Total Mesorectal Excision
Fig. 7.1 Cadaveric dissection of hemisectioned pelvis . (a) Presacral fascia covers the presacral vein over the sacrum. (b) The fascia picked up by the forceps is the rectal proper…
Maximizing Neoadjuvant Treatment Response and Watch and Wait
Fig. 18.1 Historic progression toward the current standard of care for locally advanced rectal cancer: chemoradiotherapy before total mesorectal excision. XRT radiotherapy, CRT chemoradiation therapy, TME total mesorectal excision, LR…
Laparoscopic Rectal Surgery
Trial Assigned group No. of patients Conversion rate (%) Operative time (min) Estimated blood loss (ml) Lymph node (mean) CRM + rate (overall, AR, APR) (%) COLOR II Laparoscopic 699 16 240…
Combined Transanal/Laparoscopic Total Mesorectal Excision
Fig. 11.1 Theater organization Transabdominal Approach The surgeon works from the patient’s right with the camera assistant on the surgeon’s left side and the first assistant on the patient’s left….
Local Excision: Transanal Endoscopic Microsurgery and Transanal Minimally Invasive Surgery
Fig. 4.1 TES (transanal endoscopic surgery) platforms . Rigid platforms include (a) TEM (transanal endoscopic microsurgery) (Richard Wolf Medical, Vernon Hills, IL, USA). (b) TEO (transanal endoscopic operation) (Karl Storz…
Molecular Markers and Mutational Analysis
Fig. 19.1 Pie chart showing proportion of colorectal cancer cases believed to be sporadic, familial, or due to hereditary cancer syndromes. HNPCC hereditary nonpolyposis colon cancer, FAP familial adenomatous polyposis…
Abdominoperineal Excision
Fig. 8.1 Estimated 5-year survival and recurrence rates of rectal cancer patients over time as they relate to the proportion of rectal cancer operations comprised by abdominoperineal resections Indications The…
Palliative and End-of-Life Treatment
Cause Frequency among patients with malignant ascites Peritoneal carcinomatosis (%) 53.3 Extensive liver metastasis causing portal hypertension (%) 13.3 Peritoneal carcinomatosis and extensive liver metastasis (%) 13.3 Hepatocellular carcinoma and…
Reconstruction of the Pelvis and Perineum
Fig. 15.1 Perineal defect exposing pelvic organs and creating significant dead space Primary closure is the ideal choice for perineal defects . However, in many cases, this is not possible…
Evaluation of Treatment of Locally Recurrent Rectal Cancer
Fig. 14.1 (a) PET/CT scan axial, (b) PET/CT scan coronal, (c) MRI axial, and (d) MRI coronal. Note these images are all taken from the same patient at presentation, demonstrating…
