scholarly journals Commentary on neoadjuvant therapy followed by local excision and two-stage total mesorectal excision: a new strategy for sphincter preservation in locally advanced ultra-low rectal cancer

2014 ◽  
Vol 2 (2) ◽  
pp. 134-135
Author(s):  
A. P. Zbar
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Neoadjuvant Therapy ◽  
Local Excision ◽  
Locally Advanced ◽  
Sphincter Preservation ◽  
Low Rectal Cancer ◽  
Mesorectal Excision ◽  
Two Stage ◽  
New Strategy

scholarly journals Survival analysis of local excision vs total mesorectal excision for middle and low rectal cancer in pT1/pT2 stage and intermediate pathological risk

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
I-Li Lai ◽  
Jeng-Fu You ◽  
Yih-Jong Chern ◽  
Wen-Sy Tsai ◽  
Jy-Ming Chiang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Adjuvant Therapy ◽  
Total Mesorectal Excision ◽  
Local Excision ◽  
Therapy Group ◽  
Low Rectal Cancer ◽  
Survival Outcomes ◽  
Mesorectal Excision ◽  
Alternative Treatment Option ◽  
Late Morbidity

Abstract Background Local excision (LE) is a feasible treatment approach for rectal cancers in stage pT1 and presents low pathological risk, whereas total mesorectal excision (TME) is a reasonable treatment for more advanced cancers. On the basis of the pathology findings, surgeons may suggest TME for patients receiving LE. This study compared the survival outcomes between LE with/without chemoradiation and TME in mid and low rectal cancer patients in stage pT1/pT2, with highly selective intermediate pathological risk. Methods This retrospective study included 134 patients who received TME and 39 patients who underwent LE for the treatment of intermediate risk (pT1 with poor differentiation, lymphovascular invasion, perineural invasion, relatively large tumor, or small-sized pT2 tumor) rectal cancer between 1998 and 2016. Results Overall survival (OS), disease-free survival (DFS), and cumulative recurrence rate (CRR) were similar between the LE (3-year DFS 92%) and TME (3-year DFS 91%) groups. Following subgrouping into an LE with adjuvant therapy group and a TME without adjuvant therapy group, the compared survival outcomes (OS, DFS, and CRR) were found not to be statistically different. The temporary and permanent ostomy rates were higher in the TME group than in the LE group (p < 0.001). Rates of early and late morbidity following surgery were higher in the TME group (p = 0.005), and LE had similar survival compared with TME. Conclusion For patients who had mid and low rectal cancer in stage pT1/pT2 and intermediate pathological risk, LE with chemoradiation presents an alternative treatment option for selected patients.

Predicting Difficult Laparoscopic Total Mesorectal Excision for Locally-advanced Mid-low Rectal Cancer: The EuMaRCS Score Validation

2020 ◽  
Vol 40 (4) ◽  
pp. 2079-2087
Author(s):  
NICOLA de'ANGELIS ◽  
ALEIX MARTÍNEZ-PÉREZ ◽  
GIULIO CESARE VITALI ◽  
FREDERIC PIGNEUR ◽  
ALAIN LUCIANI ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Locally Advanced ◽  
Low Rectal Cancer ◽  
Laparoscopic Total Mesorectal Excision ◽  
Mesorectal Excision

Laparoscopic versus open total mesorectal excision with anal sphincter preservation for low rectal cancer

2004 ◽  
Vol 18 (8) ◽  
pp. 1211-1215 ◽  
Author(s):  
Z. -G. Zhou ◽  
M. Hu ◽  
Y. Li ◽  
W. -Z. Lei ◽  
Y. -Y. Yu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Anal Sphincter ◽  
Sphincter Preservation ◽  
Low Rectal Cancer ◽  
Mesorectal Excision

scholarly journals Transanal total mesorectal excision for patients with middle-low rectal cancer in locally advanced stage

2018 ◽  
Vol 8 (4) ◽  
Author(s):  
Huu Thien Ho ◽  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Rectal Resection ◽  
Locally Advanced ◽  
Low Rectal Cancer ◽  
Resection Margins ◽  
Transanal Total Mesorectal Excision ◽  
Advanced Stage ◽  
Mesorectal Excision ◽  
Female Ratio

Abstract Introduction: Patients with middle-low rectal cancer in advanced stage had many difficulties in performing laparoscopic total mesorectal excision (TME), especially in those with narrow pelvis or obese with or without neoadjuvant therapy. We conducted the study of transanal TME (TaTME) for these patients to evaluate the safety and efficacity of this technique. Material and Methods: Prospective study. Patients with middle-low rectal cancer in advanced stage underwent rectal resection with TaTME technique were enrolled. Results: 38 patients including 25 middle and 13 low rectal tumors underwent elective rectal resection by TaTME from March 2015 to September 2018. Male/female ratio: 25/13. Mean age: 58.2 ± 16.4 and BMI: 24.2 ±2.5 kg/m2. Mean operation duration:210 ± 42 minutes. Specimen were removed through abdominal incision in 23 patients and 15 via anus. Anastomoses were performed by hands in 100% patients. The protective ileostomie was performed 100%. One left ureteral burning and postoperative difficulty in voiding, one presacral abscess due to anastomotic fistula and one totally leakage of the anastomose. Good Quirke assessment in 87% patients. The distal resection margins (DRM) was 20 ± 5 mm. Distal resection margins (DRM) were negative in 100% patients and circumferential resection margins (CRM) were positive in one (2.6%) patients. The hospital stay was 6 days. Median follow-up time was 12 months. One patient had local recurrence at 18th months and 1 had liver metastasis at 6th months. Conclusion: TaTME for patients with middle-low rectal cancer in advanced stage is safe and efficacious. However, there is a need for large, multicentric studies to accurately evaluate this technique.

Sign in / Sign up

Export Citation Format

Share Document