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Rectal cancer. Hernia

Gijsbert D Musters, Charlotte E L Klaver, Robbert J I Bosker, Jacobus W A Burger, Peter van Duijvendijk, Boudewijn van Etten, Anna A W van Geloven, Eelco J R de Graaf, Christiaan Hoff, Jeroen W A Leijtens, Harm J T Rutten, Baljit Singh, Ronald J C L M Vuylsteke, Johannes H W de Wilt, Marcel G W Dijkgraaf, Willem A Bemelman, Pieter J Tanis
OBJECTIVE: To determine the effect of biological mesh closure on perineal wound healing after extralevator abdominoperineal resection (eAPR). BACKGROUND: Perineal wound complications frequently occur after eAPR with preoperative radiotherapy for rectal cancer. Cohort studies have suggested that biological mesh closure of the pelvic floor improves perineal wound healing. METHODS: Patients were randomly assigned to primary closure (standard arm) or biological mesh closure (intervention arm)...
September 20, 2016: Annals of Surgery
Wei Ge, Song-Song Jiang, Wang Qi, Hao Chen, Li-Ming Zheng, Gang Chen
GOAL: To share our experience of extra-levator abdominoperineal excision (ELAPE) for low rectal cancer, focusing on perineal repair with biological mesh. METHODS: We retrospectively analyzed medical records of all patients with low rectal cancer who underwent the ELAPE procedure using biological mesh for perineal repair at the Gastrointestinal Surgery of Nanjing Drum Power Hospital between January 2013 and September 2015. All patients were closely followed up to now...
October 6, 2016: Oncotarget
Ryota Takahashi, Shintaro Akamoto, Mina Nagao, Natsumi Matsuura, Masao Fujiwara, Keiichi Okano, Yasuyuki Suzuki
BACKGROUND: Asymptomatic diaphragmatic hernia is generally thought to be rare among adults. We present two different types of asymptomatic diaphragmatic hernia diagnosed with computed tomography (CT) and discuss treatment strategies. CASE PRESENTATION: Case 1: A 37-year-old woman was diagnosed with catamenial pneumothorax in the right diaphragm. Partial resection of the diaphragm and lung was performed using a linear stapler. She was asymptomatic after the operation and gave birth 2 years later...
December 2016: Surgical Case Reports
Emilie P Colov, Mads Klein, Ismail Gögenur
BACKGROUND: Extralevator abdominoperineal excision was introduced as an alternative to conventional abdominoperineal excision for low rectal cancers. The perineal dissection is more extensive with extralevator abdominoperineal excision and leaves a greater defect. OBJECTIVE: The aim of this study was to evaluate, on a national basis, the risk of perineal wound complications, pain, and hernia after conventional and extralevator abdominoperineal excision performed for low rectal cancer...
September 2016: Diseases of the Colon and Rectum
Pia Näsvall, Ursula Dahlstrand, Thyra Löwenmark, Jörgen Rutegård, Ulf Gunnarsson, Karin Strigård
AIM: Health-related quality of life (HRQoL) assessment is important in understanding the patient's perspective and for decision-making in health care. HRQoL is often impaired in patients with stoma. The aim was to evaluate HRQoL in rectal cancer patients with permanent stoma compared to patients without stoma. METHODS: 711 patients operated for rectal cancer with abdomino-perineal resection or Hartman's procedure and a control group (n = 275) operated with anterior resection were eligible...
July 21, 2016: Quality of Life Research
Joachim Wiskemann, Kai Schommer, Dirk Jaeger, Friederike Scharhag-Rosenberger
BACKGROUND: Colorectal cancer survivors are deconditioned through anticancer therapy. Furthermore, about 10% of them have a permanent ostomy which is associated with weakened abdominal muscles and an increased risk of a hernia. This case study reports on how a firefighter with rectal carcinoma and ostomy was trained to regain operational fitness. METHODS: A 44-year-old firefighter (178 cm, 82 kg) with an adenocarcinoma of the rectum (diagnosed 24 months prior) had been treated with neoadjuvant radiochemotherapy and surgery...
