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Erratum: Author Name Correction: Outcome of Colorectal Surgery in Elderly Populations.

Mostafa SHALABY ; Nicola DI LORENZO ; Luana FRANCESCHILLI ; Federico PERRONE ; Giulio P ANGELUCCI ; Silvia QUARESIMA ; Achille L GASPARI ; Pierpaolo SILERI

Annals of Coloproctology.2016;32(5):199-199. doi:10.3393/ac.2016.32.5.199

In this article, the sixth author's name was misprinted unintentionally. The sixth author's name should be corrected.

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Major Pelvic Bleeding Following a Stapled Transanal Rectal Resection: Use of Laparoscopy as a Diagnostic Tool.

Giovanni Domenico TEBALA ; Abdul Qayyum KHAN ; Sean KEANE

Annals of Coloproctology.2016;32(5):195-198. doi:10.3393/ac.2016.32.5.195

Stapled transanal rectal resection (STARR) and stapled hemorrhoidopexy (SH) are well-established techniques for treating rectal prolapse and obstructed defecation syndrome (ODS). Occasionally, they can be associated with severe complications. We describe the case of a 59-year-old woman who underwent STARR for ODS and developed a postoperative pelvic hemorrhage. A computed tomography (CT) scan revealed a vast pelvic, retroperitoneal hematoma and free gas in the abdomen. Laparoscopy ruled out any bowel lesions, but identified a hematoma of the pelvis. Flexible sigmoidoscopy showed a small leakage of the rectal suture. The patient was treated conservatively and recovered completely. Surgeons performing STARR and SH must be aware of the risk of this rare, but severe, complication. If the patient is not progressing after a STARR or SH, a CT scan can be indicated to rule out intra-abdominal and pelvic hemorrhage. Laparoscopy is a diagnostic tool and should be associated with intraluminal exploration with flexible sigmoidoscopy.
Abdomen ; Defecation ; Female ; Hematoma ; Hemorrhage* ; Humans ; Laparoscopy* ; Middle Aged ; Pelvis ; Postoperative Hemorrhage ; Rectal Prolapse ; Sigmoidoscopy ; Surgeons ; Sutures ; Tomography, X-Ray Computed

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Synchronous Primary Anorectal Melanoma and Sigmoid Adenocarcinoma.

Inju CHO ; Kyung Jong KIM ; Sung Chul LIM

Annals of Coloproctology.2016;32(5):190-194. doi:10.3393/ac.2016.32.5.190

A primary anorectal malignant melanoma is a rare tumor. Moreover, cases involving a synchronous anorectal melanoma and colon adenocarcinoma are extremely rare. The authors report a case of a synchronous anorectal melanoma and sigmoid adenocarcinoma in an 84-year-old man. The regions of the anorectal melanoma showed melanocytic nevi in the adjacent mucosa of the anal canal and rectum. A dysplastic nevus was also identified in the anal mucosa. This case demonstrates that an anorectal melanoma can arise from pre-existing anorectal melanocytic lesions.
Adenocarcinoma* ; Aged, 80 and over ; Anal Canal ; Colon ; Colon, Sigmoid* ; Dysplastic Nevus Syndrome ; Humans ; Melanoma* ; Mucous Membrane ; Nevus, Pigmented ; Rectum

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Transmissibility of the Campaign for Colorectal Cancer Awareness in Korea Among Twitter Users.

Keun Chul LEE ; Heung Kwon OH ; Gibeom PARK ; SoHyun PARK ; Bongwon SUH ; Woo Kyung BAE ; Jin Won KIM ; Hyuk YOON ; Myung Jo KIM ; Sung Il KANG ; Il Tae SON ; Duck Woo KIM ; Sung Bum KANG

