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https://www.readbyqxmd.com/read/28722085/-anatomical-planes-and-landmarks-of-transanal-total-mesorectal-excision-for-rectal-cancer-and-prophylaxis-of-intraoperative-complications
#1
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
https://www.readbyqxmd.com/read/28655083/-anatomic-study-and-clinical-practice-of-mesopancreas-and-total-mesopancreatic-excision
#2
J Y Xu, Y R Chen, C Liu, L Tian, J W Wang, D Cui, Y Wang, W G Zhang, Y M Yang
Objective: To explore the anatomical characteristics of the mesopancreas, to define the range of the total mesopancreas excision and to evaluate the feasibility, safety and effectiveness in the treatment of pancreatic cancer. Methods: A regional anatomical and pathological study was performed on 14 cadavers with large slices and paraffin sections. The clinical and pathological data of 58 consecutive patients underwent total mesopancreas excision for pancreatic head carcinoma from January 2013 to December 2015 were prospectively collected and analysed...
July 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28643301/-application-of-robotic-surgical-system-in-sphincter-preserving-surgery-for-low-rectal-cancer
#3
Pingping Xu, Jianmin Xu
Robotic surgical system has been widely applied in sphincter-preserving surgery for low rectal cancer with the advantages of clear 3D images and stably flexile manipulation. Its application principle includes radical resection of tumor and complete preservation of function. The main operation procedures of robotic surgical system in sphincter-preserving surgery for low rectal cancer are as follows: (1) Anterior resection of low rectal cancer: It is safe and feasible and has obvious advantages in observation of pelvic nerves, dissociation of presacral and sacral side, and high rate of sphincter-preserving, while the improvement of postoperative recovery and long-term survival needs to be verified by further large sample researches...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28590033/radiological-and-pathological-evaluation-of-the-level-of-arterial-division-after-colon-cancer-surgery
#4
Ditte Louise E Munkedal, Mona Rosenkilde, Dennis Tønner Nielsen, Thorbjørn Sommer, Nicholas P West, Søren Laurberg
AIM: In aiming to cure patients with colorectal cancer surgery, the surgeon must carefully dissect the mesocolon and mesorectum and divide the vascular pedicle as near to its origin so as to include all local lymph nodes. This has been termed Complete Mesocolic Excision (CME). The distance from distal vascular tie to the bowel wall in the fixed specimen is an indication as to the quality of surgery but this does not assess the length of the residual vascular pedicle and by implication, residual lymph nodes...
June 7, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28444558/evolution-of-surgical-treatment-for-rectal-cancer-a-review
#5
Sanjeev Dayal, Nick Battersby, Tom Cecil
Surgery that produces an optimal total mesorectal excision (TME) resection specimen remains the cornerstone of curative rectal cancer management. In the modern era, despite the results of recent randomised trials, laparoscopic TME is a crucial technique in the TME surgery armamentarium. Laparoscopic surgery offers the benefit of magnified views that aid sharp and precise dissection. However operating in the confines of a narrow pelvis, particularly when the mesorectum is bulky, requires significant technical skill...
April 25, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28299781/architectural-differences-in-the-anterior-and-middle-compartments-of-the-pelvic-floor-of-young-adult-and-postmenopausal-females
#6
Yi Wu, Noshir F Dabhoiwala, Jaco Hagoort, Li-Wen Tan, Shao-Xiang Zhang, Wouter H Lamers
The pelvic floor guards the passage of the pelvic organs to the exterior. The near-epidemic prevalence of incontinence in women continues to generate interest in the functional anatomy of the pelvic floor. However, due to its complex architecture and poor accessibility, the classical 'dissectional' approach has been unable to come up with a satisfactory description, so that many aspects of its anatomy continue to raise debate. For this reason, we opted for a 'sectional' approach, using the Chinese Visible Human project (four females, 21-35 years) and the Visible Human Project (USA; one female, 59 years) datasets to investigate age-related changes in the architecture of the anterior and middle compartments of the pelvic floor...
March 16, 2017: Journal of Anatomy
https://www.readbyqxmd.com/read/28281474/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...
April 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28265766/combined-transanal-total-mesorectal-excision-tatme-with-laparoscopic-instruments-and-abdominal-robotic-surgery-in-rectal-cancer
#8
R Bravo, J-S Trépanier, M C Arroyave, M Fernández-Hevia, A Pigazzi, A M Lacy
Laparoscopic surgery for rectal cancer can be technically challenging. We describe a hybrid technique combining abdominal robotic dissection and transanal total mesorectal excision. This procedure was performed in a 50-year-old man with rectal adenocarcinoma at 5 cm from the dentate lane. Preoperative staging was T2N0M0. Surgery went well without complications, and estimated blood loss was less than 50 mL. Robotic surgical time was 90 min, and total operative time was 160 min. The patient was discharged on postoperative day 3...
