Intersphincteric resection for low rectal tumors:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Wien [u.a.]
Springer
2012
|
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | X, 190 S. zahlr. Ill., graph. Darst. Hinweis auf zusätzliches Internetmaterial im Buch |
| ISBN: | 9783709109281 3709109280 |
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| 245 | 1 | 0 | |a Intersphincteric resection for low rectal tumors |c Rudolf Schiessel ; Peter Metzger ed. |
| 264 | 1 | |a Wien [u.a.] |b Springer |c 2012 | |
| 300 | |a X, 190 S. |b zahlr. Ill., graph. Darst. |e Hinweis auf zusätzliches Internetmaterial im Buch | ||
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| 338 | |b nc |2 rdacarrier | ||
| 653 | |a Anus--Surgery. | ||
| 653 | |a Rectum--Cancer--Surgery. | ||
| 653 | |a Rectum--Tumors--Surgery. | ||
| 700 | 1 | |a Schiessel, Rudolf |e Sonstige |4 oth | |
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Datensatz im Suchindex
| _version_ | 1804149488446603264 |
|---|---|
| adam_text | Titel: Intersphincteric resection for low rectal tumors
Autor: Schiessel, Rudolf
Jahr: 2012
Pathology of low rectal cancer
The pathological assessment of the surgical
specimens originating from the lower rectum
and anal canal....................................................... 3
Barna Bogner
Development and anatomy of the anorectal wall and
surrounding structures......................................................... 3
The pathological investigation and staging of the lower
rectal/anal canal cancers...................................................... 5
The definitions of the surgical planes after TME................ 6
The rate of circumferential margin (CRM)
involvement/R status........................................................... 6
The usefulness of large histological sections........................ 7
The TNM stage of the lower rectum/anal canal cancers........ 7
The risk factors for recurrence after intersphincteric
resection............................................................................. 8
The histological consequences of neoadjuvant
chemoradiotherapy (CRT) in the anal complex..................... 8
Preoperative diagnostic procedures
Endorectal ultrasound for preoperative
staging................................................................. 13
Bryan Loh, Martin R. Weiser, and W. Douglas Wong1
Introduction...................................................................... 13
Staging of rectal cancer..................................................... 13
TNM staging system for rectal cancer ............................... 13
Primary tumor (T)......................................................... 13
Regional lymph nodes (N)............................................. 13
Metastases (M).............................................................. 14
Stage grouping.............................................................. 14
MSKCC modified ERUS staging system........................ 14
Equipment and technique................................................... 14
Normal ERUS anatomy..................................................... 14
Assessment of rectal neoplasms......................................... 15
uTO lesions.................................................................... 15
uTl lesions.................................................................... 15
uT2 lesions.................................................................... 16
uT3 lesions.................................................................... 16
uT4 lesions.................................................................... 16
Nodal involvement............................................................ 17
Accuracy of ultrasound in diagnosis of rectal cancer.......... 18
ERUS in postoperative follow-up....................................... 19
Endoanal ultrasound.......................................................... 19
EAUS for anal canal neoplasms [5] .................................. 20
Primary tumor (T)......................................................... 20
Regional nodes (N)........................................................ 20
Distant metastasis.......................................................... 20
Stage grouping.............................................................. 21
Conclusions....................................................................... 21
Intersphincteric resection: MRI for staging....... 25
Michael Urban
Introduction...................................................................... 25
Examination technique...................................................... 25
Anatomical considerations................................................. 26
The peritoneal reflection................................................ 26
The urogenital septum................................................... 27
The pelvic nerve plexuses.............................................. 28
The mesorectum and mesorectal fascia........................... 28
The normal rectal wall................................................... 28
The pelvic floor and anal sphincter................................. 29
Tumor morphology and T staging...................................... 29
Polypoidal tumors.......................................................... 31
Mucinous tumors........................................................... 32
Staging of rectal tumors................................................. 33
Image interpretation criteria for T staging................... 33
Lymph node staging................................................... 33
Venous spread........................................................ 34
The circumferential resection margin
in rectal cancer.......................................................... 35
Sphincter infiltration...................................................... 35
Future developments.......................................................... 36
Moving table MRI.................................................. 36
Diffusion weighted imaging.................................... 37
MRI after neoadjuvant therapy........................................... 37
Conclusion........................................................................ 38
Preoperative therapeutic options
Selective non-operative management of distal
rectal cancer: The Watch Wait Protocol......... 43
