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Total mesorectal excision

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https://www.readbyqxmd.com/read/28514763/the-value-of-diffusion-kurtosis-imaging-in-assessing-pathological-complete-response-to-neoadjuvant-chemoradiation-therapy-in-rectal-cancer-a-comparison-with-conventional-diffusion-weighted-imaging
#1
Feixiang Hu, Wei Tang, Yiqun Sun, Dang Wan, Sanjun Cai, Zhen Zhang, Robert Grimm, Xu Yan, Caixia Fu, Tong Tong, Weijun Peng
OBJECTIVES: The aim of this study is to comprehensively evaluate the advantage of diffusion kurtosis imaging (DKI) in distinguishing pathological complete response (pCR) from non-pCR patients with locally advanced rectal cancer (LARC) after neoadjuvant chemoradiation therapy (CRT) in comparison to conventional diffusion-weighted imaging (DWI). MATERIAL AND METHODS: Fifty-six consecutive patients diagnosed with LARC were prospectively enrolled and underwent pre- and post-CRT MRI on a 3...
April 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28501249/new-strategies-in-rectal-cancer
#2
REVIEW
Guilherme Pagin São Julião, Angelita Habr-Gama, Bruna Borba Vailati, Sergio Eduardo Alonso Araujo, Laura Melina Fernandez, Rodrigo Oliva Perez
In recent years, our understanding of rectal cancer has improved, including how locally advanced disease responds to chemotherapy and radiation. This has led to new innovations and advances in the treatment of rectal cancer, which includes organ-preserving strategies for responsive disease, and minimally invasive approaces for the performance of total mesorectal excision/protectomyh for persistently advanced disease. This article discusses new strategies for rectal cancer therapy, including Watch and Wait, local excision, minimally invasive proctectomy, and transanal total mesorectal excision particularly in the setting of preoperative multimodality treatment...
June 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28497757/safety-and-tolerability-of-veliparib-combined-with-capecitabine-plus-radiotherapy-in-patients-with-locally-advanced-rectal-cancer-a-phase-1b-study
#3
Brian G Czito, Dustin A Deming, Gayle S Jameson, Mary F Mulcahy, Houman Vaghefi, Matthew W Dudley, Kyle D Holen, Angela DeLuca, Rajendar K Mittapalli, Wijith Munasinghe, Lei He, John R Zalcberg, Samuel Y Ngan, Philip Komarnitsky, Michael Michael
BACKGROUND: Further optimisation of present standard chemoradiation is needed in patients with locally advanced rectal cancer. Veliparib, an oral poly(ADP-ribose) polymerase inhibitor, has been shown to enhance the antitumour activity of chemotherapy and radiotherapy in preclinical models. We aimed to establish the maximum tolerated dose and establish the recommended phase 2 dose of veliparib combined with neoadjuvant capecitabine and radiotherapy. METHODS: This phase 1b, open-label, multicentre, dose-escalation study was done at six hospitals (one in Australia and five in the USA)...
June 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28481859/transanal-total-pelvic-exenteration-pushing-the-limits-of-transanal-total-mesorectal-excision-with-transanal-pelvic-exenteration
#4
Dai Uematsu, Gaku Akiyama, Takehiko Sugihara, Akiko Magishi, Takuya Yamaguchi, Takayuki Sano
No abstract text is available yet for this article.
June 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28481853/the-rationale-for-and-reality-of-the-new-national-accreditation-program-for-rectal-cancer
#5
Steven D Wexner, Mariana E Berho
BACKGROUND: The treatment of rectal cancer has greatly evolved because of numerous diagnostic and therapeutic advances. More accurate staging by MRI has allowed more appropriate use of neoadjuvant therapy as well as more standardized high-quality total mesorectal excision. Lower rates of perioperative morbidity, permanent colostomy creation, and improved rates of oncologically acceptable rectal excision have led to lower recurrence and greater disease-free survival rates. The recognition of the need for pathologic assessment of the quality of total mesorectal excision, the status of the circumferential resection margins, and the finding of a minimum of 12 lymph nodes as well as identification of extramural vascular invasion has improved staging...
