Einstein (Sao Paulo)
October 2024
Background: Angiography of the superior rectal artery showed that its branches were divided into four main branches (two left and two right) in 46.8%; the second most frequent variation was one right and two left branches in 26.6%, followed by two branches to the right and one to the left in 20%; the most uncommon variations were one to the right and one to the left without further subdivision in 6.
View Article and Find Full Text PDFRobotic colectomy has been associated with comparable or improved short-term morbidity and mortality when compared to laparoscopic colectomy, including shorter length of stay. In this study, we sought to understand oncologic advantages for robotic as compared to laparoscopic colectomy in colon cancer. We analyzed the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) participant user files for all elective colon cancer cases from 1/2016 through 12/2021 performed with minimally invasive surgical techniques (robotic and laparoscopic).
View Article and Find Full Text PDFJ Gastrointest Oncol
August 2024
Background: Intraductal papillary mucinous neoplasm (IPMN)-associated pancreatic cancer is becoming a common subtype of pancreatic cancer found in resected specimens. The prognostic of this subtype is still under evaluation. The study aims to evaluate the prognosis of IPMN-associated pancreatic adenocarcinoma compared to the conventional pancreatic adenocarcinoma.
View Article and Find Full Text PDFHER2-Low is defined as low levels of HER2 expression, based on a score of 1+ on immunohistochemical (IHC) assay or as an IHC score of 2+ and negative results on in situ hybridization (ISH or FISH). They are a heterogeneous population of breast cancers that vary in prognosis and sensitivity to systemic treatments. The frequency and clinical characteristics of pathogenic germline variants (PGVs) in HER2-Low breast cancer (BC) patients is not defined.
View Article and Find Full Text PDFEinstein (Sao Paulo)
June 2024
Objective: Currently programmed cell death protein 1 (PD-1) inhibitors in combination with other therapies are being evaluated to determine their efficacy in cancer treatment. However, the effect of PD-ligand (L) 1 expression on disease outcomes in stage III (EC III) non-small cell lung cancer is not completely understood. Therefore, this study aimed to assess the influence of PD-L1 expression on the outcomes of EC III non-small cell lung cancer.
View Article and Find Full Text PDFClin Colorectal Cancer
September 2024
Background: Neoadjuvant radiation and oxaliplatin-based systemic therapy (total neoadjuvant therapy-TNT) have been shown to increase response and organ-preservation rates in localized rectal cancer. However, trials have been heterogeneous regarding treatment protocols and few have used a watch-and-wait (WW) approach for complete responders. This trial evaluates if conventional long-term chemoradiation followed by consolidation of FOLFIRINOX increases complete response rates and the number of patients managed by WW.
View Article and Find Full Text PDFThis is a video vignette of a 57-year-old asymptomatic female patient. The patient underwent a screening colonoscopy which revealed a 10 mm scar in the rectum. Biopsy resulted in a well-differentiated tubular adenocarcinoma.
View Article and Find Full Text PDFBackground And Objectives: This study evaluates the Tri-Staple™ technology in colorectal anastomosis.
Methods: Patients who underwent rectosigmoidectomy between 2016 and 2022 were retrospectively evaluated and divided into two groups: EEA™ (EEA) or Tri-Staple™ (Tri-EEA). The groups were matched for age, sex, American Society of Anesthesiologists (ASA), and neoadjuvant radiotherapy using propensity score matching (PSM).
Surg Endosc
May 2024
Background: Evidence regarding the outcomes benefits of robotic approach, when compared to a laparoscopic approach, in colectomy remain limited.
Objective: This study aimed to analyze the value of robotic approach compared to laparoscopic approach in minimally invasive colectomy.
Design: Cohort study of the National Surgical Quality Improvement Program (NSQIP).
Aim: The role of bowel preparation before colectomy in Crohn's disease patients remains controversial. This retrospective analysis of a prospective cohort study aimed to investigate the clinical outcomes associated with mechanical and antibiotic colon preparation in patients diagnosed with Crohn's disease undergoing elective colectomy.
