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Radiographics : a Review Publication of... 2019Rectal cancer is prone to local recurrence and systemic metastasis. However, owing to improvements in TNM staging and treatment, including a more widespread use of... (Review)
Review
Rectal cancer is prone to local recurrence and systemic metastasis. However, owing to improvements in TNM staging and treatment, including a more widespread use of rectal MRI and increased radiologist awareness of the key rectal cancer TNM staging features, the mortality rate of rectal cancer has been declining over the past few decades in adults over 50 years of age. Currently, rectal MRI plays a key role in the pre- and posttreatment evaluation of rectal cancer, assisting the multidisciplinary team in tailoring the most appropriate treatment option. The benefits achieved with rectal MRI are strictly dependent on obtaining good-quality images, which is important for the characterization of the main anatomic structures and their relationship with the tumor. In primary staging, rectal MRI helps the radiologist (a) describe the tumor location and morphology, (b) provide its T and N categories, (c) detect the presence of extramural vascular invasion, and (d) identify its relationship with surrounding structures, including the sphincter complex and involvement of the mesorectal fascia. These features help diagnose locally advanced rectal tumors (categories T3c-d, T4, N1, and N2), for which neoadjuvant chemoradiotherapy (CRT) is indicated. In restaging after neoadjuvant CRT, in addition to reassessing the features noted during primary staging, rectal MRI can help in the assessment of treatment response, especially with the emergence of nonsurgical approaches such as "watch and wait." RSNA, 2019.
Topics: Chemoradiotherapy; Humans; Magnetic Resonance Imaging; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Neoplasm Staging; Rectal Neoplasms; Rectum
PubMed: 30768361
DOI: 10.1148/rg.2019180114 -
Cancer Cell Jun 2018Experimental evidence from the past years highlights a key role for the intestinal microbiota in inflammatory and malignant gastrointestinal diseases. Diet exhibits a... (Review)
Review
Experimental evidence from the past years highlights a key role for the intestinal microbiota in inflammatory and malignant gastrointestinal diseases. Diet exhibits a strong impact on microbial composition and provides risk for developing colorectal carcinoma (CRC). Large metagenomic studies in human CRC associated microbiome signatures with the colorectal adenoma-carcinoma sequence, suggesting a fundamental role of the intestinal microbiota in the evolution of gastrointestinal malignancy. Basic science established a critical function for the intestinal microbiota in promoting tumorigenesis. Further studies are needed to decipher the mechanisms of tumor promotion and microbial co-evolution in CRC, which may be exploited therapeutically in the future.
Topics: Animals; Carcinogenesis; Cell Transformation, Neoplastic; Colon; Colorectal Neoplasms; Gastrointestinal Microbiome; Humans; Models, Biological; Rectum; Signal Transduction
PubMed: 29657127
DOI: 10.1016/j.ccell.2018.03.004 -
Acta Gastro-enterologica Belgica 2021
Topics: Anal Canal; Colonoscopy; Humans; Intestinal Polyps; Rectum
PubMed: 34217197
DOI: 10.51821/84.2.387 -
Orphanet Journal of Rare Diseases Jul 2007Anorectal malformations comprise a wide spectrum of diseases, which can affect boys and girls, and involve the distal anus and rectum as well as the urinary and genital... (Review)
Review
Anorectal malformations comprise a wide spectrum of diseases, which can affect boys and girls, and involve the distal anus and rectum as well as the urinary and genital tracts. They occur in approximately 1 in 5000 live births. Defects range from the very minor and easily treated with an excellent functional prognosis, to those that are complex, difficult to manage, are often associated with other anomalies, and have a poor functional prognosis. The surgical approach to repairing these defects changed dramatically in 1980 with the introduction of the posterior sagittal approach, which allowed surgeons to view the anatomy of these defects clearly, to repair them under direct vision, and to learn about the complex anatomic arrangement of the junction of rectum and genitourinary tract. Better imaging techniques, and a better knowledge of the anatomy and physiology of the pelvic structures at birth have refined diagnosis and initial management, and the analysis of large series of patients allows better prediction of associated anomalies and functional prognosis. The main concerns for the surgeon in correcting these anomalies are bowel control, urinary control, and sexual function. With early diagnosis, management of associated anomalies and efficient meticulous surgical repair, patients have the best chance for a good functional outcome. Fecal and urinary incontinence can occur even with an excellent anatomic repair, due mainly to associated problems such as a poorly developed sacrum, deficient nerve supply, and spinal cord anomalies. For these patients, an effective bowel management program, including enema and dietary restrictions has been devised to improve their quality of life.
Topics: Anal Canal; Digestive System Abnormalities; Digestive System Surgical Procedures; Female; Humans; Male; Rectum
PubMed: 17651510
DOI: 10.1186/1750-1172-2-33 -
Ugeskrift For Laeger Dec 2018Traumatic rectal lesions can be seen in both blunt and penetrating traumas and are associated with a high morbidity and high mortality. This is a review of the... (Review)
Review
Traumatic rectal lesions can be seen in both blunt and penetrating traumas and are associated with a high morbidity and high mortality. This is a review of the literature on diagnosis and treatment of intra- and extraperitoneal rectal lesions. There is a consensus, that intraperitoneal rectal lesions should be treated with primary repair alone. There is more debate concerning the extraperitoneal lesions, and the level of evidence is generally low. We suggest, that extraperitoneal rectal lesions should be treated with colostomy.
