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Original Articles
ERAS
Effect of continuous wound infiltration on patients using intravenous patient-controlled analgesia for pain management after reduced-port laparoscopic colorectal surgery
Hyeon Deok Choi, Sung Uk Bae
Ann Coloproctol. 2024;40(6):564-572.   Published online November 22, 2024
DOI: https://doi.org/10.3393/ac.2023.00143.0020
  • 475 View
  • 30 Download
  • 1 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Purpose
Continuous wound infiltration (CWI) has been introduced as a component of multimodal analgesia to counteract the adverse effects of the most frequently used opioids. Advantages of reduced-port laparoscopic surgery (RPLS) include cosmetic benefits and decreased postoperative pain. We aimed to investigate the effect of CWI in patients using intravenous (IV) patient-controlled analgesia (PCA) for pain management after RPLS for colorectal cancer.
Methods
This retrospective study included 25 patients who received both CWI (0.5% ropivacaine infused over 72 hours) and IV PCA (fentanyl citrate) and 52 patients who received IV PCA alone. The primary endpoint was pain scores on postoperative days (PODs) 0, 1, and 2. Univariate and multivariate analyses were conducted to determine the factors affecting the pain score on POD 0.
Results
On POD 0, the mean numeric rating scale score was significantly lower in the CWI group than in the control group (3.2±0.8 vs. 3.7±0.9, P=0.042). However, the scores were comparable between the groups during the rest of the period. Within 24 hours of surgery, the CWI group consumed fewer opioids (0.7±0.9 vs. 1.3±1.1, P=0.018) and more nonsteroidal anti-inflammatory drugs (2.0±1.4 vs. 1.3±1.4, P=0.046) than the control group. Time to removal of IV PCA was significantly longer in the CWI group than in the control group (4.4±1.6 days vs. 3.4±1.0 days, P=0.016).
Conclusion
CWI with ropivacaine and IV PCA was more effective than IV PCA alone in controlling postoperative pain within 24 hours of surgery, and opioid use could be reduced further.

Citations

Citations to this article as recorded by  
  • Optimizing postoperative pain management in minimally invasive colorectal surgery
    Soo Young Lee
    Annals of Coloproctology.2024; 40(6): 525.     CrossRef
Colorectal cancer
Computed tomography–assessed presarcopenia and clinical outcomes after laparoscopic surgery for rectal cancer
Ji Hyeong Song, Rak Kyun Oh, Jeong Eun Lee, Kyung Ha Lee, Ji Yeon Kim, Jin Soo Kim
Ann Coloproctol. 2023;39(6):513-520.   Published online December 12, 2023
DOI: https://doi.org/10.3393/ac.2023.00031.0004
  • 1,730 View
  • 101 Download
AbstractAbstract PDF
Purpose
Previous studies have reported that presarcopenia negatively affects rectal cancer treatment. However, most studies have analyzed patients including majority of open surgery, and the association between presarcopenia and clinical outcomes after laparoscopic rectal cancer surgery remains unclear. This study aimed to evaluate the impact of presarcopenia on the clinical and oncological outcomes after laparoscopic rectal cancer surgery.
Methods
Three hundred and one patients undergoing laparoscopic rectal cancer surgery between December 2009 and May 2016 were enrolled. Body composition was assessed using computed tomography by measuring the muscle and fat areas at the third lumbar (L3) vertebra. The L3 skeletal muscle area was used to calculate the skeletal muscle index and evaluate presarcopenia.
Results
Presarcopenia was more common in older ( ≥ 70 years, P = 0.008) or female patients (P = 0.045). Patients with presarcopenia had decreased skeletal muscle area (P < 0.001), lower hemoglobin level (P = 0.034), longer time to first flatus (P < 0.001), and more frequent surgical site infection (P = 0.001). However, survival rates were not significantly different between those with and without presarcopenia.
Conclusion
Computed tomography-assessed presarcopenia was associated with delayed functional recovery and increased surgical site infection, although it was not revealed as a prognostic factor for oncological outcomes.
Colorectal cancer
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
Ann Coloproctol. 2023;39(4):307-314.   Published online October 11, 2022
DOI: https://doi.org/10.3393/ac.2022.00255.0036
  • 4,030 View
  • 116 Download
  • 5 Web of Science
  • 5 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Purpose
Rectal cancer treatment has a wide range of possible approaches from radical extirpative surgery to nonoperative watchful waiting following chemoradiotherapy, with or without, additional chemotherapy. Our goal was to assess the personal opinion of active practicing surgeons on rectal cancer treatment if he/she was the patient.
Methods
A panel of the International Society of University Colon and Rectal Surgeons (ISUCRS) selected 10 questions that were included in a questionnaire that included other items including demographics. The questionnaire was distributed electronically to ISUCRS fellows and other surgeons included in our database and remained open from April 16 to 28, 2020.
Results
One hundred sixty-three specialists completed the survey. The majority of surgeons (n=65, 39.9%) chose the minimally invasive (laparoscopic) surgery for their personal treatment of rectal cancer. For low-lying rectal cancer T1 and T2, the treatment choice was standard chemoradiation+local excision (n=60, 36.8%) followed by local excision±chemoradiotherapy if needed (n=55, 33.7%). In regards to locally advanced low rectal cancer T3 or greater, the preference of the responders was for laparoscopic surgery (n=65, 39.9%). We found a statistically significant relationship between surgeons’ age and their preference for minimally invasive techniques demonstrating an age-based bias on senior surgeons’ inclination toward open approach.
Conclusion
Our survey reveals an age-based preference by surgeons for minimally invasive surgical techniques as well as organ-preserving techniques for personal treatment of treating rectal cancer. Only 1/4 of specialists do adhere to the international guidelines for treating early rectal cancer.

