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Low anterior resection

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https://www.readbyqxmd.com/read/29134384/totally-robotic-single-docking-low-anterior-resection-for-rectal-cancer-pearls-and-pitfalls
#1
J W T Toh, A Zakaria, I Yang, S H Kim
Total robotic resection of mid- and low rectal cancers confers technical advantages within the confines of the pelvis and allows difficult rectal cancer cases to be performed efficiently with less risk of conversion to open. To maximize the advantage of robotic surgery, we utilize the technique of single docking totally robotic dissection for rectal cancer for both the Da Vinci Si and Xi Surgical Systems. All steps are performed robotically, with the surgery divided into two phases. The first phase consists of inferior mesenteric artery and vein ligation, sigmoid and descending colon mobilization and splenic flexure takedown...
November 13, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29130229/-discovery-anatomy-and-clinical-significance-of-the-mesorectal-finish-line-of-total-mesorectal-excision
#2
Pan Chi, Xiaojie Wang, Guoxian Guan, Huiming Lin, Ying Huang, Weizhong Jiang
OBJECTIVE: To investigate the surgical endpoint of separation of mesorectum during total mesorectal excision (TME), suggesting the concept of "terminal line", in order to perform above separation better for middle-low rectal cancer. METHODS: Gross anatomy of mesorectum endpoint from 81 surgical specimens of low anterior resection (LAR, 5 to 6 cm of distance from low margin of cancer to anal edge) and 71 surgical specimens of abdominal perineal resection(APR, <5 cm of distance from low margin of cancer to anal edge) was observed...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29129378/transvaginal-natural-orifice-transluminal-endoscopic-surgery-a%C3%A2-new-approach-to-myomectomy
#3
Jan Baekelandt
OBJECTIVE: To demonstrate a new approach for performing a myomectomy via transvaginal natural-orifice transluminal endoscopic surgery (vNOTES) as an alternative to laparoscopic myomectomy. DESIGN: Stepwise explanation of the technique with the use of original video footage. SETTING: Hospital. PATIENT(S): Eight patients were treated transvaginally for intramural, subserosal, and pedunculated myomas. INTERVENTION(S): In case of a posterior myoma, a 2...
November 9, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29122369/preserved-metacognitive-ability-despite-unilateral-or-bilateral-anterior-prefrontal-resection
#4
Anne-Laure Lemaitre, Guillaume Herbet, Hugues Duffau, Gilles Lafargue
Brodmann area 10 (BA10) is thought to be at the summit of the prefrontal cortex's hierarchical organization. It is widely accepted that metacognitive abilities depend on the structural and functional properties of BA10. Our objective was to assess whether metacognition can be maintained after low-grade glioma surgery with BA10 resection. Three groups of participants were recruited: (i) patients having undergone resection of the right prefrontal cortex, including BA10 (n = 9); (ii) patients having undergone resection of the right prefrontal cortex but not BA10 (n = 10); and (iii) healthy controls (n = 38)...
November 6, 2017: Brain and Cognition
https://www.readbyqxmd.com/read/29119289/local-antibiotic-decontamination-to-prevent-anastomotic-leakage-short-term-outcome-in-rectal-cancer-surgery
#5
Ulrich Wirth, Susanne Rogers, Kristina Haubensak, Stefan Schopf, Thomas von Ahnen, Hans Martin Schardey
PURPOSE: Anastomotic leakage still presents an issue in rectal cancer surgery with rates of about 11%. As bacteria play a critical role, there is the concept of perioperative local decontamination to prevent anastomotic leakage. METHODS: To ascertain the effectiveness of this treatment, we performed a retrospective analysis on 206 rectal resections with primary anastomosis and routine use of a selective decontamination of the digestive tract (SDD) regimen for local decontamination...
November 8, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29112562/initiation-of-a-transanal-total-mesorectal-excision-program-at-an-academic-training-program-evaluating-patient-safety-and-quality-outcomes
#6
Justin A Maykel, Uma R Phatak, Pasithorn A Suwanabol, Andrew T Schlussel, Jennifer S Davids, Paul R Sturrock, Karim Alavi
BACKGROUND: Short-term results have shown that transanal total mesorectal excision is safe and effective for patients with mid to low rectal cancers. Transanal total mesorectal excision is considered technically challenging; thus, adoption has been limited to a few academic centers in the United States. OBJECTIVE: The aim of this study is to describe outcomes after the initiation of a transanal total mesorectal excision program in the setting of an academic colorectal training program...
