Abstract:
BACKGROUND:Increasing the rate of pathological complete remissions after neoadjuvant chemoradiation of rectal cancer has become a strategy to further improve the long-term oncological outcome of patients. This report evaluates the influence of preoperative intensified radiochemotherapy on the rate and outcome of surgical complications. MATERIALS AND METHODS:Patients with primary rectal cancer at stages cT3/4cNx or N+ without metastasis were preoperatively treated either with capecitabine and irinotecan or with capecitabine, irinotecan and ceutximab with a concurrent radiation (50.4 Gy). Surgery was scheduled 4-7 weeks after completion of the chemoradiation. Perioperative complications were prospectively documented during the patient's hospital stay. RESULTS:Fifty-nine patients (median age 60; male/female: 46/13) undergoing surgery at a single center were analysed. The median distance of the tumour from the dentate line was 5 cm. The operations performed were low anterior resection (n=45), Hartmann's procedure (n=4) and abdominoperineal resection (n=10). Total mesorectal excision with R0-resection was accomplished in all but one patients. Histopathological regression was described in four grades (0-3) as defined by the Japanese Society for Cancer of the Colon and Rectum. Tumors were called major responsive when assigned to the regression grades 3 or 2, and minor or nonresponsive at regression grades 1 or 0. In total, 33 patients (55.9%) had a regression grade 2 or 3. Among them, 12 patients showed a pathological complete response without any residual cancer cell (20.3%). Seven out of 45 patients (15.5%) with sphincter-preserving surgery suffered from suture breakdown; they all had previously shown a major response of the resected tumor. Two of them died during the hospital stay. CONCLUSIONS:While in general, patients undergoing neoadjuvant intensified treatment suffer from a slight increase in surgical complications, this is markedly enhanced in patients with good treatment responses. Our results underline the oncological benefit of intensified neoadjuvant chemoradiation, but the severity of complications in low rectal anastomosis of patients with good response after neoadjuvant therapy should alert surgeons and oncologists.
journal_name
Int J Colorectal Disjournal_title
International journal of colorectal diseaseauthors
Horisberger K,Hofheinz RD,Palma P,Volkert AK,Rothenhoefer S,Wenz F,Hochhaus A,Post S,Willeke Fdoi
10.1007/s00384-007-0408-6subject
Has Abstractpub_date
2008-03-01 00:00:00pages
257-64issue
3eissn
0179-1958issn
1432-1262journal_volume
23pub_type
杂志文章,随机对照试验abstract:PURPOSE:Due to diagnostic advancements, preoperative staging of rectal tumors was significantly improved. However, difficulties in obtaining accurate results can sometimes be observed in the staging of adenomas and early rectal carcinomas (pT1/2). The aim of this study was to test if confocal chromolaser endomicroscopy...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-009-0813-0
更新日期:2010-01-01 00:00:00
abstract:PURPOSE:Some recent studies have suggested that fluorescence angiography with indocyanine green (ICG) might be useful for preventing anastomotic leakage (AL) after laparoscopic colorectal surgery. However, its efficacy has not been proven. We evaluated whether intraoperative ICG fluorescence angiography could decrease ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-019-03482-0
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Diverting stomata (DS) have been shown to mitigate the clinical impact of anastomotic leakage (AL) but not without complications, and their routine use remains a matter of international debate. The objective of this study was to examine the association between stomata and the clinical consequences of AL. ME...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-020-03625-8
更新日期:2020-10-01 00:00:00
abstract:PURPOSE:Postoperative ileus (POI) occurrence within enhanced recovery programs (ERPs) has decreased. Also, intra-abdominal complications (IAC) such as anastomotic leakage (AL) generally present late. The aim was to characterize the link between POI and the other complications occurring after surgery. METHODS:This retr...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-018-3165-9
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:We aimed to evaluate comparative outcomes of robotic and laparoscopic total mesorectal excision (TME) in patients with rectal cancer. METHODS:We systematically searched electronic data sources with application of combination of free text and controlled vocabulary search adapted to thesaurus headings, search...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,评审
doi:10.1007/s00384-020-03655-2
更新日期:2020-08-01 00:00:00
