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Total mesorectal excision

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https://www.readbyqxmd.com/read/28092017/transanal-total-mesorectal-excision-for-a-large-leiomyosarcoma-at-the-lower-rectum-a-case-report-and-literature-review
#1
Nobuaki Hoshino, Koya Hida, Kenji Kawada, Takaki Sakurai, Yoshiharu Sakai
BACKGROUND: Rectal leiomyosarcoma (LMS) is an extremely rare disease. Previously, LMS was not properly distinguishable from gastrointestinal stromal tumor (GIST) until c-kit, a characteristic marker of GIST, was discovered in 1998. No standard therapeutic strategy for gastrointestinal LMS has been established except for surgical resection because of its rarity. Rectal LMS is often accompanied by symptoms, which can enable detection at a small size. However, when a large LMS is detected at the lower rectum, it is difficult to excise due to the narrow pelvic space...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28059920/local-excision-techniques-for-rectal-cancer-after-neoadjuvant-chemoradiotherapy-what-are-we-doing
#2
Fraser McLean Smith, Abdul Ahad, Rodrigo Oliva Perez, John Marks, Krzysztof Bujko, Richard J Heald
BACKGROUND: Recent evidence shows that the majority of rectal cancers demonstrate occult tumor scatter after neoadjuvant chemoradiotherapy that can extend for several centimeters under adjacent normal-appearing mucosa beside the residual mucosal abnormality or scar. OBJECTIVE: This systematic review aimed to determine all of the published selection criteria and technical descriptions for local excision to date with regard to this phenomenon. DATA SOURCES: PubMed, MEDLINE, and Embase were searched using the following key words: rectal cancer, local excision, radiotherapy, and neoadjuvant...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28056250/-outcome-evaluation-based-on-evidence-based-medicine-of-laparoscopic-surgery-for-rectal-cancer
#3
H W Yao, Y H Liu
Laparoscopic surgery of rectal cancer has experienced more than 20 years of technical development and clinical research. Based on the published high-level clinical trials such as COREAN, COLOR Ⅱ, ACOSOG Z6051 and ALacaRT, laparoscopic surgery is recommended as method to treat rectal cancer by the NCCN Clinical Practice Guideline on Rectal Cancer (version 1.2016) with class 2A evidence. But it is also suggested that the surgeons should have experiences of performing minimally invasive proctectomy with total mesorectal excision...
January 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28044239/transanal-total-mesorectal-excision-tatme-for-rectal-cancer-effects-on-patient-reported-quality-of-life-and-functional-outcome
#4
T W A Koedam, G H van Ramshorst, C L Deijen, A K E Elfrink, W J H J Meijerink, H J Bonjer, C Sietses, J B Tuynman
BACKGROUND: Transanal total mesorectal excision (TaTME) has rapidly become an important component of the treatment of rectal cancer surgery. Cohort studies have shown feasibility concerning procedure, specimen quality and morbidity. However, concerns exist about quality of life and ano(neo)rectal function. The aim of this study was to prospectively evaluate quality of life in patients following TaTME for rectal cancer with anastomosis. METHODS: Consecutive patients who underwent restorative TaTME surgery for rectal adenocarcinoma in an academic teaching center with tertiary referral function were evaluated...
January 2, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28035459/understanding-the-factors-associated-with-reduction-in-the-number-of-lymph-nodes-in-rectal-cancer-patients-treated-by-neoadjuvant-treatment
#5
L Bustamante-Lopez, C S Nahas, S C Nahas, U Ribeiro, C F Marques, G Cotti, A Rocco, I Cecconello
INTRODUCTION: Rectal cancer patients frequently present with locally advanced disease for which the standard of care includes neoadjuvant chemoradiotherapy followed by total mesorectal excision. Positive lymph nodes are one of the most powerful risk factors for recurrence and survival in colorectal cancer. In the absence of specific rectal guidelines, the literature recommends to the pathologist to optimize the number of rectal lymph nodes (LN) retrieved. We made a literature review in order to identify factors that could potentially affect the number of LN retrieved in specimens of patients with rectal cancer treated by chemoradiotherapy (CRT) followed by total mesorectal excision (TME)...
