Outcomes on diverting ostomy formation and reversal after low anterior resection in the older more advanced rectal cancer patient

2021 ◽  
Author(s):  
S.H.J. Ketelaers ◽  
R.G. Orsini ◽  
G.A.P. Nieuwenhuijzen ◽  
H.J.T. Rutten ◽  
J.W.A. Burger ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cancer Patient ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Rectal Cancer Patient ◽  
Advanced Rectal Cancer ◽  
Diverting Ostomy

Preoperative chemo-radiotherapy in rectal cancer. Effect on down staging and possibility of sphincter sparing surgery

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 14598-14598
Author(s):  
T. Z. Mohran ◽  
H. A. Rayad
Keyword(s):  
Rectal Cancer ◽  
Abdominoperineal Resection ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Curative Resection ◽  
Performance Status ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Border Line

14598 Objectives: To evaluate the influence of pre-operative chemo-radiation on resectability of locally advanced rectal cancer and the possibility of performing sphincter- sparing surgery in cases not suitable for this procedures. Methods: 30 patients with rectal carcinoma with either border line respectability or not suitable for primary sphincter sparing surgery. Performance status > 60, adequate bone marrow reserve and adequate hepatic and renal functions. All patients had been staged by radiological studies and endoscopies. Treatment: All patients were treated by combined chemo-radiation. Radiotherapy with dose of 45 Gray in 25 fractions over 5 weeks. Chemotherapy with 5-flurouracil 500 mg/m2 I.V infusion over 2 hours and leucovorin immediately before radiation setting for first 5 days of the first week and the first 5 days of the last week of radiation. Patients were evaluated 4–6 weeks after treatment. Operable patients were subjected to abdominoperineal resection (APR) or low anterior resection (AR). Toxicity was evaluated using WHO Common Toxicity Criteria. Results: 30 patients were included; the median age was 48 years. Partial response was reported in 63.4% of patients and stable disease was reported in 33.3% of patients while progressive disease was reported in only one patient. Low anterior resection (AR) had been performed in 8 patients out of 12 (66.2%) who had initially not suitable for primary sphincter preservation, while abdominoperineal resection (APR) had been performed in 11 patients out of 18 patients (61.1%) who had initially border line resectability. Tumor down staging was achieved in 66% of patients. Tumor stage was identified as the only significant prognostic factors in response. Local control rate at 18 months were 85%. Actuarial overall survival for patient with curative resection at 18 months, were 85%. Toxicities included G3 leucopenia in 10% of patients, Diarrhea G3 in 13.3% of patients. Conclusion: Preoperative chemo-radiotherapy is an effective treatment in inducing down-staging of locally advanced rectal cancer patients and enhances curative resection and sphincter preserving procedures. Keyword: Colorectal cancer; Chemo- radiotherapy No significant financial relationships to disclose.

scholarly journals Single-incision Plus One Port Laparoscopic Total Mesorectal Excision and Bilateral Pelvic Node Dissection for Advanced Rectal Cancer—A Medial Umbilical Ligament Approach

2015 ◽  
Vol 100 (3) ◽  
pp. 417-422 ◽  
Author(s):  
Masayoshi Tokuoka ◽  
Yoshihito Ide ◽  
Mitsunobu Takeda ◽  
Yasuji Hashimoto ◽  
Jin Matsuyama ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Nodes ◽  
Total Mesorectal Excision ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Single Incision ◽  
Advanced Rectal Cancer ◽  
Laparoscopic Total Mesorectal Excision ◽  
Node Dissection ◽  
Mesorectal Excision

We prove the safety and feasibility of single-incision plus 1 port (SILS+1) laparoscopic total mesorectal excision (TME) + lateral pelvic lymph node dissection (LPLD) via a medial umbilical approach for rectal cancer. Only a few reports have been published about single-incision multiport laparoscopic low anterior resection with LPLD. Recently, minimally invasive surgery such as single-incision plus 1 port (SILS + 1) for advanced rectal cancer has been reported as safe and feasible. To our knowledge, this is the first reported case of SILS + 1 used for LPLD. A wound protector was inserted through a 30-mm transumbilical incision. Next, a single-port access device was mounted to the wound protector and 3 ports (5 mm each) were placed. A 12-mm port was inserted in the right lower quadrant. Super-low anterior resection of the rectum and bilateral LPLD and temporary ileostomy were performed with SILS + 1, with a blood loss of 50 mL and a total surgical time of 525 minutes. The time for right lateral dissection was 74 minutes; the time for left lateral dissection was 118 minutes. The total number of dissected lymph nodes was 57 and the number of lateral lymph nodes dissected was 21 (8 left pelvic lymph nodes, 13 right pelvic lymph nodes). No postoperative anastomotic insufficiency or voiding dysfunction was observed. We have documented the safety and feasibility of SILS + 1-TME + LPLD via a medial umbilical approach for rectal cancer.

Abdominoperineal resection or anterior resection for rectal cancer: patient preferences before and after treatment

2006 ◽  
Vol 8 (7) ◽  
pp. 575-580 ◽  
Author(s):  
A. Zolciak ◽  
K. Bujko ◽  
L. Kepka ◽  
J. Oledzki ◽  
A. Rutkowski ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cancer Patient ◽  
Abdominoperineal Resection ◽  
Anterior Resection ◽  
Patient Preferences ◽  
Rectal Cancer Patient ◽  
Before And After
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