Innovations in Rectal Cancer Surgery
|
|
|
- Darcy James Gaines
- 5 years ago
- Views:
Transcription
1 Innovations in Rectal Cancer Surgery A. D Hoore MD PhD, EBSQ-CR, (hon)fascrs A. Wolthuis MD PhD, EBSQ-CR, FACS G. Bislenghi MD Departement of Abdominal Surgery University Hospitals Leuven, Belgium
2 invasiveness Evolution in Surgery Open surgery Laparoscopic surgery Robotic surgery recent evidence disruptive SSL incremental NOSE TAMIS NOTES time Endoscopic biopsy Diagnostic endoscopy EMR Endoscopic polypectomy
3 Development of laparoscopic surgery major disruptive change first CCD-camera
4 Minimally Invasive surgery in evolution Hand-assisted + Pfannenstiehl Total Laparoscopic IBD 2009
5 COLOR II trial (non-inferiority phase III) patients randomised (2:1) 699 in laparoscopic surgery group 345 in open surgery group Locoregional recurrence rate at 3 years : 5.0% in both groups DFS: 74.8% (laparoscopic) and 70.8% (open) OS : 86.7% (laparoscopic) and 83.6% (open) N Engl J Med 2015
6 Disease free survival Overall survival
7 becoming more proficient : CRM positivity (%) Robotic versus laparosocpic TME Laparoscopic versus open TME Laparoscopic versus open colon and rectum
8 Conversion to laparotomy remains substantial %
9 Understanding the shortcomings of laparoscopic TME - Difficult exposure deepest part pelvic dissection - Troublesome distal rectal transection - Uncontrolled distal margin persistent high conversion to laparotomy Intracorporeal rectal stapling following laparoscopic total mesorectal excision: overcoming a challenge. Brannigan AE, De Buck S, Suetens P, Penninckx F, D'Hoore A. Surg Endosc. 2006
10 Factors affecting suitability for lap TME BMI Pelvic anatomy Previous surgery Co-morbidity = patient related Experience Quality Assurance T size, fixity, level Anastomotic level Colorectal Disease 2006; 8 (s3): 30-2
11 Full laparoscopic dissection and transanal specimen extraction (TATA) a laparoscopic transanal abdominal transanal radical proctosigmoidectomy and a descending coloanal handsewn anastomosis (TATA).
12 Transanal Endoscopic Microsurgery( TEM) Buess G et al. Surg Endosc 1988; 2:
13 A new transanal platform
14 Endoluminal TAMIS TEM TAMIS
15 From TATA to notes, how tatme fits into the evolutionary surgical tree. Marks JH, Salem JF. Tech Coloproctol Aug;20(8): Laparoscopic low anterior resection and transanal pull-through for low rectal cancer: a Natural Orifice Specimen Extraction (NOSE) technique. D'Hoore A, Wolthuis AM. Colorectal Dis Nov;13 Suppl 7:28-31
16 Transanal TME (tatme)
17 Transanal natural orifice transluminal endoscopic surgery (NOTES) rectal resection: down-to-up total mesorectal excision (TME) short-term outcomes in the first 20 cases Antonio M. Lacy et al. Surg Endoscopy 2013
18
19
20 prostate
21 Hybrid, laparoscopic procedure S3 R hypogastric nerve
22 New technologies
23
24
25 Expanding the applicability of the platform - no
26
27 Transanal endoscopic proctectomy innovative procedure for difficult resection of rectal tumors in men with narrow pelvis (n=30, jan june 2011) Laparoscopic assisted (splenic flexure) Main causes for TAEP - narrow pelvis - fatty mesorectum - large anterior tumor Morbidity urethral Injuries (n=2, reoperation (n=2, 7%) 7%) Hospitalization 14d (19-25) Rouanet Ph et al. Dis Colon and Rectum 2013
28 The bulbar urethra at risk
29 Understanding the operative force vectors Operative vectors, anatomic distortion, fluid dynamics and the inherent effects of pneumatic insufflation encountered during transanal total mesorectal excision Atalah S et al. Techn Coloproctology 2017
30 TA-TME Learning Curve - CUSUM Slide courtesy of John Monson
31 2017 Ann Surg. 2017; 266(1): urethral injuries 2 bladder injuries 1 vaginal perforation 1 hypogastric nerve resection 2 macroscopic rectal tube perforations
32 cases 18.0% Improved insufflation system in 80% 27% proctored 5 urethral injuries 2 bladder injuries 1 vaginal perforation 1 hypogastric nerve resection 2 macroscopic rectal tube perforations 14 Urethral injuries 2 bladder injuries 5 vaginal perforations 11 rectal tube perforations 0.6% 0.9%
33
34 Incidence Anastomotic Failure tatme Registry International database 1594 patients Overall anastomotic failure rate = 15.7% (and probably underreported) - early leak rate 7.8% - delayed leak 2.0% Independent risk factors - male sex - tumorbulk - obesity - intraoperative blood loss - smoking - manual anastomosis - diabetes mellitus - prolonged perineal operative time
