Laparoscopic low anterior resection with extended total mesorectal excision for locally advanced rectal cancer – a video vignette

2020 ◽  
Vol 22 (11) ◽  
pp. 1763-1764
Author(s):  
S. Bankar ◽  
D. Pandey ◽  
V. Sukumar ◽  
J. Gori ◽  
A. Suman ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Mesorectal Excision ◽  
Laparoscopic Low Anterior Resection ◽  
Video Vignette

Extended Total Mesorectal Excision (e-TME) for Locally Advanced Rectal Cancer

2021 ◽  
Author(s):  
Narendra Pandit ◽  
Kunal Bikram Deo ◽  
Sujan Gautam ◽  
Tek Narayan Yadav ◽  
Awaj Kafle ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Mesorectal Excision

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 Impact of Body Mass Index on Surgical and Oncological Outcomes in Laparoscopic Total Mesorectal Excision for Locally Advanced Rectal Cancer after Neoadjuvant 5-Fluorouracil-Based Chemoradiotherapy

2017 ◽  
Vol 2017 ◽  
pp. 1-9
Author(s):  
Yanwu Sun ◽  
Pan Chi
Keyword(s):  
Body Mass Index ◽  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Resection Margin ◽  
Locally Advanced ◽  
Oncological Outcome ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Laparoscopic Total Mesorectal Excision ◽  
Mesorectal Excision

Aims.To evaluate the impact of body mass index (BMI) on the surgical outcome of laparoscopic total mesorectal excision (laTME) for locally advanced rectal cancer (LARC, clinically staged as UICC stage II/III) after neoadjuvant chemoradiotherapy (nCRT).Methods.312 LARC patients undergoing laTME after nCRT were divided into nonobese (BMI < 25.0 kg/m2,n=249) and obese (BMI ≥ 25.0 kg/m2,n=63) groups. Preoperative radiotherapy was delivered in 45–50.4 Gy/25f, 5 days/week, and concurrent chemotherapy using FOLFOX or CapeOX. Technical feasibility, postoperative and oncological outcome were compared between groups.Results.Obese patients had significantly longer operative time (P=0.004). There was no significant difference regarding estimated blood loss, conversion, postoperative recovery, and morbidities. Multivariate analysis demonstrated that higher ASA score and abdominoperineal resection were risk factors for postoperative complications and diverting stoma was a protective factor. The length of resection margin, circumferential resection margin involvement, and number of lymph node retrieved were comparable. With a median follow-up time of 55 months (ranging 20–102 months), oncological outcome was comparable in terms of overall survival, local recurrence, and distant metastasis.Conclusions.Obesity does not affect surgical or oncological outcome of laTME after nCRT. LaTME may be feasible and safe to obese LARC patients after nCRT in a specialized center.

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