Li-Jen Kuo

Li-Jen Kuo
Taipei Medical University Hospital | TMUH · Division of Colorectal Surgery

MD

About

68
Publications
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2,844
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Introduction
Robotic colorectal surgery Sphincter-saving rectal surgery Transanal minimally invasive surgery (TAMIS) Transanal total mesorectal excision (taTME)

Publications

Publications (68)
Article
Background: Streptococcal toxic-shock syndrome after hemorrhoidectomy is rare but may be catastrophic. Group A streptococci have produced various surface proteins and exotoxins due to genetic changes to fight the human body's immune response. Though life threatening infection after hemorrhoidectomy rarely occurs, all surgeons should be aware of th...
Article
Background The purpose of this study was to investigate the prevalence of ypN+ status according to ypT category in patients with locally advanced rectal cancer treated with chemoradiotherapy and total mesorectal excision, and to assess the impact of ypN+ on disease recurrence and survival by pooled analysis of individual-patient data. Methods Indi...
Article
Background: The aim of this study was to evaluate the impact of surgeons' learning curve in robotic surgery for rectal cancer on circumferential resection margin (CRM) involvement and reoperation rates. Methods: Learning curve data were prospectively collected from four centers. Patients undergoing robotic proctectomy for resectable rectal cancer w...
Article
Background: This systematic review sought to compare the urogenital functions after laparoscopic (LAP) and robotic (ROB) surgery for rectal cancer. Methods: This study conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Twenty-six studies (n = 2709 for ROB, n = 2720 for LAP) were included. T...
Article
Robotic‐assisted surgery (RAS) is growing in prevalence and is generally perceived as a safe procedure in managing colorectal lesions. However, as its use has increased, the RAS related‐complications have also risen. This video demonstrates our experience of surgical‐related complications during RAS. Between December 2011 and June 2019, 400 robotic...
Article
Full-text available
As the global population ages, the number of geriatric patients requiring surgery for colon cancer would inevitably increase. Radical oncological surgery in the elderly colorectal cancer patient has been recognized to be associated with a higher rate of postoperative complications and mortality compared to the young. While less aggressive managemen...
Article
Background Ergonomics, as defined by the optimization of one's physical environment to enhance work performance, is an important consideration in surgery. While there have been reviews on the ergonomics of laparoscopy, this has not been the case for robotic surgery despite the rising number of publications. Methods This study was performed in acco...
Article
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Background A beneficial impact of robotic proctectomy on circumferential resection margin (CRM) is expected due to the robot's articulating instruments in the pelvis. There are however concerns about a negative impact on the quality of total mesorectal excision (TME) due to the lack of tactile feedback. The aim of this study was to assess whether s...
Preprint
Full-text available
Background: Studies reporting the results of associated factors of pathological completed response (PCR) and tumor regression response in patients with rectal cancer following neoadjuvant chemoradiation therapy (nCRT) are inconsistent. Objective: The purpose of this study was to identify the prognostic factors of tumor response and outcome in recta...
Article
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We aimed to use hand dexterity and grip strength test as objective measures to compare the difference in surgeon fatigue associated with robotic and laparoscopic colorectal surgery. We used the Purdue Pegboard Test to assess hand dexterity and the Camry Electronic Handgrip Dynamometer to assess hand grip strength. Eighteen patients were operated on...
Article
The liver is the most common anatomical site for hematogenous metastases from colorectal cancer. Therefore effective treatment of liver metastases is one of the most challenging elements in the management of colorectal cancer. However, there is rare available clinical consensus or guideline only focusing on colorectal liver metastases. After six ro...
Article
Background. Transanal minimally invasive surgery (TAMIS) was developed as a less aggressive alternative treatment for rectal lesions. The purpose of this study was to report the results of robotic TAMIS for such patients. Methods. Patients eligible for TAMIS were operated on using the da Vinci robotic surgical system and GelPOINT Path Transanal Acc...
Article
Full-text available
Background Robotic surgery (RS) may overcome the limitations of laparoscopic colorectal surgeries (LS) in obese patients, but remains less well studied. This systematic review and meta-analysis aims to evaluate the outcomes of obese patients who have undergone robotic colorectal surgery. Methods This study was performed according to the PRISMA gui...
Preprint
Background Studies reporting the results of associated factors of pathological completed response (PCR) and tumor regression response in patients with rectal cancer following neoadjuvant chemoradiation therapy (nCRT) are inconsistent. The purpose of this study was to identify the prognostic factors of tumor response and outcome in rectal cancer pat...
