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https://www.readbyqxmd.com/read/28154838/surgical-anatomy-of-the-ligamentous-mesometrium-and-robotically-assisted-icg-guided-resection-in-cervical-cancer
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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)
https://www.readbyqxmd.com/read/27673926/t3-subclassification-with-emd-mesorectum-ratio-predicts-neoadjuvant-chemoradiation-outcome-in-t3-rectal-cancer-patients
#13
L Shen, Y Sun, T Tong, H Zhang, L Liang, W Deng, G Li, J Zhu, Z Zhang
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27631211/the-outcomes-of-therapeutic-decision-in-lower-3rd-rectal-cancer-patients
#14
Chien-Hsin Chen, Po-Li Wei, Mao-Chih Hsieh, En-Kwang Lin, Jeng-Fong Chiou, Yen-Jung Lu, Szu-Yuan Wu
To investigate the outcomes of the selective neoadjuvant concurrent chemoradiotherapy (CCRT) in lower 3rd rectal cancer patients in different groups (with or without neoadjuvant CCRT), especially in survival rate, local recurrence rate, and sphincter preservation rate.From January 1999 to December 2012, 69 consecutive patients who had histologically proven adenocarcinoma of lower 3rd rectum, defined preoperatively as lower tumor margin within 7 cm from the anal verge as measured by rigid sigmoidoscopy, received total mesorectum excision (TME)...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27603340/the-impact-of-general-visceral-obesity-on-completion-of-mesorectum-and-perioperative-outcomes-of-laparoscopic-tme-for-rectal-cancer-a-stard-compliant-article
#15
Bingchen Chen, Yuanchuan Zhang, Shuang Zhao, Tinghan Yang, Qingbin Wu, Chengwu Jin, Yazhou He, Ziqiang Wang
To evaluate the impact of visceral obesity on laparoscopic total mesorectal excision (TME) and decide the best index to reflect completion of mesorectum and perioperative outcomes.Patients with rectal cancer who underwent laparoscopic TME were enrolled. The data including body mass index (BMI), visceral fat area (VFA), visceral fat area/body surface area (VFA/BSA), mesorectum fat ratio (MFR), pelvic fat area (PFA), pelvic fat ratio (PFR), completion of mesorectum, and other perioperative outcomes were collected...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27593523/successful-laparoscopic-treatment-of-a-giant-solitary-fibrous-tumor-of-the-mesorectum-a-case-report-and-literature-review
#16
Junichiro Kawamura, Masaki Tani, Yuya Kida, Kimiaki Sumida, Ryotaro Ogawa, Junya Kawasoe, Takefumi Yazawa, Masahiro Yamada, Michihiro Yamamoto, Hideki Harada, Hidekazu Yamamoto, Masazumi Zaima
A solitary fibrous tumor is a ubiquitous mesenchymal fibroblastic tumor that was previously considered limited to the pleural cavity. Here, we report a rare case of a large solitary fibrous tumor of the mesorectum, which was successfully resected laparoscopically. A 56-year-old woman was referred to our hospital for a giant pelvic mass. Pelvic MRI showed a well-circumscribed mass, 12 cm in diameter, with heterogeneous signal intensity on T2 -weighted images. It was diagnosed as a benign mesorectal tumor of unknown origin...
February 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/27591734/total-mesorectal-excision-for-cancer-histological-and-immunohistochemical-evidence-of-nerve-removal-and-risk-factor-analysis
#17
D Moszkowicz, G Rougier, C Julié, K Nyangoh Timoh, A Beauchet, K Vychnevskaia, R Malafosse, B Nordlinger, F Peschaud
AIM: Whether or not nerve-sparing rectal-cancer surgery can effectively prevent removal of the pelvic autonomic nerves has not been substantiated microscopically. We aimed to analyse the quality of nerve preservation in female patients by quantifying residual nerve fibres in total mesorectal excision specimens, to analyse pro-erectile function of the nerve fibres removed and to determine risk factors for pelvic denervation. METHOD: Serial transverse sections from female patients, 64 ± 18 years of age, were studied after the mesorectal fascia was inked and studied histologically [using anti-S100 and anti-neuronal nitric oxide synthase (nNOS) antibodies]...
October 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27579984/the-left-ureteral-triangle-as-an-anatomic-landmark-for-the-identification-of-the-left-ureter-in-laparoscopic-distal-colectomies
#18
Giovanni D Tebala
Ureteral injury is one of the possible complications of distal colectomies. It may be caused by misidentification of the anatomic landmarks during the left lateral dissection, due to factor pertaining to the patient, the disease, and the surgeon. The only way to reduce the risk of this avoidable complication is the perfect knowledge and identification of the anatomy of the left ureter. In this article, we describe an anatomic triangle that can be a valid help in the identification of the ureter in the area where higher is the risk of iatrogenic injury...
October 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27554385/hemangioma-of-the-rectum-how-misleading-can-hematochezia-be
#19
Sofia Vitor, Alexandre Oliveira Ferreira, João Lopes, José Velosa
We present the case of an 18-year-old male patient that was referred to our gastrenterology department with history of intermittent painless hematochezia since childhood. During such instances, he was diagnosed with bowel intussusception, eosinophilic gastroenteritis and inflammatory bowel disease at 4, 6 and 8 years old, respectively. He underwent treatment with 5-aminosalicylic acid for two years, without improvement of symptoms. He was then lost to follow-up until our observation. His physical examination was unremarkable except for digital rectal examination which found a nodular compressible mass by the palpating finger...
August 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27545460/-current-situation-and-outlook-of-transanal-total-mesorectum-excision-in-rectal-cancer
#20
Liang Kang, Jianping Wang
Since the characteristics of metastasis and invasion of rectal cancer are confirmed gradually, the aim of surgical treatment in rectal cancer is to protect anal and reproductive function, and to minimize the damage of patients. With prominent advantages of identified lower tumor resection margin, enough circumference resection margin, more minimally invasive procedure and faster recovery, transanal total mesorectal excision(taTME) integrated with natural canal theory, transanal minimally invasive technique and TME can effectively solve the difficulties of transabdominal procedure and becomes the research hotspot in rectal cancer surgery worldwide...
August 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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