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Total mesorectal excision

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https://www.readbyqxmd.com/read/29780603/male-gender-is-associated-with-an-increased-risk-of-anastomotic-leak-in-rectal-cancer-patients-after-total-mesorectal-excision
#1
Chi Zhou, Xian-Rui Wu, Xuan-Hui Liu, Yu-Feng Chen, Jia Ke, Xiao-Wen He, Xiao-Sheng He, Tuo Hu, Yi-Feng Zou, Xiao-Bin Zheng, Hua-Shan Liu, Jian-Cong Hu, Xiao-Jian Wu, Jian-Ping Wang, Ping Lan
Background: The impact of a patient's gender on the development of anastomotic leak (AL) in rectal cancer patients following total mesorectal excision (TME) remains controversial. The aim of this study was to evaluate the association between patients' gender and the risk of AL. Methods: All rectal cancer patients following TME with a primary anastomosis during the study period from 2010 to 2014 were examined. Comparisons of the post-operative AL incidence rate between male and female patients were performed...
May 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29777457/a-nomogram-to-predict-anastomotic-leakage-in-open-rectal-surgery-hope-or-hype
#2
Johannes Klose, Ignazio Tarantino, Armin von Fournier, Moritz J Stowitzki, Yakup Kulu, Thomas Bruckner, Claudia Volz, Thomas Schmidt, Martin Schneider, Markus W Büchler, Alexis Ulrich
BACKGROUND: Anastomotic leakage is the most dreaded complication after rectal resection and total mesorectal excision, leading to increased morbidity and mortality. Formation of a diverting ileostomy is generally performed to protect anastomotic healing. Identification of variables predicting anastomotic leakage might help to select patients who are under increased risk for the development of anastomotic leakage prior to surgery. The objective of this study was to assess the applicability of a nomogram as prognostic model for the occurrence of anastomotic leakage after rectal resection in a cohort of rectal cancer patients...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29771810/transanal-total-mesorectal-excision-vs-laparoscopic-total-mesorectal-excision-in-the-treatment-of-low-and-middle-rectal-cancer-a-propensity-score-matching-analysis
#3
Roberto Persiani, Alberto Biondi, Francesco Pennestrì, Valeria Fico, Veronica De Simone, Flavio Tirelli, Francesco Santullo, Domenico D'Ugo
BACKGROUND: Transanal total mesorectal excision is a novel and promising technique in the treatment of low and middle rectal cancer. OBJECTIVE: This study aimed to compare the safety and feasibility of transanal total mesorectal excision versus laparoscopic total mesorectal excision. DESIGN: This was a retrospective study using propensity score matching analysis. SETTINGS: This study was conducted in a single high-volume university hospital...
May 15, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29766457/influence-of-age-on-variation-in-patterns-of-care-in-patients-with-rectal-cancer-in-catalonia-spain
#4
R Vernet, J M Borras, L Aliste, M Antonio, A Guarga, P Manchon-Walsh
BACKGROUND: Population ageing is a relevant concern in people diagnosed with rectal cancer. This study evaluates the adherence to clinical practice guidelines (CPGs) and patient outcomes in rectal cancer, with a particular focus on variation according to age. METHODS: This is a multicentre retrospective cohort study of all patients surgically treated for the first time for primary rectal cancer with curative intent in public hospitals in Catalonia during two study periods: first, with data from 2005 to 2007, and then with data from 2011 to 2012...
May 15, 2018: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29762145/a-succinct-critical-appraisal-of-indications-to-transanal-total-mesorectal-excision
#5
Mahir Gachabayov, Alexandra Chudner, Roberto Bergamaschi
No abstract text is available yet for this article.
May 14, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29756123/the-quality-of-total-mesorectal-excision-specimen-a-review-of-its-macroscopic-assessment-and-prognostic-significance
#6
Shi-Bo Song, Guo-Ju Wu, Hong-Da Pan, Hua Yang, Mao-Lin Hu, Qiang Li, Qiu-Xia Yan, Gang Xiao
As a surgical procedure which could significantly lower the recurrence rate of cancers, total mesorectal excision (TME) has been the gold standard for middle and lower rectal cancer treatment. However, previous studies have shown that the procedure did not achieve the ideal theoretical local recurrence rates of rectal cancers. Some researchers pointed out it was very likely that not all so-called TME treatments completely removed the mesorectum, implying that some of these TME surgical treatments failed to meet oncological quality standards...
