Level of the anastomosis does not influence functional outcome after anterior rectal resection for rectal cancer

1995 ◽  
Vol 169 (1) ◽  
pp. 147-153 ◽  
Author(s):  
Ekkehard C. Jehle ◽  
Torsten Haehnel ◽  
Michael J. Starlinger ◽  
Horst D. Becker
Keyword(s):  
Rectal Cancer ◽  
Functional Outcome ◽  
Rectal Resection ◽  
Anterior Rectal Resection ◽  
Influence Functional

scholarly journals Prediction of anastomotic leakage after anterior rectal resection

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Shubang Cheng ◽  
Bolin He ◽  
Xueyi Zeng
Keyword(s):  
Rectal Cancer ◽  
Prediction Model ◽  
Anastomotic Leakage ◽  
Roc Curve ◽  
Rectal Resection ◽  
Preoperative Chemoradiotherapy ◽  
Tumor Differentiation ◽  
Intraoperative Bleeding ◽  
Anterior Rectal Resection ◽  
Validation Set

Objective: Anastomotic Leakage (AL) is one of the most common complications after resection of rectal cancer. Recognition of the incidence and risk factors related to AL is important. This study aimed develops a model that can predict anastomotic leakage after anterior rectal resection. Methods: Data from 188 patients undergoing anterior resection of rectal cancer were collected for retrospective analysis. Patients were randomly divided in the development set and validation set at a 1:1 ratio. We first included age, sex, preoperative chemoradiotherapy, tumor size, degree of tumor differentiation, stage, TNM stage, lymph vascular invasion, distance, anastomotic method, diabetes, intraoperative time, intraoperative bleeding and smoking as candidates for variable selection with a LASSO method. A ROC curve was constructed with the validation set to assess the accuracy of the prediction model. Results: AL occurred in 20 of 188 patients (10.6%). Preoperative chemoradiotherapy (p=0.04), medium degree of tumor differentiation (p=0.04), anastomotic method (p<0.01), intraoperative bleeding≥400ml (p<0.01), smoking (p<0.01), diabetes (p<0.01) were significantly related to AL. The area under the ROC curve of the prediction model is 0.952. Conclusions: This study developed a model that can predict anastomotic leakage after anterior rectal resection, which may aid the selection of preventive ileostomy and postoperative management. doi: https://doi.org/10.12669/pjms.35.3.252 How to cite this:Cheng S, He B, Zeng X. Prediction of anastomotic leakage after anterior rectal resection. Pak J Med Sci. 2019;35(3):830-835.  doi: https://doi.org/10.12669/pjms.35.3.252 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Laparoscopic ultralow anterior rectal resection in APPEAR technique for deep rectal cancer

2011 ◽  
Vol 27 (4) ◽  
pp. 549-552 ◽  
Author(s):  
C. Marquardt ◽  
Ph. Koppes ◽  
D. Weimann ◽  
Th. Schiedeck
Keyword(s):  
Rectal Cancer ◽  
Rectal Resection ◽  
Anterior Rectal Resection

Risk of Outlet Obstruction Associated With Defunctioning Loop Ileostomy in Rectal Cancer Surgery

2021 ◽  
Vol 1 (5) ◽  
pp. 465-470
Author(s):  
HIROYA ENOMOTO ◽  
KATSUHITO SUWA ◽  
NANA TAKEUCHI ◽  
YOSHITO HANNYA ◽  
YUHEI TSUKAZAKI ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Odds Ratio ◽  
Rectal Resection ◽  
Univariate Analysis ◽  
Outlet Obstruction ◽  
Muscle Thickness ◽  
Rectus Abdominis ◽  
Rectus Abdominis Muscle ◽  
Anterior Rectal Resection

Background: The outlet obstruction (OO) rate is 5.4-18.4% after defunctioning ileostomy (DI) following rectal cancer resection to reduce the incidence and severity of anastomotic leakage; OO affects a patient’s quality of life and prolongs hospitalization. Patients and Methods: A retrospective analysis was performed of patients who underwent anterior rectal resection and DI for rectal cancer. Results: Among 100 patients undergoing anterior rectal resection with DI for rectal cancer, 28 (28%) developed OO. Anastomotic leakage and a rectus abdominis muscle thickness ≥10 mm on preoperative computed tomography were significantly associated with the risk of OO in univariate analysis. Multivariate analysis also demonstrated that anastomotic leakage (odds ratio=4.320, 95% confidence interval=1.280-14.60, p=0.019) and rectus abdominis muscle thickness ≥10 mm (odds ratio=3.710, 95% confidence intervaI=1.280-10.70, p=0.016) were significantly risk factors for OO. Conclusion: When OO is observed, an anastomotic leakage should be suspected, especially if there is a high rectus abdominis muscle thickness.

scholarly journals A Single Centre Retrospective Evaluation of Laparoscopic Rectal Resection with TME for Rectal Cancer: 5-Year Cancer-Specific Survival

2011 ◽  
Vol 2011 ◽  
pp. 1-5
Author(s):  
Raoul Quarati ◽  
Massimo Summa ◽  
Fabio Priora ◽  
Valeria Maglione ◽  
Ferruccio Ravazzoni ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Survival Rate ◽  
Minimally Invasive ◽  
Rectal Resection ◽  
Minimally Invasive Approach ◽  
Single Centre ◽  
Term Survival ◽  
Invasive Approach ◽  
Anterior Rectal Resection

