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https://www.readbyqxmd.com/read/29791978/combination-of-endoscopic-submucosal-dissection-and-transanal-minimally-invasive-surgery-for-the-resection-of-early-rectal-cancer-with-fibrosis-after-prior-partial-excision
#1
Sung Hoo Kim, Dong Hoon Yang, Seok-Byung Lim
Endoscopic submucosal dissection is an effective procedure for treating non-invasive colorectal tumors. However, in cases of severe fibrosis, endoscopic submucosal dissection may be technically difficult, leading to incomplete resection. Here, we describe the case of a 74-year-old man who had early rectal cancer along with severe submucosal fibrosis caused by prior local excision. Combination treatment with endoscopic submucosal dissection and transanal minimally invasive surgery successfully enabled complete resection...
May 23, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29791891/transanal-endoscopic-microsurgery-with-or-without-completion-total-mesorectal-excision-for-t2-and-t3-rectal-carcinoma
#2
Jeroen W A Leijtens, Thomas W A Koedam, Wernard A A Borstlap, Monique Maas, Pascal G Doornebosch, Tom M Karsten, Eric J Derksen, Laurents P S Stassen, Camiel Rosman, Eelco J R de Graaf, André J A Bremers, Jeroen Heemskerk, Geerard L Beets, Jurriaan B Tuynman, Kevin L J Rademakers
AIM: Transanal endoscopic microsurgery (TEM) is used for the resection of large rectal adenomas and well or moderately differentiated T1 carcinomas. Due to difficulty in preoperative staging, final pathology may reveal a carcinoma not suitable for TEM. Although completion total mesorectal excision is considered standard of care in T2 or more invasive carcinomas, this completion surgery is not always performed. The purpose of this article is to evaluate the outcome of patients after TEM-only, when completion surgery would be indicated...
May 23, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29791695/current-strategies-to-prevent-iatrogenic-ureteral-injury-during-colorectal-surgery
#3
Jonathan Douissard, Frederic Ris, Philippe Morel, Nicolas Christian Buchs
Iatrogenic ureteral injuries are a source of major concern among surgeons performing colorectal procedures. Although they are uncommon, these lesions lead to severe morbidity and long-term functional disabilities, as well as an increase in mortality, hospital stay, and cost. The laparoscopic approach has gained popularity in the field of colorectal surgery and is associated with improved global postoperative outcomes. However, it is also considered to increase the risk of ureteral injury when compared to open surgery, especially during left colonic and rectal resections...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29791416/oncological-outcomes-in-extended-time-intervals-betweenpreoperative-chemoradiotherapy-with-capecitabine-and-surgery-inoperable-rectal-adenocarcinoma
#4
Miguel A Muñoz, Manuel G Palacios, Jenny Malca, Raúl Mantilla, Paola C Montenegro, Ivan Chavez
OBJECTIVE: To assess whether extended time intervals (8-12, 13-20 and >20 weeks) between the end of neoadjuvant chemoradiotherapy and surgery affect overall survival, disease-free survival. MATERIALS AND METHODS: Retrospective study in 120 patients with rectal adenocarcinoma without evidence of metastasis (T1-4/N0-2/M0) at the time of diagnosis that underwent surgery with curative intent after neoadjuvant chemoradiotherapy with capecitabine and obtained R0 or R1 resection between January 2010 to December 2014 at the National Cancer Institute of Peru...
January 2018: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/29790661/transanal-minimally-invasive-surgery-as-a-treatment-option-for-a-completely-occluded-anastomosis-after-low-anterior-resection-a-new-approach-to-severe-anastomotic-stenosis
#5
Jun Woo Bong, Seok-Byung Lim
New techniques have been developed to treat severe anastomotic strictures after rectal surgery. This report describes a new approach using transanal minimally invasive surgery for the treatment of complete anastomotic occlusion. A 49-year-old man presented with a completely occluded anastomosis after low anterior resection with temporary ileostomy for rectal cancer. The lumen was completely obstructed with a blind wall. A transanal surgical approach was used to treat the obstruction. Water-soluble radiopaque contrast medium was injected intraoperatively to identify the proximal lumen, and an incision was made by electrocautery until the luminal diameter was sufficient...
