Correspondence: The right kind of rectal cancer operation for the right patient requires information on all relevant outcomes

2021 ◽  
Author(s):  
Martin Rutegård ◽  
Klas Holmgren ◽  
Jenny Häggström ◽  
Markku M Haapamäki ◽  
Peter Matthiessen ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Rectal Cancer Operation ◽  
The Right

Single-Incision Plus One Port Laparoscopic Total Pelvic Exenteration After Neoadjuvant Chemotherapy for Advanced Primary Rectal Cancer: A Case Report

2015 ◽  
Vol 100 (9-10) ◽  
pp. 1265-1270 ◽  
Author(s):  
Masayoshi Tokuoka ◽  
Yoshihito Ide ◽  
Hiroyuki Yamato ◽  
Mamoru Uemura ◽  
Yasuji Hashimoto ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Pelvic Exenteration ◽  
Single Incision ◽  
Advanced Rectal Cancer ◽  
Single Incision Laparoscopic Surgery ◽  
Moderate Degree ◽  
Total Pelvic Exenteration ◽  
Promising Alternative ◽  
The Right

Limited data on laparoscopic and robotic total pelvic exenteration (TPE) for gynecologic, urologic, and rectal malignancies have been published in the literature. Single-incision laparoscopic surgery (SILS) has been successfully introduced for colon cancer. Here, we describe our experience of TPE with SILS + 1 port (SILS+1) for advanced rectal cancer. A 64-year-old man was referred to our hospital with anemia. Computed tomography (CT) revealed a rectal tumor that was contiguous with the seminal vesicle and bladder. Rectoscopy revealed an ulcerated, bleeding, and stricturing lesion in the rectum, which was defined as an adenocarcinoma with a moderate degree of differentiation on histologic examination. The patient received neoadjuvant chemotherapy using capecitabine, oxaliplatin, and bevacizumab. After 3 courses of chemotherapy, a rectovesical fistula was suspected from examination of CT images. CT demonstrated intramural gas in the urinary bladder, which suggested a diagnosis of emphysematous cystitis. Thus, we constructed a transverse loop colostomy. Two months after the last administration of chemotherapy, we performed SILS+1 TPE. The procedure involved a 35-mm incision in the right side of the umbilicus for the insertion of a single multichannel port, and insertion of a 12-mm port into the right lower quadrant. Total operating time was 751 minutes, and estimated blood loss was 1100 mL (including urine). SILS+1 TPE is a technically promising alternative method for the treatment of selected patients with advanced rectal cancer.

scholarly journals New method of stopping bleeding from the presacral venous plexus during the rectal cancer operation: a case report

2018 ◽  
Vol 8 (3) ◽  
pp. 42-45
Author(s):  
E. M. Parfir’eva ◽  
A. O. Ivchenko ◽  
O. A. Ivchenko
Keyword(s):  
Rectal Cancer ◽  
Case Report ◽  
Pore Size ◽  
Reliable Method ◽  
Pelvic Surgery ◽  
Bleeding Control ◽  
Venous Plexus ◽  
Fatal Complication ◽  
Rectal Cancer Operation ◽  
Venous Bleeding

Presacral venous bleeding is a rare but potentially fatal complication in pelvic surgery. This type of bleeding is difficult to control. Existing methods are not without shortcomings, therefore, the search for a more reliable method. We are present a case of successful bleeding control using by plates of medium-porous nitinol (pore size of 300–450 μm, permeability of 12 × 10–9). Hemostasis was carried out by pressing  a plate to the bleeding zone for 4 minutes.

scholarly journals Success of teamwork: diagnosis and personalized treatment of advanced rectal carcinoma - case presentation

