Annals of Coloproctology最新文献

{"title":"Preclinical testing of a new radiofrequency ablation device in a porcine perianal fistula model.","authors":"Sunseok Yoon, Jung-Woo Choi, Yongtaik Son, Hyun Soon Lee, Kwang Dae Hong","doi":"10.3393/ac.2024.00626.0089","DOIUrl":"10.3393/ac.2024.00626.0089","url":null,"abstract":"<p><strong>Purpose: </strong>Anorectal fistulas present a treatment challenge, with conventional surgical methods potentially resulting in complications such as fecal incontinence. To improve patient outcomes, more effective and minimally invasive therapies are critically needed. In this study, an optimal porcine model for the creation of anorectal fistulas was developed and used to evaluate the efficacy of radiofrequency ablation (RFA) therapy.</p><p><strong>Methods: </strong>Two distinct but related experiments were conducted. In the first experiment, a reliable and standardized porcine anorectal fistula model was developed. In the second, the healing process was assessed, and outcomes were compared between the RFA-treated group and the control group using the established porcine model.</p><p><strong>Results: </strong>The results indicated that a 3.5-cm fistula tract length and a 14-day evaluation period following seton removal are optimal for the porcine anorectal fistula model. In the second experiment, the RFA group tended to exhibit better outcomes regarding fistula closure, although the differences were not statistically significant. Histopathologically, no significant difference in inflammation grade was observed between groups; however, scar tissue was more predominant in the RFA group.</p><p><strong>Conclusions: </strong>The findings suggest that RFA therapy may offer potential benefits in the treatment of anorectal fistulas, as demonstrated using a porcine model. To validate these results and explore the mechanisms of action underlying RFA therapy for anorectal fistulas, further research involving larger sample sizes and a more robust study design is required.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 1","pages":"84-92"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565854","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":"Is clinical complete response as accurate as pathological complete response in patients with mid-low locally advanced rectal cancer?","authors":"Niyaz Shadmanov, Vusal Aliyev, Guglielmo Niccolò Piozzi, Barıs Bakır, Suha Goksel, Oktar Asoglu","doi":"10.3393/ac.2024.00339.0048","DOIUrl":"10.3393/ac.2024.00339.0048","url":null,"abstract":"<p><strong>Purpose: </strong>The standard treatment for locally advanced rectal cancer involves neoadjuvant chemoradiation followed by total mesorectal excision surgery. A subset of patients achieves pathologic complete response (pCR), representing the optimal treatment outcome. This study compares the long-term oncological outcomes of patients who achieved pCR with those who attained clinical complete response (cCR) after total neoadjuvant therapy, managed using a watch-and-wait approach.</p><p><strong>Methods: </strong>This study retrospectively evaluated patients with mid-low locally advanced rectal cancer who underwent neoadjuvant treatment from January 1, 2005, to May 1, 2023. The pCR and cCR groups were compared based on demographic, clinical, histopathological, and long-term survival outcomes.</p><p><strong>Results: </strong>The median follow-up times were 54 months (range, 7-83 months) for the cCR group (n=73), 96 months (range, 7-215 months) for the pCR group (n=63), and 72 months (range, 4-212 months) for the pathological incomplete clinical response (pICR) group (n=627). In the cCR group, 15 patients (20.5%) experienced local regrowth, and 5 (6.8%) developed distant metastasis (DM). The pCR group had no cases of local recurrence, but 3 patients (4.8%) developed DM. Among the pICR patients, 58 (9.2%) experienced local recurrence, and 92 (14.6%) had DM. Five-year disease-free survival rates were 90.0% for cCR, 92.0% for pCR, and 69.5% for pICR (P=0.022). Five-year overall survival rates were 93.1% for cCR, 92.0% for pCR, and 78.1% for pICR. There were no significant differences in outcomes between the cCR and pCR groups (P=0.810); however, the pICR group exhibited poorer outcomes (P=0.002).</p><p><strong>Conclusions: </strong>This study shows no significant long-term oncological differences between patients who exhibited cCR and those who experienced pCR.