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Total mesorectal excision

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https://www.readbyqxmd.com/read/28630589/laparoscopic-colorectal-surgery-for-colorectal-polyps-experience-of-ten-years
#1
Audrius Dulskas, Žygimantas Kuliešius, Narimantas E Samalavičius
Background. Laparoscopy or its combination with endoscopy is the next step for "difficult" polyps. The purpose of the paper was to review the outcomes of the laparoscopic approach to the management of "difficult" colorectal polyps. Materials and methods. From 2006 to 2016, 58 patients who underwent laparoscopic treatment for "difficult" polyps that could not be treated by endoscopy at the National Cancer Institute, Lithuania, were included. The demographic data, the type of surgery, length of post-operative stay, complications, and final pathology were reviewed prospectively...
2017: Acta medica Lituanica
https://www.readbyqxmd.com/read/28627602/molecular-profiling-of-locally-advanced-rectal-adenocarcinoma-using-microrna-expression-review
#2
Cory Pettit, Steve Walston, Patrick Wald, Amy Webb, Terence M Williams
Treatment for locally-advanced rectal cancer (LARC) typically consists of neoadjuvant chemoradiation followed by total mesorectal excision. Recently, there has been growing interest in non-operative management for patients who are medically-inoperable or wish to avoid surgical morbidity and permanent colostomy. Approximately 50% of patients who receive pre-operative neoadjuvant chemoradiation develop some degree of pathologic response. Approximately 10-20% of patients are found to have a complete pathologic response, a finding which has frequently been shown to predict better clinical outcomes, including local-regional control, distant metastasis and survival...
June 14, 2017: International Journal of Oncology
https://www.readbyqxmd.com/read/28621181/-advantages-of-transanal-approach-in-low-rectal-cancer-resections
#3
Géza Papp, István Besznyák, Balázs Pörneczi, György Saftics, Attila Bursics
Laparoscopic surgery is proven equal technique to open rectal surgery. Despite advantages, some problems in case of low rectal surgery are existing: visualization of the pelvis, securing safe distal resection margin, preparing single stapled rectal stump with safe conjunction to the colorectal anastomosis. Approximately 500 procedures have been performed worldwide until today by applying Transanal Total Mesorectal Excision (TaTME) technique, which evolved from a combination of laparoscopy and transanal approach...
June 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28614625/modified-sentinel-lymph-node-technique-combined-with-endoluminal-loco-regional-resection-for-the-treatment-of-rectal-tumors-a-fourteen-year-experience
#4
Silvia Quaresima, Alessandro M Paganini, Giancarlo D'Ambrosio, Pietro Ursi, Andrea Balla, Emanuele Lezoche
AIM: After Endoluminal Loco-Regional Resection (ELRR) by Transanal Endoscopic Microsurgey (TEM) the N parameter may remain undefined. Nucleotide-Guided Mesorectal Excision (NGME) improves the lymph nodes harvest. The aim of the present study is to evaluate the long term oncological results after ELRR with NGME. METHOD: A total of 57 patients were enrolled over the period January 2001 to June 2015.ed. All patients underwent ELRR by TEM. Prior to surgery, 99m-Technetium-marked nanocolloid was injected in the peritumoral submucosa...
June 14, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28612478/high-stoma-prevalence-and-stoma-reversal-complications-following-anterior-resection-for-rectal-cancer-a-population-based-multi-centre-study
#5
Klas Holmgren, Daniel Kverneng Hultberg, Markku M Haapamäki, Peter Matthiessen, Jörgen Rutegård, Martin Rutegård
AIM: Fashioning a defunctioning stoma is common when performing an anterior resection for rectal cancer in order to avoid and mitigate consequences of an anastomotic leakage. We investigated the permanent stoma prevalence, factors influencing stoma outcome and complication rates following stoma reversal surgery. METHODS: Patients who had undergone an anterior resection for rectal cancer between 2007 and 2013 in the Northern healthcare region were identified using the Swedish Colorectal Cancer Registry and were followed until the end of 2014 regarding stoma outcome...
June 14, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28601342/organ-preservation-for-rectal-cancer-greccar-2-a-prospective-randomised-open-label-multicentre-phase-3-trial
#6
Eric Rullier, Philippe Rouanet, Jean-Jacques Tuech, Alain Valverde, Bernard Lelong, Michel Rivoire, Jean-Luc Faucheron, Mehrdad Jafari, Guillaume Portier, Bernard Meunier, Igor Sileznieff, Michel Prudhomme, Frédéric Marchal, Marc Pocard, Denis Pezet, Anne Rullier, Véronique Vendrely, Quentin Denost, Julien Asselineau, Adélaïde Doussau
BACKGROUND: Organ preservation is a concept proposed for patients with rectal cancer after a good clinical response to neoadjuvant chemotherapy, to potentially avoid morbidity and side-effects of rectal excision. The objective of this study was to compare local excision and total mesorectal excision in patients with a good response after chemoradiotherapy for lower rectal cancer. METHODS: We did a prospective, randomised, open-label, multicentre, phase 3 trial at 15 tertiary centres in France that were experts in the treatment of rectal cancer...
