scholarly journals EP.TU.393Management of Suspicious Neoplastic Rectal Lesions in Octogenarians by a Specialist Early Rectal Cancer MDT

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Kiran Altaf ◽  
Sukhpreet Gahunia ◽  
Dana Sochorova ◽  
Timothy Andrews ◽  
Sanchoy Sarkar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Cancer Recurrence ◽  
Early Rectal Cancer ◽  
Hybrid Procedures ◽  
Patient Demographics ◽  
Oncological Outcomes ◽  
Rectal Cancers ◽  
Endoscopic Microsurgery

Abstract Aims To assess management of early rectal cancers in octogenarians going through a regional Small and Early Rectal Cancer MDT observing oncological outcomes, morbidity, mortality and quality of life after treatment Methods Consecutive octogenarian patients treated via the SERC MDT between Dec 2013 and Dec 2019 were examined retrospectively from a prospectively maintained database. Patients underwent transanal endoscopic microsurgery (TEMS), endoscopic submucosal dissection (ESD), contact radiotherapy or hybrid combinations. Patient demographics were recorded and outcomes assessed including pre and post-operative oncological staging, morbidity, mortality, length of stay and FISI scores Results 85 patients were assessed. 38 had TEMS, 40 had EMR, ESD or hybrid procedures and 7 had contact radiotherapy. Of the 38 patients who underwent TEMS, there was minor morbidity in 5 patients, one cancer recurrence and no cancer related mortality. FISI scores pre- and post-procedure were markedly different with deterioration in control of flatus and mucus, but no faecal incontinence. Of the 40 patients who underwent EMR, ESD or hybrid procedures, 2 had minor morbidity and 3 had adenocarcinomas detected requiring further treatment Conclusions Management of octogenarians with early rectal cancer via a specialist MDT provides a safe option with minimal morbidity and no mortality in a subgroup of patients who would otherwise constitute a high risk cohort for surgical intervention. A deterioration in continence in this group highlights the need for careful counselling of patients to achieve the optimal balance between oncological outcomes and quality of life

Quality of life after transanal endoscopic microsurgery and total mesorectal excision in early rectal cancer

2007 ◽  
Vol 9 (6) ◽  
pp. 553-558 ◽  
Author(s):  
P. G. Doornebosch ◽  
R. A. E. M. Tollenaar ◽  
M. P. Gosselink ◽  
L. P. Stassen ◽  
C. M. Dijkhuis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Transanal Endoscopic Microsurgery ◽  
Early Rectal Cancer ◽  
Mesorectal Excision ◽  
Endoscopic Microsurgery

scholarly journals Oncological and quality of life outcomes following extralevator versus standard abdominoperineal excision for rectal cancer

2017 ◽  
Vol 99 (5) ◽  
pp. 402-409 ◽  
Author(s):  
D Kamali ◽  
A Sharpe ◽  
A Musbahi ◽  
A Reddy
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Abdominoperineal Excision ◽  
Long Term Effects ◽  
Recurrence Rates ◽  
Oncological Outcomes ◽  
Significant Difference

INTRODUCTION There is increasing and conflicting research debating the oncological benefits of extralevator abdominoperineal excision (ELAPE) compared with standard abdominoperineal excision (SAPE). However, there is very little in the literature on the long-term effects on patients’ wellbeing following the two procedures. The aim of this study was to determine the oncological outcomes and long-term quality of life (QoL) of patients at two hospitals having undergone ELAPE or SAPE. METHODS Consecutive patients with rectal cancer who underwent either ELAPE or SAPE between January 2009 and June 2015 at a single centre were analysed. Oncological outcomes were determined by histology and follow-up imaging. QoL data were obtained prospectively using the QLQ-C30 and QLQ-CR29 questionnaires. RESULTS A total of 48 patients (36 male, 12 female; 27 ELAPE, 21 SAPE) were reviewed. The mean age was 67.4 years and the median follow-up duration was 44 months (range: 6–79 months). Four patients (2 ELAPE, 2 SAPE) developed local recurrence. Rates of distant metastasis were similar (ELAPE: 11%, SAPE: 14%). There was no significant difference in mean global health status score (ELAPE: 77.3, SAPE: 65.3). Impotence was the most frequently reported problem (mean symptom scores of 89.7 and 78.8 for ELAPE and SAPE respectively). CONCLUSIONS This is the largest study with the longest follow-up period that compares QoL after ELAPE with that after SAPE. Although more radical in nature, ELAPE did not demonstrate any significant impact on QoL compared with SAPE. There was no significant difference in long-term oncological outcome between the groups. Impotence remains a significant problem for all patients and they should be well informed of this risk prior to surgery.

scholarly journals Transanal Endoscopic Microsurgery (TEMS) for Rectal Cancer: Patient Decision-making, Postoperative Experience and Quality of Life