abstract:AIM:Psychological stress is known to affect the immunologic system and the inflammatory response. The aim of this study was to assess the presence of psychological stress, anxiety, and depression in patients with anal fistula. METHODS:Consecutive patients with anal fistula, hemorrhoids, and normal volunteers were stud...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-015-2245-3
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Some patients with uncomplicated diverticulitis have extraluminal air. Our objective was to determine if patients with Hinchey 1a diverticulitis and isolated extraluminal air present more severe episode than patients without extraluminal air. METHODS:The present study is a monocentric observational retrospe...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-019-03424-w
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND AND AIMS:Malignant cells often exhibit perturbations in the pattern of cytosine methylation. Hypermethylation of CpG islands has been extensively documented, but genome-wide hypomethylation is also a common feature of malignant cells. The bulk of cytosine methylation in the mammalian genome occurs on repetit...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-003-0539-3
更新日期:2004-03-01 00:00:00
abstract:PURPOSE:Kras mutations are negative predictors of anti-EGFR therapy, occurring in 40% of colorectal carcinomas (CRCs). Point substitutions in codon 12 or 13 are the most frequent mutations in Kras, but multiple mutations (MMs) in other codons can also develop. Few data exist on MMs with regard to their frequency and th...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,评审
doi:10.1007/s00384-011-1238-0
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:The prognostic impact of isolated lymphovascular invasion (LVI) after radical resection of rectal cancer is controversially discussed. However, it could be relevant to decide for an adjuvant treatment. AIM:The aim of the analysis was, based on the data of an observational study, to determine the prognostic ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,多中心研究
doi:10.1007/s00384-006-0220-8
更新日期:2007-07-01 00:00:00
abstract:PURPOSE:Although the technique for the surgical repair of rectal prolapse has advanced over the years, no ideal procedure has been found. We aim to test a new surgical procedure for abdominal rectopexy that uses the greater omentum to support the rectum below the rectopexy, to reconstruct the anorectal angle and dispen...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-004-0650-0
更新日期:2005-03-01 00:00:00
abstract:INTRODUCTION:Recently, superficial elevated colorectal tumors have been increasingly diagnosed after improvements in endoscopic instruments and techniques. However, their biological characteristics remain obscure and it is difficult to predict malignant potential. The aim of this study is to clarify the characteristics...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-006-0115-8
更新日期:2007-01-01 00:00:00
abstract::Myositis of the skeletal muscle is a rare complication of inflammatory bowel disease. We report about a 33-year-old woman with quiescent ulcerative colitis known since 1995. She had suffered from recurring fever and pain in the thighs for about 4 weeks. Electromyography of quadriceps and deltoid muscles revealed myopa...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,评审
doi:10.1007/s003840050234
更新日期:1999-12-01 00:00:00
abstract::The biomechanical properties and intestinal wall composition of left colon were studied in 4-month-old, 14-month-old, and 27-month-old male rats. The hydroxyproline content and hydroxyproline concentration in old rats were increased by 36% and 26%, respectively, compared with young rats and by 20% and 17%, respectivel...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00341292
更新日期:1992-06-01 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:INTRODUCTION:It is generally believed that resumption of feeding after colorectal resection is indicated only after recovery of bowel function. This study was designed to verify safety, feasibility, and tolerance of early oral postoperative feeding (EOF) outside an enhanced recovery after surgery (ERAS) program. MATER...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
doi:10.1007/s00384-011-1138-3
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Colon capsule endoscopy (CCE) is a reliable method to detect colonic polyps in the well-prepared colon. As CCE evaluation can be time consuming, a new software algorithm might aid in reducing evaluation time. OBJECTIVES:The aim of the study was to evaluate whether it is feasible to reliably detect colon pol...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-019-03393-0
更新日期:2019-11-01 00:00:00
abstract::In a prospective study on 224 patients with so-called high-fistula in ano (189 transsphincteric, 35 suprasphincteric) the long-term results of a sphincter-saving operation technique were assessed. The follow-up period was 1 to 7.5 years. This technique consists of one-stage fistulectomy as well as of drainage of the i...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00290193
