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Search Results: 1 - 10 of 11471 matches for " rectal surgery "
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Rectal Lymphoma: A Diagnostic Challenge  [PDF]
Koh Ging Wong
Open Journal of Gastroenterology (OJGas) , 2015, DOI: 10.4236/ojgas.2015.54004
Abstract: Rectal lymphoma is a rare colorectal tumor with incidence of 0.2% - 0.6%. We report a rare case of large rectal lymphoma. Our patient is a 48-year-old man, presented with 2 months history of per rectal bleed, altered bowel habits and weight loss. Clinical examination, computed tomography scan and initial endoscopic mucosal biopsy were indistinguishable from Rectal Carcinoma. With high level of suspicion, we resorted to full thickness punch biopsy in lithotomy position for a good tissue sample. Ultimately, an immunohistochemical study confirmed Diffuse Large B-cells Lymphoma (DLBCL). This case highlighted the importance of high level of suspicion for lymphoma when dealing with a rectal tumor. Accurate diagnosis of rectal lymphoma affects the treatment modalities and prognosis of the patient.
Transanal Endoscopic Video Assisted Rectal Lesion Resection, New Techniques Addressing Neoplasms  [PDF]
Ali Mahmood, Javier Nieto, Madhu Ragupathi, Prianka Gajula
Surgical Science (SS) , 2012, DOI: 10.4236/ss.2012.36060
Abstract: Early rectal cancer beyond the reach of conventional instruments has resulted in major abdominal and pelvic operations. As visualization is compromised beyond 6 - 8 cm, proximal to the anal verge, there have been several innovations and techniques to address T1 or T2 rectal cancer in the mid to upper rectum. Transanal Endscopic Microsurgery (TEM) was a technique that had garnered some success, however with expensive instrumentation along with limitations in instrument mobility, this technology was not applicable to many patients. Transanal Endoscopic Video Assisted (TEVA) rectal resection offers a cheap and readily accessible media to address early rectal cancer. Any hospital with standard laparoscopic ability is capable to offer TEVA rectal resection. We do advocate appropriate patient selection and advise that there is a learning curve with the increased requirement for technical difficulty. Once mastered, however, this surgical approach does provide yet another tool in the armamentarium of the surgeon.
3-Port incisionless laparoscopic surgery for rectal cancer with a transrectal assistance  [PDF]
Lin Zhang, Guohu Zhang, Peihong Wang, Yonghua Wang, Yaning Song, Hong Zou, Lijun Tang
Case Reports in Clinical Medicine (CRCM) , 2013, DOI: 10.4236/crcm.2013.27103
Abstract: Introduction: To present the initial experience of 3-port incisionless laparoscopic surgery for rectal cancer with a transrectal assistance by using a toothed oval clamp. Case Presentation: One patient received 3-port incisionless laparoscopic surgery for rectal cancer with a transrectal assistance by using a toothed oval clamp. Better direct vision and exposure could be acquired for performing laparoscopic surgical procedure, avoiding additional port inserted. Using this procedure, with strictly adhering to the principles of laparoscopic colectomy and oncological procedure, along with the specimen exteriorized via recta, transacted and a stapled anastomosis performed, no incision can be achieved at the end of an operation. The operative time was 180 minutes. The estimated blood loss in the course of an operation was 80 ml. The patient recovered quickly after surgery, with no post-operative pain and no incision. The patient was dischanged home on the 6th postoperative day. Conclusions: With a transrectal assistance by using a toothed oval clamp, 3-port laparoscopic surgery for rectal cancer could be achieved without no incision at the end of the operation, the same as NOTES. It is enormously advantageous to the patient and suitable for application in developing countries, especially in a rural area.

Transanal endoscopic operation: a new proposal
Rocha, José Joaquim Ribeiro da;Féres, Omar;
Acta Cirurgica Brasileira , 2008, DOI: 10.1590/S0102-86502008000700016
Abstract: purpose: the transanal procedure for rectal cancer surgery is one of the many techniques currently available. different techniques for local excision of rectal tumors include: conventional transanal technique, posterior access surgery, therapeutic colonoscopy, transanal endoscopic surgery. methods: the aim of the present study is to describe a new method of transanal endoscopic resection, transanal endoscopic operation (teo), and performed with the aid of a surgical proctoscope especially designed for this purpose and report the results obtained in 32 patients submitted to the teo and to compare these results with those obtained with other techniques currently available. the average proportions of recurrence, post-operation complications and posterior resections were analyzed by means of a metanalysis. data on the distance and size of rectal lesions, the operative timing and hospitalization time were distributed in graphs according to authors and techniques. results: the results were favorable and equivalent to those described in the literature. conclusions: the surgical proctoscope specially designed for this study is efficient and has a low cost; the teo is easily performed with the aid of this equipment; the final results were favorable and similar to those obtained with other available techniques for endoscopic transanal intestinal resection, which are of high cost and less availability.