Citations

Citations to this article as recorded by  
  • Performance reporting design in artificial intelligence studies using image-based TNM staging and prognostic parameters in rectal cancer: a systematic review
    Minsung Kim, Taeyong Park, Bo Young Oh, Min Jeong Kim, Bum-Joo Cho, Il Tae Son
    Annals of Coloproctology.2024; 40(1): 13.     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
  • Effects of Adjuvant Chemotherapy on Oncologic Outcomes in Patients With Stage ⅡA Rectal Cancer Above the Peritoneal Reflection Who Did Not Undergo Preoperative Chemoradiotherapy
    Hyo Seon Ryu, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Yong Sang Hong, Tae Won Kim, Chang Sik Yu
    Clinical Colorectal Cancer.2024; 23(4): 392.     CrossRef
  • 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
  • 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
Review
Benign proctology
A systematic review of translation and experimental studies on internal anal sphincter for fecal incontinence
Minsung Kim, Bo-Young Oh, Ji-Seon Lee, Dogeon Yoon, Wook Chun, Il Tae Son
Ann Coloproctol. 2022;38(3):183-196.   Published online June 9, 2022
DOI: https://doi.org/10.3393/ac.2022.00276.0039
  • 3,838 View
  • 150 Download
  • 4 Web of Science
  • 4 Citations
AbstractAbstract PDF
The complexity in the molecular mechanism of the internal anal sphincter (IAS) limits preclinical or clinical outcomes of fecal incontinence (FI) treatment. So far, there are no systematic reviews of IAS translation and experimental studies that have been reported. This systematic review aims to provide a comprehensive understanding of IAS critical role in FI. Previous studies revealed the key pathway for basal tone and relaxation of IAS in different properties as follows; calcium, Rho-associated, coiled-coil containing serine/threonine kinase, aging-associated IAS dysfunction, oxidative stress, renin-angiotensin-aldosterone, cyclooxygenase, and inhibitory neurotransmitters. Previous studies have reported improved functional outcomes of cellular treatment for regeneration of dysfunctional IAS, using various stem cells, but did not demonstrate the interrelationship between those results and basal tone or relaxation-related molecular pathway of IAS. Furthermore, these results have lower specificity for IAS-incontinence due to the included external anal sphincter or nerve injury regardless of the cell type. An acellular approach using bioengineered IAS showed a physiologic response of basal tone and relaxation response similar to human IAS. However, in both cellular and acellular approaches, the lack of human IAS data still hampers clinical application. Therefore, the IAS regeneration presents more challenges and warrants more advances.

Citations

Citations to this article as recorded by  
  • Tissue engineering and regenerative medicine approaches in colorectal surgery
    Bigyan B. Mainali, James J. Yoo, Mitchell R. Ladd
    Annals of Coloproctology.2024; 40(4): 336.     CrossRef
  • 3D spheroids versus 2D-cultured human adipose stem cells to generate smooth muscle cells in an internal anal sphincter-targeting cryoinjured mouse model
    Iltae Son, Minsung Kim, Ji-Seon Lee, Dogeon Yoon, You-Rin Kim, Ji Hye Park, Bo-Young Oh, Wook Chun, Sung-Bum Kang
    Stem Cell Research & Therapy.2024;[Epub]     CrossRef
  • Differentiation of Adipose-Derived Stem Cells into Smooth Muscle Cells in an Internal Anal Sphincter-Targeting Anal Incontinence Rat Model
    Minsung Kim, Bo-Young Oh, Ji-Seon Lee, Dogeon Yoon, You-Rin Kim, Wook Chun, Jong Wan Kim, Il Tae Son
    Journal of Clinical Medicine.2023; 12(4): 1632.     CrossRef
  • Improving Efficiency and Accuracy in English Translation Learning: Investigating a Semantic Analysis Correction Algorithm
    Lingmei Cao, Junru Fu
    Applied Artificial Intelligence.2023;[Epub]     CrossRef
Original Articles
Colorectal cancer
Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer
Jung Tak Son, Yong Bog Kim, Hyung Ook Kim, Chungki Min, Yongjun Park, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim
Ann Coloproctol. 2023;39(3):260-266.   Published online May 25, 2022
DOI: https://doi.org/10.3393/ac.2022.00101.0014
  • 4,587 View
  • 161 Download
  • 2 Web of Science
  • 3 Citations
AbstractAbstract PDF
Purpose
Surgical management of obstructive left colon cancer (OLCC) is still a matter of debate. The classic Hartmann procedure (HP) has a disadvantage that requires a second major operation. Subtotal colectomy/total abdominal colectomy (STC/TC) with ileosigmoid or ileorectal anastomosis is proposed as an alternative procedure to avoid stoma and anastomotic leakage. However, doubts about morbidity and functional outcome and lack of long-term outcomes have made surgeons hesitate to perform this procedure. Therefore, this trial was designed to provide data for morbidity, functional outcomes, and long-term outcomes of STC/TC.
Methods
This study retrospectively analyzed consecutive cases of OLCC that were treated by STC/TC between January 2000 and November 2020 at a single tertiary referral center. Perioperative outcomes and long-term outcomes of STC/TC were analyzed.
Results
Twenty-five descending colon cancer (45.5%) and 30 sigmoid colon cancer cases (54.5%) were enrolled in this study. Postoperative complications occurred in 12 patients. The majority complication was postoperative ileus (10 of 12). Anastomotic leakage and perioperative mortality were not observed. At 6 to 12 weeks after the surgery, the median frequency of defecation was twice per day (interquartile range, 1–3 times per day). Eight patients (14.5%) required medication during this period, but only 3 of 8 patients required medication after 1 year. The 3-year disease-free survival was 72.7% and 3-year overall survival was 86.7%.
Conclusion
The risk of anastomotic leakage is low after STC/TC. Functional and long-term outcomes are also acceptable. Therefore, STC/TC for OLCC is a safe, 1-stage procedure that does not require diverting stoma.

