scholarly journals Success of teamwork: diagnosis and personalized treatment of advanced rectal carcinoma - case presentation

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fülöp Zsolt Zoltán ◽  
Bara Tivadar ◽  
Sárdi Kálmán ◽  
Simu Patricia ◽  
Drágus Emőke ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Seminal Vesicle ◽  
Multidisciplinary Treatment ◽  
Advanced Rectal Cancer ◽  
Metastatic Lesion ◽  
Sigmoid Resection ◽  
Middle Level ◽  
Adequate Treatment ◽  
Bowel Movements ◽  
The Right

AbstractBackground: Finding the appropriate treatment for advanced rectal cancer patients represents a challenge for surgeons. Determining the right diagnosis and the proper treatment requires multidisciplinary collaboration. Our aim is to present a case with advanced stage rectum cancer, who received successful multidisciplinary treatment.Material and method: A prospective multidisciplinary research is being conducted at our Department from 2018 within which patients with malignant rectal cancer are examined. Patients’ treatment is realized by the same multidisciplinary team. The patient’s preoperative investigations included MRI and a lymph node map designated by radiologists.Results: In case of a 60-year-old patient the preoperative MRI showed a stenotic formation in the middle level of the rectum that penetrated the seminal vesicle. During surgery, we found a 10x10 cm stenotic, perforated rectal cancer, which penetrated the bladder, seminal vesicle, prostate and sacrum, respectively a metastatic lesion in the livers 8th segment. During surgery R2 recto-sigmoid resection was performed with colostomy. The patient was mobilized on the first postoperative day and bowel movements were regained on the second day. The patient left the hospital on the eighth postoperative day.Conclusions: Adequate treatment of patients with advanced rectal cancer can be achieved only through multidisciplinary co-operation. Preoperative radiological examinations are mandatory. A map representing the positive colorectal lymph nodes, implemented by the radiologists, can significantly help the surgeons and pathologists.

Single-Incision Plus One Port Laparoscopic Total Pelvic Exenteration After Neoadjuvant Chemotherapy for Advanced Primary Rectal Cancer: A Case Report

2015 ◽  
Vol 100 (9-10) ◽  
pp. 1265-1270 ◽  
Author(s):  
Masayoshi Tokuoka ◽  
Yoshihito Ide ◽  
Hiroyuki Yamato ◽  
Mamoru Uemura ◽  
Yasuji Hashimoto ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Pelvic Exenteration ◽  
Single Incision ◽  
Advanced Rectal Cancer ◽  
Single Incision Laparoscopic Surgery ◽  
Moderate Degree ◽  
Total Pelvic Exenteration ◽  
Promising Alternative ◽  
The Right

Limited data on laparoscopic and robotic total pelvic exenteration (TPE) for gynecologic, urologic, and rectal malignancies have been published in the literature. Single-incision laparoscopic surgery (SILS) has been successfully introduced for colon cancer. Here, we describe our experience of TPE with SILS + 1 port (SILS+1) for advanced rectal cancer. A 64-year-old man was referred to our hospital with anemia. Computed tomography (CT) revealed a rectal tumor that was contiguous with the seminal vesicle and bladder. Rectoscopy revealed an ulcerated, bleeding, and stricturing lesion in the rectum, which was defined as an adenocarcinoma with a moderate degree of differentiation on histologic examination. The patient received neoadjuvant chemotherapy using capecitabine, oxaliplatin, and bevacizumab. After 3 courses of chemotherapy, a rectovesical fistula was suspected from examination of CT images. CT demonstrated intramural gas in the urinary bladder, which suggested a diagnosis of emphysematous cystitis. Thus, we constructed a transverse loop colostomy. Two months after the last administration of chemotherapy, we performed SILS+1 TPE. The procedure involved a 35-mm incision in the right side of the umbilicus for the insertion of a single multichannel port, and insertion of a 12-mm port into the right lower quadrant. Total operating time was 751 minutes, and estimated blood loss was 1100 mL (including urine). SILS+1 TPE is a technically promising alternative method for the treatment of selected patients with advanced rectal cancer.

scholarly journals Long-term results of laparoscopic treatment for advanced rectal cancer

2008 ◽  
Vol 55 (3) ◽  
pp. 31-37
Author(s):  
G. Pignata ◽  
M. Barone ◽  
M. Stefanoni ◽  
U. Bracale
Keyword(s):  
Rectal Cancer ◽  
Multidisciplinary Treatment ◽  
Stage Iv ◽  
Advanced Rectal Cancer ◽  
Minimal Invasive ◽  
Long Term Results ◽  
Invasive Treatment ◽  
Malignant Obstruction ◽  
Oncological Treatment