July 2016: Medicine (Baltimore)
Vincenzo Simonelli, Carine Boven, Patrizia Loi, Issam El Nakadi, Jean Closset
Introduction There are very few case reports of metastasis on a mesh prosthesis following laparoscopic hernia repair in the literature and its incidence is completely unknown. Case report A 76-year-old male patient presented in December 2013 with a suspicious malignant lesion of the pancreatic tail on the MRI. He was also complaining of a painful mass in the right para-rectal area. An exploratory laparoscopy performed in December 2013 revealed microscopic whitish peritoneal implants in the left hypochondrium and a massive metastasis involving a mesh prosthesis placed é years before in the right para-rectal area...
February 2016: Acta Chirurgica Belgica
Jiagang Han, Zhenjun Wang, Zhigang Gao, Guanghui Wei, Yong Yang, Bingqiang Yi, Zhiwei Zhai, Huachong Ma, Bo Zhao, Baocheng Zhao, Hao Qu, Jianliang Wang, Zhulin Li
OBJECTIVE: To evaluate the laparoscopy combined with transperineal extralevator abdominoperineal excision (TP-ELAPE) for locally advanced low rectal caner. METHODS: Clinical data of 12 patients with locally advanced low rectal cancer undergoing laparoscopy combined with TP-ELAPE in our department from May 2013 to March 2015 were retrospectively analyzed. There were 8 male and 4 female patients with median aged of 63 (46 to 72) years. The median distance from tumor lower margin to anal verge was 3...
June 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
M Bocková, J Hoch, L Frajer
UNLABELLED: Perineal hernia is defined as a protrusion of intra-abdominal viscera through a defect in the pelvic floor. Primary hernias are extremely rare; secondary (postoperative) hernias following pelvic surgery, especially abdominoperineal resection or pelvic exenteration, are more common. Impaired perineal wound healing and neoadjuvant chemoradiotherapy in cancer patients are defined as main risk factors. A growing incidence of this complication is expected in connection with an increasing use of laparoscopic approaches and ELAPE...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Shuanhu Wang, Wenbin Wang, Bing Zhu, Guolei Song, Congqiao Jiang
BACKGROUND: Parastomal hernia is a very common complication after colostomy, especially end-colostomy. It is unclear whether prophylactic placement of mesh at the time of stoma formation could prevent parastomal hernia formation after surgery for rectal cancer. A systematic review and meta-analysis were conducted to evaluate the efficacy of prophylactic mesh in end-colostomy construction. METHODS: PubMed, Embase, and the Cochrane Library were searched, covering records entered from their inception to September 2015...
October 2016: World Journal of Surgery
Michel Prudhomme, Mathias Alline, John Chauvat, Pascale Fabbro-Perray, Jérémie Ripoche, Martin Marie Bertrand
BACKGROUND: Peristomal hernia (PH) is a common complication of colostomy. It often leads to a decrease in the patient's quality of life. Surgical procedures for PH are difficult and present high failure and morbidity rates. This randomized, double blind, multicentre trial was conducted to determine the benefits and risks of mesh reinforcement vs conventional stoma formation in preventing PH. METHODS: 200 patients undergoing a permanent end colostomy are randomized into two groups...
July 2016: Digestive and Liver Disease
M Gómez Ruiz, J Alonso Martin, C Cagigas Fernández, J I Martín Parra, H Real Noval, B Martín Rivas, E Toledo Martínez, J Castillo Diego, M Gómez Fleitas
BACKGROUND: Robot-assisted total mesorectal excision is a safe alternative for rectal cancer treatment. Nevertheless, substantial data is still missing. Our aim was to assess the perioperative and oncological outcomes of the routine use of the robotic-assisted approach for rectal cancer treatment. PATIENTS AND METHODS: 198 Consecutive robotic rectal resections were performed between January 2011 and April 2015 in patients with stage I-IV disease. We prospectively evaluated peri and postoperative data, pathological findings and mid-term oncological outcomes...
June 2016: European Journal of Surgical Oncology
Arie P Dosoretz, James B Yu
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
May 20, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
P A Neumann, A S Mehdorn, G Puehse, N Senninger, E Rijcken
Secondary perineal herniation of intraperitoneal contents represents a rare complication following procedures such as abdominoperineal rectal resection or cystectomy. We present a case of a perineal hernia formation with prolapse of an ileum neobladder following radical cystectomy and rectal resection for recurrent bladder cancer. Following consecutive resections in the anterior and posterior compartment of the lesser pelvis, the patient developed problems emptying his neobladder. Clinical examination and computed tomography revealed perineal herniation of his neobladder through the pelvic floor...
