Journal of the Korean Society of Coloproctology最新文献

{"title":"Association of immune status with recurrent anal condylomata in human immunodeficiency virus-positive patients.","authors":"Ji Hyun Sung,&nbsp;Eun Jung Ahn,&nbsp;Heung-Kwon Oh,&nbsp;Sei Hyeog Park","doi":"10.3393/jksc.2012.28.6.294","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.6.294","url":null,"abstract":"<p><strong>Purpose: </strong>An anal condyloma is a proliferative disease of the genital epithelium caused by the human papillomavirus. This condition is most commonly seen in male homosexuals and is frequently recurrent. Some reports have suggested that immunosuppression is a risk factor for recurrence of a condyloma. Thus, we investigated the risk factors for a recurrent anal condyloma in human immunodeficiency virus (HIV)-positive patients.</p><p><strong>Methods: </strong>We retrospectively analyzed 85 consecutive patients who were diagnosed with and underwent surgery for an anal condyloma from January 2007 to December 2011. Outcomes were analyzed based clinical and immunologic data.</p><p><strong>Results: </strong>Recurrent anal condylomata were found in 25 patients (29.4%). Ten cases (40.0%) were within postoperative 3 months. At postoperative 6 months, the CD4 lymphocyte count in the recurrent group was lower than it was in the nonrecurrent group (P = 0.023).</p><p><strong>Conclusion: </strong>CD4-mediated immunosuppression is a risk factor for recurrent anal condylomata in HIV-positive patients.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fa/0c/jksc-28-294.PMC3548143.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31185143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Necrotizing fasciitis of the thigh secondary to radiation colitis in a rectal cancer patient.","authors":"So Hyun Park,&nbsp;Jung Ran Choi,&nbsp;Ji Young Song,&nbsp;Kyu Keun Kang,&nbsp;Woong Sun Yoo,&nbsp;Sung Wan Han,&nbsp;Choon Kwan Kim","doi":"10.3393/jksc.2012.28.6.325","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.6.325","url":null,"abstract":"<p><p>Necrotizing fasciitis usually occurs after dermal injury or through hematogenous spread. To date, few cases have been reported as necrotizing fasciitis of the thigh secondary to rectal perforation in rectal cancer patients. A 66-year-old male complained of pelvic and thigh pain and subsequently developed necrotizing fasciitis in his right thigh. Four years earlier, he had undergone a low anterior resection and radiotherapy due to of rectal cancer. An ulcerative lesion had been observed around the anastomosis site during the colonoscopy that had been performed two months earlier. Pelvic computed tomography and sigmoidoscopy showed rectal perforation and presacral abscess extending to buttock and the right posterior thigh fascia. Thus, the necrotizing fasciitis was believed to have occurred because of ulcer perforation, one of the complications of chronic radiation colitis, at the anastomosis site. When a rectal-cancer patient complains of pelvic and thigh pain, the possibility of a rectal perforation should be considered.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3393/jksc.2012.28.6.325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31185149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update and debate issues in surgical treatment of middle and low rectal cancer.","authors":"Nam Kyu Kim,&nbsp;Min Sung Kim,&nbsp;Sami F Al-Asari","doi":"10.3393/jksc.2012.28.5.230","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.5.230","url":null,"abstract":"<p><p>Based on a review of the literature, this paper provides an update on surgical treatment of middle and low rectal cancer and discusses issues of debate surrounding that treatment. The main goal of the surgical treatment of rectal cancer is radical resection of the tumor and surrounding lymphatic tissue. Local excision of early rectal cancer can be another treatment option, in which the patient can avoid possible complications related to radical surgery. Neoadjuvant chemoradiation therapy (CRT) has been recommended for patients with cT3-4N0 or any T N+ rectal cancer because CRT shows better local control and less toxicity than adjuvant CRT. However, recent clinical trials showed promising results for local excision after neoadjuvant CRT in selected patients with low rectal cancer. In addition, the \"wait and see\" concept is another modality that has been reported for the management of tumors that show complete clinical remission after neoadjuvant CRT. Although radical surgery for middle and low rectal cancer is the cornerstone therapy, an ultralow anterior resection with or without intersphincteric resection (ISR) has become an alternative