Intestinal Research

Case Report

Natural Course of an Untreated Metastatic Perirectal Lymph Node After the Endoscopic Resection of a Rectal Neuroendocrine Tumor: Sang Hyung Kim, Dong-Hoon Yang, Jung Su Lee, Soyoung Park, Ho-Su Lee, Hyojeong Lee, Sang Hyoung Park, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim, Chan Wook Kim, Jihun Kim; Intest Res 2015;13(2):175-179. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.175

Lymph node metastasis is rare in small (i.e., <10 mm) rectal neuroendocrine tumors (NETs). In addition to tumor size, pathological features such as the mitotic or Ki-67 proliferation index are associated with lymph node metastasis in rectal NETs. We recently treated a patient who underwent endoscopic treatment of a small, grade 1 rectal NET that recurred in the form of perirectal lymph node metastasis 7 years later. A 7-mm-sized perirectal lymph node was noted at the time of the initial endoscopic treatment. The same lymph node was found to be slightly enlarged on follow-up and finally confirmed as a metastatic NET. Therefore, the perirectal lymph node metastasis might have been present at the time of the initial diagnosis. However, the growth rate of the lymph node was extremely low, and it took 7 years to increase in size from 7 to 10 mm. NETs with low Ki-67 proliferation index and without mitotic activity may grow extremely slowly even if they are metastatic.

Citations

Citations to this article as recorded by

Current status of endoscopic resection for small rectal neuroendocrine tumors
Jian-Ning Liu, Hui Chen, Nian Fang
World Journal of Gastroenterology.2025;[Epub] CrossRef
Clinical application of endoscopic ultrasonography in the management of rectal neuroendocrine tumors
Soo-Young Na, Seong Jung Kim, Hyoun Woo Kang
International Journal of Gastrointestinal Intervention.2023; 12(3): 105. CrossRef
Tumor grade 2 as the independent predictor for lymph node metastasis in 10–20 mm sized rectal neuroendocrine tumor
Byung-Soo Park, Sung Hwan Cho, Gyung Mo Son, Hyun Sung Kim, Su Jin Kim, Su Bum Park, Cheol Woong Choi, Hyung Wook Kim, Dong Hoon Shin
Korean Journal of Clinical Oncology.2021; 17(1): 37. CrossRef
Lymphovascular invasion as a prognostic value in small rectal neuroendocrine tumor treated by local excision: A systematic review and meta-analysis
Ho Suk Kang, Mi Jung Kwon, Tae-Hwan Kim, Junhee Han, Young-Su Ju
Pathology - Research and Practice.2019; 215(11): 152642. CrossRef
Trans‐anal full‐thickness endoscopic resection of a rectal neuroendocrine neoplasm performed with a TEO® (Karl Storz microsurgery device) and laparoscopic indocyanine‐green‐guided lymphatic sampling – a video vignette
P. Leon, A. Balduzzi, M. Troian, N. de Manzini
Colorectal Disease.2017; 19(4): 399. CrossRef
Usefulness of endoscopic resection using the band ligation method for rectal neuroendocrine tumors
Ju Seung Kim, Yoon Jae Kim, Jun-Won Chung, Jung Ho Kim, Kyoung Oh Kim, Kwang An Kwon, Dong Kyun Park, Jung Suk An
Intestinal Research.2016; 14(2): 164. CrossRef
Lymphovascular invasion in more than one-quarter of small rectal neuroendocrine tumors
Mi Jung Kwon, Ho Suk Kang, Jae Seung Soh, Hyun Lim, Jong Hyeok Kim, Choong Kee Park, Hye-Rim Park, Eun Sook Nam
World Journal of Gastroenterology.2016; 22(42): 9400. CrossRef
Cap-assisted EMR for rectal neuroendocrine tumors: comparisons with conventional EMR and endoscopic submucosal dissection (with videos)
Dong-Hoon Yang, Yangsoon Park, Sang Hyoung Park, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang
Gastrointestinal Endoscopy.2016; 83(5): 1015. CrossRef
Are Small Rectal Neuroendocrine Tumors Safe?
Jae Ho Choi, Jae Myung Cha
Intestinal Research.2015; 13(2): 103. CrossRef

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Original Article

Patient Descriptions of Rectal Effluents May Help to Predict the Quality of Bowel Preparation With Photographic Examples: Hoonsub So, Sun-Jin Boo, Hyungil Seo, Ho-Su Lee, Hyojeong Lee, Sang Hyoung Park, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim, Seungbong Han, Dong-Hoon Yang; Intest Res 2015;13(2):153-159. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.153

Abstract PDF PubReader

<b>Background/Aims</b><br/>

Previous studies have suggested a weak correlation between self-reported rectal effluent status and bowel preparation quality. We aim to evaluate whether photographic examples of rectal effluents could improve the correlation between patient descriptions of rectal effluents and bowel preparation quality.

