International Journal of Colorectal Disease (Int J Colorectal Dis Clin Mol Gastroenterol Surg)

Publisher: Springer Verlag

Journal description

The International Journal of Colorectal Disease aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles of high scientific quality reviews will be included and controversial issues from rapidly developing areas in gastroenterology and gastrointestinal surgery addressed. The Journal offers its readers an interdisciplinary forum for clinical science and molecular research related to colorectal disease.

Current impact factor: 2.42

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 2.415
2012 Impact Factor 2.238
2011 Impact Factor 2.385
2010 Impact Factor 2.645
2009 Impact Factor 2.102
2008 Impact Factor 1.767
2007 Impact Factor 1.918
2006 Impact Factor 2.006
2005 Impact Factor 1.749
2004 Impact Factor 1.646
2003 Impact Factor 1.848
2002 Impact Factor 1.902
2001 Impact Factor 1.709
2000 Impact Factor 1.707
1999 Impact Factor 1.184
1998 Impact Factor 1.463
1997 Impact Factor 0.732
1996 Impact Factor 0.812
1995 Impact Factor 0.526
1994 Impact Factor 0.68
1993 Impact Factor 0.794
1992 Impact Factor 0.745

Impact factor over time

Impact factor

Additional details

5-year impact 2.50
Cited half-life 4.90
Immediacy index 0.38
Eigenfactor 0.01
Article influence 0.73
Website International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery website
Other titles International journal of colorectal disease (Online), Colorectal disease
ISSN 1432-1262
OCLC 60637753
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Springer Verlag

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Author's pre-print on pre-print servers such as
    • Author's post-print on author's personal website immediately
    • Author's post-print on any open access repository after 12 months after publication
    • Publisher's version/PDF cannot be used
    • Published source must be acknowledged
    • Must link to publisher version
    • Set phrase to accompany link to published version (see policy)
    • Articles in some journals can be made Open Access on payment of additional charge
  • Classification
    ​ green