35 Risk for a definitive stoma 11 % 26% Risk factors : age > 65 yrs preoperative radiotherapy anastomotic morbidity and abscess Celerier B. et al. Colorectal Dis 2015; 18
36 Human Pathol 2016; 52: distal spread beyond macroscopic tumor edge
37 Cancer patients (n=634) Quality TME specimen, n(%) Intact 503 (85%) Minor defects 65 (11%) Majors defects 24 (4.1%) Rectal tube perforations 12 (2%) Distal Margin (mm) Mean +/- SD 19 +/ Median (range) 15 (0-97) Positive DRM 2 (0.3%) Circumferential Resection Margin (mm) Mean +/- SD 9.2 +/- 8.6 Median (range) 8 (0-90) Positive CRM 14 (2.4%)
38 Cancer patients (n=634) Quality TME specimen, n(%) Intact 503 (85%) Minor defects 65 (11%) Composite Optimal Pathological Outcome Majors defects 24 (4.1%) Rectal tube perforations 12 (2%) Distal Margin (mm) CRM, DM, good specimen Mean +/- SD 19 +/ Median (range) 15 (0-97) 92.6% Positive DRM 2 (0.3%) Circumferential Resection Margin (mm) Mean +/- SD 9.2 +/- 8.6 Median (range) 8 (0-90) Positive CRM 14 (2.4%)
39 2017 Risk Factors for poor histological outcome after TaTME Univariate Analysis Patient None Technical Simultaneous operating AR vs APE Conversion Blood loss > 1L Extent post abd dissection Total operative time Tumour Tumour height Tumour location mt stage + CRM MRI M+ nrct
40 Male patient: 75 yrs. Moderate operative risk, ASA 2 well differentiated adenocarcinoma,juxta-anal (Rullier II) ct2 (3a) N?, M0
41 Surgical decision making in distal rectal cancer = complex 1. Type and extent of primary tumor 2. Response to chemo-radiation 3. Perceived ability to clear all tumor (adequate margins) DRM / CRM 4. Patient related factors (functional status, comorbidity) 5. Patients preference acceptance suboptimal functional outcome
42 From MRI based (static process) MDT decision on neoadjuvant treatment Predefined surgery at 6-8 weeks interval
43 MRI plays pivotal role in defining a dynamic treatment process - Upfront surgery (flexible interval) - Neoadjuvant chemo/radiation MR response assessment ccr non-operative restumour specific Surgery
44 Incomplete response at 12 weeks wait and follow up local excision radical surgery (TME) Pre CRT 12 w post CRT Expand the Interval 11 m 35 m
45 Early, small Advanced tumors Intentional organ preservation Chemoradiation Incidental organ preservation Chemoradiation +TME = standard > 50% 10-25% Organ Preservation Maas et al, Lancet Oncol 2010
46 Functional outcome and QoL after TME surgery Low rectal cancer & Radiotherapy: 60% bowel-related QoL Impairment Battersby et al, Dis Colon Rectum 2016
47 Actual paradox Indications for preoperative radiotherapy Decreased in early stage tumors good local control with TME alone RT does not improve survival RT causes (surgical) complications worse anorectal and urogenital function after TME Increased More complete clinical respon Watch and wait policy Organ preservation: better QoL/function No postop death and less complications
48 Cancer Genetics 2015
49 Conclusion The flexible transanal platform is the next step in MIS to rectal cancer MR response assessment after neoadjuvant treatment first step in a dynamic process to define tailored surgical treatement We should guide our patients through this dynamic process and take into account their preferences and expectations
Innovations in rectal cancer surgery TAMIS and transanal TME
Innovations in rectal cancer surgery TAMIS and transanal TME A.D Hoore MD PhD, EBSQ CR Chair Departement of Abdominal Surgery University Hospitals Leuven, Belgium Actual treatment in rectal Early rectal
State-of-the-art of surgery for resectable primary tumors
Early colorectal cancer State-of-the-art of surgery for resectable primary tumors (Special focus on rectal cancer surgery) Stefan Heinrich & Hauke Lang Department of General, Visceral and University Hospital
Laparoscopic Resection Of Colon & Rectal Cancers. R Sim Centre for Advanced Laparoscopic Surgery, TTSH
Laparoscopic Resection Of Colon & Rectal Cancers R Sim Centre for Advanced Laparoscopic Surgery, TTSH Feasibility and safety Adequacy - same radical surgery as open op. Efficacy short term benefits and
Index. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Abdominal surgery prior as factor in laparoscopic colorectal surgery, 554 555 Abscess(es) CRC presenting as, 539 540 Adenocarcinoma of
Index. Surg Oncol Clin N Am 14 (2005) Note: Page numbers of article titles are in boldface type.