Preoperative evaluation and postoperative follow-up for patients with rectal cancer
Paty P.B.,Wong Douglas W.
Acta Chirurgica Iugoslavica , 2004, DOI: 10.2298/aci0402031p
Abstract: Rectal cancer has a wide variety of presentations. In most cases, it is the surgeon who is faced with the challenge of determining the extent of disease and advising the patient how to proceed with treatment. Utilizing diagnostic tests of the highest accuracy and relevance will help in the selection of the best initial therapy, which is critical for achieving the highest cure rate while also avoiding over-treatment and unnecessary morbidity. Following curative treatment, surveillance testing for detection of recurrence is traditionally done, but the efficacy of this practice has been questioned. Surveillance will detect a number of asymptomatic recurrences that are treatable by potentially curative salvage surgery, but to what extent early detection improves salvage therapy is not well established. In this brief review, the goals, methods, and expected benefits of rectal cancer staging and surveillance are assessed.
Could the surgeon trust to radiotherapy help in rectal cancer?
Valentini V.,Gambacorta M.A.,Barba M.C.
Acta Chirurgica Iugoslavica , 2008, DOI: 10.2298/aci0803055v
Abstract: When the surgeon analyzes the ongoing literature on the evidence of the neoadjuvant approaches to rectal cancer finds a true paradox: from one side they seem to offer a relative less relevant contribute through the time, in fact whereas in the Swedish trial preoperative radiation yielded a significant improvement of local control and survival, after the introduction of TME the contribution of preoperative chemoradiation is relegate to local control with no or poor influence on survival, even if the absolute 5-year survival rate moved from 40% of the ’70 to 60-65% of the latest years1-3. From other side the growing evidence of an incidence of pCR approaching to 30%4, seems to identify a subset of patients with more favorable prognosis to neoadjuvant treatments5-6. Furthermore, the overall evidence that 30- 35% of rectal cancer patients treated with multimodality therapy still die from cancer namely by distant metastases in spite of the 4-8 % of absolute benefit of adjuvant 5Fu based adjuvant chemotherapy7, seems to vanish the efforts of the further optimization of the local treatments (surgery and radiotherapy) and of the ongoing modality of delivery the chemotherapeutic agents. We would like to address the main evidences from the literature and the main uncertainties that the surgeon could face to propose a combined treatment to his rectal cancer patient.
Rectal cancer: Is the surgeon the variable in the outcome
Ignjatovi? D.,Bergamaschi R.
Acta Chirurgica Iugoslavica , 2004, DOI: 10.2298/aci0402093i
Abstract: Four factors influence the outcome of rectal surgery: tumour biology, stage of lesion, type of surgery performed and the performing surgeon himself1. Tumour biology and tumour stage depend on each other and are not influenced on by the surgeon, while he seems to have a great influence on the latter two factors. This influence mainly consists of the following: training, volume, individual skill and experience.
Morbimortalidad del traumatismo de recto extraperitoneal
Barillaro, Guillermo;Gatica, Sandra;Escudero, Ezequiel;Jimenez, Lorena;Martini, Mariano;
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2008, DOI: 10.1590/S0102-67202008000100002
Abstract: background: extraperitoneal rectal injuries represent 3 to 5% of all traumatisms and abdominal injuries, and they are highlighted by their high morbidity/mortality presented if not early and appropriately diagnosed and treated. nowadays there is not a consensus related to an optimal surgical management. aim: to relate the experience in treating this disease, evaluating factors that influence mortality and morbidity. methods: it consisted in a descriptive retrospective study where it was reviewed handbooks of all extraperitoneal rectal trauma patients operated between january 1998 and december 2007. the abdominal trauma rate, the interval between trauma and surgery and the initial surgery's type were related to infectious complications and mortality. results: there were evaluated 13 patients: 5 injured by firearms, 5 autoimpalament and 3 by closed trauma. the abdominal trauma mean rate of infected and dead was more than 25. 61% of patients (n=8) underwent surgery before 8 hours. the infection rate was 61.5% and 90% of infected patients required additional surgeries. the series' mortality was 38.5% (5 patients). in patients operated after 8 hours there was perirectal infection in 80% of them, and 80% of mortality regardless of surgery performed type. conclusions: the delay over 8 hours in treating and the abdominal trauma rate over 25 were the main factors associated with perirectal infection and mortality in this series. absence of presacral drainage and distal rectal wash were correlated with increased incidence of perirectal infection.
