scholarly journals Role of pelvic lymphadenectomy in rectal cancer

2019 ◽  
Vol 6 (6) ◽  
pp. 1838
Author(s):  
Ibrahim H. Aboelatta ◽  
Soliman A. El-Shakhs ◽  
Abd Elmieniem F. Mohammed ◽  
Mohammed H. Milegy
Keyword(s):  
Rectal Cancer ◽  
Lymph Nodes ◽  
Total Mesorectal Excision ◽  
Cancer Treatment ◽  
Pelvic Lymphadenectomy ◽  
Mesorectal Excision ◽  
Pelvic Lymph Nodes ◽  
Rectal Cancer Treatment ◽  
Lymph Nodes Dissection ◽  
Lateral Pelvic Lymph Nodes

Background: Rectal cancer constitutes about one third of all colorectal cancer cases. Total mesorectal excision has become the gold standard in rectal cancer treatment. However total mesorectal excision does not involve any approaches for lateral pelvic lymph nodes (LPLN), which may be asource of local recurrences. Tumor containing LPLN were reported to be found in about 10%-20% of the rectal cancer patients. In japan lateral pelvic lymph node metastasis is accepted to be curable with excision.Methods: This study included 20 patients presented to Menofia Hospital for elective colorectal re sections and LPLN dissection, in the period from July 2016 to January 2019.Results: This study on 13 male (65%), 7 female (35%), all patients included in the study underwent preoperative chemoradiation according to the technique described by Marks et al. with an overall administration of 45 cGy over 5 weeks. Dissection of 180 lymph nodes was retrieved (20%) lymph nodes pathologically were positive for malignancy.Conclusions: Lateral pelvic lymph nodes dissection is an important in rectal cancer treatment.

scholarly journals Evaluation of Total Mesorectal Excision With or Without Lateral Pelvic Lymph Nodes Dissection for Middle and Lower Rectal Cancer

2021 ◽  
pp. 17
Author(s):  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Total Mesorectal Excision ◽  
Operative Time ◽  
Lower Rectal Cancer ◽  
Mesorectal Excision ◽  
Pelvic Lymph Nodes ◽  
Lymph Nodes Dissection ◽  
Lateral Pelvic Lymph Nodes

Background: The most important prognostic factor in colorectal cancer is nodal status, and lymph node metastasis is a determining factor for adjuvant chemotherapy and subsequently key to predicting disease free and overall survival. Methods: A descriptive prospective study was conducted on 40 patients presenting with middle and low rectal cancer to the outpatient clinic of Menoufia University Hospitals. All patients in the study will require resection of their tumors by total mesorectal excision by open and laparoscopic techniques. Patients will be divided into 2 groups: Group A: was operated without lateral pelvic lymph nodes dissection. Group B: was operated with lateral pelvic lymph nodes dissection during the period between November 2018 and November 2020. Results: The main presentation of patients was bleeding per rectum 12 (30%), 12 (30%) patients have constipation. 28 patients with adenocarcinoma (70%) and 8 mucinous (20 %) and 4 (10%) with signet ring. Sixteen patients undergo Low ant resection (40%), 16 patients with AP. resection (40 %) and 8 patients with Intersphencteic resection (20%). Regarding intraoperative data, with a mean operative time was (90.00 ± 3.84 min.) for without Lateral pelvic L.N dissection and (122.91±4.89 min.) for with Lateral pelvic L.N dissection. Conclusion: Surgical mortality of LPLD is low, but there is an increase of morbidities in the form of prolonged operative time, intraoperative blood loss and genito-urinary malfunction. For avoiding the drawbacks of LPLD extended lymphadenectomies with sparing of the pelvic nerves is recommended. Lateral pelvic lymph node involvement is a regional disease that is curable. LPLD was effective to control recurrence at lateral nodes sites.

