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Low anterior resection

Hideaki Nishigori, Masayuki Ishii, Yujiro Kokado, Kouji Fujimoto, Hiroshi Higashiyama
BACKGROUND: The aim of this study was to evaluate the effectiveness of pelvic floor rehabilitation (PFR) for patients with bowel dysfunction after intersphincteric resection (ISR) and to compare the treatment response to that of patients after low anterior resection (LAR). METHODS: Thirty patients with postoperative bowel dysfunction for more than 6 months were enrolled and treated with PFR for 6 months. RESULTS: In the ISR group, significant improvements in the number of bowel movements and the use of antidiarrheal medications were observed, but no significant improvement was observed in the Wexner score (WS) and the fecal incontinence severity index (FISI)...
March 19, 2018: World Journal of Surgery
Brian R Waterman, William Arroyo, Eric J Cotter, Michael A Zacchilli, E'Stephan J Garcia, Brett D Owens
Background: There remains a debate over whether to retain the index anterior cruciate ligament (ACL) graft in the setting of septic arthritis. Purpose: To evaluate and compare clinical outcomes for the treatment of septic arthritis after ACL reconstruction (ACLR) in those with and without early graft retention. Study Design: Case series; Level of evidence, 4. Methods: The Military Health System was queried for all ACLR procedures performed between 2007 and 2013...
March 2018: Orthopaedic Journal of Sports Medicine
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
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
Ali S Haider, Christopher S Graffeo, Avital Perry, Lucas P Carlstrom, Terry C Burns
Insular gliomas were previously considered inoperable lesions and were typically treated via biopsy, chemotherapy and/or radiation, if not observation alone. Stereotactic biopsies of low grade insular gliomas can underestimate tumor grade or fail to establish malignancy. Moreover, the survival advantages of maximal safe resection for insular lesions are increasingly being recognized. As such, early surgical resection is increasingly being performed. As with most lesions, a differential diagnosis exists for apparent insular gliomas, with definitive diagnosis generally obtained upon resection...
January 11, 2018: Curēus
Robin De Roover, Wouter Crijns, Kenneth Poels, Ronald Peeters, Cédric Draulans, Karin Haustermans, Tom Depuydt
PURPOSE: Liquid fiducial markers have shown to be a promising alternative to solid gold markers in terms of imaging artifact reduction, patient comfort and compatibility with different imaging modalities. This study aims to investigate the performance of the novel BioXmark® liquid marker for state-of-the-art multi-modal imaging used in prostate cancer (PCa) radiotherapy, encompassing kV CT/CBCT, multi-parametric MRI and kV X-ray imaging. In addition, automatic detection of the liquid markers in X-ray imaging for prostate motion monitoring during treatment was investigated...
March 14, 2018: Medical Physics
Tianxiao Jiang, Su Liu, Giuseppe Pellizzer, Aydin Aydoseli, Sacit Karamursel, Pulat A Sabanci, Altay Sencer, Candan Gurses, Nuri F Ince
Functional mapping of eloquent cortex before the resection of a tumor is a critical procedure for optimizing survival and quality of life. In order to locate the hand area of the motor cortex in two patients with low-grade gliomas (LGG), we recorded electrocorticogram (ECoG) from a 113 channel hybrid high-density grid (64 large contacts with diameter of 2.7 mm and 49 small contacts with diameter of 1 mm) while they executed hand clenching movements. We investigated the spatio-spectral characteristics of the neural oscillatory activity and observed that, in both patients, the hand movements were consistently associated with a wide spread power decrease in the low frequency band (LFB: 8-32 Hz) and a more localized power increase in the high frequency band (HFB: 60-280 Hz) within the sensorimotor region...
2018: Frontiers in Neuroscience
Kenji Matsuda, Shozo Yokoyama, Tsukasa Hotta, Takashi Watanabe, Koichi Tamura, Hiromitsu Iwamoto, Yuki Mizumoto, Hiroki Yamaue
BACKGROUND: This study is intended to assess whether the use of pelvic drain reduces incidence of pelvic sepsis in the era of laparoscopic low anterior resection (LAR). PATIENTS AND METHODS: In total, 200 of consecutive patients who underwent laparoscopic LAR for rectal cancer with diverting stoma were analyzed. RESULTS: Pelvic sepsis occurred in 14 of 110 patients (12.7%) in the drain group and in 9 of 90 patients (10.0%) in the no drain group (P=0...