April 2016: Annals of the Royal College of Surgeons of England
Manuel López-Cano, Xavier Serra-Aracil, Laura Mora, José Luis Sánchez-García, Luis Miguel Jiménez-Gómez, Marc Martí, Francesc Vallribera, Domenico Fraccalvieri, Anna Serracant, Esther Kreisler, Sebastiano Biondo, Eloy Espín, Salvador Navarro-Soto, Manuel Armengol-Carrasco
OBJECTIVE: The aim of this study was to assess the reduction in the incidence of parastomal hernia (PH) after placement of prophylactic synthetic mesh using a modified Sugarbaker technique when a permanent end-colostomy is needed. SUMMARY OF BACKGROUND DATA: Prevention of PH formation is crucial given the high prevalence of PH and difficulties in the surgical repair of PH. METHODS: A randomized, prospective, double-blind, and controlled trial...
March 8, 2016: Annals of Surgery
Satoshi Sugimoto, Yasuaki Miyazaki, Sou Hirose, Toshiya Michiura, Shigeo Fujita, Kazuo Yamabe, Satoru Miyazaki, Makio Nagaoka
A 78 -year-old man with rectal cancer underwent abdominoperineal resection of the rectum. In the postoperative period, the patient experienced wound infection, leading to an abdominal wall hernia. Two years following surgery, a rise in the serum CEA level was seen. A metastatic tumor was detected in the right lung on chest CT. VATS right lung inferior lobe segmental resection was performed. After lobectomy, the serum CEA level continued to increase. Another metastatic tumor was detected in the right lung on chest CT...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Xuyang Yang, Chengwu Jin, Xiangbing Deng, Meng Wang, Yuanchuan Zhang, Mingtian Wei, Wenjian Meng, Ziqiang Wang
AIMS: This study evaluated the safety, feasibility, and short-term outcomes of laparoscopic extralevator abdominoperineal excision (laparoscopic-ELAPE) with primary suturing for low rectal cancer. MATERIALS AND METHODS: Consecutive patients who underwent laparoscopic-ELAPE with primary suturing for low rectal cancer at our institution between September 2013 and January 2015 were retrospectively identified from a prospectively maintained database. Short-term outcomes, including intraoperative complications, postoperative morbidity, and oncologic adequacy of surgical specimens, were evaluated...
January 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Vanessa N Palter, Steven MacLellan, Shady Ashamalla
BACKGROUND: The extra-levator approach to abdominal perineal resection (APR) was developed in order to reduce the rates of positive circumferential resection margin. This approach, however, is associated with significant morbidity. We postulate that a less radical resection of the levators done laparoscopically could significantly decrease the rate of perineal complications while ensuring an oncologically adequate specimen. To date, to our knowledge, there are no reports in the literature describing a laparoscopic translevator approach for APR...
July 2016: Surgical Endoscopy
G De Keersmaecker, R Beckers, E Heindryckx, I Kyle-Leinhase, P Pletinckx, D Claeys, E Vanderstraeten, E Monsaert, F Muysoms
BACKGROUND: Wounds resulting from the closure of temporary stomas have a high risk of developing an incisional hernia (IH) with incidences around 30% in studies designed to investigate this outcome. A temporary diverting ileostomy (TDI) is often used in patients after low anterior resection (LAR) for rectal cancer. METHODS: The OSTRICH study is a retrospective cohort study of rectal cancer patients who had a LAR with a reversed TDI and at least one CT scan during follow-up...
April 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Mika Vierimaa, Kai Klintrup, Fausto Biancari, Mikael Victorzon, Monika Carpelan-Holmström, Jyrki Kössi, Ilmo Kellokumpu, Erkki Rauvala, Pasi Ohtonen, Jyrki Mäkelä, Tero Rautio
BACKGROUND: Prophylactic placement of a mesh has been suggested to prevent parastomal hernia, but evidence to support this approach is scarce. OBJECTIVE: The aim of this study was to evaluate whether laparoscopic placement of a prophylactic, dual-component, intraperitoneal onlay mesh around a colostomy is safe and prevents parastomal hernia formation after laparoscopic abdominoperineal resection. DESIGN: This is a prospective, multicenter, randomized controlled clinical trial...
October 2015: Diseases of the Colon and Rectum
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