Methods

Before colonoscopy, patients were asked to describe the nature of their last three rectal effluents. Photographic examples of rectal effluents were provided as a reference for scoring. Bowel preparation was subsequently assessed by a single endoscopist using a global preparation assessment scale. Preparation outcomes were grouped into two levels (excellent to good vs. fair to inadequate). Both univariate and multivariate logistic regression models were used to find any association between bowel preparation quality and patient characteristics.

Results

A total of 138 patients completed the questionnaires. The mean age was 56.5±10.4 years. The mean sum of the last three rectal effluent scores was 5.9±2.0. Higher rectal effluent scores (odds ratio [OR], 0.82; P=0.043) and the presence of diverticula (OR, 0.16; P<0.001) were risk factors for suboptimal preparation.

Conclusions

Photographic example-guided patient descriptions of rectal effluents showed a statistically significant association with bowel preparation quality. However, clinical significance seemed to be low. The presence of diverticula was an independent predictive factor for suboptimal bowel preparation quality.

Citations

Citations to this article as recorded by

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Diagnostics.2025; 15(13): 1717. CrossRef
Individualized intervention based on a preparation-related prediction model improves adequacy of bowel preparation: A prospective, multi-center, randomized, controlled study
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Digestive and Liver Disease.2024; 56(3): 436. CrossRef
Comparison of Objectively Assessed Versus Patient-Reported Clarity of Last Rectal Effluent for the Prediction of Quality of Bowel Preparation for Colonoscopy: A Prospective, Case-Control Study
Ajay Patwa, Satish Kumar, Deepak Bhagchandani, Amit Kumar, Virendra Atam, Navneet Anil, Priya Mishra, Abhishek Singh, Archana Devi, Ajay K Pal
Cureus.2024;[Epub] CrossRef
Development and validation of a novel scoring system based on a nomogram for predicting inadequate bowel preparation
Xiaxia Zhao, Yanglin Pan, Jinyong Hao, Jie Feng, Zhongyuan Cui, Huimin Ma, Xiaojun Huang
Clinical and Translational Oncology.2024; 26(9): 2262. CrossRef
Patients' Description of Rectal Effluents Help Predict the Quality of Colonoscopy Preparation
Manuel Antonio Lescano Lescano, Rodrigo Strehl Machado, Maria Rachel Rohr, Sender Jankiel Miszputen
Journal of Coloproctology.2024; 44(02): e106. CrossRef
Superiority of a preparation‐related model for predicting inadequate bowel preparation in patients undergoing colonoscopy: A multicenter prospective study
Long Chen, Gui Ren, Hui Luo, Linhui Zhang, Limei Wang, Jianghai Zhao, Rongchun Zhang, Xiaoying Zhang, Xiaoyu Kang, Yanglin Pan
Journal of Gastroenterology and Hepatology.2022; 37(12): 2297. CrossRef
Comparison of bowel-cleansing efficacy of split-dose and same-day dose bowel preparation for afternoon colonoscopy in patients with gastrectomy: a prospective randomized study
Tae-Geun Gweon, Cheal Wung Huh, Jeong Seon Ji, Chang Hyun Kim, Jin-Jo Kim, Seung-Man Park
Surgical Endoscopy.2020; 34(10): 4413. CrossRef
Evaluating the practice of canceling colonoscopies for presumed inadequate bowel preparation
Reid L. Hopkins, David Parsons, Leonie Hoyo, Brian C. Jacobson
Gastrointestinal Endoscopy.2020; 92(2): 382. CrossRef
A Randomized Controlled Trial Comparing Colonoscopic Enema With Additional Oral Preparation as a Salvage for Inadequate Bowel Cleansing Before Colonoscopy
Hyo-Joon Yang, Dong Il Park, Soo-Kyung Park, Sunyong Kim, Taeheon Lee, Yunho Jung, Chang Soo Eun, Dong Soo Han
Journal of Clinical Gastroenterology.2019; 53(8): e308. CrossRef
Comparison of Bowel Cleansing Efficacy, Safety, Bowel Movement Kinetics, and Patient Tolerability of Same-Day and Split-Dose Bowel Preparation Using 4 L of Polyethylene Glycol: A Prospective Randomized Study
Myeongsook Seo, Tae-Geun Gweon, Cheal Wung Huh, Jeong Seon Ji, Hwang Choi
Diseases of the Colon & Rectum.2019; 62(12): 1518. CrossRef
Randomized trial comparing oral sulfate solution with 4‐L polyethylene glycol administered in a split dose as preparation for colonoscopy
Hyo‐Joon Yang, Soo‐Kyung Park, Jee Hyun Kim, Jong Pil Im, Dong Han Yeom, Geom Seog Seo, Dong Il Park
Journal of Gastroenterology and Hepatology.2017; 32(1): 12. CrossRef
Patient Description of Rectal Effluents With Photographic Examples as a Predictive Indicator for the Quality of Bowel Preparation
Hyoun Woo Kang
Intestinal Research.2015; 13(4): 362. CrossRef
Author's Reply
Hoonsub So, Seungbong Han, Dong-Hoon Yang
Intestinal Research.2015; 13(4): 364. CrossRef

42,764 View
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