Surg Oncol Clin N Am 14 (2005) 433 439 Index Note: Page numbers of article titles are in boldface type. A Abdominosacral resection, of recurrent rectal cancer, 202 215 Ablative techniques, image-guided,
Rectal Cancer : Curative treatment without surgery
Rectal Cancer : Curative treatment without surgery Dieter Hahnloser dieter.hahnloser@chuv.ch CHUV University Hospital Lausanne Switzerland Reasons for intervention (surgery) Cure Live longer Feel better
Transanal Surgery for Large Rectal Polyps and Early Rectal Cancer
Transanal Surgery for Large Rectal Polyps and Early Rectal Cancer AB Harikrishnan Consultant Colorectal Surgeon, Sheffield Honorary Clinical Senior Lecturer, Sheffield University Associate TPD General
Early Rectal Cancer Surgical options Organ Preservation? Chinna Reddy Colorectal Surgeon Western General, Edinburgh
Early Rectal Cancer Surgical options Organ Preservation? Chinna Reddy Colorectal Surgeon Western General, Edinburgh What is Early rectal cancer? pt1t2n0m0 Predictors for LN involvement Size Depth Intramural
A Review of Rectal Cancer. Tim Geiger, MD Assistant Professor of Surgery, Colon and Rectal Surgery Vanderbilt University Medical Center
A Review of Rectal Cancer Tim Geiger, MD Assistant Professor of Surgery, Colon and Rectal Surgery Vanderbilt University Medical Center No disclosures Disclosures About me.. Grew up in Southern Illinois
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE INTERVENTIONAL PROCEDURES PROGRAMME Transanal total mesorectal excision of the rectum This procedure is used for patients who need to have their whole
Innovative Surgical Management in the Treatment of Rectal Cancer: MIS, Robotic, and Beyond
Innovative Surgical Management in the Treatment of Rectal Cancer: MIS, Robotic, and Beyond Jonathan E. Efron, MD, FACS, FASCRS The Mark M Ravitch, MD Endowed Professorship in Surgery Chief of the Ravitch
The Binational Colorectal Cancer Audit. A/Prof Paul McMurrick Head, Cabrini Monash University Dept of Surgery 2017
The Binational Colorectal Cancer Audit A/Prof Paul McMurrick Head, Cabrini Monash University Dept of Surgery 2017 Binational Colorectal Cancer Database 2010 First Patient 2011 Contract between CMUDS and
COLON AND RECTAL CANCER
COLON AND RECTAL CANCER Mark Sun, MD Clinical Associate Professor of Surgery University of Minnesota No disclosures Objectives 1) Understand the epidemiology, management, and prognosis of colon and rectal
Disclosures. Personalized Approaches to Gastrointestinal Cancers. Objectives. What is personalized cancer care. Go through some genomic studies
Personalized Approaches to Gastrointestinal Cancers Emily Groves, MD Colorectal Surgery Assistant Professor, Division of Surgical Oncology Disclosures None Objectives What is personalized medicine and
Hester Cheung Memorial Lecture
Hester Cheung Memorial Lecture STEVEN D WEXNER, MD, PHD (HON),FACS, FRCS, FRCS(ED) Director, Digestive Disease Center; Chairman, Department of Colorectal Surgery; Cleveland Clinic Florida Professor of
Laparoscopic vs Robotic Rectal Cancer Surgery: Making it better!
Laparoscopic vs Robotic Rectal Cancer Surgery: Making it better! Francis Seow- Choen Medical Director Seow-Choen Colorectal Centre Singapore In all situations: We have to use the right tool for the job
COLON AND RECTAL CANCER
No disclosures COLON AND RECTAL CANCER Mark Sun, MD Clinical Assistant Professor of Surgery University of Minnesota Colon and Rectal Cancer Statistics Overall Incidence 2016 134,490 new cases 8.0% of all
Preoperative adjuvant radiotherapy
Preoperative adjuvant radiotherapy Dr John Hay Radiation Oncology Program BC Cancer Agency Vancouver Cancer Centre The key question for the surgeon Do you think that this tumour can be resected with clear
PROCARE FINAL FEEDBACK
1 PROCARE FINAL FEEDBACK General report 2006-2014 Version 2.1 08/12/2015 PROCARE indicators 2006-2014... 3 Demographic Data... 3 Diagnosis and staging... 4 Time to first treatment... 6 Neoadjuvant treatment...
Case Conference. Craig Morgenthal Department of Surgery Long Island College Hospital
Case Conference Craig Morgenthal Department of Surgery Long Island College Hospital Neoadjuvant versus Adjuvant Radiation Therapy in Rectal Carcinoma Epidemiology American Cancer Society statistics for
Rectal Cancer. Madhulika G. Varma MD Associate Professor and Chief Section of Colorectal Surgery University of California, San Francisco
Rectal Cancer Madhulika G. Varma MD Associate Professor and Chief Section of Colorectal Surgery University of California, San Francisco Modern Treatment for Rectal Cancer Improve Local Control Improved
Transanal Excision of Rectal Cancer : What Next?
