A New Surgical Concept for Rectal Replacement After Low Anterior Resection

Z’graggen, Kaspar; Maurer, Christoph A.; Birrer, Stefan; Giachino, Daniel; Kern, Beatrice; Büchler, Markus W.

doi:10.1097/00000658-200112000-00009

Cited by 115 publications

(70 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Transanal reconstruction consisted of a handsewn coloanal anastomosis with a transverse coloplasty (Fig. 1) 19 . Since completion of the study, the technique has been modified by adding a small abdominal incision to allow specimen extraction and coloplasty construction.…”

Section: Surgical Techniquementioning

confidence: 99%

Laparoscopic intersphincteric resection with coloplasty and coloanal anastomosis for mid and low rectal cancer

Rullier

Cunha

Couderc

et al. 2003

British Journal of Surgery

173

113

View full text Add to dashboard Cite

show abstract

Section: Surgical Techniquementioning

confidence: 99%

Laparoscopic intersphincteric resection with coloplasty and coloanal anastomosis for mid and low rectal cancer

Rullier

Cunha

Couderc

et al. 2003

British Journal of Surgery

173

113

View full text Add to dashboard Cite

show abstract

“…In order to improve the functional results, a rectal reservoir replacement using a colonic J-pouch or a transverse coloplasty pouch should be considered for tumors of the lower rectum. However, this is not necessary for tumors in the upper third of the rectum [31, 32, 33, 34, 35]. The advantages of a posterior approach include a shorter operation, reduced blood loss and transfusion requirements, no need for a protective stoma, and a shorter hospital stay, but may be associated with a high rate of local anorectal sepsis [11, 12, 18].…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Large Sessile Villous and Tubulovillous Adenomas of the Lower Rectum

Renzulli¹,

Maurer

Netzer

et al. 2004

Dig Surg

Self Cite

View full text Add to dashboard Cite

Background: Large sessile adenomas of the rectum are premalignant lesions necessitating complete removal. Methods: We reviewed the data on 20 consecutive patients with large (≧2 cm) sessile villous and tubulovillous adenomas of the lower two thirds of the rectum (≤11 cm from the anal verge). Median (range) adenoma diameter and distance from the anal verge were 5 (2–8) and 7 (4–11) cm, respectively. All 11 patients with an adenomatous circumferential involvement of ≧50% or an endosonographic staging of ≧uT2 underwent a low anterior resection of the rectum. The remaining 9 patients underwent a posterior full-thickness local bowel wall resection (modified Mason procedure). The median (range) follow-up period was 3.8 (0.7–8.2) years. Results: Preoperative biopsy examination successfully excluded invasive carcinoma. Overstaging, however, occurred in 9 of 12 patients (75%) undergoing endosonography, resulting in surgical overtreatment of 4 patients. A curative resection (R0) was always achieved. Five patients had complications, but there was no in-hospital mortality and no cases of local recurrence. 4 out of 19 patients complained of minor stool incontinence, and 3 patients reported incomplete rectal emptying or constipation. Fourteen patients described the operative result as excellent (n = 7) or good (n = 7). Conclusions: Endosonography may lead to overstaging and overtreatment. An individualized approach based on the degree of adenomatous circumferential involvement and endosonographic staging showed no mortality, low morbidity, no local recurrence, and good functional medium-term results.

show abstract

“…Rekonstruktionsformen, wie bspw. der Kolon-JPouch oder die Koloplastie haben belegtermaßen signifikanten Einfluss auf die postoperative Stuhlfrequenz und den imperativen Stuhldrang [10,31].…”

Section: Rekonstruktion Nach Rektumresektionunclassified

Lebensqualität nach Rektumkarzinomoperation

Germer

Isbert

2009

Chirurg

View full text Add to dashboard Cite

Multimodal treatment of advanced rectal cancer involves excision of the rectum in conjunction with pelvic radiotherapy and chemotherapy. Outcome assessment in oncologic surgery for rectal cancer has conventionally included data regarding perioperative mortality and morbidity, disease recurrence, and long-term survival. Throughout the past decade however research has increased in the field of patient-reported outcome, and quality of life (QoL) is now regarded as a key measurement in assessing outcomes of interventions. The aim of this review paper was to evaluate QoL assessment in different aspects of rectal surgery. In general patients undergoing abdominoperineal excision with permanent colostomy did not have poorer QoL measures than those undergoing anterior resection. Reversal of a dysfunctional loop ileostomy in surgery for low rectal cancer improves most patients' overall QoL. The previously reported short- and long-term QoL analysis of laparoscopic vs conventional open rectal surgery revealed no significant differences. In patients undergoing restorative resection for low rectal cancer, colonic J pouches offer significant advantages in function and QoL over straight anastomosis or coloplasty.

show abstract

A New Surgical Concept for Rectal Replacement After Low Anterior Resection

Cited by 115 publications

References 27 publications

Laparoscopic intersphincteric resection with coloplasty and coloanal anastomosis for mid and low rectal cancer

Laparoscopic intersphincteric resection with coloplasty and coloanal anastomosis for mid and low rectal cancer

Surgical Management of Large Sessile Villous and Tubulovillous Adenomas of the Lower Rectum

Lebensqualität nach Rektumkarzinomoperation

Contact Info

Product

Resources

About