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https://www.readbyqxmd.com/read/29441419/modern-intensity-modulated-radiotherapy-with-image-guidance-allows-low-toxicity-rates-and-good-local-control-in-chemoradiotherapy-for-anal-cancer-patients
#1
Berardino De Bari, Laëtitia Lestrade, Alessandra Franzetti-Pellanda, Raphael Jumeau, Maira Biggiogero, Melpomeni Kountouri, Oscar Matzinger, Raymond Miralbell, Jean Bourhis, Mahmut Ozsahin, Thomas Zilli
PURPOSE: To report outcomes of a population of anal cancer patients treated with modern intensity-modulated radiotherapy and daily image-guided radiotherapy techniques. METHODS: We analyzed data of 155 patients consecutively treated with intensity-modulated radiotherapy +/- chemotherapy in three radiotherapy departments. One hundred twenty-two patients presented a stage II-IIIA disease. Chemotherapy was administered in 138 patients, mainly using mitomycin C and 5-fluorouracil (n = 81)...
February 13, 2018: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/29394702/-a-case-of-lymph-node-metastasis-of-rectal-laterally-spreading-tumor-with-mucosal-cancer-after-endoscopic-submucosal-dissection
#2
Hajime Ushigome, Yoshiya Fujimoto, Shinsuke Suzuki, Hironori Minami, Shun Miyanari, Satoshi Murahashi, Hironori Fukuoka, Toshiya Nagasaki, Takashi Akiyoshi, Tsuyoshi Konishi, Satoshi Nagayama, Yosuke Fukunaga, Masashi Ueno, Akiko Chino, Masahiro Igarashi
A screening fecal occult blood test was positive in a 76-year-old female. Colonoscopy showed laterally spreading tumor (LST)over 15 cm at lower rectum. endoscopic submucosal dissection(ESD)was performed. Pathological findings showed LST-G, 150×100 mm, adenocarcinoma(tub1-tub2), tubular adenoma, moderate-severe atypia, Tis(M), ly(-), v(-), HMX, VMX. Two years later CT detected one swollen lymph node at mesorectum and PET-CT showed FDG up take at the lymph node. We diagnosed lymph node metastasis, performed laparoscopic very low anterior resection...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29394653/-a-case-of-bladder-metastasis-occurring-after-rectosigmoid-cancer-operation
#3
Kazuhisa Tokunou, Tatsuhito Yamamoto, Akihiro Tokuhisa, Ryoji Kamei, Yoshinori Kitamura, Seiichirou Ando
A 55-year-old man was admitted to our hospital for rectosigmoid(RS)cancer. We performed high anterior resection in the patient. Pathological findings showed mucinous adenocarcinoma, pT3(SS), pN1, sM0, sP0, pCy0, fStage III a. Two years and 3 months after the first operation, the patient visited our hospital due to lumbago, and we conducted a detailed abdominal examination. CT images showed the bladder tumor expanding into the vesical trigon and invading the prostate and mesorectum. Cystoscopy revealed the tumor, and tumor biopsy indicated poorly differentiated adenocarcinoma...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29394641/-a-case-of-advanced-transverse-colon-cancer-with-relapse-behind-the-rectum-after-laparoscopic-assisted-resection
#4
Tatsushi Shingai, Takayuki Fukuzaki, Yoshiro Ito, Tadafumi Fukata, Hiromichi Miyagaki, Hisashi Nishida, Yasuhiro Toyoda, Osamu Takayama, Setsuko Yoshioka, Shigeyuki Hojo, Yoshiichi Maeura, Hiroaki Ohigashi
A 60's male patient underwent laparoscopic left hemicolectomy with D3 lymph node dissection for transverse colon cancer. Adjuvant chemotherapy with tegafur-uracil and leucovorin was administered.Thirty -four months later, MRI scan revealed a mass with sacrum invasion.Radiation therapy(39 Gy/13 Fr)was performed followed by chemotherapy(modified oxaliplatin, leucovorin, and 5-fluorouracil plus bevacizumab).Two weeks after the completion of radiation therapy, staging laparoscopy and tissue biopsy was performed in the hard tumor, which was located at the caudal end of the incisional scar of the retroperitoneum, in front of the sacrum...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29234940/st-gallen-consensus-on-safe-implementation-of-transanal-total-mesorectal-excision
#5
Michel Adamina, Nicolas C Buchs, Marta Penna, Roel Hompes
BACKGROUND: The management of rectal cancer has evolved over the years, including the recent rise of Transanal Total Mesorectal Excision (TaTME). TaTME addresses the limitations created by the bony confines of the pelvis, bulky tumours, and fatty mesorectum, particularly for low rectal cancers. However, guidance is required to ensure safe implementation and to avoid the pitfalls and potential major morbidity encountered by the early adopters of TaTME. We report a broad international consensus statement, which provides a basis for optimal clinical practice...