Angelita Habr-Gama, Rodrigo O. Perez, Patricio B. Lynn,
Guilherme Pagin Sào Juliao, and
Joaquim José Gama Rodrigues
Rationale for a non-immediate surgical approach............... 43
Response assessment......................................................... 43
Contents
Clinical assessment............................................................ 44
Radiological studies.......................................................... 45
CEA................................................................................. 46
Endoscopic biopsies after CRT.......................................... 46
Factors associated with tumor response after CRT.............. 46
Chemoradiation regimen.................................................... 46
Time for tumor response assessment.................................. 47
Tumor features and biology............................................... 48
The Watch Wait Protocol............................................... 49
Results.............................................................................. 49
Evolution: The extended chemoradiotherapy regimen......... 50
Perspectives...................................................................... 50
Surgery of low rectal cancer:
Intersphincteric resection
and its modifications
Surgical anatomy in intersphincteric
resection.............................................................. 57
Yusuke Kinugasa and Yoshihiro Moriya
Introduction...................................................................... 57
Fascial structures around the rectum.................................. 57
Fascia propria of the rectum........................................... 57
Denonvilliers fascia...................................................... 57
Pre-hypogastric nerve fascia........................................... 58
Parietal presacral fascia.................................................. 58
Rectosacral fascia.......................................................... 59
Autonomic nerves............................................................. 59
Superior hypogastric plexus........................................... 59
Hypogastric nerves........................................................ 59
Pelvic splanchnic nerves................................................ 59
Pelvic plexus................................................................. 60
Levator ani nerves......................................................... 60
Pudendal nerves............................................................. 60
Muscles and structures around the anal canal..................... 60
Anal canal..................................................................... 60
Levator ani muscle........................................................ 60
Rectourethralis muscle................................................... 61
Anococcygeal ligament.................................................. 61
Internal anal sphincter.................................................... 62
External anal sphincter................................................... 62
Conjoint longitudinal muscle layer of the anal canal....... 62
The history of rectal resection: The quest
for sphincter preservation.................................. 65
Brigitte Kovanyi-Holzer
Introduction ...................................................................... 65
Perineal approach.......................................................... 65
Sacral approach............................................................. 65
The abdominoperineal approach..................................... 66
Sphincter-saving sacral resection.................................... 69
Surgical technique of intersphincteric
resection.............................................................. 73
Rudolf Schiessei
Introduction...................................................................... 73
Indications........................................................................ 73
Diagnostic procedures....................................................... 74
Endoscopy and biopsy................................................... 74
Magnetic resonance imaging.......................................... 75
Endosonography of the rectum....................................... 75
Other imaging............................................................... 75
Sphincter manometry..................................................... 75
Planning of surgery........................................................ 76
The operation.................................................................... 76
Instruments.................................................................... 76
Positioning of the patient............................................... 76
Positioning of the surgical team..................................... 77
Surgical technique......................................................... 77
Abdominal part.............................................................. 77
Perineal part...................................................................... 79
Postoperative care.......................................................... 81
Results.......................................................................... 81
Indications..................................................................... 82
Complications............................................................... 82
Oncological results........................................................ 83
Functional results........................................................... 83
Conclusion........................................................................ 83
The laparoscopic technique of intersphincteric
rectum resection.................................................. 85
Peter Metzger
The current treatment of rectal cancer involves
a multidisciplinary approach in order to achieve
three primary goals............................................................ 85
Introduction...................................................................... 85
Laparoscopic technique for intersphincteric
rectal resection.................................................................. 86
Advantages.................................................................... 86
Disadvantages................................................................ 86
Indications - contraindications........................................... 86
