Reconsideration of the Safety of Laparoscopic Rectal Surgery for Cancer.

Reconsideration of the Safety of Laparoscopic Rectal Surgery for Cancer. Ann Coloproctol. 2019 Oct;35(5):229-237 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. Incomplete TME had unfavorable oncologic outcomes compared to complete TME. Although TME quality can be clearly identified on pathologic evaluation, there is controversy regarding the acceptable range of oncologically safe TME for laparoscopic surgery. It is not certain whether near-complete TME has an unfavorable oncologic impact and whether laparoscopic surgery with near-complete TME is an oncological threat. Therefore, the surgical community will be interested in the long-term outcomes and meta-analyses of ongoing large-scale RCTs. Laparoscopic rectal cancer surgery has been steadily improving its safety for oncology surgery, which has been reported consistently in various multicenter RCTs. To improve surgical quality, colorectal surgeo...
Source: Annals of Coloproctology - Category: Gastroenterology Tags: Ann Coloproctol Source Type: research

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This study reviewed the applicability of laparoscopy in this challenging setting.MethodsRetrospective analysis of patients who underwent trans-abdominal re-operative rectal surgery from 2010-2019 was performed.ResultsSeventy-eight patients [35 females (45%); BMI 25kg/m2) were included. Reasons for reoperation were recurrent cancer in 18 (43%) patients and anastomotic failure in 57 (73%). Twenty-two (28%) had laparoscopic surgery and 4 had attempted laparoscopy converted to laparotomy. A higher success rate was noted for laparoscopy with prior laparoscopic surgery. Benefits of laparoscopy included significant reduction in l...
Source: The American Journal of Surgery - Category: Surgery Source Type: research
ConclusionsThis framework is developed with our clinical partner, based on actual clinical conditions. The experimental protocol and the high level of accuracy show the feasibility of seamlessly integrating this framework within the surgical workflow.
Source: International Journal of Computer Assisted Radiology and Surgery - Category: Intensive Care Source Type: research
Authors: Ding Y, Li Z, Gao H, Cao Y, Jin W Abstract PURPOSE: To compare the short-term efficacy between natural orifice specimen extraction (NOSE) without abdominal incision and conventional laparoscopic surgery in the treatment of sigmoid colon cancer and upper rectal cancer. METHODS: A total of 86 patients scheduled to undergo laparoscope-assisted radical surgery of sigmoid cancer or upper rectal cancer from January 2015 to September 2017 (T1-3 stages in preoperative imaging evaluation, no distant metastasis, and body mass index
Source: Journal of B.U.ON. - Category: Cancer & Oncology Tags: J BUON Source Type: research
Conclusions. Patients' characteristics cannot be changed, but several steps were used to avoid routine PI creation. The present protocol could be a valuable option to avoid PI in selected patients. Further studies with a wider sample size, and defined criteria to stratify the patients based on the risk to develop AL, are required. PMID: 31789117 [PubMed - as supplied by publisher]
Source: Surgical Innovation - Category: Surgery Authors: Tags: Surg Innov Source Type: research
Publication date: Available online 25 November 2019Source: Surgery (Oxford)Author(s): Jason George, Timothy RockallAbstractColorectal cancer surgery represents a major component of the colorectal service workload. A solid understanding of key anatomical and oncological principles is essential for safe practice. In this article we discuss these fundamental aspects of colorectal cancer surgery. The first part of the article will deal with preoperative staging, surgical planning and principles of oncological surgery. The second part will focus on some of the most common operations. We will describe key intra-operative princip...
Source: Surgery (Oxford) - 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
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Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Video Vignette Source Type: research
ConclusionR-TME for rectal cancer can achieve better oncological outcomes compared with L-TME, especially in stage III rectal cancers. However, a longer follow-up period is needed to confirm these findings.
Source: International Journal of Colorectal Disease - Category: Gastroenterology 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
ConclusionTotal transanal mesorectal excision has been shown to be a viable method for oncologic resection of locally advanced rectal cancer with curative intent.ResumoContextoA excisão total do mesorreto por via transanal é uma aborgadem crânio-caudal para a realização de ressecção minimamente invasiva do reto e tecidos perirretais em monobloco. É adequada para pacientes com câncer de reto médio e distal confinados ao envelope mesorretal. Aqui relatamos uma série de pacientes submetidos à excisão total do mesorreto por via transanal.M...
Source: Journal of Coloproctology - Category: Gastroenterology Source Type: research
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