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Rectal surgery

Masayuki Ishii, Atsushi Shimizu, Alan Kawarai Lefor, Yujirou Kokado, Hideaki Nishigori, Yasuko Noda
PURPOSE: The term "lateral rectal ligament" in surgery for rectal cancer has caused confusion regarding its true existence and contents. In previous studies, investigators claimed the existence of the ligament and described its topographical features as neurovascular structures and their surrounding connective tissues located at the anterolateral aspect of the distal rectum or the posterolateral aspect of the middle rectum. The purpose of this study is to evaluate the structure of the so-called "lateral rectal ligament" in cadaver dissections...
March 19, 2018: International Journal of Colorectal Disease
Marsha Reyngold, Joyce Niland, Anna Ter Veer, Tanios Bekaii-Saab, Lily Lai, Joshua E Meyer, Steven J Nurkin, Deborah Schrag, John M Skibber, Al B Benson, Martin R Weiser, Christopher H Crane, Karyn A Goodman
Purpose: Intensity modulated radiation therapy (IMRT) has been rapidly incorporated into clinical practice because of its technological advantages over 3-dimensional conformal radiation therapy (CRT). We characterized trends in IMRT utilization in trimodality treatment of locally advanced rectal cancer at National Comprehensive Cancer Network cancer centers between 2005 and 2011. Methods and materials: Using the prospective National Comprehensive Cancer Network Colorectal Cancer Database, we determined treatment patterns for 976 patients with stage II-III rectal cancer who received pelvic radiation therapy at contributing centers between 2005 and 2011...
January 2018: Advances in Radiation Oncology
Guangyuan Sun, Jun Xue, Yue Zhang, Xiaobin Gao, Fei Guo
PURPOSE: This study aimed to use propensity score matching (PSM) to compare the short- and long-term outcomes of laparoscopic surgery for the treatment of rectal cancer in elderly and middle-aged patients. METHODS: Data were retrospectively obtained from 588 patients aged ≥60 years when they underwent laparoscopic surgery for rectal cancer in our hospital between January 2009 and December 2016. The patients were divided into an elderly group (≥70 years) or a middle-aged group (60-69 years), and were subsequently matched 1:1 using PSM for sex, body mass index, Charlson comorbidity index (CCI), tumor location, clinical stage, and American Society of Anesthesiologists (ASA) score...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Hitoshi Kameyama, Tatsuo Kanda, Yosuke Tajima, Yoshifumi Shimada, Hiroshi Ichikawa, Takaaki Hanyu, Takashi Ishikawa, Toshifumi Wakai
Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. However, rectal GIST is rare, the incident rate of it is approximately 5% of all GISTs. Rectal GIST symptoms generally include bleeding and/or pain and occasionally, urinary symptoms. Immunohistochemical evaluation finds that most rectal GIST tumors are CD117 (KIT) positive, and are sometimes CD34, platelet-derived growth factor receptor alpha (PDGFRA), smooth muscle actin, S-100, or vimentin positive...
2018: Translational Gastroenterology and Hepatology
Wei-Zhe Chen, Xiao-Dong Chen, Liang-Liang Ma, Feng-Min Zhang, Ji Lin, Cheng-Le Zhuang, Zhen Yu, Xiao-Lei Chen, Xiao-Xi Chen
BACKGROUND: With the increased prevalence of obesity and sarcopenia, those patients with both visceral obesity and sarcopenia were at higher risk of adverse outcomes. AIM: The aim of this study was to ascertain the combined impact of visceral obesity and sarcopenia on short-term outcomes in patients undergoing colorectal cancer surgery. METHODS: We conducted a prospective study from July 2014 to February 2017. Patients' demographic, clinical characteristics, physical performance, and postoperative short-term outcomes were collected...
March 16, 2018: Digestive Diseases and Sciences
E Duchalais, N Machairas, S R Kelley, R G Landmann, A Merchea, D T Colibaseanu, K L Mathis, E J Dozois, D W Larson
BACKGROUND: Several studies have shown a correlation between longer operative times and higher rates of postoperative morbidity for open and laparoscopic surgery for rectal cancer. The aim of the study was to determine the impact of prolonged operative time on early postoperative morbidity in patients undergoing robotic-assisted rectal cancer resection. METHODS: The study was a retrospective review of a prospectively maintained database conducted in two centers of the same institution...
