0000000000542579
AUTHOR
Tong T. Trinh
The Link Between Local Recurrence and Distant Metastases in Patients With Rectal Cancer.
BACKGROUND/AIM The relationships between local recurrence (LR), the development of distant metastases (DM) and prognosis in patients with rectal cancer remain unclear. PATIENTS AND METHODS In 606 patients who underwent curative resection, the role of LR was assessed retrospectively by time-dependent multivariate Cox models with inverse probability of treatment weighting taking into account competing risks. RESULTS Patients with LR had more DM than patients without LR (49/79, 62% vs. 86/524, 16.4%; p<0.001); 37% of LR-associated DM developed before or at LR, 63% after diagnosis of LR. Fifty-five percent of patients without DM at diagnosis of LR later developed DM. In these patients, the inci…
Permanent Stoma After Low Anterior Resection for Rectal Cancer
BACKGROUND AND OBJECTIVES: A low anterior resection procedure for removing a rectal tumor aims to preserve the sphincter and avoid a permanent stoma. Permanent stomas are primarily necessary in cases of poor anorectal function and local recurrence. The aim of this study was to clarify whether anastomosis-related complications and local recurrence influenced the rate of permanent stomas in a long-term follow-up. METHODS: Of 1032 consecutive patients with rectal cancer, 397 were treated by low anterior resection (R0 and R1 resections) between 1985 and 2007 at the Department of General and Abdominal Surgery of the University Hospital, Mainz (Germany). All patient data were collected prospectiv…
Begrenzung und Reduktion der Intensivtherapie — Allgemeinund Viszeralchirurgie
Wahrend das Problem der Begrenzung der Intensivtherapie in den USA und vielen anderen Landern seit langem diskutiert wird und umfangreiche Daten hierzu vorliegen, wird das Problem in Deutschland zwar angesprochen [10, 11], konkrete Angaben zur Indikation und Haufigkeit eines Therapieverzichts liegen allerdings bislang nicht vor. Daher war es das Ziel einer retrospektiven Untersuchung bei auf der Intensivstation der Klinik fur Allgemein- und Abdominalchirurgie der Johannes-Gutenberg-Universitat Mainz gestorbenen Patienten, die Inzidenz und Art einer Therapiebegrenzung, die Bedeutung einer Patientenverfugung sowie die Grunde fur einen Therapieverzicht zu erfassen, mit dem Ziel, hiermit zur Di…
Long-term Oncologic Outcome After Transanal Endoscopic Microsurgery for Rectal Carcinoma
Transanal endoscopic microsurgery is superior to other methods of local excision of rectal cancer, but few studies report long-term follow-up data.This study investigated the use of transanal endoscopic microsurgery alone as curative and compromise therapy based on long-term disease recurrence and mortality.This was a retrospective review of prospectively collected data.The study was conducted at a tertiary care university medical center.The study included 133 patients treated between 1985 and 2007. There were 3 groups, including transanal endoscopic microsurgery in curative intent (low-risk rectal carcinoma, including pT1, G1/2, L0, and LX with clear margins and a minimal distance between …