scholarly journals Analysis of risk factors for presacral abscess after radical resection of middle and low rectal cancer.

2021 ◽  
Author(s):  
Ang Li ◽  
Jun Shi ◽  
Binqiao Shi ◽  
Xiaohui Shi
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Blood Loss ◽  
Tumor Size ◽  
Operative Time ◽  
Preoperative Radiotherapy ◽  
Radical Resection ◽  
Low Rectal Cancer ◽  
Chi Square ◽  
Presacral Abscess

Abstract Background and ObjectivesTo investigate the risk factors of presacral abscess after radical resection of middle and low rectal cancer. MethodsClinical data of 2279 patients with middle and low rectal cancer in the department of Colorectal Surgery at the Changhai Hospital of the Second Military Medical University from January 2015 to December 2018 were analyzed retrospectively. Univariate and multivariate analyses were performed to find the risk factors of presacral abscess using Chi-square test and Logistic regression, respectively. ResultsThe median age of all cases was 62 years. Of the 27 cases with presacral abscess, 22 were males and 5 were females. 12 cases were low rectal cancer and 15 cases were middle rectal cancer. Univariate Chi-square test indicated that the relative factors associated with the presacral abscess were tumor size, operative time, blood loss, T stage lesions, receiving preoperative radiotherapy and with preventive terminal ileostomy. Multivariate analysis showed that tumor size, operative time, blood loss, receiving preoperative radiotherapy and with preventive terminal ileostomy were the independent risk factors. ConclusionsPatients with big tumor size, long operative time, high blood loss and preoperative radiotherapy are high-risk groups of presacral abscess after radical resection of middle and low rectal cancer.

scholarly journals The risk factors of local recurrence and distant metastasis on pT1/T2N0 mid-low rectal cancer after total mesorectal excision

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
I-Li Lai ◽  
Jeng-Fu You ◽  
Yih-Jong Chern ◽  
Wen-Sy Tsai ◽  
Jy-Ming Chiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Local Recurrence ◽  
Distant Metastasis ◽  
Resection Margin ◽  
Radical Resection ◽  
Hazard Ratio ◽  
Low Rectal Cancer ◽  
Distal Resection Margin ◽  
Lymph Node Yield

Abstract Background Radical resection is associated with good prognosis among patients with cT1/T2Nx rectal cancer. However, still some of the patients experienced cancer recurrence following radical resection. This study tried to identify the postoperative risk factors of local recurrence and distant metastasis separately. Methods This retrospective, single-center study comprised of 279 consecutive patients from Linkou branch of Chang Gung Memorial Hospital in 2005–2016 with rectal adenocarcinoma, pT1/T2N0M0 at distance from anal verge ≤ 8cm, who received curative radical resection. Results The study included 279 patients with pT1/pT2N0 mid-low rectal cancer with median follow-up of 73.5 months. Nineteen (6.8%) patients had disease recurrence in total. Nine (3.2%) of them had local recurrence, and fourteen (5.0%) of them had distant metastasis. Distal resection margin < 0.9 (cm) (hazard ratio = 4.9, p = 0.050) was the risk factor of local recurrence. Preoperative carcinoembryonic antigen (CEA) ≥ 5 ng/mL (hazard ratio = 9.3, p = 0.0003), lymph node yield (LNY) < 14 (hazard ratio = 5.0, p = 0.006), and distal resection margin < 1.4cm (hazard ratio = 4.0, p = 0.035) were the risk factors of distant metastasis. Conclusion For patients with pT1/pT2N0 mid-low rectal cancer, current multidisciplinary treatment brings acceptable survival outcome. Insufficient distal resection margin attracted the awareness of risk factors for local recurrence and distant metastasis as a foundation for future research.

scholarly journals Impact of the preoperative prognostic nutritional index as a predictor for postoperative complications after resection of locally recurrent rectal cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masakatsu Paku ◽  
Mamoru Uemura ◽  
Masatoshi Kitakaze ◽  
Shiki Fujino ◽  
Takayuki Ogino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Receiver Operating Characteristic ◽  
Odds Ratio ◽  
Inflammatory Markers ◽  
Operating Characteristic ◽  
Recurrent Rectal Cancer ◽  
Prognostic Nutrition Index

Abstract Background Local recurrence is common after curative resections for rectal cancer. Surgical intervention is among the best treatment choices. However, achieving a negative resection margin often requires extensive pelvic organ resections; thus, the postoperative complication rate is quite high. Recent studies have reported that the inflammatory index could predict postoperative complications. This study aimed to validate the correlation between clinical factors, including inflammatory markers, and severe complications after surgery for local recurrent rectal cancer. Methods This retrospective study included 99 patients that underwent radical resections for local recurrences of rectal cancer. Postoperative complications were graded according to the Clavien-Dindo classification. Grades ≥3 were defined as severe complications. Risk factors for severe complications were identified with univariate and multivariate logistic regression models and assessed with receiver-operating characteristic curves. Results Severe postoperative complications occurred in 38 patients (38.4%). Analyses of correlations between inflammatory markers and severe postoperative complications revealed that the strongest correlation was found between the prognostic nutrition index and severe postoperative complications. The receiver-operating characteristic analysis showed that the optimal prognostic nutrition index cut-off value was 42.2 (sensitivity: 0.790, specificity: 0.508). In univariate and multivariate analyses, a prognostic nutrition index ≤44.2 (Odds ratio: 3.007, 95%CI:1.171–8.255, p = 0.02) and a blood loss ≥2850 mL (Odds ratio: 2.545, 95%CI: 1.044–6.367, p = 0.04) were associated with a significantly higher incidence of severe postoperative complications. Conclusions We found that a low preoperative prognostic nutrition index and excessive intraoperative blood loss were risk factors for severe complications after surgery for local recurrent rectal cancer.