May 23, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29790177/mri-based-emvi-positivity-predicts-systemic-recurrence-in-rectal-cancer-patients-with-a-good-tumor-response-to-chemoradiotherapy-followed-by-surgery
#6
Min Soo Cho, Youn Young Park, Jiho Yoon, Seung Yoon Yang, Seung Hyuk Baik, Kang Young Lee, Ik Yong Kim, Nam Kyu Kim
BACKGROUND: This study aimed to determine the prognostic value of baseline magnetic resonance imaging-based extramural vascular invasion status (EMVI) among rectal cancer patients with a good tumor response to standard chemoradiotherapy followed by surgery. METHODS: A total of 359 patients with ypT0-2/N0 disease from The Yonsei Multicenter Colorectal Cancer Electronic Database were retrospectively included between January 2000 and December 2014. Magnetic resonance images and medical records were reviewed to investigate risk factors for tumor recurrence...
May 22, 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29784042/neoadjuvant-oxaliplatin-and-capecitabine-combined-with-bevacizumab-plus-radiotherapy-for-locally-advanced-rectal-cancer-results-of-a-single-institute-phase-ii-study
#7
Xin Yu, Qiao-Xuan Wang, Wei-Wei Xiao, Hui Chang, Zhi-Fan Zeng, Zhen-Hai Lu, Xiao-Jun Wu, Gong Chen, Zhi-Zhong Pan, De-Sen Wan, Pei-Rong Ding, Yuan-Hong Gao
BACKGROUND: Neoadjuvant chemoradiotherapy followed by surgery is recommended as the standard of care for locally advanced rectal cancer, reducing local recurrence but not distant metastasis. Intensified systemic therapy is warranted to reduce the risk of distant metastasis. The present study aimed to evaluate the safety and efficacy of neoadjuvant oxaliplatin and capecitabine (XELOX) combined with bevacizumab plus radiotherapy for locally advanced rectal cancer. METHODS: Patients with stages II to III rectal cancer received one cycle of induction chemotherapy and concurrent chemoradiotherapy with XELOX plus bevacizumab...
May 21, 2018: Cancer communications
https://www.readbyqxmd.com/read/29780603/male-gender-is-associated-with-an-increased-risk-of-anastomotic-leak-in-rectal-cancer-patients-after-total-mesorectal-excision
#8
Chi Zhou, Xian-Rui Wu, Xuan-Hui Liu, Yu-Feng Chen, Jia Ke, Xiao-Wen He, Xiao-Sheng He, Tuo Hu, Yi-Feng Zou, Xiao-Bin Zheng, Hua-Shan Liu, Jian-Cong Hu, Xiao-Jian Wu, Jian-Ping Wang, Ping Lan
Background: The impact of a patient's gender on the development of anastomotic leak (AL) in rectal cancer patients following total mesorectal excision (TME) remains controversial. The aim of this study was to evaluate the association between patients' gender and the risk of AL. Methods: All rectal cancer patients following TME with a primary anastomosis during the study period from 2010 to 2014 were examined. Comparisons of the post-operative AL incidence rate between male and female patients were performed...
May 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29780295/successful-in-vitro-fertilization-and-embryo-transfer-after-transplantation-of-cryopreserved-ovarian-tissue-report-of-the-first-korean-case
#9
Jung Ryeol Lee, Dayong Lee, Soohyeon Park, Eun Chan Paik, Seul Ki Kim, Byung Chul Jee, Chang Suk Suh, Seok Hyun Kim
For patients at risk of premature ovarian failure with cancer treatment, it is an important option to re-implant the ovarian tissue (OT) after cryopreservation to preserve endocrine function and fertility. With this technique, about 30% of pregnancy success rate and about 90 live births have been reported to date. However, there has been no case report of successful in vitro fertilization (IVF) and embryo transfer (ET) with oocytes collected from transplanted cryopreserved OT in Korea. We report a 30-year old woman with rectal cancer who underwent IVF and ET after cryopreserved OT thawing and re-implantation...