Transanal Excision of Rectal Cancer : What Next? November 10 th 2017 Meagan Costedio MD FACS FASCRS Medical Director Colorectal Surgery University Hospitals Ahuja Medical Center Associate Professor - Division
LONG TERM OUTCOME OF ELECTIVE SURGERY
LONG TERM OUTCOME OF ELECTIVE SURGERY Roberto Persiani Associate Professor Mini-invasive Oncological Surgery Unit Institute of Surgical Pathology (Dir. prof. D. D Ugo) Dis Colon Rectum, March 2000 Dis
Mini J.Elnaggar M.D. Radiation Oncology Ochsner Medical Center 9/23/2016. Background
Mini J.Elnaggar M.D. Radiation Oncology Ochsner Medical Center 9/23/2016 Background Mostly adenocarcinoma (scc possible, but treated like anal cancer) 39, 220 cases annually Primary treatment: surgery
PROCARE FINAL FEEDBACK Definitions
1 PROCARE FINAL FEEDBACK 2006-2014 Definitions Version 0.2 29/10/2015 2 Table of Contents Introduction... 3 Part 1: PROCARE indicators 2006-2014... 4 1.1. Methods... 4 1.1.1. Descriptive numbers... 4 1.1.2.
Transanal Endoscopic Microsurgery
Transanal Endoscopic Microsurgery Dana R. Sands, MD, FACS, FASCRS Director, Colorectal Physiology Center Staff Surgeon Department of Colorectal Surgery Cleveland Clinic Florida What is TEM? Minimally invasive
NOVA SCOTIA RECTAL CANCER PROJECT: A POPULATION-BASED ASSESSMENT OF RECTAL CANCER CARE AND OUTCOMES. Devon Paula Richardson
NOVA SCOTIA RECTAL CANCER PROJECT: A POPULATION-BASED ASSESSMENT OF RECTAL CANCER CARE AND OUTCOMES by Devon Paula Richardson Submitted in partial fulfilment of the requirements for the degree of Master
UCL. Rectum Adenocarcinoma. Quality of conformal radiotherapy Impact for the surgeon P. Scalliet & K. Haustermans
Rectum Adenocarcinoma Quality of conformal radiotherapy Impact for the surgeon P. Scalliet & K. Haustermans Fifth Belgian Surgical Week May 6th, 2004, Oostende SOR rectum adenocarcinoma Indication of radiotherapy
L impatto dell imaging sulla definizione della strategia terapeutica
GISCoR L impatto dell imaging sulla definizione della strategia terapeutica M. Galeandro U.C. Radioterapia Oncologica ASMN-IRCCS Reggio Emilia 14 Novembre 2014 Rectal Cancer TNM AJCC-7 th edition 2010
CHAPTER 7 Concluding remarks and implications for further research
CONCLUDING REMARKS AND IMPLICATIONS FOR FURTHER RESEARCH CHAPTER 7 Concluding remarks and implications for further research 111 CHAPTER 7 Molecular staging of large sessile rectal tumors In this thesis,
Transanal total mesorectal excision (TaTME): tips and tricks of a new surgical technique
Review Article Page 1 of 8 Transanal total mesorectal excision (TaTME): tips and tricks of a new surgical technique Elisa Cassinotti 1, Giorgio Palazzini 2, Massimiliano Della Porta 3, Ilaria Grosso 1,
Local Excision of Rectal Cancer Techniques and Outcomes
Local Excision of Rectal Cancer Techniques and Outcomes Manoj J. Raval, MD, MSc, FRCSC Clinical Assistant Professor, UBC Rectal Cancer Update 2008 October 25, 2008 Overview Techniques & Description Patient
Carcinoma del retto: Highlights
Carcinoma del retto: Highlights Stefano Cordio Struttura Complessa di Oncologia Medica ARNAS Garibaldi Catania Roma 17 Febbraio 2018 Disclosures Advisory Committee, research funding and speakers bureau
Handling & Grossing of Colo-rectal Specimens for Tumours. for Medical Officers in Pathology
Handling & Grossing of Colo-rectal Specimens for Tumours for Medical Officers in Pathology Dr Gayana Mahendra Department of Pathology Faculty of Medicine University of Kelaniya Your Role in handling colorectal
Rectal Cancer: Classic Hits
Rectal Cancer: Classic Hits Charles M. Friel, MD Associate Professor of Surgery Section of Colon and Rectal Surgery University of Virginia September 28, 2016 None Disclosures 1 Objectives Review the Classic
Radiotherapy for rectal cancer. Karin Haustermans Department of Radiation Oncology
Radiotherapy for rectal cancer Karin Haustermans Department of Radiation Oncology O U T L I N E RT with TME surgery? Neoadjuvant or adjuvant RT? 5 x 5 Gy or long-course CRT? RT with new drugs? Selection
Terminology: anal canal cancer. Terminology: Anal margin cancer. Treatment Epidermoid
Terminology: anal canal cancer Epidermoid Below dentate line squamous CC At and above dentate line «basaloid», «cloacogenic», or «transi6onal» = non kera6nizing types of squamous cell carcinoma same =t
Incidence and risk factors of anastomotic leaks. By: khaled Said Assistant professor of colorectal surgery Alexandria
Incidence and risk factors of anastomotic leaks By: khaled Said Assistant professor of colorectal surgery Alexandria Anastomotic leakage after colorectal surgery is a major and potentially life-threatening
Rectal Cancer Update 2008 The Last 5 cm. Consensus Building
Rectal Cancer Update 2008 The Last 5 cm Consensus Building Case Distal Rectal Cancer 65 male physician Rectal mass: 5cm from anal verge, 1cm above sphincter? Imaging choice: CT vs MR vs ERUS? Adjuvant
Quality assurance in PROCARE Surgery for rectal cancer.
