Abstract:
INTRODUCTION:In situ ablation of colorectal liver metastases is frequently assessed for palliative treatment only. The establishment of clinically relevant lesion size and a lack of long-term survival data were regarded as main limitations to using them with curative intention. In contrast to surgical liver resection, whose oncological findings seem to have remained unchanged over the years, the in situ ablation methods have considerably changed technically and clinically in the last few years. OBJECTIVE:The aim of the paper was to point out experimental and clinical data underlining the impact of in situ ablation for potentially curative treatment of colorectal liver metastases. DISCUSSION:On the basis of experimental data, the aim of complete local tumor control (R0 ablation) can only be obtained if additional energy is applied after reaching the tumor-adapted maximal coagulation volume. Analogous to the oncological safety margin in surgical resection, we defined this decisive energy difference as the "energy safety margin" for in situ ablation. The energy safety margin is the energy that must be additionally applied after reaching the plateau in the energy/volume curve to achieve complete tumor coagulation. In addition to that, in situ ablation should be combined with temporary interruption of hepatic perfusion whenever possible to prevent intralesional recurrences. In this way, the thermoprotective mechanism of hepatic perfusion can be effectively eliminated. With restrictions, the survival data after ablation in specialized centers is comparable to surgical resection with concomitantly lower morbidity and mortality. Based on recent findings and with the corresponding expertise in the field of ablation and state-of-the-art equipment, ablation is, thus, an alternative to surgical resection. The combined application of surgical resection and ablation is also a suitable method for increasing the R0 rate and thus helps improve the prognosis of treated patients. In summary, it can be said that in situ ablation is a useful expansion of the therapeutic spectrum of liver metastases and can be applied as an alternative to or in combination with surgical resection.
journal_name
Int J Colorectal Disjournal_title
International journal of colorectal diseaseauthors
Isbert C,Buhr HJ,Ritz JP,Hohenberger W,Germer CTdoi
10.1007/s00384-006-0231-5subject
Has Abstractpub_date
2007-06-01 00:00:00pages
705-15issue
6eissn
0179-1958issn
1432-1262journal_volume
22pub_type
杂志文章abstract:BACKGROUND:Preclinical and clinical evidence support an association between vitamin D deficiency and an increased risk of colorectal cancer. Normal vitamin D status has been linked to favorable health outcomes ranging from decreased risk of osteoporosis to improved cancer mortality. We performed a retrospective study t...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-008-0593-y
更新日期:2009-02-01 00:00:00
abstract:PURPOSE:The diagnosis of irritable bowel syndrome is symptom based, and colonoscopy is the most direct way to rule out organic colonic diseases. It is controversial on the necessity of colonoscopy for patients with suspected irritable bowel syndrome and lacking alarm features. This study was designed to verify the orga...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-011-1163-2
更新日期:2011-07-01 00:00:00
abstract::We report the thirteenth case of a recto-urethral fistula in Crohn's disease. The patient, a 37-year-old white male, had a 20-year history of intestinal Crohn's disease and had undergone numerous bowel resections. His symptoms were fecaluria, urorrhea and passing of urine from an orifice just outside the base of the s...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,评审
doi:10.1007/BF00346215
更新日期:1995-01-01 00:00:00
abstract:PURPOSE:Anastomotic leak (AL) in colorectal surgery leads to significant morbidity, mortality and poorer oncological outcomes. Diagnosis of AL is frequently delayed as current methods of detection are not 100% sensitive or specific. 'Biomarkers', such as cytokines and markers of ischaemia, from the milieu of the anasto...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00384-017-2799-3
更新日期:2017-07-01 00:00:00
abstract:INTRODUCTION:Although advances in multimodal treatment have led to prolongation of survival in patients after resection of colorectal liver metastasis (CRC-LM), most patients develop recurrence, which is often confined to the liver. Repeat hepatic resection (RHR) may prolong survival or even provide cure in selected pa...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-013-1670-4
更新日期:2013-08-01 00:00:00
abstract::In a prospective study we examined the value of endorectal ultrasound (ERUS) in the preoperative staging of potentially locally excisable tumours. During the study period from 1.1.1991 to 1.3.1996 a total of 160 rectal tumours in 152 patients were staged endosonographically (uT/uN) and compared postoperatively with th...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s003840050092
更新日期:1997-01-01 00:00:00
abstract:PURPOSE:The oncological results of close distal resection margins (DM) have been mixed due to variations in perioperative treatment protocols and surgical expertise. With the increased application of sphincter-saving surgery in the management of rectal cancer, "close shave" DM is an increasingly encountered phenomenon....
