XX Biennial Congress of the International Society of University Colon and Rectal Surgeons

June 6-10, 2004, Budapest, Hungary





Welcome Messages
Dear Colleagues,
As the President of the International Society of University of Colon and Rectal Surgeons I would like to welcome you to our 2004 Congress in Budapest, Hungary. This is the first time for our Congress to be held in east Europe. Thanks to Congress President, Professor Balogh and his colleagues we can expect not only the exciting scientific programs but also splendid social programs with historical backgrounds.
We look forward to seeing you in Budapest on June, 2004.

Tetsuichiro Muto M.D., PhD.
President, ISUCRS

Dear Colleagues,
The International Society of University Colon and Rectal Surgeons would like to invite you to join us at our 2004 Congress to be held in the beautiful and historical city of Budapest, Hungary.
The Congress will be held on June 6-10, 2004 at the Budapest Congress Centre.
We look forward to an exciting Congress organized by Professor Balogh and his colleagues.

Indru T. Khubchandani M.D.,
Director General, ISUCRS

Dear Colleagues and Friends,
It is my privilege and honour to invite you to the XXth ISUCRS Congress, to be held in Budapest, Hungary, on June 6-10, 2004. The organizers are planning an outstanding scientific program which will cover all the up-to-date results relating to research and clinical practice in colorectal diseases.
The capital of Hungary, Budapest, is a magical city on the River Danube, located in the heart of Europe. The historical monuments, churches and museums of our thousand-year-old state, together with the marvellous theaters and concert halls, offer a splendid touristic program.
We are convinced that the scientific program in combination with the traditionally warm Hungarian hospitality will make this congress an unforgettable experience for all participants.
We look forward to welcoming you in Budapest, Hungary.

Adam Balogh M.D.,
Congress President
ISUCRS 2004 Budapest




Planning the main topics and subjects of the XXth Biennial Congress of ISUCRS, we have chosen the slogan “Challenges of Colorectal Surgery in the 21st Century” as a headline expressing aims, tasks and mission of our Budapest meeting. Why do we think that our age is a period of quick and fundamental changes in the surgical treatment of colorectal diseases? Let us have an overview of our specialty in the last century.
The achievements of surgical techniques have made possible - already in the first half of the 20th century - the abdominoperineal extirpation of the rectum, segmental resection of different parts of the colon, principles of stoma formation and successful preservation of the anal sphincter in surgery of upper third rectal cancer by anterior rectal resection. The “traditional” methods of colorectal surgery developed by Miles, Hartmann, and Dixon, Goligher and many other creative European and American surgeons have been used without any important modification till the last quarter of the previous century.
During the same time, a lot of new factors appeared in the diagnostics and treatment of cancer disease, in anesthesiology and perioperative care, even the surgical techniques developed in this period, improving results, decreasing operative risk, mortality and morbidity. In spite all of these; we surgeons used the traditional schemes of colorectal operations - mainly in the treatment of colorectal cancer – practically unchanged. The change of paradigms happened about 1980. Surgeons recognized that operative radicality can be enhanced without increasing operative risk, due to the modern anesthesia, intensive care, antibiotic and thrombosis prophylaxis, and safe surgical techniques. Surgery is not a loco regional modality of treatment anymore. We remove colorectal cancer even in its 4th stage; even in locally advanced cases involving adjacent organs, and even with distant metastases in the same body cavity. While surgery of mammary cancer in the last two decades is characterized by decreasing extension of surgery - like breast conserving limited radicality, sentinel lymph node dissection etc. – surgery of colorectal cancer has extended its radicality. Experiences of total proctocolectomies made for the treatment of ulcerative colitis showed us that an acceptable quality of life is possible without large bowels. Based on this fact, we treat now obstructive tumors of the left colon with subtotal colectomy, extending surgical radicality enhancing oncological safety and performing emergency colorectal resection without stoma. We extended the radicality of middle and low third rectal cancer surgery by mean of total mesorectal excision preserving more sphincters and resulting in an admirable decrease of local recurrences.
At the turnover of the third millennium, we see a new direction of the development in colorectal surgery. The minimal invasive technique is already the dominating method of today in surgery of inflammatory and benign CR diseases. Minimal invasive techniques are used in a more and more impressing way for the surgical treatment of malignant CR diseases with the same radicality and oncological effect as the one of open interventions. Screening will increase the number of early CR lesions proper for endoscopic removal. We look forward a revolution in CR surgery characterized by increasing importance of minimal invasive techniques, oncogenetics and systematic screening of population in critical ages.
This book contains papers based on the material of the 2004 Budapest ISUCRS Congress, mirroring the developments of colorectal surgery in this exciting period at the beginning of the third millennium.