standard surgical method for selected patients. Many studies have reported on the oncological safety of the ISR, but few of them have addressed the issue the functional outcome. Furthermore, an abdominoperineal resection (APR) has problems with high rates of tumor perforations and positive circumferential resection margins, and those factors have contributed to its having a high rate of local recurrence and a poor survival rate for rectal cancer compared with sphincter-saving procedures. Recently, great efforts have been made to reduce these problems, and the total levator excision or the extended APR concept has emerged. Surgical management for low rectal cancer should aim to radically excise the tumor and to preserve as much of the sphincter function as possible by using multidisciplinary approaches. However, further prospective clinical trials are needed for tailored treatment of rectal cancer patients.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/94/b1/jksc-28-230.PMC3499423.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31078381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic implication of 15-hydroxyprostaglandin dehydrogenase down-regulation in patients with colorectal cancer.","authors":"Pil Sung Kang,&nbsp;Jin Ha Kim,&nbsp;Ok In Moon,&nbsp;Sung Chul Lim,&nbsp;Kyung Jong Kim","doi":"10.3393/jksc.2012.28.5.253","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.5.253","url":null,"abstract":"<p><strong>Purpose: </strong>Prostaglandin (PG) E2 is known to be closely related to cancer progression and is inactivated by 15-hydroxyprostaglandin dehydrogenase (PGDH). 15-PGDH is shown to have tumor suppressor activity and to be down-regulated in various cancers, including colorectal cancer (CRC). Therefore, we evaluated the expression of 15-PGDH and its prognostic effect in patients with CRC.</p><p><strong>Methods: </strong>15-PGDH expression was examined by using immunohistochemistry in 77 patients with CRC. Its prognostic significance was statistically evaluated.</p><p><strong>Results: </strong>Negative 15-PGDH expression was noted in 55.8% of the 77 cases of CRC. 15-PGDH expression showed no correlation with any of the various clinicopathologic parameters. The status of lymph node metastasis, tumor-node-metastasis stages, and pre-operative carcinoembryonic antigen levels showed significant prognostic effect. However, univariate analysis revealed down-regulation of 15-PGDH not to be a predictor of poor survival. The 5-year overall survival rate was 71.7% in the group with positive expression of 15-PGDH and 67.1% in the group with negative expression of 15-PGDH, but this difference was not statistically significant (P = 0.751).</p><p><strong>Conclusion: </strong>15-PGDH was down-regulated in 55.8% of the colorectal cancer patients. However, down-regulation of 15-PGDH showed no prognostic value in patients with CRC. Further larger scale or prospective studies are needed to clarify the prognostic effect of 15-PGDH down-regulation in patients with colorectal cancer.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/fd/jksc-28-253.PMC3499426.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31076695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncologic Outcomes of Stage IIIA Colon Cancer for Different Chemotherapeutic Regimens.","authors":"Yoo Sung Lee,&nbsp;Hee Cheol Kim,&nbsp;Kyung Ook Jung,&nbsp;Yong Beom Cho,&nbsp;Seong Hyeon Yun,&nbsp;Woo Yong Lee,&nbsp;Ho-Kyung Chun","doi":"10.3393/jksc.2012.28.5.259","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.5.259","url":null,"abstract":"<p><strong>Purpose: </strong>Adjuvant chemotherapy is currently recommended for Stage IIIA colon cancers. This study aimed to elucidate the oncologic outcomes of Stage IIIA colon cancer according to the chemotherapeutic regimen based on a retrospective review.</p><p><strong>Methods: </strong>From 1995 to 2008, Stage IIIA colon cancer patients were identified from a prospectively maintained database at a single institution. Exclusion criteria were as follows: rectal cancer, another malignancy other than colon cancer, no adjuvant chemotherapy and unknown chemotherapeutic regimen. One hundred thirty-one patients were enrolled in the study, and the clinicopathologic and the oncologic characteristics were analyzed. The number of males was 72, and the number of females was 59; the mean age was 59.5 years (range, 25 to 76 years), and the median follow-up period was 33 months (range, 2 to 127 months).