March 2018: Chronic Diseases and Translational Medicine
https://www.readbyqxmd.com/read/29755692/defunctioning-ileostomy-reduces-leakage-rate-in-rectal-cancer-surgery-systematic-review-and-meta-analysis
#7
Magdalena Pisarska, Natalia Gajewska, Piotr Małczak, Michał Wysocki, Jan Witowski, Grzegorz Torbicz, Piotr Major, Magdalena Mizera, Marcin Dembiński, Marcin Migaczewski, Andrzej Budzyński, Michał Pędziwiatr
Objectives: The role of a defunctioning ileostomy in every anterior rectal resection with total mesorectal excision (TME) is still controversial. In this study, we aimed to review the current literature to determine the impact of ileostomy creation on postoperative outcomes in patients undergoing anterior rectal resection with TME. Methods: MEDLINE, Embase and Cochrane Library were searched for eligible studies. We analyzed data up to October 2017. Eligible studies had to compare patients with vs...
April 17, 2018: Oncotarget
https://www.readbyqxmd.com/read/29744860/oncological-outcome-after-mri-based-selection-for-neoadjuvant-chemoradiotherapy-in-the-ocum-rectal-cancer-trial
#8
R Ruppert, T Junginger, H Ptok, J Strassburg, C A Maurer, P Brosi, J Sauer, J Baral, M Kreis, D Wollschlaeger, P Hermanek, S Merkel
BACKGROUND: It is not clear whether all patients with rectal cancer need chemoradiotherapy. A restrictive use of neoadjuvant chemoradiotherapy (nCRT) based on MRI findings for rectal cancer was investigated in this study. METHODS: This prospective multicentre observational study included patients with stage cT2-4 rectal cancer, with any cN and cM0 status. Carcinomas in the middle and lower third that were 1 mm or less from the mesorectal fascia, all cT4 tumours, and all cT3 tumours of the lower third were classified as high risk, and these patients received nCRT followed by total mesorectal excision (TME)...
May 9, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29743887/mean-corpuscular-volume-as-a-predictive-factor-of-response-to-preoperative-chemoradiotherapy-in-locally-advanced-rectal-cancer
#9
Wen-Yi Zhang, Xing-Xing Chen, Wen-Hao Chen, Hui Zhang, Chang-Lin Zou
Background: The aim of this study was to identify if blood routine parameters and serum tumor marker are potential predictive factors for tumor response to preoperative chemoradiotherapy (CRT) in locally advanced rectal cancer. Materials and Methods: 55 locally advanced rectal cancer patients were treated with preoperative CRT in this study. The total dose of preoperative radiotherapy was 45 Gy in 25 fractions of 1.8 in 5 weeks. All patients concurrently received 825 mg/m2 capecitabine orally twice daily on days 1 to 14 and 22 to 35...
2018: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29740919/transanal-total-mesorectal-excision-for-locally-advanced-pt4b-rectal-cancers
#10
Chun Han Nigel Tan, Kuok Chung Lee, Wai Kit Cheong, Choon Seng Chong
No abstract text is available yet for this article.