Quality assurance in PROCARE Surgery for rectal cancer www.kankerregister.org to measure is to know Why to measure? if you cannot measure it, you cannot improve it when you can measure what you are speaking
Operative Technique: Karen Horvath, MD, FACS. SCOAP Retreat June 17, 2011
Operative Technique: Total Mesorectal Excision Karen Horvath, MD, FACS University it of Washington, Seattle SCOAP Retreat June 17, 2011 No Disclosures Purpose What is Total Mesorectal Excision (TME)? How
Colorectal Cancer. Nimalan Pathma-Nathan
Colorectal Cancer Nimalan Pathma-Nathan Introduction Rooms at HSS and Westmead Private Outpatients at Westmead Multidisciplinary clinic Westmead Surgery and scopes HSS Westmead Public, Private and Children
8. The polyp in the illustration can be described as (circle all that apply) a. Exophytic b. Pedunculated c. Sessile d. Frank
Quiz 1 Overview 1. Beginning with the cecum, which is the correct sequence of colon subsites? a. Cecum, ascending, splenic flexure, transverse, hepatic flexure, descending, sigmoid. b. Cecum, ascending,
S. Atallah B. Martin-Perez M. Albert. T. debeche-adams G. Nassif L. Hunter S. Larach
Tech Coloproctol (2014) 18:473 480 DOI 10.1007/s10151-013-1095-7 ORIGINAL ARTICLE Transanal minimally invasive surgery for total mesorectal excision (TAMIS TME): results and experience with the first 20
FEATURE. Transanal Total Mesorectal Excision in Rectal Cancer. Short-term Outcomes in Comparison With Laparoscopic Surgery
FEATURE Transanal Total Mesorectal Excision in Rectal Cancer Short-term Outcomes in Comparison With Laparoscopic Surgery María Fernández-Hevia, MD, Salvadora Delgado, MD, PhD, Antoni Castells, MD, PhD,
Transanal endoscopic microsurgery for early rectal cancer: single center experience
Original paper Videosurgery Transanal endoscopic microsurgery for early rectal cancer: single center experience Narimantas Samalavicius 1,2, Marijus Ambrazevicius 1, Alfredas Kilius 1, Kestutis Petrulis
Quality of life after minimally invasive surgery for rectal cancer
Chen et al. Mini-invasive Surg 2018;2:42 DOI: 10.20517/2574-1225.2018.59 Mini-invasive Surgery Review Open Access Quality of life after minimally invasive surgery for rectal cancer Jason H. Chen 1, Jennifer
The Laparoscopic Approach in the Treatment of Distal Colorectal Cancer
The Open Colorectal Cancer Journal, 2011, 4, 13-17 13 Open Access The Laparoscopic Approach in the Treatment of Distal Colorectal Cancer Alexander Lebedyev 1, Damien Urban 2, Danny Rosin 1, Amram Ayalon
Audit Report. Colorectal Cancer Quality Performance Indicators. Patients diagnosed April 2016 March Published: March 2018
Colorectal Cancer Managed Clinical Network Audit Report Colorectal Cancer Quality Performance Indicators Patients diagnosed April 2016 March 2017 Published: March 2018 Mr Michael Walker NOSCAN MCN Clinical
Review Article Intersphincteric Resection for Low Rectal Cancer: An Overview
International Surgical Oncology Volume 2012, Article ID 241512, 4 pages doi:10.1155/2012/241512 Review Article Intersphincteric Resection for Low Rectal Cancer: An Overview Constantine P. Spanos 1st Department
Carcinoma del colon-retto: La Chirurgia Robotica nella Malattia Avanzata
Carcinoma del colon-retto: La Chirurgia Robotica nella Malattia Avanzata Alberto Patriti SSD Chirurgia Robotica Multidisciplinare ASL 2 Umbria Ospedale San Matteo degli Infermi Spoleto - Why MIS for Advanced
Colorectal Cancer Comparative Audit Report
SOUTH EAST SCOTLAND CANCER NETWORK (SCAN) PROSPECTIVE CANCER AUDIT Colorectal Cancer 2014 2015 Comparative Audit Report Mr B.J. Mander, NHS Lothian, Lead Colorectal Cancer Clinician, SCAN Group Chair Mr
Operational Efficiency in Colon Surgery Enhanced Recovery Pathways: 23 hour laparoscopic colectomy