December 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29094352/anorectal-dysfunction-after-laparoscopic-low-anterior-rectal-resection-for-rectal-cancer-with-and-without-radiotherapy-manometry-study
#7
Peter Ihnát, Ivana Slívová, Lubomir Tulinsky, Lucia Ihnát Rudinská, Jan Máca, Igor Penka
BACKGROUND AND OBJECTIVES: The aim was to evaluate the impact of radiotherapy (RT) on anorectal function of patients with low rectal cancer undergoing low anterior resection (LAR). METHODS: Prospective clinical cohort study conducted to assess the functional outcome by means of high-resolution anorectal manometry and LARS score. RESULTS: In total, 65 patients were enrolled in the study (27 patients underwent LAR without RT, 38 patients underwent RT and LAR)...
November 1, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29089767/thalamo-cortical-network-underlying-deep-brain-stimulation-of-centromedian-thalamic-nuclei-in-intractable-epilepsy-a-multimodal-imaging-analysis
#8
Seong Hoon Kim, Sung Chul Lim, Dong Won Yang, Jeong Hee Cho, Byung-Chul Son, Jiyeon Kim, Seung Bong Hong, Young-Min Shon
OBJECTIVE: Deep brain stimulation (DBS) of the centromedian thalamic nucleus (CM) can be an alternative treatment option for intractable epilepsy patients. Since CM may be involved in widespread cortico-subcortical networks, identification of the cortical sub-networks specific to the target stimuli may provide further understanding on the underlying mechanisms of CM DBS. Several brain structures have distinguishing brain connections that may be related to the pivotal propagation and subsequent clinical effect of DBS...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29073547/rectovaginal-fistula-after-low-anterior-resection-for-rectal-cancer-healed-by-nonoperative-treatment
#9
Shigenobu Emoto, Hiroaki Nozawa, Satomi Yoneyama, Koji Murono, Manabu Kaneko, Kazuhito Sasaki, Kensuke Otani, Takeshi Nishikawa, Toshiaki Tanaka, Keisuke Hata, Tomomichi Kiyomatsu, Kazushige Kawai, Kanako Omata, Tatsuki Noguchi, Koichi Masuda, Hiroki Sakata, Yusuke Tajima, Akio Hidemura, Hiroyuki Suzuki, Masahiro Ishimaru, Toshiaki Watanabe
BACKGROUND: Rectovaginal fistula (RVF) is a serious complication after colorectal anastomosis using a double-stapling technique. RVF following this procedure has been considered to be refractory to conservative treatment. CASE PRESENTATION: A 75-year-old woman who underwent laparoscopy-assisted low anterior resection for early rectal cancer developed RVF on the 12th postoperative day. Conservative treatment was chosen and was successful. She was discharged from the hospital after 3 weeks with a normal oral diet...
October 18, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29071264/oncological-outcomes-following-rectal-cancer-surgery-with-high-or-low-ligation-of-the-inferior-mesenteric-artery
#10
Kenji Matsuda, Shozo Yokoyama, Tsukasa Hotta, Katsunari Takifuji, Takashi Watanabe, Koichi Tamura, Yasuyuki Mitani, Hiromitsu Iwamoto, Yuki Mizumoto, Hiroki Yamaue
BACKGROUND: The level of inferior mesenteric artery (IMA) ligation for anterior resection of rectal cancer has several considerations concerning oncological outcomes. The primary endpoint of this randomized controlled trial (RCT) was to assess bowel function between high and low ligation. This study was intended to clarify oncological outcome as the secondary endpoint. OBJECTIVE: The aim of this study was to assess in a prospective RCT whether the ligation level of the IMA in rectal cancer influences oncological outcomes...
