Simultaneous robotic surgery with low anterior resection and prostatectomy/hysterectomy
AbstractCooperation with multiple departments is essential for the treatment of patients with rectal cancer and other pelvic cancers. In our department, we experienced two cases of rectal cancer that underwent robotic low anterior resection (LAR) and simultaneous resection of other pelvic organs (case 1 with prostatectomy and case 2 with hysterectomy) using the da Vinci Xi system. Here, we show the precise procedures of these two robotic surgeries. Under general anesthesia and lithotomy position, five da Vinci ports were symmetrically placed along the umbilical horizontal line with a 7 cm interval, and a 5 mm AirSeal Access Port was added in the right or left upper quadrant. Patients were placed with 22-degree Trendelenburg and 8-degree tilt to the right. The operators used the center port on the umbilicus as a camera port and chose the docking arms with either two-left-one-rig ht or one-left-two-right setting depending on their preference. This port setting was quite useful for the operators from multiple departments to change the docking arms, even if their preference may be different. Moreover, assistants could use the remaining two ports to provide a well-expanded and safer surgical field. “With a familiar view” and “with a wide view” are our two concepts to safely perform extended pelvic surgeries. We have employed this symmetrical horizontal port site position as a general setting for usual rectal surgeries.
New research suggests that just a single course of antibiotics may increase risk for colon cancer, but not rectal cancer.
Authors: Tsoukalas N, Mosa E, Tsapakidis K, Kamposioras K, Tolia M PMID: 31423856 [PubMed - as supplied by publisher]
A study looking at antibiotics and bowel cancer concludes that the drugs might increase the risk of colon cancer, but lower the risk of rectal cancer.
Scientists at Johns Hopkins University found that people who developed bowel cancer were more likely to have taken penicillin. But tetracyclines may have protective effects for rectal cancer.
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Cancer metastasis from colon cancer to an anal fistula is very rare. We herein reported a rare case in which local excision was performed for metastatic anal fistula cancer originating from rectal cancer.
ConclusionsThe GT-flap for routine perineal wound closure after APR seems feasible with limited additional theatre time, but success seems to depend on correct planning of the width of the flap. The potential for reducing perineal morbidity should be evaluated in a randomised controlled trial.
Future Oncology, Ahead of Print.
Abstract BACKGROUND: Hybrid imaging FDG PET/CT (18F‑fluordeoxyglucose positron emission tomography/computed tomography) has gained increasing importance in oncology in recent years. DIAGNOSIS: A focal increase in FDG uptake in the gastrointestinal tract may be due to colorectal carcinoma. Such a finding requires further clarification. PRIMARY STAGING: Staging of the primary and locoregional lymph nodes remains a domain of established imaging modalities as FDG PET/CT does not provide a clear additional benefit. Liver metastases can be detected with high sensitivity by FDG PET/CT, but...