Outcomes Following Pelvic Exenteration for Locally Recurrent Rectal Cancer With and Without En Bloc Sacrectomy.

Background: Extended radical resection is often the only chance of cure for locally recurrent rectal cancer. Recurrence in the posterior compartment often necessitates en bloc sacrectomy as part of pelvic exenteration to obtain clear resection margins and provide survival benefit.

Objective: To compare oncological outcomes, morbidity, and quality-of-life outcomes following pelvic exenteration with and without en bloc sacrectomy for recurrent rectal cancer.

Comparison of urological outcomes and quality of life after pelvic exenteration: partial vs radical cystectomy.

Objective: To compare perioperative morbidity, functional and quality-of-life (QoL) outcomes in patients with partial cystectomy vs radical cystectomy as part of pelvic exenteration.

Patients And Methods: Retrospective analysis of a prospectively maintained database of pelvic exenteration patients (1998-2021) was conducted in a single centre. Study outcomes included postoperative complications, quality-of-life, functional and stoma-related outcomes.

Improving Surgical Outcomes in Pelvic Exenteration Surgery: Comparison of Prone Sacrectomy With Anterior Cortical Sacrectomy Techniques.

Objective: To assess the effect of changing our sacrectomy approach from prone to anterior on surgical and oncological outcomes.

Background: In patients with advanced pelvic malignancy involving the sacrum, pelvic exenteration (PE) with en-bloc sacrectomy is the only potential curative option but morbidity is high. Over time sacrectomy techniques have evolved from prone sacrectomy (PS) to abdominolithotomy sacrectomy (ALS, ≤S3) and high anterior cortical sacrectomy (HACS, >S3) to optimize surgical outcomes.

Bladder preservation or complete cystectomy during pelvic exenteration of patients with locally advanced or recurrent rectal cancer, what should we do?

Introduction: In patients with locally advanced (LARC) or locally recurrent (LRRC) rectal cancer and bladder involvement, pelvic exenteration (PE) with partial (PC) or radical (RC) cystectomy can potentially offer a cure. The study aim was to compare PC and RC in PE patients in terms of oncological outcome, post-operative complications and quality-of-life (QoL).

Materials & Methods: This was a retrospective cohort analysis of a prospectively maintained surgical database.

Peristomal Necrosis Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: A Case Report.

Background: Peristomal necrosis is a rare but challenging condition requiring multidisciplinary management involving surgical debridement and intensive WOC nurse management.

Case: Mr T was a 56-year-old man who underwent cytoreductive surgery with intraperitoneal chemotherapy for a high-grade appendiceal neoplasm. As part of the procedure, an Abcarian stoma (end-ileostomy with a distal lumen from the transverse colon brought out flush with skin beside the proximal stoma) was created.

Understanding the Philosophy, Anatomy, and Surgery of the Extra-TME Plane of Locally Advanced and Locally Recurrent Rectal Cancer; Single Institution Experience with International Benchmarking.

Pelvic exenteration surgery has become a widely accepted procedure for treatment of locally advanced (LARC) and locally recurrent rectal cancer (LRRC). However, there is still unwarranted variation in peri-operative management and subsequently oncological outcome after this procedure. In this article we will elaborate on the various reasons for the observed differences based on benchmarking results of our own data to the data from the PelvEx collaborative as well as findings from 2 other benchmarking studies.

Factors Associated With Wound- and Implant-Related Complications After Surgical Treatment of Ankle Fractures.

We have described the epidemiology of complications after surgical treatment of ankle fractures and assessed which factors are associated with the most frequent complications. We conducted a retrospective cohort study at 2 level 2 and 1 level 1 trauma center in a single trauma region in the Netherlands. The study variables were collected from the electronic medical patient records; all ankle fractures were classified using the Lauge-Hansen classification, and the complications were recorded.

Liver perfusion in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI): comparison of enhancement in Gd-BT-DO3A and Gd-EOB-DTPA in normal liver parenchyma.

Purpose: Within-patient comparison of the enhancement patterns of normal liver parenchyma after gadobutrol and gadoxetate disodium, with emphasis on the start of hepatocytic uptake of gadoxetate disodium.

Materials And Methods: Twenty-one patients (12 female, 9 male) without chronic liver disease underwent 1.5-T contrast-enhanced MRI twice, once with an extracellular contrast agent (gadobutrol) and once with a hepatospecific agent (gadoxetate disodium), using a T1-weighted keyhole sequence.

Multipolar radiofrequency ablation for colorectal liver metastases close to major hepatic vessels.

Background: Resection of colorectal liver metastases (CRLM) is often hindered by their location close to the major hepatic vessels. So far, radiofrequency ablation for perivascular tumours was thought to be ineffective and unsafe due to either the heat sink effect or vascular thrombosis. The aim of this study was to examine whether RFA using multipolar probes could be a safe and effective option for CRLM adjacent to major hepatic vessels.

Does Radiofrequency Ablation Add to Chemotherapy for Unresectable Liver Metastases?

In patients with unresectable colorectal liver metastases (CRLM), radiofrequency ablation (RFA) might be a good alternative, whenever possible. In contrast to systemic therapy, the aim of RFA is to achieve complete local tumor control in an attempt to provide long-term survival. In this article we discuss the available evidence regarding the treatment of patients with unresectable CRLM, focusing on RFA in conjunction with modern systemic therapies.

Preoperative imaging of colorectal liver metastases after neoadjuvant chemotherapy: a meta-analysis.

Background: Chemotherapy treatment induces parenchymal changes that potentially affect imaging of CRLM. The purpose of this meta-analysis was to provide values of diagnostic performance of magnetic resonance imaging (MRI), computed tomography (CT), fluorodeoxyglucose positron emission tomography (FDG-PET), and FDG-PET/CT for preoperative detection of colorectal liver metastases (CRLM) in patients treated with neoadjuvant chemotherapy.

Methods: A comprehensive search was performed for original articles published from inception to 2011 assessing diagnostic performance of MRI, CT, FDG-PET, or FDG-PET/CT for preoperative evaluation of CRLM following chemotherapy.

Semi-automatic software increases CT measurement accuracy but not response classification of colorectal liver metastases after chemotherapy.

Objectives: This study evaluates intra- and interobserver variability of automatic diameter and volume measurements of colorectal liver metastases (CRLM) before and after chemotherapy and its influence on response classification.

Methods: Pre-and post-chemotherapy CT-scans of 33 patients with 138 CRLM were evaluated. Two observers measured all metastases three times on pre-and post-chemotherapy CT-scans, using three different techniques: manual diameter (MD), automatic diameter (AD) and automatic volume (AV).