scholarly journals Pelvic Anatomy for Distal Rectal Cancer Surgery

2021 ◽  
Author(s):  
Sanghyun An ◽  
Ik Yong Kim
Keyword(s):  
Rectal Cancer ◽  
Pelvic Floor ◽  
Surgical Techniques ◽  
Oncologic Outcome ◽  
Autonomic Nerve ◽  
Rectal Cancer Surgery ◽  
Pelvic Anatomy ◽  
Distal Rectal Cancer ◽  
Minimally Invasive Surgical ◽  
Pelvic Fascia

Worldwide, colorectal cancer is the third most common cancer and one of the leading causes of cancer-related deaths. Currently, total mesorectal excision (TME) is considered as the gold standard surgical procedure for rectal cancer. To achieve a good oncologic outcome and functional outcome after TME in distal rectal cancer, exact knowledge regarding the pelvic anatomy including pelvic fascia, pelvic floor, and the autonomic nerve is essential. Accurate TME along the embryologic plane not only reduces local recurrence rate but also preserves urinary and sexual function by minimizing nerve damage. In the past, pelvic floor muscles and autonomic nerves could not be visualized clearly, however, the development of imaging studies and improvements of minimally invasive surgical techniques such as laparoscopic and robotic surgery can clearly show the anatomy of the pelvic region. In this chapter, we will provide accurate anatomy of the rectum and the anal canal, pelvic fascia, and the pelvic autonomic nerve. This anatomical information will be an important indicator for performing an adequate operation for distal rectal cancer.

Incidence of minimally invasive colorectal cancer (CRC) surgery in patients treated at NCCN institutions

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6575-6575
Author(s):  
M. Weiser ◽  
D. Romanus ◽  
A. terVeer ◽  
A. Rajput ◽  
J. Skibber ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Minimally Invasive ◽  
Open Surgery ◽  
Early Stage ◽  
Oncologic Outcome ◽  
Stage I ◽  
Invasive Approach ◽  
Conversion To Open Surgery ◽  
The North ◽  
Minimally Invasive Surgical

6575 Background: In May 2004 the Clinical Outcomes of Surgical Therapy Study Group published the results of the North American randomized trial demonstrating that oncologic outcome is similar for laparoscopic assisted and open surgery for CRC. This and other studies have shown quicker recovery with laparoscopic CRC surgery including earlier resolution of postoperative ileus, less discomfort, and earlier discharge from the hospital. The extent to which surgeons have adopted the minimally invasive surgical (MIS) approach in CRC is unknown. Methods: Using the NCCN Colon/Rectal Cancer Outcomes Project Database, 715 patients were identified who underwent CRC resection in 2005–6. The distribution of lesions included right colon (39%), left colon (31%), and rectum (30%). The incidence of MIS for CRC and clinicopathologic features associated with this approach were analyzed by logistic regression; results are reported as odd ratio (OR) with 95% confidence intervals (CI), and significance defined at p<0.05 level. Results: A total of 167 (23%) patients underwent MIS colorectal surgery (laparoscopy in 98% and robotic in 2%). Conversion to open surgery was noted in 33 cases (20%). Surgery was performed in outside institutions in 21% of cases prior to patients presenting to NCCN institutions for further treatment. The MIS approach was more common in colon than rectal cancer (30% vs.12%, OR 2.96, CI 1.94–4.51, p<0.0001). Within the colon cancer cohort, right sided lesions were more likely to be approached with MIS techniques rather than left sided lesions (32% vs. 25%; OR 1.42, CI 1.96–2.21, p<0.0001). Stage I tumors were also more likely to be managed with the less invasive approach: Stage I-41%; II-20%; III-21%; IV-19% (Stage I vs. IV, OR=3.00, CI 1.74–5.16 p<0.0001). No differences in surgical approach were noted based on age, gender, race, Charlson comorbidity score, insurance type, or location of surgery (NCCN vs outside facility). Conclusion: The majority of CRC surgery for patients presenting to NCCN institutions is performed by open techniques. Right sided and early stage CRCs were more likely treated with MIS, possibly related to the less demanding nature of the procedure. The adoption of MIS is expected to rise as surgeons become trained in MIS techniques for CRC. No significant financial relationships to disclose.

Rationale of pelvic autonomic nerve preservation in rectal cancer surgery based on immunohistochemical study

2010 ◽  
Vol 15 (5) ◽  
pp. 462-467
Author(s):  
Tadahiko Masaki ◽  
Yasuo Ohkura ◽  
Hiroyoshi Matsuoka ◽  
Takaaki Kobayashi ◽  
Shozo Miyano ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Immunohistochemical Study ◽  
Cancer Surgery ◽  
Autonomic Nerve ◽  
Rectal Cancer Surgery ◽  
Nerve Preservation ◽  
Pelvic Autonomic Nerve Preservation ◽  
Pelvic Autonomic Nerve ◽  
Autonomic Nerve Preservation

Autonomic nerve damage in rectal cancer surgery

2001 ◽  
Vol 27 (2) ◽  
pp. 124
Author(s):  
B. Moran
Keyword(s):  
Rectal Cancer ◽  
Nerve Damage ◽  
Cancer Surgery ◽  
Autonomic Nerve ◽  
Rectal Cancer Surgery

The risk factors for urinary dysfunction after autonomic nerve-preserving rectal cancer surgery: a multicenter retrospective study at Yokohama Clinical Oncology Group (YCOG1307)

