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Abdominoperineal resection

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https://www.readbyqxmd.com/read/29027023/how-we-do-it-repair-of-large-perineal-hernia-after-abdominoperineal-resection
#1
J Li, W Zhang
BACKGROUND: Symptomatic perineal hernia is a rare complication after abdominoperineal resection (APR). Management of these hernias is challenging. The recurrence rate after surgical repair is high because of the difficulty of prosthetic material fixation; there is no consensus regarding the best method of repair. METHODS: We introduced a novel combined laparoscopic-perineal dual fixation technique in the repair of perineal hernias after APR. This technique begins with a perineal approach under laparoscopic vision...
October 12, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29023631/population-based-study-of-factors-predicting-treatment-intention-in-patients-with-locally-recurrent-rectal-cancer
#2
K Westberg, G Palmer, F Hjern, C Nordenvall, H Johansson, T Holm, A Martling
BACKGROUND: Local recurrence of rectal cancer (LRRC) is associated with poor survival unless curative treatment is performed. The aim of this study was to investigate predictive factors for treatment with curative intent in patients with LRRC. METHODS: Population-based data for patients treated for primary rectal cancer between 1995 and 2002, and with LRRC reported as first event were collected from the Swedish Colorectal Cancer Registry and medical records. The associations between patient-, primary tumour- and LRRC-related factors and intention of the treatment for LRRC were determined...
October 12, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/29022795/local-recurrence-after-standard-abdominoperineal-resection-do-we-really-need-elape
#3
A Xanthis, D Greenberg, B Jha, O Olafimihan, R Miller, N Fearnhead, J Davies, N Hall
Introduction Low rectal cancers requiring abdominoperineal resection tend to have a worse prognosis than higher tumours, which may be treated by anterior resection. One of the reasons for this may be inadequate local surgery, in particular the narrow waist of the resection specimen of a standard abdominoperineal resection may be associated with a high positive circumferential resection margin. The extralevator abdominoperineal excision (ELAPE) aims to improve the R0 resection rate but carries significant morbidity...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29022779/short-term-surgical-outcomes-and-patient-quality-of-life-between-robotic-and-laparoscopic-extralevator-abdominoperineal-excision-for-adenocarcinoma-of-the-rectum
#4
D Kamali, A Reddy, S Imam, K Omar, A Jha, M Jha
Introduction Some studies advocate a laparoscopic extralevator abdominoperineal excision (l-ELAPE) approach for low rectal cancer. The da Vinci™ robot (r-ELAPE) technique has potential to overcome some limitations of l-ELAPE, such as reduction of the learning curve and more precise tissue handling. It is unknown whether this approach results in improved surgical or quality of life outcomes compared with l-ELAPE. This study aimed to address this issue. Methods Consecutive patients having undergone either robotic or laparoscopic ELAPE for adenocarcinoma were studied...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28982899/transanal-assisted-resection-with-closure-of-anal-canal-for-lower-rectal-diseases
#5
Hidejiro Kawahara, Tadashi Akiba, Katsuhiko Yanaga
BACKGROUND/AIM: Abdominoperineal resection (APR) has been performed for lower rectal cancer, anal cancer and inflammatory diseases, but is associated with postoperative complications such as inflammation of pelvic dead space or perineal wound infection. We are performing a novel procedure (transanal assisted resection with closure of anal canal, TARC) that resects the intestine by using transanal assist and close the anal canal for patients who do not require resection of the anus and anal canal...
October 2017: Anticancer Research
https://www.readbyqxmd.com/read/28976805/single-port-and-conventional-laparoscopy-in-colorectal-surgery-comparison-of-two-techniques
#6
Udit Gibor, Zvi Perry, Sergey Domchik, Solly Mizrahi, Boris Kirshtein
BACKGROUND: Single-incision laparoscopic surgery (SILS) was introduced to further the enhanced outcome of conventional multiport laparoscopy (CML). We compared their short- and long-term outcomes in colorectal surgery. MATERIALS AND METHODS: Retrospective review of patients who underwent elective laparoscopic colorectal surgery during 3-year period. Patients' data, surgery outcomes, and oncological results were compared. RESULTS: Sixty-one patients (33 male, 28 female), mean age 67...
October 4, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28959428/coincidence-or-not-a-rare-case-of-rectal-leiomyosarcoma-amidst-incidental-findings-of-anal-squamous-cell-carcinoma-case-presentation-and-literature-review
#7
Gosta Iwasiuk, Jason Nealy
Leiomyosarcoma accounts for only a small percentage of colorectal malignancies and remains a difficult disease to diagnose and treat. Here, we describe a case of leiomyosarcoma in a middle-age female first identified on colonoscopy. The cancer had invaded the posterior vaginal wall necessitating an abdominoperineal resection with partial vaginectomy and pelvic floor reconstruction with neovagina creation. Final pathologic analysis revealed invasion into the posterior vaginal wall without direct involvement of the vaginal squamous mucosa...