June 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28481851/what-to-do-with-lateral-nodal-disease-in-low-locally-advanced-rectal-cancer-a-call-for-further-reflection-and-research
#6
Miranda Kusters, Andrew Slater, Rebecca Muirhead, Roel Hompes, Richard J Guy, Oliver M Jones, Bruce D George, Ian Lindsey, Neil J Mortensen, Chris Cunningham
BACKGROUND: There remains a lack of international consensus on the appropriate management of lateral nodal disease. Although the East manages this more aggressively with lateral lymph node dissections, the West aims to eradicate small-volume disease with neoadjuvant chemoradiotherapy and lateral nodal disease is not considered for routine surgical treatment. However, recent studies have shown that, despite neoadjuvant treatment, a significant number of patients with lateral nodal disease develop local recurrence in the lateral compartment after total mesorectal excision...
June 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28476941/systemic-chemotherapy-as-salvage-treatment-for-locally-advanced-rectal-cancer-patients-who-fail-to-respond-to-standard-neoadjuvant-chemoradiotherapy
#7
Francesco Sclafani, Gina Brown, David Cunningham, Sheela Rao, Paris Tekkis, Diana Tait, Federica Morano, Chiara Baratelli, Eleftheria Kalaitzaki, Shahnawaz Rasheed, David Watkins, Naureen Starling, Andrew Wotherspoon, Ian Chau
BACKGROUND: The potential of chemotherapy as salvage treatment after failure of neoadjuvant chemoradiotherapy for locally advanced rectal cancer (LARC) has never been explored. We conducted a single-center, retrospective analysis to address this question. PATIENTS AND METHODS: Patients with newly diagnosed LARC who were inoperable or candidates for extensive (i.e., beyond total mesorectal excision [TME]) surgery after long-course chemoradiotherapy and who received salvage chemotherapy were included...
May 5, 2017: Oncologist
https://www.readbyqxmd.com/read/28476708/laparoscopic-surgery-is-feasible-for-the-treatment-of-rectal-cancer-after-neoadjuvant-chemoradiotherapy
#8
Wencui Ju, Xiaoyong Luo, Baowei Han
This case-control study aimed to clarify the short- and long-term outcomes of laparoscopic surgery for rectal cancer after neoadjuvant chemo radiotherapy compared with conventional open resection. Between January 2008 and December 2014, a series of 227 patients with rectal cancer underwent radical surgery after neoadjuvant chemo radiotherapy. Age, gender, American Society of Anesthesiologists score, clinical stage, and type of resection were matched by propensity scoring and 106 patients (53 patients with laparoscopic total mesorectal excision and 53 patients with open resection) were selected for analysis...
September 2016: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28474202/neoadjuvant-capeox-therapy-followed-by-sphincter-preserving-surgery-for-lower-rectal-cancer
#9
Taishi Hata, Hidekazu Takahashi, Daisuke Sakai, Naotsugu Haraguchi, Junichi Nishimura, Toshihiro Kudo, Matsuda Chu, Ichiro Takemasa, Satoh Taroh, Tsunekazu Mizushima, Yuichiro Doki, Masaki Mori
PURPOSE: This retrospective study investigates the safety of neoadjuvant chemotherapy with oxaliplatin capecitabine (CapeOx), followed by laparoscopic surgery, for lower rectal cancer, and its efficacy in preserving the sphincter. METHODS: Ten patients with diagnosed lower rectal cancer received three or four cycles of neoadjuvant CapeOx chemotherapy, prior to undergoing low anterior resection or intersphincteric resection, with total mesorectal excision. The primary outcomes were R0 resection and the rate of sphincter preservation...
May 4, 2017: Surgery Today
https://www.readbyqxmd.com/read/28470365/objective-assessment-of-minimally-invasive-total-mesorectal-excision-performance-a-systematic-review
#10
REVIEW
N J Curtis, J Davids, J D Foster, N K Francis
INTRODUCTION: Laparoscopy is widely used in colorectal practice, but recent trial results have questioned its use in rectal cancer resections. Patient outcomes are directly linked to the quality of total mesorectal excision (TME) specimen. Objective assessment of intraoperative performance could help ensure competence and delivery of optimal outcomes. Objective tools may also contribute to TME intervention trials, but their nature, structure and utilisation is unknown. AIM: To systemically review the available literature to report on the available tools for the objective assessment of minimally invasive TME operative performance and their use within multicentre laparoscopic TME randomised controlled trials...
