Annals of Coloproctology最新文献

{"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":"40 2","pages":"89-113"},"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":" ","pages":"176-181"},"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":"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":" ","pages":"44-51"},"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":" ","pages":"1-2"},"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":"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":" ","pages":"3-12"},"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":"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":"40 1","pages":"62-73"},"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}

{"title":"Performance reporting design in artificial intelligence studies using image-based TNM staging and prognostic parameters in rectal cancer: a systematic review.","authors":"Minsung Kim, Taeyong Park, Bo Young Oh, Min Jeong Kim, Bum-Joo Cho, Il Tae Son","doi":"10.3393/ac.2023.00892.0127","DOIUrl":"10.3393/ac.2023.00892.0127","url":null,"abstract":"<p><strong>Purpose: </strong>The integration of artificial intelligence (AI) and magnetic resonance imaging in rectal cancer has the potential to enhance diagnostic accuracy by identifying subtle patterns and aiding tumor delineation and lymph node assessment. According to our systematic review focusing on convolutional neural networks, AI-driven tumor staging and the prediction of treatment response facilitate tailored treat-ment strategies for patients with rectal cancer.</p><p><strong>Methods: </strong>This paper summarizes the current landscape of AI in the imaging field of rectal cancer, emphasizing the performance reporting design based on the quality of the dataset, model performance, and external validation.</p><p><strong>Results: </strong>AI-driven tumor segmentation has demonstrated promising results using various convolutional neural network models. AI-based predictions of staging and treatment response have exhibited potential as auxiliary tools for personalized treatment strategies. Some studies have indicated superior performance than conventional models in predicting microsatellite instability and KRAS status, offer-ing noninvasive and cost-effective alternatives for identifying genetic mutations.</p><p><strong>Conclusion: </strong>Image-based AI studies for rectal can-cer have shown acceptable diagnostic performance but face several challenges, including limited dataset sizes with standardized data, the need for multicenter studies, and the absence of oncologic relevance and external validation for clinical implantation. Overcoming these pitfalls and hurdles is essential for the feasible integration of AI models in clinical settings for rectal cancer, warranting further research.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"40 1","pages":"13-26"},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10915525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982222","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 bowel functional outcomes following anal sphincter-preserving surgery for upper and middle rectal cancer: a single-center longitudinal study.","authors":"Ahmad Sakr, Seung Yoon Yang, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim","doi":"10.3393/ac.2022.01067.0152","DOIUrl":"10.3393/ac.2022.01067.0152","url":null,"abstract":"<p><strong>Purpose: </strong>Despite advances in neoadjuvant chemoradiotherapy and anal sphincter-preserving surgery for rectal cancer, bowel dysfunction is still unavoidable and negatively affects patients' quality of life. In this longitudinal study, we aimed to investigate the changes in bowel function with follow-up time and the effect of neoadjuvant chemoradiotherapy on bowel function following low anterior resection for rectal cancer.</p><p><strong>Methods: </strong>In this study, 171 patients with upper or middle rectal cancer who underwent low anterior resection between 2012 and 2018 were included. Bowel function was assessed longitudinally with Memorial Sloan Kettering Cancer Center Bowel Function Instrument and Wexner scores every 6 months after restoration of bowel continuity. Patients with at least 2 follow-up visits were included.</p><p><strong>Results: </strong>Overall, 100 patients received neoadjuvant chemoradiotherapy. Urgency, soilage, and fecal incontinence were noted within 24 months in the patients treated with neoadjuvant chemoradiotherapy. After 2 years of follow-up, significant bowel dysfunction and fecal incontinence were observed in the neoadjuvant chemoradiotherapy group. Low tumor level and neoadjuvant chemoradiotherapy were associated with delayed bowel dysfunction.</p><p><strong>Conclusion: </strong>Neoadjuvant chemoradiotherapy in combination with low tumor level was significantly associated with delayed bowel dysfunction even after 2 years of follow-up. Therefore, careful selection and discussion with patients are paramount.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"40 1","pages":"27-35"},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10915532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982220","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":"Can the Heald anal stent help to reduce anastomotic or rectal stump leak in elective and emergency colorectal surgery? A single-center experience.","authors":"Michael Jones, Brendan Moran, Richard John Heald, John Bunni","doi":"10.3393/ac.2023.00038.0005","DOIUrl":"10.3393/ac.2023.00038.0005","url":null,"abstract":"<p><p>Anastomotic and rectal stump leaks are feared complications of colorectal surgery. Diverting stomas are commonly used to protect low rectal anastomoses but can have adverse effects. Studies have reported favorable outcomes for transanal drainage devices instead of diverting stomas. We describe our use of the Heald anal stent and its potential impact in reducing anastomotic or rectal stump leak after elective or emergency colorectal surgery. We performed a single-center retrospective analysis of patients in whom a Heald anal stent had been used to \"protect\" a colorectal anastomosis or a rectal stump, in an elective or emergency context, for benign and malignant pathology. Intraoperative and postoperative outcomes were reviewed using clinical and radiological records. The Heald anal stent was used in 93 patients over 4 years. Forty-six cases (49%) had a colorectal anastomosis, and 47 (51%) had an end stoma with a rectal stump. No anastomotic or rectal stump leaks were recorded. We recommend the Heald anal stent as a simple and affordable adjunct that may decrease anastomotic and rectal stump leak by reducing intraluminal pressure through drainage of fluid and gas.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"40 1","pages":"82-85"},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10915531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982219","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 restrictive transfusion sufficient in colorectal cancer surgery? A retrospective study before and during the COVID-19 pandemic in Korea","authors":"Hyeon Kyeong Kim, Ho Seung Kim, G. T. Noh, J. Nam, S. Chung, Kwang Ho Kim, R.-A. Lee","doi":"10.3393/ac.2023.00437.0062","DOIUrl":"https://doi.org/10.3393/ac.2023.00437.0062","url":null,"abstract":"Purpose: Blood transfusion is one of the most common procedures used to treat anemia in colorectal surgery. Despite controversy regarding the adverse effects of blood products, surgeons have maintained standards for administering blood transfusions. However, this trend was restrictive during the COVID-19 pandemic because of a shortage of blood products. In this study, we conducted an analysis to investigate whether the restriction of blood transfusions affected postoperative surgical outcomes.Methods: Medical records of 318 patients who underwent surgery for colon and rectal cancer at Ewha Womans University Mokdong Hospital between June 2018 and March 2022 were reviewed retrospectively. The surgical outcomes between the liberal and restrictive transfusion strategies in pre– and post–COVID-19 groups were analyzed.Results: In univariate analysis, postoperative transfusion was associated with infectious complications (odds ratio [OR], 1.705; 95% confidence interval [CI], 1.015–2.865; P=0.044). However, postoperative transfusion was not an independent risk factor for the development of infectious complications in multivariate analysis (OR, 1.305; 95% CI, 0.749–2.274; P=0.348). In subgroup analysis, there was no significant association between infectious complications and the hemoglobin threshold level for the administration of a transfusion (OR, 1.249; 95% CI, 0.928–1.682; P=0.142).Conclusion: During colorectal surgery, the decision to perform a blood transfusion is an important step in ensuring favorable surgical outcomes. According to the results of this study, restrictive transfusion is sufficient for favorable surgical outcomes compared with liberal transfusion. Therefore, modification of guidelines is suggested to minimize unnecessary transfusion-related side effects and prevent the overuse of blood products.","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"23 5","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139129972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}