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JAMA Network Open Mar 2024
Topics: Humans; Proctoscopy; Cytology; Anus Neoplasms; HIV Infections
PubMed: 38427356
DOI: 10.1001/jamanetworkopen.2024.0068 -
Colorectal Disease : the Official... Apr 2024
Topics: Humans; Anal Canal; Anastomosis, Surgical; Proctectomy; Rectal Neoplasms; Robotic Surgical Procedures; Surgical Stapling; Transanal Endoscopic Surgery
PubMed: 38424701
DOI: 10.1111/codi.16921 -
Scientific Reports Feb 2024Colonoscopy and endoscopic ultrasound play pivotal roles in the assessment of rectal diseases, especially rectal cancer and inflammatory bowel diseases. Optical...
Colonoscopy and endoscopic ultrasound play pivotal roles in the assessment of rectal diseases, especially rectal cancer and inflammatory bowel diseases. Optical coherence tomography (OCT) offers a superior depth resolution, which is a critical factor for individualizing the therapeutic concept and evaluating the therapy response. We developed two distinct rectoscope prototypes, which were integrated into a 1300 nm MHz-OCT system constructed at our facility. The rapid rotation of the distal scanning probe at 40,000 revolutions per minute facilitates a 667 Hz OCT frame rate, enabling real-time endoscopic imaging of large areas. The performance of these OCT-rectoscopes was assessed in an ex vivo porcine colon and a post mortem human in-situ colon. The OCT-rectoscope consistently distinguished various layers of the intestinal wall, identified gut-associated lymphatic tissue, and visualized a rectal polyp during the imaging procedure with 3D-reconstruction in real time. Subsequent histological examination confirmed these findings. The body donor was preserved using an ethanol-glycerol-lysoformin-based technique for true-to-life tissue consistency. We could demonstrate that the novel MHZ-OCT-rectoscope effectively discriminates rectal wall layers and crucial tissue characteristics in a post mortem human colon in-situ. This real-time-3D-OCT holds promise as a valuable future diagnostic tool for assessing disease state and therapy response on-site in rectal diseases.
Topics: Animals; Swine; Humans; Tomography, Optical Coherence; Proctoscopy; Endoscopy, Gastrointestinal; Rectum; Rectal Diseases; Rectal Neoplasms
PubMed: 38409328
DOI: 10.1038/s41598-024-55338-5 -
Colorectal Disease : the Official... Apr 2024
Response to May and Bethune Comment on 'Transanal total mesorectal excision for abdominoperineal resection is associated with poor oncological outcomes in rectal cancer patients: a word of caution from a multicentric Canadian cohort study'.
Topics: Humans; Rectal Neoplasms; Proctectomy; Canada; Treatment Outcome; Male; Female; Cohort Studies; Multicenter Studies as Topic; Perineum; Transanal Endoscopic Surgery; Aged; Middle Aged
PubMed: 38379133
DOI: 10.1111/codi.16920 -
Diseases of the Colon and Rectum May 2024
Topics: Humans; Rectum; Transanal Endoscopic Surgery; Neoplasms; Rectal Neoplasms; Minimally Invasive Surgical Procedures; Anal Canal; Treatment Outcome
PubMed: 38323637
DOI: 10.1097/DCR.0000000000003078 -
Colorectal Disease : the Official... Apr 2024
Topics: Humans; Rectal Prolapse; Transanal Endoscopic Surgery; Female; Middle Aged
PubMed: 38317292
DOI: 10.1111/codi.16910 -
Diseases of the Colon and Rectum May 2024
Topics: Humans; Robotic Surgical Procedures; Rectal Neoplasms; Rectum; Anastomosis, Surgical; Transanal Endoscopic Surgery; Laparoscopy
PubMed: 38294827
DOI: 10.1097/DCR.0000000000003243 -
Colorectal Disease : the Official... Mar 2024
Topics: Humans; Robotic Surgical Procedures; Rectal Neoplasms; Robotics; Transanal Endoscopic Surgery; Minimally Invasive Surgical Procedures
PubMed: 38282188
DOI: 10.1111/codi.16885 -
Medicine Jan 2024Laparoscopic total mesorectal excision (LaTME) and transanal total mesorectal excision (TaTME) are popular mid and low rectal cancer trends. However, there is currently... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Laparoscopic total mesorectal excision (LaTME) and transanal total mesorectal excision (TaTME) are popular mid and low rectal cancer trends. However, there is currently no systematic comparison between LaTME and TaTME of mid and low rectal cancer. Therefore, we systematically study the perioperative and pathological outcomes of LaTME and TaTME in mid and low rectal cancer.