Preprint
Background: Minimally-invasive surgery has been shown to more demanding on the surgeon than open surgery. This can be manifested as physical fatigue and impaired dexterity, affecting the performance of the surgeon. In this study, we aimed to use hand dexterity and grip strength test as objective measures to compare the difference in surgeon fatigue...
Article
Introduction: Although the process of learning robotic surgery for rectal cancer is associated with a prolonged operating time and higher complication rates, its impact on histopathologic outcomes is unknown. The aim of this meta-analysis was to evaluate the impact of the learning curve in robotic surgery for rectal cancer on histopathologic outco...
Article
Full-text available
In recent years, natural orifice specimen extraction surgery (NOSES) in the treatment of colorectal cancer has attracted widespread attention. The potential benefits of NOSES including reduction in postoperative pain and wound complications, less use of postoperative analgesic, faster recovery of bowel function, shorter length of hospital stay, bet...
Article
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Context: Taiwanofungus camphoratus is a parasitic mushroom found in the heartwood of Cinnamomum kanehirai and is used as a nutritional supplement. It has an anticancer action, both alone and synergistically with amphotericin B (AmB). Objective: The study intended to assess the efficacy of a T camphoratus ethanol extract (TCEE) combined with AmB...
Article
Neuroendocrine tumors (NETs) are neoplasms that arise from the enterochromaffin cells of the endocrine or nervous system. NETs can develop in many different areas of the body, and are most often located in the gastrointestinal (GI) tract. The standard treatment for rectal NETs is complete tumor resection. This case report describes afull thickness...
Article
Full-text available
Transanal total mesorectal excision (taTME) has been proposed to overcome the limitations of laparoscopic TME. The robotic surgical platform has already established its benefits in providing superior ergonomics, and the purported advantages of taTME may play less important a role in the era of robots.
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Background: Robotic intersphincteric resection (ISR) has been introduced for sphincter-preservation in the treatment of low rectal cancer. However, many patients experience anorectal symptoms and defecatory dysfunction after ISR. This study aims to evaluate the?anorectal complications that develop?after ISR. Methods: The medical records of 108 p...
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Pancreatic cancer remains the fourth leading cause of cancer-related death in the USA with a 5-year survival rate of 5 %. The effects of epidermal growth factor receptor and vascular endothelial growth factor A blockade with chemotherapy on pancreatic tumor growth were examined. Mice bearing human PANC-1 cell xenografts were divided into three grou...
Article
Full-text available
Objective Robot-assisted rectal surgery is gaining popularity, and robotic single-site surgery is also being explored clinically. We report our initial experience with robotic transanal total mesorectal excision (R-taTME) and radical proctectomy using the robotic single-site plus one-port (R-SSPO) technique for low rectal surgery. Methods Between J...
Article
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Background and aims: Contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) are used to assess the response of hepatocellular carcinoma after transarterial chemoembolization. Our aim was to perform a systematic review to compare CEUS and CECT for therapeutic response assessment to transarterial chemoembolization in th...
Article
No instrument is available to assess the impact of faecal incontinence (FI) of quality of life for Chinese-speaking population. The purpose of the study was to adapt the Faecal Incontinence Quality of Life Scale (FIQL) for patients with colorectal cancer, assess the factor structure and reduce the items for brevity. A sample of 120 participants wer...
Article
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The objective of this study is to evaluate the efficacy and safety profiles of the targeted medications, bevacizumab and cetuximab, in combination with cytostatic drugs in patients with locally advanced or metastatic pancreatic cancer. In this retrospective phase 2 study, a total of 59 patients with pancreatic cancer were recruited and received con...
Article
Background Rectal submucosal tumours are rare. The purpose of this study was to evaluate the safety and feasibility of robot-assisted rectal surgery.Methods Patients who received robot-assisted intersphincteric resection (ISR) were included in the present study. Clinical outcomes, operating time, length of hospital stay and pathological status were...
Article
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This study aims to assess the efficacy and benefits of pelvic rehabilitation programs in terms of functional outcomes and quality of life for patients with fecal incontinence and defecation disorders after rectal cancer surgery. This was a prospective, observational study. Data included in this study were collected at a single institution. Patients...
Article
Glucose-regulated protein 78 (GRP78) is a key modulator of prostate cancer progression and therapeutic resistance. Prostate cancer is a worldwide health problem, and therapeutic resistance is a critical obstacle for the treatment of hormone-refractory prostate cancer patients. Shikonin inhibits prostate cancer proliferation and metastasis. However,...