May 8, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29739356/korean-society-of-coloproctology-kscp-trial-of-consolidation-chemotherapy-for-locally-advanced-mid-or-low-rectal-cancer-after-neoadjuvant-concurrent-chemoradiotherapy-a-multicenter-randomized-controlled-trial-konclude
#11
Chang Woo Kim, Byung Mo Kang, Ik Yong Kim, Ji Yeon Kim, Sun Jin Park, Won Cheol Park, Ki Beom Bae, Byung-Noe Bae, Seong Kyu Baek, Seung Hyuk Baik, Gyung Mo Son, Yoon Suk Lee, Suk-Hwan Lee
BACKGROUND: Neoadjuvant chemoradiotherapy (CRT) followed by total mesorectal excision (TME) has been a standard treatment option for locally advanced rectal cancer with improved local control. However, systemic recurrence despite neoadjuvant CRT remained unchanged. The only significant prognostic factor proven to be important was pathologic complete response (pCR) after neoadjuvant CRT. Several efforts have been tried to improve survival of patients who treated with neoadjuvant CRT and to achieve more pCR including adding cytotoxic chemotherapeutic agents, chronologic modification of chemotherapy schedule or adding chemotherapy during the perioperative period...
May 8, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29725785/salvage-tme-following-tem-a-possible-indication-for-tatme
#12
F Letarte, M Raval, A Karimuddin, P T Phang, C J Brown
BACKGROUND: Salvage surgery after transanal endoscopic microsurgery (TEM) has shown mixed results. Transanal total mesorectal excision (TaTME) might be advantageous in this population. The aim of this study was to assess the short-term oncologic and operative outcomes of salvage surgery after TEM, comparing TaTME to conventional salavge TME (sTME). METHODS: Consecutive patients treated with salvage surgery after TEM were identified. Patients who underwent TaTME were compared to those who had conventional sTME...
May 4, 2018: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29724664/cognitive-skills-training-in-digital-era-a-paradigm-shift-in-surgical-education-using-the-tatme-model
#13
REVIEW
Joep Knol, Deborah S Keller
Surgical competence is a complex, multifactorial process, requiring ample time and training. Optimal training is based on acquiring knowledge and psychomotor and cognitive skills. Practicing surgical skills is one of the most crucial tasks for both the novice surgeon learning new procedures and surgeons already in practice learning new techniques. Focus is placed on teaching traditional technical skills, but the importance of cognitive skills cannot be underestimated. Cognitive skills allow recognizing environmental cues to improve technical performance including situational awareness, mental readiness, risk assessment, anticipating problems, decision-making, adaptation, and flexibility, and may also accelerate the trainee's understanding of a procedure, formalize the steps being practiced, and reduce the overall training time to become technically proficient...
April 30, 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/29722727/grading-of-total-mesorectal-excision-specimens-assessment-of-interrater-agreement
#14
Emily A Goebel, Melissa Stegmaier, Donald R Gorassini, Matthew Kubica, Jeremy R Parfitt, David K Driman
BACKGROUND: Total mesorectal excision is the standard of care for patients with rectal cancer. Pathological evaluation of the quality of the total mesorectal excision specimen is an important prognostic factor that correlates with local recurrence, but is potentially subjective. OBJECTIVE: This study aimed to determine the degree of variation in grading, both between assessors and between fresh and formalin-fixed specimens. DESIGN: Raters included surgeons, pathologists, pathology residents, pathologists' assistants, and pathologists' assistant trainees...
June 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29722725/antegrade-enema-after-total-mesorectal-excision-for-rectal-cancer-the-last-chance-to-avoid-definitive-colostomy-for-refractory-low-anterior-resection-syndrome-and-fecal-incontinence
#15
Romain Didailler, Quentin Denost, Paula Loughlin, Edouard Chabrun, Julie Ricard, Flor Picard, Frank Zerbib, Eric Rullier
BACKGROUND: Total mesorectal excision and preoperative radiotherapy in mid and low rectal cancer allow us to achieve very good oncological results. However, major and refractory low anterior resection syndrome and fecal incontinence alter the quality of life of patients with a long expected life span. OBJECTIVE: We assessed the functional results of patients treated by antegrade enema for refractory low anterior resection syndrome and fecal incontinence after total mesorectal excision...
