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Clinics in Colon and Rectal Surgery

journal
https://www.readbyqxmd.com/read/29200980/locally-advanced-disease-and-pelvic-exenterations
#1
REVIEW
Christos Kontovounisios, Paris Tekkis
Advanced primary and recurrent colorectal cancer can be successfully treated by experienced, dedicated centers delivering good outcomes with low mortality and morbidity. Development and implementation of a comprehensive referral pathway is to be encouraged. Multidisciplinary team management is essential in the management of this complex group of patients and is associated with significantly more complete preoperative evaluation and more accurate provision of patient information, as well as improved access to the most appropriate individualized management plan...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184477/molecular-biology-are-we-getting-any-closer-to-providing-clinically-useful-information
#2
REVIEW
Georgios Karagkounis, Matthew F Kalady
Advances in molecular biology and biomarker research have significantly impacted our understanding and treatment of multiple solid malignancies. In rectal cancer, where neoadjuvant chemoradiation is widely used for locally advanced disease, most efforts have focused on the identification of predictors of response in an attempt to appropriately select patients for multimodality therapy. A variety of biomarkers have been studied, including genetic mutations, chromosomal copy number alterations, and single as well as multigene expression patterns...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184476/organ-preserving-strategies-for-the-management-of-near-complete-responses-in-rectal-cancer-after-neoadjuvant-chemoradiation
#3
REVIEW
Patricio B Lynn, Paul Strombom, Julio Garcia-Aguilar
In recent years, organ preservation has been considered a feasible alternative to total mesorectal excision for patients with locally advanced rectal cancer with a clinical complete response to neoadjuvant therapy. However, the degree of tumor response to neoadjuvant therapy is variable. A fraction of the patients who did not achieve a complete response had grossly visible tumors. These patients, with clearly incomplete clinical response, need a total mesorectal excision. In addition, some patients with a significant tumor response still have some abnormalities in the bowel wall, such as superficial ulceration or tissue nodularity, which, while not conclusive for the presence of a tumor, are indicative of the possibility of a residual tumor in the bowel wall or in mesorectal lymph nodes...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184475/management-of-the-complete-clinical-response
#4
REVIEW
Angelita Habr-Gama, Guilherme Pagin São Julião, Bruna Borba Vailati, Ivana Castro, Debora Raffaele
Organ preservation is considered in the management of selected patients with rectal cancer. Complete clinical response observed after neoadjuvant chemoradiation for rectal cancer is one of these cases. Patients who present complete clinical response are candidates to the watch-and-wait approach, when radical surgery is not immediately performed and is offered only to patients in the event of a local relapse. These patients are included in a strict follow-up, and up of 70% of them will never be operated during the follow-up...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184474/neoadjuvant-strategies-locally-advanced-rectal-cancer
#5
REVIEW
Shahab Ahmed, Cathy Eng
Colorectal cancer is one of the major leading causes of death in both men and women. The successful management of colon or rectal cancer demands a multidisciplinary approach. In the last few years, significant improvement has been noticed in the management of localized rectal cancer to reduce local recurrence and obtain complete pathological response following appropriate surgical steps, if necessary. Implementation of neoadjuvant therapy not only enhances disease control, it may also ensure sphincter preserving procedures or organ-preserving options...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184473/neoadjuvant-treatment-strategies-advanced-radiation-alternatives
#6
REVIEW
Bruce D Minsky
Long-course chemoradiation therapy (CRT) has been the standard approach for locally advanced rectal tumors. Neoadjuvant CRT is associated to improved local disease control, with less toxicity when compared with adjuvant CRT, as well as the chance for pathologic complete response. The CRT regimens have improved over the past years. This article will examine selected controversies, including novel chemoradiation regimens, duration of radiation (short vs. long course), and radiation techniques such as intensity-modulated radiation therapy (IMRT)...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184472/intersphincteric-resection-pushing-the-envelope-for-sphincter-preservation
#7
REVIEW
Quentin Denost, Eric Rullier
During the last 15 years, a significant evolution has emerged in the surgical treatment of rectal cancer and restoration of bowel continuity has been one of the main goals. For many years the treatment of distal rectal cancer would necessarily require an abdominoperineal resection and end colostomy. The surgical procedure of intersphincteric resection has been proposed to offer sphincter preservation in patients with low rectal cancer and has been legitimized if executed according to adequate oncologic criteria...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184471/abdominoperineal-excision-technical-challenges-in-optimal-surgical-and-oncological-outcomes-after-abdominoperineal-excision-for-rectal-cancer
#8
REVIEW
Torbjörn Holm
Treatment results in rectal cancer have improved significantly during the recent two decades, but local control and survival after abdominoperineal excision (APE) have not improved to the same degree as that seen after anterior resection (AR). The reason for this is an increased risk of inadvertent bowel perforations and tumor involved margins after APE as compared with AR. The conventional synchronous combined APE has not been a standardized procedure and consequently oncological outcomes have varied considerably between different institutions and in different reports...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184470/is-there-any-reason-to-still-consider-lateral-lymph-node-dissection-in-rectal-cancer-rationale-and-technique
#9
REVIEW
Miranda Kusters, Keisuke Uehara, Cornelis J H van de Velde, Yoshihiro Moriya
Nodal dissemination in locally advanced rectal cancer occurs mainly in two directions: upward and lateral. Lateral node involvement has been demonstrated; however, lateral lymph node dissection (LLND) is not routinely performed in Western countries and the focus is more on neoadjuvant treatment regimens. The main reasons for this are the high morbidity associated with the operation and the uncertain oncological benefit. There is, however, recent evidence that in selected cases, neoadjuvant treatment combined with total mesorectal excision only might not be sufficient...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184469/transanal-total-mesorectal-excision-why-when-and-how
