Nodal drainage pathways in primary rectal cancer: anatomy of regional and distant nodal spread

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

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Authors: Son GM, Kye BH, Kim MK, Kim JG Abstract The oncological outcomes of laparoscopic rectal cancer surgery were evaluated in recent multicenter randomized clinical trials (RCTs). The MRC-CLASSIC, COLOR II, and COREAN trials found no differences in local recurrence or diseasefree survival rate between laparoscopic and open surgery. However, the noninferiority of laparoscopic surgery with respect to open surgery for rectal cancer was not established on statistical analysis in the ACOSOG Z6051 and the ALaCaRT trials. Quality of total mesorectal excision (TME) is one of the most important prognostic factors. Incom...
Source: Annals of Coloproctology - Category: Gastroenterology Tags: Ann Coloproctol Source Type: research
No abstract available
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Viewpoints Source Type: research
This study was conducted in a tertiary referral center. PATIENTS: All consecutive patients undergoing redo pelvic surgery after low anterior resection for rectal cancer between January 2005 and March 2018 were included. INTERVENTIONS: Redo surgery was divided into redo anastomosis and intersphincteric completion proctectomy. Transanal minimally invasive surgery procedures since November 2014 were compared with the conventional approach. MAIN OUTCOME MEASURES: Primary end points were procedural characteristics and 90-day major complications. RESULTS: In total, 104 patients underwent redo surgery; 47 received a r...
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Colorectal Cancer Source Type: research
BACKGROUND: Reconstruction of the pelvic floor defect caused by extralevator abdominoperineal excision poses a challenge for the surgeon. OBJECTIVE: The aim of this study was to analyze the long-term perineal wound complications in patients undergoing conventional primary closure versus biological mesh–assisted repair after extralevator abdominoperineal excision. DESIGN: This was a single-institution retrospective observational study. SETTINGS: The study was conducted at a tertiary academic medical center. PATIENTS: Patients with low advanced rectal cancer undergoing extralevator abdominoperineal excisi...
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Colorectal Cancer Source Type: research
No abstract available
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Video Vignette Source Type: research
This study aimed to compare the performance of two lymph node revealing solutions.MethodsThis randomized clinical trial (NTC02704988) investigated patients with colon or rectal cancer who underwent surgical resection with D2 lymphadenectomy. Specimens submitted for conventional pathological examination were randomly assigned for additional fixation with Carnoy or GEWF solution, and dissection was performed to examine the missed lymph nodes. The number of lymph nodes retrieved, additional identified metastatic lymph nodes, lymph node upstaging, and complementary indication of adjuvant therapy were investigated.ResultsThe nu...
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
ConclusionsOne-fifth of patients with locally advanced rectal cancer are manageable with a rectum-sparing approach after neoadjuvant therapy. With this strategy, about 80% patients will have their rectum preserved and 90% will be without stoma at long term.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
ConclusionsMale gender, diffuse peritonitis, positive lymph nodes, type of surgeon and postoperative anastomotic dehiscence significantly influence recurrence of  colorectal cancer in this series.
Source: Techniques in Coloproctology - Category: Surgery Source Type: research
ConclusionsAn 11-point modified frailty index as measured in NSQIP correlates with readmissions after colorectal resection in patients with colon and rectal cancer.
Source: The American Journal of Surgery - Category: Surgery Source Type: research
Publication date: Available online 11 November 2019Source: Pathology - Research and PracticeAuthor(s): Can Yi, Chao Huang, Huan Wang, Chen Wang, Lijuan Dong, Xiuli Gu, Xianhong Feng, Bifeng ChenAbstractCYP24A1, an essential gene in regulation of vitamin D, has been reported to play an important role in enhancing immune activity and inhibiting tumorigenesis. Previous studies proposed that rs2585428, rs4809960, rs6022999 and rs6068816 in CYP24A1 gene might be greatly associated with cancer risk. To validate the findings, we here investigated the associations of these four polymorphisms and colorectal cancer (CRC) risk in a c...
Source: Pathology Research and Practice - Category: Pathology Source Type: research
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