Enhanced Recovery Pathways: 23 hour laparoscopic colectomy Conor P. Delaney MD MCh PhD Chairman, Digestive Disease Institute Professor of Surgery, Cleveland, Ohio Disclosure Slide Conor Delaney MD PhD
TME and autonomic nerve preservation techniques: based on Video and Cadaveric anatomy
TME and autonomic nerve preservation techniques: based on Video and Cadaveric anatomy Nam Kyu Kim M.D., Ph.D., FACS, FRCS, FASCRS Professor Department of Surgery Yonsei University College of Medicine Seoul,
Influence of multiple stapler firings used for rectal division on colorectal anastomotic leak rate
Surg Endosc (2017) 31:5318 5326 DOI 10.1007/s00464-017-5611-0 and Other Interventional Techniques Influence of multiple stapler firings used for rectal division on colorectal anastomotic leak rate Tamara
Index. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Abdominoperineal excision, of rectal cancer, 93 111 current controversies in, 106 109 extent of perineal dissection and removal of pelvic floor,
Sphincter Sparing Procedures: Is it a standard for Management of Low Rectal Cancer
Journal of the Egyptian Nat. Cancer Inst., Vol. 16, No. 4, December: 210-215, 2004 Sphincter Sparing Procedures: Is it a standard for Management of Low Rectal Cancer EL-SAYED ASHRAF KHALIL, M.D.FRCS; MOHAMAD
Transanal minimally invasive surgery (TAMIS): validating short and long-term benefits for excision of benign and early stage rectal cancers
Editorial Page 1 of 5 Transanal minimally invasive surgery (TAMIS): validating short and long-term benefits for excision of benign and early stage rectal cancers Anthony P. D Andrea, Erin Duggan, Patricia
Evaluation of the National Training Programme for Laparoscopic Colorectal Surgery of England (Lapco)
Evaluation of the National Training Programme for Laparoscopic Colorectal Surgery of England (Lapco) Mr Hugh Mackenzie, Dr Melody Ni, Mr Danilo Miskovic, Mr Mark Coleman, Professor George Hanna National
Delayed anastomotic leakage following laparoscopic intersphincteric resection for lower rectal cancer: report of four cases and literature review
Iwamoto et al. World Journal of Surgical Oncology (2017) 15:143 DOI 10.1186/s12957-017-1208-2 CASE REPORT Open Access Delayed anastomotic leakage following laparoscopic intersphincteric resection for lower
Outcomes Following Surgery for Distal Rectal Cancers: A Comparison between Laparoscopic and Open Abdomino- Perineal Resection
ORIGINAL ARTICLE Outcomes Following Surgery for Distal Rectal Cancers: A Comparison between Laparoscopic and Open Abdomino- Perineal Resection K K Tan, FRCS (Edin), C S Chong, MRCS (Edin), C B Tsang, FRCS
Henrique Prata Director General
PROGRAM ADVANCED COURSE IIN COLORECTAL SURGERY SEPTEMBER 12 TT HH TO 14 TT HH,, 2019 CHAIRMAN Henrique Prata Director General Hospital de Amor - Barretos PRESIDENT DIRECTOR COURSE DIRECTOR Jacques Marescaux
Guidelines for Laparoscopic Resection of Curable Colon and Rectal Cancer
SAGES Society of American Gastrointestinal and Endoscopic Surgeons http://www.sages.org Guidelines for Laparoscopic Resection of Curable Colon and Rectal Cancer Author : SAGES Webmaster PREAMBLE The following
Meta analysis in Rectal Cancer
Meta analysis in Rectal Cancer Dr. Monica Irukulla Professor and Head Department of Radiation Oncology Nizam s Institute of Medical Sciences hyderabad Areas of meta analysis in rectal cancers Epidemiology
3rd Annual Minimally Invasive Approaches to Rectal Cancer Symposium
presents Minimally Invasive Approaches to Rectal Cancer Symposium May 3 & 4, 2019 InterContinental Hotel and Conference Center Cleveland, Ohio Hands On Lab Limited slots available Register today! ccfcme.org/rectal2019
Index. Note: Page numbers of article title are in boldface type.