Annals of Coloproctology.2016;32(5):184-189. doi:10.3393/ac.2016.32.5.184

PURPOSE: The Korean Society of Coloproctology holds its annual colorectal awareness month every September. This study analyzed the users and the contents of Korean tweets regarding colorectal cancer and estimated the transmissibility of the awareness campaign among Twitter users. METHODS: Prospective data collection was employed to accumulate Korean tweets containing the keywords "colorectal cancer," "colorectal cancer awareness campaign," "gold ribbon," and/or "love handle," from August 1 to September 30, 2014. Twitter users and contents were analyzed, and the credibility of information-sharing tweets throughout the study period was evaluated. RESULTS: In total, 10,387 tweets shared by 1,452 unique users were analyzed. As for users, 57.8% were individuals whereas 5.8% were organizations/communities; spambots accounted for a considerable percentage (36.4%). As for content, most tweets were spam (n = 8,736, 84.1%), repetitively advertising unverified commercial folk remedies, followed by tweets that shared information (n = 1,304, 12.6%) and non-information (n = 347, 3.3%). In the credibility assessment, only 80.6% of the information-sharing tweets were medically correct. After spam tweets had been excluded, a significant increase was seen in the percentage of information-sharing tweets (77.1% to 81.1%, P = 0.045) during the awareness campaign month. CONCLUSION: Most Korean tweets regarding colorectal cancer during the study months were commercial spam tweets; informative public tweets accounted for an extremely small percentage. The transmissibility of the awareness campaign among Twitter users was questionable at best. To expand the reach of credible medical information on colorectal cancer, public health institutions and organizations must pay greater attention to social media.
Colorectal Neoplasms* ; Data Collection ; Korea* ; Medicine, Traditional ; Prospective Studies ; Public Health ; Social Media

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The Outcomes of Management for Colonoscopic Perforation: A 12-Year Experience at a Single Institute.

Jung Yun PARK ; Pyong Wha CHOI ; Sung Min JUNG ; Nam Hoon KIM

Annals of Coloproctology.2016;32(5):175-183. doi:10.3393/ac.2016.32.5.175

PURPOSE: Optimal management of colonoscopic perforation (CP) is controversial because early diagnosis and prompt management play critical roles in morbidity and mortality. Herein, we evaluate the outcomes and clinical characteristics of patients with CP according to treatment modality to help establish guidelines for managing CP. METHODS: Our retrospective analysis included 40 CP patients from January 1, 2003, to December 31, 2014. Patients with CP were categorized into 2 groups according to therapeutic modality: operation (surgery) and nonoperation (endo-luminal clip application or conservative treatment) groups. RESULTS: The postoperative morbidity rate was 40%, and no mortalities were noted. The incidence of abdominal pain and tenderness in patients who received only conservative management was significantly lower than in those who underwent surgery (P < 0.001 and P = 0.004, respectively). Patients tended to undergo surgery more often for diagnosis times longer than 24 hours and for diagnostic CPs. The mean hospital stays for the operation and nonoperation groups were 14.6 ± 7.77 and 5.9 ± 1.62 days, respectively (P < 0.001). Compared to the operation group, the nonoperation group began intake of liquid diets significantly earlier after perforation (3.8 ± 1.32 days vs. 5.6 ± 1.25 days, P < 0.001) and used antibiotics for a shorter duration (4.7 ± 1.29 days vs. 8.7 ± 2.23 days, P < 0.001). CONCLUSION: The time of diagnosis and the injury mechanism may be useful indications for conservative management. Nonoperative management, such as endo-luminal clip application, might be beneficial, when feasible, for the treatment of patients with CP.
Abdominal Pain ; Anti-Bacterial Agents ; Colonoscopy ; Diagnosis ; Diet ; Early Diagnosis ; Humans ; Incidence ; Length of Stay ; Mortality ; Retrospective Studies

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Anismus, Physiology, Radiology: Is It Time for Some Pragmatism? A Comparative Study of Radiological and Anorectal Physiology Findings in Patients With Anismus.

Umberto PISANO ; Lesley IRVINE ; Justina SZCZACHOR ; Ahsin JAWAD ; Andrew MACLEOD ; Michael LIM

