Clinical and Oncological Impact of a Protective Ileostomy in Rectal Cancer Patients Undergoing Adjuvant Chemotherapy.

Background/aim: During low anterior rectal resection for rectal cancer, a protective ileostomy (PI) is routinely created to reduce the severity of anastomotic complications. The aim of this study was to investigate the side-effects of PI during adjuvant chemotherapy.

Patients And Methods: A retrospective cohort of patients was operated on for non-metastatic rectal cancer with a PI during 2005-2022.

Retroperitoneal soft tissue sarcomas: Predictive factors for incomplete resection.

Introduction: Curative management of retroperitoneal sarcoma relies on surgery, and complete monoblock resection is one of the main prognostic factors. The goal of this study was to search predictive factors for incomplete resection.

Methods: All patients undergoing surgery for retroperitoneal sarcoma in two University hospitals between 2010 and 202 were included.

Review of definition and treatment of upper rectal cancer.

While the treatment of locally advanced lower and middle rectal cancer with total mesorectal excision (TME) after neoadjuvant therapy is now well defined, the treatment of locally advanced upper rectal cancer (LAURC) remains controversial. Although most teams and academic societies recommend upfront surgery (US) with partial mesorectal excision (PME), as this appears to be sufficient for these tumors, the literature remains conflicting regarding the additional use of neoadjuvant therapy and TME. Current recommendations for the treatment of LAURC do not reflect actual clinical practice.

Comparison of a robotic surgery program for rectal cancer: short- and long-term results from a comparative, retrospective study between two laparoscopic and robotic reference centers.

Background: It is assumed that robotic-assisted surgery (RAS) may facilitate complex pelvic dissection for rectal cancer compared to the laparoscopic-assisted resection (LAR). The aim of this study was to compare perioperative morbidity, short- and long-term oncologic, and functional outcomes between the RAS and LAR approaches.

Methods: Between 2015 and 2021, all rectal cancers operated on by (LAR) or (RAS) were retrospectively reviewed in two colorectal surgery centers.

Impact of Modern Management Strategies on the Clinical Outcome of Patients With Low Rectal Cancer - A Retrospective, Monocentric Cohort Study.

Background: The aim of this study was to retrospectively investigate the impact of intersphincteric resection (ISR) and Enhanced Recovery After Surgery (ERAS) protocols for rectal cancer.

Patients And Methods: Since we implemented rectal ERAS protocol and ISR in 2016, we retrospectively assessed and compared clinical, pathological and survival outcomes of two groups of patients: group 1, treated 2000-2015 (n=242); and group 2, treated 2016-2020 (n=108). Propensity score matching using nearest-neighbor method was used to match each patient of group 1 to a patient of group 2.

Pectoralis major muscle atrophy is associated with mitochondrial energy wasting in cachectic patients with gastrointestinal cancer.

Background: Cancer cachexia is a multifactorial syndrome characterized by involuntary and pathological weight loss, mainly due to skeletal muscle wasting, resulting in a decrease in patients' quality of life, response to cancer treatments, and survival. Our objective was to investigate skeletal muscle alterations in cachectic cancer patients.

Methods: This is a prospective study of patients managed for pancreatic or colorectal cancer with an indication for systemic chemotherapy (METERMUCADIG - NCT02573974).

Prognostic Impact of Upfront Surgery for Locally Advanced Upper Rectal Adenocarcinoma.

Background/aim: Impact of neoadjuvant chemoradiotherapy (CRT) in locally advanced upper rectal adenocarcinoma (LAURC) is debated. The aim of this study was to compare outcomes between LAURC and locally advanced sigmoid and recto-sigmoid junction cancer (LASC).

Patients And Methods: This retrospective study included 149 consecutive patients [42 CRT/LAURC, 16 upfront surgery (US/LAURC) and 91 LASC].

Long term outcome of anastomotic leakage in patients undergoing low anterior resection for rectal cancer.

Background: The influence of anastomotic leakage (AL) on local recurrence rates and survival in rectal cancer remains controversial. The aim of this study was to analyze the effect of asymptomatic anastomotic leakage (AAL) and symptomatic anastomotic leakage (SAL) on short- and long-term outcome after curative rectal cancer resection.

Methods: All patients who underwent surgical resection of non-metastatic rectal cancer with curative intent from January 2005 to December 2017 were retrospectively analyzed.

Complete Pathological Response Following Radiochemotherapy for Locally Advanced Rectal Cancer: Short and Long-term Outcome.

Background/aim: Preoperative radiochemotherapy (RCT) followed by total mesorectum excision has become the gold standard for locally advanced carcinoma of the low and middle rectum. The aim of the study is to evaluate the short and long-term outcomes of patients in complete pathological response (PR) following this treatment sequence.

Patients And Methods: One hundred and thirty patients were retrospectively included between 2005 and 2017 in an expert centre, with 3 groups formed, according to the PR: i) complete PR (absence of tumour cells on the surgical specimen ypT0N0), ii) partial PR (T or N downsizing) and iii) without PR.

Low Tie Compared to High Tie Vascular Ligation of the Inferior Mesenteric Artery in Rectal Cancer Surgery Decreases Postoperative Complications Without Affecting Overall Survival.

Background/aim: The aim of this study was to determine the clinical impact of low tie ligation (LT) of the inferior mesenteric artery (IMA) below the left colic artery versus high tie ligation (HT) at the origin of the IMA in patients undergoing rectal cancer surgery.

Patients And Methods: Between January 2005 and December 2017, all consecutive patients who underwent rectal resection for non-metastatic cancer were retrospectively included. Patients who had LT were compared to those who had HT.

Long-term hospital mortality due to small bowel obstruction after major colorectal surgery in a national cohort database.

Purpose: Adhesions following major colorectal surgery can be responsible for bowel obstruction, mostly occurring in the small intestine. Published data for long-term survival following major colorectal surgery complicated with intestinal obstruction are limited. The aim of this study was to identify the mortality rates and mortality risk factors in patients with primary colorectal surgery (PMCS) complicated with surgical small bowel obstruction (SBO).

Only Surgical Treatment to Be Considered for Adhesive Small Bowel Obstruction: A New Paradigm.

Background: Adhesive small bowel obstruction (SBO) represents a heavy burden in healthcare systems worldwide and is associated with significant morbidity and mortality. Although conservative treatment alone can lead to SBO resolution in most cases, its optimal duration is still a matter of debate. The aim of this study was to analyze different SBO evolution patterns in order to further determine when to switch to surgical treatment.