Metformin in Colorectal Cancer: Epidemiological Evidence, Predictive Biomarkers, and Implications for Prevention and Treatment.

Interest in metformin as a potential anticancer agent for colorectal cancer (CRC) has increased. However, compelling epidemiological links and strong preclinical evidence suggest that metformin has variable efficacy in patients with CRC. This variability highlights the need to identify the patients who are most likely to benefit from effective stratification.

Laparoscopic and robotic surgery for colorectal cancer in Korea: a nationwide health insurance database analysis from 2019 to 2023.

Purpose: This study examined nationwide data regarding laparoscopic and robotic surgery for colorectal cancer (CRC) in Korea.

Methods: Nationwide data concerning patients who underwent surgery for CRC from 2019 to 2023 were obtained from the Health Insurance Review and Assessment Service database.

Results: From 2019 to 2023, a total of 109,573 patients with CRC underwent surgical resection in Korea.

Survival benefit of adjuvant chemotherapy in high-risk patients with colon cancer regardless of microsatellite instability.

Introduction: The predictive utility of high-risk features (HRFs) and microsatellite instability (MSI) status for adjuvant chemotherapy (ACT) in patients with stage II colon cancer remains unclear. We examined the impact of HRFs and MSI in predicting the benefits of adjuvant ACT in patients with stage II colon cancer.

Materials And Methods: We included 1801 patients with resected stage II colon cancer who underwent ACT (5-fluorouracil [FU] and oxaliplatin) or surgery alone between January 2010 and December 2017.

Tailoring rectal cancer surgery: Surgical approaches and anatomical insights during deep pelvic dissection for optimal outcomes in low-lying rectal cancer.

This review article explores advanced surgical approaches and anatomical insights for tailoring rectal cancer surgery, particularly focusing on low-lying rectal cancer. With the evolution of imaging technologies, precise preoperative planning has become possible, enhancing the visualization of anatomy surrounding the rectum and enabling more accurate assessments of circumferential resection margin (CRM) involvement. The article emphasizes the dynamic nature of rectal cancer treatment, advocating for individualized surgical planning based on comprehensive preoperative imaging and intraoperative assessment.

Plastic Wound Protector vs Surgical Gauze for Surgical Site Infection Reduction in Open GI Surgery: A Randomized Clinical Trial.

Importance: Surgical site infections (SSIs) are prevalent hospital-acquired infections with significant patient impacts and global health care burdens. The World Health Organization recommends using wound protector devices in abdominal surgery as a preventive measure to lower the risk of SSIs despite limited evidence.

Objective: To examine the efficacy of a dual-ring, plastic wound protector in lowering the SSI rate in open gastrointestinal (GI) surgery irrespective of intra-abdominal contamination levels.

mFOLFIRINOX versus mFOLFOX 6 as adjuvant treatment for high-risk stage III colon cancer - the FROST trial: study protocol for a multicenter, randomized controlled, phase II trial.

Background: High-risk stage III colon cancer has a considerably poorer prognosis than stage II and low-risk stage III colon cancers. Nevertheless, most guidelines recommend similar adjuvant treatment approaches for all these stages despite the dearth of research focusing on high-risk stage III colon cancer and the potential for improved prognosis with intensive adjuvant treatment. Given the the proven efficacy of triplet chemotherapy in metastatic colorectal cancer treatment, the goal of this study is to evaluate the oncologic efficacy and safety of mFOLFIRINOX in comparison to those of the current standard of care, mFOLFOX 6, as an adjuvant treatment for patients diagnosed with high-risk stage III colon cancer after radical resection.

The effect of circular stapler size on anastomotic stricture formation in colorectal surgery: A propensity score matched study.

Background: Small circular staplers possess the advantage of being relatively easy to use when compared to larger circular staplers. However, there is some contention as to whether the use of small circular staples in colorectal surgery increases the incidence of anastomotic strictures. This study aimed to determine whether the frequency of anastomosis site stricture formation differs depending on stapler size when performing anastomosis in colorectal surgery.

Mesh size may not affect recurrence in laparoscopic totally extraperitoneal repair of inguinal hernias.

A mesh is usually employed to cover defects when performing laparoscopic totally extraperitoneal repair (TEP) of inguinal hernias. However, there is insufficient evidence for an appropriate mesh size. Therefore, we aimed to compare the recurrence rate between large- and medium-mesh laparoscopic TEP.

Short-Term Impact of Temporary Shutdown of a University-Affiliated Hospital on Patients With Colorectal Cancer During the Coronavirus Disease 2019 Pandemic.

Owing to in-hospital transmission of coronavirus disease 2019 (COVID-19), Uijeongbu St. Mary's Hospital, a university-affiliated hospital in South Korea, was temporarily closed for disinfection in March 2020. This study aimed to investigate the impact of both the hospital shutdown and the prolonged COVID-19 pandemic on short-term outcomes of colorectal cancer (CRC) patients.