Citations

Citations to this article as recorded by  
  • Influence of the type of anatomic resection on anastomotic leak after surgery for colon cancer
    Suat Chin Ng, Andrew McCombie, Frank Frizelle, Tim Eglinton
    ANZ Journal of Surgery.2024; 94(3): 424.     CrossRef
  • Complete Obstruction, a Real Risk Factor: A Comprehensive Study on Obstruction in Stage IIA Colon Cancer With Propensity Score Matching Analysis
    Soo Young Oh, Chan Wook Kim, Seonok Kim, Min Hyun Kim, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu
    Clinical Colorectal Cancer.2024; 23(2): 135.     CrossRef
  • Is it possible to use colon stenting as part of the implementation of the early rehabilitation after surgery concept in the surgical treatment of patients with colon cancer complicated by obstructive intestinal obstruction? Review
    Saday A. Aliyev, Emil S. Aliyev
    Russian Journal of Oncology.2024;[Epub]     CrossRef
Right-sided acute diverticulitis in the West: experience at a university hospital in Argentina
René M. Palacios Huatuco, Diana A. Pantoja Pachajoa, Julian E. Liaño, Héctor A. Picón Molina, Rafael Palencia, Alejandro M. Doniquian, Matías Parodi
Ann Coloproctol. 2023;39(2):123-130.   Published online November 24, 2021
DOI: https://doi.org/10.3393/ac.2021.00402.0057
  • 4,563 View
  • 144 Download
  • 2 Web of Science
  • 1 Citations
AbstractAbstract PDF
Purpose
In the West, diverticular disease is located mainly in the left colon. However, it can also present in the right colon, with an incidence of 1% to 2% in Caucasians. The purpose of this study was to describe our experience in right-sided acute diverticulitis (RD).
Methods
In this retrospective study, 410 patients with acute diverticulitis treated from 2013 to 2020 were included in a university hospital in Córdoba, Argentina. Colonic diverticulitis was stratified into 2 groups; RD and left-sided acute diverticulitis. Demographic and clinical variables, laboratory and imaging findings, type of treatment, follow-up, and recurrence were analyzed.
Results
Sixteen patients (3.9%) with RD were identified; 62.5% were male and the mean age was 40.7±11.7 years. A total of 81.3% were Caucasian and 18.7% Native American. Significant differences were found between both groups of diverticulitis; patients with RD were younger (P=0.001), with lower BMI (P=0.01), comorbidity rate (P=0.01), Charlson comorbidity index (P=0.02), hospital stay (P=0.01), severity according to the Hinchey classification (P=0.001) and had a lower recurrence rate (P=0.001). There were no significant differences in sex (P=0.95), duration of pain until admission (P=0.05), laboratory findings (P=0.23) and treatment (P=0.34).
Conclusion
Conservative treatment predominated in RD, with a lower rate of complications and recurrences, providing data that support conservative therapy as initial treatment in RD in our environment.

Citations

Citations to this article as recorded by  
  • Comparison of surgical management and outcomes of acute right colic and sigmoid diverticulitis: a French national retrospective cohort study
    E. Karam, C. Sabbagh, L. Beyer-Bergeot, P. Zerbib, V. Bridoux, G. Manceau, Y. Panis, E. Buscail, A. Venara, I. Khaoudy, M. Gaillard, M. Viennet, A. Thobie, B. Menahem, C. Eveno, C. Bonnel, J.-Y. Mabrut, B. Badic, C. Godet, Y. Eid, E. Duchalais, Z. Lakkis,
    Techniques in Coloproctology.2024;[Epub]     CrossRef
Comparison of long-term outcomes of colonic stenting as a “bridge to surgery” and emergency surgery in patients with left-sided malignant colonic obstruction
Supakij Khomvilai, Sukit Pattarajierapan
Ann Coloproctol. 2023;39(1):17-26.   Published online July 29, 2021
DOI: https://doi.org/10.3393/ac.2021.00227.0032
  • 6,167 View
  • 217 Download
  • 4 Web of Science
  • 5 Citations
AbstractAbstract PDF
Purpose
Long-term oncologic outcomes of colonic stenting as a “bridge to surgery” in patients with left-sided malignant colonic obstruction (LMCO) are unclear. This study was performed to compare long-term outcomes of self-expandable metal stent (SEMS) insertion as a bridge to surgery and emergency surgery in patients with acute LMCO.
Methods
This retrospective cohort study included patients with acute LMCO who underwent SEMS insertion as a bridge to surgery or emergency surgery. The primary outcomes were 5-year disease-free survival (DFS), overall survival (OS), and recurrence rate. Survival outcomes were determined using the Kaplan-Meier method and compared using log-rank tests.
Results
There was a trend of worsening 5-year OS rate in the SEMS group compared with emergency surgery group (45% vs. 57%, P=0.07). In stage-wise subgroup analyses, a trend of deteriorating 5-year OS rate in the SEMS group with stage III (43% vs. 59%, P=0.06) was observed. The 5-year DFS and recurrence rate were not different between groups. The overall median follow-up time was 58 months. On multivariate analysis, age of ≥65 years and American Joint Committee on Cancer stage of ≥III, and synchronous metastasis were significant poor prognostic factors for OS (hazard ratio [HR], 1.709; 95% confidence interval [CI], 1.007–2.900; P=0.05/HR, 1.988; 95% CI, 1.038–3.809; P=0.04/HR, 2.146; 95% CI, 1.191–3.866; P=0.01; respectively).
Conclusion
SEMS as a bridge to surgery may have adverse oncologic outcomes. Patients in the SEMS group had a trend of worsening 5-year OS rate without higher recurrence.

