Outcomes of surgical treatment for patients with distal rectal cancer: A retrospective review from a single university hospital

AbstractSatisfaction with life and disease acceptance by patients with a stomy related to surgical treatment of the rectal cancer depend on multiple factors. Such factors as social support, life conditions and time that elapsed after stomy creation, are very important in this context.was to conduct an early evaluation of life satisfaction and disease acceptance by patients with a stomy related to surgical treatment of the rectal cancer.The study was conducted at Dr. Jan Biziel University Hospital No. 2 in Bydgoszcz and at the prof. F. Łukaszczyk Oncology Centre in Bydgoszcz in 2014. The final analysis included 96 subjects aged 41-87 years (median 59 years). Satisfaction With Life Scale (SWLS) and Acceptance of Illness Scale (AIS) adapted by Zygfryd Juczyński, were used in this study.Most patients had satisfaction with life score of 5 or 6, 23 (24%) and 28 (29.2%) subjects, respectively. Twenty nine (30.2%) study subjects had low satisfaction level, while 16 (16.7%) had high satisfaction level. Average disease acceptance score was 23.2 points. Most patients, 71 (74%) had a moderate disease acceptance score, while the lowest number of subjects, 9 (9.4%), had high disease acceptance score. None of the study subjects who were under the care of a psychologist (14/100%) did not have a low acceptance level.Half of the study subjects had a moderate level of satisfaction with life. Most patients with stomy related to surgical treatment of the rectal cancer in an early postoperative period had moderate level of the disease acceptance. Patients with high level of satisfaction with life, accept the disease better. Few patients who used help by a psychologist, were two- and three-fold more likely to have higher level of satisfaction with life and disease acceptance, respectively.

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Intersphincteric Resection Pushing the Envelope for Sphincter Preservation

Clinics in Colon and Rectal Surgery ◽

10.1055/s-0037-1606114 ◽

2017 ◽

Vol 30 (05) ◽

pp. 368-376 ◽

Cited By ~ 5

Author(s):

Quentin Denost ◽

Eric Rullier

Keyword(s):

Rectal Cancer ◽

Surgical Treatment ◽

Sphincter Preservation ◽

Intersphincteric Resection ◽

Technical Aspects ◽

Oncological Outcomes ◽

Distal Rectal Cancer ◽

End Colostomy ◽

Bowel Continuity ◽

Restoration Of Bowel Continuity

AbstractDuring the last 15 years, a significant evolution has emerged in the surgical treatment of rectal cancer and restoration of bowel continuity has been one of the main goals. For many years the treatment of distal rectal cancer would necessarily require an abdominoperineal resection and end colostomy. The surgical procedure of intersphincteric resection has been proposed to offer sphincter preservation in patients with low rectal cancer and has been legitimized if executed according to adequate oncologic criteria. This article will discuss the best indications, technical aspects, functional, and oncological outcomes of intersphicteric resection in the management of rectal cancer.

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Combination therapy for patients with advanced forms of distal rectal cancer during neoadjuvant thermoradiotherapy

Pelvic Surgery and Oncology ◽

10.17650/2686-9594-2020-10-3-4-43-53 ◽

2020 ◽

Vol 10 (3-4) ◽

pp. 43-53

Author(s):

Yu. A. Barsukov ◽

S. I. Tkachev ◽

Z. Z. Mamedli ◽

A. G. Perevoshchikov ◽

O. A. Vlasov ◽

...

Keyword(s):

Rectal Cancer ◽

Surgical Treatment ◽

Combination Therapy ◽

Survival Rates ◽

Relapse Free Survival ◽

Free Survival ◽

Distal Rectal Cancer ◽

Short Course ◽

Radiotherapy Alone ◽

Study Participants

Objective: to evaluate the efficacy of combination therapy in patients with stage сT3N0M0 and сT2–3N1–2M0 distal rectal cancer during a short course of neoadjuvant thermoradiotherapy compared to radiotherapy or surgical treatment alone.Materials and methods. A total of 166 patients received 3 sessions of local microwave hyperthermia (LMH) at a temperature of 43–45 °C for 60 minutes during a short course of radiotherapy (LMH + CT); 138 patients received combination treatment (CT) using preoperative radiotherapy alone; 197 patients received surgical treatment (ST) only.Results. In patients receiving LMH + CT, overall incidence of complications was 38.6 % and did not significantly differ from that in patients receiving ST (p = 0.8464) and CT (p = 0.5383). We observed no significant differences in the severity of postoperative complications (according to the Clavien–Dindo classification) between the three groups of study participants treated using different regimens. The incidence of relapses was 6 % in the LMH + CT group vs 17.3 % in the ST group (p <0.0011) and 10.9 % in the CT group (p = 0.1258). Relapse-free survival rates were significantly higher in patients receiving LMH + CT than in patients who had ST alone: 59.4 % vs 51 % (p = 0.04). Difference in relapse-free survival between the CT and ST groups was not significant (56.5 % vs 51 %, respectively, p = 0.07). The frequency of therapeutic pathomorphosis was significantly higher (p <0.00001) in the LMH + CT group than in the CT group (14.9 % and 1.5 %, respectively).Conclusions. LMH has a universal radiosensitizing potential that can increase tumor radiosensitivity and improve treatment outcomes.

