How important is rigid proctosigmoidoscopy in localizing rectal cancer?

Schoellhammer, Hans F.; Gregorian, Armen; Sarkisyan, Grant; Petrie, Beverley A.

doi:10.1016/j.amjsurg.2008.08.005

Cited by 40 publications

(26 citation statements)

References 4 publications

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“…In our series, all patients with lesions in these locations underwent a rigid proctosigmoidoscopy in order to confirm or correct any localization errors. The discrepancy between measurements made by rigid proctosigmoidoscopy and colonoscopy has been shown to increase with increasing distance from the anal verge [10]. Rigid proctosigmoidoscopy is safe, accurate, and inexpensive and should be performed on all patients with lesions in the rectum or rectosigmoid.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of colonoscopic localization

2010

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Preoperative colonoscopic localization of colorectal lesions was reasonably accurate (96%) in this large series. The majority of inaccurately identified lesions occurred in the sigmoid and descending colon. Erroneous localization, even though not common, can result in significant changes in the intraoperative plan and the ultimate outcome. Therefore, every effort should be made to localize the lesion before surgery, especially when thought to be in the left or sigmoid colon, to reduce the need for intraoperative localization efforts, the need for an intraoperative change in procedure, and the risk of a surprise for the patient after surgery.

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Section: Discussionmentioning

confidence: 99%

Accuracy of colonoscopic localization

2010

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“…DRE is important to evaluate the function of the sphincter and the distance to the anorectal ring in order to evaluate the possibility of doing a sphincter-preserving procedure. Rigid rectoscopy provides a more correct determination of tumour localisation than flexible colonoscopy [10], with an accurate assessment of the distance between the distal edge of the tumour and the dentate line, or alternatively the anal verge.…”

Section: Formulating Recommendations and Consensus Processmentioning

confidence: 99%

“…After dividing the inferior mesenteric vein under the pancreas and the inferior mesenteric artery (IMA), complete mobilization is achieved by lateral dissection and mobilization of the splenic flexure and the descending colon and freeing the greater omentum from the transverse colon. Dissection will proceed with medial dissection of distal sigmoid and rectum [2][3][4][5][6][7][8][9][10][11][12][13][14][15].…”

Section: (100% [Strong Consensus]; Gor C: 100% [Strong Consensus])mentioning

confidence: 99%

Laparoscopic extraperitoneal rectal cancer surgery: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES)

et al. 2011

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Background The laparoscopic approach is increasingly applied in colorectal surgery. Although laparoscopic surgery in colon cancer has been proved to be safe and feasible with equivalent long-term oncological outcome compared to open surgery, safety and long-term oncological outcome of laparoscopic surgery for rectal cancer remain controversial. Laparoscopic rectal cancer surgery might be efficacious, but indications and limitations are not clearly defined. Therefore, the European Association for Endoscopic Surgery (EAES) has developed this clinical practice guideline. Methods An international expert panel was invited to appraise the current literature and to develop evidence-based recommendations. The expert panel constituted for a consensus development conference in May 2010. Thereafter, the recommendations were presented at the annual congress of the EAES in Geneva in June 2010 in a plenary session. A second consensus process (Delphi process) of the recommendations with the explanatory text was necessary due to the changes after the consensus conference. Results Laparoscopic surgery for extraperitoneal (midand low-) rectal cancer is feasible and widely accepted. The laparoscopic approach must offer the same quality of surgical specimen as in open surgery. Short-term outcomes such as bowel function, surgical-site infections, pain and hospital stay are slightly improved with the laparoscopic approach. Laparoscopic resection of rectal cancer is not

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“…Colonoscopic localization of rectosigmoid or rectal cancers differs from the measurements obtained with a rigid sigmoidoscope and is believed to be more accurate. 38 Similarly, the distance from …”

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confidence: 98%