更新日期:1994-08-01 00:00:00
abstract:PURPOSE:Lynch syndrome (LS) is associated with a high risk of colorectal cancer (CRC). The aim of this study was to assess the cumulative risk for the development of colorectal adenomas or carcinomas in a LS CRC surveillance program and to audit the quality of the endoscopic procedures. METHODS:We evaluated 147 asympt...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-018-3002-1
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND AND AIMS:This study determined correlations of clinical and manometric features with those of anal endosonography (AES). PATIENTS AND METHODS:Between 1996 and 1999 we examined 58 patients suffering from anal incontinence (AI) by AES using a linear probe and anorectal manometry following a standardized proto...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s003840100354
更新日期:2002-03-01 00:00:00
abstract:PURPOSE:The use of computed tomography (CT) to detect anastomotic leakage (AL) is becoming the standard of care. Accurate detection of AL is crucial. The aim of this study was to define CT criteria that are most predictive for AL. METHODS:From January 2006 to December 2012, all consecutive patients who had undergone C...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-015-2215-9
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Ostomies are being placed in 35 % of patients after colorectal cancer surgery. As decision-making regarding colorectal surgery is challenging in the older patients, it is important to have insight in the potential impact due to ostomies. METHODS:An internet-based survey was sent to all members with register...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-016-2665-8
更新日期:2017-01-01 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:BACKGROUND:Colorectal cancer (CRC) is the third most frequent cancer diagnosed in men and the second in women. Laparoscopic surgery has been a technical revolution in colorectal surgery, facilitating a better recovery of patients with lower morbidity and better esthetic results, compared to traditional surgery via lapa...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00384-018-3157-9
更新日期:2018-11-01 00:00:00
abstract:PURPOSE:The aim of the study was to determine the spatiotemporal expression of Wnt5a during hindgut and anorectum development in human embryos and to explore the possible role of Wnt5a during the morphogenesis of the human hindgut and anorectum. MATERIALS AND METHODS:The embryos (n = 107) were sectioned serially and s...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-011-1191-y
更新日期:2011-08-01 00:00:00
abstract:INTRODUCTION:A multidisciplinary tertiary service for adolescents with inflammatory bowel disease (IBD) was commenced in April 2008, aiming to provide specialist treatment for adolescent patients and bridge the gap between existing paediatric and adult surgical services. A single laparoscopic colorectal surgeon who nor...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
doi:10.1007/s00384-010-1058-7
更新日期:2011-03-01 00:00:00
abstract:INTRODUCTION:The ileal pouch-anal anastomosis (IPAA) has become a standard procedure for patients with ulcerative colitis requiring surgical intervention. The technique has greatly improved and, since 1990, all patients at Huddinge University Hospital have been operated on with the double stapled technique. Pelvic seps...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-004-0717-y
更新日期:2005-11-01 00:00:00
abstract:PURPOSE:Fecal incontinence (FI) is a debilitating condition that can be socially and personally incapacitating. A broad range of treatment options, often stepwise, are available, depending on severity. This prospective study reports a large single-centered series of patients who have benefited of temperature-controlled...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
doi:10.1007/s00384-008-0514-0
更新日期:2008-10-01 00:00:00
abstract:PURPOSE:Anastomotic leakage after low anterior resection for rectal cancer is a critical problem. Many risk factors have been suggested and surgical techniques have improved, but anastomotic leakage remains a major postoperative challenge. This study sought to create a nomogram for precise prediction of anastomotic lea...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-018-2970-5
更新日期:2018-04-01 00:00:00
abstract:PURPOSE:Entero-vesical or entero-vaginal fistulae (EVF) are an uncommon septic complication mainly of diverticular disease. The fistulae are usually situated within extensive and dense inflammatory masses occluding the entrance of the pelvis. There are still some controversies regarding laparoscopic feasibility and tre...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-015-2395-3
更新日期:2016-01-01 00:00:00