The management of rectal cancer with synchronous liver metastases: a modern surgical dilemma.


INTRODUCTION:One in ten patients with rectal cancer presents with synchronous colorectal liver metastases. We present an up-to-date review of the different surgical strategies available for rectal cancer patients with synchronous colorectal liver metastases. METHOD:A literature review of MEDLINE, Cochrane and Google scholar was performed. RESULTS:Twenty retrospective studies comparing staged versus simultaneous resections were found. Overall survival was similar for both approaches whilst the length of stay was decreased in simultaneous resections. Only two studies comparing the 'reverse' versus staged or simultaneous resections were found. The studies investigating resection versus non-resection for rectal primaries with unresectable liver metastases were limited. CONCLUSION:Simultaneous resections are a reasonable alternative to staged resections for either advanced rectal cancers with limited liver disease or early rectal cancers with extensive liver disease. Currently, staged resections are favoured over simultaneous resections in patients with locally advanced rectal cancers with extensive liver disease. There are too few studies to determine the safety of reverse resections in the context of locally advanced rectal cancers. A resection of the primary tumour or a non-surgical intervention can be justified in the management of the rectal cancer primary in the presence of unresectable liver metastases.


Tech Coloproctol


Slesser AA,Bhangu A,Brown G,Mudan S,Tekkis PP




Has Abstract


2013-02-01 00:00:00












  • New-onset rectoanal intussusception may not result in symptomatic improvement after laparoscopic ventral rectopexy for external rectal prolapse.

    abstract:BACKGROUND:This study was designed to assess defecatory function in patients who underwent laparoscopic ventral rectopexy (LVR) for external rectal prolapse (ERP). METHODS:Thirty-one patients who underwent evacuation proctography 6 months postoperatively were assessed. Preoperative proctography had been performed in 2...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Tsunoda A,Takahashi T,Ohta T,Fujii W,Kusanagi H

    更新日期:2016-02-01 00:00:00

  • Currently available and experimental dyes for intraoperative near-infrared fluorescence imaging of the ureters: a systematic review.

    abstract:BACKGROUND:Iatrogenic ureteral injury (IUI) following abdominal surgery has a relatively low incidence, but is associated with high risks of morbidity and mortality. Conventional assessment of IUI includes visual inspection and palpation. This is especially challenging during laparoscopic procedures and has translated ...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Slooter MD,Janssen A,Bemelman WA,Tanis PJ,Hompes R

    更新日期:2019-04-01 00:00:00

  • Large bowel obstruction in women with pelvic malignancies. What is the primary?

    abstract:BACKGROUND:Large bowel obstruction is occasionally the mode of presentation of advanced colorectal or pelvic malignancies, and a prognostic of poor survival. The choices of treatment range from palliative tube decompression to curative or palliative surgery. METHODS:Twelve out of 500 women with various malignancies an...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Papapolychroniadis C,Kaimakis D,Giannoulis K,Berovalis P,Fotiadis P,Maidatsi P,Zaralidou A,Kokkonis G,Papakonstantinou P,Giala M,Harlaftis N

    更新日期:2004-11-01 00:00:00

  • Robotic transanal total mesorectal excision: a pilot study.

    abstract:BACKGROUND:The introduction of transanal minimally invasive surgery (TAMIS) in 2009 allowed colorectal surgeons to approach transanal access with a different perspective. This has lead to the development of TAMIS for total mesorectal excision (TME). We have previously described robotic transanal TME and here report our...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Atallah S,Martin-Perez B,Pinan J,Quinteros F,Schoonyoung H,Albert M,Larach S

    更新日期:2014-11-01 00:00:00

  • Early and late complications of stapled haemorrhoidopexy: a 6-year experience from a single surgical clinic.

    abstract:PURPOSE:Introduction of stapled hemorrhoidopexy (SH) brought a radical change in the treatment of haemorrhoidal disease. The aim of this study is to evaluate the results and the complications (early and late) from the use of this technique. METHODS:During the last 6 years (2005-2011), 123 patients underwent a SH in ou...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Grigoropoulos P,Kalles V,Papapanagiotou I,Mekras A,Argyrou A,Papageorgiou K,Derian A

    更新日期:2011-10-01 00:00:00

  • Sacrococcygeal dimensions and curvature are associated with resection quality in rectal cancer excision.