December 12, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29221180/pelvic-recurrence-after-definitive-surgery-for-locally-advanced-rectal-cancer-a-retrospective-investigation-of-implications-for-precision-radiotherapy-field-design
#6
Chao Li, Yinju Zhu, Tong Tong, Ye Xu, Yun Guan, Jingwen Wang, Huankun Wang, Ji Zhu
Background: To analyze the local distribution of pelvic recurrence after total mesorectal excision, with a view to simplifying the formulation of optimal individualized radiotherapy plans. Methods: We retrospectively investigated the data of 168 patients diagnosed with recurrent pelvic cancer treated at Fudan University Shanghai Cancer Center between January 2008 and December 2012. The following were collected depending on availability: operative report, histological report, specimen photographs, initial preoperative images, images confirming local recurrence, and clinical history...
November 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/29219924/combined-laparoscopic-and-perineal-approach-to-omental-interposition-repair-of-complex-rectovaginal-fistula
#7
Hester de Bruijn, Yasuko Maeda, Jamie Murphy, Janindra Warusavitarne, Carolynne J Vaizey
INTRODUCTION: Surgical repair of rectovaginal fistula remains a challenge. Complex and recurrent rectovaginal fistula repairs often fail because of scarring and devascularization of the surrounding tissue. Omental interposition may promote healing by introducing bulky vascularized tissue into the rectovaginal septum. TECHNIQUE: With the patient in the lithotomy position, the rectovaginal septum was dissected transperineally up to the fistula tract and the openings on both vaginal and rectal sides were closed using interrupted, absorbable sutures...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29198494/distribution-of-metastases-in-mesorectum-is-unpredictable-metastases-do-not-respect-tumor-localization-even-in-small-non-circumferential-rectal-cancers
#8
Magdaléna Linter Kapišinská, Eva Hovorková, Veronika Závalová, Zdeněk Šubrt, Martin Kuneš, Alexander Ferko
INTRODUCTION: Low anterior resection with total mesorectal excision (TME) is the gold standard for surgical treatment of rectal carcinoma. The radicality of this procedure is negatively counterbalanced by morbidity, lethality, and numerous other complications. Local excision would appear to be an attractive alternative, but its radicality is disputable due to risk of undetected metastasis to the mesorectum. The study aimed to determine the location of mesorectal metastases with respect to circumferentially - located tumors in patients with tumors involving less than one-third of the rectal circumference...
January 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29151943/total-mesopancreas-excision-for-the-treatment-of-pancreatic-head-cancer
#9
Jingyong Xu, Xiaodong Tian, Yiran Chen, Yongsu Ma, Chang Liu, Long Tian, Jianwei Wang, Jianqiang Dong, Di Cui, Yang Wang, Weiguang Zhang, Yinmo Yang
Mesopancreas is a controversial structure. This study aimed to explore the anatomical characteristics of the mesopancreas, define the range of the total mesopancreas excision (TMpE), and evaluate the feasibility, safety and effectivity of TMpE in the treatment of pancreatic head cancer. The clinical and pathological data of 58 consecutive patients undergoing TMpE for pancreatic head carcinoma from January 2013 to December 2015 were analyzed prospectively. The perioperative morbidity, mortality and clinical outcomes of patients undergoing TMpE were compared with the patients undergoing conventional pancreaticoduodenectomy...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/29130229/-discovery-anatomy-and-clinical-significance-of-the-mesorectal-finish-line-of-total-mesorectal-excision
#10
Pan Chi, Xiaojie Wang, Guoxian Guan, Huiming Lin, Ying Huang, Weizhong Jiang
OBJECTIVE: To investigate the surgical endpoint of separation of mesorectum during total mesorectal excision (TME), suggesting the concept of "terminal line", in order to perform above separation better for middle-low rectal cancer. METHODS: Gross anatomy of mesorectum endpoint from 81 surgical specimens of low anterior resection (LAR, 5 to 6 cm of distance from low margin of cancer to anal edge) and 71 surgical specimens of abdominal perineal resection(APR, <5 cm of distance from low margin of cancer to anal edge) was observed...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29112562/initiation-of-a-transanal-total-mesorectal-excision-program-at-an-academic-training-program-evaluating-patient-safety-and-quality-outcomes
#11
Justin A Maykel, Uma R Phatak, Pasithorn A Suwanabol, Andrew T Schlussel, Jennifer S Davids, Paul R Sturrock, Karim Alavi
BACKGROUND: Short-term results have shown that transanal total mesorectal excision is safe and effective for patients with mid to low rectal cancers. Transanal total mesorectal excision is considered technically challenging; thus, adoption has been limited to a few academic centers in the United States. OBJECTIVE: The aim of this study is to describe outcomes after the initiation of a transanal total mesorectal excision program in the setting of an academic colorectal training program...