March 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28154838/surgical-anatomy-of-the-ligamentous-mesometrium-and-robotically-assisted-icg-guided-resection-in-cervical-cancer
#9
Rainer Kimmig, Paul Buderath, Peter Rusch, Bahriye Aktas
The ligamentous mesometrium is a 3-dimensional structure consisting of a rectouterine/-vaginal part with attachment to the anterior lateral mesorectum and a sacrouterine part surrounding the mesorectum attached to the pelvic fascia and the mesorectum dorsolaterally. The lymphatic network draining the posterior cervix connected caudally ventrally to the deep venous lymph network of the vascular mesometrium is running at the lateral surface of the sacrouterine part and dorsomedially of the inferior hypogastric plexus; it drains to the deep internal iliac, prespinal and preischiadic nodes...
May 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28144213/abdominal-approaches-to-rectal-prolapse
#10
REVIEW
Kyla Joubert, Jonathan A Laryea
Rectal prolapse is a debilitating condition with a complex etiology. Symptoms are most commonly prolapse of the rectum and pain with bowel movements or straining, with worsening fecal incontinence over time due to progressive stretching of the anal sphincters. Physical findings are fairly consistent from patient to patient-most notably diastasis of the levator ani muscles, deep pouch of Douglas, redundant sigmoid colon, a mobile mesorectum, and occasionally a solitary rectal ulcer. Evaluation includes a physical exam or imaging demonstrating the prolapse, and evaluating for other causes of pelvic floor dysfunction...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28092330/prediction-of-anastomotic-leakage-after-laparoscopic-low-anterior-resection-in-male-rectal-cancer-by-pelvic-measurement-in-magnetic-resonance-imaging
#11
Atsushi Tsuruta, Jo Tashiro, Toshimasa Ishii, Yasuo Oka, Asami Suzuki, Hiroka Kondo, Shigeki Yamaguchi
OBJECTIVE: Anastomotic leakage after laparoscopic low anterior resection in male rectal cancer patients with a narrow pelvis cannot be easily resolved. The objective of this study is to assess numerical information of narrow pelvis and to determine whether prediction of morbidity can be possible. METHODS: Retrospective medical record review was performed. From July 2007 to January 2013, 43 consecutive male patients with low rectal cancer who underwent laparoscopic low anterior resection were divided into the anastomotic leakage-negative group and anastomotic leakage-positive group...
February 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28000657/combined-laparoscopic-and-transanal-total-mesorectal-excision-for-rectal-cancer-initial-experience-and-early-results
#12
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/27895814/robotic-rectal-surgery-state-of-the-art
#13
REVIEW
Fabio Staderini, Caterina Foppa, Alessio Minuzzo, Benedetta Badii, Etleva Qirici, Giacomo Trallori, Beatrice Mallardi, Gabriele Lami, Giuseppe Macrì, Andrea Bonanomi, Siro Bagnoli, Giuliano Perigli, Fabio Cianchi
Laparoscopic rectal surgery has demonstrated its superiority over the open approach, however it still has some technical limitations that lead to the development of robotic platforms. Nevertheless the literature on this topic is rapidly expanding there is still no consensus about benefits of robotic rectal cancer surgery over the laparoscopic one. For this reason a review of all the literature examining robotic surgery for rectal cancer was performed. Two reviewers independently conducted a search of electronic databases (PubMed and EMBASE) using the key words "rectum", "rectal", "cancer", "laparoscopy", "robot"...
November 15, 2016: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27853973/clinical-outcomes-and-case-volume-effect-of-transanal-total-mesorectal-excision-for-rectal-cancer-a-systematic-review
#14
REVIEW
C L Deijen, A Tsai, T W A Koedam, M Veltcamp Helbach, C Sietses, A M Lacy, H J Bonjer, J B Tuynman
Transanal total mesorectal excision (TaTME) has been developed to improve quality of TME for patients with mid and low rectal cancer. However, despite enthusiastic uptake and teaching facilities, concern exists for safe introduction. TaTME is a complex procedure and potentially a learning curve will hamper clinical outcome. With this systematic review, we aim to provide data regarding morbidity and safety of TaTME. A systematic literature search was performed in MEDLINE (PubMed), EMBASE (Ovid) and Cochrane Library...
