The rectal ‘no man's land’ and sphincter preservation during rectal excision

2010 ◽  
Vol 97 (12) ◽  
pp. 1749-1751 ◽  
Author(s):  
N. S. Williams
Keyword(s):  
Sphincter Preservation ◽  
Rectal Excision ◽  
No Man's Land

No Man’s Land Revisited: Managing Unstable High Thoracic Fractures

2014 ◽  
Vol 75 (S 01) ◽  
Author(s):  
A. Danison ◽  
J. Boddu ◽  
J. Rostron ◽  
J. Hamilton
Keyword(s):  
No Man's Land

Safety and feasibility of sphincter preservation surgery in low lying rectal cancers

2021 ◽  
Author(s):  
Swapnil Patel ◽  
Vivek Sukumar ◽  
Mufaddal Kazi ◽  
Avanish Saklani
Keyword(s):  
Sphincter Preservation ◽  
Rectal Cancers

scholarly journals Can Pre-Treatment Inflammatory Parameters Predict the Probability of Sphincter-Preserving Surgery in Patients with Locally Advanced Low-Lying Rectal Cancer?

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 946
Author(s):  
Richard Partl ◽  
Katarzyna Lukasiak ◽  
Bettina Stranz ◽  
Eva Hassler ◽  
Marton Magyar ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anal Verge ◽  
Locally Advanced ◽  
Multivariable Analysis ◽  
Sphincter Preservation ◽  
Independent Predictive Factor ◽  
Lymphocyte Ratio ◽  
Inflammatory Parameters ◽  
Pre Treatment

There is evidence suggesting that pre-treatment clinical parameters can predict the probability of sphincter-preserving surgery in rectal cancer; however, to date, data on the predictive role of inflammatory parameters on the sphincter-preservation rate are not available. The aim of the present cohort study was to investigate the association between inflammation-based parameters and the sphincter-preserving surgery rate in patients with low-lying locally advanced rectal cancer (LARC). A total of 848 patients with LARC undergoing radiotherapy from 2004 to 2019 were retrospectively reviewed in order to identify patients with rectal cancer localized ≤ 6 cm from the anal verge, treated with neo-adjuvant radiochemotherapy (nRCT) and subsequent surgery. Univariable and multivariable analyses were used to investigate the role of pre-treatment inflammatory parameters, including the C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) for the prediction of sphincter preservation. A total of 363 patients met the inclusion criteria; among them, 210 patients (57.9%) underwent sphincter-preserving surgery, and in 153 patients (42.1%), an abdominoperineal rectum resection was performed. Univariable analysis showed a significant association of the pre-treatment CRP value (OR = 2.548, 95% CI: 1.584–4.097, p < 0.001) with sphincter preservation, whereas the pre-treatment NLR (OR = 1.098, 95% CI: 0.976–1.235, p = 0.120) and PLR (OR = 1.002, 95% CI: 1.000–1.005, p = 0.062) were not significantly associated with the type of surgery. In multivariable analysis, the pre-treatment CRP value (OR = 2.544; 95% CI: 1.314–4.926; p = 0.006) was identified as an independent predictive factor for sphincter-preserving surgery. The findings of the present study suggest that the pre-treatment CRP value represents an independent parameter predicting the probability of sphincter-preserving surgery in patients with low-lying LARC.

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.

scholarly journals Onderwysstudente se parodieë as hibridiese tekste: ’n navorsingsverslag

Literator ◽  
2006 ◽  
Vol 27 (2) ◽  
pp. 83-108
Author(s):  
E. Kruger
Keyword(s):  
South African ◽  
Fairy Tale ◽  
Research Programme ◽  
Theoretical Background ◽  
Context Dependency ◽  
Research Report ◽  
Original Text ◽  
Education Students ◽  
No Man's Land ◽  
Teacher Education Students

Parody as hybridic text: research report Parody can be seen as one of the techniques of selfreferentiality through which a consciousness of the context dependency of meaning is revealed in an aesthetic way. This article explores the theoretical background of parody as literary style against which the researcher challenged a group of teacher education students in a research programme to generate their own parodies. The task required that they choose a well-known fairy tale and use its structure to mock their own society. Students of another group were asked as the writers’ peers to read the stories in order to engage in a dialogue between encoder and decoder in the process of reception. The educational aim of the programme was to equip students to reflect critically and react creatively to social, political and economic issues that surround them. Furthermore, the researcher wanted to discover how these texts would generate a flexibility, fluency and hybridity in relationship with the students’ cultural identity and how they would project their own liminality in a no-man’s land between youth and adulthood. Analysis and interpretation of the parody texts revealed themes of late capitalism, materialism and consumerism, as well as typical student cultural manifestations of language usage and some of their existing attitudes toward the South African political society in post-apartheid. The students’ parodies have intertextual density with imitation and subversion of the original text contexts and values. The writers used a variety of stylistic techniques to generate double-voiced narratives as manifestation of literary creativity.

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