Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 18 January 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Sacral resection provides local control of recurrent rectal cancer

Sacrectomy for rectal cancer is a high-risk procedure that can achieve clear resection margins with good local control, and low mortality in select patients, finds August's issue of Diseases of the Colon & Rectum.

News image

fiogf49gjkf04

Composite sacropelvic resection for locally advanced recurrent rectal cancer is a high-risk procedure that benefits select patients.

Dr Genevieve Melton and colleagues from New York reviewed a recent institutional experience to evaluate case selection, morbidity, and outcomes for these patients.

Between 1987 and 2004, 29 patients underwent composite resection for recurrent locoregional rectal cancer.

The research team evaluated clinicopathologic indicators as indicators of survival by log-rank test and Cox proportional hazards model.

The researchers reported that 10 patients received radiotherapy with their previous surgery, 17 before sacrectomy, and 12 received intraoperative therapy.

Sacral resections were performed at S2/S3 or S4/S5 using anterior or combined anterior-posterior approach, with adherence to or cortical invasion in the sacrum.

The researchers found the majority of those who had undergone previous abdominoperineal resection had total exenteration.

Most patients who had undergone a previous sphincter-preserving procedure had abdominoperineal resection and none had exenteration.

The team noted that pedicle flaps were used often.

A median of 5 units of blood was given intraoperatively.

The 2-year recurrence rate was 47%
Diseases of the Colon & Rectum

The researchers observed that transfusions were associated with previous abdominoperineal resection, correlating strongly with postoperative morbidity.

There were 33 complications in 17 patients, most commonly perineal wound breakdown in 9, and pelvic abscess in 5.

Median hospital stay was 18 days, significantly longer in patients with previous abdominoperineal resection or postoperative morbidity.

The team noted that only postoperative death was from pelvic sepsis.

Resection was complete in 18 patients, with microscopically positive margins in 10, and grossly positive margins in 1.

The researchers identified that the 2-year and 5-year recurrence rates were 47% and 85%, respectively.

Disease-specific survival was 63% and 20%, at 2- and 5 years, respectively.

The team found that less transfusion, complete resection, lack of anterior organ involvement, and absence of cortical bone invasion were associated with better survival on univariate analysis.

Original colorectal cancer stage was not associated with improved survival.

Dr Melton's team commented, “Sacrectomy for rectal cancer is a high-risk procedure that can achieve clear resection margins with low mortality in select patients.”

“This procedure has a low cure rate but may provide local disease control with acceptable morbidity.”

Dis Col Rectum 2006: 49(8): 1099-107
17 August 2006

Go to top of page Email this page Email this page to a colleague

 18 January 2018 
Sleeve gastrectomy vs Roux-en-Y gastric bypass
 18 January 2018 
Healthcare costs of liver cancer in the USA
 18 January 2018 
High-risk adenomas at colonoscopy
 17 January 2018 
“Weekend effect” in upper GI hemorrhage
 17 January 2018 
Gut dysbiosis and non-antibiotic prescription medications
 17 January 2018 
Reducing surgical infections in high-outlier colorectal unit
 16 January 2018 
Bundle of care in GI cancer surgery
 16 January 2018 
Anxiety about colonoscopy
 16 January 2018 
Thiopurines and colorectal neoplasia in IBD
 15 January 2018 
Risks of death after liver transplants for liver cancer
 15 January 2018 
Recent advances in hepatocellular carcinoma
 15 January 2018 
Ileostomy output using telemedicine
 12 January 2018 
Surveillance protocols after colorectal cancer resection
 12 January 2018 
Biologic therapy by pregnant women with IBD and infant vaccines
 12 January 2018 
Biologic therapies for IBD in the USA
 11 January 2018 
Genetic risk factors in GERD
 11 January 2018 
Predictor of colorectal adenoma
 11 January 2018 
Ectopic pregnancy in IBD 
 10 January 2018 
Fecal immunochemical tests for colorectal cancer screening
 10 January 2018 
Risk factors for advanced NAFLD
 10 January 2018 
Dyspepsia prevalence with gastroesophageal reflux–type symptoms
 09 January 2018 
Screening intervals for people with family histories of colorectal cancer
 09 January 2018 
Financial impact of colorectal cancer
 09 January 2018 
Current practice and future research in autoimmune hepatitis
 08 January 2018 
Reliability of the IBD index
 08 January 2018 
Improving prognosis in patients with primary sclerosing cholangitis
 08 January 2018 
Aprepitant and nausea with gastroparesis
 05 January 2018 
Autoimmune pancreatitis and IBD
 05 January 2018 
Primary nonresponse to infliximab therapy
 05 January 2018 
Anesthesia assistance in outpatient colonoscopy
 04 January 2018 
Dietary polyphenols in the etiology of IBD
 04 January 2018 
Yoga vs low-FODMAP in IBS
 04 January 2018 
Local esophageal food allergen injections in eosinophilic esophagitis
 03 January 2018 
Population health management for IBD
 03 January 2018 
GERD in asthma and COPD
 03 January 2018 
Critical research gaps in colorectal cancer
 22 December 2017 
Costs of extrahepatic manifestations of Hep C
 22 December 2017 
Cholera vaccine and risk of death in colorectal cancer
 22 December 2017 
Colonoscopy after colorectal cancer resection
 21 December 2017 
Human oral microbiome and pancreatic cancer risk
 21 December 2017 
Health management for IBD
 21 December 2017 
PPI and Alzheimer's disease
 20 December 2017 
Management of abnormal liver blood tests
 20 December 2017 
Incidence of biopsy-verified celiac disease
 20 December 2017 
Osteoporotic fractures in Barrett's esophagus
 19 December 2017 
Alcohol abstinence and alcoholic hepatitis
 19 December 2017 
Family burden of pediatric Crohn's in the USA
 19 December 2017 
Early readmission in IBD patients
 18 December 2017 
Colorectal cancer mortality with low-risk adenomas at colonoscopy
 18 December 2017 
Disease activity indices in celiac disease
 18 December 2017 
Smoking behaviour predicted the risk of surgery in Crohn's
 15 December 2017 
Molecular classification of Crohn's disease
 15 December 2017 
Medical cannabinoid legalization policy and vomiting
 15 December 2017 
Inflammatory diet pattern and colorectal cancer risk
 14 December 2017 
PPIs and gastric cancer after H.pylori eradication
 14 December 2017 
H. pylori eradication therapies in countries with clarithromycin resistance
 13 December 2017 
Disease severity in NAFLD
 13 December 2017 
Tryptophan metabolism and IBD activity
 12 December 2017 
Risk factors in undiagnosed cirrhosis
 12 December 2017 
Monitored anesthesia care for outpatient GI endoscopy

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us