#10
REVIEW
Marta Penna, Christopher Cunningham, Roel Hompes
Transanal total mesorectal excision (taTME) has evolved over the past decade fueled by advances in minimally invasive surgery. The technique aims to overcome the constraints posed by a narrow rigid pelvis and poor TME visualization that are encountered during "top-down" rectal surgery. A more accurate pelvic dissection should subsequently result in safer oncological resections and better preservation of pelvic autonomic nerves. taTME is an advanced complex technique that requires dedicated training and experience in TME surgery...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184468/is-there-any-reason-not-to-perform-standard-laparoscopic-total-mesorectal-excision
#11
REVIEW
Zaher Lakkis, Yves Panis
The curative treatment of locally advanced rectal cancer is currently based on chemoradiotherapy and total mesorectal excision (TME). Laparoscopy has developed considerably because of obvious clinical benefits such as reduced pain and shorter hospital stay. Recently, several prospective randomized clinical trials with long-term follow-up have showed that laparoscopy is noninferior to laparotomy with the same oncologic outcomes in terms of survival and local control rate. However, laparoscopic TME remains a challenging procedure requiring a high level of expertise and a long learning curve to ensure an adequate and safe resection...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184467/the-perfect-total-mesorectal-excision-obviates-the-need-for-anything-else-in-the-management-of-most-rectal-cancers
#12
REVIEW
Richard John Heald, Ines Santiago, Oriol Pares, Carlos Carvalho, Nuno Figueiredo
This article discusses the local control of primary rectal cancer and its locoregional spread in the light of modern advances. In recent years, the use of neoadjuvant chemoradiation has spread widely. However, its true benefit is not always balanced with its morbidities. Often total mesorectal excision (TME) is the best option. We will discuss the indications for immediate surgery for chemoradiation in advance and the importance of a delay in the management plan. To understand this selection, it is mandatory to know the true extent of tissue at risk for tumor dissemination and spread...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184466/local-excision-and-endoscopic-resections-for-early-rectal-cancer
#13
REVIEW
Guilherme Pagin São Julião, Juan Pablo Celentano, Flavia Andrea Alexandre, Bruna Borba Vailati
Radical surgery is considered as the standard treatment for rectal cancer. Transanal local excision has been considered an interesting alternative for the management of selected patients with rectal cancers for many decades. Different approaches had been considered for local excision, from endoscopic submucosal dissection to resections using platforms, such as transanal endoscopic microsurgery or transanal minimally invasive surgery. Identifying the ideal candidate for this approach is crucial, as a local failure after local excision is associated with poor outcomes, even for an initial early rectal tumor...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184465/how-should-imaging-direct-orient-management-of-rectal-cancer
#14
REVIEW
Jemma Bhoday, Svetlana Balyasnikova, Anita Wale, Gina Brown
Modern rectal cancer management is dependent on preoperative staging, and radiological assessment is a crucial part of this process. Imaging must provide sufficient information to guide preoperative decision-making that is reliable and reproducible. Different methods have been used for local staging; however, magnetic resonance imaging (MRI) has shown to be the most reliable tool for this purpose. MRI offers prognostic information about the patients and guides the decision between neoadjuvant treatment and total mesorectal excision alone...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184464/new-horizons-in-rectal-cancer-management-in-colon-and-rectal-surgery
#15
Robert D Madoff
No abstract text is available yet for this article.
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184463/new-horizons-in-rectal-cancer-management
#16
Rodrigo Oliva Perez
No abstract text is available yet for this article.
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29184462/rodrigo-oliva-perez-md-phd
#17
Scott R Steele
No abstract text is available yet for this article.
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28924403/the-bigger-picture-picking-the-right-soap-box-is-it-possible-to-connect-with-different-audience-targets-practitioners-and-patients-from-the-same-platform
#18
REVIEW
Mohammed Ali A Abbass, Hari B Keshava, Conor P Delaney
The use of Internet and social media has skyrocketed in the past decade. It did not take long until physicians realized that they could use social media as a tool for communication with patients and colleagues. Since then use of social media has exploded and the information that has become available for physicians and their patients is remarkable. In addition, because of the immediacy of the platform, messages that are incorrect or not desired can be rapidly promoted, whether deliberately or accidentally. To obtain the best use of social media, the right platform should be chosen, and this varies depending on the group one is trying to reach, and the message or visibility desired...
September 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28924402/breaking-international-barriers-colorectalsurgery-is-globalsurgery
#19
REVIEW
Julio Mayol, Jaime Otero
Colorectal surgeons have lagged behind other professionals in the use of social media. Currently, Twitter is the most widely utilized social platform for professional purposes among them. Connection and contagion are the two key actions that, together with immediate feedback and quantifiable impact, favor the use of Twitter over other social networks. In early 2016, a group of colorectal surgeons launched the #colorectalsurgery hashtag and, in less than 1 year, the ecosystem has incorporated over 2,600 users that generated over 24,000 tweets and 100 million impressions...
September 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28924401/the-trump-effect-with-no-peer-review-how-do-we-know-what-to-really-believe-on-social-media
#20
REVIEW
Justin T Brady, Molly E Kelly, Sharon L Stein
Social media is a source of news and information for an increasing portion of the general public and physicians. The recent political election was a vivid example of how social media can be used for the rapid spread of "fake news" and that posts on social media are not subject to fact-checking or editorial review. The medical field is susceptible to propagation of misinformation, with poor differentiation between authenticated and erroneous information. Due to the presence of social "bubbles," surgeons may not be aware of the misinformation that patients are reading, and thus, it may be difficult to counteract the false information that is seen by the general public...
September 2017: Clinics in Colon and Rectal Surgery
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