Postoperative Complications Following Surgery for Rectal Cancer

Paun, Bogdan C.; Cassie, Scott; MacLean, Anthony R.; Dixon, Elijah; Buie, W. Donald

doi:10.1097/sla.0b013e3181dae4ed

Cited by 437 publications

(307 citation statements)

References 104 publications

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“…Обладая высоким Онкологическая ONCOLOGY ТОМ 6 / VOL. 6 Colorectal КОЛОПРОКТОЛОГИЯ 4' 2016 О р и г и н а л ь н ы е и с с л е д о в а н и я контрастом, МРТ стала стандартом оценки распрост-раненности рака прямой кишки. Долгое время счи-тали, что стандартные МР-последовательности не позволяют проводить дифференцировку остаточной опухолевой ткани и воспалительных/фиброзных из-менений, происходящих в опухоли на фоне лечения.…”

Section: Discussionunclassified

“…Онкологическая ONCOLOGY ТОМ 6 / VOL. 6 Colorectal КОЛОПРОКТОЛОГИЯ 4' 2016 О р и г и н а л ь н ы е и с с л е д о в а н и я Л И Т Е Р А Т У Р А / R E F E R E N C E S…”

Section: заключениеunclassified

“…6 Colorectal КОЛОПРОКТОЛОГИЯ 4' 2016 О р и г и н а л ь н ы е и с с л е д о в а н и я Введение Интегрирование в клиническую практику пролон-гированного курса предоперационной химиолучевой терапии (ХЛТ) с последующим хирургическим лечени-ем при местно-распространенном раке прямой кишки позволило увеличить частоту регрессии опухоли и ра-дикальных операций и снизить частоту возникновения местных рецидивов, что привело к улучшению отда-ленных результатов лечения [1]. Лучевая терапия по-давляет пролиферативную активность опухолевых клеток и приводит к их гибели.…”

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“…У пациентов с радиочув-ствительными опухолями регрессия может достичь полного клинического и патоморфологического отве-та, что сопровождается тотальным замещением опухо-ли фиброзными тканями. Выполнение хирургического вмешательства в таком случае, по мнению некоторых авторов, является излишним, подвергающим пациен-та рискам, связанным с осложнениями, послеопера-ционной летальностью, нарушениями мочеполовой функции и формированием постоянной колостомы [5,6].…”

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“…При отсутствии признаков роста опухоли продолжали ди-намическое наблюдение каждые 3 мес, включающее пальцевое ректальное и эндоскопическое исследование прямой кишки, МРТ малого таза, рентгенологическое Онкологическая ONCOLOGY ТОМ 6 / VOL. 6 Colorectal КОЛОПРОКТОЛОГИЯ 4' 2016 О р и г и н а л ь н ы е и с с л е д о в а н и я исследование или компьютерную томографию (КТ) грудной клетки, ультразвуковое исследование или КТ брюшной полости.…”

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See 4 more Smart Citations

Organ Saving Treatment of Rectal Cancer

Расулов¹,

Мамедли²,

Кузьмичев³

et al. 2016

Onkol. koloproktol.

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Section: Discussionunclassified

Section: заключениеunclassified

unclassified

See 3 more Smart Citations

Organ Saving Treatment of Rectal Cancer

Расулов¹,

Мамедли²,

Кузьмичев³

et al. 2016

Onkol. koloproktol.

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Risk Factors for Anastomotic Leakage After Anterior Resection for Rectal Cancer

Kang¹,

Halabi²,

Chaudhry³

et al. 2013

JAMA Surg

351

237

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Transanal Drainage Tube Use for Preventing Anastomotic Leakage After Laparoscopic Low Anterior Resection in Patients With Rectal Cancer

et al. 2021

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Preventing anastomotic leakage (AL) is crucial for colorectal surgery. Some studies have suggested a positive role of transanal drainage tubes (TDTs) in AL prevention after low anterior resection, but this finding is controversial.OBJECTIVE To assess the effect of TDTs in AL prevention after laparoscopic low anterior resection for rectal cancer. DESIGN, SETTING, AND PARTICIPANTSThis multicenter randomized clinical trial with parallel groups (TDT vs non-TDT) was performed from February 26, 2016, to September 30, 2020. Participants included patients from 7 different hospitals in China who were undergoing laparoscopic low anterior resection with the double-stapling technique for mid-low rectal cancer; 576 patients were initially enrolled in this study, and 16 were later excluded. Ultimately, 560 patients were randomly divided between the TDT and non-TDT groups.INTERVENTIONS A silicone tube was inserted through the anus, and the tip of the tube was placed approximately 5 cm above the anastomosis under laparoscopy at the conclusion of surgery. The tube was fixed with a skin suture and connected to a drainage bag. The TDT was scheduled for removal 3 to 7 days after surgery. MAIN OUTCOMES AND MEASURESThe primary end point was the postoperative AL rate within 30 days. RESULTSIn total, 576 patients were initially enrolled in this study; 16 of these patients were excluded. Ultimately, 560 patients were randomly divided between the TDT group (n = 280; median age, 61.5 years [IQR, 54.0-68.8 years]; 177 men [63.2%]) and the non-TDT group (n = 280; median age, 62.0 years [IQR, 52.0-69.0 years]; 169 men [60.4%]). Intention-to-treat analysis showed no significant difference between the TDT and non-TDT groups in AL rates (18 [6.4%] vs 19 [6.8%]; relative risk, 0.947; 95% CI, 0.508-1.766; P = .87) or AL grades (grade B, 14 [5.0%] and grade C, 4 [1.4%] vs grade B, 11 [3.9%] and grade C, 8 [2.9%]; P = .43). In the stratified analysis based on diverting stomas, there was no significant difference in the AL rate between the groups, regardless of whether a diverting stoma was present (without stoma, 12 [5.8%] vs 15 [7.9%], P = .41; and with stoma, 6 [8.3%] vs 4 [4.5%], P = .50). Anal pain was the most common complaint from patients in the TDT group (130 of 280, 46.4%). Accidental early TDT removal occurred in 20 patients (7.1%), and no bleeding or iatrogenic colonic perforations were detected. CONCLUSIONS AND RELEVANCEThe results from this randomized clinical trial indicated that TDTs may not confer any benefit for AL prevention in patients who undergo laparoscopic low anterior resection for mid-low rectal cancer without preoperative radiotherapy.

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Postoperative Complications Following Surgery for Rectal Cancer

Abstract: Benchmark complication rates for radical rectal cancer surgery were obtained for use in sample size calculations in future studies and for quality control purposes. Postoperative death rates showed improvement in recent years.

Cited by 437 publications

References 104 publications

Organ Saving Treatment of Rectal Cancer

Organ Saving Treatment of Rectal Cancer

Risk Factors for Anastomotic Leakage After Anterior Resection for Rectal Cancer

Transanal Drainage Tube Use for Preventing Anastomotic Leakage After Laparoscopic Low Anterior Resection in Patients With Rectal Cancer

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