Index Note: Page numbers of article title are in boldface type. A Abscess(es) in Crohn s disease, 168 169 IPAA and, 110 114 as unexpected finding in colorectal surgery, 46 Adhesion(s) trocars-related laparoscopy
Index. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Adenocarcinoma, pancreatic ductal, laparoscopic distal pancreatectomy for, 61 Adrenal cortical carcinoma, laparoscopic adrenalectomy for, 114
Surgical Management of Advanced Stage Colon Cancer. Nathan Huber, MD 6/11/14
Surgical Management of Advanced Stage Colon Cancer Nathan Huber, MD 6/11/14 Colon Cancer Overview Approximately 50,000 attributable deaths per year Colorectal cancer is the 3 rd most common cause of cancer-related
The main issues of the rectal resection for carcinoma
The main issues of the rectal resection for carcinoma - Level of the vessels transection and mobilisation of the splenic flexure - Lymphadenectomy - Distal margin - Parietal invasion of rectal wall - Functional
Colorectal Cancer Quality Performance Indicators
Publication Report Colorectal Cancer Quality Performance Indicators Patients diagnosed between April 2013 and March 2016 Publication date 27th June 2017 An Official Statistics Publication for Scotland
The effect of rectal washout on local recurrence following rectal cancer surgery
COLORECTAL SURGERY Ann R Coll Surg Engl 208; 00: 46 5 doi 0.308/rcsann.207.0202 The effect of rectal washout on local recurrence following rectal cancer surgery SR Moosvi, K Manley, J Hernon Norfolk and
IMAGING GUIDELINES - COLORECTAL CANCER
IMAGING GUIDELINES - COLORECTAL CANCER DIAGNOSIS The majority of colorectal cancers are diagnosed on colonoscopy, with some being diagnosed on Ba enema, ultrasound or CT. STAGING CT chest, abdomen and
Can Robotics be useful to a General Surgeon Performing Colorectal Surgery? Curtis L. Peery MD April 27 th 2018 Throckmorton Surgical Society
Can Robotics be useful to a General Surgeon Performing Colorectal Surgery? Curtis L. Peery MD April 27 th 2018 Throckmorton Surgical Society 1.Intuitive Surgical 2.C-Sats 3.Virtual Incision Study comparing
Karen Lok Man Tung, Michael Ka Wah Li. Introduction
Original Article Page 1 of 5 Hybrid natural orifice transluminal endoscopic surgery colectomy versus conventional laparoscopic colectomy for left-sided colonic tumors: intermediate follow up of a randomized
Adjuvant Chemotherapy for Rectal Cancer: Are we making progress?
Adjuvant Chemotherapy for Rectal Cancer: Are we making progress? Hagen Kennecke, MD, MHA, FRCPC Division Of Medical Oncology British Columbia Cancer Agency October 25, 2008 Objectives Review milestones
Audit Report. Colorectal Cancer Quality Performance Indicators. Patients diagnosed April 2014 March Published: July 2016
NORTH OF SCOTLAND PLANNING GROUP Colorectal Cancer Managed Clinical Network Audit Report Colorectal Cancer Quality Performance Indicators Patients diagnosed April 2014 March 2015 Published: July 2016 Mr
University of Groningen. Colorectal Anastomoses Bakker, Ilsalien
University of Groningen Colorectal Anastomoses Bakker, Ilsalien IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,800 116,000 120M Open access books available International authors and editors Downloads Our
Original Policy Date
MP 7.01.92 Transanal Endoscopic Microsurgery Medical Policy Section Surgery Issue 12/2013 Original Policy Date 12/2013 Last Review Status/Date Reviewed with literature search/12/2013 Return to Medical
Colorectal Cancer. Mark Chapman. MA MS FRCS EBSQ(coloproct) 21 st March 2018 Consultant Coloproctologist
Colorectal Cancer Mark Chapman MA MS FRCS EBSQ(coloproct) 21 st March 2018 Consultant Coloproctologist Overview Epidemiology of colorectal cancer Adenoma carcinoma sequence Tumour diagnosis & staging Treatment
Incidence of Colorectal Cancers- Australia. Anterior Resection 5/23/2018. What spurs us to investigate?
Incidence of Colorectal Cancers- Australia 17,000 Colorectal cancers in 2018 20% of Colorectal cancers are in the Rectum 12.3% of all new cancers Anterior Resection Syndrome (ARS) Lisa Wilson. Colorectal
Short course radiation therapy for rectal cancer in the elderly: can radical surgery be avoided?