2019 ◽  
Vol 34 (10) ◽  
pp. 1697-1703 ◽  
Author(s):  
Kenichiro Toritani ◽  
Jun Watanabe ◽  
Yusuke Suwa ◽  
Shinsuke Suzuki ◽  
Kazuya Nakagawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Retrospective Study ◽  
Clinical Oncology ◽  
Cancer Surgery ◽  
Urinary Dysfunction ◽  
Autonomic Nerve ◽  
Rectal Cancer Surgery ◽  
Oncology Group

scholarly journals An Old Method Turnbull Cutait; Using for Middle and Distal Rectal Cancer Surgery without Ileostomy. Oncological and Fuctional Late Outcomes

2020 ◽  
Vol 30 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Osman Serhat Güner ◽  
Latif Volkan Tümay ◽  
Barış Gülcü ◽  
Abdullah Zorluoğlu
Keyword(s):  
Rectal Cancer ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Distal Rectal Cancer

scholarly journals Autonomic nerve preservation in rectal cancer surgery - the forgotten part of the TME message a practical "workshop" description for surgeons

2008 ◽  
Vol 55 (3) ◽  
pp. 11-16 ◽  
Author(s):  
B. Heald
Keyword(s):  
Rectal Cancer ◽  
Cancer Surgery ◽  
Autonomic Nerve ◽  
Rectal Cancer Surgery ◽  
Autonomic Nerves ◽  
Nerve Preservation ◽  
Lateral Ligaments ◽  
Original Hypothesis ◽  
Autonomic Nerve Preservation ◽  
Cancer Spread

Conceptually TME has its basis in embryology. The original hypothesis was that cancer spread will tend, initially at least, to remain within the embryologic lymphovascular hindgut "envelope" the mesorectum and mesocolon. The corollary to the perfect specimen and cure is the perfect preservation of the layers surrounding the mesorectum which, are formed by the autonomic nerves and plexuses. The first obstacle is that few realistic photographs, sketches or diagrams have been published and visualisation and lighting low down in the pelvis is always problematic. Even when they are understood and visualised the difficulties inherent in preserving these nerves are due to the fact that they are actually adherent to the mesorectum at certain points where the dissection becomes particularly challenging. The most important and most adherent areas are the so-called "lateral ligaments" - low down laterally and anterolaterally where the inferior hypogastric plexuses (virtually the pelvic sex-brain) tether the whole mesorectal package. When the specimen has been carefully released it lifts up in a somewhat spectacular fashion - hence the old idea that there are ligaments at these points. A lesser degree of adherence may be found at various other points and particular care is required anteriorly where the nerves are converging towards the bulb of the penis with a trapezoidal septum between them - Denonvillier?s "fascia"- which is in turn adherent to the anterior mesorectum and lower down in the prostate.

scholarly journals The importance of training and education in performing total mesorectal excision in rectal cancer surgery

2017 ◽  
Vol 74 (4) ◽  
pp. 349-353
Author(s):  
Tomislav Petrovic ◽  
Ferenc Vicko ◽  
Dragana Radovanovic ◽  
Nemanja Petrovic ◽  
Milan Ranisavljevic ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Surgical Treatment ◽  
Local Recurrence ◽  
Anastomotic Leakage ◽  
New Technologies ◽  
Surgical Techniques ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Significant Difference ◽  
Duration Of Surgery

Background/Aim. In the last two decades there has been a significant progress in rectal cancer surgery. Preoperative radiotherapy, the introduction of staplers and largely improved surgical techniques have greatly contributed to better treatment outcomes, primarily by reducing the frequency of early surgical complications and the rate of local recurrence. The aim of this study was to compare operative and postoperative results in the treatment of rectal cancer between the two groups of surgeons ? those who are closely engaged in colorectal surgery and those who deal with these issues sporadically. Methods. This retrospective study included 146 patients who had underwent rectal cancer surgery at the Institute of Oncology of Vojvodina in the period from January 1, 2008 to December 31, 2010. The patients were divided into two groups, the group N1 of 101 patients operated on by trained colorectal surgeons, and the group N2 of 45 patients operated on by surgeons without training in totalmesorectal excision (TME). Results. Preoperative chemoradiotherapy was received by 49 (33.56%) of the patients. A statistically significant difference between the two groups was noted in the duration of surgery and the need for blood transfusion during surgery. Anastomotic leakage occurred in 3 patients from the group N1 and in 10 patients from the group N2. Seven (4.79%) of the patients developed local recurrence after surgical treatment. There were significant differences in local recurrence rate and anastomotic leakage rate between the compared groups. Conclusion. It is necessary to continue education and training in surgery for rectal cancer to master new technologies and surgical techniques and to improve the results of surgical treatment.

Surgical Treatment for Colorectal Cancer

2011 ◽  
Vol 96 (2) ◽  
pp. 120-126 ◽  
Author(s):  
Art Hiranyakas ◽  
Yik-Hong Ho
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Surgical Treatment ◽  
Surgical Techniques ◽  
Cancer Surgery ◽  
Oncologic Outcomes ◽  
Rectal Cancer Surgery ◽  
Short Term ◽  
Colon And Rectal Cancer ◽  
Laparoscopic Colon

Abstract The rapid in development of surgical technology has had a major effect in surgical treatment of colorectal cancer. Laparoscopic colon cancer surgery has been proven to provide better short-term clinical and oncologic outcomes. However this quickly accepted surgical approach is still performed by a minority of colorectal surgeons. The more technically challenging procedure of laparoscopic rectal cancer surgery is also on its way to demonstrating perhaps similar short-term benefits. This article reviews current evidences of both short-term and long-term outcomes of laparoscopic colorectal cancer surgery, including the overall costs comparison between laparoscopic surgery and conventional open surgery. In addition, different surgical techniques for laparoscopic colon and rectal cancer are compared. Also the relevant future challenge of colorectal cancer robotic surgery is reviewed.

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