June 7, 2017: Lancet
https://www.readbyqxmd.com/read/28600594/-minimally-invasive-approaches-for-transanal-surgery
#7
REVIEW
W Kneist
Since the introduction of transanal endoscopic microsurgery (TEM) in the 1980 s, the minimally invasive transanal approach has been a treatment option for selected patients with colorectal diseases. Recently, transanal minimally invasive surgery (TAMIS) was introduced as an alternative technique. TAMIS is a hybrid between TEM and single-port laparoscopy and was followed by introduction of transanal total mesorectal excision (TaTME). Although the TaTME experience remains preliminary, it appears to be an attractive minimally invasive procedure for carefully selected patients with resectable rectal cancer...
June 9, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28594714/tailored-treatment-strategy-for-locally-advanced-rectal-carcinoma-based-on-the-tumor-response-to-induction-chemotherapy-preliminary-results-of-the-french-phase-ii-multicenter-greccar4-trial
#8
Philippe Rouanet, Eric Rullier, Bernard Lelong, Philippe Maingon, Jean-Jacques Tuech, Denis Pezet, Florence Castan, Stéphanie Nougaret
BACKGROUND: Preoperative radiochemotherapy and total mesorectal excision are the standard-of-care for locally advanced rectal carcinoma, but some patients could be over- or undertreated. OBJECTIVE: This study aimed to assess the feasibility of radiochemotherapy tailored based on the tumor response to induction chemotherapy (FOLFIRINOX) to obtain a minimum R0 resection rate of 90% in the 4 arms of the study. DESIGN: This study is a multicenter randomized trial (NCT01333709)...
July 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28589242/surgery-beyond-the-visible-light-spectrum-theoretical-and-applied-methods-for-localization-of-the-male-urethra-during-transanal-total-mesorectal-excision
#9
S Atallah, A Mabardy, A P Volpato, T Chin, J Sneider, J R T Monson
The risk of urethral injury during transanal total mesorectal excision (taTME) is delineated, and potential risk factors for iatrogenic transection are reviewed. A variety of applied and theoretical techniques can be used by surgeons to diminish the risk of injury in males undergoing this operation. Many of the approaches utilize non-optic media and wavelengths beyond the visible light spectrum which can enhance the surgeon's frame of reference. The aim of the present study was to assess the techniques and theoretical approaches to urethral localization during taTME...
June 6, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28583651/dual-energy-ct-can-detect-malignant-lymph-nodes-in-rectal-cancer
#10
I Al-Najami, M J Lahaye, R G H Beets-Tan, G Baatrup
BACKGROUND: There is a need for an accurate and operator independent method to assess the lymph node status to provide the most optimal personalized treatment for rectal cancer patients. This study evaluates whether Dual Energy Computed Tomography (DECT) could contribute to the preoperative lymph node assessment, and compared it to Magnetic Resonance Imaging (MRI). The objective of this prospective observational feasibility study was to determine the clinical value of the DECT for the detection of metastases in the pelvic lymph nodes of rectal cancer patients and compare the findings to MRI and histopathology...
May 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28581407/continuous-effect-of-radial-resection-margin-on-recurrence-and-survival-in-rectal-cancer-patients-who-receive-preoperative-chemoradiation-and-curative-surgery-a-multicenter-retrospective-analysis
#11
SooYoon Sung, Sung Hwan Kim, Joo Hwan Lee, Taek Keun Nam, Songmi Jeong, Hong Seok Jang, Jin Ho Song, Jeong Won Lee, Jung Min Bae, Jong Hoon Lee
PURPOSE: To elucidate the proper length and prognostic value of resection margins in rectal cancer patients who received preoperative chemoradiotherapy (CRT) followed by curative total mesorectal excision (TME). METHODS AND MATERIALS: A total of 1476 rectal cancer patients staging cT3-4N0-2M0 were analyzed. All patients received radiation dose of 50.4 Gy in 28 fractions with concurrent 5-fluorouracil or capecitabine. Total mesorectal excision was performed 4 to 8 weeks after radiation therapy...
July 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28576182/evolving-role-of-radiotherapy-in-the-management-of-rectal-carcinoma
#12
REVIEW
Clayton A Smith, Lisa A Kachnic
Management of locally advanced rectal cancer has evolved over time from surgical resection alone to multimodality therapy with preoperative radiation, chemotherapy, and total mesorectal excision resulting in excellent local control rates. Refinements in neoadjuvant therapies and their sequencing have improved pathologic complete response rates such that consideration of selective radiation and nonoperative management are now active clinical trial questions. Advances in radiation treatment planning and delivery techniques may allow for further reduction in acute treatment-related toxicity in select patient populations...
July 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28571800/the-length-and-complexity-of-mesentery-are-related-to-the-locoregional-recurrence-of-the-carcinoma-in-gut
#13
Jie Shen, Daxing Xie, Yixin Tong, Jianping Gong
Local-regional relapse is the main recurrence pattern of the carcinoma in gut, and leads to poor prognosis. With the development of the total mesorectal and complete mesocolic excision (TME/CME), the local relapse rate of colorectal cancer has significantly decreased. People attributed it to the improvement of lymphadenectomy, but lymphatic metastasis is difficult to explain the local relapse in N0 patients. Previously, we have proven the existence of "Metastasis V" in mesogastrium and mesocolorectum, and supposed that it is one of the major risk factors in local recurrence...
