Journal of the Korean Society of Coloproctology最新文献

{"title":"An analysis of factors associated with increased perineal descent in women.","authors":"Jina Chang,&nbsp;Soon Sup Chung","doi":"10.3393/jksc.2012.28.4.195","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.4.195","url":null,"abstract":"<p><strong>Purpose: </strong>Treatment of descending perineal syndrome is focused on personal etiology and on improving symptoms. However, the etiology of increased perineal descent (PD) is unclear. Therefore, the aim of the present study was to evaluate factors associated with increased resting and dynamic PD in women.</p><p><strong>Methods: </strong>From January 2004 to August 2010, defecographic findings in 201 female patients were reviewed retrospectively. Patient's age, surgical history, manometric results and defecographic findings were compared with resting and dynamic PD.</p><p><strong>Results: </strong>Age (P < 0.01), number of vaginal deliveries (P < 0.01) and resting anorectal angle (P < 0.01) were correlated with increased resting PD. Also, findings of rectoceles (P < 0.05) and intussusceptions (P < 0.05) were significantly correlated with increased resting PD. On the other hand, increased dynamic PD was correlated with age (P < 0.05), resting anal pressure (P < 0.01) and sigmoidoceles (P < 0.05). No significant correlation existed between non-relaxing puborectalis, history of pelvic surgery and increased PD. Also, no significant differences in PD according to the symptoms were observed.</p><p><strong>Conclusion: </strong>Increased number of vaginal deliveries and increased resting rectoanal angle are associated with increased resting PD whereas increased resting anal pressure is correlated with increased dynamic PD. Older age correlates with both resting and dynamic PD. Defecographic findings, such as rectoceles and intussusceptions, are associated with resting PD, and sigmoidoceles correlated with dynamic PD. These results can serve as foundational research for understanding the pathophysiology and causes of increasing PD in women better and for finding a fundamental method of treatment.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":"28 4","pages":"195-200"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/e2/jksc-28-195.PMC3440488.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30918347","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":"Anal myolipoma: a new benign entity in patients with an anal tumor?","authors":"Tae Young Kang,&nbsp;Moo Ryang Huh,&nbsp;Su Jin Kim","doi":"10.3393/jksc.2012.28.4.219","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.4.219","url":null,"abstract":"<p><p>A myolipoma is an extremely rare benign neoplasm, occurring most frequently in adults in the deep soft tissue of the abdomen or retroperitoneum. We experienced a case of an anal myolipoma occurring in a 30-year-old woman, and it was surgically resected. To our knowledge, this is the first reported case of a myolipoma arising from the anus, so such a possibility needs to be considered in the differential diagnosis.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":"28 4","pages":"219-21"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/40/ff/jksc-28-219.PMC3440492.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30918351","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":"Clinical significance of serial serum carcinoembryonic antigen values for treating rectal cancer with preoperative chemoradiotherapy.","authors":"Young Jae Ryu,&nbsp;Chang Hyun Kim,&nbsp;Hun Jin Kim,&nbsp;Hyo Kang,&nbsp;Sang Woo Lim,&nbsp;Jung Wook Huh,&nbsp;Jae Kyun Ju,&nbsp;Young Jin Kim,&nbsp;Hyeong Rok Kim","doi":"10.3393/jksc.2012.28.4.205","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.4.205","url":null,"abstract":"<p><strong>Purpose: </strong>Preoperative chemoradiotherapy is now widely accepted to treat rectal cancer; however, the prognosis for rectal cancer patients during and after chemoradiotherapy must be determined. The aim of this study was to evaluate the serial serum carcinoembryonic antigen (s-CEA) samples in patients with rectal cancer who underwent radical surgery after concurrent chemoradiotherapy (CRT).</p><p><strong>Methods: </strong>This study evaluated 236 patients with rectal cancer who received preoperative CRT followed by curative surgery between June 2005 and June 2010. We measured the patient's s-CEA levels pre-CRT, post-CRT and post-surgery. Patients were classified into four groups according to their s-CEA concentrations (group 1, high, high, high; group 2, high, high, normal; group 3, high, normal, normal; group 4, normal, normal, normal). We analyzed the clinicopathologic factors and the outcomes among these groups.