March 15, 2018: Surgical Endoscopy
X Serra-Aracil, A Zárate, L Mora, S Serra-Pla, A Pallisera, J Bonfill, J Bargalló, A Pando, S Delgado, E Balleteros, C Pericay
PURPOSE: Compared with the open approach, laparoscopic total mesorectal excision (TME) achieves faster patient recovery, reduces morbidity rates, and shortens hospital stay. However, in laparoscopic low anterior resection (L-LAR), conversion to open surgery is required in almost 20% of cases. Transanal TME (Ta-TME) combined with laparoscopy, also called hybrid natural orifice transluminal endoscopic surgery (NOTES), is a less invasive procedure that can overcome some of the limitations of laparoscopic rectal surgery...
March 16, 2018: International Journal of Colorectal Disease
Alessandra Di Giovanni, Lucia Casarella, Marina Coppola, Domenico Iuzzolino, Marianna Rasile, Mario Malzoni
STUDY OBJECTIVE: To assess sensitivity and accuracy of combined transvaginal/transabdominal ultrasonography for evaluation of deep infiltrating bowel endometriosis nodules measured after surgery. DESIGN: A prospective study (Canadian Task Force classification II.1). SETTING: A Center for Advanced Endoscopic Gynecologic Surgery from January 2014 to December 2016. PATIENTS: All women undergoing laparoscopic surgery and scheduled for segmental resection for clinically suspected bowel endometriosis...
March 12, 2018: Journal of Minimally Invasive Gynecology
Juliane Kupsch, Thomas Jackisch, Klaus E Matzel, Joerg Zimmer, Andreas Schreiber, Anja Sims, Helmut Witzigmann, Sigmar Stelzner
PURPOSE: Severity of anorectal dysfunction after low anterior resection is associated with various patient- and treatment-related factors. We aimed to quantify anorectal dysfunction after treatment for rectal cancer using the low anterior resection syndrome (LARS) score. METHODS: We retrieved from a prospective database 331 eligible patients on whom anterior resection for rectal cancer had been performed from 2000 to 2014. All patients were sent a LARS score accompanied by a supplementary questionnaire...
March 15, 2018: International Journal of Colorectal Disease
Xiao Sun, Tanxiao Huang, Fangsheng Cheng, Kaibing Huang, Ming Liu, Wan He, Mingwei Li, Xiaoni Zhang, Mingyan Xu, Shifu Chen, Ligang Xia
Postoperative monitoring for patients with colorectal cancer (CRC) requires sensitive biomarkers that are associated with medical response and adjuvant therapy following surgery. Conventional tumor biomarkers [including carcinoembryonic antigen (CEA), CA19-9 and CA125] are widely used, but none of the markers provide high sensitivity or specificity. Previous studies indicated that circulating tumor DNA (ctDNA) is useful for postoperative monitoring of patients with cancer. However, the majority of previous studies involved patients with lung cancer, and therefore further studies are required which investigate patients with CRC...
April 2018: Oncology Letters
I Thomassin-Naggara, S Bendifallah, P Rousset, M Bazot, M Ballester, E Darai
Diagnostic performance of MR imaging for the diagnosis of pelvic endometriosis are good. Even if some differences of performances exists according the location considered, the risk of misdiagnosis is lower than 10% for trained teams (NP2). The performance of pelvic MR imaging and surgery are quite similar to diagnose endometrioma (sensitivity and specificity>90%). A negative pelvic MR imaging allows to exclude deep pelvic endometriosis with a performance similar to surgery but a positive MR imaging is less accurate than surgery because of a high number of false positives (23%)...
March 11, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Émilie Liot, Nicolas Christian Buchs, Jacques Klein, Boris Schiltz, Philippe Morel, Frederic Ris
Patients with rectal cancer have an increased risk of developing sexual disorders. These dysfunctions are caused by the disease itself (negative psychological impact, nerve compression in the pelvis), as well as by the treatments (radiotherapy, chemotherapy and surgery). Most sexual disorders are due to the surgery and can be attributed to injuries of the retroperitoneal nerves. Sexuality assessment of patients before and after treatment, a precise knowledge of the pelvic anatomy by the surgeon, and an appropriate care by specialists (gynaecologists, urologists and sexologists) are essential to reduce the risk of sexual disorders and to minimize their impact on overall quality of life...
March 14, 2018: Revue Médicale Suisse
M Ballester, H Roman
Deep endometriosis with colorectal involvement is considered one of the most severe forms of the disease due to its impact on patients' quality of life and fertility but also by the difficulties encountered by the clinicians when proposing a therapeutic strategy. Although the literature is very rich, evidence based medicine remains poor explaining the great heterogeneity concerning the management of such patients. Surgery therefore remains a therapeutic option. It improves the intensity of gynecological, digestive and general symptoms and the quality of life...