Citations

Citations to this article as recorded by  
  • Complete Obstruction, a Real Risk Factor: A Comprehensive Study on Obstruction in Stage IIA Colon Cancer With Propensity Score Matching Analysis
    Soo Young Oh, Chan Wook Kim, Seonok Kim, Min Hyun Kim, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu
    Clinical Colorectal Cancer.2024; 23(2): 135.     CrossRef
  • Is it possible to use colon stenting as part of the implementation of the early rehabilitation after surgery concept in the surgical treatment of patients with colon cancer complicated by obstructive intestinal obstruction? Review
    Saday A. Aliyev, Emil S. Aliyev
    Russian Journal of Oncology.2024;[Epub]     CrossRef
  • Colonic stenting: is the bridge to surgery worth its cost? A cost-effectiveness analysis at a single Asian institution
    Michelle Shi Qing Khoo, Frederick H. Koh, Sharmini Su Sivarajah, Leonard Ming-Li Ho, Darius Kang-Lie Aw, Cheryl Xi-Zi Chong, Fung Joon Foo, Winson Jianhong Tan
    Annals of Coloproctology.2024; 40(6): 555.     CrossRef
  • Comparison of colonic stenting and stoma creation as palliative treatment for incurable malignant colonic obstruction
    Sukit Pattarajierapan, Chatiyaporn Manomayangoon, Panat Tipsuwannakul, Supakij Khomvilai
    JGH Open.2022; 6(9): 630.     CrossRef
  • Oncologic safety of colonic stenting as a bridge to surgery in left-sided malignant colonic obstruction: Current evidence and prospects
    Sukit Pattarajierapan, Nattapanee Sukphol, Karuna Junmitsakul, Supakij Khomvilai
    World Journal of Clinical Oncology.2022; 13(12): 943.     CrossRef
Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Minimally invasive surgery
Should transanal total mesorectal excision be implemented in medium-sized colorectal unit? technical and oncological outcome
Man-fung Ho, Dennis Chung-Kei Ng, Janet Fung-yee Lee, Simon Siu-man Ng
Ann Coloproctol. 2022;38(3):207-215.   Published online July 28, 2021
DOI: https://doi.org/10.3393/ac.2020.00941.0134
  • 3,689 View
  • 146 Download
  • 3 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
This study was performed to evaluate the outcome of implementation of transanal total mesorectal excision (TaTME) for low rectal cancer in a regional hospital and in comparison to laparoscopic (Lap) TME.
Methods
Consecutive patients with low rectal cancer of which the lowest border of the tumour was located beween 1 and 5 cm from the puborectalis who underwent TME at North District Hospital between January 2013 and December 2019 were included. Clinical, operative, and pathologic outcomes were compared between Lap TME and TaTME. The primary end point was complication profile.
Results
Thirty-five patients underwent Lap TME and 45 patients underwent TaTME for low rectal cancer. The conversion rate of the TaTME group was significantly lower than that of the Lap TME group (4.4% vs. 20%, P=0.029), but the operating time was longer (259 minutes vs. 219 minutes, P=0.009). The tumour location was significantly lower in the TaTME group, but the distal resection margins were adequate and not different between both groups. The TaTME group had higher incidence rates of prolonged ileus and urinary tract infection, but the other complications were similar between the two groups. The resection margin positivity rates of the TaTME and Lap TME groups were 2.2% and 5.7%, respectively (P=0.670). At a median follow up of 39 months, no abnormal early recurrence was detected.
Conclusion
It is technically feasible and oncologically safe to perform TaTME in a medium-volume colorectal unit. Patients with difficult pelvic anatomy can benefit by reducing the risk of conversion and margin positivity rate.

Citations

Citations to this article as recorded by  
  • 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
  • Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
    Ji-Hyun Seo, In-Ja Park
    Cancers.2023; 15(21): 5211.     CrossRef
Benign proctology
Long-term outcomes after anal fistula surgery: results from two university hospitals in Thailand
Weeraput Chadbunchachai, Varut Lohsiriwat, Krisada Paonariang
Ann Coloproctol. 2022;38(2):133-140.   Published online June 7, 2021
DOI: https://doi.org/10.3393/ac.2021.01.06
  • 7,415 View
  • 213 Download
  • 4 Web of Science
  • 3 Citations
AbstractAbstract PDF
Purpose
This study aimed to evaluate long-term outcomes after anal fistula surgery from university hospitals in Thailand.
Methods
A prospectively collected database of patients with cryptoglandular anal fistula undergoing surgery from 2011 to 2017 in 2 university hospitals was reviewed. Outcomes were treatment failure (persistent or recurrent fistula), fecal continence status, and chronic postsurgical pain.
Results
This study included 247 patients; 178 (72.1%) with new anal fistula and 69 (27.9%) with recurrent fistula. One hundred twenty-one patients (49.0%) had complex fistula; 53 semi-horseshoe (21.5%), 41 high transsphincteric (16.6%), 24 horseshoe (9.7%), and 3 suprasphincteric (1.2%). Ligation of intersphincteric fistula tract (LIFT) was the most common operation performed (n=88, 35.6%) followed by fistulotomy (n=79, 32.0%). With a median follow-up of 23 months (interquartile range, 12–45 months), there were 18 persistent fistulas (7.3%) and 33 recurrent fistulae (13.4%)—accounting for 20.6% overall failure. All recurrence occurred within 24 months postoperatively. Complex fistula was the only significant predictor for recurrent fistula with a hazard ratio of 4.81 (95% confidence interval, 1.82–12.71). There was no significant difference in healing rates of complex fistulas among seton staged fistulotomy (85.0%), endorectal advancement flap (72.7%), and LIFT (65.9%) (P=0.239). Four patients (1.6%) experienced chronic postsurgical pain. Seventeen patients (6.9%) reported worse fecal continence.
Conclusion
Overall failure for anal fistula surgery was 20.6%. Complex fistula was the only predictor for recurrent fistula. At least 2-year period of follow-up is suggested for detecting recurrent diseases and assessing patient-reported outcomes such as chronic pain and continence status.