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Conventional approach x laparoscopic abdominoperineal resection for rectal cancer treatment after neoadjuvant chemoradiation: results of a prospective randomized trial

Revista do Hospital das Clínicas ◽

10.1590/s0041-87812003000300002 ◽

2003 ◽

Vol 58 (3) ◽

pp. 133-140 ◽

Cited By ~ 88

Author(s):

Sergio Eduardo Alonso Araujo ◽

Afonso Henrique da Silva e Sousa Jr ◽

Fábio Guilherme Caserta Marysael de Campos ◽

Angelita Habr-Gama ◽

Rodrigo Blanco Dumarco ◽

...

Keyword(s):

Rectal Cancer ◽

Surgical Treatment ◽

Abdominoperineal Resection ◽

Conventional Approach ◽

Open Approach ◽

Operative Morbidity ◽

Distal Rectal Cancer ◽

Significant Difference ◽

Laparoscopic Abdominoperineal Resection

OBJECTIVE: The aims of this study were to evaluate the safety and efficacy of laparoscopic abdominoperineal resection compared to conventional approach for surgical treatment of patients with distal rectal cancer presenting with incomplete response after chemoradiation. METHOD: Twenty eight patients with distal rectal adenocarcinoma were randomized to undergo surgical treatment by laparoscopic abdominoperineal resection or conventional approach and evaluated prospectively. Thirteen underwent laparoscopic abdominoperineal resection and 15 conventional approach. RESULTS: There was no significant difference (p<0,05) between the two studied groups regarding: gender, age, body mass index, patients with previous abdominal surgeries, intra and post operative complications, need for blood transfusion, hospital stay after surgery, length of resected segment and pathological staging. Mean operation time was 228 minutes for the laparoscopic abdominoperineal resection versus 284 minutes for the conventional approach (p=0.04). Mean anesthesia duration was shorter (p=0.03) for laparoscopic abdominoperineal resection when compared to conventional approach : 304 and 362 minutes, respectively. There was no need for conversion to open approach in this series. After a mean follow-up of 47.2 months and with the exclusion of two patients in the conventional abdominoperineal resection who presented with unsuspected synchronic metastasis during surgery, local recurrence was observed in two patients in the conventional group and in none in the laparoscopic group. CONCLUSIONS: We conclude that laparoscopic abdominoperineal resection is feasible, similar to conventional approach concerning surgery duration, intra operative morbidity, blood requirements and post operative morbidity. Larger number of cases and an extended follow-up are required to adequate evaluation of oncological results for patients undergoing laparoscopic abdominoperineal resection after chemoradiation for radical treatment of distal rectal cancer.

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Prognostic factors after surgical treatment for locally recurrent distal rectal cancer

Romanian Journal of Medical Practice ◽

10.37897/rjmp.2016.4.9 ◽

2016 ◽

Vol 11 (4) ◽

pp. 342-347

Author(s):

Denis ASLAN ◽

◽

Adrian BORDEA ◽

Razvan SCAUNASU ◽

Ileana POPA ◽

...

Keyword(s):

