An assessment of the anatomical relationship between the pelvic plexus and the rectal wall to determine the indications for its preservation in surgery for rectal cancer

Surgery Today ◽  
1997 ◽  
Vol 27 (11) ◽  
pp. 1005-1009 ◽  
Author(s):  
Hideki Yamakoshi ◽  
Hideyuki Ike ◽  
Sigeo Oki ◽  
Masamichi Hara ◽  
Hiroshi Shimada
Keyword(s):  
Rectal Cancer ◽  
Rectal Wall ◽  
Pelvic Plexus ◽  
Anatomical Relationship

scholarly journals Retrospective study of the functional and oncological outcomes of conformal sphincter preservation operation in the treatment of very low rectal cancer

2020 ◽  
Vol 24 (10) ◽  
pp. 1025-1034 ◽  
Author(s):  
G. Sun ◽  
Z. Lou ◽  
H. Zhang ◽  
G. Y. Yu ◽  
K. Zheng ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Rectal Wall ◽  
Anal Verge ◽  
Disease Free Survival ◽  
Sphincter Preservation ◽  
Low Rectal Cancer ◽  
Anal Function ◽  
Oncological Outcomes ◽  
Rectal Cancers ◽  
Very Low Rectal Cancer

Abstract Background Conformal sphincter preservation operation (CSPO) is a new surgical procedure for very low rectal cancers (within 4–5 cm from the anal verge). CSPO preserves more of the dentate line and distal rectal wall and also avoids injuring nerves in the intersphincteric space, resulting in satisfactory anal function after resection. The aim of this study was to analyze the short-term surgical results and long-term oncological and functional outcomes of CSPO. Methods Consecutive patients with very low rectal cancer, who had CSPO between January 2011 and October 2018 at Changhai Hospital, Shanghai were included. Patient demographics, clinicopathological features, oncological outcomes and anal function were analyzed. Results A total of 102 patients (67 men) with a mean age of 56.9 ± 10.8 years were included. The median distance of the tumor from the anal verge was 3 (IQR, 3–4) cm. Thirty-five patients received neoadjuvant chemoradiation (nCRT). The median distal resection margin (DRM) was 0.5 (IQR, 0.3–0.8) cm. One patient had a positive DRM. All circumferential margins were negative. There was no perioperative mortality. The postoperative complication rate was 19.6%. The median duration of follow-up was 28 (IQR, 12–45.5) months. The local recurrence rate was 2% and distant metastasis rate was 10.8%. The 3-year overall survival and disease-free survival rates were 100% and 83.9%, respectively. The mean Wexner incontinence and low anterior resection syndrome scores 12 months after ileostomy reversal were 5.9 ± 4.3, and 29.2 ± 6.9, respectively. Conclusions For patients with very low rectal cancers, fecal continence can be preserved with CSPO without compromising oncological results.

Proliferating cell nuclear antigen and mitotic activity in rectal cancer: predictor of response to preoperative irradiation.

1994 ◽  
Vol 12 (4) ◽  
pp. 679-682 ◽  
Author(s):  
C G Willett ◽  
G Warland ◽  
R Cheek ◽  
J Coen ◽  
J Efird ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Mitotic Activity ◽  
Proliferating Cell Nuclear Antigen ◽  
Residual Disease ◽  
Tumor Regression ◽  
Rectal Wall ◽  
Clinical Stage ◽  
Nuclear Antigen ◽  
Preoperative Irradiation ◽  
Proliferating Cell

PURPOSE This study examines the association between the pathologic response of rectal cancer after irradiation and its pretreatment proliferative state as assayed by proliferating cell nuclear antigen (PCNA) and mitotic activity. PATIENTS AND METHODS Ninety patients with clinical stage T3 and T4 rectal cancer received preoperative irradiation followed by surgery. Pretreatment tumor biopsies were scored for PCNA activity (number of tumor cells staining immunohistochemically with an anti-PCNA monoclonal antibody) and the number of mitoses per 10 high-powered fields (hpf). Postirradiation surgical specimens were examined for extent of residual disease. RESULTS The tumors of 33 of 90 patients (37%) exhibited marked pathologic downstaging (no residual tumor or cancer confined to the rectal wall) after preoperative irradiation. Two features were independently associated with the likelihood of marked pathologic regression after preoperative irradiation: lesion size and PCNA/mitotic activity. When stratified by tumor size, marked tumor regression occurred most frequently in smaller tumors with high PCNA/mitotic activity compared with larger tumors with lower PCNA/mitotic activity. Intermediate downstaging rates were seen for small or large tumors with moderate PCNA/mitotic activity. CONCLUSION Tumor PCNA/mitotic activity predicts the likelihood of response to irradiation, which may aid in formulating treatment policies for patients with rectal cancer.

