Annals of Coloproctology最新文献

{"title":"The Korean Rectal Cancer Multidisciplinary Committee Clinical Practice Guidelines for Rectal Cancer version 2.0.","authors":"Hyo Seon Ryu, Hyun Jung Kim, Dong Hyun Kang, Yoo-Kang Kwak, Han Deok Kwak, Yoon-Hye Kwon, Dalyong Kim, Baek-Hui Kim, Jae Hyun Kim, Ji Hun Kim, Jin Won Kim, Tae Hyung Kim, Hae Young Kim, Soo Min Nam, Gyoung Tae Noh, Jun Woo Bong, Nak Song Sung, Seon Hui Shin, Kil-Yong Lee, Sung Chul Lee, Sea-Won Lee, Jung Won Lee, Jong Min Lee, Myung Hoon Ihn, Joo Han Lim, Woong Bae Ji, Dae Hee Pyo, Young Ki Hong, Jung-Myun Kwak","doi":"10.3393/ac.2025.01396.0199","DOIUrl":"10.3393/ac.2025.01396.0199","url":null,"abstract":"<p><p>Rectal cancer, which accounts for approximately 40% of colorectal cancers, remains a major clinical concern. Recent advances in diagnostic imaging, surgical techniques, radiotherapy, and systemic treatment have steadily improved rectal cancer outcomes. Considering this, the Korean Rectal Cancer Multidisciplinary (KRCM) Committee has aimed to provide clinicians and policymakers with up-to-date, evidence-based clinical practice guidelines to support optimal decision-making, reflecting current evidence, the Korean healthcare context, and patient values and preferences. The Clinical Practice Guidelines for Rectal Cancer version 2.0 were developed through multidisciplinary collaboration with related academic societies, building upon and updating the KRCM Clinical Practice Guidelines version 1.0 (titled \"Multidisciplinary guidelines for the management of rectal cancer\"). These consensus guidelines of the KRCM were established based on a comprehensive literature review, evidence synthesis, with recommendation development guided by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology, and consideration of applicability in real-world clinical practice under the national health insurance system. Each recommendation has been presented with its strength and level of evidence.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 1","pages":"4-33"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389240","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 the proposed new classification of anal fistulas with the Garg classification.","authors":"Pankaj Garg, Nicola Clemente, Kaushik Bhattacharya, Sattyadeep Garg","doi":"10.3393/ac.2025.00871.0124","DOIUrl":"10.3393/ac.2025.00871.0124","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 1","pages":"145-147"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389215","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":"Comparative outcomes of early and late rectourethral fistula: insights from a multicentric retrospective study on multidisciplinary management strategies.","authors":"Pauline Jeannot, Edouard Roussel, Alexandre Dutoit, Maxime Collard, Niki Christou, Jérémie H Lefevre, Amine Souadka, Alves Arnaud, Antonio Castaldi, Martin Bertrand, Nicolas Michot, Benjamin Faivre d'Arcier, Jean Jacques Tuech, Franck Bruyère, Urs Giger-Pabst, Mehdi Ouaïssi","doi":"10.3393/ac.2025.00696.0099","DOIUrl":"10.3393/ac.2025.00696.0099","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to evaluate the natural history of early and late rectourethral fistulas (RUFs) and to determine the long-term outcomes of a multidisciplinary management approach.</p><p><strong>Methods: </strong>A multicenter retrospective study was performed on patients with RUF who were treated by a combined colorectal and urological team. Early RUF (ERUF) was defined as occurring within 31 days after surgery, while late RUF (LRUF) was defined as occurring thereafter. Surgical procedures and the surgeons involved were recorded, in addition to clinical assessments, radiological findings, and oncological assessments.</p><p><strong>Results: </strong>A total of 72 patients diagnosed with RUF were treated between January 1, 2010, and June 2023. Patients were divided into ERUF (n=37) and LRUF (n=35) groups. After conservative management, comparisons of success rates for graciloplasty, York-Mason, and delayed coloanal anastomosis as second and third treatments showed higher rates for graciloplasty in ERUF than in LRUF (83% vs. 40%, P=0.034; 71% vs. 33%, P=0.500; and 60% vs. 40%, P>0.999, respectively). The ERUF group demonstrated significantly higher cure rates after the second treatment (83.8% vs. 40.0%, P<0.001). At final follow-up, complete healing was significantly more frequent in ERUF than in LRUF (83.8% vs. 42.9%, P<0.005). Definitive digestive and urinary diversion rates were lower in ERUF (13.5% vs. 48.5%, P=0.001; and 13.5% vs. 25.7%, P=0.240, respectively).</p><p><strong>Conclusion: </strong>These findings suggest that 30% of patients required a definitive colostomy, with a significantly higher proportion observed in the LRUF group. Moreover, repeated surgical procedures in the LRUF group were frequently unsuccessful.