Purpose and Methods: This study evaluated clinical outcomes of bridge to surgery (BTS) for right-sided malignant colonic obstruction (RMCO). Among 95 patients who underwent primary tumor resection, 82 received BTS and were divided into a stent group (S group, n = 41) with self-expandable metallic stents (SEMS) and a tube group (T group, n = 41) with transnasal ileus tubes.

Results: The S group had more cases resuming oral intake (40 vs. 0) and being discharged after decompression (35 vs. 0), with a significantly shorter postoperative hospital stay (7 vs. 8 days, p = 0.015). C-D grade III or higher complications occurred in 4 cases (S) and 3 cases (T), with anastomotic leakage in 1 and 3 cases, respectively. No significant differences were observed in 5-year recurrence-free survival (45.5% vs. 55.7%) or overall survival (54.2% vs. 75.7%).

Conclusion: In patients with RMCO, BTS using SEMS may enable earlier resumption of oral intake and potentially reduce the burden on patients.

Objective: Few studies have explored the long-term outcomes of ALTA therapy for internal hemorrhoids. This study evaluated therapeutic results over more than 10 years and identified recurrence-related factors.

Methods: A prospective analysis was conducted on 226 patients without strict eligibility criteria. Recurrence was defined as re-prolapse of Goligher grade II or higher. Nine factors were assessed: age, sex, Goligher classification, external hemorrhoidal bulge, large hemorrhoids, polyps, anal tags, ALTA injection volume, and the number of treated hemorrhoidal sites. Cumulative recurrence-free rate was analyzed using the Kaplan-Meier method, and multivariate analysis was performed with the Cox proportional hazards model.

Results: The median recurrence-free duration was 1.99 years (95% CI: 1.29-2.57). Recurrence-free rates were 61.7%, 31.9%, and 19.9% at 1, 5, and 10 years, respectively. Independent risk factors for recurrence were age under 60 years (HR 1.69) and absence of anal tags (HR 1.54).

Conclusions: While ALTA therapy demonstrates strong short-term efficacy, its long-term effectiveness is limited. The absence of adverse recurrence factors in cases previously deemed ineligible suggests potential flexibility in applying eligibility criteria.

Basal cell carcinoma is commonly found on exposed areas such as the face, head and neck, and rarely found in the perianal region. In this report, we describe two cases of perianal basal cell carcinoma, with a review of the literature. Case 1 was a 77-year-old man. He presented to our clinic with complaints of anal pain, bleeding, and hemorrhoidal swelling. A 9 × 9 mm, blackish, slightly elevated nodule was found on the perianal skin at 7 o'clock. Case 2 was a 72-year-old man. He had noticed a mass in his anus for the past 6 months and recently had pain due to rubbing. An 18 × 15 mm, slightly blackish nodule with good mobility was found on the perianal skin at 7 o'clock. In both cases, tumor resection was performed with a 5-mm margin, and the subcutaneous tissue was sufficiently attached to the resected side. Histopathological examination revealed a diagnosis of basal cell carcinoma, and the resection margin was negative in both cases.

A 78-year-old female underwent endoscopic submucosal dissection (ESD) for a 30-mm 0-Is polyp of the lower rectum (Rb). She was diagnosed with rectal cancer with deeper submucosal invasion (pT1b or deeper) by pathological examination. Since additional surgery was recommended, she underwent laparoscopic abdominoperineal resection with proximal D3 lymph node dissection 2 months later. Pathological examination revealed neither residual cancer nor lymph node metastases. She was finally diagnosed with pStage I rectal cancer, and visited the outpatient clinic regularly without receiving postoperative adjuvant chemotherapy. One year after surgery, computed tomography demonstrated multiple swollen lymph nodes from the para-aortic to the bilateral common iliac artery region. Increased FDG accumulation was observed also in the left cervical lymph node on PET/CT examination. Biopsy of the left cervical lymph node revealed metastasis of previous rectal cancer; thus, systemic chemotherapy was introduced. However, her medical condition progressed, and she passed away 30 months after surgery. The incidence of skip lymph node metastases of colorectal cancer is rare, reportedly about 10%. Even in cases of early cancer, periodical surveillance is needed.

We report the case of a 65-year-old male patient who was diagnosed with an implantation cyst after robot-assisted laparoscopic high anterior resection for rectal cancer. The pathological findings revealed a moderately to poorly differentiated tubular adenocarcinoma with mucinous features (tub2>muc>por2), staged as pT3N1M0 (stage IIIb). A cystic lesion near the anastomotic site was identified on CT 6 months postoperatively. Due to its progressive enlargement and the presence of mucinous carcinoma in the primary resected specimen, recurrence of mucinous carcinoma at the anastomosis site was suspected.

The patient underwent preoperative chemoradiotherapy (CRT) followed by surgery one year after the initial procedure. Pathological examination of the resected lesion showed no evidence of viable tumor cells or necrosis within the mucinous nodule. The patient remains free of recurrence 25 months after the second surgery.

In this case, the lesion was considered to be either an implantation cyst or a recurrence at the anastomotic site that achieved complete response to chemoradiotherapy (CRT). Post-CRT imaging showed no tumor shrinkage, and pathological examination revealed neither malignant features nor findings suggestive of tumor cell necrosis within the mucinous nodule. Therefore, the lesion was diagnosed as an implantation cyst, a rare benign condition.

Adenocarcinoma with enteroblastic differentiation is often recognized in the stomach and is associated with poor prognosis. Colorectal adenocarcinoma with enteroblastic differentiation (CAED) is extremely rare, and its clinical and pathological features remain unclear. Here, we present two cases of CAED. Case 1 was a 75-year-old female with a type 2 lesion in the rectosigmoid colon, and Case 2 was a 61-year-old male with a type 2 lesion in the sigmoid colon. Both tumors were successfully treated with laparoscopic surgery, and pathological examination revealed tubular and papillary proliferation of tumor cells, resembling the fetal intestinal epithelium. These tumors were found to be CAED upon further immunohistopathological examination, which were positive for GPC3 and SALL4. According to the results of our PubMed search, only 25 cases of CAED have been reported in the literature, including the present two cases. These reported cases frequently showed regional lymph node metastasis and distant metastasis, suggesting a poor prognosis. Despite its rarity, CAED should be recognized as a highly malignant tumor.