</p><p><strong>Results: </strong>Of the 236 patients, 12 were in group 1, 31 were in group 2, 67 were in group 3, and 126 were in group 4. The 3-year disease-free survival rate in group 1 was poorer than those in group 3 (P = 0.007) and group 4 (P < 0.001). In a univariate analysis, type of surgery, clinical N stage, pathologic T or N stage, lymphovascular invasion, perineural invasion, and CEA group were prognostic factors. A multivariate analysis revealed that type of surgery, pathologic T stage, and lymphovascular invasion were independent prognostic factors; however, no statistical significance was associated with the CEA group.</p><p><strong>Conclusion: </strong>High pre-CRT, post-CRT, and post-surgery s-CEA levels in patients with rectal cancer were associated with high rates of systemic recurrence and poor survival. Therefore, patients with sustained high s-CEA levels during CRT require careful monitoring after surgery.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":"28 4","pages":"205-12"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/76/0b/jksc-28-205.PMC3440490.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30918349","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":"A case of a mucinous adenocarcinoma arising from a rectal diverticulum.","authors":"Jang Hoon Kwon,&nbsp;Koon Hee Han,&nbsp;Woo-Sung Chang,&nbsp;Ki-Ho Nam,&nbsp;Myoung Sik Han,&nbsp;Jae Hong Ahn,&nbsp;Sang Hak Han,&nbsp;Gab Jin Cheon","doi":"10.3393/jksc.2012.28.4.222","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.4.222","url":null,"abstract":"<p><p>The occurrence of an adenocarcinoma arising from a rectal diverticulum that causes mechanical ileus is very rare. Recently, we diagnosed a case of a mucinous adenocarcinoma in a rectal diverticulum after an emergent abdominal perineal resection and permanent colostomy by laparotomy. Here, we present a case report and a review of the literature.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":"28 4","pages":"222-4"},"PeriodicalIF":0.0,"publicationDate":"2012-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/56/8e/jksc-28-222.PMC3440493.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30918352","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":"T3 subdivision correlation with nodal or distant metastasis in colorectal cancer; is it practically useful?","authors":"Nam Kyu Kim","doi":"10.3393/jksc.2012.28.3.119","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.3.119","url":null,"abstract":"See Article on Page 160-164 \u0000 \u0000The pathological staging system has been regarded as a guideline for predicting the prognosis of patients and for deciding on the need for further adjuvant treatment. In this issue, the Yoo et al. [1] analyzed 555 colorectal cancer patients who underwent curative surgery, especially for pT3 cancer subdivided according to the depth of tumor infiltration beyond the muscle proper layer: 15 mm. These 4 types of pT3 subdivisions were shown to be deeply correlated to the known prognostic histopathologic factors. One thing they did not analyze was the relation between T3 subdivision and the 5-year disease-free survival rate. They only compared pT3 subdivision with nodal and distant metastasis; furthermore, their multivariate analysis revealed that pT3 subtype might be an independent prognostic factor in colorectal cancer. Some studies regarding the relevant risk factors for regional lymph node metastasis in submucosal adenocarcinomas have been performed, and some of those measured not only the submucosal depth of invasion but also tumor budding, lymphatic invasion, vascular invasion, etc. In rectal cancer, the circumferential resection margin (CRM) and tumor deposit also have been reported as important risk factors for predicting patient prognosis, but none of those are recognized as definite prognostic factors in the current American Joint Committee on Cancer (AJCC) staging system. However, several reports have already demonstrated extramural invasion depth to be related with nodal metastasis and distant metastasis in colorectal cancer. Interestingly, pT3 subdivision has been analyzed and has been reported as a prognostic factor in rectal cancer patients not colon cancer patients. Miyoshi et al. [2] analyzed pT3 rectal cancer patients according to a 6-mm cutoff value for the extent of mesorectal invasion, and there were definite differences in the overall 5-year survival rates between the two groups of patients. Kim et al. [3] reported an interesting study regarding how to select high-risk rectal cancer patients based on preoperative local staging using rectal magnetic resonance imaging (MRI). He compared the extent of mesorectal invasion between whole mounted rectal cancer histopathology and MRI using a 5-mm cutoff value to evaluate its value as a prognostic indicator. The overall accuracy of preoperative MRI was 88%, which means MRI can be used to select patient who show T3 with 5-mm infiltration beyond the muscle layer. Those patients could be candidates for preoperative chemoradiation. Unfortunately, T3 pathological subdivision is not accepted as a prognostic factor in the new AJCC tumor-node-metastasis staging system, Furthermore, cutoff points for the penetration depth of cancer invasion beyond the muscle proper layer have not been determined. Currently, most pathologists do not report T3 subdivision, and as far as I can determine, they seem in Korea to be reluctant to measure the distance of tumor infiltration beyo","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":"28 3","pages":"119-20"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c2/4e/jksc-28-119.PMC3398106.