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fülöp Zsolt Zoltán ◽  
Bara Tivadar ◽  
Sárdi Kálmán ◽  
Simu Patricia ◽  
Drágus Emőke ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Seminal Vesicle ◽  
Multidisciplinary Treatment ◽  
Advanced Rectal Cancer ◽  
Metastatic Lesion ◽  
Sigmoid Resection ◽  
Middle Level ◽  
Adequate Treatment ◽  
Bowel Movements ◽  
The Right

AbstractBackground: Finding the appropriate treatment for advanced rectal cancer patients represents a challenge for surgeons. Determining the right diagnosis and the proper treatment requires multidisciplinary collaboration. Our aim is to present a case with advanced stage rectum cancer, who received successful multidisciplinary treatment.Material and method: A prospective multidisciplinary research is being conducted at our Department from 2018 within which patients with malignant rectal cancer are examined. Patients’ treatment is realized by the same multidisciplinary team. The patient’s preoperative investigations included MRI and a lymph node map designated by radiologists.Results: In case of a 60-year-old patient the preoperative MRI showed a stenotic formation in the middle level of the rectum that penetrated the seminal vesicle. During surgery, we found a 10x10 cm stenotic, perforated rectal cancer, which penetrated the bladder, seminal vesicle, prostate and sacrum, respectively a metastatic lesion in the livers 8th segment. During surgery R2 recto-sigmoid resection was performed with colostomy. The patient was mobilized on the first postoperative day and bowel movements were regained on the second day. The patient left the hospital on the eighth postoperative day.Conclusions: Adequate treatment of patients with advanced rectal cancer can be achieved only through multidisciplinary co-operation. Preoperative radiological examinations are mandatory. A map representing the positive colorectal lymph nodes, implemented by the radiologists, can significantly help the surgeons and pathologists.

scholarly journals Management of Anastomotic Leakage Following Rectal Cancer Operation

2011 ◽  
Vol 64 (5) ◽  
pp. 319-327
Author(s):  
Yoshinori Oikawa ◽  
Yukio Saito ◽  
Hideaki Yano ◽  
Ryuichiro Suda ◽  
Yoshimasa Gouda ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Rectal Cancer Operation

scholarly journals Biomarkers That Predict The Response to Chemo-radiotherapy in Rectal Cancer

2017 ◽  
Vol 1 (2) ◽  
Author(s):  
Nam Kyu Kim
Keyword(s):  
Rectal Cancer ◽  
Tumor Response ◽  
Management Plan ◽  
Tumor Biomarker ◽  
Great Success ◽  
Strong Indicator ◽  
High Incidence ◽  
The Right ◽  
Locally Advance Rectal Cancer ◽  
The Given

The treatment of locally advance rectal cancer is a challenging with a relatively high incidence of local recurrence. CRT, however, has proven to be a great success in controlling rectal tumor locally. Nevertheless, recognizing relevant biomarkers are of paramount importance in order to tailor patient management and to avoid unnecessary chemotherapy related morbidity. In addition, biomarkers could outline oncological outcomes early on. Tumor response considered a strong indicator about tumor status and response to the given treatment. Unfortunately, there is no single effective method to predict tumor response to CRT treatment solely. However development of clinical and immunohistochemistry markers are essential to know what it takes to design a proper management plan for the right patient. We focus in our review to summarize relevant articles emphasizing predictive value of tumor biomarker in estimating rectal cancer response to preoperative CRT.   

Clinical impact of primary tumor location in patients with metastatic colorectal cancer (mCRC) treated with regorafenib or trifluridine/tipiracil as later-line.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 105-105
Author(s):  
Hiromichi Nakajima ◽  
Shota Fukuoka ◽  
Toshikazu Moriwaki ◽  
Toshiki Masuishi ◽  
Atsuo Takashima ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Prognostic Factor ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Primary Tumor ◽  
Univariate Analysis ◽  
Tumor Location ◽  
Primary Tumor Location ◽  
The Right ◽  
The Impact