METHODS
Articles included searching through the Embase, Cochrane Library, PubMed, Medline, and Web of science for articles on LaTME and TaTME. We calculated pooled standard mean difference (SMD), relative risk (RR), and 95% confidence intervals (CIs). The protocol for this review has been registered on PROSPERO (CRD42022380067).
RESULTS
There are 8761 participants included in 33 articles. Compared with TaTME, patients who underwent LaTME had no statistical difference in operation time (OP), estimated blood loss (EBL), postoperative hospital stay, over complications, intraoperative complications, postoperative complications, anastomotic stenosis, wound infection, circumferential resection margin, distal resection margin, major low anterior resection syndrom, lymph node yield, loop ileostomy, and diverting ileostomy. There are similarities between LaTME and TaTME for 2-year DFS rate, 2-year OS rate, distant metastasis rat, and local recurrence rate. However, patients who underwent LaTME had less anastomotic leak rates (RR 0.82; 95% CI: 0.70-0.97; I2 = 10.6%, P = .019) but TaTME had less end colostomy (RR 1.96; 95% CI: 1.19-3.23; I2 = 0%, P = .008).
CONCLUSION
This study comprehensively and systematically evaluated the differences in safety and effectiveness between LaTME and TaTME in the treatment of mid and low rectal cancer through meta-analysis. Patients who underwent LaTME had less anastomotic leak rate but TaTME had less end colostomy. There is no difference in other aspects. Of course, in the future, more scientific and rigorous conclusions need to be drawn from multi-center RCT research.
Topics: Humans; Animals; Rats; Rectum; Anastomotic Leak; Margins of Excision; Transanal Endoscopic Surgery; Rectal Neoplasms; Laparoscopy; Postoperative Complications; Treatment Outcome
PubMed: 38277570
DOI: 10.1097/MD.0000000000036859 -
BMJ Case Reports Jan 2024Rectal squamous cell carcinoma (rSCC) is a rare cancer (0.5% of all rectal cancers). It typically presents at an advanced stage and has a poor prognosis. Recently,...
Rectal squamous cell carcinoma (rSCC) is a rare cancer (0.5% of all rectal cancers). It typically presents at an advanced stage and has a poor prognosis. Recently, chemoradiotherapy with organ preservation has become an option for complete response (CR). Surveillance is essential to prompt recognition of recurrence due to its high risk. We present a case of an elderly woman with rSCC stage cT4N1aM0 who underwent a combination of chemotherapy (mitomycin and fluoropyrimidine) and radiotherapy with CR and organ preservation. The patient has been in follow-up for 2 years with digital rectal examination, tumour markers, pelvic MRI, thoracic and upper abdominal CT, proctoscopy and positron emission tomography, with no disease recurrence. This highlights the success of chemoradiotherapy for rSCC treatment, allowing organ preservation.
Topics: Female; Humans; Aged; Treatment Outcome; Neoplasm Staging; Neoplasm Recurrence, Local; Tomography, X-Ray Computed; Rectal Neoplasms; Chemoradiotherapy; Carcinoma, Squamous Cell; Neoadjuvant Therapy; Retrospective Studies
PubMed: 38272508
DOI: 10.1136/bcr-2023-255284