December 29, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28024946/short-and-mid-term-outcomes-after-endoscopic-transanal-or-laparoscopic-transabdominal-total-mesorectal-excision-for-low-rectal-cancer-a-single-institutional-case-control-study
#6
Bernard Lelong, Hélène Meillat, Christophe Zemmour, Flora Poizat, Jacques Ewald, Diane Mege, Jean Claude Lelong, Jean Robert Delpero, Cécile de Chaisemartin
BACKGROUND: Transabdominal laparoscopic proctectomy for rectal cancer was associated with post-operative recovery improvement. Early studies showed favourable short-term results of endoscopic transanal proctectomy with low conversion rates to an open procedure. We aimed to compare efficacy, morbidity, and functional outcomes of endoscopic transanal proctectomy (ETAP) to standard laparoscopic proctectomy (LAP) for low rectal cancer. STUDY DESIGN: From 2008 to 2013, 72 consecutive patients received proctectomy and coloanal manual anastomosis for low rectal adenocarcinoma...
December 23, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28000657/combined-laparoscopic-and-transanal-total-mesorectal-excision-for-rectal-cancer-initial-experience-and-early-results
#7
Morten Holt Thomsen, Henrik Ovesen, Jens Ravn Eriksen
INTRODUCTION: Incomplete specimens resulting in residual mesorectum in the patient and an increased risk of local recurrence remains a problem. We have introduced transanal-total mesorectal excision (Ta-TME) in our department to potentially overcome this problem due to more direct access to the lower pelvis in patients undergoing TME for rectal cancer and this article presents our initial experience with the new procedure. MATERIALS AND METHODS: Patients with a T1-T3 mid or low rectal cancer eligible for TME or intersphincteric abdominoperineal excision were selected for a combined transanal and transabdominal laparoscopic resection...
December 21, 2016: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28000135/robotic-total-mesorectal-excision-for-rectal-cancer-a-series-of-392-cases-and-mid-term-outcomes-from-a-single-center-in-china
#8
Bo Tang, Chao Zhang, Chuan Li, Jun Chen, Huaxing Luo, Dongzhu Zeng, Peiwu Yu
BACKGROUND: Robotic total mesorectal excision (RTME) for rectal cancer has recently been increasingly used; technical feasibility and short-term outcomes have been reported in detail. Few studies have presented clinical efficacy and mid-term outcomes for a large sample size. The aim of this study is to present oncologic efficacy and mid-term outcomes of robotic total mesorectal excision for rectal cancer and to provide our experiences regarding these surgically challenging issues. METHODS: Three hundred ninety-two patients received RTME between March 2010 and June 2015...
December 20, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27997526/organ-preservation-with-local-excision-or-active-surveillance-following-chemoradiotherapy-for-rectal-cancer
#9
B Creavin, E Ryan, S T Martin, A Hanly, P R O'Connell, K Sheahan, D C Winter
BACKGROUND: Organ preservation has been proposed as an alternative to radical surgery for rectal cancer to reduce morbidity and mortality, and to improve functional outcome. METHODS: Locally advanced non-metastatic rectal cancers were identified from a prospective database. Patients staged ⩾T3 or any stage N+ were referred for neoadjuvant chemoradiotherapy (CRT) (50-54 Gy and 5-fluorouracil), and were reassessed 6-8 weeks post treatment. An active surveillance programme ('watch and wait') was offered to patients who were found to have a complete endoluminal response...
December 20, 2016: British Journal of Cancer
https://www.readbyqxmd.com/read/27997470/oncological-outcomes-after-robotic-proctectomy-for-rectal-cancer-analysis-of-a-prospective-database
#10
Tarik Sammour, Songphol Malakorn, Brian K Bednarski, Harmeet Kaur, Ui Sup Shin, Craig Messick, Yi-Qian Nancy You, George J Chang
OBJECTIVE: The aim of this study is to evaluate the oncological outcomes of robotic total mesorectal excision (TME) at an NCI designated cancer center. SUMMARY BACKGROUND DATA: The effectiveness of laparoscopic TME could not be established, but the robotic-assisted approach may hold some promise, with improved visualization and ergonomics for pelvic dissection. Oncological outcome data is presently lacking. METHODS: Patients who underwent total mesorectal excision or tumor-specific mesorectal excision for rectal cancer between April 2009 and April 2016 via a robotic approach were identified from a prospective single-institution database...
