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https://www.readbyqxmd.com/read/29777268/defunctioning-stomas-result-in-significantly-more-short-term-complications-following-low-anterior-resection-for-rectal-cancer
#1
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/29771806/supine-bottom-up-extralevator-abdominoperineal-excision-with-primary-perineal-approach
#2
Cécile de Chaisemartin, Diane Mège, Jean Michel Durey, Hélène Meillat, Jean Robert Delpero, Bernard Lelong
To improve poor oncological outcomes of conventional abdominoperineal excision (APE), an extralevator abdominoperineal excision has been developed. This technique is associated with a larger pelvic floor defect and needs position changing and flap reconstruction, which increase operating time and morbidity without proof of best oncological results. Based on the recent development of transanal approaches for retrograde transanal mesorectal excision, we describe a novel approach for APE by a primary perineal dissection...
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
#3
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
#4
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/29768703/a-statistical-tool-for-risk-assessment-as-function-of-number-of-retrieved-lymph-nodes-from-rectal-cancer-patients
#5
Zhenyu Wu, Guoyou Qin, Naiqing Zhao, Huixun Jia, Xueying Zheng
PURPOSE: Although a minimum of 12 lymph nodes (LNs) has been recommended for colorectal cancer, there remains considerable debates for rectal cancer patients. Inadequacy of examined LNs would lead to under-staging, and inappropriate treatment as a consequence. We describe statistical tool that allows an estimate the probability of false-negative nodes. METHODS: A total of 26,778 adenocarcinoma rectum cancer patients with tumour stage (T stage) 1-3, diagnosed between 2004 and 2013, who did not receive neoadjuvant therapies and had at least one histologically assessed LN, were extracted from the Surveillance, Epidemiology and End Results (SEER) database...
May 16, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29767693/neoadjuvant-score-in-locally-advancer-rectal-cancer-integrating-downstaging-in-risk-assessment-and-looking-for-new-valuable-end-points
#6
S Roselló, A Cervantes
No abstract text is available yet for this article.
May 14, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
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
#7
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
https://www.readbyqxmd.com/read/29766457/influence-of-age-on-variation-in-patterns-of-care-in-patients-with-rectal-cancer-in-catalonia-spain
#8
R Vernet, J M Borras, L Aliste, M Antonio, A Guarga, P Manchon-Walsh
BACKGROUND: Population ageing is a relevant concern in people diagnosed with rectal cancer. This study evaluates the adherence to clinical practice guidelines (CPGs) and patient outcomes in rectal cancer, with a particular focus on variation according to age. METHODS: This is a multicentre retrospective cohort study of all patients surgically treated for the first time for primary rectal cancer with curative intent in public hospitals in Catalonia during two study periods: first, with data from 2005 to 2007, and then with data from 2011 to 2012...
May 15, 2018: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29761276/does-robotic-rectal-cancer-surgery-improve-the-results-of-experienced-laparoscopic-surgeons-an-observational-single-institution-study-comparing-168-robotic-assisted-with-184-laparoscopic-rectal-resections
#9
Rogier M P H Crolla, Paul G Mulder, George P van der Schelling
BACKGROUND: The role of robotic assistance in colorectal cancer surgery has not been established yet. We compared the results of robotic assisted with those of laparoscopic rectal resections done by two surgeons experienced in laparoscopic as well as in robotic rectal cancer surgery. METHODS: Two surgeons who were already experienced laparoscopic colorectal surgeons in 2005 started robotic surgery with the daVinci SI system in 2012. All their rectal cancer resections between 2005 and 2015 were retrieved from a prospectively recorded colorectal database of routinely collected patient data...
May 14, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29753642/adjuvant-management-of-pathologic-node-positive-disease-after-definitive-surgery-for-clinical-t1-2-n0-rectal-cancer
#10
Praveen Polamraju, Waqar Haque, Vivek Verma, Lee Wiederhold, Sandra Hatch, E Brian Butler, Bin S Teh
INTRODUCTION: Patients with cT1-2N0M0 rectal cancer are often treated with up-front surgical resection, with adjuvant treatment reserved for patients upstaged with pathologic node-positive (pN+) disease at surgery. This study evaluates practice patterns and clinical outcomes when comparing different forms of adjuvant treatment for this patient population. METHODS: The National Cancer Data Base was queried for cT1-2N0M0 rectal cancer patients between 2004 and 2015 with postoperative pN+ disease treated without neoadjuvant treatment...