December 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29094377/prognostic-significance-of-the-distribution-of-lymph-node-metastasis-in-rectal-cancer-after-neoadjuvant-chemoradiation
#12
Soo Young Lee, Chang Hyun Kim, Young Jin Kim, Hyeong Rok Kim
BACKGROUND: This study aimed to evaluate the prognostic significance of lymph node distribution (LND) in rectal cancer after neoadjuvant chemoradiation. METHODS: A total of 519 patients with primary rectal cancer who underwent curative resection after neoadjuvant chemoradiation were included. LND was classified into four groups: LND0, no lymph node metastasis (368/519, 70.9%); LNDp, lymph node metastasis along the inferior mesenteric artery (proximal) (15/519, 2...
November 1, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29072488/t3-sub-classification-using-the-emd-mesorectum-ratio-predicts-neoadjuvant-chemoradiation-outcome-in-t3-rectal-cancer-patients
#13
Lijun Shen, Yiqun Sun, Hui Zhang, Jing Zhang, Weijuan Deng, Yaqi Wang, Ye Yao, Lifeng Yang, Ji Zhu, Tong Tong, Liping Liang, Zhen Zhang
PURPOSE: To evaluate the feasibility of the EMD (extramural depth)/mesorectum ratio as a marker for T3 rectal cancer and its ability to predict tumor response to neoadjuvant chemoradiation and survival. METHODS: From 2010 to 2016, 284 T3 rectal cancer patients who underwent high resolution MRI before neoadjuvant chemoradiation were enrolled. The EMD was defined as the distance from the outer edge of the muscularis propria to the outermost edge of the tumor. The measurement of the tumor EMD and mesorectum was in the same layer and their ratio was calculated...
October 26, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29044484/meta-analysis-of-the-impact-of-surgical-approach-on-the-grade-of-mesorectal-excision-in-rectal-cancer
#14
REVIEW
B Creavin, M E Kelly, E Ryan, D C Winter
BACKGROUND: The subspecialization of colorectal surgeons, and improvements in the quality of mesorectal excision have revolutionized rectal cancer surgery. With the increasing use of minimally invasive techniques, the completeness of the mesorectal excision has been questioned. This study aimed to assess the pathological outcomes of open versus laparoscopic rectal resection. METHODS: A meta-analysis of RCTs was undertaken. The primary endpoint was the adequacy of the mesorectal excision...
November 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28949102/robotic-surgery-for-rectal-cancer
#15
REVIEW
Hiroaki Nozawa, Toshiaki Watanabe
Laparoscopic surgery has gained acceptance as a less invasive approach in the treatment of colon cancer. However, laparoscopic surgery for rectal cancer, particularly cancer of the lower rectum, is still challenging because of limited accessibility. Robotic surgery overcomes the limitations of laparoscopy associated with anatomy and offers certain advantages, including 3-D imaging, dexterity and ambidextrous capability, lack of tremors, motion scaling, and a short learning curve. Robotic rectal surgery has been reported to reduce conversion rates, particularly in low anterior resection, but it is associated with longer operative times than the conventional laparoscopic approach...