Surgical treatment of rectal prolapse: experience and late results with 51 patients
Sobrado, Carlos Walter;Kiss, Desidério Roberto;Nahas, Sérgio C.;Araújo, Sérgio E. A.;Seid, Victor E.;Cotti, Guilherme;Habr-Gama, Angelita;
Revista do Hospital das Clínicas , 2004, DOI: 10.1590/S0041-87812004000400003
Abstract: the "best" surgical technique for the management of complete rectal prolapse remains unknown. due to its low incidence, it is very difficult to achieve a representative number of cases, and there are no large prospective randomized trials to attest to the superiority of one operation over another. purpose: analyze the results of surgical treatment of complete rectal prolapse during 1980 and 2002. method: retrospective study. results: fifty-one patients underwent surgical treatment during this period. the mean age was 56.7 years, with 39 females. besides the prolapse itself, 33 patients complained of mucous discharge, 31 of fecal incontinence, 14 of constipation, 17 of rectal bleeding, and 3 of urinary incontinence. abdominal operations were performed in 36 (71%) cases. presacral rectopexy was the most common abdominal procedure (29 cases) followed by presacral rectopexy associated with sigmoidectomy (5 cases). the most common perineal procedure was perineal rectosigmoidectomy associated with levatorplasty (12 cases). intraoperative bleeding from the presacral space developed in 2 cases, and a rectovaginal fistula occurred in another patient after a perineal rectosigmoidectomy. there were 2 recurrences after a mean follow-up of 49 months, which were treated by reoperation. conclusion: abdominal and perineal procedures can be used to manage complete rectal prolapse with safety and good long-term results. age, associated medical conditions, and symptoms of fecal incontinence or constipation are the main features that one should bear in mind in order to choose the best surgical approach.
Estudo retrospectivo de 47 complica??es em 380 pacientes operados de cancer retal
Cruz, Geraldo Magela Gomes da;Ferreira, Renata Magali Ribeiro Silluzio;Neves, Peterson Martins;
Revista Brasileira de Coloproctologia , 2006, DOI: 10.1590/S0101-98802006000200005
Abstract: in a 31-year period of practice in coloproctology, from 1965 to 1996, the author had the opportunity to attend 24,200 patients, bearing 923 (3.8%) cancer of the large bowel. eight hundred and seventy (870 - 3.6%) of the tumours were colorectal cancer (adenocarcinoma) and 53 (0.2%) were carcinoma of the anus of several hystological types. in 490 cases (56.3%) cancer were localized in the colon and 380 (43.7%) in the rectum. the main purpose of this study was to collect data concerning 380 patients bearing rectal cancer attended from 1965 to 1996, 373 of them undergoing surgery, with enphasis to surgical techniques specially 47 surgical complications. cancer were far more common in the upper (126; 33.1%) and low (172; 45.3%) than in the middle rectum (82; 21.6%). resecability of tumours of the upper rectum reached 88.9% (112 patients), being abdominal rectosigmoidectomy with handmade anastomosis the most used surgery (76 patients; 60.3%). resecability of tumours of the middle rectum reached 90.2% (112 patients), being abdominal rectosigmoidectomy with handmade and stappled anastomosis the most used surgery (40 patients; 48.7%). resecability of tumours of the low rectum reached 89.5% (112 patients), being abdominaperineal amputation (miles) the most used surgery (154 patients; 74.4%). resecability of tumour was very high reaching 88.9% (338 patients). the most used surgical technique was miles procedure (135 patients; 35.5%) and abdominal rectosigmoidectomy with handmade and stappled anastomosis (130 patients; 34.3%). immediate major surgical complication rate was 12.6% (47 cases in 380 patients); and mortality rate was 1.6% (6 cases). the two most used surgical techniques presented low complication rate: miles procedure - 135 surgeries, 13 complications (9.6%) and 2 deaths (1.5%); and abdominal rectosigmoidectomy with hand made and stappled anastomosis - 130 surgeries, 19 complications (14.6%) and 2 deaths (1.5%). the highest immediate major surgical complication rate
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