Publications in this journal

  • International Journal of Colorectal Disease 07/2015; DOI:10.1007/s00384-015-2297-4
  • International Journal of Colorectal Disease 07/2015; DOI:10.1007/s00384-015-2300-0
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    ABSTRACT: The adoption of the total mesorectum excision technique and circular stapler devices has enabled the performance of ultralow colorectal anastomosis in rectal cancer surgery. However, rupture of the anastomosis still usually leads to a permanent stoma. The aim of this study was to analyze the cumulative failure rate and risk factors associated with reversal of colorectal or coloanal anastomosis after sphincter-saving surgery for rectal cancer, using standardized surgical regimen with the routine use of covering stoma. Our secondary interest was the feasibilities of redo surgery after failure. This was a retrospective study with 579 consecutive rectal cancer patients operated on at Helsinki University Hospital, Helsinki, Finland during 2005-2011. Data were collected from patient records. After exclusions, 273 consecutive patients treated with a low anterior resection with a protective stoma were included. In total, 23 out of 271 (8.5 %) of the colorectal/coloanal anastomoses were converted to a permanent stoma. In five patients (1.8 %), the covering stoma was not closed. The permanent stoma rate was thus 28 out of 271 (10.3 %). The risk factors associated with failure were the tumor distance from the anal verge (p = 0.03), coloanal anastomosis (p = 0.003), early anastomotic complication (p < 0.001), anastomotic fistula (p < 0.001), anal incontinence (p = 0.05), and local recurrence (p < 0.001). Our standardized surgical regimen with a covering stoma in low anterior resection for rectal cancer resulted in a minor anastomosis failure rate and a low risk of permanent stoma.
    International Journal of Colorectal Disease 06/2015; DOI:10.1007/s00384-015-2291-x
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    ABSTRACT: The pelvic pouch procedure (PPP) carries significant post-operative complication risks including a 4-14 % risk of ileo-anal anastomotic (IAA) leak [1-4]. The aim of this study is to evaluate the severity of disease at the distal resection margin as an independent risk factor for an IAA leak following the PPP for patients with ulcerative colitis (UC). A retrospective matched case-control study was undertaken. The distal margin of each subject's specimen was reviewed by a blinded pathologist and the degree of inflammation was scored using a modified histological activity index (mHAI)-a 0 to 5 graded scale with HAI of 5 representing ulcerations >25 % the depth of bowel wall. Forty-nine patients with perioperative IAA leaks (mean 11 days ±0.92) were identified and matched for gender, age and year of surgery. The case cohort had 33 males (67 %) of mean age at time of surgery of 36.3 years (±1.42). The severity of distal inflammation did not increase the risk of IAA leak. The presence of a diverting ileostomy was associated with a decreased incidence of an IAA leak (p = 0.01). Studies with greater power will be required to evaluate the association (if any) between histological severity of UC at the distal margin of a PPP procedure and IAA leak rate. This risk factor could influence preoperative management and post-operative outcome in patients requiring the PPP.
    International Journal of Colorectal Disease 06/2015; DOI:10.1007/s00384-015-2290-y
  • International Journal of Colorectal Disease 06/2015; DOI:10.1007/s00384-015-2287-6
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    ABSTRACT: Adequate postoperative analgesia is essential for recovery following colorectal surgery. Transversus abdominis plane (TAP) blocks have been found to be beneficial in improving pain following a variety of abdominal operations. The objective of this study was to determine if TAP blocks are useful in improving postoperative recovery following laparoscopic colorectal surgery. A prospective double-blind randomized clinical trial, involving 226 consecutive patients having laparoscopic colorectal surgery, was performed by a university colorectal surgical department. Patients were randomized to either TAP blockade using ultrasound guidance, or control, with the primary outcome being postoperative pain, as measured by analgesic consumption. Secondary outcomes assessed were pain visual analogue score (VAS), respiratory function, time to return of gut function, length of hospital stay, postoperative complications, and patient satisfaction. A total of 142 patients were followed up to trial completion (74 controls, 68 interventions). Patients were well matched with regard to demographics. No complications occurred as a result of the intervention of TAP blockade. There was no difference between groups with regards to analgesic consumption (161 mEq morphine control vs 175 mEq morphine TAP; p = 0.596). There was no difference between the two groups with regards to the secondary outcomes of daily VAS, respiratory outcome, time to return of gut function, length of hospital stay, postoperative complications, and patient satisfaction. We conclude that TAP blockade appears to be a safe intervention but confers no specific advantage following laparoscopic colorectal surgery.