September 2017: Gastrointestinal Tumors
https://www.readbyqxmd.com/read/29069855/rectovaginal-fistula-after-low-anterior-resection-in-chinese-patients-with-colorectal-cancer
#11
Hongtu Zheng, Tianan Guo, Yuchen Wu, Cong Li, Sanjun Cai, Fangqi Liu, Ye Xu
Rectovaginal fistula is a postoperative complication of low anterior resection. We investigated the incidence of rectovaginal fistula (RVF) after low anterior resection, its risk factors and its optimal treatment. We analyzed data from 1,493 female patients who underwent low anterior resection for colorectal cancer between January 2006 and March 2016. We calculated the incidence of RVF and performed univariate and multivariate logistic regression analyses to identify risk factors. Twenty-four patients experienced RVF, giving an incidence of 1...
September 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/29068989/outcomes-of-patients-with-abdominoperineal-resection-apr-and-low-anterior-resection-lar-who-had-very-low-rectal-cancer
#12
Seung-Seop Yeom, In Ja Park, Sung Woo Jung, Se Heon Oh, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seok-Byung Lim, Nayoung Kim, Chang Sik Yu, Jin Cheon Kim
We compared the oncological outcomes of sphincter-saving resection (SSR) and abdominoperineal resection (APR) in 409 consecutive patients with very low rectal cancer (i.e., tumors within 3 cm from the anal verge); 335 (81.9%) patients underwent APR and 74 (18.1%) underwent SSR. The APR group comprised higher proportions of men (67.5% vs 55.4%, P = .049) and advanced-stage patients (P < .001). Preoperative chemoradiotherapy (PCRT) was more frequently administered in the SSR group (83.8% vs 52.8%, P < ...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29067426/effect-of-robotic-assisted-vs-conventional-laparoscopic-surgery-on-risk-of-conversion-to-open-laparotomy-among-patients-undergoing-resection-for-rectal-cancer-the-rolarr-randomized-clinical-trial
#13
RANDOMIZED CONTROLLED TRIAL
David Jayne, Alessio Pigazzi, Helen Marshall, Julie Croft, Neil Corrigan, Joanne Copeland, Phil Quirke, Nick West, Tero Rautio, Niels Thomassen, Henry Tilney, Mark Gudgeon, Paolo Pietro Bianchi, Richard Edlin, Claire Hulme, Julia Brown
Importance: Robotic rectal cancer surgery is gaining popularity, but limited data are available regarding safety and efficacy. Objective: To compare robotic-assisted vs conventional laparoscopic surgery for risk of conversion to open laparotomy among patients undergoing resection for rectal cancer. Design, Setting, and Participants: Randomized clinical trial comparing robotic-assisted vs conventional laparoscopic surgery among 471 patients with rectal adenocarcinoma suitable for curative resection conducted at 29 sites across 10 countries, including 40 surgeons...
October 24, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29066704/-two-cases-of-unresectable-advanced-rectal-cancer-with-a-long-term-survival-for-which-pathological-complete-response-was-achieved-through-neoadjuvant-effective-chemotherapy
#14
Kenji Gonda, Yosuke Tachiya, Yuichi Hatakeyama, Masahiko Shibata, Koji Kono, Yuichi Rokkaku
We report 2 unusual cases of Stage IV rectal cancer for which pathological complete response was achieved with neoadjuvant chemotherapy(NAC)consisting of a combination of 5-fluorouracil(5-FU), oxaliplatin, Leucovorin(mFOLFOX6)or irinotecan(FOLFIRI), and bevacizumab, without radiotherapy. Case 1: A 65-year-old man was diagnosed as having rectal cancer with an invasive carcinoma of the prostate and lymph node metastasis. He refused to undergo surgery and received NAC instead. After NAC with mFOLFOX6 and FOLFIRI was performed, CT scan and colonoscopy revealed no evidence of disease...