Topics: Colostomy; Humans; Rectum; Wounds, Penetrating
PubMed: 30520720
DOI: No ID Found -
Ugeskrift For Laeger Sep 2018Rectal foreign bodies are not uncommon as previously thought and should be recognised as a potentially serious condition. The diagnosis is often delayed due to patient... (Review)
Review
Rectal foreign bodies are not uncommon as previously thought and should be recognised as a potentially serious condition. The diagnosis is often delayed due to patient embarrassment and reluctance to seek medical help, which may increase the likelihood of complications. Clinicians should be aware of this condition, as it may be a manifestation of underlying psychiatric conditions, drug trafficking or due to sexual assault.
Topics: Adult; Body Packing; Critical Pathways; Female; Foreign Bodies; Humans; Male; Mental Disorders; Middle Aged; Rectum; Sex Offenses; Sexual Behavior; Young Adult
PubMed: 30187856
DOI: No ID Found -
BMJ Case Reports Mar 2022A man in his 70s presented with narrowing of his stool calibre and a palpable mass on rectal examination. Colonoscopy revealed a submucosal bulge without a mucosal...
A man in his 70s presented with narrowing of his stool calibre and a palpable mass on rectal examination. Colonoscopy revealed a submucosal bulge without a mucosal lesion. CT and MRI demonstrated an 8×5.4×7 cm mass in lower rectum. Biopsy of the mass confirmed a rectal gastrointestinal stromal tumour (GIST). It was moderately sensitive to neoadjuvant imatinib and radiotherapy, which slightly downsized the tumour. He required abdominal perineal resection with curative intent. Uncommonly found in the rectum, when located here, GISTs are typically aggressive and are a rare cause of stool calibre narrowing. Rectal GISTs should be considered in patients presenting with this symptom.
Topics: Antineoplastic Agents; Gastrointestinal Stromal Tumors; Humans; Imatinib Mesylate; Male; Rectal Neoplasms; Rectum
PubMed: 35288433
DOI: 10.1136/bcr-2021-248505 -
Proceedings of the Royal Society of... Jun 1958
Topics: Histological Techniques; Humans; Intestine, Large; Rectum
PubMed: 13567687
DOI: No ID Found -
American Journal of Physiology.... Oct 2020Fecal continence is maintained by several mechanisms including anatomical factors, anorectal sensation, rectal compliance, stool consistency, anal muscle strength,... (Review)
Review
Fecal continence is maintained by several mechanisms including anatomical factors, anorectal sensation, rectal compliance, stool consistency, anal muscle strength, mobility, and psychological factors. The homeostatic balance is easily disturbed, resulting in symptoms including fecal incontinence and constipation. Current technologies for assessment of anorectal function have limitations. Overlap exist between data obtained in different patient groups, and there is lack of correlation between measurements and symptoms. This review describes a novel technology named Fecobionics for assessment of anorectal physiology. Fecobionics is a simulated stool, capable of dynamic measurements of a variety of variables during defecation in a single examination. The data facilitate novel analysis of defecatory function as well as providing the foundation for modeling studies of anorectal behavior. The advanced analysis can enhance our physiological understanding of defecation and future interdisciplinary research for unraveling defecatory function, anorectal sensory-motor disorders, and symptoms. This is a step in the direction of improved diagnosis of anorectal diseases.
Topics: Anal Canal; Biomechanical Phenomena; Defecation; Feces; Humans; Manometry; Models, Biological; Pressure; Rectum; Sensation
PubMed: 32783614
DOI: 10.1152/ajpgi.00242.2020 -
Techniques in Coloproctology Mar 2022Rectal endoscopic full- thickness dissection (EFTD) using a flexible colonoscope is an alternative to the well-established trans-anal endoscopic microsurgery (TEM) and...
BACKGROUND
Rectal endoscopic full- thickness dissection (EFTD) using a flexible colonoscope is an alternative to the well-established trans-anal endoscopic microsurgery (TEM) and the trans-anal minimally invasive surgery (TAMIS) techniques for resecting dysplastic or malignant rectal lesions. This study evaluated EFTD safety by analyzing outcomes of the first patients to undergo rectal EFTD at the University Hospital of North-Norway.
METHODS
The first 10 patients to undergo rectal EFTD at the University Hospital of North-Norway April, 2016 and January, 2021, were included in the study. The procedural indications for EFTD were therapeutic resection of non-lifting adenoma, T1 adenocarcinoma (AC), recurrent neuroendocrine tumor (NET) and re-excision of a T1-2 AC.
RESULTS
EFTD rectal specimen histopathology revealed three ACs, five adenomas with high-grade dysplasia (HGD), one NET and one benign lesion. Six procedures had negative lateral and vertical resection margins and in three cases lateral margins could not be evaluated due to piece-meal dissection or heat damaged tissue. Two patients experienced delayed post-procedural hemorrhage, one of whom also presented with a concurrent post-procedural infection. No serious complications occurred.
CONCLUSION
Preliminary results from this introductory trial indicate that EFTD in the rectum can be conducted with satisfactory perioperative results and low risk of serious complications.
Topics: Adenoma; Humans; Rectal Neoplasms; Rectum; Retrospective Studies; Treatment Outcome
PubMed: 34964075
DOI: 10.1007/s10151-021-02558-w