Budapest, 14th May 2004
Prof. Dr. Adam Balogh,
M.D., Ph. D., D. Sc., F.A.C.S.
President of the Congress








Anatomy, Physiology and Functional Disorders of the Colon and Rectum


Injectable Silicone Implants for the Treatment of Incontinent Patients
L. Oliveira and A. Povedano



Inflammatory Bowel Disease

Long-term Follow-up of Strictureplasty for Obstrctive Crohn’s Disease
K. Futami, K. Kawahara, D. Higashi, T. Kamitani, K. Seki and S. Arima

The 9-pouch: A New Ileal Reservoir Used in Restorative Proctocolectomy
N.-G. Oh, G.-M. Son, Y.-H. Cho, J.-Y. Sin, T.-Y. Jeon,
X.-Z. Ding, R. Witt and T.E. Adrian

Gracilis Transposition for Repair of Recurrent Rectovaginal Fistulas in Crohn´s Disease
J. Swol-Ben, G. Sandmann, A. Agha, H.J. Schlitt and A. Fürst



Benign Colorectal Conditions

Hand-sewn Circumferential Mucosectomy in Hemorrhoids
Jung- Gu Kang and Young-Gi Hong

CO2 Laser Vaporization of Internal Hemorrhoids
M. Zielanowski

Synchronous Sigmoid and Cecal Volvulus: Case Report
I.Y. Kim, S.H. Sung, D.S. Kim and B.S. Rho

Five Years Follow-up of the Use of Topic Ketanserin Gel Treatment for Anal Fisure
M. Zielanowski

Surgical Approach to Giant Condyloma Accuminata
E. Balik, D. Bugra, S. Yamaner, T. Bulut, A. Akyüz, Y. Büyükuncu and N. Sökücü

Surgical Approach to Extensive Hidradenitis Suppurativa
E. Balik, D. Bugra, S. Yamaner, T. Bulut, A. Akyüz, Y. Büyükuncu and N. Sökücü

Rectal Prolapse – Abdominal or Perineal Approach: Tailoring the Technique to the Patient
C.L. Simmang



Colorectal Cancer Surgery


Presidential Address: What’s On in Colorectal Cancer Study – A 30 Years Experience of Japanese Society for Cancer of the Colon and Rectum (JSCCR)
T. Muto

Clinicopathological Analysis of Patients with Pulmonary Metastases from Colorectal Cancer
S. Yoshitani, M. Kuroda, H. Harada and S. Takashima

Misdiagnosis in Colorectal Carcinoma: A Survey of Seven Cases Collected in a Year
G. Accarpio, A. Cariati, R. Puglisi, GM. Accarpio and R. Zaffarano

The Rate of Liver Metastasis of Colorectal Cancer in Relation to Clinical and Histopathological Factors
B.K. Ahn, S.U. Baek and S.H. Lee

Expression of Survivin in Colorectal Cancers
M. Baek, J. Kim, T. Kim, S. Kim, M. Lee, Y. Jang, C. Kim, O. Song, E. Lee, D. Jung and C. Kim

Tumor Budding and Its Prognostic Implication in Colon Carcinoma
H. Choi, K. Park, H. Kwon and M. Roh

Survival After Resection for Adenocarcinoma of the Colon – Comparison Between Right and Left Colon
M.J. Jucá

Effectiveness of Endoscopic Transanal Decompression for Acute Obstructing Colorectal Cancer as a Preoperative Treatment
K. Okamoto

Functional End-to-end Anastomosis for Colonic Cancer Surgery
H. Motohashi, T. Akasu, Y. Fujimoto, S. Yamamoto, S. Fujita and Y. Moriya

Pelvic Exenteration with Reconstruction of Urinary and Anal Sphincter Functions for the Treatment of Advanced Colorectal Cancer
K. Koda, T. Tobe, Y. Gunji, N. Takiguchi, T. Igarashi, S. Miyazaki, K. Oda, H. Miyauchi, H. Makino, K. Seike, H. Ito, M. Miyazaki and T. Ochiai

A Case of Sigmoid Colon Cancer with Metastases to Small Intestine
M. Kuroda, H. Harada, S. Yoshitani and S. Takashima

Indications and Procedure for Bladder Augmentation Following Extended Resection of Intrapelvic Organs
H. Onodera, S. Nagayama, A. Mori and M. Imamura

Nover Bladder Sparing Surgery for Patients with Rectal Carcinomas Involving the Prostate and Seminal Vesicle
N. Saito, T. Suzuki, M. Ono, M. Sugito and M. Ito

Transverse Coloplasty Pouch Anal Anastomosis for Low Rectal Cancer: Preliminary Results
T. Akasu, Y. Fujimoto, H. Motohashi, S. Yamamoto, S. Fujita and Y. Moriya

Investigation of an Adjacent Organ Infiltrate Colorectal Cancer
K. Hirano, K. Futami, K. Kawahara, D. Higasi, T. Kamitani, K. Seki, Y. Egawa and S. Arima

A New Ultimate Anus-preserving Operation for Extremely Low Rectal Cancer or Anal Canal – Histologic Theoretical Evidence –
K. Shirouzu, Y. Ogata, Y. Araki, Y. Kishimoto and Y. Sato

A Study on the Lymph Node Metastasis of the Right Side Colon Cancer
S. Takashima, S. Yoshitani, H. Harada and M. Kuroda



Laparoscopic Colorectal Surgery

Clipless Hand-assisted Laparoscopic Total Colectomy
Y. Araki, M. Kanazawa, N. Ishibashi, Y. Ogata and K. Shirouzu