In Vivo ◽  
2021 ◽  
Vol 35 (2) ◽  
pp. 1235-1245
Author(s):  
ALEXANDRA KORELI ◽  
GEORGE BRIASSOULIS ◽  
MICHAIL SIDERIS ◽  
ANASTAS PHILALITHIS ◽  
SAVVAS PAPAGRIGORIADIS
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Rectal Cancer ◽  
Cancer Patient ◽  
Transanal Endoscopic Microsurgery ◽  
Rectal Cancer Patient ◽  
Patient Decision Making ◽  
Patient Decision ◽  
Endoscopic Microsurgery

scholarly journals Quality of Life and Bowel Dysfunction after Transanal Endoscopic Microsurgery for Rectal Cancer: One Third of Patients Experience Major Low Anterior Resection Syndrome

2019 ◽  
Vol 37 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Maarten van Heinsbergen ◽  
Jeroen W. Leijtens ◽  
Gerrit D. Slooter ◽  
Maryska L. Janssen-Heijnen ◽  
Joop L. Konsten
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Transanal Endoscopic Microsurgery ◽  
Bowel Dysfunction ◽  
Low Anterior Resection Syndrome ◽  
Anterior Resection Syndrome ◽  
Endoscopic Microsurgery

Background/Aims: The low anterior resection syndrome (LARS) severely affects quality of life (QoL) after rectal cancer surgery. Studies investigating LARS and the effect on QoL after transanal endoscopic microsurgery (TEM) for rectal cancer are scarce. The aim of our study was to assess bowel dysfunction and QoL after TEM. Methods: Seventy-three ­patients who underwent TEM for stage I rectal cancer were included in this single-centre, cross-sectional study Bowel dysfunction was assessed by the LARS-Score, QoL by the ­European Organization for the Research and Treatment of Cancer QLQ-C30 and -CR29 questionnaires. Results: Fifty-five respondents (75.3%) could be included for the analyses. The median interval since treatment was 4.3 years, and the median age at the follow-up point was 72 years. “Major LARS” was observed in 29% of patients and “minor LARS” in 26%. Female gender (OR 4.00; 95% CI 1.20–13.36), neo-adjuvant chemoradiotherapy (OR 3.63; 95% CI 1.08–12.17) and specimen thickness in millimetres (OR 1.10 for each mm increase in thickness; 95% CI 1.01–1.20) were associated with the development of major LARS. Patients with major LARS fared worse in most QoL domains. Conclusion: This is the first study demonstrating major LARS after TEM treatment for rectal cancer, with a negative effect on QoL, even years after treatment. Our data provides an adequate counselling before TEM in terms of postoperative bowel dysfunction and its effect on QoL.

scholarly journals Oncological outcomes and quality of life after rectal cancer surgery

Open Medicine ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. 653-662 ◽  
Author(s):  
Roberto Peltrini ◽  
Gaetano Luglio ◽  
Gianluca Cassese ◽  
Alfonso Amendola ◽  
Emanuele Caruso ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Multidisciplinary Approach ◽  
New Technologies ◽  
Correct Choice ◽  
Rectal Cancer Surgery ◽  
Pelvic Anatomy ◽  
Novel Technologies ◽  
Oncological Outcomes

AbstractSurgery for rectal cancer has been completely revolutionized thanks to the adoption of new technologies and up-to-date surgical procedures that have been applied to the traditional milestone represented by Total Mesorectal Excision (TME).The multimodal and multidisciplinary approach, with new technologies increased the patients’ life expectancies; nevertheless, they have placed the surgeon in front of newer issues, represented by both oncological outcomes and the patients’ need of a less destructive surgery and improved quality of life.In this review we will go through laparoscopic, robotic and transanal TME surgery, to show how the correct choice of the most appropriate technique, together with a deep knowledge of oncological principles and pelvic anatomy, is crucial to pursue an optimal cancer treatment. Novel technologies might also help to decrease the patients’ fear of surgery and address important issues such as cosmesis and improved preservation of postoperative functionality.

scholarly journals Hybrid transanal and total mesorectal excision after transanal endoscopic microsurgery for unfavourable early rectal cancer: a report of two cases

2017 ◽  
Vol 24 (3) ◽  
pp. 188-192 ◽  
Author(s):  
Narimantas E. Samalavičius ◽  
Audrius Dulskas ◽  
Kęstutis Petrulis ◽  
Alfredas Kilius ◽  
Renatas Tikuišis ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Transanal Endoscopic Microsurgery ◽  
Low Rectal Cancer ◽  
Early Rectal Cancer ◽  
Mesorectal Excision ◽  
Final Histology ◽  
Complex Procedure ◽  
Endoscopic Microsurgery

Completion total mesorectal excision (TME) is a rare but complex procedure after transanal endoscopic microsurgery for early rectal cancer with unfavourable final histology. Two cases are reported when completion TME was performed after upfront transanal partial mesorectal dissection. Intact non-perforated TME specimens with negative and adequate distal and circumferential margins were created. The quality of both total mesorectal excisions was complete and distal margins were sufficient. We believe that our technique might be a way of approaching completion TME after TEM, especially in cases of low rectal cancer.

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