Citations

Citations to this article as recorded by  
  • The Clinical Utility of Anorectal Manometry: A Review of Current Practices
    Eleanor Aubrey Belilos, Zoë Post, Sierra Anderson, Mark DeMeo
    Gastro Hep Advances.2025; 4(2): 100562.     CrossRef
  • Exploring Health-Related Quality of Life in Patients with Anal Fistulas: A Comprehensive Study
    Tudor Mateescu, Lazar Fulger, Durganjali Tummala, Aditya Nelluri, Manaswini Kakarla, Lavinia Stelea, Catalin Dumitru, George Noditi, Amadeus Dobrescu, Cristian Paleru, Ana-Olivia Toma
    Life.2023; 13(10): 2008.     CrossRef
  • Lower Fistula Recurrence with Pulling Seton: A Retrospective Cohort Study
    Ahmad Izadpanah, Ali Reza Safarpour, Mohammad Rezazadehkermani, Ali Zahedian, Reza Barati-Boldaji
    Shiraz E-Medical Journal.2022;[Epub]     CrossRef
Benign proctology
Proposal for a New Score: Hemorrhoidal Bleeding Score
Nadia Fathallah, Hélène Beaussier, Gilles Chatellier, Jean Meyer, Marc Sapoval, Nadia Moussa, Vincent de Parades
Ann Coloproctol. 2021;37(5):311-317.   Published online September 18, 2020
DOI: https://doi.org/10.3393/ac.2020.08.19
  • 5,315 View
  • 189 Download
  • 5 Web of Science
  • 11 Citations
AbstractAbstract PDF
Purpose
We conducted a prospective study to evaluate a new hemorrhoidal bleeding score (HBS).
Methods
All consecutive patients who had consulted between May 1, 2016 and June 30, 2017 for bleeding hemorrhoidal disease were prospectively assessed at a proctological department. The study was conducted in 2 stages. The first stage assessed the validity of the score on a prospective patient cohort. A second stage assessed the interobserver reproducibility of the score on another prospective cohort.
Results
One hundred consecutive patients were studied (57 males; mean age, 49.70 years). A positive association between HBS and surgery indication was found (P<0.001). A cut-off value of the score of 5 (≤5 vs. >5) separated patients from surgical to medical-instrumental treatment with a sensitivity and specificity of 75.00% and 81.25%, respectively. In the multivariate analysis, only HBS was significantly associated with the operative decision (odds ratio, 12.22). Prolapse was no longer significantly associated with the surgical indication. After a mean follow-up after treatment of 7 months, HBS improved statistically significantly (P<0.0001). For the reproducibility of the score, an additional 30 consecutive patients (13 males; mean age, 53.14 years) were enrolled with an excellent agreement between 2 proctologists (kappa=0.983).
Conclusion
HBS is sensitive, specific, and reproducible. It can assess the severity of hemorrhoidal bleeding. It can discriminate between the most severe surgery-indicated patients and does so in a more efficient way than the Goligher prolapse score. It also allows quantifying the extent of change in hemorrhoidal bleeding after treatment.

Citations

Citations to this article as recorded by  
  • The efficacy of Aescin combined with MPFF for early control of bleeding from acute hemorrhoids, A randomized controlled trial
    Suwan Sanmee, Witcha Vipudhamorn, Pawit Sutharat, Ekkarin Supatrakul
    Asian Journal of Surgery.2025; 48(1): 193.     CrossRef
  • Hemorrhoidal disease: what role can rectal artery embolization play?
    Julien Panneau, Diane Mege, Mathieu Di Bisceglie, Julie Duclos, Idir Khati, Vincent Vidal, Gaetano Gallo, Farouk Tradi
    Frontiers in Surgery.2025;[Epub]     CrossRef
  • Hemorrhoidal disease: Epidemiological study and analysis of predictive factors for surgical management
    Nadia Fathallah, Amine Alam, Anne L. Rentien, Giorgio La Greca, Joshua Co, Elise Pommaret, Amélie Barré, Stéphane Kegne, Hélène Beaussier, Lucas Spindler, Vincent de Parades
    Journal of Visceral Surgery.2024; 161(3): 161.     CrossRef
  • Pathologie hémorroïdaire : étude épidémiologique et analyse des facteurs de risque de chirurgie
    Nadia Fathallah, Amine Alam, Anne-Laure Rentien, Giorgio La Greca, Joshua Co, Elise Pommaret, Amélie Barré, Stéphane Kegne, Hélène Beaussier, Lucas Spindler, Vincent de Parades
    Journal de Chirurgie Viscérale.2024; 161(3): 177.     CrossRef
  • Imaging for Hemorrhoidal Disease: Navigating Rectal Artery Embolization from Planning to Follow-up
    Jonathan Lindquist, James Hart, Katherine Marchak, Eduardo Bent Robinson, Premal Trivedi
    Seminars in Interventional Radiology.2024; 41(03): 263.     CrossRef
  • Russian multicenter observational HDQ study on the validation of the questionnaire for hemorrhoidal disease
    Yu. A. Shelygin, Yu. M. Stoyko, Ivan V. Kostarev, E. A. Zagriadskiǐ, A. M. Bogomazov, E. B. Golovko, Yu. V. Khomitskaya, B. B. Kvasnikov, O. Zh. Linnik
    Koloproktologia.2024; 23(4): 101.     CrossRef
  • Emborrhoid technique performed on a patient with portal hypertension and chronic hemorrhoidal bleeding as a salvage therapy
    Filipa Alves e Sousa, Pedro Marinho Lopes, Inês Bolais Mónica, Ana Catarina Carvalho, Pedro Sousa
    CVIR Endovascular.2022;[Epub]     CrossRef
  • Emborrhoid: Rectal Artery Embolization for Hemorrhoid Disease
    Julien Panneau, Diane Mege, Mathieu Di Biseglie, Julie Duclos, Paul Habert, Vincent Vidal, Farouk Tradi
    Seminars in Interventional Radiology.2022; 39(02): 194.     CrossRef
  • Rectal Artery Embolization for Hemorrhoidal Disease: Anatomy, Evaluation, and Treatment Techniques
    Julien Panneau, Diane Mege, Mathieu Di Biseglie, Julie Duclos, Paul Habert, Axel Bartoli, Vincent Vidal, Farouk Tradi
    RadioGraphics.2022; 42(6): 1829.     CrossRef
  • Treatment of Hemorrhoid in Unusual Condition-Pregnancy
    Hyo Seon Ryu
    The Ewha Medical Journal.2022;[Epub]     CrossRef
  • Hemorrhoid embolization: A review of current evidences
    Reza Talaie, Pooya Torkian, Arash Dooghaie Moghadam, Farouk Tradi, Vincent Vidal, Marc Sapoval, Jafar Golzarian
    Diagnostic and Interventional Imaging.2021;[Epub]     CrossRef
Benign GI diease
Routine Intraoperative Bacterial Culture May Be Needed in Complicated Appendicitis
Jung Tack Son, Gue Chun Lee, Hyung Ook Kim, Taewoon Kim, Donghyoun Lee, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim, Ho-Kyung Chun
Ann Coloproctol. 2020;36(3):155-162.   Published online June 30, 2020
DOI: https://doi.org/10.3393/ac.2019.11.04.1
  • 4,380 View
  • 127 Download
  • 10 Web of Science
  • 12 Citations
AbstractAbstract PDF
Purpose
Choosing the appropriate antibiotic is important for treatment of complicated appendicitis. However, increasing multidrug resistant bacteria have been a serious problem for successful treatment. This study was designed to identify bacteria isolated from patients with complicated appendicitis and reveal their susceptibilities for antibiotics and their relationship with patient clinical course.
Methods
This study included patients diagnosed with complicated appendicitis and examined the bacterial cultures and antimicrobial susceptibilities of the isolates. Data were retrospectively collected from medical records of Kangbuk Samsung Hospital from January 2008 to February 2018.
Results
The common bacterial species cultured in complicated appendicitis were as follows: Escherichia coli (n=113, 48.9%), Streptococcus spp. (n=29, 12.6%), Pseudomonas spp. (n=23, 10.0%), Bacteriodes spp. (n=22, 9.5%), Klebsiella (n=11, 4.8%), and Enterococcus spp. (n=8, 3.5%). In antibiotics susceptibility testing, the positive rate of extended-spectrum beta lactamase (ESBL) was 9.1% (21 of 231). The resistance rate to carbapenem was 1.7% (4 of 231), while that to vancomycin was 0.4% (1 of 231). E. coli was 16.8% ESBL positive (19 of 113) and had 22.1% and 19.5% resistance rates to cefotaxime and ceftazidime, respectively. Inappropriate empirical antibiotic treatment (IEAT) occurred in 55 cases (31.8%) and was significantly related with organ/space surgical site infection (SSI) (7 of 55, P=0.005).
Conclusion
The rate of antibiotic resistance organisms was high in community-acquired complicated appendicitis in Koreans. Additionally, IEAT in complicated appendicitis may lead to increased rates of SSI. Routine intraoperative culture in patients with complicated appendicitis may be an effective strategy for appropriate antibiotic regimen.