April 21, 2018: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29746338/oncological-and-survival-outcomes-in-watch-and-wait-patients-with-a-clinical-complete-response-after-neoadjuvant-chemoradiotherapy-for-rectal-cancer-a-systematic-review-and-pooled-analysis
#11
Mit Dattani, Richard J Heald, Ghaleb Goussous, Jack Broadhurst, Guilherme P São Julião, Angelita Habr-Gama, Rodrigo Oliva Perez, Brendan J Moran
OBJECTIVE: The aim of this study was to evaluate the oncological and survival outcomes of a Watch and Wait policy in rectal cancer after a clinical complete response (cCR) following neoadjuvant chemoradiotherapy. BACKGROUND: The detection of a cCR after neoadjuvant treatment may facilitate a nonoperative approach in selected patients. However, the long-term safety of this strategy remains to be validated. METHOD: This is a systematic review of the literature to determine the oncological outcomes in Watch and Wait patients...
May 9, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29745478/laparoscopic-abdominoperineal-resection-with-lateral-lymph-node-dissection-for-advanced-rectal-and-prostate-cancer-with-synchronous-lateral-lymph-node-metastases
#12
Takahisa Ishikawa, Shigenori Homma, Makoto Nishikawa, Hiroki Nakamoto, Ryoji Yokoyama, Akinobu Taketomi
Here we report a case of advanced rectal and prostate cancer with synchronous lateral lymph node (LLN) metastases that was treated with laparoscopic surgery. A 71-year-old man presented with fecal occult blood and was diagnosed with rectal cancer. A metastatic right LLN was suspected after CT examination of a 19-mm lymph node (proximal internal iliac artery region) and a 13-mm lymph node (distal internal iliac artery region) in the right lateral region. We planned neoadjuvant chemotherapy to suppress local and distant recurrence...
May 10, 2018: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29744860/oncological-outcome-after-mri-based-selection-for-neoadjuvant-chemoradiotherapy-in-the-ocum-rectal-cancer-trial
#13
R Ruppert, T Junginger, H Ptok, J Strassburg, C A Maurer, P Brosi, J Sauer, J Baral, M Kreis, D Wollschlaeger, P Hermanek, S Merkel
BACKGROUND: It is not clear whether all patients with rectal cancer need chemoradiotherapy. A restrictive use of neoadjuvant chemoradiotherapy (nCRT) based on MRI findings for rectal cancer was investigated in this study. METHODS: This prospective multicentre observational study included patients with stage cT2-4 rectal cancer, with any cN and cM0 status. Carcinomas in the middle and lower third that were 1 mm or less from the mesorectal fascia, all cT4 tumours, and all cT3 tumours of the lower third were classified as high risk, and these patients received nCRT followed by total mesorectal excision (TME)...
May 9, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29741977/laparoscopic-pelvic-exenteration-for-locally-advanced-rectal-cancer-technique-and-short-term-outcomes
#14
Ashish Pokharkar, Praveen Kammar, Ashwin D'souza, Rahul Bhamre, Pavan Sugoor, Avanish Saklani
BACKGROUND: Since last two decades minimally invasive techniques have revolutionized surgical field. In 2003 Pomel first described laparoscopic pelvic exenteration, since then very few reports have described minimally invasive approaches for total pelvic exenteration. METHODS: We report the 10 cases of locally advanced rectal adenocarcinoma which were operated between the periods from March 1, 2017 to November 11, 2017 at the Tata Memorial Hospital, Mumbai. All male patients had lower rectal cancer with prostate involvement on magnetic resonance imaging (MRI)...
May 9, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29739356/korean-society-of-coloproctology-kscp-trial-of-consolidation-chemotherapy-for-locally-advanced-mid-or-low-rectal-cancer-after-neoadjuvant-concurrent-chemoradiotherapy-a-multicenter-randomized-controlled-trial-konclude
#15
Chang Woo Kim, Byung Mo Kang, Ik Yong Kim, Ji Yeon Kim, Sun Jin Park, Won Cheol Park, Ki Beom Bae, Byung-Noe Bae, Seong Kyu Baek, Seung Hyuk Baik, Gyung Mo Son, Yoon Suk Lee, Suk-Hwan Lee
BACKGROUND: Neoadjuvant chemoradiotherapy (CRT) followed by total mesorectal excision (TME) has been a standard treatment option for locally advanced rectal cancer with improved local control. However, systemic recurrence despite neoadjuvant CRT remained unchanged. The only significant prognostic factor proven to be important was pathologic complete response (pCR) after neoadjuvant CRT. Several efforts have been tried to improve survival of patients who treated with neoadjuvant CRT and to achieve more pCR including adding cytotoxic chemotherapeutic agents, chronologic modification of chemotherapy schedule or adding chemotherapy during the perioperative period...