Regional lymph node status after neoadjuvant chemoradiation of rectal cancer producing a complete or near complete rectal wall response

2015 ◽  
Vol 17 (7) ◽  
pp. 595-599 ◽  
Author(s):  
C. Shwaartz ◽  
N. Haim ◽  
D. Rosin ◽  
Y. Lawrence ◽  
M. Gutman ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Regional Lymph Node ◽  
Rectal Wall ◽  
Neoadjuvant Chemoradiation ◽  
Lymph Node Status ◽  
Node Status

Transanal endoscopic microsurgery: results of the first 50 cases

2012 ◽  
Vol 19 (1) ◽  
pp. 45-49
Author(s):  
Narimantas Evaldas SAMALAVIČIUS ◽  
Alfredas KILIUS ◽  
Kęstutis PETRULIS ◽  
Simona LETAUTIENĖ ◽  
Rūta GRIGIENĖ ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Transanal Endoscopic Microsurgery ◽  
Rectal Wall ◽  
Anal Verge ◽  
Abdominal Cavity ◽  
Safety Margin ◽  
Adjuvant Chemoradiotherapy ◽  
Rectal Stricture ◽  
Early Rectal Cancer ◽  
Endoscopic Microsurgery

The aim of the study was to share the experience and first results of implementation of transanal endoscopic microsurgery (TEM) technique for the removal of rectal adenomas, early rectal cancer or rectal stricture in the Center of Oncosurgery, Oncology Institute of Vilnius University. Materials and methods. From October 2009 to October 2011, a total of 50 patients underwent TEM for rectal adenomas, early rectal cancer or rectal stricture. The patients were 25 women and 25 men, 31 to 87 years of age (average 65 years). Rectal lesions were from 0.9 to 7.0 cm in diameter, 3–13 cm from the anal verge. Full thickness excision with 1 cm safety margin was achieved in all cases except two (mucosal excision), followed by closing of the rectal wall defect in one-layer running monocryl 3.0 suture using silver clips. In one case (TEM was performed for T2 rectal cancer), abdominal cavity was penetrated and two-layer closure was preferred. Results. In these series of 50 patients there was 1 (2%) complication (cystitis). No postoperative exitus occurred. The hospitalisation period ranged from 2 to 13 days (average 6 days). Final histology revealed 30 (60%) tubular or villous adenomas, 6 (12%) carcinomas in situ (pTis), 7 (14%) T1, 4 (8%) T2 cancers, and well-differentiated neuroendocrine tumors in 3 (6%) were diagnosed. One patient underwent open partial TME in pT1 group; the tumor was in the upper third of rectum and preoperatively evaluated as pTis disease. In two cases (pT1 group) lymphovascular invasion was present on final pathology, so they were offered a postoperative adjuvant chemoradiotherapy. Other 4 patients in T1 group are under surveillance. All 4 patients with T2 lesions were offered adjuvant chemoradiotherapy, one patient refused further treatment. Conclusions. TEM is an alternative for transanal excision of rectal adenomas and early rectal cancer. Further follow-up is necessary to evaluate the recurrence rate of cancer in invasive cancer patients group.

scholarly journals Role of Imaging in Rectal Cancer

JMS SKIMS ◽  
2012 ◽  
Vol 15 (1) ◽  
pp. 4-6
Author(s):  
Ajaz Ahmad Malik
Keyword(s):  
Rectal Cancer ◽  
Rectal Wall ◽  
Preoperative Staging ◽  
Positron Emission ◽  
Adjacent Structures ◽  
Tumor Involvement ◽  
Magnetic Resonance Imaging Mri ◽  
Optimal Treatment Strategy

THIS ARTICLE HAS NO ABSTRACT (FIRST 100 WORDS OF THE ARTICLE ARE DISPLAYED): Staging of rectal cancer is necessary to provide the optimal treatment strategy although proctoscopy or sigmoidoscopy with biopsy are diagnostic. This is achieved by locoregional assessment of the disease by various available radiological investigations. Staging information includes extent of tumor involvement of the rectal wall and adjacent structures, presence or absence of adjacent lymphadenopathy, and determination of distant metastasis. Several modalities exist for the preoperative staging of rectal cancer, like computed tomography (CT); magnetic resonance imaging (MRI) with traditional body, endorectal, or phasedarray coils; endorectal ultrasonography (ERUS) with rigid or flexible probes; and positron emission tomography (PET) with and without. JMS 2012;15(1):4-6.

scholarly journals Study of Invasion into the Pelvic Plexus in Rectal Cancer by Fully-cut Preparations of the Pelvic Plexus.

1995 ◽  
Vol 28 (4) ◽  
pp. 825-830 ◽  
Author(s):  
Keiko Suzuki ◽  
Shingo Kameoka ◽  
Kiyotaka Nakajima ◽  
Masahiro Kaneki ◽  
Kyoichi Hamano
Keyword(s):  
Rectal Cancer ◽  
Pelvic Plexus
Sign in / Sign up

Export Citation Format

Share Document