May 21, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29779486/risk-factors-for-prolonged-postoperative-ileus-in-adult-patients-undergoing-elective-colorectal-surgery-an-observational-cohort-study
#10
Andrea Pisani Ceretti, Nirvana Maroni, Marco Longhi, Marco Giovenzana, Roberto Santambrogio, Matteo Barabino, Carmelo Luigiano, Giovanni Radaelli, Enrico Opocher
Purpose Prolonged postoperative ileus (PPOI) after abdominal surgery may effect unfavourably the patient recovery. The aim of this study was to estimate the incidence of PPOI in patients elective for colorectal resection and investigate perioperative variables associated with PPOI. Methods A consecutive series of 428 patients undergoing colorectal resection (median age 72, range 24-92, years; men/women ratio 1.14) were analyzed. Data were extracted retrospectively throughout a five-year period from an electronic prospectively maintained database...
May 20, 2018: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/29778632/how-to-save-both-transverse-colon-and-continence-after-extensive-left-colon-surgery-a-case-report-of-a-new-procedure
#11
Marica Grasso, Alessandro Cimmino, Nicola Sangiuliano, Antonello Niglio
INTRODUCTION: Nowadays, after wide left colectomy, it is necessary to choose one of the following procedures: a definitive transverse colostomy, an ileo-rectal anastomosis or a right colo-rectal anastomosis (Deloyers procedure). PRESENTATION OF CASE: We performed our new procedure on a 63 years-old man. After an extensive left proctocolectomy, the intestinal continuity between the transverse colon and rectum was obtained by transposition and rotation of the right colon into the pelvis...
April 21, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29778617/bowel-dysfunction-after-sigmoid-resection-underestimated-multicentre-study-on-quality-of-life-after-surgery-for-carcinoma-of-the-rectum-and-sigmoid
#12
M van Heinsbergen, M L Janssen-Heijnen, J W Leijtens, G D Slooter, J L Konsten
AIM: The Low Anterior Resection Syndrome (LARS) severely affects quality of life (QoL) after rectal cancer surgery. There are no data about functional complaints after sigmoid cancer surgery. We investigated LARS and QoL in patients with a resection for sigmoid cancer versus patients who had surgery for rectal cancer. METHODS: 506 patients after resection for rectal or sigmoid cancer who were at least one year colostomy-free were included between January 2008 and December 2013...
May 9, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29777457/a-nomogram-to-predict-anastomotic-leakage-in-open-rectal-surgery-hope-or-hype
#13
Johannes Klose, Ignazio Tarantino, Armin von Fournier, Moritz J Stowitzki, Yakup Kulu, Thomas Bruckner, Claudia Volz, Thomas Schmidt, Martin Schneider, Markus W Büchler, Alexis Ulrich
BACKGROUND: Anastomotic leakage is the most dreaded complication after rectal resection and total mesorectal excision, leading to increased morbidity and mortality. Formation of a diverting ileostomy is generally performed to protect anastomotic healing. Identification of variables predicting anastomotic leakage might help to select patients who are under increased risk for the development of anastomotic leakage prior to surgery. The objective of this study was to assess the applicability of a nomogram as prognostic model for the occurrence of anastomotic leakage after rectal resection in a cohort of rectal cancer patients...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29777268/defunctioning-stomas-result-in-significantly-more-short-term-complications-following-low-anterior-resection-for-rectal-cancer
#14
Andrew Emmanuel, Ezzat Chohda, Christo Lapa, Andrew Miles, Amyn Haji, Joe Ellul
BACKGROUND: Studies suggest that defunctioning stomas reduce the rate of anastomotic leakage and urgent reoperations after anterior resection. Although the magnitude of benefit appears to be limited, there has been a trend in recent years towards routinely creating defunctioning stomas. However, little is known about post-operative complication rates in patients with and without a defunctioning stoma. We compared overall short-term post-operative complications after low anterior resection in patients managed with a defunctioning stoma to those managed without a stoma...
May 17, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29776947/rectal-mucocele-in-the-anterior-wall-of-the-rectum
#15
Daisuke Ishii, Takanori Aoki, Satoshi Inaba, Hidehiko Yabuki
An 84-year-old man presented in 2009 with a sensation of discomfort in his anus, combined with difficulty in urination. He had previously undergone a haemorrhoidectomy in 1964. After examination, he was diagnosed with a rectal mucosal cyst and followed up for observation. In 2015, he presented to our hospital complaining that the cyst was prolapsing from his anus. CT revealed a 48×41 mm cystic mass in the anterior wall of the rectum. Tumour extirpation, via a transanal route, was performed. The postoperative pathological diagnosis confirmed a rectal mucocele...