Quality Of Life ◽

Rectal Cancer ◽

Surgical Treatment ◽

Local Recurrence ◽

Major Complication ◽

Lower Rectal Cancer ◽

Rectal Cancer Surgery ◽

Related Factors ◽

Distal Rectal Cancer

Objectives. Local recurrence after distal rectal cancer surgery is a major complication with an increased morbidity and mortality. The therapeutic strategy consists in a complex association of radiochemotherapy with surgical approach that may improve prognosis and quality of life. It is necessary to identify the risk factors for local recurrence and to have a highly-selected patients for oncological radical treatment. Materials and methods. The study included the analysis of 79 patients with middle and lower rectal cancer who were diagnosed and operated at Coltea Clinic Surgical Clinic Hospital, Bucharest, for a period of 4 years. Male patients were more frequent (64.4%). The average age was 65 years old. The surgical strategy included 33 patients (41.8%) who underwent abdominoperineal resection, 36 patients (45.6%) who underwent low anterior resection with stapled colorectal anastomosis and 10 patients (12.75) who underwent ultralow anterior resection. Results. Local recurrence rate was 12.7%. The mean time from surgery until the time of discovery of local recurrence was 14.5 months. Local recurrence was associated with advanced tumor stages T3 (10.1%) and T4 (2.5%). It was also associated with histopathological features related to serous infiltration (100%) and tumor invasion of the radial margins (3.8%). The surgical treatment strategy consisted of abdominoperineal resection, permanent colostoma and R2 resections. Discussion. The radical surgical resection is the most significant prognostic factor. There are a number of other patient-related factors and tumor-related factors that can significantly influence the evolution and overlall survival. Periodic clinical, imaging scans and colonoscopy follow-ups are able to early detect the tumor recurrence and to allow a curative cancer treatment. Conclusions. Local recurrence after mid and lower rectal cancer surgery is a major complication with direct impact on morbidity, mortality, prognosis and quality of life of these patients. The treatment strategy must be established by a multidisciplinary team in order to identify carefully-selected patients to undergo the optimal oncological therapy.

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“The Paradigm of Surgical Treatment of Distal Rectal Cancer: What to Remove vs What to Leave Behind”

Cirugía Española (English Edition) ◽

10.1016/j.cireng.2014.10.001 ◽

2015 ◽

Vol 93 (3) ◽

pp. 207-208

Author(s):

Javier A. Cienfuegos ◽

Jorge Baixauli ◽

Fernando Rotellar ◽

José Luis Hernández Lizoáin

Keyword(s):

Rectal Cancer ◽

Surgical Treatment ◽

Distal Rectal Cancer

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Tiesiosios žarnos vėžio chirurginis gydymas Ostravos universiteto ligoninėje, Čekijos Respublika

Lietuvos chirurgija ◽

10.15388/lietchirur.2004.3.2361 ◽

2004 ◽

Vol 2 (3) ◽

pp. 0-0

Author(s):

Petr Vavra ◽

Marie Rydlova ◽

Anton Pelikan ◽

Lubomir Martinek ◽

Petra Gunkova ◽

...

Keyword(s):

Rectal Cancer ◽

Czech Republic ◽

Surgical Treatment ◽

University Hospital ◽

Laparoscopic Treatment ◽

Treatment Results ◽

Safety Distance ◽

Resection Line ◽

Well Differentiated ◽

Distal Intramural Spread

Petr Vavra1, Marie Rydlova3, Anton Pelikan1, Lubomir Martinek1, Petra Gunkova1, Michaela Vavrova2, Igor Gunka11 Department of Surgery and 2 Department of Radiology,University Hospital of Ostrava,3 Department of Pathology, Medical-Social Facultyof University of Ostrava,17 listopadu 1790, 708 52 Ostrava Poruba,Czech RepublicE-mail: [email protected] Background / objective Czech Republic is among the countries with the highest incidence of rectal cancer. The aim of the prospective study was to monitor the surgical treatment of patients with the diagnosis of rectal cancer. Patients and methods 188 patients (121 males and 67 females) with rectal cancer were operated on within the period of three years (2000–2002). The definitive analysis encompassed 171 patients. The following aspects were observed: the types of operations carried out, the safety distance of the lower resection line during the operation of rectal cancer mainly, the amount of lymphatic nodes spotted in the mesorectum and the possibility of their laparoscopic treatment. Results 129 patients were operated on by conventional methods and 42 patients (24.6%) by laparoscopical methods (25 anterior resections, 6 abdominoperineal amputations, 10 colostomies, 1 proctocolectomy). At a distance of 2 mm from the aboral edge of the tumour, the distal intramural spread of cancer was detected in 8 (11.8%), at 5 mm in 6 (9%), at 1 cm in 2 (2.6%), at 2 cm in 4 patients (5.8 %) and at 5 cm from the macroscopical edge no distal intramural spread was recorded. Enlarged lymphatic nodes were discovered in 128 patients. In total, there were 1383 lymphatic nodes, i.e. 10.8 lymphatic nodes per patient. 271 lymphatic nodes (19.5%) affected by a tumour process, i.e. 2.1 affected lymphatic nodes per patient were found. The number of the affected lymphatic nodes in the mesorectum was compared in connection with the usage of conventional or laparascopical operation. There was no difference in oncological radicality as far as these types of operations are concerned. Conclusions There is no evidence of the spread of well differentiated adenocarcinoma from the aboral edge of the tumour. All positive findings of distal intramural spread were found in the medium and lower differentiated adenocarcinomas. The distal intramural spread of the tumour is quite rare, but when present it signifies a very advanced and aggressive progress of the illness with a bad prognosis. It is too early to formulate the conclusions comparing the conventional and the laparoscopic approaches to rectal cancer.

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