Laparoscopic-assisted Right Colectomy with Lymph Node Dissection via Minilaparotomy (LAC mini) Is Safe, Sure and Less Invasive Procedure
A. Hanai, K. Ashikawa, S. Noda, K. Yamada, T. Yamamura and S. Yamaguchi

Any Laparoscopic APR: Any Proven Health-Related Benefits Beyond Feasibility?
C.C. Chung and M.K.W. Li

Laparoscopic Assisted Minilaparotomic Surgery for Rectal Cancer
K. Yamada, T. Yamamura, T. Suwa, K. Horikoshi, T. Asano, K. Ashikawa, S. Noda, A. Hanai and S. Yamaguchi

Laparoscopic-assisted Sigmoidectomy with Lymph Node Dissection Via Minilaparotomy
T. Yamamura, S. Ashikawa, S. Noda, H. Hanai, K.Yamada and S. Yamaguchi

Hand-assisted Laparoscopic Surgery for Colorectal Diseases
M. Itabashi, T. Hashimoto, T. Hirosawa, S. Ogawa, N. Saito, K. Aratake, A. Seshimo, N. Shirotani, S. Kameoka and K. Hamano

Application of HALS for Diverse Intestinal Diseases
C.N. Kim, Y.J. Kang, S. Joe, M.K. Lee, J.S. Park and J.C. Kim

Laparoscopy for Colorectal Cancer Implementing It on a National Level
J. Pfeifer

Continued Multimodality Treatment of Colorectal Cancer
The Modern Methods of Combined Treatment of Disseminated Colorectal Cancer
A. Kitaev, V. Petrov and S. Leonov

Hepatic Arterial Infusion of Interleukin-2-based Immuno-chemotherapy After Potentially Curative Resection of Colorectal Liver Metastases
K. Okuno, K. Inoue, T. Yoshifuji, T. Tokoro, T. Uchida, J. Hida and M. Yasutomi

The Outcomes of Preoperative Chemoradiation to Suspected Unresectable or Non-curative Resectable Rectal Cancers Due to Fixed Lesion by Digital Examination and Advanced CT Stage
B.K. Ahn, S.H. Lee and S.U. Baek

Administration of One Versus Two Doses of Ticarcilline / Clavoulanic Acid for Chemoprophylaxis on Colectomies. Our Experience
P. Ntasiou, K. Kanellakopoulou, S. Pinis, N. Galanakis, A. Dervisoglou, P. Giannakakis and H. Giamarellou

Hepatic Resection after Hepatic Arterial Infusion Chemotherapy for Initially Unresectable Liver Metastases from Colorectal Carcinoma
Y. Fujimoto, T. Akasu, H. Motohashi, S. Yamamoto, S. Fujita and Y. Moriya

Anxiety and Depression and Quality of Life in Colorectal Cancer Patients
A. Tsunoda, K. Nakao, K. Hiratsuka, K. Yamazaki,
N. Yasuda, Y. Tsunoda and M. Kusano

Does Neoadjuvant Oncotherapy Elevate the Risk of Perioperative Morbidity of Colorectal Cancer?
K. Szluha, B. Juhász, H. Urbancsek, M. Dank, B. Piko and Á. Horváth




Usefulness of Molecular Detection of P16 Promoter Methylation in the Serum of Patients with Colorectal Cancer
M. Adachi, H. Iinuma, H. Yago, T. Arai, T. Omi, E.K. Haku, K. Nozawa, K. Matsuda,
T. Mimura, S. Kodaira and K. Okinaga

Mitochondrial and Nuclear Events in Sulindac-induced Apoptosis of Colon Cancer Cells
H. Choi, K. Park and Y. Yoo




Rigid Sigmoidoscopy – An Obsolete Diagnostic Tool?
A. Modi, K. Gokul and D.Y. Artioukh

Management of Massive Lower Gastrointestinal Bleeding
A. Prochotsky, R. Okolicany and L. Jancula

Geriatric Aspects of Rectal Surgery in Szekszard, Hungary
I. Zöllei, A. Gyori, J. Csapo, G. Wener,
G. Hajdu and E. Varga

Diagnosis and Treatment of Familial Adenomatous Polyposis
S. Clark

Sutureless Intestinal Anastomosis with the Biofragmentable Anastomosis Ring: Experience of 632 Anastomoses in a Single Institute
H. Choi, S. Kim, K. Park, M. Kim, Y. Kim, S. Cho and G. Jung

Virtual Colonoscopy for Colorectal Polyps
Y. Kawamura

A Case with Adenocarcinoma Developing in Anal Cyst Hamartomas
K. Nozawa, K. Haku, T. Oomi, T. Arai, K. Matsuda, T. Mimura, M. Adachi, K. Okinaga and S. Kodaira

The Foreign Body of Distal Colon as a Reason of Pneumoperitoneum. Report of a Case
A. Prochotsky, L. Jancula, R. Okolicany and J. Kralik

Gastrointestinal Autonomic Nerve Tumor (GANT) in the Lower Rectum: Report of a Case
J.H. Baek, D.H. Jung and J.H. Oh

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