    International Journal of Colorectal Disease 06/2015; DOI:10.1007/s00384-015-2286-7
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    ABSTRACT: Factors other than antithrombotic drugs associated with diverticular bleeding remain unknown. Visceral adiposity contributes to atherosclerosis and may affect arteriolar change at the diverticulum. We investigated whether visceral adipose tissue (VAT) measured by computed tomography (CT) is a risk factor for diverticular bleeding. A cohort of 283 patients (184 with asymptomatic diverticulosis and 99 with diverticular bleeding) undergoing colonoscopy and CT was analyzed. Associations between body mass index (BMI), VAT, subcutaneous adipose tissue (SAT), and diverticular bleeding were assessed by logistic regression models adjusted for age, gender, alcohol, smoking, diabetes mellitus, hypertension, dyslipidemia, chronic kidney disease, and antithrombotic drugs (nonsteroidal anti-inflammatory drugs (NSAIDs), low-dose aspirin, and other antiplatelet drugs). In univariate analysis, hypertension, dyslipidemia, chronic kidney disease, and NSAIDs use, low-dose aspirin, non-aspirin antiplatelets, increasing BMI, and increasing VAT area were associated with diverticular bleeding. In multivariate analysis adjusted for confounding factors, VAT area (p = 0.021), but not BMI (p = 0.551) or SAT area (p = 0.635), was positively associated with diverticular bleeding. When BMI was considered simultaneously, VAT area remained positively associated with diverticular bleeding (p = 0.018). However, none of obesity indices including VAT area were associated with recurrence of diverticular bleeding or prolonged hospitalization. This study presents new information on risk factors for diverticular bleeding. A large volume of visceral adipose tissue, but not BMI or SAT, appears to entail a risk for diverticular bleeding, after age, gender, metabolic factors, and antithrombotic drugs use adjustments.
    International Journal of Colorectal Disease 06/2015; DOI:10.1007/s00384-015-2295-6
  • International Journal of Colorectal Disease 06/2015; DOI:10.1007/s00384-015-2285-8
  • International Journal of Colorectal Disease 06/2015; DOI:10.1007/s00384-015-2288-5
  • International Journal of Colorectal Disease 06/2015; DOI:10.1007/s00384-015-2292-9
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    ABSTRACT: Parastomal herniation is reported in up to 50 % of patients with a colostomy. A prophylactic stoma mesh has been reported to reduce parastomal hernia rates. The aim of the study was to evaluate the rate of parastomal hernias in a population-based cohort of patients, operated with and without a prophylactic mesh at two different time periods. All rectal cancer patients operated with an abdominoperineal excision or Hartmann's procedure between 1996 and 2012 were included. From 2007, a prophylactic stoma mesh was placed in the retro-muscular plane. Patients were followed prospectively with clinical and computed tomography examinations. There were no differences with regard to age, gender, pre-operative albumin levels, ASA score, body mass index (BMI), smoking or type of surgical resection between patients with (n = 71) and without a stoma mesh (n = 135). After a minimum follow-up of 1 year, 187 (91 %) of the patients were alive and available for analysis. At clinical and computed tomography examinations, exactly the same parastomal hernia rates were found in the two groups, viz, 25 and 53 %, respectively (p = 0.95 and p = 0.18). The hernia sac contained omentum or intestinal loops in 26 (81 %) versus 26 (60 %) patients with and without a mesh, respectively (p = 0.155). In the multivariate analyses, high BMI was associated with parastomal hernia formation. A prophylactic stoma mesh did not reduce the rate of clinically or computed tomography-verified parastomal hernias. High BMI was associated with an increased risk of parastomal hernia formation regardless of prophylactic stoma mesh.
    International Journal of Colorectal Disease 06/2015; DOI:10.1007/s00384-015-2293-8
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    ABSTRACT: Urinary retention is a common complication of pelvic surgery, leading to urinary tract infection and prolonged hospital stays. Tamsulosin is an alpha blocker that works by relaxing bladder neck muscles. It is used to treat benign prostatic hypertrophy and retention. We aim to investigate the potential benefits of preemptive tamsulosin use on rates of urinary retention in men undergoing pelvic surgery. This is a retrospective review of an institutional colorectal database. All men undergoing pelvic surgery between 2004 and 2013 were included. Patients given 0.4 mg of tamsulosin 3 days prior and after surgery at discretion of surgeon starting in 2007 were compared with patients receiving expectant