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30777924","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":"Comparison of Long-term Clinical Outcomes according to the Change in the Rectocele Depth between Transanal and Transvaginal Repairs for a Symptomatic Rectocele.","authors":"Choon Sik Chung,&nbsp;Sang Hwa Yu,&nbsp;Jeong Eun Lee,&nbsp;Dong Keun Lee","doi":"10.3393/jksc.2012.28.3.140","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.3.140","url":null,"abstract":"<p><strong>Purpose: </strong>This study was aimed to compare the results of a transanal repair with those of a transvaginal levatorplasty and to determine the long-term clinical outcomes according to the change in the depth of the rectocele after the procedure.</p><p><strong>Methods: </strong>Of 50 women who underwent a rectocele repair from March 2005 to February 2007, 26 women (group A) received a transanal repair, and 24 (group B) received a transvaginal repair with or without levatorplasty. At 12 months after the procedures, 45 (group A/B, 22/23 women) among the 50 women completed physiologic studies, including anal manometry and defecography, and clinical-outcome measurements. The variations of the clinical outcomes with changes in the depth of the rectocele were also evaluated in 42 women (group A/B, 20/22) at the median follow-up of 50 months.</p><p><strong>Results: </strong>On the defecographic findings, the postoperative depth of the rectocele decreased significantly in both groups (group A vs. B, 1.91 ± 0.20 vs. 2.25 ± 0.46, P = 0.040). At 12 months after surgery, 17 women in each group (group A/B, 77/75%) reported improvement of their symptoms. However, only 11 and 13 women (group A/B, 55/59%) of groups A and B, respectively, maintained their improvement at the median follow-up of 50 months. Better results were reported in patients with a greater change in the depth of their rectocele (≥4 cm) after the procedure (P = 0.001)</p><p><strong>Conclusion: </strong>In both procedures, clinical outcomes might become progressively worse as the length of the follow-up is increased.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":"28 3","pages":"140-4"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/88/6b/jksc-28-140.PMC3398109.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30777927","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":"Treatment of a recurrent rectourethral fistula by using transanal rectal flap advancement and fibrin glue: a case report.","authors":"Taek-Gu Lee,&nbsp;Sung-Su Park,&nbsp;Sang-Jeon Lee","doi":"10.3393/jksc.2012.28.3.165","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.3.165","url":null,"abstract":"<p><p>Rectourethral fistulas (RUFs) in adults are rare and could result from complicated trauma, and prostatic or rectal surgery. RUFs have been treated initially by using primary repair and omental interposition with or without a colostomy during surgery. Recurrent RUFs require complex surgery, such as a low rectal resection and coloanal anastomosis, an interposition flap of the datos muscle or gracilis muscle, and others. Recently, transanal rectal flap advancement and fibrin glue injection have provided an effective occlusion of RUFs. However, no reports about this technique exist for cases of recurrent RUFs. We report a case of a recurrent RUF successfully repaired by using transanal rectal flap advancement combined with fibrin glue injection into the fistula tract. The postoperative course was uneventful without complications. At the 1-year follow-up, no complications such as urethral stricture or recurrence existed, and voiding was normal without anal incontinence.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":"28 3","pages":"165-9"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f2/a7/jksc-28-165.PMC3398113.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30777420","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":"Appendicitis during Pregnancy: The Clinical Experience of a Secondary Hospital.","authors":"Soo Jung Jung,&nbsp;Do Kyung Lee,&nbsp;Jun Hyun Kim,&nbsp;Pil Sung Kong,&nbsp;Kyung Ha Kim,&nbsp;Sung Woo Bae","doi":"10.3393/jksc.2012.28.3.152","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.3.152","url":null,"abstract":"<p><strong>Purpose: </strong>Appendicitis is the most common condition leading to an intra-abdominal operation for a non-obstetric problem in pregnancy. The aim of this study was to examine our experience and to analyze the clinical characteristics and the pregnancy outcomes for appendicitis during pregnancy that was reported in Korea.