Annals of Coloproctology最新文献

{"title":"Estimation of risk posed by malignant polyps amongst colorectal surgeons in Australia and New Zealand.","authors":"Andrew P Zammit, Ian Brown, John D Hooper, David A Clark, Andrew D Riddell","doi":"10.3393/ac.2023.00178.0025","DOIUrl":"10.3393/ac.2023.00178.0025","url":null,"abstract":"<p><strong>Purpose: </strong>The estimation of the risk posed by malignant polyps for residual or lymphatic disease plays a central role. This study investigated colorectal surgeons' assessment of these risks associated with malignant polyps.</p><p><strong>Methods: </strong>A cross-sectional questionnaire was electronically administered to colorectal surgeons in Australia and New Zealand in October 2022. The questionnaire contained 17 questions on demographics, when surgeons consider colorectal resection appropriate, and the risk assessment for 5 hypothetical malignant polyps.</p><p><strong>Results: </strong>The mean risk of residual or lymphatic disease that would prompt surgeons to recommend colonic resection was 5%. However, this increased to a mean risk of 10% if the malignant polyp was located in the rectum, and the only resection option was abdominoperineal resection with end-colostomy. There was high concordance between the estimated risk of residual or lymphatic disease by colorectal surgeons and the Association of Coloproctology of Great Britain and Ireland (ACPGBI) guidelines for the 5 hypothetical malignant polyps, with the ACPGBI estimated risk lying within the 95% confidence interval for 4 of the 5 malignant polyps. Nonetheless, 96.6% of surgeons felt that an online risk calculator would improve clinical practice.</p><p><strong>Conclusion: </strong>Colorectal surgeons in Australia and New Zealand accurately estimated the risk posed by malignant polyps. An online risk calculator may assist in better conveying risk to patients.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11082546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206266","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":"Colon cancer: the 2023 Korean clinical practice guidelines for diagnosis and treatment.","authors":"Hyo Seon Ryu, Hyun Jung Kim, Woong Bae Ji, Byung Chang Kim, Ji Hun Kim, Sung Kyung Moon, Sung Il Kang, Han Deok Kwak, Eun Sun Kim, Chang Hyun Kim, Tae Hyung Kim, Gyoung Tae Noh, Byung-Soo Park, Hyeung-Min Park, Jeong Mo Bae, Jung Hoon Bae, Ni Eun Seo, Chang Hoon Song, Mi Sun Ahn, Jae Seon Eo, Young Chul Yoon, Joon-Kee Yoon, Kyung Ha Lee, Kyung Hee Lee, Kil-Yong Lee, Myung Su Lee, Sung Hak Lee, Jong Min Lee, Ji Eun Lee, Han Hee Lee, Myong Hoon Ihn, Je-Ho Jang, Sun Kyung Jeon, Kum Ju Chae, Jin-Ho Choi, Dae Hee Pyo, Gi Won Ha, Kyung Su Han, Young Ki Hong, Chang Won Hong, Jung-Myun Kwak","doi":"10.3393/ac.2024.00059.0008","DOIUrl":"10.3393/ac.2024.00059.0008","url":null,"abstract":"<p><p>Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients' values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11082542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856971","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 importance of compression time in stapled hemorrhoidopexy: is patience a virtue?","authors":"Byung Eun Yoo, Wook Ho Kang, Yong Teak Ko, Young Chan Lee, Cheong Ho Lim","doi":"10.3393/ac.2022.00556.0079","DOIUrl":"10.3393/ac.2022.00556.0079","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate whether longer compression time before firing the stapler reduced the postoperative complications related to staple line formation in stapled hemorrhoidopexy.</p><p><strong>Methods: </strong>This retrospective case-control study was conducted at a colorectal-anal specialty hospital. Consecutive patients with grades III and IV hemorrhoids who underwent stapled hemorrhoidopexy between January 2016 and November 2019 were included. According to the compression time, patients were assigned to the long compression time group (2 minutes) or the typical compression time group (30 seconds). The primary outcome measure was incidence of staple line complications such as dehiscence, bleeding, and stenosis.