scholarly journals Laparoscopy-Assisted Transanal Total Mesorectal Excision

Folia Medica ◽  
2019 ◽  
Vol 61 (2) ◽  
pp. 180-187
Author(s):  
Dimitar K. Penchev ◽  
Plamen G. Ivanov ◽  
Ventzislav M. Mutafchiyski
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Cancer Treatment ◽  
Surgical Approach ◽  
Postoperative Mortality ◽  
Endocrine Surgery ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Rectal Cancer Treatment ◽  
Laparoscopic Assistance

Abstract Background: Rectal cancer located in distal third still remains a technical challenge for surgeons. Transanal total mesorectal excision with laparoscopic assistance is quite new surgical approach for rectal cancer treatment that seems to solve some of the associated technical issues. The aim of the study was to present our experience in laparoscopy-assisted transanal total mesorectal excision. Materials and methods: After obtaining approval from the local Ethics Committee, a single centre prospective double-arm comparative non-randomized trial was initiated. With recruiting still in progress at present, between 27.02.2017 and 01.10.2017 four laparoscopy-assisted transanal total mesorectal excision procedures and two laparoscopic total mesorectal excisions were performed in the department of Endoscopic Endocrine Surgery and Coloproctolgy at the Military Medical Academy in Sofia. Results: There is no conversion in both groups. No postoperative mortality 30 days after surgery. The quality of total mesorectal excision was satisfactory in all patients estimated by the Quirque classification. There was no distal or proximal tumor involvement of surgical margins. In one of the cases, we reported positive circumferential resection margin. We had two cases with postoperative morbidity. Conclusion: Transanal total mesorectal excision with laparoscopic assistance is quite new minimally invasive surgical approach for rectal cancer treatment. Avoiding the procedure-related complications during the learning curve is essential before applying the method to every patient. Multicenter randomized control trial is needed so that we could answer the questions raised in this study.

scholarly journals Transanal Total Mesorectal Excision (TaTME): Experience in Klaipėda University Hospital

2019 ◽  
Vol 18 (4) ◽  
pp. 235-238
Author(s):  
Vita Klimašauskienė ◽  
Narimantas Evaldas Samalavičius
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Cancer Treatment ◽  
Dentate Line ◽  
University Hospital ◽  
Lithotomy Position ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Rectal Cancer Treatment ◽  
Laparoscopic Tme

Introduction. Colorectal cancer ranks third on the list of the most common cancers. In 1979 R. J. Heald described total mesorectam excision (TME) which became a gold standard for rectal cancer treatment. This operation is performed all over the world open, laparoscopic and robotic. Operating on low and very low rectal cancer, distal bowel mobilisation if often the most difficult part of the operation. Aa a solution to this problem transanal abdominotransanal rectal resection (TATA) and transanal total mesorectal excision (TaTME) were proposed. This article reviews the experience and short-term postoperative outcomes of TaTME performed in Klaipėda University Hospital.Methods. The first stage of surgery was performed with patient placed in the prone jackknife (Kraske) position. Using electrocauthery circular mobilisation of the rectum was performed starting at least 1 cm from the lower edge of the tumour. Up to 10 cm of the rectum was mobilised from below. The second stage was performed with patient in lithotomy position. Laparoscopic TME was performed. For 11 (78.57%) patients hand sown anastomosis was performed and for 1 (7.17%) patient stapler was used. 2 (14.28%) patients underwent the Hartmann’s procedure.Results. In period 2018.03–2019.10 TaTME was performed for 14 patients. The medium tumour high counting from dentate line was 2.54 (±1.28). 13 out of 14 patients were operated from 8 to 12 weeks after chemoradiotherapy. All (100%) rectal resections were radical (R0). On average 11.43 (±3.78) lymphnodes were harvested. 5 (35.71%) patients had complications after surgery.Conclusions. TaTME performed at Klaipėda University Hospital is effective operation for rectal cancer treatment.

Rectal cancer treatment by transanal total mesorectal excision: Results in 100 consecutive patients

2019 ◽  
Vol 97 (9) ◽  
pp. 510-516
Author(s):  
Vicente Simó ◽  
Jorge Arredondo ◽  
Cristina Hernán ◽  
Luís Miguel Jiménez ◽  
Benedetto Ielpo ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Cancer Treatment ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Rectal Cancer Treatment
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