postoperative management. One hundred eighty-five patients were included in the study (study group: N = 30; control group: N = 155). Study group patients were older (56.8 vs. 50.1 years). Overall urinary retention rate was 22 % with significantly lower rates in the study group compared with control (6.7 vs. 25 %; p = 0.029). Study group had higher rates of minimally invasive surgery (61 vs. 29.7 %); however, this did not impact urinary retention rate (20.6 vs. 22.7 % for minimally invasive surgery vs. open surgery; p = 0.85). Independent predictors of urinary retention included lack of preemptive tamsulosin (odds ratio (OR), 7.67; 95 % confidence interval (CI), 1.4-41.7) and cancer location in the distal third of the rectum (OR, 18.8; 95 % CI, 2.1-172.8). Preemptive perioperative use of tamsulosin may significantly decrease the incidence of urinary retention in men undergoing pelvic surgery. This may play a role in avoidance of urinary retention, particularly in patients with distal rectal cancer.
    International Journal of Colorectal Disease 06/2015; DOI:10.1007/s00384-015-2294-7
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    ABSTRACT: The aim of this study was to compare the clinical effect of graciloplasty using two different gracilis encircled loops for the treatment of fecal incontinence after anoplasty for imperforate anus. From January 2009 to January 2012, 38 patients were treated by graciloplasty. The patients were randomly divided into two groups, one group consisting of 18 cases underwent the "γ-loop" and the other group consisting of 20 cases underwent the "υ-loop." All patients underwent postoperative defecation training and regular follow-up. All patients were evaluated via Wexner score and anal manometry (including anal resting pressure, anal maximal squeeze pressure, duration of anal squeeze, and rectal maximum tolerable volume) before and after graciloplasty. In addition, it was assessed whether the patients had difficulty defecating while squatting after surgery. The surgeries on the 38 patients were accomplished successfully. There were no differences in postoperative complications between the two groups (P > 0.05). The Wexner score and anal manometry parameters of the two groups were gradually improved after operation. The generalized estimating equation results of the Wexner score indicated that the difference of measurement time was statistically significant (P < 0.05) but the difference of measurement group was not statistically significant (P > 0.05). The results of anal manometry parameters using repeated measures ANOVA indicated that differences between different time points were statistically significant (all P < 0.05) but differences between different surgery groups were not statistically significant (all P > 0.05). Regarding the postoperative defecating difficulties while squatting, the probability of occurrence in the "γ-loop" group was significantly higher than that in the "υ-loop" group. The difference between the two groups was statistically significant (P < 0.05). Graciloplasty with different gracilis loops can improve anal function in patients. However, "υ-loop" can significantly improve difficulties in defecating while squatting.
    International Journal of Colorectal Disease 06/2015; DOI:10.1007/s00384-015-2274-y
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    ABSTRACT: Tumor lesions in previously irradiated area may have a less favorable response to chemotherapy compared to tumor sites outside the radiation field. The aim of the present study was to evaluate the response to chemotherapy of locally recurrent rectal cancer (LRRC) within the previous radiation field compared to the response of distant metastases outside the radiation field. All patients with LRRC referred between 2000 and 2012 to our tertiary university hospital were reviewed. The response to chemotherapy of LRRC within previously irradiated area was compared to the response of synchronous distant metastases outside the radiation field according to the Response Evaluation Criteria in Solid Tumors (RECIST). Out of 363 cases with LRRC, 29 previously irradiated patients with distant metastases were treated with chemotherapy and eligible for analysis. Twenty-six patients (89 %) suffered a first recurrence and three patients (11 %) a second recurrence. These patients were followed with a median of 22 months (IQR, 9-40 months) and had a median survival of 33 months (IQR, 14-42). In 23 patients (79 %), the local recurrence showed stable disease, but the overall response rate of the local recurrences in the previously irradiated area was significantly lower than the response rate of distant metastases outside the radiation field (10 vs. 41 %,p = 0.034). Previously irradiated patients with LRRC have a lower response rate to chemotherapy of the local recurrence within the radiation field compared to the response rate of distant metastases outside the radiation field. This suggests that chemotherapy for local palliation may not have the desired effect.