May 18, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29771810/transanal-total-mesorectal-excision-vs-laparoscopic-total-mesorectal-excision-in-the-treatment-of-low-and-middle-rectal-cancer-a-propensity-score-matching-analysis
#16
Roberto Persiani, Alberto Biondi, Francesco Pennestrì, Valeria Fico, Veronica De Simone, Flavio Tirelli, Francesco Santullo, Domenico D'Ugo
BACKGROUND: Transanal total mesorectal excision is a novel and promising technique in the treatment of low and middle rectal cancer. OBJECTIVE: This study aimed to compare the safety and feasibility of transanal total mesorectal excision versus laparoscopic total mesorectal excision. DESIGN: This was a retrospective study using propensity score matching analysis. SETTINGS: This study was conducted in a single high-volume university hospital...
May 15, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29771797/measuring-in-hospital-recovery-after-colorectal-surgery-within-a-well-established-enhanced-recovery-pathway-a-comparison-between-hospital-length-of-stay-and-time-to-readiness-for-discharge
#17
Saba Balvardi, Nicolò Pecorelli, Tanya Castelino, Petru Niculiseanu, A Sender Liberman, Patrick Charlebois, Barry Stein, Franco Carli, Nancy E Mayo, Liane S Feldman, Julio F Fiore
BACKGROUND: Hospital length of stay is often used as a measure of in-hospital recovery but may be confounded by organizational factors. Time to readiness for discharge may provide a superior index of recovery. OBJECTIVE: The purpose of this study was to contribute evidence for the construct validity of time to readiness for discharge and length of stay as measures of in-hospital recovery after colorectal surgery in the context of a well-established enhanced recovery pathway...
May 15, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29770881/robot-assisted-laparoscopic-resection-of-clinical-t4b-tumours-of-distal-sigmoid-and-rectum-initial-results
#18
Rogier M P H Crolla, Janneke J C Tersteeg, George P van der Schelling, Jan H Wijsman, Jennifer M J Schreinemakers
BACKGROUND: Radical resection by multivisceral resection of colorectal T4 tumours is important to reduce local recurrence and improve survival. Oncological safety of laparoscopic resection of T4 tumours is controversial. However, robot-assisted resections might have advantages, such as 3D view and greater range of motion of instruments. The aim of this study is to evaluate the initial results of robot-assisted resection of T4 rectal and distal sigmoid tumours. METHODS: This is a cohort study of a prospectively kept database of all robot-assisted rectal and sigmoid resections between 2012 and 2017...
May 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29770764/predictive-value-of-mri-detected-extramural-vascular-invasion-in-stage-t3-rectal-cancer-patients-before-neoadjuvant-chemoradiation
#19
Yiqun Sun, Jianwen Li, Lijun Shen, Xiaolin Wang, Tong Tong, Yajia Gu
PURPOSE: We set out to explore the probability of MRI-detected extramural vascular invasion (mr-EMVI) before chemoradiation to predict responses to chemoradiation and survival in stage T3 rectal cancer patients. METHODS: A total of 100 patients with T3 rectal cancer who underwent MRI examination and received neoadjuvant chemoradiation and surgery were enrolled. The correlation between mr-EMVI and other clinical factors were analyzed by chi-square. Logistic regression model was performed to select the potential factors influencing tumor responses to neoadjuvant chemoradiation...
May 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/29767284/diagnostic-accuracy-of-mri-in-assessing-tumor-regression-and-identifying-complete-response-in-patients-with-locally-advanced-rectal-cancer-after-neoadjuvant-treatment
#20
Medhat Aker, Darren Boone, Anuradha Chandramohan, Bruce Sizer, Roger Motson, Tan Arulampalam
BACKGROUND: The diagnostic accuracy of Magnetic Resonance Imaging (MRI) in restaging locally advanced rectal cancers (LARC) after neoadjuvant chemo-radio therapy (NCRT) has been under recent scrutiny. There is limited data on the accuracy of MRI and its timing in assessing tumor regression grade (TRG) and in identifying patients with complete response (CR). NCRT seems to cause tissue inflammation and oedema which renders reading the scans difficult for radiologist. AIM: This study aims to assess the accuracy of MRI at different time intervals after NCRT in staging TRG and in identifying CR...
May 16, 2018: Abdominal Radiology
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