March 8, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Audrey S Kulaylat, Christopher S Hollenbeak, David B Stewart
BACKGROUND: Although longer operative times are associated with increased postoperative morbidity, the influence of surgical residents on this association is unclear. OBJECTIVE: The purpose of this study was to evaluate whether morbidity associated with operative times in laparoscopic colorectal surgery is increased by resident training. DESIGN: This was a retrospective cohort study. SETTINGS: The study was conducted using a national database...
March 8, 2018: Diseases of the Colon and Rectum
Karl Roessler, Burkhard S Kasper, Roland Coras, Soheil Arinrad, Michael Scholz, Hajo H Hamer, Ingmar Blümcke, Michael Buchfelder
BACKGROUND: Temporal lobe resection (TLR) including amygdalo-hippocampectomy (AHE) is the most frequent performed procedure in epilepsy surgery. Due to close anatomical relationship of the mesial temporal structures and the midbrain and choroidal fissure, the risk of severe complications like postoperative stroke is up to 2.5%. METHODS: We developed a modification of the classical technique for AHE by early entering the choroidal fissure for identification of crus cerebri, posterior cerebri artery and oculomotor nerve via the anterior part of the fronto- mesial temporal horn cleft...
March 7, 2018: World Neurosurgery
Mazen A Juratli, Nour-Eldin A Nour-Eldin, Hans Ackermann, Nils Habbe, Sabine Hannes, Wolf O Bechstein, Guido Woeste
PURPOSE: The incidence of incisional hernia (IH) at ileostomy closure site has not been sufficiently evaluated. Temporary loop ileostomy is routinely used in patients after low anterior resection for rectal cancer. The goal of this study was to compare the IH rates of standard suture skin closure and purse-string skin closure techniques. PATIENTS AND METHODS: Patients undergoing ileostomy reversal and follow-up CT scan at the University Hospital Frankfurt between January 2009 and December 2015 were retrospectively analyzed regarding IH and associated risk factors...
March 9, 2018: International Journal of Colorectal Disease
Brian K P Goh, Lip-Seng Lee, Ser-Yee Lee, Pierce K H Chow, Chung-Yip Chan, Adrian K H Chiow
BACKGROUND: Presently, the adoption of laparoscopic hepatectomy is rapidly increasingly worldwide. However, the application of robotic hepatectomy (RH) remains limited and its role remains undefined today. METHODS: A retrospective review of 43 consecutive patients who underwent RH at two institutions in the Singapore Health Services Group. RESULTS: Forty-three consecutive patients underwent 48 resections during the study period. Seven (16...
March 7, 2018: ANZ Journal of Surgery
Philipp Schuster, Markus Geßlein, Michael Schlumberger, Philipp Mayer, Hermann Josef Bail, Jörg Richter
PURPOSE: No systematic studies on optimal treatment of postoperative septic arthritis following arthroscopic meniscus repair are available. The purpose of this study was to retrospectively evaluate the fate of repaired menisci in cases of postoperative septic arthritis, with treatment for infection focused on arthroscopic irrigation and debridement (I&D) and intention to maintain the meniscus. METHODS: Data of two sports orthopedics centers of the last 10 years were pooled (approximately 25,000 arthroscopic procedures of the knee)...
March 6, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Noritoshi Mizuta, Hirofumi Kosuga, Youichiro Nakamura, Mitsutoshi Ogino, Kozo Tsunemi
A 43-year-old female noticed hematochezia and lower-right abdominal pain during menstruation. Her family doctor detected a mass by computed tomography at the ileocecum. She was referred to our hospital and colonoscopy was performed. We observed extrinsic pressure resulting in mucosal change at the ileocecum. We also observed a submucosal tumor-like lesion at the rectosigmoid. We performed biopsy from both lesions, both were benign. Ileocecal resection and rectal low anterior resection were performed for diagnosis...
February 2018: Journal of Surgical Case Reports
Geoffroy Canlorbe, Cyril Touboul, Cyrus Chargari, Enrica Bentivegna, Amandine Maulard, Patricia Pautier, Catherine Genestie, Philippe Morice, Sébastien Gouy
AIM: To evaluate the influence on relapse-free survival (RFS) and overall survival (OS) of a transitory protective stoma (TPS) at the time of complete cytoreductive surgery for advanced-stage ovarian cancer. PATIENTS AND METHODS: From our Institution, we retrospectively selected patients from 2006 to 2011 with ovarian cancer with the following criteria: stage IIIB to IVA (pleural effusion) according to the International Federation of Gynaecology and Obstetrics classification; complete cytoreductive surgery (CC0 according to Sugarbaker's classification); and a low anterior resection...