Annals of Coloproctology.2016;32(5):170-174. doi:10.3393/ac.2016.32.5.170

PURPOSE: Anismus is a functional disorder featuring obstructive symptoms and paradoxical contractions of the pelvic floor. This study aims to establish diagnosis agreement between physiology and radiology, associate anismus with morphological outlet obstruction, and explore the role of sphincteric pressure and rectal volumes in the radiological diagnosis of anismus. METHODS: Consecutive patients were evaluated by using magnetic resonance imaging proctography/fluoroscopic defecography and anorectal physiology. Morphological radiological features were associated with physiology tests. A categorical analysis was performed using the chi-square test, and agreement was assessed via the kappa coefficient. A Mann-Whitney test was used to assess rectal volumes and sphincterial pressure distributions between groups of patients. A P-value of <0.05 was significant. RESULTS: Forty-three patients (42 female patients) underwent anorectal physiology and radiology imaging. The median age was 54 years (interquartile range, 41.5–60 years). Anismus was seen radiologically and physiologically in 18 (41.8%) and 12 patients (27.9%), respectively. The agreement between modalities was 0.298 (P = 0.04). Using physiology as a reference, radiology had positive and negative predictive values of 44% and 84%, respectively. Rectoceles, cystoceles, enteroceles and pathological pelvic floor descent were not physiologically predictive of animus (P > 0.05). The sphincterial straining pressure was 71 mmHg in the anismus group versus 12 mmHg. Radiology was likely to identify anismus when the straining pressure exceeded 50% of the resting pressure (P = 0.08). CONCLUSION: Radiological techniques detect pelvic morphological abnormalities, but lead to overdiagnoses of anismus. No proctographic pathological feature predicts anismus reliably. A stronger pelvic floor paradoxical contraction is associated with a greater likelihood of detection by proctography.
Defecography ; Diagnosis ; Female ; Humans ; Magnetic Resonance Imaging ; Medical Overuse ; Pelvic Floor ; Physiology* ; Rectocele

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Use of a Comprehensive Geriatric Assessment to Predict Short-Term Postoperative Outcome in Elderly Patients With Colorectal Cancer.

Yoon Hyun LEE ; Heung Kwon OH ; Duck Woo KIM ; Myong Hoon IHN ; Jee Hyun KIM ; Il Tae SON ; Sung Il KANG ; Gwang Il KIM ; Soyeon AHN ; Sung Bum KANG

Annals of Coloproctology.2016;32(5):161-169. doi:10.3393/ac.2016.32.5.161

PURPOSE: This study was conducted to identify the effectiveness of a preoperative comprehensive geriatric assessment (CGA) for predicting postoperative morbidity in elderly patients who underwent surgery for colorectal cancer. METHODS: Elderly patients (≥70 years old) who underwent surgery for colorectal cancer at a tertiary hospital in Korea were identified, and their cases were analyzed using data from a prospectively collected database to establish an association between major postsurgical complications and 'high-risk' patient as defined by the CGA. RESULTS: A total of 240 patients, with a mean age of 76.7 ± 5.2 years, were enrolled. Ninety-five patients (39.6%) were classified as "high-risk" and 99 patients (41.3%) as having postoperative complications. The univariate analysis indicated that risk factors for postoperative complications were age, American Society of Anesthesiologists physical status classification, serum hemoglobin, carcinoembryonic antigen, cancer stage, and "high-risk" status. The multivariable analyses indicated that "high-risk" status (odds ratio, 2.107; 95% confidence interval, 1.168–3.804; P = 0.013) and elevated preoperative carcinoembryonic antigen (odds ratio, 2.561; 95% confidence interval, 1.346–4.871, P = 0.004) were independently associated with postoperative complications. A multivariable analysis of the individual CGA domains indicated that high comorbidities and low activities of daily living were significantly related with postoperative complications. CONCLUSION: A preoperative CGA indicating "high-risk" was associated with major postoperative complications in elderly patients who underwent surgery for colorectal cancer. Thus, using the CGA to identify elderly colorectal-cancer patients who should be given more care during postoperative management may be clinically beneficial.
Activities of Daily Living ; Aged* ; Carcinoembryonic Antigen ; Classification ; Colorectal Neoplasms* ; Comorbidity ; Geriatric Assessment* ; Humans ; Korea ; Postoperative Complications ; Prospective Studies ; Risk Factors ; Tertiary Care Centers

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How Can We Ameliorate the Role of Colorectal Cancer Awareness Month?.

Weon Young CHANG

Annals of Coloproctology.2016;32(5):160-160. doi:10.3393/ac.2016.32.5.160

No abstract available.
Colorectal Neoplasms*

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Current Situation on the Diagnosis of Anismus-Discordances Between Imaging and a Physiologic Study.

Kyung Ha LEE ; Ji Yeon KIM

Annals of Coloproctology.2016;32(5):159-159. doi:10.3393/ac.2016.32.5.159

No abstract available.
Diagnosis*

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Comparison of a Subtotal Colectomy With Self-Expandable Metallic Stent in the Management of Patients With Obstructive Left Colon Cancer.

Byung Chun KIM

Annals of Coloproctology.2016;32(6):203-204. doi:10.3393/ac.2016.32.6.203

No abstract available.
Colectomy* ; Colon* ; Colonic Neoplasms* ; Humans ; Stents*

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