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 1","pages":"103-114"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389210","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":"Over and above what is visible and conventional: development of new territories in colorectal cancer management.","authors":"In Ja Park","doi":"10.3393/ac.2026.00227.0032","DOIUrl":"10.3393/ac.2026.00227.0032","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 1","pages":"1-3"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389180","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":"Mini-invasive J-colpo-perineo-rectopexy with titanized polypropylene mesh for global perineal descent: a technical note.","authors":"Carlotta La Raja, Francesca Lecchi, Sandro Carnio, Chiara Casiraghi, Paola Cellerino, Alberto Giori, Giorgio La Greca, Federica Marazzi, Pierpaolo Prestianni, Pietro Muselli, Angelo Stuto","doi":"10.3393/ac.2025.01214.0173","DOIUrl":"10.3393/ac.2025.01214.0173","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"42 1","pages":"141-144"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389225","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":"Safety and patient's satisfaction of preoperative carbohydrate drink until 2 hours before colorectal cancer surgery: a single-center, prospective randomized controlled trial.","authors":"Yun Min Lee, Kyeong Eui Kim, Sung Uk Bae, Seong Kyu Baek, Woon Kyung Jeong","doi":"10.3393/ac.2025.00521.0074","DOIUrl":"10.3393/ac.2025.00521.0074","url":null,"abstract":"<p><strong>Purpose: </strong>Traditionally, fasting from midnight has been a standard practice in elective surgery for reduce the risk of aspiration. However, Enhanced Recovery After Surgery (ERAS) programs recommend clear fluid intake until 2 hours before anesthesia. This study aimed to evaluate the safety and patient satisfaction of preoperative carbohydrate drink intake until 2 hours before colorectal cancer surgery.</p><p><strong>Methods: </strong>Sixty patients who underwent colorectal cancer surgery between April 2021 and February 2023 at Keimyung University Dongsan Medical Center were enrolled. This study included 30 patients who fasted from midnight (nothing by mouth [NPO] group) and 30 patients who consumed a high concentration of complex carbohydrate fluids (New Care NO-NPO) until 2 hours before surgery (No-NPO group). Patient satisfaction was assessed using a visual analog scale. Perioperative and postoperative outcomes were compared.</p><p><strong>Results: </strong>Basic characteristics of patients were similar for the 2 groups. The No-NPO group had a significantly higher patient satisfaction score than the NPO group (3.7 vs. 2.2, P=0.040). Scores of operative difficulty, operation time, blood loss, postoperative recovery parameters, and postoperative complication rates were similar for the 2 groups. Pathological outcomes were also comparable. No mortality occurred in either group.</p><p><strong>Conclusion: </strong>High-concentration carbohydrate fluid intake until 2 hours before induction of anesthesia could improve patient satisfaction without increasing postoperative complications, demonstrating its safety and feasibility in colorectal cancer surgery. Trial registration CRIS (cris.nih.go.kr) identifier: KCT0011323.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 6","pages":"519-527"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12766387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899111","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":"Pathologic complete response in rectal cancer: advocating for local excision.","authors":"Daniel Gonzalez-Nunez, Luis Torres, Mauricio Gonzalez-Dorado, Juan C Reyes","doi":"10.3393/ac.2025.00829.0118","DOIUrl":"10.3393/ac.2025.00829.0118","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 6","pages":"592-595"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12766393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899033","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":"Preoperative magnetic resonance imaging-based radiomics nomogram model for predicting postoperative anastomotic leakage in colorectal cancer.","authors":"Junfeng Yan, Qiushuang Wang, Qiang Li, Jiatong Lu, Qiang Tong","doi":"10.3393/ac.2025.00689.0098","DOIUrl":"10.3393/ac.2025.00689.0098","url":null,"abstract":"<p><strong>Purpose: </strong>Anastomotic leakage (AL) is a serious postoperative complication after colorectal cancer surgery, and accurate preoperative prediction remains challenging. This study aimed to develop and validate a magnetic resonance imaging (MRI)-based radiomics nomogram for the preoperative prediction of AL.</p><p><strong>Methods: </strong>A total of 146 patients with colorectal cancer, including 11 with AL, were retrospectively enrolled and randomly divided into training and validation cohorts at a 7:3 ratio. Clinical variables and preoperative MRI-based radiomic features were analyzed. A clinical model was constructed using logistic regression. Radiomic features were selected using the least absolute shrinkage and selection operator method to develop a radiomics model, from which a radiomic score was calculated. A combined radiomics nomogram integrating the radiomic score and significant clinical factors was subsequently established. Model performance was evaluated using receiver operating characteristic curve analysis in both cohorts.</p><p><strong>Results: </strong>The clinical model achieved an area under the curve (AUC) of 0.766 in the training cohort and 0.583 in the validation cohort. The radiomics model demonstrated improved discrimination, with AUCs of 0.822 and 0.800, respectively. The combined radiomics nomogram showed the best predictive performance, yielding AUCs of 0.869 in the training cohort and 0.858 in the validation cohort.