Anterior Resection for Malignant Lesions of the Upper Part of the Rectum and Lower Part of the Sigmoid

Dixon, Claude F.

doi:10.1097/00000658-194809000-00009

Cited by 180 publications

(62 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Later, in an effort to improve postoperative quality of life by re-establishing intestinal continuity, anterior resection was introduced. 2 With the subsequent introduction ofcircular stapling devices, tumors of the lower rectum could be excised reliably with re-establishment of intestinal continuity. 3'4 There is no difference in recurrence or survival rates between abdominoperineal excision and anterior resection when there is an adequate distal margin.`Moreover, even in very low anterior resections, acceptable bowel function usually is achieved, and quality of life is superior to that after abdominoperineal excision.…”

Section: Resultsmentioning

confidence: 99%

The Long-Term Effect of Adjuvant Postoperative Chemoradiotherapy for Rectal Carcinoma on Bowel Function

et al. 1994

View full text Add to dashboard Cite

ObjectiveThe authors assessed the long-term effect of postoperative chemoradiotherapy on bowel function. Summary Background DataAdjuvant postoperative radiation therapy, often combined with chemotherapy, is being used increasingly often for rectal carcinoma. However, the long-term effect of this treatment on bowel function has not been investigated. MethodsThe records were reviewed of all patients undergoing anterior resection for rectal carcinoma 2 to 5 years previously. During this period, patients with Astler-Coller stage B2 or C tumors generally were given postoperative radiation therapy with chemotherapy, whereas those with earlier stage tumors were not. To minimize possible confounding factors that may have been more common in the group receiving chemoradiotherapy and that may affect bowel function, extensive exclusion criteria were used, such as invasion of contiguous organs, local or distant metastases, use of a dysfunctioning stoma, and anastomotic or pelvic complications. One hundred remaining patients were suitable for inclusion in the study and participated in a telephone questionnaire; 41 patients had postoperative chemoradiotherapy, and 59 did not. ResultsThe two groups were well matched for sex, level of anastomosis, and length of follow-up, although the group receiving chemoradiotherapy was slightly younger. The group that had chemoradiotherapy had more bowel movements per day than the group that did not have radiation therapy (median 7 vs. median 2, p < 0.001); the former group had "clustering" of bowel movements more often (42% vs. 3%, p < 0.001), had nighttime movements more often (46% vs. 14%, p < 0.001), had occasional or frequent incontinence more often (39% and 17% vs. 7% and 0%, p < 0.001), wore a pad more often (41% vs. 10%, p < 0.001), and were unable to defer defecation for more than 15 minutes more often (78% vs. 19%, p < 0.001). The group that had chemoradiotherapy also had stool of liquid consistency, used antidiarrheal medications, had perianal skin irritation, were unable to differentiate stool from gas, and needed to defecate again within 30 minutes of a movement significantly more often than the group that did not receive chemoradiotherapy. 676

show abstract

Section: Resultsmentioning

confidence: 99%

The Long-Term Effect of Adjuvant Postoperative Chemoradiotherapy for Rectal Carcinoma on Bowel Function

et al. 1994

View full text Add to dashboard Cite

show abstract

“…4 In his classic paper, Claude F. Dixon called the last 20 cm "the most controversial segment of the large intestine… It is for this region new procedures are constantly being advocated and interest in old ones is being rekindled". 3 Over 60 years later, his statement is still accurate, although perhaps most relevant now to the distal-most 5 cm of the rectum.…”

Section: Historical Backgroundmentioning

confidence: 98%

“…Successful performance of anterior resection for cancers of the middle and upper rectum, as published by Claude Dixon in 1948 3 led to the acceptance of this procedure and the creation of a "5 cm rule" from the dentate line-reserving APR for cancers below this level.…”

Section: Historical Backgroundmentioning

confidence: 99%

Sphincter-Sparing Surgery in Patients with Low-Lying Rectal Cancer: Techniques, Oncologic Outcomes, and Functional Results

Bordeianou

Maguire

Alavi

et al. 2014

Journal of Gastrointestinal Surgery

View full text Add to dashboard Cite

Background Rectal cancer management has evolved into a complex multimodality approach with survival, local recurrence, and quality of life parameters being the relevant endpoints. Surgical treatment for low rectal cancer has changed dramatically over the past 100 years. Discussion Abdominoperineal resection, once the standard of care for all rectal cancers, has become much less frequently utilized as surgeons devise and test new techniques for preserving the sphincters, maintaining continuity, and performing oncologically sound ultra-low anterior or local resections. Progress in rectal cancer surgery has been driven by improved understanding of the anatomy and pathophysiology of the disease, innovative surgical technique, improved technology, multimodality approaches, and increased appreciation of the patient's quality of life. The patient with a low rectal cancer, once almost universally destined for impotence and a colostomy, now has the real potential for improved survival, avoidance of a permanent stoma, and preservation of the normal route of defecation.Keywords Rectal cancer . Sphincter preservation . Total mesorectal excision . Anterior resection . Intersphincteric resection . Local excision rectal cancer Historical BackgroundThe modern era of rectal cancer surgery began with the description of the abdominoperineal resection (APR) by Miles in 1908. Prior perineal and sacral approaches (e.g., Kraske approach) to rectal cancer resection produced high rates of complications, cancer recurrence, poor quality of life (QOL), and poor overall survival. Miles' operation reflected greater understanding of the natural history of rectal cancer that was based on postmortem examination of his patients after perineal resection. He observed cancerous implants in the pelvic peritoneum, mesorectum, and affected nodes of the left common iliac bifurcation. These findings led him to develop a "cylindrical concept" of the spread of rectal cancer to upward, downward, and lateral zones. 1 The original operation included resection of the rectum, sigmoid, mesorectum, nodes of the iliac bifurcation, and a perineal component to include the anus and levator ani muscles. Postoperative mortality was high initially, but local recurrence decreased

show abstract

“…В 1948 г. извест-ным американским хирургом C.F. Dixon был внедрен термин «передняя резекция прямой кишки», обозна-чавший, что доступ осуществляется через переднюю брюшную стенку [19]. С 80-х годов прошлого столетия начали выделять внутрибрюшную резекцию, которая выполняется при локализации опухоли на 13-20 см выше анального края, переднюю резекцию, если опу-холь расположена на 9-12 см выше, и низкую перед-нюю резекцию, применяемую при расположении опухоли на 6-8 см выше ануса [20].…”

unclassified

Comparative analysis of laparoscopic low rectal resections

Черниковский¹

2015

Onkol. koloproktol.

View full text Add to dashboard Cite

Anterior Resection for Malignant Lesions of the Upper Part of the Rectum and Lower Part of the Sigmoid

Cited by 180 publications

References 3 publications

The Long-Term Effect of Adjuvant Postoperative Chemoradiotherapy for Rectal Carcinoma on Bowel Function

The Long-Term Effect of Adjuvant Postoperative Chemoradiotherapy for Rectal Carcinoma on Bowel Function

Sphincter-Sparing Surgery in Patients with Low-Lying Rectal Cancer: Techniques, Oncologic Outcomes, and Functional Results

Comparative analysis of laparoscopic low rectal resections

Contact Info

Product

Resources

About