Article
Full-text available
Recent literature suggests that the benefit of adjuvant chemotherapy (aCT) for rectal cancer patients might depend on the response to neoadjuvant chemoradiation (CRT). Aim was to evaluate whether the effect of aCT in rectal cancer is modified by response to CRT and to identify which patients benefit from aCT after CRT, by means of a pooled analysis...
Article
Full-text available
This study evaluated the feasibility of robot-assisted intersphincteric resection (ISR) for low rectal cancer. Further, we attempted to analyze the learning curve for robotic surgery. A total of 64 patients were retrospectively chart-reviewed. Patients were classified into a laparoscopic procedure (n = 28) group and a robot-assisted (n = 36) group....
Article
Background: Up to 20% of colorectal cancer (CRC) is diagnosed with distant metastasis. The combination of chemotherapy with anti-vascular endothelial growth factor (VEGF) antibody can improve patient survival. Glucose-regulated protein 78 (GRP78) has an important role in cancer progression, but little is known about its role in VEGF production in...
Article
Background: Laparoscopic total extraperitoneal (TEP) inguinal hernioplasty is significantly less painful than open repair, but it is not completely painless. Local anesthetics are thought to decrease postoperative pain when placed at the surgical site. We conducted a systematic review of randomized controlled trials (RCTs) to evaluate the efficacy...
Article
Background: Laparoscopic rectal cancer surgery is regarded as more complex because of its technical difficulties in pelvic exposure, dissection, and sphincter preservation. This study therefore aimed to investigate the feasibility of laparoscopic resection for low rectal cancer using intersphincteric resection (ISR) and to assess its short-term on...
Article
Bevacizumab is a monoclonal antibody that prevents angiogenesis by inhibiting vascular endothelial growth factor (VEGF) activity. Clinically, it has been used to treat a diverse range of cancer types. In this pilot phase II study, we investigated the efficacy and safety profiles of bevacizumab in combination with docetaxel plus cisplatin for patien...
Article
Purpose: It remains unclear whether perianal abscess is a prediabetes condition or the initial presentation of type 2 diabetes. Using a population-based dataset, this study aimed to explore the risk of type 2 diabetes following perianal abscess. Methods: We used data sourced from the Longitudinal Health Insurance Database 2000. In total, there w...
Article
Survivin is a potential therapeutic target for cancer. Increased survivin expression promotes cell survival and therapeutic resistance. However, there is little information regarding whether the expression level of survivin affects curcumin treatment in hepatocellular carcinoma (HCC). Survivin expression was suppressed in HCC cells using a short in...
Article
Chronic groin pain after inguinal hernia repair, a serious problem, is caused by entrapment of the ilioinguinal nerve either by mesh or development of fibrosis. Division of the ilioinguinal nerve during hernioplasty has been found to reduce the incidence of chronic groin pain. However, the traditional approach favors preservation of the ilioinguina...
Article
Full-text available
Survivin is an antiapoptotic molecule that is widely expressed in cancers, including hepatocellular carcinoma (HCC). Survivin has become a general therapeutic target for cancers because of its selective overexpression in a majority of tumors. However, little is known regarding the effect of survivin expression in combination with gemcitabine on HCC...
Article
Background/Purpose: Neoadjuvant chemoradiation is considered to be the treatment of choice for locally advanced rectal cancer. However, patient-oriented outcomes and postoperative quality of life are unsatisfactory. In this study, we analyze histopathologic changes in the sphincter apparatus in patients who received abdominoperineal resection with...
Article
Full-text available
Pathologic complete response has been proven to have oncological benefits for locally advanced rectal cancer treated with chemoradiation therapy. The aims of this study are to analyze and determine the factors to predict pathologic complete response for patients treated with preoperative neoadjuvant therapy. Patients with biopsy-proven, locally adv...
Article
In this study, we intended to dissect the mechanism of 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)-enhanced migration of gastric cancer. Smoking has been defined as a risk factor for gastric cancer. Tobacco-specific carcinogen, NNK, was reported to enhance cancer progression in gastric cancer. Currently, metastasis is the major issue for c...
Article
Glucose-regulated protein 78 (GRP78) plays an important role in embryonic development and cancer progression. However, there is little information regarding the regulation of GRP78 in hepatocellular carcinoma (HCC) metastasis. We used RNA silencing and cDNA expression vectors to manipulate target gene expression in HCC cells. The transwell migratio...
Article
The intersphincteric resection technique has been used to extend the opportunity for sphincter preservation in patients with very low rectal cancer. The aim of this study is to assess the long-term oncological and functional outcomes of intersphincteric resection. Patients with extraperitoneal rectal cancer were treated and retrospectively chart re...