    abstract:BACKGROUND:Technical factors affect oncologic outcomes in rectal cancer surgery. The anatomy of the bony pelvis can affect technical aspects of surgery, but is seldom considered preoperatively. We performed a morphometric analysis of the bony pelvis in patients having rectal cancer resection to assess its effect on sur...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Simpson G,Marks T,Blacker S,Smith D,Walsh C

    更新日期:2020-10-01 00:00:00

  • Laparoscope-assisted anal sphincter-preserving operation preceded by transanal procedure.

    abstract:BACKGROUND:Transanal intersphincteric resection (ISR) was introduced and has been increasingly performed as an ultimate surgical treatment for extremely low rectal cancer. We considered that high quality and less invasive surgery could be achieved if ISR and laparoscopic surgery were combined. METHODS:Between December...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Uchikoshi F,Nishida T,Ueshima S,Nakahara M,Matsuda H

    更新日期:2006-03-01 00:00:00

  • Long-term outcome of sacral neuromodulation for chronic refractory constipation.

    abstract:PURPOSE:Sacral neuromodulation has been reported as a treatment for severe idiopathic constipation. This study aimed to evaluate the long-term effects of sacral neuromodulation by following patients who participated in a prospective, open-label, multicentre study up to 5 years. METHODS:Patients were followed up at 1, ...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章,多中心研究


    authors: Maeda Y,Kamm MA,Vaizey CJ,Matzel KE,Johansson C,Rosen H,Baeten CG,Laurberg S

    更新日期:2017-04-01 00:00:00

  • A prospective case-control study of extralevator abdominoperineal excision (ELAPE) of the rectum versus conventional laparoscopic and open abdominoperineal excision: comparative analysis of short-term outcomes and quality of life.

    abstract:BACKGROUND:Conventional abdominoperineal excision (APE) of the rectum is associated with higher circumferential resection margin (CRM) involvement, increased local recurrence, and reduced survival compared to anterior resection. A more radical extralevator APE (ELAPE) technique may improve oncological outcome. However,...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Vaughan-Shaw PG,Cheung T,Knight JS,Nichols PH,Pilkington SA,Mirnezami AH

    更新日期:2012-10-01 00:00:00

  • Perforated left-sided diverticulitis with faecal peritonitis: is the Hinchey classification the best guide for surgical decision making?

    abstract:BACKGROUND:Although the Hinchey scoring system has guided surgical decision making for perforated diverticulitis, what constitutes optimal surgical management is controversial. We report our experience of selective primary closure of the perforation without use of a transverse colostomy and the specific circumstances i...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Naraynsingh V,Maharaj R,Hassranah D,Hariharan S,Dan D,Zbar AP

    更新日期:2011-06-01 00:00:00

  • Laparoscopic total mesorectal excision.

    abstract::This article describes the operative technique that my colleagues and I apply to total mesorectal excision in patients with rectal cancer. A body of data support improvement of short-term outcomes over open resection. Although long-term data remain scarce, several ongoing trials may clarify this deficiency. The approp...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Khanna A

    更新日期:2013-02-01 00:00:00

  • Ligation under vision of haemorrhoidal cushions for therapy of bleeding haemorrhoids.

    abstract::Ligation under vision (LUV) is a simple method for the surgical treatment of haemorrhoids. In this study, we evaluated the results of our initial experience with the procedure in terms of postoperative pain, patients' final satisfaction and complications. We reviewed a group of patients who had undergone suture ligati...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Bronstein M,Issa N,Gutman M,Neufeld D

    更新日期:2008-06-01 00:00:00

  • Restorative surgery for ulcerative colitis in the elderly: an analysis of ileal pouch-anal anastomosis procedures from the American College of Surgeons National Surgical Quality Improvement Program.

    abstract:BACKGROUND:Ileal pouch-anal anastomosis (IPAA) for ulcerative colitis(UC) can be performed as either 2- or 3-stage procedure. IPAA in the elderly has been reported as safe and feasible, but little work to date has assessed outcomes by procedure. The aim of our study was to assess use and short-term outcomes of 2- and 3...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Pellino G,Reif de Paula T,Lawlor G,Keller DS

    更新日期:2020-08-16 00:00:00

  • How I do it: the stapled ileal J pouch at restorative proctocolectomy.

    abstract:BACKGROUND:Ileal pouch-anal anastomosis (IPAA) following proctocolectomy is the preferred option for patients with medically refractory ulcerative colitis, indeterminate colitis, and familial adenomatous polyposis. However, it remains a procedure associated with morbidity and mortality. Pelvic sepsis, pouch fistulae, a...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Martin ST,Tevlin R,Heeney A,Peirce C,Hyland JM,Winter DC