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 1","pages":"57-67"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565851","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 colorectal cancer surgery patients in intensive care between rural and metropolitan hospitals in Australia: a national cohort study.","authors":"Jessica A Paynter, Zakary Doherty, Chun Hin Angus Lee, Kirby R Qin, Janelle Brennan, David Pilcher","doi":"10.3393/ac.2024.00269.0038","DOIUrl":"10.3393/ac.2024.00269.0038","url":null,"abstract":"<p><strong>Purpose: </strong>A small proportion of colorectal cancer (CRC) surgical patients will require an admission to an intensive care unit (ICU) within the early postoperative period. This study aimed to compare the characteristics and outcomes of patients admitted to an ICU following CRC surgery per hospital type (metropolitan vs. rural) over a decade in Australia.</p><p><strong>Methods: </strong>A retrospective cohort analysis was undertaken of all adult patients admitted to a participating Australian ICUs following CRC surgery between January 2011 and December 2021. The primary outcome was in-hospital mortality.</p><p><strong>Results: </strong>Over the 10-year period, 19,611 patients were treated in 122 metropolitan ICUs and 4,108 patients were treated in 42 rural ICUs. Rural ICUs had a lower proportion of annual admissions following CRC surgery (20 vs. 36, P<0.001). Patients admitted to a rural ICU were more likely to have undergone emergency CRC surgery compared to those admitted to a metropolitan cohort (28.5% vs. 13.8%, P<0.001). There was no difference in in-hospital mortality between metropolitan and rural hospitals (odds ratio [OR], 1.03; 95% confidence interval [CI], 0.73-1.35; P=0.500). There was a general trend for lower mortality in later years of the study with the odds of death in the final year of the study (2021) almost half that of the first study year (OR, 0.52; 95% CI, 0.34-0.80; P=0.003).</p><p><strong>Conclusions: </strong>There was no difference between in-hospital mortality outcomes for CRC surgical patients requiring ICU admission between metropolitan and rural hospitals. These findings may contribute to discussions regarding rural scope of colorectal practice within Australia and globally.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":" ","pages":"68-76"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027830","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":"The effect of tumor resection on intestinal microbiota dysbiosis in patients with right-sided colon cancer.","authors":"Aldhimas Marthsyal Pratikna, M Iqbal Rivai, Rini Suswita, Andani Eka Putra, Irwan Abdul Rachman, Avit Suchitra","doi":"10.3393/ac.2024.00346.0049","DOIUrl":"10.3393/ac.2024.00346.0049","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the effect of tumor resection on dysbiosis of the intestinal microbiota in patients with right-sided colon cancer.</p><p><strong>Methods: </strong>This study utilized a longitudinal design to explore the outcomes of patients diagnosed with right-sided colon cancer who underwent surgical resection at Dr. M. Djamil General Hospital from July to December 2023. We excluded patients with a documented history of comorbidities, specifically those affecting the digestive system. To compare the microbiota (genus and phylum) between patients with right-sided colon cancer and the control group, we conducted bivariate analyses using the independent t-test or Mann-Whitney test. Furthermore, we employed the dependent t-test or Wilcoxon test to assess changes in the dysbiosis of the microbiota (genus and phylum) before and after resection. A P-value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>This study included a total of 21 patients diagnosed with right-sided colon cancer. In the control group, Bacteroidetes constituted the highest proportion of intestinal microbiota, accounting for 56.34%. Prior to tumor resection, the intestinal microbiota of patients exhibited Proteobacteria as the predominant phylum, representing 52.97%. Following tumor resection, Bacteroidetes remained the most prevalent, comprising 50.9% of the intestinal microbiota. Significant variations in the levels of Proteobacteria, Verrucomicrobia, and Cyanobacteria/Chloroplast were observed in the intestinal microbiota of patients with right-sided colorectal cancer before and after tumor excision (all P=0.001).</p><p><strong>Conclusions: </strong>The microbiome of patients with right-sided colorectal cancer differed significantly from that of the control group. However, following tumor resection, the microbiome composition of these patients became more similar to that observed in the control group.