</p><p><strong>Results: </strong>A total of 348 patients treated with stapled hemorrhoidopexy were evaluated. Seventy-three and 275 patients were included in the long compression time group and the typical compression time group, respectively. No significant differences were observed in patient characteristics between the groups. However, additional procedures were performed more frequently in the typical compression time group (78.1% vs. 92.0%, P=0.001). Bleeding occurred more frequently in the typical compression time group (1.4% vs. 8.4%, P=0.030). The rates of dehiscence and stenosis were not significantly different between the groups. Fecal urgency developed more frequently in the typical compression time group (0% vs. 5.1%, P=0.040). In logistic regression analysis, typical compression time (30 seconds) was the only risk factor for bleeding (odds ratio, 8.496; P=0.040).</p><p><strong>Conclusion: </strong>Longer compression time was associated with a decreased incidence of postoperative bleeding after stapled hemorrhoidopexy.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11082544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10734230","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":"Evaluating prognostic significance of preoperative C-reactive protein to albumin ratio in older patients with pathological stage II or III colorectal cancer.","authors":"Koji Numata, Yukari Ono, Mihwa Ju, Shizune Onuma, Ayano Tanaka, Taichi Kawabe, Sho Sawazaki, Akio Higuchi, Kazuki Yamanaka, Shinsuke Hatori, Hiroyuki Saeki, Hiroshi Matsukawa, Yasushi Rino, Kazuyuki Tani","doi":"10.3393/ac.2022.00367.0052","DOIUrl":"10.3393/ac.2022.00367.0052","url":null,"abstract":"<p><strong>Purpose: </strong>This study was performed to evaluate the prognostic value of preoperative C-reactive protein to albumin ratio (CAR) in older patients with colorectal cancer (CRC) undergoing curative resection.</p><p><strong>Methods: </strong>We retrospectively analyzed 244 older patients (aged 75 years or higher) with pathological stage II or III CRC who underwent curative surgery between 2008 and 2016. The optimal value of CAR was calculated and its correlation with the clinicopathological factors and prognosis was examined.</p><p><strong>Results: </strong>The optimal cutoff value of the CAR was 0.085. High preoperative CAR was significantly associated with high carcinoembryonic antigen levels (P=0.001), larger tumor size (P<0.001), and pT factor (P=0.001). On multivariate analysis, high CAR was independent prognostic factor for relapse-free survival (P=0.042) and overall survival (P=0.001).</p><p><strong>Conclusion: </strong>Preoperative elevated CAR could be considered as an adverse predictor of both relapse-free survival and overall survival in older patients with CRC undergoing curative surgery.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11082553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33500992","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":"Learning curve for single-port robot-assisted colectomy.","authors":"Moon Suk Choi, Seong Hyeon Yun, Sung Chul Lee, Jung Kyong Shin, Yoon Ah Park, Jungwook Huh, Yong Beom Cho, Hee Cheol Kim, Woo Yong Lee","doi":"10.3393/ac.2022.00745.0106","DOIUrl":"10.3393/ac.2022.00745.0106","url":null,"abstract":"<p><strong>Purpose: </strong>Since the introduction of robotic surgery, robots for colorectal cancer have replaced laparoscopic surgery, and a single-port robot (SPR) platform has been launched and is being used to treat patients. We analyzed the learning curve and initial complications of using an SPR platform in colorectal cancer surgery.</p><p><strong>Methods: </strong>We reviewed 39 patients who underwent SPR colectomy from April to October 2019. All surgeries were performed by the same surgeon using an SPR device. A learning curve was generated using the cumulative sum methodology to assess changes in total operation time, docking time, and surgeon console time. We grouped the patients into 3 groups according to the time period: the first 11 were phase 1, the next 11 were phase 2, and the last 17 were phase 3.</p><p><strong>Results: </strong>The mean age of the patients was 61.28±13.03 years, and they had a mean body mass index of 23.79±2.86 kg/m2. Among the patients, 23 (59.0%) were male, and 16 (41.0%) were female. The average operation time was 186.59±51.30 minutes, the average surgeon console time was 95.49±35.33 minutes, and the average docking time (time from skin incision to robot docking) was 14.87±10.38 minutes. The surgeon console time differed significantly among the different phases (P<0.001). Complications occurred in 8 patients: 2 ileus, 2 postoperation hemoglobin changes, 3 urinary retentions, and 1 complicated fluid collection.</p><p><strong>Conclusion: </strong>In our experience, the learning curve for SPR colectomy was achieved after the 18th case.