December 16, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27990592/combined-notes-total-mesorectal-excision-and-single-incision-laparoscopy-principles-for-conservative-proctectomy-a-single-centre-study
#11
H Meillat, C de Chaisemartin, F Poizat, E Bories, R Fara, J R Delpero, B Lelong
BACKGROUND: Surgery for low rectal cancer remains a challenge when a standard laparoscopic approach is used. Transanal endoscopic total mesorectal excision (TME) has been shown to be feasible and to be associated with a low conversion rate. Combining the transanal and transabdominal single-port approaches (with an abdominal single port implanted in the future stoma and extraction site) could allow TME with minimal wound trauma, low morbidity, and faster recovery. The aim of the current study was to assess the short- and mid-term results of this technique...
December 19, 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27955972/the-importance-of-the-mesofascial-interface-in-complete-mesocolic-excision
#12
REVIEW
Luca Maria Siani, Gianluca Garulli
Complete mesocolic excision (CME) with Central Vascular Ligation (CVL) is progressively gaining acceptance as the most updated surgical treatment in the multimodal management of colonic cancer. The concept is based on excision of the affected organ with its related primitive dorsal mesenterium as an intact package to maximize local clearance, and high tie ligation to boost regional control, translating the original concept of Total Mesorectal Excision proposed by Heald for rectal cancer. Aim of this review is to analyze the modern concept of the mesenteric organ, with particular regard to the interfaces between its single components and the importance of the meso-fascial interface as the correct plane of separation...
December 9, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27941329/advantages-of-early-preventive-ileostomy-closure-after-total-mesorectal-excision-surgery-for-rectal-cancer-an-institutional-retrospective-study-of-123-consecutive-patients
#13
Min-Wei Zhou, Zi-Hao Wang, Zong-You Chen, Jian-Bin Xiang, Xiao-Dong Gu
BACKGROUND/AIM: Preventive ileostomy is frequently constructed to minimizethe consequences of anastomotic leakage after resection of rectal cancer. There is no consensus regarding the best timing for temporary stoma closure after proctectomy for rectal cancer. This retrospective study sought to determine whether the timing of stoma closure influenced postoperative outcomes. METHODS: Subjects were 123 patients with rectal cancer undergoing laparoscopic or open total mesorectal excision surgery with preventive ileostomy from 2012 to 2015...
December 10, 2016: Digestive Surgery
https://www.readbyqxmd.com/read/27938573/-investigate-the-radical-extent-of-lymphadenectomy-of-right-colon-cancer
#14
Y Xiao, L Xu, J Y Lu
Considering radical surgeries of right colon cancer, the reasonable extent of lymphadenectomy has always been argued. The concept of complete mesocolic excision (CME) has recently been established and optimized, which follows similar oncological principles as total mesorectal excision (TME) does for rectal cancer and is recommended by more and more surgeons. Studies published so far in the literature have been comprehensively reviewed, they do not, however, provide convincing evidence that demonstrate the standardized operation indications...
1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27934790/abdomino-endoscopic-perineal-excision-of-the-rectum-for-benign-and-malignant-pathology-technique-considerations-for-true-transperineal-verus-transanal-total-mesorectal-excision-endoscopic-proctectomy
#15
Hazar Al Furajii, Niall Kennedy, Ronan A Cahill
PURPOSE: Transanal minimally invasive surgery using single port instrumentation is now well described for the performance of total mesorectal excision with restorative colorectal/anal anastomosis most-often in conjunction with transabdominal multiport assistance. While non-restorative abdomino-endoscopic perineal excision of the anorectum is conceptually similar, it has been less detailed in the literature. METHODS: Consecutive patients undergoing non-restorative ano-proctectomy including a transperineal endoscopic component were analysed...