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 1","pages":"47-56"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565864","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":"Dynamics of the microbiota in right-sided colon cancer patients: pre- and post-tumor resection.","authors":"Youn Young Park","doi":"10.3393/ac.2025.00094.0013","DOIUrl":"10.3393/ac.2025.00094.0013","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 1","pages":"1-2"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565846","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":"Antibiotic use during the first episode of acute perianal sepsis: a still-open question.","authors":"Stanislas Blondin, David Lobo, Axel Egal, Saliha Ysmail-Dahlouk, Milad Taouk, Josée Bourguignon, David Blondeel, Isabelle Etienney","doi":"10.3393/ac.2024.00472.0067","DOIUrl":"10.3393/ac.2024.00472.0067","url":null,"abstract":"<p><strong>Purpose: </strong>The role of antibiotics in preventing fistula formation following an initial abscess remains a subject of debate. This study compared the incidence of fistula in ano in patients experiencing their first episode of acute perianal sepsis, with and without antibiotic therapy, and evaluated the prevalence of fistula in ano necessitating surgical intervention at 1 year.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at a tertiary care hospital with a dedicated proctology department. All patients who presented to the emergency proctology unit with a first episode of acute perianal sepsis were eligible for inclusion.</p><p><strong>Results: </strong>This study included 276 patients. At 1 year, fistula formation was identified in 65.6% of all patients, 54.0% of those who had received antibiotics, and 75.0% of those who had not (P<0.001). This finding remained significant after weighted propensity analysis (odds ratio, 0.53; 95% confidence interval, 0.31-0.92; P=0.025).</p><p><strong>Conclusions: </strong>The rate of fistula formation was relatively high in this study. However, it was lower among patients with perianal sepsis who were treated with antibiotics, although a causal relationship could not be established. Prolonged follow-up is needed to clarify the role of antibiotic therapy in preventing or delaying fistula development in patients with acute perianal sepsis.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":" ","pages":"40-46"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143077920","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":"Technical approach in the management of perianal fistula: combining ovine extracellular matrix with endoanal ultrasound to review the surgical outcome.","authors":"Xavier Chan, Cheryl H M Tan, Cheryl X Z Chong, Sharmini S Sivarajah, Frederick H Koh","doi":"10.3393/ac.2024.00612.0087","DOIUrl":"10.3393/ac.2024.00612.0087","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":" ","pages":"93-96"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078096","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":"Ligation of the intersphincteric fistula tract (LIFT) for high transsphincteric fistulas: a double-center retrospective study with long-term follow-up.","authors":"Leichang Zhang, Chuanyu Zhan, Lu Li, Wanjin Shao, Guidong Sun, Yugen Chen, Guanghua Chen, Yulei Lang, Zenghua Xiao, Xiao Xiao","doi":"10.3393/ac.2024.00024.0003","DOIUrl":"10.3393/ac.2024.00024.0003","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the long-term efficacy of the ligation of the intersphincteric fistula tract (LIFT) procedure in treating high transsphincteric fistulas.</p><p><strong>Methods: </strong>We conducted a retrospective study to evaluate the success rate of LIFT treatment in 82 patients with high transsphincteric fistulas involving at least one-third of the external sphincter. This study was carried out across 2 centers from November 2009 to February 2023.</p><p><strong>Results: </strong>All patients underwent successful surgery with a median operative time of 48.9 minutes (range, 20-80 minutes), and no intraoperative or postoperative complications were reported. The median follow-up duration was 85.5 months (range, 4-120 months), with 5 patients (6.1%) lost to follow-up. Treatment was successful in 62 patients, whose symptoms disappeared and both the external opening and the intersphincteric incision completely healed, yielding an overall efficiency rate of 80.5%. There were 15 cases (19.5%) of treatment failure, including 6 (7.8%) that converted to intersphincteric anal fistula and 9 (11.7%) that experienced persistent or recurrent fistulas. Only 1 patient reported minor overflow during the postoperative follow-up, but no other patients reported any significant discomfort. There were no statistically significant differences between patients with surgical success and those with treatment failure in terms of fistula length, history of previous abscess or anal fistula surgery, number of external orifices or fistulas, and location of fistulas (all P>0.05).