Wound recurrence following conventional treatment of colorectal cancer

Wt, Reilly; Nelson, Heidi; Schroeder, Georgene; Hs, Wieand; Bolton, John S.; Mj, O'Connell

doi:10.1007/bf02068076

Cited by 296 publications

(157 citation statements)

References 24 publications

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“…This is our first case of detected abdominal metastasis in 280 colorectal cancer cases which were operated between 2009 and 2014 (0.36%). Tumor recurrence due to the implantation sometimes occurs in the operating field, or in different places depending on the performed surgical procedure (19). There are many reports describing the implantation of tumor cells on the trocar sites during laparoscopic procedures (20).…”

Section: Discussionmentioning

confidence: 99%

A Case of Parastomal Hernia with Isolated Abdominal Wall Metastasis of Colorectal Cancer

Özyıldız¹,

Yazıcıoğlu²,

Turgut³

et al. 2017

Acta Oncol Tur.

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ÖZETKolorektal kanserin en yaygın uzak ve lokal metastazı sırasıyla karaciğer ve küçük pelvise olur. Kolorektal kanserin atipik lokalizasyonda izole metastazı, tanı anında ya da ameliyat sonrası izlem sürecinde görülebilir. Cerrahi teknik, kanserin evresi ve hastalığın doğal seyri gibi birden fazla faktör bu sürecin hayati bileşenlerini oluştursa bile bunların çoğunluğu tümör kolonizasyonu nedeniyle oluşur. Ancak tümör dökülmesine bağlı lokal nüksle nadiren karşılaşılır ve cerrahi teknik eksikliği en çok suçlanan nedendir. 72 yaşındaki kadın hastada da tübülövillöz adenoma zemininde gelişen orta derecede diferansiye distal rektal adenokarsinom (T1N0M0) için 2012 yılında geçirdiği APR (Abdominoperineal rezeksiyon) ameliyatından iki yıl sonra Parastomal herni tespit edildi. Parastomal herni onarımı için operasyona alınan hastada karın duvarının içinde şüpheli bir kitle palpe edildi. Kitle eksize edildi ve patolojik inceleme sonrası adenokarsinom olarak rapor edildi. Yeniden operasyona alınan hastaya kolostomi ile çevresindeki cildin ve 15 cm kolon segmentinin rezeksiyonunu içeren geniş rezeksiyon yapıldı. Biz, kolorektal kanserin izole metastazının izlem süresi boyunca görülebileceğini, bu nedenle atipik lokalizasyondaki herhangi bir kitlenin dikkatli değerlendirilmesi gerektiğini vurgulamayı amaçladık. Anahtar kelimeler: kolorektal kanser, parastomal herni, adenokanser, izole batın duvarı metastazı, kolostomi ABSTRACTThe most common distant and local metastasis of colorectal cancer is to liver and small pelvis respectively. The isolated metastasis of colorectal cancer in the atypical localization can be seen at the time of diagnosis or at postoperative follow-up period. Multiple factors such as surgical technique, stage of cancer, and natural history of the disease are vital components of the process, however majority of them are due to tumor colonization. However local recurrence due to tumor exfoliation rarely encountered, indetermination of surgical technique is the most accused reason. Parastomal hernia was detected in a 72 years old female patient two years after her APR (Abdominoperineal resection) operation in 2012 for moderately differentiated distal rectal adenocarcinoma (T1N0M0) that developed over tubulovillous adenoma. We found a suspicious mass within the abdominal wall closed to parastomal hernia in the operation. The mass was excised and reported as adenocarcinoma after pathological examination. Reoperation was planned and wide resection was performed with appropriate surgical margin including 15 cm of colon loops with skin of colostomy site. We aimed to emphasize that isolated metastasis of colorectal cancer can be seen during follow-up period so that any mass at atypical localization must be evaluated carefully.

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Section: Discussionmentioning

confidence: 99%

A Case of Parastomal Hernia with Isolated Abdominal Wall Metastasis of Colorectal Cancer

Özyıldız¹,

Yazıcıoğlu²,

Turgut³

et al. 2017

Acta Oncol Tur.

