The impact of surgical quality on prognosis in patients undergoing rectal carcinoma surgery after preoperative chemoradiation

2015 ◽  
Vol 31 (2) ◽  
pp. 247-255 ◽  
Author(s):  
Marcus Kiehlmann ◽  
Klaus Weber ◽  
Jonas Göhl ◽  
Rainer Fietkau ◽  
Abbas Agaimy ◽  
...  
Keyword(s):  
Rectal Carcinoma ◽  
Preoperative Chemoradiation ◽  
Surgical Quality ◽  
The Impact

scholarly journals IMPACT OF LAPAROSCOPIC COLORECTAL SURGERY ON BODY IMAGE

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
A Fernández Candela ◽  
L Sánchez-Guillén ◽  
L García Catalá ◽  
C Curtis Martínez ◽  
M Bosch Ramírez ◽  
...  
Keyword(s):  
Body Image ◽  
Colorectal Surgery ◽  
Laparoscopic Colorectal Surgery ◽  
Wound Complication ◽  
Descriptive Study ◽  
Surgical Quality ◽  
Body Image Scale ◽  
Study Results ◽  
The Impact ◽  
Observational Descriptive Study

Abstract INTRODUCTION The aim of this study is to evaluate the impact of laparoscopic colorectal surgery (LCS) on body image using the validated Body Image Scale (BIS) as a parameter of surgical quality. MATERIAL AND METHODS We conducted an observational descriptive study. Patients who underwent scheduled LCS between June 2015 and December 2019 by a General Hospital Coloproctology Unit were included. RESULTS The sample included 180 patients, 115 men (63.9%) and 65 women (36.1%) with a median age of 67 years. Right hemicolectomies (31.7%) and sigmoidectomies (28.3%) were the main procedures performed. In most patients, a suprapubic (69.4%) or transverse (19.4%) incision was made. 21.9% suffered some type of postoperative complication (13.9% wound complication, 10.6% incisional hernia). The general result of the BIS questionnaire was satisfactory, with a median of 0 in the responses (no alteration of body image). We found that 46.2% of the women had some alteration in body image, compared to 28.7% of the men (p = 0.018) and low and ultra-low anterior resection were the surgeries that obtained worst scores, with 13,5% and 12,5% respectively of patients with a BIS score above 5 (p = 0.044). Patients with a stoma also obtained worst punctuation (25% above 5 vs 6,1%, p = 0.001). No statistically significant differences were found regarding type of incision, presence of complications and anxiety or depression. CONCLUSION Study results show, in general, good post-surgical body image after LCS. However, patients with stoma and women were more dissatisfied. Interestingly, there is no worse body image due to type of incision, so we recommend the least iatrogenic one.

scholarly journals Relation between body composition and severe diarrhea in patients treated with preoperative chemoradiation with capecitabine for rectal cancer: a single-centre cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. M. van Rees ◽  
W. Hartman ◽  
J. J. M. E. Nuyttens ◽  
E. Oomen-de Hoop ◽  
J. L. A. van Vugt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Body Composition ◽  
Logistic Regression ◽  
Cohort Study ◽  
Preoperative Chemoradiation ◽  
Regression Analyses ◽  
Single Centre ◽  
Severe Diarrhea ◽  
The Impact

Abstract Background Chemoradiation with capecitabine followed by surgery is standard care for locally advanced rectal cancer (LARC). Severe diarrhea is considered a dose-limiting toxicity of adding capecitabine to radiation therapy. The aim of this study was to describe the risk factors and the impact of body composition on severe diarrhea in patients with LARC during preoperative chemoradiation with capecitabine. Methods A single centre retrospective cohort study was conducted in a tertiary referral centre. All patients treated with preoperative chemoradiation with capecitabine for LARC from 2009 to 2015 were included. Patients with locally recurrent rectal cancer who received chemoradiation for the first time were included as well. Logistic regression analyses were performed to identify risk factors for severe diarrhea. Results A total of 746 patients were included. Median age was 64 years (interquartile range 57–71) and 477 patients (64%) were male. All patients received a radiation dosage of 25 × 2 Gy during a period of five weeks with either concomitant capecitabine administered on radiation days or continuously during radiotherapy. In this cohort 70 patients (9%) developed severe diarrhea. In multivariable logistic regression analyses female sex (OR: 4.42, 95% CI 2.54–7.91) and age ≥ 65 (OR: 3.25, 95% CI 1.85–5.87) were the only risk factors for severe diarrhea. Conclusions Female patients and patients aged sixty-five or older had an increased risk of developing severe diarrhea during preoperative chemoradiation therapy with capecitabine. No relation was found between body composition and severe diarrhea.

MRI-Based Use of Neoadjuvant Chemoradiotherapy in Rectal Carcinoma: Surgical Quality and Histopathological Outcome of the OCUM Trial

2019 ◽  
Vol 27 (2) ◽  
pp. 417-427 ◽  
Author(s):  
Martin E. Kreis ◽  
◽  
Reinhard Ruppert ◽  
Rainer Kube ◽  
Joachim Strassburg ◽  
...  
Keyword(s):  
Rectal Carcinoma ◽  
Neoadjuvant Chemoradiotherapy ◽  
Surgical Quality

Rectal cancer treatment without neoadjuvant chemoradiation based on preoperative magnetic resonance imaging: Determinants of surgical quality in the German OCUM study.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 526-526
Author(s):  
Martin Ernst Kreis ◽  
Joachim Strassburg ◽  
Reinhard Ruppert ◽  
Henry Ptok ◽  
Theodor Junginger ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Neoadjuvant Chemoradiation ◽  
Preoperative Chemoradiation ◽  
Tumor Cell Dissemination ◽  
Circumferential Margin ◽  
Resonance Imaging ◽  
Surgical Quality ◽  
Preoperative Magnetic Resonance ◽  
Cell Dissemination

526 Background: Preoperative chemoradiation adds functional impairment to patients undergoing total mesorectal excision (TME). Surgical quality is of paramount importance to achieve low local recurrence rates in patients operated without preoperative chemoradiation when a negative circumferential margin was shown by preoperative magnetic resonance imaging (MRI). We aimed to determine surgical quality in a prospective multicenter cohort study (OCUM) in patients selected by MRI for surgery without neoadjuvant chemoradiation. Methods: Quality of TME was assessed in three categories for 282 patients from 12 hospitals enrolled for surgery without preoperative chemoradiation (Nagtegaal et al. 2005, Quirke and Morris 2007). Tumor perforation, local tumor cell dissemination and number of lymph nodes were assessed. Further, negative predictive value of MRI for histopathological involvement of the circumferential margin was determined. Results: In patients undergoing TME the muscularis propria plane (category III) was reached in 1/282 patients (0,4 %). Intraoperative tumor cell dissemination was observed in 3/282 patients (1,1 %). Total number of lymph nodes was 25 (median, range 10-79) and 79/282 patients had positive lymph nodes (28 %). The number of 12 lymph nodes recommended by UICC was not reached in one patient. Preoperative MRI correctly predicted a negative circumferential margin involvement as determined by histopathological workup in 98,9 % of patients. Conclusions: Excellent results in terms of surgical quality are possible justifying surgery without pretreatment in patients with MRI-negative circumferental margin tumors. This concept avoids additional functional impairment and reduced quality of life following preoperative chemoradiation in selected patients. Clinical trial information: NCT01325649.

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