</p><p><strong>Results: </strong>Of the 131 patients, fluorouracil/leucovorin (FL)/capecitabine chemotherapy was performed in 109 patients, and FOLFOX chemotherapy was performed in 22 patients. When the patients who received FL/capecitabine chemotherapy and the patients who received FOLFOX chemotherapy were compared, there was no significant difference in the clinicopathologic factors between the two groups. The 5-year overall survival and the 5-year disease-free survival were 97.2% and 94.5% in the FL/capecitabine patient group and 95.5% and 90.9% in the FOLFOX patient group, respectively, and no statistically significant differences were noted between the two groups.</p><p><strong>Conclusion: </strong>Stage IIIA colon cancer showed good oncologic outcomes, and the chemotherapeutic regimen did not seem to affect the oncologic outcome.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/50/ee/jksc-28-259.PMC3499427.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31076696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyclooxygenase and prostaglandin in cancer.","authors":"Jong-Woo Kim","doi":"10.3393/jksc.2012.28.5.226","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.5.226","url":null,"abstract":"See Article on Page 253-258 \u0000 \u0000Inflammation, especially longstanding abnormal inflammation, seems to contribute to neoplastic transformation to some extent. We cannot help thinking of cyclooxygenase (Cox) and prostaglandin (PG) whenever we mention it. Three isoenzymes of Cox have been identified so far: Cox-1, Cox-2, and Cox-3, but Cox-3, recently identified, is a variant of Cox-1 and is also called Cox-1v. It is formed from a frame shift of the original Cox-1 gene, but it seems not to play usual Cox physiologic roles as in inflammation and fever, and it is still being studied [1, 2]. Although Cox-1 and Cox-2 enzymes basically work in the same way, they are expressed in different ways and at different levels in various organs and tissues. That is the reason side effects are different from selective inhibition against each enzyme. Cox-1, as a constitutional enzyme, is expressed from most cells in homeostatic processes and is inhibited in feedback. On the other hand, Cox-2 is mostly an enzyme that is induced under certain conditions such as inflammation or neoplastic process, but is rarely inhibited. Therefore, Cox-2 selective inhibitors effectively play their roles, especially at inflammatory sites, and do not damage the mucosa protection of gastric tissue without prohibiting the secretion of Cox-1, which is easily blocked by nonsteroidal antiinflammatory drugs (NSAIDs) in general. However, the selectivity of Cox-2 inhibitors does not seem to relieve other side effects of NSAIDs. Recently, increased risks of heart attack, cerebral stroke and renal failure have been reported with Cox-2 selective inhibitors, which seems to result from the reduced level of prostacyclin caused by Cox-2 inhibition. Prostacyclin has an important role in preventing platelets aggregation and blood clotting [3, 4]. \u0000 \u0000As we know, Cox converts arachidonic acid in the cell membrane to prostaglandin H2, the precursor of the final series-2 prostanoids such as PGE2, PGD2, PGF2, PGI2, and thromboxane A2. PGE2, one of the final products, is well known for its activities, such as softening the cervix, uterine contraction, inducing abortion, etc., in obstetric field [5]. However, the important thing is that PGE2 has recently been shown to have a strong relation with tumorigenesis in that it increases cell proliferation, angiogenesis and metastatic potential, and inhibits apoptosis and cellular immunity, which seem to be due to the increased expression of PGE2 by Cox-2 because excessive levels of PGE2 and Cox-2 are implicated in mediating several kinds of malignancies. However, we must also consider the Cox-2 activity in tumor tissue on its own without mediating prostaglandins. It can behave directly for tumorigenesis with activities similar to those mentioned above. For example, Cox-2 directly increases the intranuclear nuclear factor-κB, which is the main stimulus for gene activation and replication, and forms endogenous mutagen, malondialdehyde, from arachidonic acid, which can c","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fc/13/jksc-28-226.PMC3499421.