Technical requirements...................................................... 87
Standardized surgical technique of the laparoscopic
part of intersphincteric rectum resection............................. 89
Pneumoperitoneum and port-positions............................ 89
Begin of the laparoscopic preparation............................. 89
Should we always mobilize the splenic flexure
in the surgery of the lower rectal cancer?....................... 90
Division of the inferior mesenteric vessels...................... 91
Laparoscopic TME........................................................ 91
Lateral dissection....................................................... 91
Dorsal dissection........................................................ 92
Anterior dissection..................................................... 92
End of the mesorectum.............................................. 93
Perineal part.................................................................. 93
Clinical and pathological data.................................... 94
Operation data, Complications.................................... 95
Functional outcome.................................................... 95
Discussion......................................................................... 95
Windows to the future....................................................... 96
Laparoscopic intersphincteric resection
for ultra-low rectal cancer.................................. 99
Carlo Staudacher and Elena Orsenigo
Introduction...................................................................... 99
Indications, advantages, and disadvantages of laparoscopic
intersphincteric resection............................................... 100
How is laparoscopic intersphincteric resection done?..... 101
Discussion........................................................................ 105
Contents
A concept of sphincter salvage in low
rectal cancer...................................................... 111
Kric Rullier. Quentin Denost. and Christophe Laurent
Introduction..................................................................... I l I
Limits of the abdominoperineal resection procedure.......... I I I
Sphincter preservation: E olution of the concept
and new rules................................................................... I 12
Bordeaux surgical strategy for low rectal cancer.............. I 12
Surgical technique of ISR................................................. I 14
Abdominal step............................................................ I 14
Perineal step................................................................. 114
Personal results of ISR..................................................... 1 14
Oncologic results.......................................................... 1 5
Functional results.......................................................... I 15
Laparoscopic experience................................................... 1 16
How to manage difticult cases?......................................... I 16
Intraoperative difficulty................................................. I 16
Rl resection after ISR................................................... 1 17
Faecal incontinence after ISR........................................ 1 17
Oncologic and functional outcomes
of external sphincter resection........................ 121
Kazuo Shirouzu and Yutaka Ogata
Abstract........................................................................... I2I
Introduction..................................................................... 121
Patients and methods........................................................ 121
Patients........................................................................ 121
Operative techniques..................................................... 122
Oncologic assessment and selection of the operative
procedure..................................................................... 122
Functional assessment................................................... 123
Postoperative follow-up................................................ 124
Statistical analysis........................................................ 124
Results............................................................................. 125
Preoperative characteristics of the patients and tumors... 125
Surgical outcomes......................................................... 125
Pathological outcomes.................................................. 125
Oncologic outcomes..................................................... 126
Functional outcomes..................................................... 126
Discussion........................................................................ 127
Intersphincteric resection for very low rectal
cancer. Special reference to surgical
techniques......................................................... 131
Yoshihiro Moriya
Introduction ..................................................................... 131
Anatomy of the anal canal................................................ 131
Patient selection............................................................... 13-
Surgical techniques........................................................... I 3-
Abdominal approaches.................................................. 132
Pelvic approaches......................................................... I 33
First step of the pel ic dissection.................................. 1 33
Second step of pelvic dissection.................................... 134
Third step of pelvic dissection....................................... I 34
Trans-anal approach...................................................... 135
Patient position......................................................... 135
Coloanal anastomosis................................................ 136
Pathological, functional and oncological outcomes............ 137
Morbiditv..................................................................... 137
Pathologic lindings....................................................... 137
Functional outcome.................................................... 137
Recurrences and sun i al ......................................... I 37
Conclusion.................................................................... 138
ISR practice and experience for extra-low
rectal cancer in China.................................
