Benefits of minimally-invasive surgery for sigmoid and rectal cancer in older adults compared with younger adults: Do older adults have the most to gain?

Publication date: Available online 6 November 2019Source: Journal of Geriatric OncologyAuthor(s): Tyler R. Chesney, Humzah A. Quereshy, Arman Draginov, Sami A. Chadi, Fayez A. QuereshyAbstractIntroductionRandomized trials demonstrated oncologic safety and short-term benefits of laparoscopy. We investigated if the benefit of laparoscopy on short-term outcomes is greater for older adults compared with younger adults.MethodsWe identified all older (≥70 years old) and younger (
Source: Journal of Geriatric Oncology - Category: Cancer & Oncology Source Type: research

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AbstractAbdomino-perineal resection (APR) for rectal cancer is challenging, due to the difficult exposure of the surgical field. Many investigations proved worst results in terms of circumferential resection margin (CRM) involvement compared to rectal anterior resection (RAR) with total mesorectal excision (TME). Extralevator abdomino-perineal excision (ELAPE) improved oncologic outcomes, but is burdened by important limitations (positioning, wound closure). Applying the concept of transanal minimally invasive surgery (TAMIS) and the experience in transanal TME (TaTME) to the perineal phase of APR could overcome these limi...
Source: Updates in Surgery - Category: Surgery 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
Clinics in Colon and Rectal Surgery DOI: 10.1055/s-0039-1698395Transanal total mesorectal excision (taTME) is the culmination of major developments in rectal cancer management and minimally invasive surgery. This surgical breakthrough holds great promise and excitement for the care of the rectal cancer patient. We would be remiss in discussing taTME to not acknowledge the role of transanal abdominal transanal proctosigmoidectomy, transanal endoluminal microsurgery, laparoscopy, and natural orifice transluminal endoscopic surgery that got us to this modern day explosion of the taTME approach. In this article, we detail and ...
Source: Clinics in Colon and Rectal Surgery - Category: Surgery Authors: Tags: Review Article 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
ConclusionsAll surgical techniques for rectal cancer dissection have a role and may be considered appropriate. Some techniques have advantages over others in certain clinical situations, and the best outcomes may be achieved by considering all options before applying an individualised approach to each clinical situation.
Source: Techniques in Coloproctology - Category: Surgery Source Type: research
Publication date: Available online 1 June 2019Source: Journal of ColoproctologyAuthor(s): Marcus Valadão, Rodrigo Otavio Araujo, Eduardo Linhares, José Paulo de JesusAbstractThe treatment of rectal cancer is complex and responsible for sequelae due to the various therapeutic modalities, especially the surgical resection. The advent of minimally invasive surgery provided a faster postoperative recovery and a lower complication rate when compared to conventional surgery. The implementation of laparoscopic approach in rectal cancer was responsible for these better results, but the limitations of this method adde...
Source: Journal of Coloproctology - Category: Gastroenterology Source Type: research
ConclusionsOur results underline that the robotic approach to rectal resection is the better way to obtain a complete TME. However, it is mandatory that randomized clinical trials should be performed to assess definitively if robotic minimally invasive surgery is better than a laparoscopic resection.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
CONCLUSION: Considering current evidence, taTME failed to show superiority compared to conventional anterior lapTME. Although taTME has some potential advantages, it carries substantial risks. If performed outside of clinical trials, it should therefore only be used in carefully selected patients with a high possibility of conversion, following adequate patient informed consent and after intense and systematic training of the surgeon. PMID: 30911795 [PubMed - as supplied by publisher]
Source: Der Chirurg - Category: Surgery Authors: Tags: Chirurg Source Type: research
Authors: Komen N, Dewint P, Van den Broeck S, Pauli S, de Schepper H Abstract The field of rectal cancer treatment is a dynamic and changing field, due to better understanding of the pathology and new medical treatment options, but perhaps mostly due to innovations in the surgical approach. Surgery is the cornerstone for rectal cancer treatment. Currently, Total Mesorectal Excision is the gold standard. After evolution towards laparoscopic TME, improving technology has led to the development of platforms that allow transanal TME and robotic TME. In addition, local excision can be performed safer and more accurately...
Source: Acta Gastro-Enterologica Belgica - Category: Gastroenterology Tags: Acta Gastroenterol Belg Source Type: research
AbstractMinimally invasive surgery (MIS) is gaining popularity in rectal tumor treatment. However, contrasting data are available regarding its safety and efficacy. Our aim is to compare the open and MIS approaches for rectal cancer treatment. Two-hundred-thirty-seven patients were included: 113 open and 124 MIS rectal resections. After the propensity score matching analysis (PS), the cases were matched into 42 open and 42 MIS. Short- and long-term outcomes, and pathological findings were analyzed before and after PS. A further comparison of the same outcomes and costs was conducted between the laparoscopic and the robotic...
Source: Updates in Surgery - Category: Surgery Source Type: research
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