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Total mesorectal excision

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https://www.readbyqxmd.com/read/28433044/-laparoscopic-diverting-ileostomy-in-rectal-cancer-surgery
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28381943/transanal-total-mesorectal-excision-a-novel-approach-to-rectal-surgery
#7
REVIEW
Pasithorn A Suwanabol, Justin A Maykel
Less invasive approaches continue to be explored and refined for diseases of the colon and rectum. The current gold standard for the surgical treatment of rectal cancer, total mesorectal excision (TME), is a technically precise yet demanding procedure with outcomes measured by both oncologic and functional outcomes (including bowel, urinary, and sexual). To date, the minimally invasive approach to rectal cancer has not yet been perfected, leaving ample opportunity for rectal surgeons to innovate. Transanal TME has recently emerged as a safe and effective technique for both benign and malignant diseases of the rectum...
April 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28378317/risk-factor-analysis-for-newly-developed-urogenital-dysfunction-after-total-mesorectal-excision-and-impact-of-pelvic-intraoperative-neuromonitoring-a-prospective-2-year-follow-up-study
#8
Daniel W Kauff, Hauke Lang, Werner Kneist
AIM: Urogenital dysfunction is a common sequela following total mesorectal excision for rectal cancer. This prospective study analyzed potential risk factors and investigated the impact of pelvic intraoperative neuromonitoring. METHOD: Included were 85 patients undergoing total mesorectal excision for rectal cancer, 43 under the control of pelvic intraoperative neuromonitoring. Urogenital function was assessed with validated questionnaires within a 2-year follow-up period...
April 4, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28373415/detection-of-free-cancer-cells-in-pelvic-lavage-with-double-immunocytochemistry-at-rectal-cancer-surgery
#9
COMPARATIVE STUDY
Csaba Kindler, Kenneth Smedh, Abbas Chabok, Jayant Shetye, George Dafnis, Maziar Nikberg
BACKGROUND/AIM: The aim of the present study was to describe a double immunocytochemical staining method for detecting free cancer cells after rectal cancer surgery and to evaluate their extent and prognostic role. MATERIALS AND METHODS: Immunocytochemistry was performed using antibodies against cytokeratin 20/caudal-typehomeobox transcription factor 2 (CDX2) and mucin glycoprotein-2 (MUC2)/p53 protein. The study included 29 patients with infraperitoneal rectal cancer who underwent bowel resection and four controls...
April 2017: Anticancer Research
https://www.readbyqxmd.com/read/28369422/ileal-pouch-anal-anastomosis-for-dysplasia-or-cancer-complicating-inflammatory-bowel-disease-is-total-mesorectal-excision-always-mandatory-an-analysis-of-36-consecutive-patients
#10
Chloé Coton, Léon Maggiori, Diane Mège, Clotilde Naudot, Justine Prost À la Denise, Yves Panis
Background & Aim: The extent of lymph node harvesting during surgery for colorectal neoplasm (dysplasia and/or cancer) complicating inflammatory bowel disease (IBD) is the matter of debate. This study aimed to assess the risk of invasive rectal cancer in patients undergoing ileal pouch-anal anastomosis (IPAA) for colonic neoplasm complicating IBD, and thus to clarify if a systematic total mesorectal excision (TME) should be systematically performed or not in those patients. Methods: From 1998 to 2015, all patients who underwent IPAA for colorectal neoplasm complicating IBD were included...
March 22, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28366499/potential-impact-of-lateral-lymph-node-dissection-llnd-for-low-rectal-cancer-on-prognoses-and-local-control-a-comparison-of-2-high-volume-centers-in-japan-that-employ-different-policies-concerning-llnd
#11
Yukihide Kanemitsu, Koji Komori, Dai Shida, Hiroki Ochiai, Shunsuke Tsukamoto, Takashi Kinoshita, Yasuhiro Moriya
BACKGROUND: Controversy remains around whether the addition of lateral lymph node dissection to total mesorectal excision offers benefits in terms of survival or local control to patients with low rectal cancer. This study aimed to examine the impact of lateral lymph node dissection in the treatment of low rectal cancer on prognosis and local control and to identify patients who might benefit from lateral lymph node dissection at 2 high-volume centers in Japan that employ different policies with regard to adopting lateral lymph node dissection...
