammation, and surgeon. Staples (TA(R), GIA(R)) were used in all cecal resection cases except for diverticulectomy. Five complications were observed, 3 in cecal resection cases (one wound seroma, one wound infection and one bleeding), and 2 in appendectomy and drainage cases (two wound infections). There was no postoperative mortality. The average length of the postoperative stay was 10.2 days in the drainage group and 8.8 days in the cecal resection group. Two recurrences were observed. One was the patient who had diverticulectomy performed. The other was a patient who had had appendectomy and drainage.
CONCLUSION
We concluded that the preferred surgical management of an acute cecal diverticulitis operated for a presumed acute appendicitis is cecectomy using staples depending on its location and severity of inflammation. It was safe, relatively easy to do through the same incision, and could be a definitive treatment.

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