Citations

Citations to this article as recorded by  
  • Culture-based bacterial evaluation of the appendix lumen and antibiotic susceptibility of acute appendicitis in Japan: A single-center retrospective analysis
    Hiroe Kitahara, Yonfan Park, Kai Seharada, Masaki Yoshimura, Akira Horiuchi, Yukihiko Karasawa
    Medicine.2024; 103(29): e39037.     CrossRef
  • Optimizing Antibiotic Management for Adult Patients Presenting with Acute Perforated Appendicitis: A Quality Improvement Study
    Carlos Gallego-Navarro, Jason Beckermann, Maria E. Linnaus, Hayden J. Swartz, Shelby Stewart, Justin M. York, Ryan R. Gassner, Christopher A. Kasal, Annaliese G. Seidel, Corey J. Wachter, Kirstin J. Kooda, Jennifer R. Rich, Mark D. Sawyer
    Surgical Infections.2024;[Epub]     CrossRef
  • Bacterial pathogens in pediatric appendicitis: a comprehensive retrospective study
    Julia Felber, Benedikt Gross, Arend Rahrisch, Eric Waltersbacher, Evelyn Trips, Percy Schröttner, Guido Fitze, Jurek Schultz
    Frontiers in Cellular and Infection Microbiology.2023;[Epub]     CrossRef
  • An Update on Acute Appendicitis in Lebanon: Insights From a Single-Center Retrospective Study
    Nagham Bazzi, Samer Dbouk, Ahmad Rached, Sadek Jaber, Hala Bazzi, Manal Jrad, Mariam Bazzi
    Cureus.2023;[Epub]     CrossRef
  • Bacterial peritonitis in paediatric appendicitis; microbial epidemiology and antimicrobial management
    Keir Bhaskar, Simon Clarke, Luke S. P. Moore, Stephen Hughes
    Annals of Clinical Microbiology and Antimicrobials.2023;[Epub]     CrossRef
  • Aerobic Intraoperative Abdominal Cavity Culture Modifies Antibiotic Therapy and Reduces the Risk of Surgical Site Infection in Complicated Appendicitis with Peritonitis
    Víctor Manuel Quintero-Riaza, Romario Chancí-Drago, Natalia Guzmán-Arango, Pablo Posada-Moreno, Tatiana López-Sandoval, Isabel Cristina Ramírez-Sánchez, Johanna Marcela Vanegas-Munera
    Journal of Gastrointestinal Surgery.2023; 27(11): 2563.     CrossRef
  • Does the Covid-19 pandemic have an effect on wound culture in patients undergoing appendectomy? A Case Control Study
    Hacı BOLAT, Tuğba AVAN MUTLU
    Journal of Contemporary Medicine.2022; 12(2): 332.     CrossRef
  • Are We Hitting the Target?
    Julia Elrod, Fatima Yarmal, Christoph Mohr, Martin Dennebaum, Michael Boettcher, Deirdre Vincent, Konrad Reinshagen, Ingo Koenigs
    Pediatric Infectious Disease Journal.2022; 41(6): 460.     CrossRef
  • Is Routine Intra-operative Gram Stain, Culture, and Sensitivity during an Appendectomy is Effective in Decreasing the Rate of Post-operative Infective Complications?
    Muqdad Fuad, Ahmed Modher, Mohammed Habash
    Open Access Macedonian Journal of Medical Sciences.2022; 10(B): 868.     CrossRef
  • Die Bedeutung mikrobiologischer Ergebnisse für die Therapie der komplizierten Appendizitis – eine monozentrische Fall-Kontroll-Studie
    F-X. Anzinger, K. Rothe, S. Reischl, C. Stöss, A. Novotny, D. Wilhelm, H. Friess, P-A. Neumann
    Die Chirurgie.2022; 93(10): 986.     CrossRef
  • Implications of bacteriological study in complicated and uncomplicated acute appendicitis
    Sorin Cimpean, Alberto Gonzalez Barranquero, Ion Surdeanu, Benjamin Cadiere, Guy-Bernard Cadiere
    Annals of Coloproctology.2022;[Epub]     CrossRef
  • Do Cultures from Percutaneously Drained Intra-abdominal Abscesses Change Treatment: A Retrospective Review
    Andrew C. Esposito, Yuqi Zhang, Nupur Nagarkatti, William D. Laird, Nathan A. Coppersmith, Vikram Reddy, Ira Leeds, Anne Mongiu, Walter Longo, Ritche M. Hao, Haddon Pantel
    Diseases of the Colon & Rectum.2022;[Epub]     CrossRef
Benign GI diease, Inflammatory bowel disease
Clinical Characteristics and Postoperative Outcomes of Patients Presenting With Upper Gastrointestinal Tract Crohn Disease
Joon Suk Moon, Jong Lyul Lee, Chang Sik Yu, Seok-Byung Lim, In Ja Park, Yong Sik Yoon, Chan Wook Kim, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park, Hassan Abdullah Alsaleem, Jin Cheon Kim
Ann Coloproctol. 2020;36(4):243-248.   Published online March 16, 2020
DOI: https://doi.org/10.3393/ac.2019.10.16.1
  • 3,689 View
  • 121 Download
  • 7 Web of Science
  • 6 Citations
AbstractAbstract PDF
Purpose
Upper gastrointestinal (GI) tract involvement in Crohn disease (CD) is rare and effectiveness of surgical treatment is limited. The aim of this study was to evaluate characteristics and surgical outcomes of upper GI CD.
Methods
Medical records of 811 patients who underwent intestinal surgery for CD between January 2006 and December 2015 at a single institution were reviewed. Upper GI CD was defined by involvement of the stomach to the fourth portion of duodenum, with or without concomitant small/large bowel CD involvement according to a modification of the Montreal classification.
Results
We identified 24 patients (21 males, 3 females) who underwent surgery for upper GI CD. The mean age at diagnosis was 27 ± 12 years, the mean age at surgery was 33 ± 11 years, and the mean duration of CD was 73.6 ± 56.6 months. Fifteen patients (62.5%) had history of previous perianal surgery. Ten patients (41.7%) had duodenal or gastric stricture and 14 patients (58.3%) had penetrating fistula; patients with fistula were significantly more likely to develop complications (57.1% vs. 20.0%, P = 0.035). One patient with stricture had surgical recurrence. In seven patients with fistula, fistula was related to previous anastomosis. Patients with fistula had significantly longer hospital stays than those with stricture (16 days vs. 11 days, P = 0.01).
Conclusion
Upper GI CD is rare among CD types (2.96%). In patients with upper GI CD, penetrating fistula was associated with longer hospital stay and more complications.