Backgraound. The management of advanced rectal cancer has changed into a multidisciplinary treatment model. Only limited randomized data are available for patients with rectal cancer treated laparoscopically. Aim. We report a multimodal treatment of advanced rectal cancer: preoperative oncological treatment, use of endoscopic stent (for malignant obstruction), minimal invasive treatment. Methods. The Authors reported a series of 45 laparoscopic rectal resections for adenocarcinoma, some of them with malignant obstruction. Long term oncological results were reviewed. Results. The 30-day mortality was 2.2%. Of 45 adenocarcinoma, 4 cases were obstructed. Successful stent positioning was obtained in all patients and treated with radiochemiotherapy before laparoscopic resection. The 5-year global survival rate (including stage IV) was 62.2%; for stage II was 77.9% and 53.8% for stage III. Conclusion. This study indicates that laparoscopy for advanced rectal cancer have good long-term results. In high and middle rectal malignant obstructions, we considered the use of stents to be useful.

scholarly journals Rectal Cancer: Asynchronous Metastasis to the Temporal Bone, Temporomandibular Joint and Middle Ear

2020 ◽  
pp. 1-3
Author(s):  
Ali Mahmood ◽  
Aiva Mahmood ◽  
Ali Mahmood ◽  
Nasrullah Manji
Keyword(s):  
Rectal Cancer ◽  
Radiation Therapy ◽  
Diagnostic Imaging ◽  
Temporomandibular Joint ◽  
Temporal Bone ◽  
Middle Ear ◽  
Metastatic Disease ◽  
Advanced Rectal Cancer ◽  
Distant Metastatic Disease ◽  
The Right

Rectal cancer has the potential to metastasize to multiple anatomical sites. The hallmark of treatment presides with sound oncologic surgery, adjunct with chemotherapy and radiation therapy when indicated. The initial presentation determines the management regimen, consisting of physical examination and diagnostic imaging. A 54-year-old female presented with locally advanced rectal cancer. Upon conclusion of neoadjuvant chemotherapy and radiation therapy, she underwent a low anterior resection with total mesorectal excision. Her surgical margins were negative; however, of the 21 lymph nodes retrieved, 11 were positive for cancer. The patient underwent further adjuvant chemotherapy. 2 years, 8 months later, the patient presented to the emergency department with worsening swelling of the right side of the face, with increasing pain, hearing, and visual impairments. Diagnostic imaging revealed a large lesion in the cranial anatomy, invading the temporal bone, temporomandibular joint, sphenoid bone and anterior superior epitympanum of the right middle ear. The patient underwent operative intervention followed by radiation and chemotherapy. Asynchronous metastasis of rectal cancer to the cranium is a rare finding and an invasion into the temporal bone even more scarcely reported. The prognosis for distant metastatic disease is poor because it involves metastatic spread via the lymph channels or vascular system. Patients that have undergone treatment for advanced rectal cancer must be approached with a high index of suspicion for distant metastatic disease, even in the advent of routine negative surveillance

Multidisciplinary treatment of locally advanced rectal cancer: a literature review. Part 1

2009 ◽  
Vol 10 (14) ◽  
pp. 2245-2258 ◽  
Author(s):  
Rossana Berardi ◽  
Elena Maccaroni ◽  
Azzurra Onofri ◽  
Riccardo Giampieri ◽  
Alessandro Bittoni ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Literature Review ◽  
Multidisciplinary Treatment ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer

scholarly journals From mininvasive to maxinvasive surgery in colorectal cancer: Modern evolution of oncologic specialized units

2010 ◽  
Vol 57 (3) ◽  
pp. 73-75 ◽  
Author(s):  
G. Romano ◽  
F. Bianco ◽  
P. Delrio ◽  
F. Cremona ◽  
F. Ruffolo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Surgical Margin ◽  
Length Of Hospital Stay ◽  
Advanced Rectal Cancer ◽  
R0 Resection ◽  
En Bloc ◽  
Pelvic Cancer ◽  
Wide Range ◽  
The Right

In the last years a wide range of new technique offers the possibility to have R0 resection in colorectal cancer. We report our experience about Single Port Laparoscopic Surgery (SPL) for not advanced right colon cancer and about pelvectomy with cilindric Abdominal Perineal Resection (APR) for advanced rectal cancer. SPL offer mainly cosmetic advantages but also quicker recovery. No touch technique with adequate surgical margin and lymphectomy were respected. Operative time of SPL was 85- 115 minutes, the incision was 5 cm long. There were no complications. Length of hospital stay was 4-6 days. With advanced pelvic cancer, pelvic exenteration with en-bloc resection is indicated. Then we propose a case of a 55 years old woman with a pelvic recurrence from a metastatic rectal cancer involving the right obturator fossa, the vaginal stump, the right ureter. Modern surgical technique give us the chance to offer the most appropriate oncologic surgical treatment.

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