March 2018: Anticancer Research
Kazuhiro Sakamoto, Makoto Takahashi, Rina Takahashi, Shingo Kawano, Masaya Kawai, Kiichi Sugimoto, Hirohiko Kamiyama, Yutaka Kojima, Atsushi Okuzawa, Yuichi Tomiki
Here, we report a case of repeated laparoscopic resection of extra-regional lymph node metastases in a patient after laparoscopic surgery for rectal cancer. A 72-year-old woman was diagnosed with upper rectal cancer and underwent laparoscopic low anterior resection and D3 dissection. The pathological stage was considered as T3, N2b, M0, Stage IIIC. Six months after the operation, positron emission tomography-computed tomography (PET-CT) showed fluorodeoxyglucose (FDG) accumulation in the infra-renal para-aortic lymph nodes (PALNs)...
April 2018: Journal of Minimal Access Surgery
Yali Yue, Yongkang Liu, Lina Song, Xiao Chen, Yaohui Wang, Zhongqiu Wang
BACKGROUND: Low-grade fibromyxoid sarcoma (LGFMS) is a distinctive slow growing soft tissue neoplasm, mostly affecting young individuals with no gender difference. It usually arises in deep soft tissue of the lower limbs and trunk, but few cases of LGFMS located in pelvis have been reported. CASE PRESENTATION: We describe the magnetic resonance imaging(MRI) features of LGFMS located in the anterior pelvic wall of a 21-year-old female and correlate them with clinicopathological features...
February 26, 2018: BMC Musculoskeletal Disorders
Meena M Archie, Johnathon C Rollo, Hugh A Gelabert
INTRODUCTION: Surgical management of spontaneous subclavian thrombosis due to venous thoracic outlet syndrome (vTOS) results in durable relief of symptoms. The need to re-operate is rare. We report our experience with re-operation for vTOS. METHODS: Patients evaluated for vTOS between 1996 and 2016 were identified in a prospective database. Data recorded included demographics, initial presentation, initial surgery, recurrent presentation, re-operation, and final outcomes...
February 22, 2018: Annals of Vascular Surgery
Benjamin Goode, Gourish Mondal, Michael Hyun, Diego Garrido Ruiz, Yu-Hsiu Lin, Jessica Van Ziffle, Nancy M Joseph, Courtney Onodera, Eric Talevich, James P Grenert, Iman H Hewedi, Matija Snuderl, Daniel J Brat, Bette K Kleinschmidt-DeMasters, Fausto J Rodriguez, David N Louis, William H Yong, M Beatriz Lopes, Marc K Rosenblum, Nicholas Butowski, Tarik Tihan, Andrew W Bollen, Joanna J Phillips, Arun P Wiita, Iwei Yeh, Matthew P Jacobson, Boris C Bastian, Arie Perry, David A Solomon
Chordoid glioma is a rare brain tumor thought to arise from specialized glial cells of the lamina terminalis along the anterior wall of the third ventricle. Despite being histologically low-grade, chordoid gliomas are often associated with poor outcome, as their stereotypic location in the third ventricle makes resection challenging and efficacious adjuvant therapies have not been developed. Here we performed genomic profiling on 13 chordoid gliomas and identified a recurrent D463H missense mutation in PRKCA in all tumors, which localizes in the kinase domain of the encoded protein kinase C alpha (PKCα)...
February 23, 2018: Nature Communications
Sophie K Allen, Kat E Schwab, Timothy A Rockall
Once considered an incurable disease, the continuous evolution of technologies and techniques has improved both oncological outcomes and quality of life for patients with rectal cancer. Multiport laparoscopic surgery for rectal cancer is the standard of care in many institutions and countries and is the approach that has been most subjected to controlled trial. Following a number of randomized trials as well as large series and registry reports and several Cochrane reviews there is no evidence of any oncological disadvantage to laparoscopic surgery compared to the open approach and there is good evidence of improved short-term outcomes and some evidence of improved long-term outcomes...
February 21, 2018: Minerva Chirurgica
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