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10915530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10734231","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":"To go high, or to go low: the never-ending debate of inferior mesenteric artery ligation.","authors":"HyungJoo Baik","doi":"10.3393/ac.2024.00094.0013","DOIUrl":"10.3393/ac.2024.00094.0013","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10915534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139701677","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":"Laser hemorrhoidoplasty in the treatment of symptomatic hemorrhoids: a pilot Australian study.","authors":"Anshini Jain, Chen Lew, Gamze Aksakal, Richard Hiscock, Naseem Mirbagheri","doi":"10.3393/ac.2022.00164.0023","DOIUrl":"10.3393/ac.2022.00164.0023","url":null,"abstract":"<p><strong>Purpose: </strong>Traditional therapeutic approaches to the surgical management of hemorrhoid disease such as hemorrhoidectomies are plagued with severe postoperative pain and protracted recovery. Our pilot study aims to the laser hemorrhoidoplasty (LH) patients with symptomatic hemorrhoid disease that have failed conservative management for the first time in an Australian population.</p><p><strong>Methods: </strong>Thirty patients were prospectively enrolled to undergo LH. Postoperative pain, time to return to function, and quality of life (QoL) were determined through the Hemorrhoid Disease Symptom Score and Short Health Scale adapted for hemorrhoidal disease and compared to a historical group of 43 patients who underwent a Milligan-Morgan hemorrhoidectomy by the same surgeon at 3, 6, and 12 months.</p><p><strong>Results: </strong>The LH group had significantly lower mean predicted pain scores on days 1 and 2 and lower defecation pain scores and lower opioid analgesia use on days 1, 2, 3, and 4. The median time to return to normal function was significantly lower in the LH group (2 days vs. 9 days, P<0.001). Similarly, the median days to return to the workplace was significantly lower in the LH group (6 days vs. 13 days, P=0.007). During long-term follow-up (12 months), hemorrhoid symptoms and all QoL measures were significantly improved, especially among those with grade II to III disease.</p><p><strong>Conclusion: </strong>This pilot study demonstrates low pain scores with this revivified procedure in an Australian population, indicating possible expansion of the therapeutic options available for this common condition. Further head-to-head studies comparing LH to other hemorrhoid therapies are required to further determine the most efficacious therapeutic approach.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10915529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49424217","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":"Multimodal prerehabilitation for elderly patients with sarcopenia in colorectal surgery.","authors":"Jingting Wu, Hannah Chi, Shawn Kok, Jason M W Chua, Xi-Xiao Huang, Shipin Zhang, Shimin Mah, Li-Xin Foo, Hui-Yee Peh, Hui-Bing Lee, Phoebe Tay, Cherie Tong, Jasmine Ladlad, Cheryl H M Tan, Nathanelle Khoo, Darius Aw, Cheryl X Z Chong, Leonard M L Ho, Sharmini S Sivarajah, Jialin Ng, Winson J H Tan, Fung-Joon Foo, Bin-Tean Teh, Frederick H Koh","doi":"10.3393/ac.2022.01207.0172","DOIUrl":"10.3393/ac.2022.01207.0172","url":null,"abstract":"<p><p>Sarcopenia, which is characterized by progressive and generalized loss of skeletal muscle mass and strength, has been well described to be associated with numerous poor postoperative outcomes, such as increased perioperative mortality, postoperative sepsis, prolonged length of stay, increased cost of care, decreased functional outcome, and poorer oncological outcomes in cancer surgery. Multimodal prehabilitation, as a concept that involves boosting and optimizing the preoperative condition of a patient prior to the upcoming stressors of a surgical procedure, has the purported benefits of reversing the effects of sarcopenia, shortening hospitalization, improving the rate of return to bowel activity, reducing the costs of hospitalization, and improving quality of life. This review aims to present the current literature surrounding the concept of sarcopenia, its implications pertaining to colorectal cancer and surgery, a summary of studied multimodal prehabilitation interventions, and potential future advances in the management of sarcopenia.