Short communication Short course radiation therapy for rectal cancer in the elderly: can radical surgery be avoided? Michael A. Cummings 1, Kenneth Y. Usuki 1, Fergal J. Fleming 2, Mohamedtaki A. Tejani
COLORECTAL CANCER COMPARATIVE AUDIT REPORT SOUTH EAST SCOTLAND CANCER NETWORK PROSPECTIVE CANCER AUDIT. Mr B.J. Mander SCAN Group Chair
SOUTH EAST SCOTLAND CANCER NETWORK PROSPECTIVE CANCER AUDIT COLORECTAL CANCER 2013-2014 COMPARATIVE AUDIT REPORT Mr B.J. Mander SCAN Group Chair Mr K Pal, NHS Borders Mr S Whitelaw, NHS Dumfries & Galloway
Treatment strategy of metastatic rectal cancer
35.Schweizerische Koloproktologie-Tagung Treatment strategy of metastatic rectal cancer Gilles Mentha University hospital of Geneva Bern, January 18th, 2014 Colorectal cancer is the third most frequent
Laparoscopic Colorectal Surgery. Advanced Course. November 19 & Directors of the course: Jacques MARESCAUX
Laparoscopic Colorectal Surgery November 19 & 20-2010 Directors of the course: Jacques MARESCAUX Richard John HEALD United Kingdom Joël LEROY Faculty : Patrick AMBROSETTI Switzerland Richard BARTHELEMY
Transanal Endoscopic Microsurgery (TEM)
Transanal Endoscopic Microsurgery (TEM) Policy Number: 7.01.112 Last Review: 7/2014 Origination: 1/2008 Next Review: 7/2015 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage
Role of MRI for Staging Rectal Cancer
Role of MRI for Staging Rectal Cancer High-resolution MRI has supplanted endoscopic ultrasound for staging rectal cancer. High-resolution MR images closely match histology and can show details such as
Current Issues and Controversies in the Management of Rectal Cancer
Current Issues and Controversies in the Management of Rectal Cancer Ghazi M. Nsouli MD 11 th Annual Congress of the Lebanese Society of Gastroenterology November 16, 2012 GMN 20121116 1 Staging of rectal
Colorectal Pathway Board (Clinical Subgroup): Imaging Guidelines September 2015
Colorectal Pathway Board (Clinical Subgroup): Imaging Guidelines September 2015 1 Contents Page No. 1. Objective 3 2. Imaging Techniques 3 3. Staging of Colorectal Cancer 5 4. Radiological Reporting 6
S Nachiappan, A Askari, A Currie, RH Kennedy, O Faiz. 30 th June 2014 Tripartite Colorectal Meeting, Birmingham, UK
S Nachiappan, A Askari, A Currie, RH Kennedy, O Faiz 30 th June 2014 Tripartite Colorectal Meeting, Birmingham, UK local recurrence in rectal cancer Long-term cancer specific survival 16% died within 30
Ein Leben nach tiefer Rektumresektion: Was erwartet unsere Patienten im Langzeitverlauf?
Ein Leben nach tiefer Rektumresektion: Was erwartet unsere Patienten im Langzeitverlauf? Dieter Hahnloser Klinik für Viszeral- und Transplantationschirurgie UniverstätsSpital Zürich Low Rectal Resection
Robotic versus Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Comparative Study of Short-term Outcomes
ORIGINAL ARTICLE pissn 2234-778X eissn 2234-5248 J Minim Invasive Surg 2015;18(4):98-105 Journal of Minimally Invasive Surgery Robotic versus Laparoscopic Intersphincteric Resection for Low Rectal Cancer:
Current innovations in colorectal surgery
Current innovations in colorectal surgery KS Chapple Consultant Colorectal Surgeon Sheffield Teaching Hospitals NHS Trust Do we need more innovations? What innovations are there and are they worthwhile?
Rectal Cancer. Rectal Cancer: The CCF perspective 16/11/2017. Meagan Costedio, MD, FACS, FASCRS. 38,220 new cases estimated in
Rectal Cancer: The CCF perspective Meagan Costedio, MD, FACS, FASCRS Medical Director Colorectal Surgery University Hospitals Ahuja Medical Center Associate Professor - Division of Colorectal Surgery Rectal
FIRST ANNUAL ORLANDO COLORECTAL CONGRESS LIVE! November 8-10, 2017
FIRST ANNUAL ORLANDO COLORECTAL CONGRESS LIVE! November 8-10, 2017 Florida Hospital Nicholson Center 404 Celebration Place Celebration, FL 34747 Featuring: Presented by: Center for Colon & Rectal Surgery
Laparoscopic Surgery for Rectal Carcinoma An Experience of 20 Cases in a Government
Laparoscopic Sugery World for Rectal Journal Carcinoma An of Laparoscopic Experience Surgery, of September-December 20 Cases in a Government 2008;1(3):53-57 Sector Hospital Laparoscopic Surgery for Rectal
RECTAL CANCER CLINICAL CASE PRESENTATION
RECTAL CANCER CLINICAL CASE PRESENTATION Francesco Sclafani Medical Oncologist, Clinical Research Fellow The Royal Marsden NHS Foundation Trust, London, UK esmo.org Disclosure I have nothing to declare
Robotic Versus Laparoscopic Surgery for Rectal Cancer after Preoperative Chemoradiotherapy: Case-Matched Study of Short-Term Outcomes
pissn 1598-2998, eissn 2005-9256 Cancer Res Treat. 2016;48(1):225-231 Original Article http://dx.doi.org/10.4143/crt.2014.365 Open Access Robotic Versus Laparoscopic Surgery for Rectal Cancer after Preoperative
Transanal Endoscopic Microsurgery. Description. Section: Surgery Effective Date: April 15, 2017
Subject: Transanal Endoscopic Microsurgery Page: 1 of 10 Last Review Status/Date: March 2017 Transanal Endoscopic Microsurgery Description Transanal endoscopic microsurgery (TEMS) is a minimally invasive
RECTAL CANCER APPARENT COMPLETE RESPONSE (acr) AFTER LONG COURSE CHEMORADIOTHERAPY
COLORECTAL CLINICAL SUBGROUP RECTAL CANCER APPARENT COMPLETE RESPONSE (acr) AFTER LONG COURSE CHEMORADIOTHERAPY Finalised by: Dr Simon Gollins Mr Andrew Renehan Dr Mark Saunders Mr Nigel Scott Dr Shabbir