Article
Long-term cigarette smoking increases the risk of colorectal cancer mortality. Tobacco's addictive toxin, nicotine, was reported to increase DNA synthesis of colon cancer cells. Because metastasis is the major cause of cancer death, the influence of nicotine on the migration of colon cancer cells remains to be determined. The influence of nicotine...
Article
Survivin has multiple functions during the progression of cancer. However, the role of survivin in the progression and metastasis of hepatocellular carcinoma (HCC) remains unknown. Survivin expression in HCC cells (Mahlavu and Hep3B) was assessed using reverse transcription real-time PCR and Western blot analyses. In addition, survivin expression i...
Article
361 Background: Neoadjuvant chemoradiation (CRT) for rectal cancer increasingly results in pathologic response. It has been suggested that patients with different degrees of response might not have the same benefit of adjuvant chemotherapy. The aim was to determine whether patients with a pathologic complete response (pCR), ypT1-2 or ypT3-4 tumor a...
Article
The objective was to study the mechanism of nicotine-enhanced migration of gastric cancer cells. Long-term cigarette smoking increases the risk of gastric cancer mortality. Tobacco-specific mitogen, nicotine, was reported to correlate with cancer progression on gastric cancer. Since metastasis is the major cause of cancer death, the influence of ni...
Article
Glucose-regulated protein 78 (GRP78) plays an important role in the therapeutic treatment and progression of cancer. However, little is known about the effect of GRP78 expression to curcumin in hepatocellular carcinoma (HCC). In this study, we generated GRP78 knockdown cells (GRP78KD) by a short interfering RNA (siRNA) technique. The antiproliferat...
Article
Parastomal hernia is a major complication after stoma placement. Surgical procedures for repairing parastomal hernia are difficult and their failure rate is high. The use of a mesh implanted at the primary operation has shown promising results. Therefore, we performed a systematic review of the literature to evaluate the results of the placement of...
Article
Locally advanced rectal cancer is usually treated with preoperative chemoradiation. After chemoradiation and surgery, 15-27% of the patients have no residual viable tumour at pathological examination, a pathological complete response (pCR). This study established whether patients with pCR have better long-term outcome than do those without pCR. In...
Article
Neoadjuvant chemoradiation therapy has improved the local control rate and overall survival in locally advanced rectal cancers. The purpose of this retrospective study is to evaluate the correlation between the final pathologic stage and survival in these patients. Patients with biopsy-proven rectal carcinoma, pretreatment staging by magnetic reson...
Article
Full-text available
Endometriosis is often seen in gynecology practice and is treated medically. However, intestinal involvement of endometriosis causing obstruction is relatively uncommon and is hard to differentiate from malignancy before surgery. Herein, we present a case of acute colonic obstruction caused by rectal endometriosis. Repeat colonoscopic biopsy and im...
Article
Neoadjuvant concomitant chemoradiotherapy has been used in cases of locally advanced rectal cancer to preserve sphincter function, decrease local recurrence, and improve survival. Preoperative staging is essential for planning and providing optimal therapy. The purpose of this study is to determine the accuracy of staging with magnetic resonance im...
Article
Full-text available
Postoperative femoral neuropathy is an uncommon complication occurring after pelvic surgery. Inappropriate stretching and prolonged compression of the nerve are 2 major mechanisms of the neuropathy. Here we report 2 cases of femoral neuropathy immediately following pelvic surgery. Both cases had neither previous vascular nor peripheral nerve diseas...
Article
The prognosis for metastatic colorectal cancer is grave. Whether to perform surgical resection or palliative treatment remains controversial for this advanced disease. In this retrospective study, we collected data from patients with Stage IV colorectal cancer to identify prognostic factors for predicting selection criteria for surgical treatment i...
Article
Angiomyolipoma of the colon is very rare. Only three cases have been reported in the literature. Here we report the case of a 54-year-old male, who presented with a progressive abdominal cramping pain. We performed left hemicolectomy under the impression of a cancerous mass over the splenic flexure of the colon. Histology revealed an angiomyolipoma...
Article
: Angiomyolipoma of the colon is very rare. Only three cases have been reported in the literature. Here we report the case of a 54-year-old male, who presented with a progressive abdominal cramping pain. We performed left hemicolectomy under the impression of a cancerous mass over the splenic flexure of the colon. Histology revealed an angiomyolipo...
Article
Approximately 20% of patients with colorectal carcinoma are iniatally seen with stage IV of the disease. Here, we report a 45-year old female patient with synchronous sigmoid colon cancer and multiple liver metastases. She underwent a palliative anterior resection and hepatic arterial infusion pump implantation. Left lower leg swelling developed fo...

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