</p><p><strong>Methods: </strong>We reported 25 cases of appendicitis during pregnancy that were treated at Good Moonhwa Hospital from January 2004 to March 2010. We also analyzed appendicitis during pregnancy reported in Korea between 1970 and 2008 by a review of journals.</p><p><strong>Results: </strong>The incidence of acute appendicitis during pregnancy was one per 568 deliveries. The mean age was 27.92 years old, the gestational stage at the onset of symptoms was the first trimester in 10 patients (40%), the second trimester in 14 patients (56%), and the third trimester in 1 patient (4%). Among the 25 cases, 21 were treated with an open appendectomy and 4 with laparoscopic appendectomies. The postoperative complications were 2 wound infections and 1 spontaneous abortion.</p><p><strong>Conclusion: </strong>Our experience demonstrated that appendectomies on pregnant patients can be successfully performed at secondary hospitals.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":"28 3","pages":"152-9"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/07/9e/jksc-28-152.PMC3398111.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30777929","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":"New hope for wound healing after bowel resection.","authors":"Ryung-Ah Lee","doi":"10.3393/jksc.2012.28.3.117","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.3.117","url":null,"abstract":"See Article on Page 132-139 \u0000 \u0000The anastomotic leakage is a crucial complication after colorectal surgery and has a variable incidence, occurring in up to 1.8 to 12% of cases [1-3]. The importance of this potential complication is emphasized to colorectal surgeons, especially in the case of lower rectal surgery, because it is a major cause of surgical morbidity and mortality, early local recurrence for cancer surgery and the need for advertent additional surgery. Also, leakage increases both the hospital stay and the medical cost. The stem cell engineering technique is an emerging field of medicine and has been put on the stage because of the hidden potential of stem cells. Collawn et al. [4] recently reported the effectiveness of adipose-derived stromal cells in the skin wound healing process. Adipose tissue is a major reservoir of mesenchymal stem cells, which can be differentiated into endothelial progenitors, adipocytes, chondrocytes, etc. \u0000 \u0000This article showed very promising results for the use of adipose stem cells in the bowel wall healing process. Rat adipose tissue harvested from the suprascapular and inguinal areas was used. After 14 days of organ culture, the outgrown cells in the fibrin matrix were recovered by selective degradation of the fibrin matrix, plated on tissue culture dishes, and propagated using a conventional two-dimensional culture. In vitro and in vivo experiments revealed that the experimental group showed significantly favorable histopathologic features, including less inflammation and more microvascular density. However, this feature does not confirm stem cell effects because vascular endothelial growth factor was used to induce endothelial differentiation during the cell manipulation stage. If this new technique is to be applied to clinical fields, an easier and more conventional process without additional pharmacological treatment would be expected.","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":"28 3","pages":"117"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/d8/jksc-28-117.PMC3398104.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30777922","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":"A case of rectal cancer in a patient with neurofibromatosis type 1.","authors":"Se Heon Oh,&nbsp;Jai Hyuen Lee,&nbsp;Hwan Namgung","doi":"10.3393/jksc.2012.28.3.170","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.3.170","url":null,"abstract":"<p><p>A rectal cancer was found in a 67-year-old man with a history of neurofibromatosis type 1. A low anterior resection was performed, and he received concurrent chemoradiation for 6 months. Twelve months after the surgery, a tumor was found at the anastomotic site by positron emission tomography-computed tomography and colonoscopy and was mistaken as anastomotic site recurrence. The tumor was confirmed as an inflammatory myofibroblastic tumor through transanal excision.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":"28 3","pages":"170-3"},"PeriodicalIF":0.0,"publicationDate":"2012-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3c/d9/jksc-28-170.PMC3398114.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30777421","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}