</p><p><strong>Conclusions: </strong>LIFT is a safe and effective sphincter-preserving procedure that yields satisfactory healing outcomes and has minimal impact on anal function.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":" ","pages":"77-83"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999001","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":"The 2024 Korean Enhanced Recovery After Surgery (ERAS) guidelines for colorectal cancer: a secondary publication.","authors":"Kil-Yong Lee, Soo Young Lee, Miyoung Choi, Moonjin Kim, Ji Hong Kim, Ju Myung Song, Seung Yoon Yang, In Jun Yang, Moon Suk Choi, Seung Rim Han, Eon Chul Han, Sang Hyun Hong, Do Joong Park, Sang-Jae Park","doi":"10.3393/ac.2024.00836.0119","DOIUrl":"10.3393/ac.2024.00836.0119","url":null,"abstract":"<p><p>The Korean Enhanced Recovery After Surgery (ERAS) Committee within the Korean Society of Surgical Metabolism and Nutrition was established to develop ERAS guidelines tailored to the Korean context. This guideline focuses on creating the most current evidence-based practice guidelines for ERAS purposes, based on systematic reviews. All key questions targeted randomized controlled trials exclusively, and if fewer than 2 were available, studies employing propensity score matching were also included. Recommendations for each key question were marked with strength of recommendation and level of evidence following internal and external review processes by the committee.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 1","pages":"3-26"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565860","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":"Diagnostic performance of various radiological modalities in the detection of sarcopenia within Asian populations: a systematic review.","authors":"Shi Wei Ang, Jacqueline Liew, Vanessa Malishree Dharmaratnam, Vanessa Yi Jean Yik, Shawn Kok, Syed Aftab, Cherie Tong, Hui Bing Lee, Shimin Mah, Clement Yan, Bin-Tean Teh, Frederick H Koh","doi":"10.3393/ac.2024.00080.0011","DOIUrl":"10.3393/ac.2024.00080.0011","url":null,"abstract":"<p><strong>Purpose: </strong>Diagnosing sarcopenia necessitates the measurement of skeletal muscle mass. However, guidelines lack a standardized imaging modality with thresholds validated among Asians. This systematic review compared ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), and bioelectrical impedance analysis (BIA)/body composition monitoring in the detection of sarcopenia within Asian populations.</p><p><strong>Methods: </strong>PubMed and Embase were systematically searched for studies analyzing ultrasonography, CT, MRI, and BIA in diagnosing sarcopenia among Asians. Study quality was assessed using the Newcastle-Ottawa scale.</p><p><strong>Results: </strong>Pooled findings from 21,598 patients across 25 studies were examined. In receiver operating characteristic analysis, ultrasound displayed a pooled mean area under the curve (AUC) of 0.767 (95% confidence interval [CI], 0.709-0.806), with mean sensitivity of 81.1% (95% CI, 0.744-0.846) and specificity of 73.1% (95% CI, 0.648-0.774), for detecting sarcopenia in Asian populations. CT exhibited an AUC of 0.720 (sensitivity, 54.0%; specificity, 92.0%). MRI demonstrated an AUC of 0.839 (sensitivity, 67.0%; specificity, 66.0%). BIA displayed an AUC of 0.905 (95% CI, 0.842-0.968), 80.7% sensitivity (95% CI, 0.129-0.679), and 82.4% specificity (95% CI, 0.191-0.633).</p><p><strong>Conclusions: </strong>Various modalities aid in diagnosing sarcopenia, and selection should be individualized. Although only BIA and dual-energy x-ray absorptiometry are recommended by the Asian Working Group for Sarcopenia and the European Working Group on Sarcopenia in Older People, ultrasound imaging may hold diagnostic value for sarcopenia in the Asian population. In certain groups, diagnostic use of CT and MRI is warranted. Future research can standardize and validate modality-specific thresholds and protocols within Asian populations.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 1","pages":"27-39"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565764","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}