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At least 19 recordsLinked to original sources
PubMed2004

Early outcomes of 100 patients with laparoscopic resection for rectal neoplasm.

BACKGROUND: Laparoscopic resection has been shown to be a feasible option in patients with colorectal diseases. However, there have been only a few studies on laparoscopic resection for rectal neoplasm. This report aimed to evaluate the early outcomes of patients treated by laparoscopic rectal resection for neoplasm. METHODS: From May 2000 to April 2003, 100 patients underwent laparoscopic resection for rectal neoplasm with mesorectal excision. Data on the patients' demographics, operative details, and outcomes were collected prospectively. In those with successful laparoscopic resection, comparison was made between patients with predominantly intracorporeal surgery (ICS) and those with anterior resection performed with extracorporeal rectal transection and anastomosis following intracorporeal bowel mobilization and vessel ligation (IECS). RESULTS: Sixty-six men and 34 women (median age, 69 years; range, 40-85) were included. Operations included 91 anterior resections, eight abdominoperineal resections, and one Hartmann's procedure. Conversion was required in 15 patients and no conversion was needed in patients treated by laparoscopic abdominoperineal resection. One patient died 30 days after surgery because of liver failure. Postoperative complications occurred in 31 patients. Among them, three had anastomotic leakage and all of them could be treated conservatively. Reoperation was required in one patient with intestinal obstruction. Patients with conversion were found to have significantly more blood loss, longer time to resume diet, a longer hospital stay, and a higher morbidity rate when compared to those with successful laparoscopic surgery. Among those with successful laparoscopic procedures, no difference was observed between patients with ICS (n = 57) and those with IECS (n = 28), except that a shorter incision and less blood loss were found in patients in the former group. CONCLUSIONS: Laparoscopic rectal resection with mesorectal dissection is feasible. The operating mortality and reoperation rates were low. Conversion was associated with an increased morbidity rate, leading to a longer hospital stay. Laparoscopically assisted anterior resection with rectal transection by a transverse stapler through the abdominal incision produced similar results when compared to a procedure that was predominantly intracorporeally performed.

Adult↗
PubMedDate not supplied

Quality assurance procedures in radiotherapy of rectal neoplasms.

Major uncertainties which impact on pre- or postoperative radiotherapy of rectal neoplasms and operational measures taken to lower the risks in prescription, planning, delivery and follow-up of radiotherapy, are examined. In prescription, major problems related with the selection of treatment dose and volumes, are considered. In planning, irradiation techniques and systems for intestinal loop displacement from treatment site, are analyzed. In dose delivery, methods used to ensure treatment reproducibility and support care, are examined. Finally, in follow-up procedures used in the evaluation of disease progress, late side-effects, and life quality, are discussed.

Humans↗
PubMed1991

Mass screening for rectal neoplasm in Jiashan County, China.

Jiashan county is a rural area in China with very high incidence and mortality rates of colorectal cancer. From 1980 to 1984, we conducted a mass screening for rectal neoplasm in the 11 people's communes in this county. Of the 72,879 individuals who were eligible for screening, 60,496 participated, representing an overall participation rate of 83.0%. Both the fecal occult blood (OB) test and rectoscopy were performed on 47,560 of the participants, and rectoscopy only was performed on the remaining 12,936 individuals. From the mass screening, 15 rectal cancers, 3 carcinoids, 899 polyps, 98 ulcers, and 7 inflammatory tumors were detected, a total of 1022 cases. Eight of the 15 detected cases of rectal cancer were in Dukes' stage A. We did not find any evidence for an association between schistosomiasis and colorectal cancer. Results from the OB test were found to have a negative correlation with results from rectoscopy (odds ratio = 0.8, 95% CI = 0.6, 1.1). The OB test had a high false positive rate of 32.7%, and a poor positive predictive value of 3.5%. Both its positive and negative predictive powers were below 1.0, in other words, its positive likelihood ratio was below 1.0 and negative likelihood ratio was above 1.0, indicating that the OB test is not informative and has a poor predictive accuracy for rectal neoplasm. In addition, there were a number of practical problems concerning the use of the OB test for mass screening in the rural community.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1980

[Combined therapy of colonic and rectal neoplasms in an advanced phase].

The results obtained in a series of 75 patients suffering from advanced cancer of the colon-rectum are examined. Survival of these patients is looked at as a function of the extent of surgical demolition, and as a function of postoperative chemotherapy. Demolition interventions were followed by much higher survival than was observed following palliative operations. At the same time, survival was higher in patients who underwent post-operative chemotherapy. The results therefore justify a more aggressive approach in advanced cancer of the colon-rectum.

Adult↗
PubMed1994

[Primary reconstruction of intestinal continuity in patients with complicated colon and rectal neoplasms].

Experience in surgical treatment of 290 patients with carcinoma of the large intestine following a complicated course shows that primary restoration of the intestinal continuity is possible. In this event, the allowable operative risk with consideration for the pronounced character of the pathological process must be analysed, and adequate anesthiological and resuscitation services must be provided. It is advisable that such operations are performed in specialized surgical institutions.

Colonic Neoplasms↗
PubMed1978

[Methods of local excision of rectal neoplasms].

Recent experience in the behaviour of rectal carcinomas allows local tumour excision under certain conditions to be carried out as a "total excision-biopsy in healthy tissue". The indication for operation depends on criteria referring to the tumour as well as to the patient. The operation technique is that of transanal excision. Brief survey of personal results.

Humans↗
PubMed2001

[Trans-anal resection of low rectal neoplasms].

BACKGROUND: The rising incidence of colorectal neoplasms, and in particular those localised in the lower rectum is stressed and the therapeutic opportunities offered by the trans-anal resection technique are underlined. METHODS: The indispensable conditions for adopting a surgical approach are pointed out. These are identified as the size of the neoplasm, which should not exceed 4 cm, the fixity, site, the polypoid and non-ulcerated nature of the lesion, and the involvement of not more than 1/4 of the circumference of the bowel. Using these inclusion criteria, the authors operated on five patients in the 4th Division of General Surgery at G. Martino Polyclinic in Messina, using trans-anal resection of low rectal neoplasm. RESULTS: No hemorrhagic complications or lesions in the visceral wall occurred. All patients underwent a follow-up of up to 36 months and to date no patient has presented long-term metastasis; local recidivation was observed in one patient after 14 months and this was treated using the trans-anal method. CONCLUSIONS: The authors affirm that trans-anal resection may be regarded as the elective treatment of patients with neoplasms confined to the visceral wall and without dissemination; it is palliative in cases where the tumour is larger than 4 cm, with lymph node involvement. But even in this case, and in more advanced situations, this method allows mortality due to occlusive complications to be reduced and ensures a better quality of residual life.

Adenocarcinoma↗