The quest for precision in transanal total mesorectal excision

Abstract Transanal total mesorectal excision (TME) is an emerging minimally invasive approach to rectal cancer, with encouraging preliminary results. However, the new surgical anatomy of the bottom-up approach complicates surgical understanding and increases the risks of inadvertent injuries to crucial anatomical structures, including nerves. Key elements to improve the safety and stimulate interest in such a complex technique might be robotics and image guidance, to enhance the level of precision. In this editorial, some of the technologies that could be used for precision TME are outlined, in light of the experience of our Institute for Image-Guided Surgery.
Source: Techniques in Coloproctology - Category: Surgery Source Type: research

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AbstractNodal involvement is a significant prognostic factor in rectal cancer and difficult to assess preoperatively. An understanding of the patterns of nodal spread from different regions of the rectum can assist in this process and is essential for the purposes of surgical planning. In this article we define patterns of spread to mesenteric and pelvic sidewall nodal subgroups and discuss the importance of accurate anatomic localization of nodes for the purposes of staging and surgical planning.
Source: Abdominal Imaging - Category: Radiology Source Type: research
ConclusionRACRS is safe in the treatment of patients with stage I –III colorectal cancer. Oncological outcome did not differ between RACRS and LCRS groups. RACRS had lower conversion and intra-operative complication rates.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
AbstractTotal mesorectal excision (TME) is currently recognised as the standard of care for patients with rectal cancer. Complete TME is known to be associated with lower rates of recurrence. Robotic and endoscopic TaTME approaches are reported to offer excellent proximal and distal rectal dissection into the TME plane, however, combining both approaches in a hybrid procedure could potentially optimise visualisation of the dissection plane and confer improved circumferential and distal margin rates. The aim of this study was to analyse the feasibility of a hybrid robotic abdominal approach with conventional TaTME for recta...
Source: Journal of Robotic Surgery - Category: Surgery Source Type: research
AbstractBackground/ObjectivesMetabolic syndrome (MetS) has become a major public health problem. However, few studies have examined the impact of MetS on the postoperative complications of colorectal cancer and the conclusions remain controversial. The present study aimed to investigate whether MetS, as defined based on visceral fat area (VFA) instead of BMI or waist circumference, would predict complications after surgery for rectal cancer.Subjects/MethodsWe conducted a retrospective study of patients who underwent surgery for rectal cancer at our department between January 2013 and August 2018. Univariate and multivariat...
Source: Obesity Surgery - Category: Surgery Source Type: research
Condition:   Rectal Cancer Patients Intervention:   Diagnostic Test: MA_LARS Sponsors:   Moroccan Society of Surgery;   Institut National d'Oncologie Sidi Mohammed Ben Abdellah Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Conditions:   Anastomotic Leak Rectum;   Rectal Cancer Intervention:   Procedure: The efficacy of various interventions for anastomotic leakage after rectal cancer resection are investigated Sponsors:   Radboud University;   Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Rectal Cancer Patients Intervention:   Diagnostic Test: MA_LARS Sponsors:   Moroccan Society of Surgery;   Institut National d'Oncologie Sidi Mohammed Ben Abdellah Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Conditions:   Anastomotic Leak Rectum;   Rectal Cancer Intervention:   Procedure: The efficacy of various interventions for anastomotic leakage after rectal cancer resection are investigated Sponsors:   Radboud University;   Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
CONCLUSION: Serial 18F-FDG-PET/CT is a potentially reliable non-invasive method to predict recurrence in patients with LARC. Volumetric parameters were the best predictors. This could be potentially important in risk-stratifying patients who may benefit from conservative management. ADVANCES IN KNOWLEDGE: This paper will add to the literature in risk-stratifying, using PET/CT, in patients with LARC based on prognosis. This will potentially improve outcomes with an increasing trend towards conservative management. PMID: 31617737 [PubMed - as supplied by publisher]
Source: The British Journal of Radiology - Category: Radiology Authors: Tags: Br J Radiol Source Type: research
ConclusionsThe present data indicate that in URCC patients, the integration of HPP/target-therapy and precision oncotherapy based upon liquid biopsy is as effective and efficacious as third-line treatment in local disease control and, therefore, deserves to be further assessed and compared to conventional systemic treatments in future prospective randomized trials.
Source: Journal of Cancer Research and Clinical Oncology - Category: Cancer & Oncology Source Type: research
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