Safety of laparoscopic appendectomy for the management of acute appendicitis during pregnancy.

Laparoscopic appendectomy during pregnancy is widely accepted as a safe procedure in Korea, where the rate of laparoscopic surgery is high. Although the Society of American Gastrointestinal and Endoscopic Surgeons guideline currently mentions laparoscopic appendectomy as the treatment of choice for pregnant patients with appendicitis, some concerns arising from pneumoperitoneum during laparoscopic surgery exist in maternal postoperative and fetal outcomes. Further effort to provide firm evidence to clarify the safety of laparoscopic appendectomy during pregnancy is still needed.

Use of gentamicin-collagen sponge (Collatamp® G) in minimally invasive colorectal cancer surgery: A propensity score-matched study.

Background: Minimally invasive surgery is commonly used to treat patients with colorectal cancer, although it can cause surgical site infections (SSIs) that can affect the oncologic outcome. Use of a gentamicin-collagen sponge may help reduce the occurrence of SSIs. We aimed to determine the effectiveness of a gentamicin-collagen sponge in reducing SSIs in minimally invasive surgery for colorectal cancer.

Routine antibiotics may not be needed to treat uncomplicated right diverticulitis: A retrospective cohort study.

We aimed to investigate whether antibiotic administration is necessary for patients with uncomplicated right colonic diverticulitis. Data from patients diagnosed with uncomplicated right colonic diverticulitis, who received inpatient treatment at a single center between January 2019 and January 2021, were retrospectively examined. The patients were divided into two groups according to whether antibiotics were administered.

Metachronous carcinoma at the colostomy site after abdominoperineal resection of rectal cancer: a case report.

Metachronous carcinoma at the colostomy site is very rare after abdominoperineal resection. A 53-year-old male patient underwent an abdominoperineal resection 6 years earlier for rectal cancer developed metachronous carcinoma at the site of stoma. A portion of the colon, including the stoma and the surrounding skin, was resected and a new stoma was created in the transverse colon.

Predictive factors for conservative treatment failure of right colonic diverticulitis.

Purpose: Conservative treatment is the first-line therapy for acute colonic diverticulitis without severe complications, but treatment failure may increase hospitalization duration, medical costs, and morbidities. Usage of the modified Hinchey classification is insufficient to predict the outcome of conservative management. We aimed to investigate the clinical efficacy of the modified Hinchey classification and to evaluate predictive factors such as inflammatory markers for the failure of conservative management.

Step-wise learning of laparoscopic low anterior resection.

A primary goal of training is the development of one's own procedure by self-learning, which can be facilitated by laparoscopic surgery owing to its recordable system. This video demonstrates laparoscopic low anterior resection for a 56-year-old male diagnosed with synchronous S-colon cancer and rectal cancer. The surgery was performed by a second-year fellow in the colorectal division under supervision.

Routine colonoscopy may be needed for uncomplicated acute right colonic diverticulitis.

Background: Routine colonoscopy is recommended to determine the coexistence of colon cancer after medical treatment for colon diverticulitis. However, in the case of uncomplicated diverticulitis diagnosed by computed tomography, the clinical relevance of routine follow-up colonoscopy has recently been debated. Yet, the role of follow-up colonoscopy for right colon diverticulitis, which tends to develop at a younger age than left colon diverticulitis, has not been specifically evaluated.

A link between appendectomy and gastrointestinal cancers: a large-scale population-based cohort study in Korea.

An association between appendectomy and subsequent gastrointestinal (GI) cancer development has been postulated, although the evidence is limited and inconsistent. To provide clarification, we investigated the link between appendectomy and GI cancers in a large nationwide appendectomy cohort. This cohort was derived from the claims database of the National Health Insurance Service in South Korea and comprised 158,101 patients who had undergone appendectomy between 2007 and 2014.

Survival outcomes after isolated local recurrence of rectal cancer and risk analysis affecting its resectability.

Background And Objectives: This study aimed to investigate the clinical course and prognostic factors after isolated local recurrence (iLR) and to identify the predictive factors for R0 resection of locally recurrent rectal cancer (LRRC).

Methods: We retrospectively reviewed the medical records of 76 patients with iLR who had undergone radical surgery for a primary tumor from 2003 to 2015.

Results: The iLR rate was 2.

Difference in Clinical Features between Right- and Left-Sided Acute Colonic Diverticulitis.

Right colonic diverticulitis (RCD) and left colonic diverticulitis (LCD) may have different clinical features due to the different embryologic origins and anatomical locations of each colon. Therefore, we aimed to compare RCD and LCD in terms of the associated clinical features. We retrospectively collected clinical data from patients who were diagnosed with acute colonic diverticulitis based on computed tomography findings between 2011 and 2017.