June 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29721748/oncological-outcomes-of-robotic-assisted-laparoscopic-versus-open-lateral-lymph-node-dissection-for-locally-advanced-low-rectal-cancer
#16
Tomohiro Yamaguchi, Yusuke Kinugasa, Akio Shiomi, Hiroyasu Kagawa, Yushi Yamakawa, Akinobu Furutani, Shoichi Manabe, Yusuke Yamaoka, Hitoshi Hino
BACKGROUND: The long-term outcomes of robotic-assisted laparoscopic lateral lymph node dissection (RALLD) have not been fully investigated. This study aimed to assess the oncological and long-term outcomes of RALLD for rectal cancer through comparison with those of open lateral lymph node dissection (OLLD) in a retrospective study. METHODS: Between September 2002 and October 2014, the medical data of 426 patients who underwent total mesorectal excision with lateral lymph node dissection for primary rectal cancer were collected...
May 2, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29706021/effect-of-pathologist-s-dedication-on-lymph-node-detection-rate-and-postoperative-survival-in-colorectal-cancer
#17
W Lukas Unger, Moritz Muckenhuber, Riss Stefan, Stanislaus Argeny, Judith Stift, Ildiko Mesteri, Anton Stift
BACKGROUND: As adjuvant chemotherapy in colorectal cancer relies on the identification of lymph-node metastases, pathologist's expertise may have a considerable influence on postoperative survival. MATERIALS AND METHODS: The aim of this retrospective study was to assess the impact of the pathologist's expertise on lymph node detection rate and postoperative survival in patients operated on by a single experienced colorectal surgeon within a 5 year period. We assessed 229 patients undergoing total mesorectal excision or complete mesocolic excision by the senior author between Jan...
April 28, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29696348/perioperative-radiotherapy-is-an-independent-risk-factor-for-major-lars-a-cross-sectional-observational-study
#18
Frederiek Nuytens, Dries Develtere, Gregory Sergeant, Isabelle Parmentier, André D'Hoore, Mathieu D'Hondt
PURPOSE: Sphincter-preserving surgery for rectal cancer is often associated with low anterior resection syndrome (LARS). The aim of our study was to determine the prevalence of LARS in our institution and identify possible risk factors for LARS. Furthermore, we evaluated which of the LARS symptoms was considered most disabling by patients and whether or not there is an adaptation of the LARS score over time. METHODS: This study includes a prospective database of 100 patients who underwent total or partial mesorectal excision between January 2009 and September 2014...
April 26, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29695572/the-feasibility-and-efficacy-of-laparoscopic-extended-total-mesorectal-excision-for-locally-advanced-lower-rectal-cancer
#19
Takashi Nonaka, Akiko Fukuda, Kyoichiro Maekawa, Shigeki Nagayoshi, Takayuki Tokunaga, Mitsutoshi Takatsuki, Tomoo Kitajima, Ken Taniguchi, Hikaru Fujioka
BACKGROUND/AIM: Extended total mesorectal excision (ETME) is defined as en bloc resection of the adjacent organs outside the mesorectal fascia, that is indicated in cases with locally advanced lower rectal cancer (T4 tumor). The aim of this study was to evaluate the clinical and oncological outcomes of laparoscopic ETME (L-ETME) for locally advanced lower rectal cancer. PATIENTS AND METHODS: The present study analyzed clinical outcomes and oncological outcomes of 11 consecutive patients who underwent L-ETME for cT4 lower rectal cancer in Nagasaki Medical Center between 2012 and 2015...
May 2018: In Vivo
https://www.readbyqxmd.com/read/29693307/trans-anal-total-mesorectal-excision-is-it-really-safe-and-better-than-laparoscopic-total-mesorectal-excision-with-perineal-approach-first-in-patients-with-low-rectal-cancer-a-learning-curve-with-case-matched-study-in-68-patients
#20
Diane Mege, Elisabeth Hain, Zaher Lakkis, Léon Maggiori, Justine Prost À la Denise, Yves Panis
AIM: To compare learning curve of trans-anal total mesorectal excision (TATME) with laparoscopic TME started by perineal approach (LTME). METHOD: The first 34 consecutive patients who underwent TATME for low rectal cancer were matched with LTME performed by the same surgeon, for gender, body mass index and chemoradiation. RESULTS: 34 patients undergoing TATME (23 males; 58±14 years) were matched with 34 undergoing LTME (23 males; 59±13 years)...
April 25, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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