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31078379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Evidence-based Medicine to Personalized Medicine.","authors":"Suk-Hwan Lee","doi":"10.3393/jksc.2012.28.5.228","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.5.228","url":null,"abstract":"See Article on Page 259-264 \u0000 \u0000Over the last two decades, many studies have shown the role of the adjuvant chemotherapy in stage III colon cancer [1-8]. With the introduction of excellent cytotoxic agents such as oxaliplatin and irinotecan, the median survival of even stag IV disease has been prolonged by more than 24 months. Based on the National Comprehensive Cancer Network (NCCN) guideline and the recently published Korean guideline, the oxaliplatin-based regimen has been the preferred regimen for stage III colon cancer over a single-agent regimen such as the capecitabine or 5-fluorouracil/leucovorin (FL) regimen. However, some concerns exist regarding the toxicity and the efficacy in adjuvant chemotherapy for stage III colon cancer. Because adjuvant chemotherapy means largely prophylactic chemotherapy rather than therapeutic chemotherapy like palliative chemotherapy, the efficacy of adjuvant chemotherapy should be balanced with its possible side effects, such as peripheral neuropathy or febrile neutropenia. For many years, the ideal duration of adjuvant chemotherapy has been under evaluation. Particularly with regard to the cumulative neuropathic adverse effects of oxaliplatin, a further decrease in the treatment duration is warranted. The SAFFA study showed no differences in term of overall survival between six months of a bolus FL regimen or three months of a protracted FL regimen [3]. However, a shorter adjuvant treatment duration is currently under evaluation in the IDEA program, which includes 12,000 patients from six ongoing trials [9]. \u0000 \u0000Recently, the elderly population has grown remarkably worldwide. South Korea is also one of the countries with a fast-growing elderly population. The subgroup analysis of the NSABP C-07 trial showed a trend towards better disease-free survival in patients younger than age 70 (hazard ratio, 0.80; 95% confidence interval, 0.68 to 0.95; P = 0.013), but no positive effect was evident in older patients with the addition of oxaliplatin to the FL regimen [10]. Even the NCCN guideline recommended that the oxaliplatin-based regimen not be used for elderly patients older than 70 years. Conversely, capecitabine showed a constant efficacy even in elderly patients [11]. \u0000 \u0000Lymph node metastasis is the single most important prognostic factor in colon cancer. It also determines the necessity of adjuvant chemotherapy in colon cancer. In the 7th American Joint Committee on Cancer tumor-node-metastasis staging system [12], the 5-year survival of stage IIIA colon cancer was even better than that of stage IIA colon cancer, which raised the concerns about the necessity of and ideal regimen for adjuvant chemotherapy in stage IIIA colon cancer. In this issue of the Journal of the Korean Society of Coloproctology, an article entitled \"Oncologic Outcome of Stage IIIA Colon Cancer According to Chemotherapeutic Regimen\" dealt with this specific concern. Although the study was a single-institution-based retrospective review and ","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/70/30/jksc-28-228.PMC3499422.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31078380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial clinical experience with robotic lateral pelvic lymph node dissection for advanced rectal cancer.","authors":"Ju-A Park,&nbsp;Gyu-Seog Choi,&nbsp;Jun Seok Park,&nbsp;Soo Yeun Park","doi":"10.3393/jksc.2012.28.5.265","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.5.265","url":null,"abstract":"<p><strong>Purpose: </strong>This study was conducted to evaluate the technical feasibility and safety of robotic extended lateral pelvic lymph node dissection (LPLD) in patients with advanced low rectal cancer.</p><p><strong>Methods: </strong>A review of a prospectively-collected database at Kyungpook National University Medical Center from January 2011 to November revealed a series of 8 consecutive robotic LPLD cases with a preoperative diagnosis of lateral node metastasis. Data regarding patient demographics, operating time, perioperative blood loss, surgical morbidity, lateral lymph node status, and functional outcome were analyzed.</p><p><strong>Results: </strong>In all eight patients, the procedures were completed without conversion to open surgery. The mean operative time of extended pelvic node dissection was 38 minutes (range, 20 to 51 minutes), the mean number of lateral lymph nodes harvested was 4.1 (range, 1 to 13), and 3 patients (38%) were found to have lymph node metastases. Postoperative mortality and morbidity were 0% and 25%, respectively, but, there was no LPLD-related morbidity. The mean hospital stay was 7.5 days (range, 5 to 12 days).</p><p><strong>Conclusion: </strong>Robotic LPLD is safe and feasible, with the advantage of being a minimally invasive approach. Further large-scale studies comparing robotic and conventional surgery with long-term follow-up evaluation are needed to confirm these findings.