    International Journal of Colorectal Disease 06/2015; DOI:10.1007/s00384-015-2270-2
  • International Journal of Colorectal Disease 06/2015; DOI:10.1007/s00384-015-2281-z
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    ABSTRACT: It is well known that an increased body mass index (BMI) is associated with cancer development. Results from studies on colorectal cancer (CRC) treatment outcome and BMI are however conflicting. Our hypothesis was that a high as well as a low BMI will have negative effects on short-term outcome after CRC surgery. Data from the Swedish Colorectal Cancer Registry from 2007 to 2012 was analyzed. A total of 24,587 patients operated on for CRC were included in the study and divided into one of five categories for BMI. Operative bleeding, operating time, surgical complications, and 30-day mortality were compared between groups. Operative bleeding as well as operating time was significantly increased when comparing normal-weight patients to overweight (p < 0.001). 15.1 % of normal-weight patients suffered from postoperative surgical complications. This was significantly increased with each BMI step but did not affect the 30-day mortality. However, underweight patients, on the other hand, had fewer complications (13.3 %) but an increased 30-day mortality. Longer operating times and increased perioperative bleeding may be explanatory factors behind increased postoperative complication rates for CRC patients with higher BMI. In underweight patients, advanced disease may be a reason for a higher 30-day mortality. To improve outcome, specific precautions are suggested when operating on under- as well as overweight CRC patients. We also suggest that the registry introduces a better marker than BMI for central visceral fat-the link between obesity and cancer development. Further studies are needed to analyze the findings in detail and to study long-term effects.
    International Journal of Colorectal Disease 06/2015; DOI:10.1007/s00384-015-2280-0
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    ABSTRACT: The objectives of this paper were to establish a model for the conversion of laparoscopic rectal resection to open surgery and to predict possible conversion before surgery. The clinical data of 602 cases of laparoscopic rectal resection were retrospectively assessed. Risk factors associated with conversion of laparoscopic rectal resection to open rectal surgery were identified by logistic regression analysis. Also, a scoring system was created to calculate a score for the conversion of laparoscopic rectal resection to predict possible conversion for patients who underwent laparoscopic rectal resection before surgery. A total of 90 patients required conversion (total conversion rate = 14.95 %). The established model included six variables: male gender, surgical experience (≤25 cases), history of abdominal surgery, body mass index ≥ 28, tumor diameter ≥ 6 cm, and tumor invasion or metastasis, for which 6, 4, 5, 10, 15, and 21 points were assigned, respectively. A patient with a total score >14.5 points was considered to have a high probability of conversion, whereas a patient with a total score <14.5 points was considered at a low risk. Preoperative determination of conversion score may predict possible conversion of laparoscopic rectal resection and thus reduce unnecessary open rectal surgery.
    International Journal of Colorectal Disease 06/2015; DOI:10.1007/s00384-015-2275-x
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    ABSTRACT: The aim of this study is to evaluate the effect of neoadjuvant chemoradiotherapy in stage IV rectal cancer. Primary rectal cancer patients with synchronous distant metastases between September 2001 and August 2011 were enrolled. Of 86 patients, 40 patients underwent neoadjuvant chemoradiotherapy (RTX group) and the remaining 46 patients underwent postoperative systemic chemotherapy without radiotherapy (NRTX group). Sharp mesorectal excision according to tumor location was performed. Oncologic outcomes were compared. The lower tumor location was more common in RTX group than NRTX group (60.0 vs. 28.3 %, P = 0.003). Clinical T and N status and American Society of Anesthesiologist (ASA) score were similar in both groups. The incidence of pathologic LN metastases in the NRTX group was 93.5 % compared with 70.0 % in RTX group (P = 0.007). Pattern of distant metastasis was similar between groups. However, metastatectomy was frequently performed in RTX group than NRTX group (57.5 vs. 30.4 %, P = 0.020). There was no statistical difference in local recurrence rate between groups (10.0 % in RTX vs. 15.2 % in NRTX, P = 0.470). The median PFS was similar in both groups (12.00 months in RTX vs. 12.00 months in NRTX, P = 0.768). The median OS between groups was also not different (24.00 months in RTX vs. 27.00 months in NRT, P = 0.510). Neoadjuvant chemoradiotherapy may not affect local control and overall survival in locally advanced rectal cancer with distant metastasis.
    International Journal of Colorectal Disease 06/2015; DOI:10.1007/s00384-015-2272-0