April 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28467625/peritumoral-indocyanine-green-fluorescence-injection-during-transanal-total-mesorectal-excision-to-identify-the-plane-of-dissection
#11
Giovanni Dapri, Ronan Cahill, Pierre Bourgeois, Gabriel Liberale, Maria Galdon Gomez, Guy-Bernard Cadière
TAMIS or transanal minimally invasive surgery for rectal cancer is becoming more popular. Besides its use in sentinel node mapping, indocyanine green (ICG) fluorescence has remained of interest to evaluate the adequacy of perfusion of the anastomosis. This video presents the use of peritumoral ICG injection during transanal total mesorectal excision (TaTME) to demonstrate another advantage - that of enhancing visualisation of the plane of dissection and the relationship to the surrounding structures. This article is protected by copyright...
May 3, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28462478/consensus-on-structured-training-curriculum-for-transanal-total-mesorectal-excision-tatme
#12
Nader Francis, Marta Penna, Hugh Mackenzie, Fiona Carter, Roel Hompes
BACKGROUND: The interest and adoption of transanal total mesorectal excision (TaTME) is growing amongst the colorectal surgical community, but there is no clear guidance on the optimal training framework to ensure safe practice for this novel operation. The aim of this study was to establish a consensus on a detailed structured training curriculum for TaTME. METHODS: A consensus process to agree on the framework of the TaTME training curriculum was conducted, seeking views of 207 surgeons across 18 different countries, including 52 international experts in the field of TaTME...
May 1, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28444558/evolution-of-surgical-treatment-for-rectal-cancer-a-review
#13
Sanjeev Dayal, Nick Battersby, Tom Cecil
Surgery that produces an optimal total mesorectal excision (TME) resection specimen remains the cornerstone of curative rectal cancer management. In the modern era, despite the results of recent randomised trials, laparoscopic TME is a crucial technique in the TME surgery armamentarium. Laparoscopic surgery offers the benefit of magnified views that aid sharp and precise dissection. However operating in the confines of a narrow pelvis, particularly when the mesorectum is bulky, requires significant technical skill...
April 25, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28439842/controversies-in-the-multimodality-management-of-locally-advanced-rectal-cancer
#14
REVIEW
Robert Díaz Beveridge, Dilara Akhoundova, Gema Bruixola, Jorge Aparicio
Neoadjuvant radiotherapy previous to radical surgery, both as short-course radiotherapy and as long-course radiotherapy combined with 5-FU-based chemotherapy (LCRCT), is routinely used in the management of locally advanced rectal cancer, with consistent benefits in the reduction in the local relapse risk. Unfortunately, survival benefits have been elusive to demonstrate with this approach, especially in the setting of radical surgery in the form of total mesorectal excision (TME). Concerns about over-treating early-stage patients and about the possible long-term side effects have also cast more doubts in a blanket approach of treating all patients with neoadjuvant radiotherapy, especially with LCRCT...