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/8e/jksc-28-265.PMC3499428.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31076697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors of parastomal hernia and creation of an ostomy.","authors":"Jin Kwon Lee,&nbsp;Won Kyung Kang","doi":"10.3393/jksc.2012.28.5.225","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.5.225","url":null,"abstract":"See Article on Page 241-246 \u0000 \u0000A parastomal hernia at the site of a permanent end colostomy is a common and troublesome complication, and its incidence is estimated to be up to 48.1% [1]. The aim of this study was to analyze the incidence of and the risk factors for a parastomal hernia. In this study, the plausible risk factors for a parastomal hernia were as follows: female gender, age over 60 years, body mass index more than 25 kg/m2, and hypertension. Other risk factors from other studies were obesity and waist circumference greater than 100 cm. Although the prophylactic use of mesh may be an option for those patients requiring a permanent stoma [2], the efficacy of using prophylactic mesh for patients with a permanent stoma is a subject of debate due to mesh-associated complications [3, 4]. In this study, the parastomal hernias were assessed by using computed tomography scans. No objective grading-system was used, and no subject symptoms were noted. Also, no descriptions of the stoma-creation techniques used by the authors were given. \u0000 \u0000The key factor to prevent a parastomal hernia is the surgical accuracy of stoma creation. As general rules, stomas should be placed through the rectus sheath for additional muscular support, fascial openings should be fit to the size of the exteriorized bowel circumference, prophylactic application of mesh may only be considered for those patients requiring a permanent stoma, and an extraperitoneal tunneling of the bowel may be considered [4]. The procedure of an end colostomy is usually performed as a final surgical procedure; the surgeon should do his or her best to create an appropriate stoma because the incidence of a \"too loose stoma\" might be double the incidence of a \"too tight stoma.\" \u0000 \u0000Further detailed studies regarding the degree of herniation and standardization of the stoma-creation method may be helpful for focusing on the risk factors. This study appears to support the prophylactic use of mesh in high-risk patients.","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1f/b7/jksc-28-225.PMC3499420.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31078377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and risk factors of parastomal hernia.","authors":"Yeun Ju Sohn,&nbsp;Sun Mi Moon,&nbsp;Ui Sup Shin,&nbsp;Sun Hee Jee","doi":"10.3393/jksc.2012.28.5.241","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.5.241","url":null,"abstract":"<p><strong>Purpose: </strong>Among the various stoma complications, the parastomal hernia (PSH) is the most common. Prevention of PSH is very important to improve the quality of life and to prevent further serious complications. The aim of this study was to analyze the incidence and the risk factors of PSH.</p><p><strong>Methods: </strong>From January 2002 and October 2008, we retrospectively reviewed 165 patients who underwent an end colostomy. As a routine oncologic follow-up, abdomino-pelvic computed tomography was used to examine the occurrence of the PSH. The associations of age, sex, body mass index (BMI), history of steroid use and comorbidities to the development of the PSH were analyzed. The median duration of the follow-up was 36 months (0 to 99 months).</p><p><strong>Results: </strong>During follow-up, 50 patients developed a PSH and the 5-year cumulative incidence rate of a PSH, obtained by using the Kaplan-Meier method, was 37.8%. In the multivariate COX analysis, female gender (hazard ratio [HR], 3.29; 95% confidence interval [CI], 1.77 to 6.11; P < 0.0001), age over 60 years (HR, 2.37; 95% CI, 1.26 to 4.46; P = 0.01), BMI more than 25 kg/m(2) (HR, 1.8; 95% CI, 1.02 to 3.16; P = 0.04), and hypertension (HR, 2.08; 95% CI, 1.14 to 3.81; P = 0.02) were all independent risk factors for the development of a PSH.</p><p><strong>Conclusion: </strong>The 5-year incidence rate of a PSH was 37.8%. The significant risk factors of a PSH were as follows: female gender, age over 60 years, BMI more than 25 kg/m(2), and hypertension. Using a prophylactic mesh during colostomy formation might be advisable when the patients have these factors.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d3/49/jksc-28-241.PMC3499424.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31078382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}