March 30, 2017: Surgery
https://www.readbyqxmd.com/read/28346223/early-rectal-cancer-a-choice-between-local-excision-and-transabdominal-resection-a-review-of-the-literature-and-current-guidelines
#12
Giuseppe Pappalardo, Massimo Chiaretti
INTRODUCTION: Indication for Local Excision (LE) or Trans Abdominal Resections with Total Mesorectal Excision (TAR) in Early Rectal Cancer (ERC) are still controversial. MATERIAL OF STUDY: We reviewed meta-analyses, scientific societies guidelines, randomized and controlled clinical trials from 1999 to 2016 for a total of 146,231 patients. We included in our analysis the accuracy of different tools of investigation, the reliability of the endoscopic biopsies and compared the results of the various LE and TAR...
March 27, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28338156/-pay-attention-to-the-selective-lateral-pelvic-lymph-node-dissection-in-mid-low-rectal-cancer
#13
Wenjian Meng, Ziqiang Wang
Lateral pelvic lymph node metastasis is an important metastatic mode and a major cause of locoregional recurrence of mid-low rectal cancer. Recently, there is an East-West discrepancy in regard to the diagnosis, clinical significance, treatment and prognosis of lateral pelvic lymph node metastasis. In the West, lateral nodal involvement may represent systemic disease and preoperative chemoradiotherapy can sterilize clinically suspected lateral nodes. Thus, in many Western countries, the standard therapy for lower rectal cancer is total mesorectal excision with chemoradiotherapy, and pelvic sidewall dissection is rarely performed...
March 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28335081/the-impact-of-body-mass-index-and-nuclear-%C3%AE-catenin-on-survival-in-locally-advanced-rectal-cancer-treated-with-preoperative-radiochemotherapy
#14
Jaime Gomez-Millan, Maria Isabel Queipo, Maria Del Mar Delgado, Lidia Perez-Villa, Alicia Roman, Fernando De la Portilla, Esperanza Torres, Vanessa De Luque, Eloisa Bayo, Jose Antonio Medina
BACKGROUND AND OBJECTIVE: We examined the prognostic value of obesity and nuclear β-catenin in patients with locally advanced rectal cancer. METHODS: We prospectively recruited a total of 98 eligible patients with locally advanced cancer for preoperative radiochemotherapy followed by total mesorectal excision. Patients' height and weight were reaorded before radiochemotherapy, and the immunohistochemical expression of nuclear β-catenin was analyzed. Disease-free survival (DFS) was analyzed using the Kaplan-Meier method and a Cox regression model was employed for the multivariate analysis...
March 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28315018/influence-of-pelvic-volume-on-surgical-outcome-after-low-anterior-resection-for-rectal-cancer
#15
G Zur Hausen, J Gröne, D Kaufmann, S M Niehues, K Aschenbrenner, A Stroux, B Hamm, M E Kreis, Johannes C Lauscher
BACKGROUND: Low anterior resection (LAR) for rectal cancer is a potentially challenging operation due to limited space in the pelvis. CT pelvimetry allows to quantify pelvic space, so that its relationship with outcome after LAR may be assessed. Studies investigating this, however, yielded conflicting results. We hypothesized that a small pelvis is associated with a higher rate of incomplete mesorectal excision, anastomotic leakages, and increased rate of urinary dysfunction in patients operated for rectal cancer...