Laparoscopic colon resection has established its role as a minimally invasive approach to colorectal diseases. Better long-term survival rate is suggested to be achievable with this approach in colon cancer patients, whereas some doubts were raised about its safety in rectal cancer. Here we report on our single centre experience of rectal laparoscopic resections for cancer focusing on short- and long-term oncological outcomes. In the last 13 years, 248 patients underwent minimally invasive approach for rectal cancer at our centre. We focused on 99 stage I, II, and III patients with a minimum follow-up period of 5 years. Of them 43 had a middle and 56 lower rectal tumor. Laparoscopic anterior rectal resection was performed in 71 patients whereas laparoscopic abdomino-perineal resection in 28. The overall mortality rate was 1%; the overall morbidity rate was 29%. The 5-year disease-free survival rate was 69.7%, The 5-year overall survival rate was 78.8%.

scholarly journals Sphincter Saving Techniques in Low Rectal Cancer Surgical Treatment: Results, Perspectives

2015 ◽  
Vol 61 (1) ◽  
pp. 10-14
Author(s):  
C. Russu ◽  
C. Copotoiu ◽  
V. Bud ◽  
C. Saracut ◽  
M. Gherghinescu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Rectal Resection ◽  
Colorectal Anastomosis ◽  
Low Rectal Cancer ◽  
Postoperative Results ◽  
Sphincter Function ◽  
Anterior Rectal Resection ◽  
Sphincter Saving ◽  
Peranal Anastomosis

Abstract Objective: Sphincter saving techniques in low rectal cancer represents a challenge for the surgeons in their attempt to preserve the sphincter function and also to respect the principles of oncological surgery, in order to improve the quality of the patient’s life. The paper’s aim is to compare different sphincter saving techniques in regards to the early postoperative results. Methods: An observational, retrospective study was performed on 76 patients (N = 76) operated for low rectal cancer in the Surgical Clinic no.1 of the Targu Mures Emergency Clinical County Hospital, between January 2010 and October 2014, to whom the rectal resection was followed by a primary restorative technique for preservation of the sphincter function. The immediate postoperative results after different types of sphincter saving procedures were analyzed and compared. Results: From the studied patients, in 41 cases (53.94%) an anterior rectal resection with low colorectal anastomosis was done („very low” Dixon procedure), for 29 patients (38.15%) a sphincter saving technique with a peranal anastomosis was performed and in 6 cases (7.89%) an intersphinteric rectal resection with coloanal anastomosis was made. Conclusions: Sphincter saving techniques, if oncological principles are respected, represents a viable option in the treatment of low rectal cancer and brings hope for improving the quality of the patients’ life.

scholarly journals The results of anterior rectal resection with the formation of a hardware anastomosis in cancer patients

2021 ◽  
Vol 2 (4) ◽  
pp. 6-12
Author(s):  
E. N. Kolesnikov ◽  
A. V. Snezhko ◽  
V. S. Trifanov ◽  
M. A. Kozhushko ◽  
Yu. A. Fomenko ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Rectal Resection ◽  
Colorectal Anastomosis ◽  
Research Centre ◽  
Surgical Interventions ◽  
X Ray ◽  
National Medical ◽  
Anterior Rectal Resection ◽  
Intestinal Stoma ◽  
Mesenteric Excision

Purpose of the study. A retrospective analysis of the immediate results of performing anterior rectal resections in cancer. Materials and methods. In the Department of Abdominal Oncology No. 1 with a group of X-ray vascular methods of diagnosis and treatment of the clinic of the National Medical Research Centre for Oncology of the Ministry of Health of Russia treatment for rectal cancer operations of anterior rectal resection were performed in 334 patients, while in 143 (42.8 %) cases they were low. As a standard, total mesenteric excision and lymphoid dissection in volume D2 were performed. Combined surgical interventions were performed in 68 (20.4 %) patients for locally spread tumors. As a rule, they were resection in nature and were performed with tumor infiltration of adjacent organs (bladder with ureters, ovaries, uterus, vagina, small intestine, abdominal wall). Colorectal anastomosis using crosslinking devices was formed in all cases, in 316 (94.6 %) cases it was a "side – to-end" junction, in 18 patients – "end-to-end". A preventive proximal intestinal stoma was formed in 73 (21.9 %) cases, where 67 cases it was an ileostomy, and 6 – a transversostomy. The preventive proximal intestinal stoma was not formed among 261 patients. Results. After performing anterior resections for rectal cancer operations, the complications developed in 75 (22.5 %) patients. The most threatening and dangerous complication was the failure of the colorectal anastomosis, which was noted in 12 (3.5 %) cases.This complication occurred in 8.2 % (6 patients out of 73) of preventatively stoma-treated patients, in 2.3 % of patients without a stoma (6 patients out of 261).Conclusion. The use of a preventive proximal intestinal stoma allows you to form a colorectal anastomosis even in the presence of complicated forms of rectal cancer. The number of complications directly referred to the formation of a preventive proximal intestinal stoma is relatively small, but when planning surgery for uncomplicated rectal cancer, the probability of their possible occurrence should be taken into account.

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