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10915526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9588126","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":"Development of a home health care service platform for ostomy patient management.","authors":"Seongwoo Yang, Ji Won Park, Hyuk Hur, Min Jung Kim, Seung-Yong Jeong, Kyounghoon Park, Ik Yong Kim","doi":"10.3393/ac.2022.00360.0051","DOIUrl":"10.3393/ac.2022.00360.0051","url":null,"abstract":"<p><strong>Purpose: </strong>The use of an ostomy for urination and defecation leads to reduced quality of life. Although many ostomy management strategies are needed, such strategies are often implemented by patients. Thus, there is a need for a home health care service platform that can be used in ostomy patient management.</p><p><strong>Methods: </strong>We developed an ostomy patient management platform by identifying the needs of patients and medical staff through the Chronic Care Ostomy Self-Management Training Program in the United States and from studies conducted in Korea.</p><p><strong>Results: </strong>The platform encompassed physical management, psychological management, maintenance of social function, spiritual stability, and home medical care. These components were implemented through monitoring, self-care guidance, and a community platform. For the monitoring function, patients entered their health status in a mobile application (app); the medical staff at the affiliated hospital then monitored the stoma status through a web interface.</p><p><strong>Conclusion: </strong>Our platform allows medical staff to monitor ostomy patients through a web interface and help such patients to fully manage their ostomy at home using an app. We expect that the continued development of patient-oriented functions in our app will allow ostomy patients to experience quality-of-life improvements.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10915528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40696282","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":"Long-term clinical outcomes after high and low ligations with lymph node dissection around the root of the inferior mesenteric artery in patients with rectal cancer.","authors":"Min Wan Lee, Sung Sil Park, Kiho You, Dong Eun Lee, Dong Woon Lee, Sung Chan Park, Kyung Su Han, Dae Kyung Sohn, Chang Won Hong, Bun Kim, Byung Chang Kim, Hee Jin Chang, Dae Yong Kim, Jae Hwan Oh","doi":"10.3393/ac.2023.00094.0013","DOIUrl":"10.3393/ac.2023.00094.0013","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the long-term clinical outcomes based on the ligation level of the inferior mesenteric artery (IMA) in patients with rectal cancer.</p><p><strong>Methods: </strong>This was a retrospective analysis of a prospectively collected database that included all patients who underwent elective low anterior resection for rectal cancer between January 2013 and December 2019. The clinical outcomes included oncological outcomes, postoperative complications, and functional outcomes. The oncological outcomes included overall survival (OS) and relapse-free survival (RFS). The functional outcomes, including defecatory and urogenital functions, were analyzed using the Fecal Incontinence Severity Index, International Prostate Symptom Score, and International Index of Erectile Function questionnaires.</p><p><strong>Results: </strong>In total, 545 patients were included in the analysis. Of these, 244 patients underwent high ligation (HL), whereas 301 underwent low ligation (LL). The tumor size was larger in the HL group than in the LL group. The number of harvested lymph nodes (LNs) was higher in the HL group than in the LL group. There were no significant differences in complication rates and recurrence patterns between the groups. There were no significant differences in 5-year RFS and OS between the groups. Cox regression analysis revealed that the ligation level (HL vs. LL) was not a significant risk factor for oncological outcomes. Regarding functional outcomes, the LL group showed a significant recovery in defecatory function 1 year postoperatively compared with the HL group.</p><p><strong>Conclusion: </strong>LL with LNs dissection around the root of the IMA might not affect the oncologic outcomes comparing to HL; however, it has minimal benefit for defecatory function.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10915527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982221","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}