Method: Data were collected from the American College of Surgeons National Surgical Quality Improvement Program participant user files from 2016 to 2021.
Robotic surgical systems have rapidly become integrated into colorectal surgery practice in recent years, particularly for rectal resections, where the advantages of robotic platforms over conventional laparoscopy are more pronounced. However, as with any technological advancement, the initial high costs can be a limiting factor, leading to unequal health service access, especially in middle- and lower-income countries. A narrative review was conducted with the objective of providing an overview of the escalating adoption, current training programmes, and certification process of robotic colorectal surgery in Brazil.
View Article and Find Full Text PDFColorectal Dis
September 2023
Introduction And Importance: Colorectal cancer is a leading cause of cancer-related deaths worldwide. It is estimated that approximately 1.93 million new cases of colorectal cancer were diagnosed and almost one million global colorectal cancer-caused deaths in 2020.
View Article and Find Full Text PDFInactivation of the cyclin-dependent kinase inhibitor 2A (CDKN2A) gene is considerably more frequent in squamous cell lung cancer (SqCLC) than in other subtypes of lung cancer and may be a promising target for this histology. Here, we present the course of diagnosis and treatment of a patient with advanced SqCLC, harboring not only CDKN2A mutation but also PIK3CA amplification, Tumor Mutational Burden-High (>10 mutations/megabase), and a Tumor Proportion Score of 80%. After disease progression on multiple lines of chemotherapy and immunotherapy, he responded favorably to treatment with the CDK4/6i Abemaciclib and later achieved a durable partial response to immunotherapy rechallenge with a combination of anti-PD-1 and anti-CTLA-4, nivolumab, and ipilimumab.
View Article and Find Full Text PDFJ Vasc Interv Radiol
May 2023
Purpose: To compare short-term and medium-term results of superior rectal artery embolization versus surgical hemorrhoidectomy in the treatment of patients with hemorrhoidal disease.
Material And Methods: This study was a prospective randomized clinical trial following 33 patients with symptomatic hemorrhoidal disease Grades 2 and 3 who were randomly assigned to 2 different groups: the superior rectal artery embolization group (n = 15) and Ferguson closed hemorrhoidectomy surgical group (n = 14). Four patients were excluded from the analysis.
Trials
January 2023
Background: Ileostomy closure is associated with a high rate of postoperative morbidity, and adynamic ileus is the most common complication, with an incidence of up to 32%. This complication is associated with delayed initiation of oral diet intake, abdominal distention, prolonged hospital stay, and more significant patient discomfort. The present study aims to evaluate the rectal stimulus with prebiotics and probiotics before ileostomy reversal.
View Article and Find Full Text PDFPurpose: This study aimed to review the outcomes of redo procedures for failed colorectal or coloanal anastomoses.
Methods: A systematic review was performed using the PubMed, Embase, Cochrane, and LILACS databases. The inclusion criteria were adult patients undergoing colectomy with primary colorectal or coloanal anastomosis and studies that assessed the postoperative results.
Background: The aim of this study was to evaluate the influence of the institutional volume of abdominoperineal resections (APR) on the short-term outcomes and costs in the Brazilian Public Health system.
Methods: This population-based study evaluated the number of APRs by institutions performed in the Brazilian Public Health system from January/2010 to July/2022. Data were extracted from a public domain from the Brazilian Public Health system.
Neoadjuvant chemotherapy is considered a new treatment option for potentially resectable pancreatic cancer. However, data are not well established on overall survival and delaying surgery in resectable pancreatic cancer, as well as on those patients that ultimately cannot undergo surgery. We analyzed pancreatic cancer patients treated in a tertiary hospital from January 2016 to December 2020.
View Article and Find Full Text PDFIntroduction: The resection of the primary colorectal tumor and liver metastases is the only potentially curative strategy. In such cases, there is no consensus on whether the resection of the primary tumor and metastases should be performed simultaneously or whether a staged approach should be performed (resection of the primary tumor and after, hepatectomy, or the "liver first" approach). The aim of this study is to evaluate the results of hepatectomy associated with colectomy in colorectal neoplasms, comparing simultaneous and staged resection.
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