Zhenjiin Wang and Jiagang Han
139
Epidemiology of rectal cancer in China: Including cancer
incidence, distribution, etc................................................ I 39
Current treatment of rectal cancer in China....................... 139
ISR specifications in China............................................... 139
The proposal of modified partial ISR ................................ 140
Results of ISR study......................................................... 140
ISR inclusion criteria.................................................... 141
ISR does nol increase complications after surgery......... 141
ISR does not increase local recurrence rate.................... 141
ISR does not reduce sun i al rate.................................. 142
ISR has a better postoperative anal function.................. 142
The advantages o( laparoscopic ISR.............................. 143
Intersphincteric resection of low rectal
tumors: Experience from a German
Cancer Center.................................................... 145
Jonas Gold, Werner Hohenberger, and Susanne Merkel
Summary ......................................................................... 145
Introduction ..................................................................... 145
Patients and methods........................................................ 145
Patients........................................................................ 145
Patient selection for abdomino-pcranal intersphincteric
resection....................................................................... 147
Technique of abdomino-peranal intersphincteric
resection....................................................................... 147
Results............................................................................. 148
Neoadjuvant or adjuvant radiochemotherapy.................. 148
Operative procedures.................................................... 148
Distal margin of clearance............................................ 149
Circumferential margin................................................ 149
R0 resections................................................................ 150
Stage distribution.......................................................... 150
Postoperative complications and mortality rales............. 150
I.ocoregional rccurrences.................................................. 150
Cancer-related sun ival rates......................................... 151
Conclusion..................................................................... 151
Transanal abdominal transanal
proctosigmoidectomy with descending
coloanal anastomosis (the TATA procedure)
for low rectal cancer treated with
chemoradiation 153
.lohn II. Marks. George J. Nassil. and Gerald Marks
Technical description ................................................. 154
Abdominal portion / operation..................................... 156
Abdominal portion....................................................... 156
Pelvic portion.............................................................. 156
Overall results................................................................ 157
Conclusion................................................................. 158
Contents
Robot-assisted intersphincteric resection........ 159
Seon Hahn Kim and Jae Won Shin
Operation room setup, patient positioning, and port
placement......................................................................... 159
The surgical procedure..................................................... 160
Postoperative function
Quality of life following rectal resection......... 167
Brigitte Kovanyi-Holzer
Introduction..................................................................... 167
Social well-being.............................................................. 167
Psychological well-being.................................................. 167
Preoperative expectations.............................................. 168
QOL instruments.......................................................... 169
Social factors (education, religion)................................ 170
Conclusion....................................................................... 171
Do we need a pouch after intersphincteric
resection?........................................................... 173
Rudolf Schiessel
Introduction..................................................................... 173
Management of limitations for sphincter
preservation and functional failure following
intersphincteric resection................................. 177
Harald R. Rosen
Introduction..................................................................... 177
Oncological limitations..................................................... 177
Functional failure following intersphincteric resection....... 179
List of contributors.............................................. 183
Subject index...................................................... 185
About the editors................................................ 189
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| isbn | 9783709109281 3709109280 |
| language | English |
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| spelling | Intersphincteric resection for low rectal tumors Rudolf Schiessel ; Peter Metzger ed. Wien [u.a.] Springer 2012 X, 190 S. zahlr. Ill., graph. Darst. Hinweis auf zusätzliches Internetmaterial im Buch txt rdacontent n rdamedia nc rdacarrier Anus--Surgery. Rectum--Cancer--Surgery. Rectum--Tumors--Surgery. Schiessel, Rudolf Sonstige oth HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=025279784&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Intersphincteric resection for low rectal tumors |
| title | Intersphincteric resection for low rectal tumors |
| title_auth | Intersphincteric resection for low rectal tumors |
| title_exact_search | Intersphincteric resection for low rectal tumors |
| title_full | Intersphincteric resection for low rectal tumors Rudolf Schiessel ; Peter Metzger ed. |
| title_fullStr | Intersphincteric resection for low rectal tumors Rudolf Schiessel ; Peter Metzger ed. |
| title_full_unstemmed | Intersphincteric resection for low rectal tumors Rudolf Schiessel ; Peter Metzger ed. |
| title_short | Intersphincteric resection for low rectal tumors |
| title_sort | intersphincteric resection for low rectal tumors |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=025279784&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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