Neoadjuvant Radiotherapy Versus Surgery Alone for Stage II/III Mid-low Rectal Cancer With or Without High-risk Factors

2019 ◽  
Vol 272 (6) ◽  
pp. 1060-1069 ◽  
Author(s):  
Xiangbing Deng ◽  
Ping Liu ◽  
Dan Jiang ◽  
Mingtian Wei ◽  
Xin Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
High Risk ◽  
Low Rectal Cancer ◽  
Stage Ii ◽  
Neoadjuvant Radiotherapy ◽  
High Risk Factors

The effect of increased body mass index values on surgical outcomes after radical resection for low rectal cancer

Surgery Today ◽  
2019 ◽  
Vol 49 (5) ◽  
pp. 401-409 ◽  
Author(s):  
Xubing Zhang ◽  
Qingbin Wu ◽  
Chaoyang Gu ◽  
Tao Hu ◽  
Liang Bi ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Rectal Cancer ◽  
Body Mass ◽  
Surgical Outcomes ◽  
Radical Resection ◽  
Low Rectal Cancer

scholarly journals No Downstaging After Short-Term Preoperative Radiotherapy in Rectal Cancer Patients

2001 ◽  
Vol 19 (7) ◽  
pp. 1976-1984 ◽  
Author(s):  
C.A.M. Marijnen ◽  
I.D. Nagtegaal ◽  
E. Klein Kranenbarg ◽  
J. Hermans ◽  
C.J.H. van de Velde ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Tumor Size ◽  
Preoperative Radiotherapy ◽  
Multicenter Trial ◽  
Short Term ◽  
Size Number ◽  
Tumor Node Metastasis Stage ◽  
Poorly Differentiated

PURPOSE: In retrospective studies, total mesorectal excision (TME) surgery has been demonstrated to result in a reduction in the number of local recurrences of rectal cancer. Reports on improved local control after preoperative, hypofractionated radiotherapy have led to the introduction of a randomized multicenter trial to evaluate the effect of TME surgery with and without preoperative radiotherapy. Treatment with preoperative radiotherapy might have an effect on the pathologic characteristics that determine staging of rectal cancer. We investigated the occurrence of downstaging in rectal cancer patients treated with and without preoperative radiotherapy. PATIENTS AND METHODS: We analyzed the differences in tumor size, number of examined lymph nodes, tumor-node-metastasis stage, and histopathologic features in 1,321 patients entered onto a randomized trial. The trial compared preoperative radiotherapy (5 × 5 Gy) followed by TME surgery with TME surgery alone. Patients who had an interval of more than 10 days between the start of radiotherapy and surgery were excluded from analysis. RESULTS: Differences were observed in tumor size (P < .001) and total number of examined lymph nodes (P < .001). No difference in tumor or node classification was detected. The irradiated group demonstrated more poorly differentiated tumors as well as more mucinous tumors. CONCLUSION: In rectal cancer patients, short-term, preoperative radiotherapy with 5 × 5 Gy does not lead to downstaging if the interval between the start of radiotherapy and surgery does not exceed 10 days.

scholarly journals Application of Laparoscopic Radical Resection for Type III and IV Hilar Cholangiocarcinoma Treatment

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Sulai Liu ◽  
Xinyu Liu ◽  
Xuepeng Li ◽  
Ou Li ◽  
Weimin Yi ◽  
...  
Keyword(s):  
Bile Duct ◽  
Blood Loss ◽  
Tumor Size ◽  
Hilar Cholangiocarcinoma ◽  
Preoperative Evaluation ◽  
Operation Time ◽  
Bile Leakage ◽  
Radical Resection ◽  
Operative Strategy ◽  
Type Iii

Background. This study is aimed at investigating the feasibility and safety of the laparoscopic radical resection for treating type III and IV hilar cholangiocarcinoma (III/IV Hilar C). Methods. Six patients with III/IV Hilar C were enrolled in our hospital. All patients underwent total laparoscopic surgery, including basic surgery (laparoscopic gallbladder, hilar bile duct, and common bile duct resection and hepatoduodenal ligament lymph node dissection) combined with left hepatic and caudate lobe resection/portal resection. The tumor size, operation time, intraoperative blood loss, and postoperative complications were observed. The follow-up of the patients after discharge was recorded. Results. Surgery was successfully completed in 6 patients. We found that the tumor size of 6 patients ranged from 1.5 to 3.6 cm, with 4 lymph nodes. The operation time was 540-660 minutes, and the blood loss was 300-500 ml. One patient developed bile leakage after surgery, healed within 2 weeks after drainage. The postoperative hospital stay was 16 (13-24) days. There were 4 cases of negative bile duct margin tumor, 1 case was positive, and 1 case was not reported. All 6 patients were discharged smoothly without perioperative death. Regular examinations were conducted every 3 months after discharge, and the median duration was 7 months. Only 1 patient had a marginal dysplasia, and 5 patients had no obvious signs of recurrence. Conclusions. Application of laparoscopic radical resection for III/IV Hilar C is safe and feasible and has good short-term efficacy with adequate preoperative evaluation, appropriate case selection, and precise operative strategy.

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