    更新日期:2011-12-01 00:00:00

  • Appendicular intussusception into a polyp.

    abstract::Intussusception of the appendix is a rare condition. We present the case of a 72-year-old woman with multiple polyps in the colon with an appendix completely intussuscepted into a polyp within the caecum. The clinical features, preoperative diagnosis, classification and treatment of this condition are discussed with r...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Mathew J,Aldean IM,Ghafar FA,Haboubi NY

    更新日期:2004-08-01 00:00:00

  • Fistulotomy or fistulectomy and primary sphincteroplasty for anal fistula (FIPS): a systematic review.

    abstract::There is still no clear consensus about surgical treatment of anal fistulas. Fistulotomy or fistulectomy and primary sphincter reconstruction is still regarded with skepticism. The aim of this systematic review was to evaluate the evidence in the literature supporting the use of this technique in the treatment of comp...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章,评审


    authors: Ratto C,Litta F,Donisi L,Parello A

    更新日期:2015-07-01 00:00:00

  • Local correction of a transverse loop colostomy prolapse by means of a stapler device.

    abstract::Prolapse is a common complication in patients with a transverse loop colostomy. In most cases, the prolapse can be managed conservatively awaiting time for closure eventually. However, loop stoma may also be intentionally permanent or the patient may be too fragile to have the colostomy closed and in these cases a lap...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Maeda K,Maruta M,Utsumi T,Sato H,Aoyama H,Katsuno H,Hultén L

    更新日期:2004-03-01 00:00:00

  • The circumferential resection margin in rectal carcinoma surgery.

    abstract::After radical resection of rectal carcinoma, the circumferential resection margin (CRM) on the non-peritonealized surface of the resected specimen is of critical importance. Histopathological examination of resected specimens must include careful assessment of the CRM. There is a need to distinguish between CRM-positi...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章,评审


    authors: Hermanek P,Junginger T

    更新日期:2005-12-01 00:00:00

  • Pudendal nerve block versus local anesthesia for harmonic scalpel hemorrhoidectomy: a prospective randomized study.

    abstract:BACKGROUND:This prospective randomized trial was used to compare two different local anesthetic techniques, local perianal anesthesia and pudendal nerve block, used for harmonic scalpel hemorrhoidectomy (HSH). METHODS:A total of 120 patients with grade III or IV hemorrhoids were randomly chosen to perform HSH (60 pati...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章,随机对照试验


    authors: Tepetes K,Symeonidis D,Christodoulidis G,Spyridakis M,Hatzitheofilou K

    更新日期:2010-11-01 00:00:00

  • Patient quality of life and short-term surgical outcomes between robotic and laparoscopic anterior resection for adenocarcinoma of the rectum.

    abstract:PURPOSE:To compare patient quality of life (QoL) and short-term surgical outcomes between robotic anterior resection (r-AR) and laparoscopic (l-AR) approach. METHODS:Consecutive patients having undergone either robotic or laparoscopic AR for adenocarcinoma were studied. All operations were performed by two surgeons ex...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Kamali D,Omar K,Imam SZ,Jha A,Reddy A,Jha M

    更新日期:2017-05-01 00:00:00

  • Systematic review of blood diagnostic markers in colorectal cancer.

    abstract::The purpose of this systematic review was to compare the diagnostic ability of blood markers for colorectal cancer (CRC). A systematic review of the literature for diagnostic blood markers for primary human colorectal cancer over the last 5 years was performed. The primary outcome was to assess the diagnostic ability ...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章,评审


    authors: Nikolaou S,Qiu S,Fiorentino F,Rasheed S,Tekkis P,Kontovounisios C

    更新日期:2018-07-01 00:00:00

  • Chemoprevention of colorectal cancer: an update.

    abstract::Colorectal cancer (CRC) is the leading cause of cancer-related mortality in western countries. Adjuvant treatment does not seem to be highly effective and recurrent or metastatic disease occurs in half of the new cases within one year of diagnosis and median survival does not exceed 18 months. CRC represents an optima...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章,评审


    authors: Serrano D,Lazzeroni M,Decensi A

    更新日期:2004-12-01 00:00:00

  • Synchronous polyps in patients with colorectal cancer.

