Defining the rectum: surgically, radiologically and anatomically

Salerno, Gisella; Sinnatamby, Chummy S.; Branagan, Graham; Daniels, Ian R.; Heald, R. J.; Moran, Brendan

doi:10.1111/j.1463-1318.2006.01062.x

Cited by 107 publications

(72 citation statements)

References 9 publications

(8 reference statements)

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“…Anatomical and radiological studies show that in the lowest part of the rectum the mesorectum tapers and terminates at the pelvic floor 17 . If a tumor is located in the distal third of the rectum, the surrounding mesorectum is very thin, especially on the ventral side 18 .…”

Section: Abdominoperineal Resectionmentioning

confidence: 99%

Patterns of local recurrence in rectal cancer; a study of the Dutch TME trial

Kusters

Marijnen

Velde

et al. 2010

European Journal of Surgical Oncology (EJSO)

280

197

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Aim of the study: In patients from the Dutch TME trial patterns of local recurrence (LR) in rectal cancer were studied. The purpose was to reconstruct the most likely mechanisms of LR and the effect of preoperative radiotherapy.Methods: 1417 patients were analyzed; 713 were randomized into preoperative radiotherapy and total mesorectal excision (RT+TME), 704 into TME alone. Of the 114 patients with LR, the subsites of LR were determined and related to tumor and treatment factors. Results:Overall 5-year LR-rate was 4.6% in the RT+TME group and 11.0% in the TME group.Presacral local recurrences occurred most in both groups. Radiotherapy reduced anastomotic LR significantly, except when after low anterior resection (LAR) distal margins were less than 5 mm.Abdominoperineal resection (APR) mainly resulted in presacral LR. Even after resection with a negative circumferential resection margin, LR rates were high. 30% of the patients had advanced tumors, which resulted in 58% of all LRs. Lateral LR comprised 20% of all LR. Presacral LR resulted in a poor prognosis, in contrast to anterior or anastomotic LRs with a relatively good prognosis. Conclusions:RT reduces LR in all subsites and is especially effective in preventing anastomotic LR after LAR. APR surgery mainly results in presacral LR, which may be prevented by a wider resection.In the TME trial many advanced tumors were included, rather requiring chemoradiotherapy in stead of RT. Currently, with good imaging techniques, better selection can take place. Especially lateral LR might be a problem in the future.

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Section: Abdominoperineal Resectionmentioning

confidence: 99%

Patterns of local recurrence in rectal cancer; a study of the Dutch TME trial

Kusters

Marijnen

Velde

et al. 2010

European Journal of Surgical Oncology (EJSO)

280

197

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“…Most studies have arbitrarily defined three parts of the rectum: the low rectum (up to 5 cm from the anal verge), the mid-rectum (5 cm to <10 cm), and the upper rectum (10-15 cm) 17 . Tumours with distal extension to 15 cm or less from the anal margin (as measured by rigid sigmoidoscopy) are classified as rectal; more proximal tumours are classified as colonic cancer 17,18 .…”

Section: Summary Of Evidencementioning

confidence: 99%

Consensus Statement: The 16th Annual Western Canadian Gastrointestinal Cancer Consensus Conference; Saskatoon, Saskatchewan; September 5–6, 2014

et al. 2015

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The 16th annual Western Canadian Gastrointestinal Cancer Consensus Conference was held in Saskatoon, Saskatchewan, September 4–5, 2014. The Consensus Conference is an interactive, multidisciplinary event attended by health care professionals from across western Canada (British Columbia, Alberta, Saskatchewan, and Manitoba) involved in the care of gastrointestinal cancer. Surgical, medical, and radiation oncologists; pathologists; radiologists; and allied health care professionals participated in presentation and discussion sessions for the purposes of developing the recommendations presented here. This consensus statement addresses current issues in the management of colorectal cancer.

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“…As the preoperative workup, all patients were assessed using optical colonoscopy, endosonography, and CE-CTC. All of the tumors were located in the submucosa of the middle to lower rectum, 9 cm from the anal verge [12], with no lymph nodes or distant metastases. All patients were treated by an endoscopic procedure, such as endoscopic mucosal resection or submucosal dissection.…”

Section: Study Patientsmentioning

confidence: 99%

Contrast-Enhanced CT Colonography Features of Rectal Carcinoid Tumors

Tsurumaru¹,

Kawanami²,

Nishimuta³

et al. 2014

ACT

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Purpose: The purpose of this study was to retrospectively assess the detectability and enhancement pattern of rectal carcinoid tumors on contrast-enhanced computed tomography colonography (CE-CTC). Methods: The study sample consisted of 12 lesions in nine patients of rectal carcinoid tumors. To evaluate the detectability, two radiologists reviewed axial and 3D images including air enema (AE), virtual endoscopy (VE), and virtual colon dissection (VCD). To determine the contrast enhancement pattern of the tumors, the CT attenuation value of each lesion was measured in three phases. Results: Four of the 12 lesions (33%) were detected on axial images in patients in both the prone and supine positions, the sizes of which were 6 mm or larger. Seven lesions (58%), including the four lesions mentioned above, were detected on 3D images including AE and VE in patients in the prone position, the sizes of which were 5 mm or larger. The ranges of CT attenuation values of the lesions at 40 s, 70 s and 240 s were 112 -147, 116 -140 and 82 -97 HU, respectively. Conclusion: Rectal carcinoid tumors are challenging to detect on CE-CTC. They demonstrated enhancement at the early phase and washout at the delayed phase on CE-CTC.

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Defining the rectum: surgically, radiologically and anatomically

Cited by 107 publications

References 9 publications

Patterns of local recurrence in rectal cancer; a study of the Dutch TME trial

Patterns of local recurrence in rectal cancer; a study of the Dutch TME trial

Consensus Statement: The 16th Annual Western Canadian Gastrointestinal Cancer Consensus Conference; Saskatoon, Saskatchewan; September 5–6, 2014

Contrast-Enhanced CT Colonography Features of Rectal Carcinoid Tumors

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