May 8, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29732957/prospective-trial-on-probe-based-confocal-laser-endomicroscopy-for-the-identification-of-the-distal-limit-in-rectal-adenocarcinoma
#16
Arthur R Wijsmuller, Jean-Pierre Ghnassia, Sharmini Varatharajah, Mickael Schaeffer, Joel Leroy, Jacques Marescaux, Mihaela Ignat, Didier Mutter
BACKGROUND: Intraoperative decision of the level of distal resection in rectal cancer is often imprecise, based exclusively on digital examination and pretherapeutic imaging. DESIGN: Prospective, single institution, nonrandomized trial ( ClinicalTrial.gov identification no. NCT01887509) to evaluate the contribution of probe-based confocal laser endomicroscopy (pCLE) to establish the optimal resection margin of rectal adenocarcinoma. The primary outcome was the concordance in the identification of lower tumor margins between pCLE and histopathology...
May 1, 2018: Surgical Innovation
https://www.readbyqxmd.com/read/29731507/primary-papillary-serous-carcinoma-of-the-fallopian-tube-presenting-as-a-vaginal-mass-a-case-report-and-review-of-the-literature
#17
Einav Kadour-Peero, Lena Sagi-Dain, Gil Cohen, Roman Korobochka, Abed Agbarya, Jacob Bejar, Shlomi Sagi
BACKGROUND There is now evidence to support that some cases of high-grade serous papillary carcinoma arise from the fallopian tubes rather than the ovaries. Common symptoms at presentation include abdominal pain and swelling, vomiting, altered bowel habit and urinary symptoms. To our knowledge, this is the first case of serous papillary carcinoma presenting as a vaginal mass lesion. CASE REPORT A 41-year-old woman was referred to the Bnai-Zion Medical Center with the main complaint of irregular vaginal bleeding, vaginal mucous discharge, and suspected pelvic mass...
May 7, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29731188/endoscopic-criteria-to-evaluate-tumor-response-of-rectal-cancer-to-neoadjuvant-chemoradiotherapy-using-magnifying-chromoendoscopy
#18
Akiko Chino, Tsuyoshi Konishi, Atsushi Ogura, Hiroshi Kawachi, Hiroki Osumi, Toshiyuki Yoshio, Teruhito Kishihara, Daisuke Ide, Shoichi Saito, Masahiro Igarashi, Takashi Akiyoshi, Masashi Ueno, Junko Fujisaki
BACKGROUND AND AIMS: Precise endoscopic assessment of complete response to neoadjuvant chemoradiotherapy before surgery is important for optimizing surgical and non-surgical treatment. We prospectively evaluated the accuracy of the newly proposed endoscopic criteria to identify complete response, using magnifying chromoendoscopy. METHODS: New endoscopic criteria were created to define endoscopic complete response, near complete response and incomplete response, using magnifying chromoendoscopy...
April 25, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29726260/-radiotherapy-in-the-treatment-of-rectal-cancer-is-it-time-to-move-on
#19
P Ihnát, P Vávra, I Slívová, L Tulinský, I Penka
Multidisciplinary treatment approach in accordance with current guidelines represents a gold standard of care for patients with rectal cancer. Radical surgical resection is a fundamental and the only curative treatment modality. Patients with locally advanced rectal cancer (cT3-4N0M0 or anyTN1-2M0) are indicated for neoadjuvant radiotherapy or radiochemotherapy. However, there are many controversies regarding neoadjuvant radiotherapy indications in the available literature. Evidence-based medicine data suggest that neoadjuvant radiotherapy is associated with improved local control of the disease, but has no impact on patients survival...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29721745/hemoglobin-level-and-xrcc1-polymorphisms-to-select-patients-with-locally-advanced-rectal-cancer-candidate-for-neoadjuvant-chemoradiotherapy-with-concurrent-capecitabine-and-a-platinum-salt
#20
Vincenzo Formica, Michaela Benassi, Giovanna Del Vecchio Blanco, Elena Doldo, Laura Martano, Ilaria Portarena, Antonella Nardecchia, Jessica Lucchetti, Cristina Morelli, Emilia Giudice, Piero Rossi, Alessandro Anselmo, Pierpaolo Sileri, Giuseppe Sica, Augusto Orlandi, Riccardo Santoni, Mario Roselli
A platinum salt (oxaliplatin or cisplatin) is widely used to enhance chemoradation (CRT) response. The potential of cisplatin in neoadjuvant CRT for locally advanced rectal cancer (LARC) has not been fully investigated. Consecutive patients with histologically confirmed LARC were treated with standard pelvic radiotherapy and concurrent cisplatin plus capecitabine (CisCape CRT). Surgery and eight cycles of adjuvant FOLFOX4 were offered to all patients after CRT. Common biochemical variables and key germline genetic polymorphisms were analyzed as predictors of pathological complete response (pCR)...
May 2, 2018: Medical Oncology
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