June 2017: Medical Oncology
https://www.readbyqxmd.com/read/28433044/-laparoscopic-diverting-ileostomy-in-rectal-cancer-surgery
#15
P Ihnát, P Vávra, P Guňková, A Zatloukal, S Czudek, P Zonča
INTRODUCTION: Low anterior resection (LAR) with total mesorectal excision (TME) represents the gold standard for patients with low rectal carcinoma. Protective ileostomy (PI) is commonly performed during LAR in an effort to protect low rectal anastomosis. The aim of this study is to analyse outcomes in our own patient population, focusing on morbidity associated with PI. METHOD: A retrospective clinical study of patients operated on between 2013 and 2015 was conducted in University Hospital Ostrava...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28429950/-can-robotic-rectal-cancer-surgery-improve-quality-of-total-mesorectal-excision
#16
D Langer, I Tučková, J Kalvach, M Ryska
INTRODUCTION: The introduction of total mesorectal excision (TME) in the 1980s was pivotal in the surgical treatment for rectal carcinoma (RC). Routinely applied TME led to a significant reduction in the incidence of local recurrences. The purpose of our paper is to present the results of our non-randomized study comparing prospectively acquired data from radical resection / rectal extirpation using classic open access, laparoscopy and da Vinci robotic system. METHOD: The study group included 116 patients with RC who underwent radical surgical treatment between 1/2014-12/2016, after which the collected resection specimens were assessed in pathology laboratories of the referring hospital using the Quirkes protocol...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28413679/anorectal-functional-outcome-following-laparoscopic-low-anterior-resection-for-rectal-cancer
#17
Li-Guo Liu, Xue-Bing Yan, Ze-Zhi Shan, Lei-Lei Yan, Chun-Yu Jiang, Jia Zhou, Yuan Tian, Zhi-Ming Jin
Low anterior resection (LAR) with total mesorectal excision has been considered a standard treatment for patients with rectal cancer. However, the functional outcome and life quality of laparoscopic LAR (LLAR) in Chinese patients remain unclear. A cohort of 51 Chinese patients (22 men and 29 women) who had undergone LLAR was included in this study. Anorectal manometry combined with the Wexner scores questionnaire were applied to assess functional outcome preoperatively (1 week) and postoperatively (at 3, 6 and 9 months)...
April 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28399840/a-multicentre-randomised-controlled-trial-to-evaluate-the-efficacy-morbidity-and-functional-outcome-of-endoscopic-transanal-proctectomy-versus-laparoscopic-proctectomy-for-low-lying-rectal-cancer-etap-greccar-11-trial-rationale-and-design
#18
Bernard Lelong, Cécile de Chaisemartin, Helene Meillat, Sandra Cournier, Jean Marie Boher, Dominique Genre, Mehdi Karoui, Jean Jacques Tuech, Jean Robert Delpero
BACKGROUND: Total mesorectal excision is the standard surgical treatment for mid- and low-rectal cancer. Laparoscopy represents a clear leap forward in the management of rectal cancer patients, offering significant improvements in post-operative measures such as pain, first bowel movement, and hospital length of stay. However, there are still some limits to its applications, especially in difficult cases. Such cases may entail either conversion to an open procedure or positive resection margins...
April 11, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28383446/oncological-outcomes-of-lateral-pelvic-lymph-node-metastasis-in-rectal-cancer-treated-with-preoperative-chemoradiotherapy
#19
Soichiro Ishihara, Kazushige Kawai, Toshiaki Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Hioaki Nozawa, Teppei Morikawa, Toshiaki Watanabe
BACKGROUND: Oncological outcomes of lateral pelvic lymph node metastasis in rectal cancer treated with preoperative chemoradiotherapy remain to be elucidated. OBJECTIVE: The purpose of this study was to clarify the therapeutic effect of chemoradiotherapy on lateral pelvic lymph node metastasis, the risk factors of lateral pelvic lymph node metastasis, and oncological outcomes of lateral pelvic lymph node dissection after chemoradiotherapy. DESIGN: This was a nonrandomized, retrospective study...
May 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28383445/anorectal-function-and-quality-of-life-in-patients-with-early-stage-rectal-cancer-treated-with-chemoradiation-and-local-excision
#20
MULTICENTER STUDY
Patricio B Lynn, Lindsay A Renfro, Xiomara W Carrero, Qian Shi, Paul L Strombom, Oliver Chow, Julio Garcia-Aguilar
BACKGROUND: Little is known about anorectal function and quality of life after chemoradiation followed by local excision, which is an alternative to total mesorectal excision for selected patients with early rectal cancer. OBJECTIVE: The purpose of this study was to prospectively assess anorectal function and health-related quality of life of patients with T2N0 rectal cancer who were treated with an alternative approach. DESIGN: This was a prospective, phase II trial...
May 2017: Diseases of the Colon and Rectum
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