November 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28883706/simple-instruments-facilitating-achievement-of-transanal-total-mesorectal-excision-in-male-patients
#16
Chang Xu, Hua-Yu Song, Shao-Liang Han, Shi-Chang Ni, Hu-Xiang Zhang, Chun-Gen Xing
AIM: To assess the efficacy of a modified approach with transanal total mesorectal excision (taTME) using simple customized instruments in male patients with low rectal cancer. METHODS: A total of 115 male patients with low rectal cancer from December 2006 to August 2015 were retrospectively studied. All patients had a bulky tumor (tumor diameter ≥ 40 mm). Forty-one patients (group A) underwent a classical approach of transabdominal total mesorectal excision (TME) and transanal intersphincteric resection (ISR), and the other 74 patients (group B) underwent a modified approach with transabdominal TME, transanal ISR, and taTME...
August 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28846947/transanal-total-mesorectal-excision-as-a-surgical-procedure-for-diffuse-cavernous-hemangioma-of-the-rectum-a-case-report
#17
Xian-Rui Wu, Wei-Wen Liang, Xing-Wei Zhang, Liang Kang, Ping Lan
BACKGROUND: The safety and feasibility of transanal total mesorectal excision (TaTME) were demonstrated in the management of rectal cancer. However, its role in the management of patients with diffuse cavernous hemangioma of the rectum (DCHR) has not been evaluated. METHODS: A female patient with DCHR was admitted to our hospital. Colonoscopy, magnetic resonance imaging (MRI), abdominal computed tomography (CT) and arteriography were performed. Lesions were detected in mesorectum and rectal wall extending from the dentate line to 5cm proximally...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28836243/-how-to-standardize-transanal-total-mesorectum-excision
#18
Liang Kang
Transanal total mesorectum excision (taTME) is a novel approach to treat rectal cancer by colorectal surgeons. How to standardize taTME is important for colorectal surgeons, especially at their initial attempt. They can start this approach cautiously only after they master skilled laparoscopic technique and pelvic anatomy, get the knowledge of taTME clearly, and are approved by healthcare department. The female patients with age <70 years old, distance of 5 to 7 cm from tumor inferior margin to anal verge, tumor size <3 cm, cTNM stage <T3aN0 are suitable for taTME...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28830475/preoperative-intensity-modulated-radiotherapy-with-a-simultaneous-integrated-boost-combined-with-capecitabine-in-locally-advanced-rectal-cancer-short-term-results-of-a-multicentric-study
#19
Marco Lupattelli, Fabio Matrone, Maria Antonietta Gambacorta, Mattia Osti, Gabriella Macchia, Elisa Palazzari, Luca Nicosia, Federico Navarria, Giuditta Chiloiro, Vincenzo Valentini, Cynthia Aristei, Antonino De Paoli
BACKGROUND: Preoperative radiotherapy (RT) in combination with fluoropyrimidine-based chemotherapy (CT) is the standard of care in patients with locally advanced, T3-T4 N0-2, rectal cancer (LARC). Given the correlation between RT dose-tumor response and the prognostic role of the tumor regression grade (TRG), treatment intensification represents an area of active investigation. The aim of the study was to analyze the role of RT dose-intensification in the preoperative treatment of LARC in terms of feasibility, efficacy and toxicity...
August 22, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28722085/-anatomical-planes-and-landmarks-of-transanal-total-mesorectal-excision-for-rectal-cancer-and-prophylaxis-of-intraoperative-complications
#20
Zhanlong Shen, Yingjiang Ye, Shan Wang
Total mesorectal excision (TME) is a mile-stone procedure in the history of rectal cancer surgery, but the exposure of surgical field of distal rectum is usually poor in patients with male, obese and narrow pelvis, which may lead to tumor residue and relative complications. Recently, a new technique called transanal TME (taTME) is considered to solve the above problems, but most medical centers are still in the learning curve of this procedure. Therefore, anatomical planes and landmarks of taTME for rectal cancer and prophylaxis of intraoperative complications are induced in this paper, which includes posterior plane: angle of anus and distal mesorectum and bleeding of mesorectum; rectosacral fascia and presacral bleeding; lateral and posterior-lateral plane: posterior branches of pelvic plexus and damage of anal function; anterior plane: vessel branches of neurovascular bundle and bleeding...
July 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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