</p><p><strong>Conclusion: </strong>The proposed MRI-based radiomics nomogram demonstrates good predictive performance for postoperative anastomotic leakage and may serve as a useful tool for preoperative risk stratification in patients with colorectal cancer.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 6","pages":"554-564"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12766395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899123","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 purse-string technique versus linear suture for skin closure after stoma reversal: a meta-analysis of high-quality studies.","authors":"Filippo Carannante, Guglielmo Niccolò Piozzi, Gianluca Costa, Valentina Miacci, Gianfranco Bianco, Vincenzo Schiavone, Jim S Khan, Marco Caricato, Gabriella Teresa Capolupo","doi":"10.3393/ac.2025.00801.0114","DOIUrl":"10.3393/ac.2025.00801.0114","url":null,"abstract":"<p><strong>Purpose: </strong>Stoma reversal is associated with notable postoperative morbidity. Several techniques exist for skin closure after stoma reversal, with linear primary closure (LC) and purse-string closure (PS) being the most common. This systematic review and meta-analysis aim to compare LC and PS skin closure after stoma reversal in terms of surgical site infection (SSI) rates, wound healing, and cosmesis.</p><p><strong>Methods: </strong>In accordance with the PRISMA statement, a systematic review of skin closure after stoma reversal was conducted using MEDLINE (PubMed), Embase, Web of Science, and Scopus.</p><p><strong>Results: </strong>Eleven studies, enrolling 1,052 patients (PS, n=534; LC, n=518), published between 2006 and 2024, were included. The overall quality of the studies was considered acceptable, with a mean Jadad scale score of 4 (range, 3-5). Patients underwent ileostomy or ileostomy/colostomy in 6 and 5 studies, respectively. No differences were observed between groups in operative time, length of hospital stay, intestinal obstruction, or incisional hernia. However, SSI and overall infection rates were higher in the LC group, with a statistically significant difference for SSI.</p><p><strong>Conclusion: </strong>Skin closure following stoma reversal using the PS technique may offer advantages over LC. PS is associated with significantly lower SSI rates compared to LC. Although a large randomized controlled trial with long-term follow-up is still required, current findings suggest that PS could be considered the standard of care for wound closure after ileostomy reversal.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 6","pages":"491-500"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12766392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899125","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 anatomical insight into the muscular structure of the anal canal: revealing Treitz muscle as a directional shift of the internal anal sphincter.","authors":"Satoru Muro, Kumiko Yamaguchi, Naoko Inoshita, Yasuo Nakajima, Danyo Jennifer Edinam, Akimoto Nimura, Keiichi Akita","doi":"10.3393/ac.2024.00647.0092","DOIUrl":"10.3393/ac.2024.00647.0092","url":null,"abstract":"<p><strong>Purpose: </strong>Understanding the muscular structure of the anal canal is crucial for the diagnosis and treatment of anorectal diseases. Treitz muscle is a vital yet poorly understood component. It supports the anal venous plexus and contributes to anal cushion formation. However, its anatomical details remain unclear, and various theories suggest different origins for its muscle bundles, which affects our understanding of the pathophysiology of hemorrhoids. In this study, we sought to clarify the origin and localization of Treitz muscle to provide an anatomical foundation for understanding anal function.</p><p><strong>Methods: </strong>In this descriptive cadaveric study of 11 cadavers, we performed macroscopic examinations and immunohistological analyses on tissues from the anterior, lateral, and posterior walls of the anal canal. The origin and localization of Treitz muscle were qualitatively evaluated.</p><p><strong>Results: </strong>Treitz muscle is a smooth muscle formed by a directional change in the muscle bundles of the internal anal sphincter, running longitudinally along its surface. A shift in the direction of muscle bundles originating from the internal anal sphincter, giving rise to Treitz muscle, was frequently observed in the anterolateral wall of the anal canal.</p><p><strong>Conclusion: </strong>In summary, Treitz muscle, a smooth muscle extending from the internal anal sphincter, is considered part of the muscularis propria. Its directional shift was localized to the anterolateral wall, indicating that Treitz muscle is not uniformly distributed around the anal canal. This site-specific localization may influence the risk of hemorrhoids or cancer invasion depending on its anatomical position.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"41 6","pages":"501-509"},"PeriodicalIF":2.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12766385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898784","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}