    abstract:BACKGROUND:The aim of this study is to underscore the incidence of synchronous polyps in patients with colorectal cancer and to emphasise the importance of their perioperative detection and management. PATIENTS AND METHODS:Three hundred and seven patients underwent a potentially curative resection for colorectal cance...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Demetriades H,Kanellos I,Blouhos K,Tsachalis T,Vasiliadis K,Pramateftakis MG,Betsis D

    更新日期:2004-11-01 00:00:00

  • The utilization of intraluminal formalin for intractable rectal haemorrhage in advanced rectal cancer: a case report.

    abstract::A patient with a metastatic fixed low rectal carcinoma presented severe rectal bleeding requiring massive transfusion over with a 36-hour period. Bleeding was controlled with the instillation of a 4% intrarectal formalin solution permitting the completion of a course of neoadjuvant chemoradiotherapy. This technique ha...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Zbar AP,Bernstein S,Greaves N,Iniss M,Shenoy RK

    更新日期:2005-04-01 00:00:00

  • Robotic versus laparoscopic surgery for rectal cancer: a comparative cost-effectiveness study.

    abstract:BACKGROUND:The differences between the costs of robotic rectal resection and of the laparoscopic approach are still not well known. The aim of this study was to evaluate the cost-effectiveness of robotic versus laparoscopic surgery. METHODS:We conducted an observational, comparative, prospective, non-randomized study ...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Quijano Y,Nuñez-Alfonsel J,Ielpo B,Ferri V,Caruso R,Durán H,Díaz E,Malavé L,Fabra I,Pinna E,Isernia R,Hidalgo Á,Vicente E

    更新日期:2020-03-01 00:00:00

  • Colonic motility studies in severe chronic constipation: an organic approach to a functional problem.

    abstract::Chronic constipation is one of the more frequent functional gastrointestinal symptoms. The more severe cases not infrequently undergo a major surgical approach. However, there is still a need for a better diagnostic and therapeutic approach, since the results are still unpredictable, probably due to a poor selection o...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章,评审


    authors: Bassotti G,de Roberto G,Sediari L,Morelli A

    更新日期:2004-11-01 00:00:00

  • Long-term outcomes of biological mesh repair following extra levator abdominoperineal excision of the rectum: an observational study of 100 patients.

    abstract:BACKGROUND:Current evidence suggests that pelvic floor reconstruction following extralevator abdominoperineal excision of rectum (ELAPER) may reduce the risk of perineal herniation of intra-abdominal contents. Options for reconstruction include mesh and myocutaneous flaps, for which long-term follow-up data is lacking....

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Thomas PW,Blackwell JEM,Herrod PJJ,Peacock O,Singh R,Williams JP,Hurst NG,Speake WJ,Bhalla A,Lund JN

    更新日期:2019-08-01 00:00:00

  • Prospective randomized crossover trial comparing fibre with lactulose in the treatment of idiopathic chronic constipation.

    abstract:BACKGROUND:Fibre is often recommended as the first-choice treatment but its effects can be uneven. The aim of the study was to compare the clinical efficacy and tolerability of fibre versus lactulose in outpatients with chronic constipation. METHODS:In a prospective randomized crossover trial, patients were randomized...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章,随机对照试验


    authors: Quah HM,Ooi BS,Seow-Choen F,Sng KK,Ho KS

    更新日期:2006-07-01 00:00:00

  • Stapled mucosal prolapsectomy for haemorrhoidal prolapse with Lone Star Retractor System.

    abstract::This technical note presents a variation of the stapled mucosal prolapsectomy for haemorrhoidal prolapse using the Lone Star Retractor. Our experience highlights the simplicity and usefulness of the technique which is based on the complete eversion of the prolapse carried out by the Lone Star Retractor, without using ...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Carriero A,Dal Borgo P,Pucciani F

    更新日期:2001-04-01 00:00:00

  • Robotic multivisceral pelvic resection: experience from an exenteration unit.

    abstract:BACKGROUND:Pelvic exenteration remains a viable and effective treatment option for the management of locally advanced or recurrent pelvic malignancy. The aim of this study was to present an early experience of robotic multivisceral resection of pelvic malignancy, and to compare this experience with similar series throu...

    journal_title:Techniques in coloproctology

    pub_type: 杂志文章


    authors: Smith N,Murphy DG,Lawrentschuk N,McCormick J,Heriot A,Warrier S,Lynch AC

    更新日期:2020-11-01 00:00:00