September 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28948124/synchronous-sigmoid-colon-cancer-seeding-a-fistula-in-ano
#8
George E Fowler, Christopher J Young
A seeded fistula-in-ano from a synchronous sigmoid colon cancer is rare. The literature is still divided regarding the standard treatment, although an abdominoperineal resection is considered the best option when curative resection is possible. This case is distinct from previous reports, as the patient had known metastatic liver disease before surgery, and proceeded with a pan-proctocolectomy after neo-adjuvant chemotherapy. The patient died 20 months post-operatively of his metastatic liver disease, having been otherwise asymptomatic for eight months on continued chemotherapy, before commencing palliative treatment (completed five cycles)...
July 23, 2017: Curēus
https://www.readbyqxmd.com/read/28935274/a-matter-of-margins-surgical-and-pathologic-risk-factors-for-recurrence-in-extramammary-paget-s-disease
#9
Beverly Long, Adam R Schmitt, Amy L Weaver, Michaela McGree, Jamie N Bakkum-Gamez, Jerry Brewer, William A Cliby
OBJECTIVES: To determine surgical and pathologic variables associated with recurrence in extramammary Paget's disease (EMPD). METHODS: Medical records of patients seeking care for EMPD from 1/1992-9/2015 were reviewed. Follow-up was restricted to 5years following primary surgery. Recurrence-free survival (RFS) was estimated using the Kaplan-Meier method. Risk factors were evaluated for an association with recurrence and positive margins, respectively, using Cox proportional hazards regression and logistic regression...
September 18, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28929316/mucinous-adenocarcinoma-on-perianal-fistula-a-rising-entity
#10
C J Alvarez-Laso, S Moral, D Rodríguez, A Carrocera, E Azcano, A Cabrera, R Rodríguez
INTRODUCTION: Mucinous adenocarcinoma on perianal fistula is a rare entity; it could be underdiagnosed because it behaves often as a regular perianal fistula. MATERIALS AND METHODS: We have recently treated four cases in our unit. We present them and review the literature, emphasizing on clinical characteristic and therapeutic options. The four patients were male with a mean age of 64. Three of them were classified as locally advances cases and therefore treated with neoadjuvant therapy...
September 19, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28923226/randomized-clinical-trials-in-localized-anal-cancer
#11
REVIEW
Clayton A Smith, Lisa A Kachnic
Management of anal carcinoma began as abdominoperineal resection and has evolved to combined chemotherapy and radiation. Early randomized trials demonstrated superior clinical outcomes of combined modality therapy over radiotherapy alone. Subsequent trials investigated alterations in the standard backbone of radiotherapy concurrent with 5-fluorouracil and mitomycin C with intent to maintain clinical outcomes while reducing treatment-related morbidity. The addition of intensity-modulated radiotherapy to radiation planning and delivery has subsequently reduced acute toxicity and detrimental treatment breaks...
October 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28916892/precision-in-robotic-rectal-surgery-using-the-da-vinci-xi-system-and-integrated-table-motion-a-technical-note
#12
Sofoklis Panteleimonitis, Mick Harper, Stuart Hall, Nuno Figueiredo, Tahseen Qureshi, Amjad Parvaiz
Robotic rectal surgery is becoming increasingly more popular among colorectal surgeons. However, time spent on robotic platform docking, arm clashing and undocking of the platform during the procedure are factors that surgeons often find cumbersome and time consuming. The newest surgical platform, the da Vinci Xi, coupled with integrated table motion can help to overcome these problems. This technical note aims to describe a standardised operative technique of single docking robotic rectal surgery using the da Vinci Xi system and integrated table motion...
September 15, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28891039/a-systematic-review-of-transabdominal-levator-division-during-abdominoperineal-excision-of-the-rectum-aper
#13
D L H Baird, C Simillis, C Kontovounisios, Q Sheng, S Nikolaou, W L Law, S Rasheed, P P Tekkis
BACKGROUND: The aim of the present study was to evaluate the surgical technique, short-term oncological and perioperative outcomes for the transabdominal division of the levator ani muscles during abdominoperineal excision of the rectum (APER). METHODS: A systematic review was performed to identify studies reporting on transabdominal division of the levator ani during APER. A comprehensive literature search was performed using a combination of free-text terms and controlled vocabulary when applicable on the following databases: MEDLINE, EMBASE, Science Citation Index Expanded and Cochrane Central Register of Controlled Trials in the Cochrane Library...
