Short-term outcomes after transanal and laparoscopic total mesorectal excision for rectal cancer
Conclusions Our initial experience demonstrates comparable short-term results for taTME and lap TME. Further investigation is necessary to assess long-term functional and oncologic outcomes.
AbstractBackgroundGuidelines for rectal cancer treatment differ in Japan, Europe, and the United States. Neoadjuvant chemoradiotherapy (CRT) has been used to control lateral lymph nodes (LLNs) in the West. The usefulness of LLN dissection (LLND) has been discussed in Japan, and a randomized study stated the possible advantage of local control. However, it is still unclear whether adding LLND to CRT is beneficial.MethodsTo investigate the effectiveness of LLND on rectal cancer patients who underwent neoadjuvant CRT, we retrospectively collected magnetic resonance images (MRIs) in a cohort of 1500 patients with cStage II/III...
CONCLUSIONS: Based on this nationwide database study, and after multivariate and propensity score-matched analyses, there was no increased risk of positive circumferential resection margin after laparoscopic vs open rectal resection. See Video Abstract at http://links.lww.com/DCR/A996. MARGEN DE RESECCIÓN CIRCUNFERENCIAL DESPUÉS DE LA RESECCIÓN RECTAL LAPAROSCÓPICA Y ABIERTA: UN ESTUDIO DE COHORTE DE PUNTUACIÓN DE PROPENSIÓN A NIVEL NACIONAL ANTECEDENTES: Estudios recientes sugieren mejores resultados oncológicos después de la resección rectal abierta ver...
CONCLUSION: The surgical technique described here, consisting of component separation and mesh at loop ileostomy reversal, is effective for repairing parastomal hernia. PMID: 31476794 [PubMed - as supplied by publisher]
CONCLUSION: Patients with laparoscopic LAR for rectal cancer who have experienced neoadjuvant therapy and chemotherapy, due to the thickening of the intestinal wall, the anastomosis nail is easy to fall off, more likely to have AL, and even the anastomotic is completely detachment. The use of transanal drainage tube with negative pressure flushing might avoid patients who with AL undergoing reoperation. PMID: 31431416 [PubMed - as supplied by publisher]
AbstractThe aim of our study was to compare long term outcomes of robotic and laparoscopic sphincter-saving total mesorectal excision (TME) in male patients with mid-low rectal cancer (RC) after neoadjuvant chemoradiotherapy (NCRT). The study was conducted as a retrospective review of a prospectively maintained database, and we analyzed 14 robotic and 65 laparoscopic sphincter-saving TME (R-TME and L-TME, respectively) performed by one surgeon between 2005 and 2013. Patient characteristics, perioperative recovery, postoperative complications and pathology results were compared between the two groups. The patient characteri...
ConclusionsThe ‘pelvis-first’ approach to proctectomy is advantageous for patients with a highly redundant sigmoid colon. Transabdominal division of the levator ani during APR ensures excellent circumferential margin. Although Lynch syndrome-associated rectal cancer can show excellent response to NCRT,3 patients undergoing watchful delay of surgery require close monitoring and prompt triggering of salvage proctectomy when tumor regrowth is observed.4,5
CONCLUSIONS: Compared with open approach, laparoscopic sphincter-sparing surgery of rectal cancer had less intraoperative bleeding, less postoperative complications and faster recovery of intestinal function after operation. Survival of open surgery and laparoscopic rectal sphincter preservation surgery was similar in both groups. ypTNM stage and Charlson comorbidity index are the risk factors affecting the survival of patients with rectal cancer. PMID: 31127992 [PubMed - in process]
AbstractBackgroundC-reactive protein (CRP) has been suggested as a satisfactory early marker of postoperative complications after colorectal surgery. The aim of this study was to assess the impact of a CRP monitoring-driven discharge strategy, after stoma reversal following laparoscopic sphincter-saving surgery for rectal cancer.MethodsEighty-eight patients who had stoma reversal between June 2016 and April 2018 had CRP serum level monitoring on postoperative day (POD) 3 and, if necessary, on POD5. Patients were discharged on POD4 if the CRP level was
CONCLUSIONS: The current data supported the concept that laparoscopic surgery had correlated with a longer operative time but a shorter hospital stay, without superior advantages in short-term survival rates or oncologic efficiency for locally treating advanced rectal cancer after neoadjuvant chemo-radiotherapy. However, prospective investigation on long-term oncological results from laparoscopic surgery is required in the future to verify the benefits of laparoscopic surgery over open surgery after chemo-radiation therapy for treating locally advanced rectal cancer. PMID: 30987563 [PubMed - as supplied by publisher]
ConclusionsThis study achieved a high pCR rate with favorable toxicity and postoperative complications in poor-risk locally advanced low rectal cancer. Multicenter study is warranted to evaluate this regimen.