June 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28568650/robotic-proctectomy-for-rectal-cancer-analysis-of-71-patients-from-a-single-institution
#14
Philip M Spanheimer, John G Armstrong, Sunyang Fu, Junlin Liao, Scott E Regenbogen, John C Byrn
BACKGROUND: Despite increasing use of robotic surgery for rectal cancer, few series have been published from the practice of generalizable US surgeons. METHODS: A retrospective chart review was performed for 71 consecutive patients who underwent robotic low anterior resection (LAR) or abdominoperineal resection (APR) for rectal adenocarcinoma between 2010 and 2014. RESULTS: 46 LARs (65%) and 25 APRs (35%) were identified. Median procedure time was 219 minutes (IQR 184-275) and mean blood loss 164...
June 1, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28555067/outcome-of-a-modified-laparoscopic-suture-rectopexy-for-rectal-prolapse-with-the-use-of-a-single-or-double-suture-a-case-series-of-15-patients
#15
Daiki Yasukawa, Tomohide Hori, Takafumi Machimoto, Toshiyuki Hata, Yoshio Kadokawa, Tatsuo Ito, Shigeru Kato, Yuki Aisu, Yusuke Kimura, Yuichi Takamatsu, Taku Kitano, Tsunehiro Yoshimura
BACKGROUND Surgery is considered to be a mainstay of therapy for full-thickness rectal prolapse (FTRP). Surgical procedures for FTRP have been described, but optimal treatment is still controversial. The aim of this report is to evaluate the safety and feasibility of a simplified laparoscopic suture rectopexy (LSR) in a case series of 15 patients who presented with FTRP and who had postoperative follow-up for six months. CASE REPORT Fifteen patients who underwent a modified LSR at our surgical unit from September 2010 were retrospectively evaluated...
May 30, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28553924/-surgical-treatment-of-mid-and-low-rectal-cancer
#16
Maya Xania Bjørn, Sharaf Karim Perdawood
Total mesorectal excision (TME) is standard treatment of mid- and low rectal cancer and has evolved with minimally invasive surgery. Laparoscopic TME has proven to be technically challenging, and recent randomized controlled studies fail to prove it oncologically superior to open TME. Robotic-assisted TME may overcome the technical difficulties and shows comparable oncological results, yet it is associated with significant additional costs. Transanal TME is a promising method which seems to overcome the technical and financial issues of the other techniques, without compromising the short-term oncological results...
May 29, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28549014/robot-assisted-versus-laparoscopic-surgery-for-rectal-cancer-a-phase-ii-open-label-prospective-randomized-controlled-trial
#17
Min Jung Kim, Sung Chan Park, Ji Won Park, Hee Jin Chang, Dae Yong Kim, Byung-Ho Nam, Dae Kyung Sohn, Jae Hwan Oh
OBJECTIVE: The phase II randomized controlled trial aimed to compare the outcomes of robot-assisted surgery with those of laparoscopic surgery in the patients with rectal cancer. BACKGROUND: The feasibility of robot-assisted surgery over laparoscopic surgery for rectal cancer has not been established yet. METHODS: Between February 21, 2012 and March 11, 2015, patients with rectal cancer (cT1-3NxM0) were enrolled. Patients were randomized 1:1 to either robot-assisted or laparoscopic surgery, and stratified per sex and administration of preoperative chemoradiotherapy...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28546522/redefining-the-positive-circumferential-resection-margin-by-incorporating-preoperative-chemoradiotherapy-treatment-response-in-locally-advanced-rectal-cancer-a-multicenter-validation-study
#18
Joo Ho Lee, Eui Kyu Chie, Seung-Yong Jeong, Tae-You Kim, Dae Yong Kim, Tae Hyun Kim, Sun Young Kim, Ji Yeon Baek, Hee Jin Hang, Min Ju Kim, Sung Chan Park, Jae Hwan Oh, Sung Hwan Kim, Jong Hoon Lee, Doo Ho Choi, Hee Chul Park, Sung-Bum Kang, Jae-Sung Kim
Purpose: This study was conducted to validate the prognostic influence of treatment response among patients with positive circumferential resection margin for locally advanced rectal cancer. Materials and Methods: Clinical data of 197 patients with positive circumferential resection margin defined as ≤ 2mm after preoperative chemoradiotherapy followed by total mesorectal excision between 2004 and 2009 were collected for this multicenter validation study. All patients underwent median 50...
May 24, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28534091/transanal-total-mesorectal-excision-with-intersphincteric-resection-and-use-of-fluorescent-angiography-and-a-lighted-urethral-stent-for-distal-rectal-cancer
#19
A Mabardy, L Lee, A P Valpato, S Atallah
No abstract text is available yet for this article.
May 22, 2017: Techniques in Coloproctology
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
#20
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
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