Citations

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  • Update S2k-Guideline Helicobacter pylori and gastroduodenal ulcer disease of the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS)
    Wolfgang Fischbach, Jan Bornschein, Jörg C. Hoffmann, Sibylle Koletzko, Alexander Link, Lukas Macke, Peter Malfertheiner, Kerstin Schütte, Dieter-Michael Selgrad, Sebastian Suerbaum, Christian Schulz
    Zeitschrift für Gastroenterologie.2024; 62(02): 261.     CrossRef
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    Zeitschrift für Gastroenterologie.2023; 61(05): 544.     CrossRef
  • A systematic review and meta‐analysis of prevalence and clinical features of upper gastrointestinal (UGI) tract Crohn's disease in adults compared to non‐UGI types
    Babak Tamizifar, Peyman Adibi, Maryam Hadipour, Vahid Mohamadi
    JGH Open.2023; 7(5): 325.     CrossRef
  • Upper gastrointestinal tract involvement of Crohn disease: clinical implications in children and adolescents
    Eun Sil Kim, Mi Jin Kim
    Clinical and Experimental Pediatrics.2022; 65(1): 21.     CrossRef
  • Profiling non-coding RNA levels with clinical classifiers in pediatric Crohn’s disease
    Ranjit Pelia, Suresh Venkateswaran, Jason D. Matthews, Yael Haberman, David J. Cutler, Jeffrey S. Hyams, Lee A. Denson, Subra Kugathasan
    BMC Medical Genomics.2021;[Epub]     CrossRef
  • Surgical Treatment of Upper Gastrointestinal Tract Crohn Disease: A Long Way to Go to Identify the Optimal Method
    Soo Yeun Park
    Annals of Coloproctology.2020; 36(4): 207.     CrossRef
Benign proctology
Propiverine Hydrochloride as a Treatment for Fecal Incontinence
Yasue Irei, Shota Takano, Kazutaka Yamada
Ann Coloproctol. 2020;36(2):88-93.   Published online March 16, 2020
DOI: https://doi.org/10.3393/ac.2019.09.30.2
  • 3,779 View
  • 138 Download
  • 2 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
Propiverine hydrochloride (PH) is widely used for the treatment of urinary incontinence (UI) due to bladder overactivity. Moreover, the comorbidity of UI with fecal incontinence (FI) is known to be due to the relationship of both to nervous system disorders and dysfunction or weakening of the pelvic floor muscles. The aim of this single-arm prospective study was to evaluate the therapeutic value of PH for FI.Methods: Patients (n = 24) who were diagnosed as having both FI and UI from April 2015 to November 2016 were included in the study and administered a dosage of 10–20 mg PH every day for 1 month. The primary endpoint was to create a reduction in the frequency of FI per week. An evaluation criterion of ≥50% reduction in frequency was determined as effective. The percentage of the patients who achieved the ≥50% endpoint (responders) was also calculated.Results: The frequency of FI per week was 6.0 ± 8.2 (0.25–30) at baseline and reduced to 1.6 ± 2.1 (0–7) at the posttherapeutic state (P = 0.005). A reduction of ≥50% was seen in 14 of the patients (58.3%).Conclusion: PH reduced the frequency of FI in patients with both FI and UI. This study introduces a possible therapeutic option for the pharmacological treatment of FI.