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“…The duration of the close contact between potentially tumor-laden trocars together with passing tumor-contaminated instruments and specimens through trocars have also been implicated in seeding at the wound site. Furthermore, disease-related factors such as the biological aggressiveness of a tumor, represented by the presence of ascites, advanced stage, or higher grade, have been linked to increased abdominal wall recurrences [24][25][26][27].…”

Section: Port-site Metastasismentioning

confidence: 99%

Medical Device Safety and Surgical Dissemination of Unrecognized Uterine Malignancy: Morcellation in Minimally Invasive Gynecologic Surgery

et al. 2015

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There is a risk of dissemination of uterine malignancies during minimally invasive hysterectomies when morcellation is used. Although the technique of uterine power morcellation allows timely removal of large benign tumors through small laparoscopic incisions, there are concerns about iatrogenic spread of cancers and reduced survival for women with preoperatively unrecognized malignancies. This review examines the literature on intraperitoneal spread and implantation of mechanically disrupted malignant tissue, discusses the current diagnostic tools for preoperative assessment of uterine tumors, and summarizes the current recommendations of the Society of Gynecologic Oncologists, the American College of Obstetricians and Gynecologists, and the American Association of Gynecologic Laparoscopists. Recommendations include informed consent of the risk of disseminating an otherwise contained malignancy, appropriate preoperative evaluation for malignancy, and development of alternatives to intracorporeal morcellation. Implications for Practice: Preoperative assessment of uterine masses or abnormal uterine bleeding must include understanding of the limitations of an endometrial biopsy and imaging studies to evaluate the possibility of a uterine malignancy. Minimally invasive surgery using morcellation of benign uterine growths is well established and safe; however, alternative surgical techniques to morcellation must be considered when the malignant potential of a uterine mass is uncertain. Morcellation carries the risk of widespread peritoneal seeding of an unrecognized uterine malignancy. Gynecologic surgeons must weigh the unlikely occurrence of disseminating an undiagnosed uterine sarcoma with the much more common surgical risks of abdominal surgery.

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“…Several case series, and even some registries, reported rates of trocar-site recurrences in excess of what was historically reported for open surgery. [78][79][80][81][82] This generated great interest in animal model investigations including mechanisms of tumor cell dissemination and immunologic studies. Clinical evidence was required to refute or confirm the association between the wound tumor implants and laparoscopic colectomy for cancer.…”

Section: Laparoscopic Resection For Colon Cancermentioning

confidence: 99%

Minimal Access Cancer Management

Greene

Kercher

Teigland

et al. 2007

CA: A Cancer Journal for Clinicians

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Minimal access approaches in the treatment of a variety of solid tumors of the stomach, large bowel, and genitourinary system are now being advocated in several surgical specialty areas. The laparoscope has evolved from a diagnostic tool to a modality that allows for removal of tumors using small incisions and the application of pneumoperitoneum with carbon dioxide. Through studies using animal models and patient investigation, the immunologic benefits of laparoscopic cancer procedures appear to be beneficial when compared with conventional laparotomy. Overall benefits of analgesic reduction, more rapid postoperative recovery, and patient satisfaction are the byproducts of minimal access approaches. Patients with cancers of the stomach, colon, and kidney show similar long-term outcomes when compared with conventional open techniques. Caution, however, should be exercised in recommending laparoscopic approaches for routine management of primary tumors of the rectum and adrenal gland.

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Wound recurrence following conventional treatment of colorectal cancer

Cited by 296 publications

References 24 publications

A Case of Parastomal Hernia with Isolated Abdominal Wall Metastasis of Colorectal Cancer

A Case of Parastomal Hernia with Isolated Abdominal Wall Metastasis of Colorectal Cancer

Medical Device Safety and Surgical Dissemination of Unrecognized Uterine Malignancy: Morcellation in Minimally Invasive Gynecologic Surgery

Minimal Access Cancer Management

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