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Anastomotic leakage in rectal cancer surgery:Retrospective analysis of risk factors

World Journal of Clinical Cases 2022年第36期10卷 13321-13336页

作者： Giuseppe Brisinda Maria Michela Chiarello Gilda Pepe Maria Cariati Valeria Fico Paolo Mirco Valentina Bianchi Department of Medical and Surgical Sciences Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Department of surgery UniversitàCattolica S CuoreRome 00168Italy Department of surgery Azienda Sanitaria Provinciale di CosenzaCosenza 87100Italy Emergency surgery and Trauma Center Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Department of surgery Azienda Sanitaria Provinciale di CrotoneCrotone 88900Italy

BACKGROUND Anastomotic leakage(AL)after restorative surgery for rectal cancer(RC)is associated with significant morbidity and *** To ascertain the risk factors by examining cases of AL in rectal surgery in this retrospective cohort *** To identify risk factors for AL,a review of 583 patients who underwent rectal resection with a double-stapling colorectal anastomosis between January 2007 and January 2022 was ***,demographic and operative features,intraoperative outcomes and oncological characteristics were *** The incidence of AL was 10.4%,with a mean time interval of 6.2±2.1 *** mortality was 0.8%.Mortality was higher in patients with AL(4.9%)than in patients without leak(0.4%,P=0.009).Poor bowel preparation,blood transfusion,median age,prognostic nutritional index<40 points,tumor diameter and intraoperative blood loss were identified as risk factors for *** of anastomosis,number of stapler cartridges used to divide the rectum,diameter of circular stapler,level of vascular section,T and N status and stage of disease were also correlated to AL in our *** diverting ileostomy did not reduce the leak rate,while the use of the transanastomic tube significantly *** Clinical,surgical and pathological factors are associated with an increased risk of *** adversely affects the morbidity and mortality of RC patients.

关键词： Anastomosis Leak Anterior resection Morbidity Mortality rectal surgery

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Robotic surgery for rectal cancer: A systematic review of current practice

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World Journal of Gastrointestinal Oncology 2014年第6期6卷 184-193页

作者： Tony Wing Chung Mak Janet Fung Yee Lee Kaori Futaba Sophie Sok Fei Hon Dennis Kwok Yu Ngo Simon Siu Man Ng Division of Colorectal surgery Department of Surgery The Chinese Uni-versity of Hong Kong Prince of Wales Hospital Department of Colorectal surgery University Hospital Birmingham NHS Trust

AIM: To give a comprehensive review of current litera-ture on robotic rectal cancer ***: A systematic review of current literature via PubMed and Embase search engines was per-formed to identify relevant articles from january 2007 to november 2013. The keywords used were: "robotic surgery", "surgical robotics", "laparoscopic computer-assisted surgery", "colectomy" and "rectal resection". RESULTS: After the initial screen of 380 articles, 20 pa-pers were selected for review. A total of 1062 patients(male 64.0%) with a mean age of 61.1 years and body mass index of 24.9 kg/m2 were included in the *** of 1062 robotic-assisted operations, 831(78.2%) anterior and low anterior resections, 132(12.4%) in-tersphincteric resection with coloanal anastomosis, 98(9.3%) abdominoperineal resections and 1(0.1%) Hart-mann's operation were included in the review. Robotic rectal surgery was associated with longer operative time but with comparable oncological results and anastomotic leak rate when compared with laparoscopic rectal surgery. CONCLUSION: Robotic colorectal surgery has con-tinued to evolve to its current state with promising re-sults; feasible surgical option with low conversion rate and comparable short-term oncological results. The challenges faced with robotic surgery are for more high quality studies to justify its cost.