March 18, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28314302/kras-mutant-status-may-be-associated-with-distant-recurrence-in-early-stage-rectal-cancer
#16
Michail Sideris, Jane Moorhead, Salvador Diaz-Cano, Amyn Haji, Savvas Papagrigoriadis
BACKGROUND/AIM: Total mesorectal excision combined with neo-adjuvant chemoradiotherary (CRT) and adjuvant chemotherapy, has been the standard treatment of locally advanced rectal cancer (LARC). Although TNM (Tumor, Node, Metastasis) classification for malignant Tumors is still the cornerstone in rectal cancer staging, there has been an effort to identify molecular biomarkers with additional prognostic or predictive value. MATERIALS AND METHODS: We retrospectively analyzed molecular biomarkers on prospectively collected histological specimens and clinical data from a cohort of 135 consecutive rectal cancer cases who underwent radical excision in a tertiary center between 2011-2014 (males=87, females=48, age range=22-89 years, mean=64,67 years, SD=13...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28291841/prognosis-of-locally-advanced-rectal-cancer-can-be-predicted-more-accurately-using-pre-and-post-chemoradiotherapy-neutrophil-lymphocyte-ratios-in-patients-who-received-preoperative-chemoradiotherapy
#17
SooYoon Sung, Seok Hyun Son, Eun Young Park, Chul Seung Kay
PURPOSE: The neutrophil-lymphocyte ratio (NLR) has been suggested as an inflammation-related factor, but also as an indicator of systemic anti-tumor immunity. We aimed to evaluate the prognostic value of the NLR and to propose a proper cut-off value in patients with locally advanced rectal cancer who received preoperative chemoradiation (CRT) followed by curative total mesorectal excision (TME). METHODS: A total of 110 rectal cancer patients with clinical T3-4 or node-positive disease were retrospectively analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28288057/mesorectal-excision-with-or-without-lateral-lymph-node-dissection-for-clinical-stage-ii-iii-lower-rectal-cancer-jcog0212-a-multicenter-randomized-controlled-noninferiority-trial
#18
Shin Fujita, Junki Mizusawa, Yukihide Kanemitsu, Masaaki Ito, Yusuke Kinugasa, Koji Komori, Masayuki Ohue, Mitsuyoshi Ota, Yoshihiro Akazai, Manabu Shiozawa, Takashi Yamaguchi, Hiroyuki Bandou, Kenji Katsumata, Kohei Murata, Yoshihito Akagi, Nobuhiro Takiguchi, Yoshihisa Saida, Kenichi Nakamura, Haruhiko Fukuda, Takayuki Akasu, Yoshihiro Moriya
OBJECTIVE: The aim of the study was to confirm the noninferiority of mesorectal excision (ME) alone to ME with lateral lymph node dissection (LLND) in terms of efficacy. BACKGROUND: Lateral pelvic lymph node metastasis is occasionally found in clinical stage II or III lower rectal cancer, and ME with LLND is the standard procedure in Japan. ME alone, however, is the international standard surgical procedure for rectal cancer. METHODS: Eligibility criteria included histologically proven rectal cancer at clinical stage II/III; main lesion located in the rectum, with the lower margin below the peritoneal reflection; no lateral pelvic lymph node enlargement; Peformance Status of 0 or 1; and age 20 to 75 years...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28281474/combined-laparoscopic-and-transanal-total-mesorectal-excision-for-rectal-cancer-initial-experience-and-early-results
#19
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...
April 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28281215/neoadjuvant-treatment-for-locally-advanced-rectal-cancer-new-concepts-in-clinical-trial-design
#20
REVIEW
Nitesh Rana, A Bapsi Chakravarthy, Lisa A Kachnic
Treatment for locally advanced rectal cancer has evolved from surgery alone to surgery plus adjuvant therapy. Preoperative 5-fluorouracil- or capecitabine-based chemoradiation with standard fractionated radiation, surgery utilizing total mesorectal excision, and further chemotherapy has become the standard of care in the USA. Preoperative adjuvant chemoradiation treatment sequencing has allowed for decreased toxicity, more sphincter-sparing surgery, and improved local control rates as compared to delivering the chemoradiation postoperatively...
February 2017: Current Treatment Options in Oncology
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