January 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27931837/an-update-on-the-multimodality-of-localized-rectal-cancer
#16
REVIEW
Mehmet Artac, Levent Korkmaz, Bassel El-Rayes, Philip A Philip
New strategies have reduced the local recurrence (LR) rate and extended the duration of overall survival (OS) in patients with localized rectal cancer (RC) in recent decades. The mainstay of curative treatment remains radical surgery; however, downsizing the tumor by neo-adjuvant chemo-radiotherapy and adjuvant cytotoxic therapy for systemic disease has shown significant additional benefit. The standardization of total mesorectal excision (TME), radiation treatment (RT) dose and fractionation, and optimal timing and sequencing of treatment modalities with the use of prolonged administration of fluoropyrimidine concurrent with RT have significantly decreased the rates of LR in locally advanced rectal cancer (LARC) patients...
December 2016: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/27917208/histologic-response-after-neoadjuvant-chemoradiotherapy-in-locally-advanced-rectal-adenocarcinoma-experience-from-sudan
#17
Ahmed Abd Elrahman Abdalla, Awad Ali M Alawad, Hussein Abdalla M Ali
BACKGROUND: Locally advanced rectal cancer can be down staged by neoadjuvant therapy and the resultant tumor response can be quantified histologically. This study aimed to assess pathological response of neoadjuvant chemoradiation in patients with locally advanced rectal cancers treated in Wad Medani Teaching Hospital (WMTH) and National Cancer Institute (NCI), Wad Medani, Sudan. PATIENTS AND METHODS: A total of 36 consecutive patients with locally advanced rectal cancer that were managed in WMTH and NCI during the period from 2006-2011 were reviewed...
September 2016: African Health Sciences
https://www.readbyqxmd.com/read/27914773/transanal-total-mesorectal-excision-tatme-for-rectal-cancer-step-by-step-description-of-the-surgical-technique-for-a-two-teams-approach
#18
M C Arroyave, F B DeLacy, A M Lacy
Interest in transanal total mesorectal excision (TaTME) is growing worldwide due to the application of minimally invasive techniques to rectal cancer surgery while maintaining adequate oncologic outcomes. This article presents the standardised and refined technique after performing more than 300 operations at Hospital Clinic of Barcelona.
November 20, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27912892/-mesocolic-excision-for-colonic-adenocarcinoma
#19
REVIEW
Clotilde Debove, Jérémie H Lefèvre, Yann Parc
On the same principle than total mesorectal excision in rectal cancer, the effect of complete mesocolic excision on short and long-term outcomes is actually evaluated for colonic adenocarcinoma. This method, usually performed for left colectomy, offers a surgical specimen of higher quality, with a larger number of lymph nodes harvested. For right colectomy, surgical specifications make it less common complete mesocolic excision and conventional surgery offer comparable outcomes, as regards to postoperative morbidity and mortality rates...
November 29, 2016: Bulletin du Cancer
https://www.readbyqxmd.com/read/27893653/adjuvant-radiotherapy-for-the-treatment-of-stage-iv-rectal-cancer-after-curative-resection-a-propensity-score-matched-analysis-and-meta-analysis
#20
Min Jung Kim, Sang Jin Kim, Sung-Chan Park, Dae Yong Kim, Ji Won Park, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park, Heung Kwon Oh, Duck-Woo Kim, Sung-Bum Kang, Jung Nam Joo, Jae Hwan Oh
The role of pelvic radiotherapy (RT) in stage IV rectal cancer with total mesorectal excision (TME) has not been defined. We evaluated the impact of RT on oncologic outcomes among patients with stage IV rectal cancer who underwent TME and performed a meta-analysis of published studies.The records of stage IV rectal cancer patients who underwent TME between August 2001 and December 2011 were reviewed. Patients who received pelvic RT (RT group) and those who did not (non-RT group) were matched using a propensity score...
November 2016: Medicine (Baltimore)
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