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-012-1467-x
更新日期:2012-10-01 00:00:00
abstract::This short communication describes the results with respect to stage of colorectal cancer in people detected via screening and patients with clinical complaints. ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-018-3073-z
更新日期:2018-10-01 00:00:00
abstract::255 patients who underwent potentially curative surgical treatment for rectal carcinoma at the Cantonal Hospital Aarau from 1981 to 1989 have been followed up and the results analysed for overall survival and the timing and occurrence of local and distant recurrence in relation to the initial tumor stage. The patients...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00341187
更新日期:1993-09-01 00:00:00
abstract::Twenty-one patients suffering from rectal prolapse (n = 15) or internal rectal procidentia (n = 6) were investigated clinically and by anorectal manometry prior to and six months following retopexy. Rectal prolapse was associated with incontinence in 67% (10/15) of the patients preoperatively. The moderately or severe...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF01649678
更新日期:1988-03-01 00:00:00
abstract::The authors of the published version of this article inadvertently omitted the table note of the Table 2 under the Appendix section. The complete Table 2 is shown in this article]. ...
journal_title:International journal of colorectal disease
pub_type: 已发布勘误
doi:10.1007/s00384-020-03572-4
更新日期:2020-04-20 00:00:00
abstract:PURPOSE:Cancerous involvement of a ureter is sometimes encountered in pelvic surgery for malignancy. We usually perform transureteroureterostomy (TUU) in cases of unilateral lower ureteral cancerous involvement. We report the outcomes in patients treated with TUU in our institute. METHODS:We retrospectively reviewed t...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-016-2672-9
更新日期:2017-01-01 00:00:00
abstract::Since 1983 we have used radial and linear ultrasound probes in the laboratory and clinical examination of the rectum. Normal endosonographic appearances have been characterised by examining polyethylene membranes and resection specimens. Twenty normal subjects and 11 patients with rectal cancer have been examined, and...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF01648338
更新日期:1986-10-01 00:00:00
abstract:PURPOSE:Large bowel obstruction and megacolon formation secondary to complicated diverticulitis is rare. METHODS:We present a case of an 84-year-old woman surviving large bowel obstruction and mega-megacolon formation secondary to complicated diverticulitis, with an impressive presentation of abdominal distention. RE...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-020-03642-7
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND AND AIMS:Pouchitis is the major long-term complication after ileal pouch-anal anastomosis (IPAA) in patients operated on for ulcerative colitis. The cause is unknown, but both the history of ulcerative colitis and increased bacterial concentration are important factors. Chemokines are mediators for the recru...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-003-0500-5
更新日期:2004-03-01 00:00:00
abstract:PURPOSE:Although the effectiveness of antiemetic therapy for colorectal cancer chemotherapy has improved with further drug development, some patients still suffer from chemotherapy-induced nausea and vomiting (CINV) even with only 5-hydroxytryptamine-3 receptor antagonist and dexamethasone. The present study investigat...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-020-03731-7
更新日期:2020-12-01 00:00:00
abstract::The function of the striated anal sphincter during defaecation straining was recorded by manometry and electromyography (E.M.G.) in 31 constipated patients who were unable to expel a water-filled rectal balloon with effort. This group was divided on the basis of measurement of colonic diameter into those with megacolo...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF01660715
更新日期:1988-11-01 00:00:00
abstract::Anal fissure is a common condition affecting young to middle-aged adults. It causes severe pain on defecation and rectal bleeding. The aetiology remains uncertain. Spasm of the internal anal sphincter is a constant feature. Nitric oxide (NO) is the major inhibitory neurotransmitter of the internal anal sphincter (IAS)...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-005-0757-y
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND AND AIMS:This pilot study examines whether single-dose intravenous metronidazole preoperatively is at least as effective as a broad-spectrum multi-drug regimen in preventing infection-related wound complications following excision of pilonidal sinuses with primary closure. PATIENTS AND METHODS:A double-blin...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00384-002-0416-5
