Benign multicystic peritoneal mesothelioma: a rare tumor of the abdomen, is a diagnostic dilemma. This report emphasizes the importance of diagnostic laparoscopy in the diagnosis of the tumour.

BACKGROUND:Despite short-course radiation and chemotherapy gaining popularity because of similar or better oncological outcomes, functional outcomes relative to long-course radiation have not been evaluated. OBJECTIVE:To compare bowel function outcomes after long-course or short-course radiation and delayed operation for advanced rectal cancers.DESIGN: Propensity-matched analysis. SETTINGS:This study was conducted at a single tertiary cancer center. Patients were operated on between 2014 and 2020. PATIENTS:The study included patients with locally advanced, nonmetastatic, mid, and low rectal cancers who underwent low anterior resection with stapled anastomosis and diverting ostomy. Extended or beyond total mesorectal excisions and lateral node dissections were excluded. INTERVENTIONS:Long-course radiation delivered as a radiation dose of 50 Gy in 25 fractions or short-course radiation (5 Gy in 5 fractions) and delayed surgery after 4 to 6 weeks with or without chemotherapy. MAIN OUTCOME MEASURES:One-time assessment of low anterior resections syndrome and Wexner incontinence scores at least 6 months after stoma reversal. RESULTS:After matching 124 patients in the 1:2 ratio between short-and long-course radiations, 93 patients were included for analysis. Any low anterior resection syndrome was found in 90.3% of short-course patients compared to 54.8% after long-course radiation (p < 0.001). Major incontinence was detected in 6.5% after short-course radiation as opposed to 8.1% of patients after long-course radiation (p = 0.781). On multivariate logistic regression, short-course radiation predicted the development of any low anterior resection syndrome with an OR of 4.4. LIMITATIONS:Selection and misclassification biases from retrospective recruitment. CONCLUSIONS:For patients with locally advanced, nonmetastatic, mid, and low rectal cancers who underwent preoperative radiation followed by stapled low anterior resection, short-course radiation had higher probability of developing low anterior resection syndrome than long-course radiation. See Video Abstract at http://links.lww.com/DCR/C37.

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