Needlescopic surgery for very low rectal cancer with no abdominal skin incision

2020 ◽  
Vol 13 (2) ◽  
pp. 180-185
Author(s):  
Hironori Fukuoka ◽  
Yosuke Fukunaga ◽  
Hironori Minami ◽  
Shun Miyanari ◽  
Shinsuke Suzuki ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Skin Incision ◽  
Low Rectal Cancer ◽  
Abdominal Skin ◽  
Needlescopic Surgery ◽  
Very Low Rectal Cancer

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.

Safety and Feasibility of Laparoscopic Intersphincteric Resection for Very Low Rectal Cancer

2010 ◽  
Vol 14 (4) ◽  
pp. 645-650 ◽  
Author(s):  
Yoshiya Fujimoto ◽  
Takashi Akiyoshi ◽  
Hiroya Kuroyanagi ◽  
Tsuyoshi Konishi ◽  
Masashi Ueno ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Intersphincteric Resection ◽  
Low Rectal Cancer ◽  
Very Low Rectal Cancer ◽  
Laparoscopic Intersphincteric Resection

Extended intersphincteric resection with quadrant resection of external sphincter after neoadjuvant mid-course chemoradiotherapy in the very low rectal cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14181-e14181
Author(s):  
Nahmgun Oh ◽  
Sanghwa Ko ◽  
Hyunsung Kim
Keyword(s):  
Rectal Cancer ◽  
Anal Verge ◽  
External Sphincter ◽  
Postoperative Mortality ◽  
Intersphincteric Resection ◽  
Low Rectal Cancer ◽  
Pelvic Cavity ◽  
Group I ◽  
Very Low Rectal Cancer ◽  
The Mean

e14181 Background: To evaluate the results of extended intersphincteric resection of T3 rectal cancer situated below 4cm from the anal verge, comparing the results of simple intersphincteric resection of T2 rectal cancer after mid-course chemoradiotherapy. Methods: Between 2000 Between 2000 and 2006, 67 patients with rectal cancer below 4cm from anal verge, underwent abdomino-intersphincteric resection reconstructed by inversion proctoplasty with a colonic J-pouch and diverting ileostomy. All patients received a total irradiation dose of 30 Gy with conventional fractions for 3 weeks. Capecitabine was administered 1000mg/m2 twice a day on 21 days during radiotherapy, followed curative surgery in a week without resting period. After preoperative radio-chemotherapy, patients with overt T2 lesion were 27 cases (40.3%) and received intersphincteric resection (Group I: simple intersphincteric resection), and patients with borderline cases or T3 lesion were 40 cases (59.7%) and received intersphincteric resection with quadrant resection of upper external sphincter and primary repair of the external sphincter as inversion proctoplasty (Group II: extended intersphincteric resection). Results: The mean patients age was 61.2 years. The mean location of cancer was at 3.2cm from anal verge (2-4cm). Anastomotic leakage was confirmed in 11 patients (16.4%). There was no postoperative mortality. The grade I, II of continence by Kirwan classification was 81.5%, 80.0% in Group I and II. Under 3 times stool frequency per day was 51.9%, 62.5% in Group I and II. Two patients (3.0%) experienced locoregional recurrence of pelvic cavity. 5-year overall survival rate was 83.6%. Conclusions: Simple and extended intersphincteric resection is seemed to be a safe and functionally acceptable procedure. And, neoadjuvant mid-course chemoradiotherapy using oral capecitabine 2,000 mg/m2/day on 21 days during 2 Gy radiation of each 15 weekdays is seemed to be a tolerable and effective modality, in patients with very low rectal cancer.

Using gluteus maximus muscle to reconstruct the anal sphincter for very low rectal cancer

2007 ◽  
Vol 4 (2) ◽  
pp. 98-102 ◽  
Author(s):  
Jinchun Cong ◽  
Chunsheng Chen ◽  
Hong Zhang ◽  
Lei Qiao ◽  
Xianwei Dai
Keyword(s):  
Rectal Cancer ◽  
Anal Sphincter ◽  
Gluteus Maximus ◽  
Low Rectal Cancer ◽  
Gluteus Maximus Muscle ◽  
Very Low Rectal Cancer

Laparoscopic Intersphincteric Resection With a SILS Port for Very Low Rectal Cancer

2012 ◽  
Vol 22 (3) ◽  
pp. e138-e141 ◽  
Author(s):  
Masayasu Hara ◽  
Mikinori Sato ◽  
Satoru Takayama ◽  
Hiroyuki Imafuji ◽  
Ryo Ogawa ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Intersphincteric Resection ◽  
Low Rectal Cancer ◽  
Very Low Rectal Cancer ◽  
Sils Port ◽  
Laparoscopic Intersphincteric Resection
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