Citations

Citations to this article as recorded by  
  • A systematic review of translation and experimental studies on internal anal sphincter for fecal incontinence
    Minsung Kim, Bo-Young Oh, Ji-Seon Lee, Dogeon Yoon, Wook Chun, Il Tae Son
    Annals of Coloproctology.2022; 38(3): 183.     CrossRef
  • Is It a Refractory Disease?- Fecal Incontinence; beyond Medication
    Chungyeop Lee, Jong Lyul Lee
    The Ewha Medical Journal.2022;[Epub]     CrossRef
Benign GI diease, Inflammatory bowel disease
Short-term Outcomes of Elective 2-Stage Restorative Proctocolectomy for Ulcerative Colitis in Korea: Does Laparoscopy Have Benefits?
Jun Woo Bong, Yong Sik Yoon, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Ann Coloproctol. 2020;36(1):41-47.   Published online February 29, 2020
DOI: https://doi.org/10.3393/ac.2019.03.29
  • 3,541 View
  • 85 Download
  • 4 Web of Science
  • 3 Citations
AbstractAbstract PDF
Purpose
This study aimed to compare the short-term outcomes of the open and laparoscopic approaches to 2-stage restorative proctocolectomy (RPC) for Korean patients with ulcerative colitis (UC).
Methods
We retrospectively analyzed the medical records of 73 patients with UC who underwent elective RPC between 2009 and 2016. Patient characteristics, operative details, and postoperative complications within 30 days were compared between the open and laparoscopic groups.
Results
There were 26 cases (36%) in the laparoscopic group, which had a lower mean body mass index (P = 0.025), faster mean time to recovery of bowel function (P = 0.004), less intraoperative blood loss (P = 0.004), and less pain on the first and seventh postoperative days (P = 0.029 and P = 0.027, respectively) compared to open group. There were no deaths, and the overall complication rate was 43.8%. There was no between-group difference in the overall complication rate; however, postoperative ileus was more frequent in the open group (27.7% vs. 7.7%, P = 0.043). Current smoking (odds ratio [OR], 44.4; P = 0.003) and open surgery (OR, 5.4; P = 0.014) were the independent risk factors for postoperative complications after RPC.
Conclusion
Laparoscopic RPC was associated with acceptable morbidity and faster recovery than the open approach. The laparoscopic approach is a feasible and safe option for surgical treatment for UC in selective cases.

Citations

Citations to this article as recorded by  
  • Patient-reported Outcome Measures in Ileoanal Pouch Surgery: a Systematic Review
    Zakary Ismail Warsop, Carlo Alberto Manzo, Natalie Yu, Bilal Yusuf, Christos Kontovounisios, Valerio Celentano
    Journal of Crohn's and Colitis.2024; 18(3): 479.     CrossRef
  • Creation of an institutional preoperative checklist to support clinical risk assessment in patients with ulcerative colitis (UC) considering ileoanal pouch surgery
    Bruno Augusto Alves Martins, Amira Shamsiddinova, Manal Mubarak Alquaimi, Guy Worley, Phil Tozer, Kapil Sahnan, Zarah Perry-Woodford, Ailsa Hart, Naila Arebi, Manmeet Matharoo, Janindra Warusavitarne, Omar Faiz
    Frontline Gastroenterology.2024; 15(3): 203.     CrossRef
  • Benefits of Elective Laparoscopic 2-Stage Restorative Proctocolectomy for Ulcerative Colitis in Korea
    Sun Min Park, Won-Kyung Kang
    Annals of Coloproctology.2020; 36(1): 3.     CrossRef
Review
Reconsideration of the Safety of Laparoscopic Rectal Surgery for Cancer
Gyung Mo Son, Bong-Hyeon Kye, Min Ki Kim, Jun-Gi Kim
Ann Coloproctol. 2019;35(5):229-237.   Published online October 31, 2019
DOI: https://doi.org/10.3393/ac.2019.10.16
  • 4,197 View
  • 116 Download
  • 4 Web of Science
  • 4 Citations
AbstractAbstract PDF
The oncological outcomes of laparoscopic rectal cancer surgery were evaluated in recent multicenter randomized clinical trials (RCTs). The MRC-CLASSIC, COLOR II, and COREAN trials found no differences in local recurrence or diseasefree survival rate between laparoscopic and open surgery. However, the noninferiority of laparoscopic surgery with respect to open surgery for rectal cancer was not established on statistical analysis in the ACOSOG Z6051 and the ALaCaRT trials. Quality of total mesorectal excision (TME) is one of the most important prognostic factors. Incomplete TME had unfavorable oncologic outcomes compared to complete TME. Although TME quality can be clearly identified on pathologic evaluation, there is controversy regarding the acceptable range of oncologically safe TME for laparoscopic surgery. It is not certain whether near-complete TME has an unfavorable oncologic impact and whether laparoscopic surgery with near-complete TME is an oncological threat. Therefore, the surgical community will be interested in the long-term outcomes and meta-analyses of ongoing large-scale RCTs. Laparoscopic rectal cancer surgery has been steadily improving its safety for oncology surgery, which has been reported consistently in various multicenter RCTs. To improve surgical quality, colorectal surgeons should choose the most appropriate surgical technique, including laparoscopic surgery.

Citations

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  • Operative and Survival Outcomes of Robotic-Assisted Surgery for Colorectal Cancer in Elderly and Very Elderly Patients: A Study in a Tertiary Hospital in South Korea
    Hugo Cuellar-Gomez, Siti Mayuha Rusli, María Esther Ocharan-Hernández, Tae-Hoon Lee, Guglielmo Niccolò Piozzi, Seon-Hahn Kim, Cruz Vargas-De-León, Yazhou He
    Journal of Oncology.2022; 2022: 1.     CrossRef
  • Evidenz in der minimal-invasiven onkologischen Chirurgie des Kolons und des Rektums
    Carolin Kastner, Joachim Reibetanz, Christoph-Thomas Germer, Armin Wiegering
    Der Chirurg.2021; 92(4): 334.     CrossRef
  • The Safety and Feasibility of Laparoscopic Surgery for Very Low Rectal Cancer: A Retrospective Analysis Based on a Single Center’s Experience
    Hyuk-Jun Chung, Jun-Gi Kim, Hyung-Jin Kim, Hyeon-Min Cho, Bong-Hyeon Kye
    Biomedicines.2021; 9(11): 1720.     CrossRef
  • Reoperative laparoscopic rectal surgery: Another potential tool for the expert’s toolbox
    Marc D. Basson
    The American Journal of Surgery.2020; 219(6): 894.     CrossRef

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