Ischaemic strictures in patients treated with a low anterior resection and perioperative radiotherapy for rectal carcinoma

1989 ◽  
Vol 76 (6) ◽  
pp. 605-606 ◽  
Author(s):  
L. Påhlman ◽  
B. Glimelius ◽  
G. Frykholm
Keyword(s):  
Rectal Carcinoma ◽  
Anterior Resection ◽  
Low Anterior Resection

scholarly journals The association of age with decline in renal function after low anterior resection and loop ileostomy for rectal cancer: a retrospective cohort prognostic factor study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amal Rhemouga ◽  
Stefan Buettner ◽  
Wolf O. Bechstein ◽  
Guido Woeste ◽  
Teresa Schreckenbach
Keyword(s):  
Rectal Cancer ◽  
Rectal Carcinoma ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Older Patients ◽  
Retrospective Cohort ◽  
Loop Ileostomy ◽  
Linear Regression Analysis ◽  
Multivariate Linear Regression Analysis ◽  
Group B

Abstract Background Low anterior resection (LAR) is often performed with diverting loop ileostomy (DLI) for anastomotic protection in patients with rectal cancer. We aim to analyze, if older patients are more prone to a decline in kidney function following creation and closure of DLI after LAR for rectal carcinoma versus younger patients. Methods A retrospective cohort study from a database including 151 patients undergoing LAR for rectal carcinoma with DLI was used. Patients were divided in two age groups (Group A: <65 years, n = 79; Group B: ≥65 years, n = 72). For 123 patients undergoing DLI reversal prognostic factors for an impairment of serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) 3 months after DLI reversal was analyzed using a multivariate linear regression analysis. Results SCr before LAR(T0) was significant higher in Group B (P = 0.04). Accordingly, the eGFR at T0 in group B was significantly lower (P < 0.001). No patients need to undergo hemodialysis after LAR or DLI reversal. Age and SCr at T0were able to statistically significant predict an increase in SCr (P<0.001) and eGFR (P=0.001) three months after DLI reversal (The R² for the overall model was .82 (adjusted R² = .68). Conclusion DLI creation may result in a reduction of eGFR in older patients 3 months after DLI closure. Apart from this, patients do not have a higher morbidity after creation and closure of DLI resulting from LAR regardless of their age.

scholarly journals Heterotopic Ossification in Rectal Carcinoma: Report of a Case and Review of the Literature

2016 ◽  
Vol 9 (3) ◽  
pp. 698-704 ◽  
Author(s):  
Jiro Shimazaki ◽  
Akira Takemura ◽  
Kiyotaka Nishida ◽  
Hideki Kajiyama ◽  
Mitsugi Shimoda ◽  
...  
Keyword(s):  
Heterotopic Ossification ◽  
Histological Examination ◽  
Rectal Carcinoma ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Virtual Colonoscopy ◽  
Rectal Wall ◽  
Medical Center ◽  
Uneventful Recovery ◽  
Spindle Cells

Heterotopic ossification in colorectal carcinoma is extremely rare. This report presents the case of a 57-year-old male who had undergone a low anterior resection following a diagnosis of rectal carcinoma. Histological examination showed heterotopic ossification in the tumor. The patient was referred to Ibaraki Medical Center, Tokyo Medical University, with a diagnosis of rectal carcinoma by a local physician. Abdominal computed tomography revealed thickening of the rectal wall with calcified deposits, and virtual colonoscopy showed stenosis with a mass in the rectum. The patient underwent a low anterior resection and diverting ileostomy in May 2014. Histological examination of the excised tumor showed moderately differentiated adenocarcinoma and an infiltration of spindle cells with numerous foci of osteoid and ossification, with osteoblastic rimming in the stroma. Immunohistochemical analysis of these spindle cells and osteoblasts revealed negative staining for AE1/AE3, suggesting a reactive change. There was metastasis in 1 of the 12 lymph nodes, and the tumor was diagnosed as stage IIIB (T4a, N1a, M0) rectal carcinoma. The patient had an uneventful recovery and was followed up at our outpatient clinic. In conclusion, the malignant potential of heterotopic ossification in rectal carcinoma has not been determined. However, heterotopic ossification is induced by tumor progression in a microenvironment, suggesting a high tumor malignity. The patient should be carefully monitored after surgery in terms of improved patient outcome.

Modified Double-Stapling Technique in Low Anterior Resection for Lower Rectal Carcinoma

Surgery Today ◽  
2005 ◽  
Vol 36 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Harunobu Sato ◽  
Koutarou Maeda ◽  
Tsunekazu Hanai ◽  
Masahisa Matsumoto ◽  
Hiroyuki Aoyama ◽  
...  
Keyword(s):  
Rectal Carcinoma ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Double Stapling Technique ◽  
Stapling Technique ◽  
Double Stapling ◽  
Lower Rectal Carcinoma

scholarly journals Risk Factors for Anastomotic Leakage after Low Anterior Resection

Folia Medica ◽  
2020 ◽  
Vol 62 (2) ◽  
pp. 290-294
Author(s):  
Gancho G. Kostov ◽  
Rossen S, Dimov ◽  
Daniela D. Almeida
Keyword(s):  
Risk Factors ◽  
Anastomotic Leakage ◽  
Rectal Carcinoma ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Colorectal Anastomosis ◽  
Dentate Line ◽  
Sphincter Preservation ◽  
University Hospital ◽  
Permanent Colostomy

Introduction: Low anterior resection (LAR) is a standard surgical procedure for distal rectal carcinoma that allows creation of a colorectal anastomosis, with anal sphincter preservation and permanent colostomy avoidance. Anastomotic leakage (AL) is a potential complication of LAR present in 3% to 20% of cases leading to a significant increase in postoperative morbidity. AL represents a communication between the intra luminal and extra luminal compartments caused by a violation of the integrity of the intestinal wall. The risk factors of this procedure have been discussed and still remain a controversial issue. Prevention is the best management. Patients with predisposing factors should be paid special attention. Aim: Our objective was to identify and analyze the risk factors of anastomotic leakage after low anterior resection of rectal carcinoma. Patients and methods: This study included all patients who underwent low anterior resection for rectal cancer at the Department of Surgery of University Hospital Kaspela between 2011 and 2016. Results: Low anterior resections were performed in 141 patients during the study period. Due to a positive air leak test on 16 patients, a protective ileostomy was created and these patients were eliminated from the study. The sex distribution of the remaining 125 patients was 69 men (55.2%) and 56 women (44.8%). The height of the anastomosis from the dentate line was 3.0 cm on an average (range 2.5 to 4 cm). Conclusion: Anastomotic leakage remains the most feared and serious complication after low anterior resection surgery. The evidence suggests that the main risk factors for anastomotic leakage at low anterior resection are the height of the anastomosis and the high ASA score.

Peranal coloanal anastomosis following low anterior resection for rectal carcinoma

1985 ◽  
Vol 28 (8) ◽  
pp. 576-581 ◽  
Author(s):  
Warren E. Enker ◽  
Maus W. Stearns ◽  
Abbe J. Janov
Keyword(s):  
Rectal Carcinoma ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Coloanal Anastomosis

Protective defunctioning stoma in low anterior resection for rectal carcinoma

2005 ◽  
Vol 92 (9) ◽  
pp. 1137-1142 ◽  
Author(s):  
I. Gastinger ◽  
F. Marusch ◽  
R. Steinert ◽  
S. Wolff ◽  
F. Koeckerling ◽  
...  
Keyword(s):  
Rectal Carcinoma ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Defunctioning Stoma
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