December 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27829942/safety-and-usefulness-of-needle-guided-resection-of-levator-muscles-in-laparoscopic-abdominoperineal-resection-for-low-rectal-cancer
#15
Takehito Yamamoto, Akiyoshi Kanazawa, Hiroyuki Matsubara, Takuya Okamoto
INTRODUCTION: During laparoscopic abdominoperineal resection (APR) for low rectal cancer, it is difficult to resect the levator muscles and remove a cylindrical specimen without venturing close to the rectal wall to ensure negative circumferential resection margins (CRM). To solve this problem, we developed a needle-guided, laparoscopic, abdominoperineal resection (LAPR) technique. AIM: To present the safety and superiority of our technique, "needle-guided LAPR"...
2016: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/27781241/-laparoscopic-total-mesorectum-excision-with-the-guidance-of-membrane-anatomy
#16
Pan Chi
The efficacy of laparoscopic total mesorectum excision (TME) has been confirmed by many clinical trials and guidelines. But two issues on laparoscopic TME are still questioned, including the integrity of specimen membrane of TME and the incidence of postoperative sexual dysfunction. According to my experiences and the primary results of the multicenter clinical trial (LASRE, clinicaltrials.gov identifier: NCT01899547) conducted by me, the integrity of the specimen membrane of laparoscopic TME is not inferior to the open TME...
October 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27749488/single-incision-laparoscopic-anterior-resection-using-a-curved-stapler
#17
Jun Watanabe, Mitsuyoshi Ota, Yusuke Suwa, Atsushi Ishibe, Hidenobu Masui, Kaoru Nagahori
INTRODUCTION: Single-incision laparoscopic colectomy is technically limited because of such factors as instrument crowding, in-line viewing, and insufficient countertraction. In particular, it is technically difficult to cut the distal rectum from the umbilicus using an articulating linear stapler in single-incision laparoscopic anterior resection. TECHNIQUE: After treating the mesorectum, the 5-mm trocar is replaced with a 12-mm trocar. The cartridge of the curved stapler is mounted while the shaft of the stapler is inserted into the 12-mm port extracorporeally...
November 2016: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27714521/prospective-multicenter-registration-study-of-colorectal-cancer-significant-variations-in-radicality-and-oncosurgical-quality-swiss-group-for-clinical-cancer-research-protocol-sakk-40-00
#18
MULTICENTER STUDY
Christoph A Maurer, Daniel Dietrich, Martin K Schilling, Urs Metzger, Urban Laffer, Peter Buchmann, Bruno Lerf, Peter Villiger, Gian Melcher, Christian Klaiber, Christian Bilat, Peter Brauchli, Luigi Terracciano, Katharina Kessler
PURPOSE: This study aimed to investigate in a multicenter cohort study the radicality of colorectal cancer resections, to assess the oncosurgical quality of colorectal specimens, and to compare the performance between centers. METHODS: One German and nine Swiss hospitals agreed to prospectively register all patients with primary colorectal cancer resected between September 2001 and June 2005. The median number of eligible patients with one primary tumor included per center was 95 (range 12-204)...
January 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27697137/cancer-of-the-upper-rectum
#19
REVIEW
Peter Bondeven
Rectal cancer constitutes one-third of all colorectal cancers, and the incidence in Denmark increasing. In 2012, 1.400 cases were registered, and of these 38% were located in the upper rectum. There have been several key advances in the optimal management of rectal cancer during the past decades, primarily by standardisation and improvement of the surgical procedure. There is now general agreement that the optimal surgical treatment involves the concept of total mesorectal excision and that a resection with tumour-free margins is crucial...
October 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27684810/patterns-of-lymph-node-metastasis-in-locally-advanced-cervical-cancer
#20
Zhikai Liu, Ke Hu, An Liu, Jie Shen, Xiaorong Hou, Xin Lian, Shuai Sun, Junfang Yan, Fuquan Zhang
The aim of this study was to investigate patterns and locations of lymph node metastasis in locally advanced cervical cancers.A total of 244 consecutive patients with stage IIb cervical cancer were retrospectively evaluated. Contrast-enhanced CT scans were used for lymph node grading. Lymph nodes with the shortest axis (>1 cm) were categorized as positive and those between 0.5 and 1 cm were categorized as suspicious. All lymph nodes (LNs) were also classified by their anatomic locations.Nine hundred thirty-one LNs (136 positive and 795 suspicious) were identified...
September 2016: Medicine (Baltimore)
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