105 Background: In the recent years, primary tumor location (PTL) is considered as an important prognostic and predictive factor in first-line treatment of mCRC. Although regorafenib (REG) and trifluridine/tipiracil (TFTD) have been available recently, the prognostic value of PTL in later-line with these agents is not well understood. TFTD improved survival regardless of PTL in the RECOURSE trial, while REG did not show survival benefit in the patients (pts) with rectal cancer in the CORRECT trial. Methods: We retrospectively evaluated pts with mCRC who were registered in a multicenter observational study (the REGOTAS study). The main inclusion criteria were ECOG PS of 0–2, refractory or intolerant to fluoropyrimidines, oxaliplatin, irinotecan, and anti-VEGF and anti-EGFR therapy (if KRAS wild type), and no prior use of REG and TFTD. The impact of PTL on overall survival (OS) were evaluated using Cox proportional hazards models based on baseline characteristics and propensity score matching. Results: A total of 550 pts (223 pts in the REG group, 327 pts in the TFTD group; 122 pts in the right-sided, 428 pts in the left-sided) were included in this study. Although the right-sided pts was significantly shorter OS compared with the left-sided pts by univariate analysis (hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.63-0.99, P = 0.04), multivariate analysis revealed that PTL was not an independent prognostic factor (HR 0.88, 95% CI 0.69-1.1, P = 0.26). The similar results were obtained in each treatment group. In subgroup analysis according to PTL, OS were comparable between REG and TFTD groups regardless of PTL (HR 0.93, 95% CI 0.62-1.39 in the right-sided; HR 1.08, 95% CI 0.83-1.39 in the left-sided [excluding rectum]; and HR 1.01, 95% CI 0.62-1.62 in the rectal cancer pts). These results were similar in sensitivity analysis using propensity score-matching. Conclusions: In the present study, PTL is not a prognostic factor in patient with mCRC treated with either REG or TFTD as later-line. No difference in OS was observed between REG and TFTD groups irrespective of PTL.

scholarly journals Rectal Cancer: Asynchronous Metastasis to the Temporal Bone, Temporomandibular Joint and Middle Ear

2020 ◽  
pp. 1-3
Author(s):  
Ali Mahmood ◽  
Aiva Mahmood ◽  
Ali Mahmood ◽  
Nasrullah Manji
Keyword(s):  
Rectal Cancer ◽  
Radiation Therapy ◽  
Diagnostic Imaging ◽  
Temporomandibular Joint ◽  
Temporal Bone ◽  
Middle Ear ◽  
Metastatic Disease ◽  
Advanced Rectal Cancer ◽  
Distant Metastatic Disease ◽  
The Right

Rectal cancer has the potential to metastasize to multiple anatomical sites. The hallmark of treatment presides with sound oncologic surgery, adjunct with chemotherapy and radiation therapy when indicated. The initial presentation determines the management regimen, consisting of physical examination and diagnostic imaging. A 54-year-old female presented with locally advanced rectal cancer. Upon conclusion of neoadjuvant chemotherapy and radiation therapy, she underwent a low anterior resection with total mesorectal excision. Her surgical margins were negative; however, of the 21 lymph nodes retrieved, 11 were positive for cancer. The patient underwent further adjuvant chemotherapy. 2 years, 8 months later, the patient presented to the emergency department with worsening swelling of the right side of the face, with increasing pain, hearing, and visual impairments. Diagnostic imaging revealed a large lesion in the cranial anatomy, invading the temporal bone, temporomandibular joint, sphenoid bone and anterior superior epitympanum of the right middle ear. The patient underwent operative intervention followed by radiation and chemotherapy. Asynchronous metastasis of rectal cancer to the cranium is a rare finding and an invasion into the temporal bone even more scarcely reported. The prognosis for distant metastatic disease is poor because it involves metastatic spread via the lymph channels or vascular system. Patients that have undergone treatment for advanced rectal cancer must be approached with a high index of suspicion for distant metastatic disease, even in the advent of routine negative surveillance

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