September 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28884049/potential-predictive-factors-for-pathologic-complete-response-after-the-neoadjuvant-treatment-of-rectal-adenocarcinoma-a-single-center-experience
#14
Feryel Letaief, Meher Nasri, Mouna Ayadi, Khedija Meddeb, Amina Mokrani, Yosra Yahyaoui, Nesrine Chraiet, Henda Raies, Amel Mezlini
OBJECTIVE: : To assess the response rate of patients with rectal adenocarcinoma to neoadjuvant therapy and to identify the predictors of histological regression after neoadjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). METHODS: : This study recruited 64 patients. The patients had resectable cancer of the lower and the middle rectum (T3/T4 and/or N+) without distant metastasis and received neoadjuvant RT or CCRT followed by radical surgery with total mesorectal excision (TME) between January 2006 and December 2011...
August 2017: Cancer Biology & Medicine
https://www.readbyqxmd.com/read/28880495/case-report-of-perineal-hernia-after-laparoscopic-abdominoperineal-resection
#15
Kumpei Honjo, Kazuhiro Sakamoto, Shunsuke Motegi, Ryoichi Tsukamoto, Shinya Munakata, Kiichi Sugimoto, Hirohiko Kamiyama, Makoto Takahashi, Yutaka Kojima, Tetsu Fukunaga, Yoshiaki Kajiyama, Seiji Kawasaki
Perineal hernia (PH) is a rare complication following laparoscopic abdominoperineal resection (APR) for rectal cancer. We present a case report of perineal hernia after laparoscopic APR and discuss its management. The patient was a 77-year-old man who was diagnosed with lower rectal cancer. He underwent laparoscopic APR and bilateral lateral lymph node dissection. Two months after the surgery, pain and bulging in the perineal region developed, and PH was diagnosed by CT. Repair with a polypropylene mesh was performed using a combination of laparoscopic abdominal and transperineal approaches...
September 7, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28877798/omental-pedicle-flap-does-not-decrease-the-incidence-of-bowel-obstruction-after-abdominoperineal-resection
#16
Kunal Kochar, Slawomir Marecik, Leela M Prasad, John Park
No abstract text is available yet for this article.
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28876659/abdominoperineal-resection-in-the-prone-position-early-outcomes-at-a-tertiary-institution-in-the-western-cape-south-africa
#17
N Stevenson, A V V Lambrechts
BACKGROUND: Abdominoperineal resection (APR) in the prone position is a new technique in the developing world, where colorectal cancer incidence is rising fast and the patient population is different from those in the developed world. Literature is lacking on the outcomes of this technique under these conditions. METHOD: All patients who underwent APR in the prone position for rectal adenocarcinoma from February 2011 to February 2017 were reviewed. Main endpoints were stage at presentation, neoadjuvant treatment, circumferential resection margin involvement, perineal wound complications, length of intensive care unit (ICU) stay and days discharged after surgery...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28840372/persistent-perineal-sinus-after-abdominoperineal-resection
#18
Amélie Chau, Mathieu Prodeau, Hélène Sarter, Corinne Gower, Moshe Rogosnitzky, Yves Panis, Philippe Zerbib
BACKGROUND AND AIMS: Persistent perineal sinus (PPS) defined as a perineal wound remaining unhealed more than 6 months after abdominoperineal resection (APR) is a well-known complication. The aim of our study was (1) to evaluate the incidence of PPS after APR for Crohn's disease (CD) in the era of biotherapy, (2) to determine long-term outcome of PPS, (3) to study risk factors associated with delayed perineal healing, and (4) to compare the results in this CD patient group with patients without CD...
August 25, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28836255/-application-research-of-presacral-space-drainage-tube-combined-with-subcutaneous-vacuum-pressure-suction-in-the-laparoscopic-assisted-abdominoperineal-resection
#19
Liqi Chen, Changqing Zeng, Liangjie Chi, Liangxiang Huang, Jiandang Li
OBJECTIVE: To study the management for the perineal incision after laparoscopic-assisted abdominoperineal resection for rectal cancer. METHODS: Clinical data of 87 patients undergoing laparoscopic Miles operation for lower rectal cancer from June 2009 to February 2014 were collected and studied. Presacral space drainage group: presacral space drainage tube was applied in 42 patients. Combined drainage group: presacral space drainage tube combined with subcutaneous vacuum pressure suction was applied in 45 cases...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28823064/preoperative-hypoalbuminemia-is-an-independent-risk-factor-for-increased-high-grade-morbidity-after-elective-rectal-cancer-resection
#20
J Hardt, L Pilz, J Magdeburg, P Kienle, S Post, R Magdeburg
PURPOSE: This study investigated the association of preoperative hypoalbuminemia and postoperative complications after elective resection for rectal cancer. METHODS: From September 2009 to December 2014, all patients who underwent elective rectal resection for adenocarcinoma of the rectum were identified using a prospective colorectal cancer database. Hypoalbuminemia was defined as a serum albumin < 35 g/L. Characteristics and outcomes of hypoalbuminemic patients were compared to those of patients with normal albumin levels...
August 19, 2017: International Journal of Colorectal Disease
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