October 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29066682/-a-case-of-bilateral-lymph-node-metastases-of-rectal-cancer-treated-with-chemotherapy-and-surgery
#15
Tomohiro Tate, Yudai Fukui, Kenji Tomizawa, Yutaka Hanaoka, Shigeo Toda, Shuichiro Matoba, Hiroya Kuroyanagi
We present a case of bilateral lymph node metastases of rectal cancer treated with chemotherapy and surgery. The patient was a 65-year-old man with upper rectal cancer. Laparoscopic low anterior resection(LAR)was performed. Pathological findings were tub2>por>muc, pT3, ly2, v3, pN2, pM0. Six months after surgery, the CEA level was elevated. CT and PET-CT confirmed bilateral metastasis to the lymph nodes. Five courses of FOLFOX4 plus bevacizumab were administered, and then, we performed laparoscopic bilateral lymph node dissection...
October 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29064311/transanal-endoscopic-microsurgery-implementation-in-ultra-low-anterior-resection
#16
Hayim Gilshtein, Mariya Neymark, Elias Manassa, Wisam Khoury, Daniel Duek
BACKGROUND: Distal rectal cancer resection is an ongoing challenge for the colorectal surgeon. In recent years new technical approaches, especially with implementation of transanal platforms were developed to help in the visualization and resection of these tumors. Nevertheless, the use of these platforms is demanding with significant complications during the onset phase. METHODS: Patients with very low rectal cancer were operated on in a single tertiary center with a combined abdominal and transanal endoscopic microsurgery (TEM) approach...
October 24, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29058085/stercoral-perforation-proximal-to-the-stapled-anastomosis-after-low-anterior-resection-with-an-intraluminal-device
#17
J B van Praagh, I S Bakker, K Havenga
Stercoral perforation of the colon is a rare phenomenon and a potential life-threatening condition requiring acute intervention. A little more than 200 cases have been described to date. The mechanism is not completely understood. In this short communication, we present three patients with a colon perforation proximal to the anastomosis, similar to a stercoral perforation, following colorectal cancer resection with application of an intraluminal device, the C-seal.
October 23, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29052070/the-feasibility-of-laparoscopic-rectal-resection-in-patients-undergoing-reoperation-after-transanal-endoscopic-microsurgery-tem
#18
M Ortenzi, R Ghiselli, A Paolucci, M Guerrieri
BACKGROUND: The success of transanal endoscopic microsurgery (TEM) for early rectal cancer depends on proper indications and strict patient selection. When unfavorable pathologic features are identified after TEM operation, total mesorectal excision is recommended to minimize the risk of recurrence. In this study, data were collected in a retrospective series of patients to determine the results of laparoscopic reoperation after TEM. METHODS: All patients underwent an accurate rectal-digital examination and clinical tumor staging by transanal endosonography, CT, and/or MRI...
October 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29046790/intraluminal-rectal-cancer-metastasis-to-the-small-bowel-an-extremely-rare-case-report
#19
Paraskevas Stamopoulos, Nikolaos Machairas, Stylianos Kykalos, Afrodite Nonni, Gregory Kouraklis, Georgios C Sotiropoulos
Prolonged survival in patients suffering from colorectal cancer (CRC) may lead to the emergence of rare metastatic sites that are not well-documented in the literature. We herein describe a very rare case of an intraluminal small intestinal metastasis in a patient with previously resected CRC. A 71-year-old Caucasian male patient with a history of rectosigmoid junction cancer was initially treated with anterior resection. The tumor was classified as pT3pN0 (0/26) M0, stage II. Eighteen months after the primary surgery, local recurrence was detected in the presacral region, and the patient received combined image-guided radiotherapy and chemotherapy...
October 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29040698/clinical-outcome-after-endoscopic-endonasal-resection-of-tuberculum-sella-meningiomas
#20
Khaled Elshazly, Varun R Kshettry, Christopher J Farrell, Gurston Nyquist, Marc Rosen, James J Evans
BACKGROUND: In select cases, the endoscopic endonasal approach (EEA) has distinct advantages for resection of tuberculum sella meningiomas (TSM). OBJECTIVE: To report the extent of resection (EOR), complication rates, and outcomes in a large series of TSM treated by the EEA. METHODS: Twenty-five consecutive TSM cases treated by EEA from 2008 to 2016 were retrospectively reviewed. Patient history, imaging, volumetric EOR, complications, and outcomes are presented...
October 10, 2017: Operative Neurosurgery (Hagerstown, Md.)
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