关键词： rectal cancer Robotics Minimal invasive surgery Systematic review rectal surgery

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Current and future perspectives in the management and treatment of colorectal cancer

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World Journal of Clinical Oncology 2025年第2期16卷 9-17页

作者： Sigfredo E Romero-Zoghbi Evita Krumina Fernando López-Campos Felipe Couñago Department of Radiation Oncology GenesisCare Talavera de la ReinaToledo 45600Spain Department of Radiation Oncology GenesisCare GuadalajaraGuadalajara 19004Spain Department of Radiation Oncology Hospital Universitario Ramón Y CajalMadrid 28034Spain Department of Radiation Oncology GenesisCare-Hospital Universitario Vithas Madrid La MilagrosaMadrid 28010Spain

In this editorial,we reviewed the article by Fadlallah et al that was recently published in the World Journal of Clinical *** article provided a comprehensive and in-depth view of the management and treatment of colorectal cancer(CRC),one of the leading causes of cancer-related morbidity and mortality *** article analyzed the therapeutic modalities and their sequencing,focusing on total neoadjuvant therapy for locally advanced rectal *** highlighted the role of immunotherapy in tumors with high microsatellite instability or deficient mismatch repair,addressing recent advances that have improved prognosis and therapeutic response in localized and metastatic *** in surgical techniques,advanced radiotherapy,and systemic agents targeting specific mutational profiles are also discussed,reflecting on how they revolutionized clinical *** tumor DNA has emerged as a promising tool for detecting minimal residual disease,prognosis,and therapeutic monitoring,solidifying its role in precision *** review emphasized the importance of technological and therapeutic advancements in improving clinical outcomes and personalizing CRC treatment.

关键词： Colorectal cancer Metastatic colorectal cancer Total neoadjuvant therapy Chemoradiotherapy Colon surgery rectal surgery Chemotherapy Immunotherapy

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Presacral venous bleeding during mobilization in rectal cancer

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World Journal of Gastroenterology 2017年第9期23卷 1712-1719页

作者： Jose Enrique Casal Núnez Vincenzo Vigorita Alejandro Ruano Poblador Ana María Gay Fernández Maria ángeles Toscano Novella Nieves Cáceres Alvarado Lucinda Pérez Dominguez Coloproctology Unit and General and Digestive surgery Unit Vigo University Hospital Complex36212 VigoSpain

To analyze the anatomy of sacral venous plexus flow, the causes of injuries and the methods for controlling presacral hemorrhage during surgery for rectal *** review of the databases MEDLINE® and Embase™ was conducted, and relevant scientific articles published between January 1960 and June 2016 were examined. The anatomy of the sacrum and its venous plexus, as well as the factors that influence bleeding, the causes of this complication, and its surgical management were *** is a review of 58 published articles on presacral venous plexus injury during the mobilization of the rectum and on techniques used to treat presacral venous bleeding. Due to the lack of cases published in the literature, there is no consensus on which is the best technique to use if there is presacral bleeding during mobilization in surgery for rectal cancer. This review may provide a tool to help surgeons make decisions regarding how to resolve this serious *** series of alternative treatments are described; however, a conventional systematic review in which optimal treatment is identified could not be performed because few cases were analyzed in most publications.

关键词： Presacral hemorrhaging rectal surgery Sacral venous plexus Pelvic surgery Sacral anatomy

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Endoluminal vacuum-assisted therapy to treat rectal anastomotic leakage:A critical analysis

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World Journal of Gastroenterology 2022年第14期28卷 1394-1404页

作者： Andrea Vignali Paola De Nardi Department of Gastrointestinal surgery IRCCS San Raffaele Scientific InstituteMilano 20132Italy Department of surgery Vita-Salute UniversityMilano 20132Italy

Endoluminal vacuum-assisted therapy(EVT)has been introduced recently to treat colorectal anastomotic leaks in clinically stable non-peritonitic *** application has been mainly reserved to low colorectal and colo-anal *** main advantage of this new procedure is to ensure continuous drainage of the abscess cavity,to promote and to accelerate the formation of granulation tissue resulting in a reduction of the abscess *** reported results are promising allowing a higher preservation of the anastomosis when compared to conventional treatments that include trans-anastomotic tube placement,percutaneous drainage,endoscopic clipping of the anastomotic defect or stent ***,despite this procedure is gaining acceptance among the surgical community,indications,inclusion criteria and definitions of success are not yet standardized and extremely heterogeneous,making it difficult to reach definitive conclusions and to ascertain which are the real benefits of this new ***,long-term and functional results are poorly *** present review is focused on critically analyzing the theoretical benefits and risks of the procedure,short-and long-term functional results and future direction in the application of EVT.

关键词： Anastomotic leakage rectal surgery Endoluminal vacuum therapy Endosponge Complications

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