Pullthrough operation with delayed anastomosis for rectal cancer

Kirwan, W. O.; Turnbull, Rupert B.; Fazio, Victor W.; Weakley, Frank L.

doi:10.1002/bjs.1800651008

Cited by 159 publications

(69 citation statements)

References 8 publications

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“…Clinical assessment concerning stool frequency, fragmentation, urgency, soiling, and fecal incontinence varied widely in open‐ISR. Anal continence assessed by the Kirwan grade74 and the Wexner score75 appeared relatively good. Anorectal manometric examination may be useful for an objective assessment of anal function.…”

Section: Discussionmentioning

confidence: 90%

Intersphincteric resection for very low rectal cancer: A review of the updated literature

Shirouzu

Murakami

Akagi

2017

Annals of Gastroent Surgery

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Intersphincteric resection (ISR) has rapidly increased worldwide including laparoscopic surgery. However, there are some concerns for the definition of ISR, surgical technique, oncological outcome, anal function, and quality of life (QoL). The aim of the present study is to evaluate those issues. A review of this surgical technique was carried out by searching English language literature of the PubMed online database and appropriate articles were identified. With regard to open‐ISR, the morbidity rate ranged from 7.5% to 38.3%, with lower mortality rates. Local recurrence rates varied widely from 0% to 22.7%, with a mean follow‐up duration of 40–94 months. Disease‐free and overall 5‐year survival rates were 68–86% and 76–97%, respectively. Those outcomes were equivalent to laparoscopic‐ISR. Surgical and oncological outcomes of ISR were generally acceptable. However, accurate evaluation of anal function and QoL was difficult because of a lack of standard assessment of various patient‐related factors. The surgical and oncological outcomes after ISR seem to be acceptable. The ISR technique seems to be valid as an alternative to abdominoperineal resection in selected patients with a very low rectal cancer. However, both necessity for ISR and expectations of QoL impairment as a result of functional disorder should be fully discussed with patients before surgery.

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Section: Discussionmentioning

confidence: 90%

Intersphincteric resection for very low rectal cancer: A review of the updated literature

Shirouzu

Murakami

Akagi

2017

Annals of Gastroent Surgery

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“…A number of instruments exist to measure functional bowel outcomes, including the Wexner and Kirwan scores, but these are limited to one or few functional components 6,7 . The "LARS Score" has recently emerged as a validated tool for measuring multiple functional components as a composite outcome 8 .…”

Section: Introductionmentioning

confidence: 99%

A Cross-Sectional Review of Reporting Variation in Postoperative Bowel Dysfunction After Rectal Cancer Surgery

Chapman

Bolton²,

Corrigan³

et al. 2017

Diseases of the Colon &Amp; Rectum

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word count: 253 WordsContributions: DGJ and NY conceptualised the idea and had input to the study design. SJC and WB performed searches and collected data. SJC and NC performed statistical analysis. All authors contributed to the final writing of the manuscript. SJC and WSB contributed equally to this work and are joint first authors. DGJ is the study guarantor. AbstractBackground: Postoperative bowel dysfunction affects quality of life after sphincter-

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“…If the local conditions in the anus are satisfactory, a standard hand-sewn coloanal anastomosis is performed immediately. When there are other fistulous tracts close to the neodentate line or the internal opening of the fistula is close to the suture line, a delayed coloanal anastomosis as described by Cutait and Turnbull [35][36][37] should be considered. The highlight of this procedure relies on placing 8 sutures around the anus through the neodentate line.…”

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confidence: 99%

Contemporary surgical management of rectovaginal fistula in Crohn's disease

Valente

Hull

2014

WJGP

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Rectovaginal fistula is a disastrous complication of Crohn's disease (CD) that is exceedingly difficult to treat. It is a disabling condition that negatively impacts a women's quality of life. Successful management is possible only after accurate and complete assessment of the entire gastrointestinal tract has been performed. Current treatment algorithms range from observation to medical management to the need for surgical intervention. A wide variety of success rates have been reported for all management options. The choice of surgical repair methods depends on various fistula and patient characteristics. Before treatment is undertaken, establishing reasonable goals and expectations of therapy is essential for both the patient and surgeon. This article aims to highlight the various surgical techniques and their outcomes for repair of CD associated rectovaginal fistula.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Rectovaginal fistula; Crohn's disease; Fistula; Advancement flap; Sleeve advancement; Episioproctotomy Core tip: Rectovaginal fistula secondary to Crohn's disease is a devastating and disabling condition with a significant negative impact on quality of life. Furthermore, these fistulae pose an extremely challenging dilemma for the clinician with unique and often frustrating management challenges. Medical management is often futile and surgery may offer the only chance for cure. In this article, we aim to review the various treatment options to close these difficult to treat fistulae, with an emphasis on surgical technique and complex decision making. INTRODUCTIONFistula-in-ano is the most common perianal manifestation of Crohn's disease (CD) and was first reported by Gabriel [1] in 1921, nine years before Crohn et al [2] identified regional enteritis as a clinical entity. These fistulae are classified by their relationship to the sphincter complex as either high (supra-or extra-sphincteric vs low (inter-or trans-sphincteric). Low fistulae that transverse the anal sphincter are more appropriately named anovaginal fistulae, but by convention, all such fistulae are termed rectovaginal fistula (RVF). After obstetrical trauma, CD is the most common etiological factor for RVF, and will occur in up to 10% of women with CD [3,4] . Rectovaginal fistulae secondary to CD are associated with significant morbidity and carry an increased risk for proctectomy [5,6] . It is a devastating and disabling condition and is a source of considerable social embarrassment Contemporary surgical management of rectovaginal fistula in Crohn's diseaseMichael A Valente, Tracy L Hull and has a significant negative impact on quality of life. Furthermore, CD associated RVF are an extremely challenging dilemma for the clinician and present unique and often frustrating management challenges. In this article, we aim to review the various treatment options to close these difficult to treat fistulae, with an emphasis on surgical technique and decision making. PRESENTATION AND DIAGNOSISThe presence of a fis...

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Pullthrough operation with delayed anastomosis for rectal cancer

Cited by 159 publications

References 8 publications

Intersphincteric resection for very low rectal cancer: A review of the updated literature

Intersphincteric resection for very low rectal cancer: A review of the updated literature

A Cross-Sectional Review of Reporting Variation in Postoperative Bowel Dysfunction After Rectal Cancer Surgery

Contemporary surgical management of rectovaginal fistula in Crohn's disease

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