March 10, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Hisanaga Horie, Koji Koinuma, Homare Ito, Ai Sadatomo, Daishi Naoi, Yoshihiko Kono, Yoshiyuki Inoue, Mitsuaki Morimoto, Makiko Tahara, Alan K Lefor, Naohiro Sata, Takahiro Sasaki, Hideharu Sugimoto
INTRODUCTION: Laparoscopic lateral pelvic lymph node dissection (LPLD) is technically challenging because of the complicated anatomy of the pelvic wall. To overcome this difficulty, we introduced preoperative 3-D simulation. The aim of the study is to investigate the usefulness of preoperative 3-D simulation for the safe conduct of laparoscopic LPLD for rectal cancer. METHODS: After undergoing colonoscopy, patients were brought to the radiology suite where multi-detector row CT was performed...
March 12, 2018: Asian Journal of Endoscopic Surgery
Ri Na Yoo, Gun Kim, Bong-Hyeon Kye, Hyeon-Min Cho, HyungJin Kim
PURPOSE: Sphincter-saving surgery is widely accepted operative modality to treat rectal cancer. It often requires temporary diverting stoma to avoid the complications of anastomotic failure. This study investigates the cumulative failure rate in sphincter preservation for rectal cancer and the risk factors associated with the permanent stoma. METHODS: A retrospective study on 358 patients diagnosed with primary rectal cancer from 2009 to 2013 was conducted at a single institute...
March 12, 2018: International Journal of Colorectal Disease
H Roman, M Ballester, J Loriau, M Canis, P A Bolze, J Niro, S Ploteau, C Rubod, C Yazbeck, P Collinet, B Rabischong, B Merlot, X Fritel
The article presents French guidelines for surgical management of endometriosis. Surgical treatment is recommended for mild to moderate endometriosis, as it decreases pelvic painful complaints and increases the likelihood of postoperative conception in infertile patients (A). Surgery may be proposed in symptomatic patients with ovarian endometriomas which diameter exceeds 20mm. Cystectomy allows for better postoperative pregnancy rates when compared to ablation using bipolar current, as well as for lower recurrences rates when compared to ablation using bipolar current or CO2 laser...
March 8, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Andreas Lorenz, Pamela Kogler, Marcus Huth, Reinhold Kafka-Ritsch, Dietmar Öfner, Alexander Perathoner
PURPOSE: Resection of a long rectal stump after previous colectomy or Hartmann procedure often requires a combined transperitoneal and transperineal approach because of limited access through a perineal incision alone. Risks associated with this procedure include iatrogenic injury to bowels, nerves, ureters, vessels and sexual organs. This study reports on the feasibility and safety of perianal minimally invasive surgery (PAMIS) for the resection of long rectal stumps that would otherwise require a combined transperitoneal and perianal approach...
March 10, 2018: International Journal of Colorectal Disease
Jessica Gates, Akhilesh Sharma, Arunesh Kumar
We present the case of a 34-year-old Nigerian woman who was referred to the Respiratory team with a 12-month history of breathlessness. She was concurrently being investigated for an abdominal mass and rectal and vaginal bleeding. Consequently, she underwent cross-sectional imaging of her chest, abdomen and pelvis, revealing a small right-sided pneumothorax and right lower lobe pleural-based lesion. Shortly thereafter, she was admitted to the hospital with chest pain and required chest drain insertion. This partially treated her pneumothorax but she required referral to a cardiothoracic centre for definitive diagnosis and to manage her non-resolving pneumothorax...
March 9, 2018: BMJ Case Reports
J Loriau, E Petit, A Mephon, B Angliviel, E Sauvanet
Management of deep pelvic and digestive endometriosis can lead to colorectal resection and anastomosis. Colorectal anastomosis carries risks for dreaded infectious and functional morbidity. The aim of the study was to establish, regarding the published data, the role of the three most common used surgical techniques to prevent such complications: pelvic drainage, diverting stoma, epiplooplasty. Even if many studies and articles have focused on colorectal anastomotic leakage prevention in rectal cancer surgery data regarding this topic in the setting of endometriosis where lacking...
March 7, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Nabil Wasif, David Etzioni, Elizabeth B Habermann, Amit Mathur, Barbara A Pockaj, Richard J Gray, Yu-Hui Chang
BACKGROUND: Regionalization of complex visceral surgery across the United States has followed identification of a volume-outcome association. However, a simultaneous trend towards improved surgical outcomes may have attenuated this relationship. We hypothesize that the difference in adjusted postoperative mortality between low, medium and high volume hospitals has decreased over time. STUDY DESIGN: The National Inpatient Sample (NIS) was used to identify patients undergoing bladder, esophageal, pancreatic, liver, lung, and rectal surgery from 2003-2011...
March 7, 2018: Journal of the American College of Surgeons
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