更新日期:2002-09-01 00:00:00
abstract:PURPOSE:The appendix can be a rare cause for chronic right lower quadrant abdominal pain (RLQAP), even though no objective disorder can be determined to the appendix. This condition can be described as chronic appendicitis or (neurogenic) appendicopathy. After careful selection, elective appendectomy is performed in ou...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-014-1978-8
更新日期:2014-10-01 00:00:00
abstract:PURPOSE:Crohn's disease (CD) commonly recurs after surgery, and a number of patients need repeated surgery, especially smokers and those with repeated surgeries or penetrating disease. Whether infliximab prevents postsurgical recurrence in high-risk CD remains unknown. In the present pilot open-labeled study, we invest...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
doi:10.1007/s00384-011-1398-y
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND AND AIMS:When assessing quality of care the outcome in terms of quality of life (QOL) is of major significance. This study examined QOL in IBD outpatients and the contribution of individual expectations and various other factors including disease activity. PATIENTS AND METHODS:The study included 306 outpati...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-003-0522-z
更新日期:2004-07-01 00:00:00
abstract:PURPOSE:Compared with the open approach, laparoscopic total mesorectal excision (TME) achieves faster patient recovery, reduces morbidity rates, and shortens hospital stay. However, in laparoscopic low anterior resection (L-LAR), conversion to open surgery is required in almost 20% of cases. Transanal TME (Ta-TME) comb...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s00384-018-2996-8
更新日期:2018-05-01 00:00:00
abstract:PURPOSE:Rectal advancement flap is an accepted approach for treating complex fistula-in-ano. However, a diversity of technical modifications have been described. The aim of this study was to evaluate recurrence and fecal continence rates after performing rectal advancement flaps depending upon flap thickness (full-thic...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00384-017-2779-7
更新日期:2017-05-01 00:00:00
abstract::A combined manometric and radioisotope study is described which was designed to investigate the motility characteristics of induced defaecation in the colon, rectum and anal canal, in patients with severe constipation. Five women with severe idiopathic constipation, aged 30-45 years, were studied. A multiple channel w...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00341220
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND:Extrarenal retroperitoneal angiomyolipomas are benign tumours of mesenchymal tissue origin. The diagnosis of these tumours is usually based on the perioperative findings and confirmed by the resultant specimen's histology. The main differential diagnosis is liposarcoma, and accurate preoperative imaging comb...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-003-0492-1
更新日期:2003-11-01 00:00:00
abstract:PURPOSE:Intestinal anastomosis is a fundamental procedure in general surgery and required to restore intestinal continuity following resection. The aim of this study was to evaluate whether a gentamicin-coated polyvinylidene fluoride (PVDF) suture material has beneficial effect on anastomotic healing. METHODS:Ninety S...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-015-2345-0
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND AND AIMS:This study evaluated the postoperative complications and clinical results of restorative proctocolectomy without diverting ileostomy for ulcerative colitis. PATIENTS AND METHODS:One hundred selected patients had a hand-sewn ileal J-pouch anal anastomosis with mucosectomy using an ultrasonically act...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-003-0538-4
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND AND AIMS:Pancreatic stellate cells (PSCs) play a key role in the development of pancreatic fibrosis. The molecular mechanisms underlying their activation in response to profibrogenic mediators, however, are largely unknown. Extending previous studies on the transcriptional regulation of PSC activation, we ha...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-003-0565-1
更新日期:2004-09-01 00:00:00
abstract:PURPOSE:Subtotal colectomy (STC) is performed for severe acute and refractory colitis. The diagnosis can be difficult even after the surgery when colectomy specimen has overlapping features of ulcerative colitis (UC) and Crohn's disease (CD). The aim of this study was to evaluate the rate of postoperative diagnostic re...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-020-03783-9
更新日期:2020-10-21 00:00:00