The management of rectal cancer recognizes surgical resection as the most important step towards a permanent cure. Respecting the oncological principles, functional preservation represents a priority in achieving an acceptable quality of life for the patient. This study aimed to compare the results after low anterior resection (LAR) versus very low anterior resection (VLAR), in terms of postoperative outcome. We conducted a retrospective, observational study on a group of 147 patients with LAR or VLAR done for low rectal cancer in the 1st Department of General Surgery of the Emergency County Hospital of Targu Mures, between January 2015 and December 2019. We considered as low rectal cancer tumors located between 5-10 cm from the anal verge and very low those situated less than 5 cm from it. Patients were divided in two groups according to the type of operation. The postoperative evolution was followed. The two groups, LAR with 81 and VLAR with 66 cases, had homogenous distribution regarding patients demographic and biological parameters and tumor pathological features. A significantly (p=0.0223) longer surgical intervention time was reported in VLAR than in LAR procedures. We found no statistically significant differences between LAR and VLAR in terms of associated postoperative morbidity or mortality, neither in hospitalization time. There was no statistical difference in terms of early postoperative outcomes among LAR and VLAR. The most important factor in achieving good oncologic and functional results in low rectal cancer is choosing the adequate, tailored to the case surgical management.

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http://dx.doi.org/10.21614/chirurgia.116.3.321DOI Listing

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Article Synopsis
  • Low anterior resection syndrome (LARS) is a common condition characterized by symptoms like frequency, incontinence, urgency, and constipation in patients after sphincter-sparing rectum surgery (SSRC).
  • A study analyzed 129 patients who underwent SSRC to assess the incidence and risk factors for LARS, finding that 47% of these patients experienced LARS, particularly those who had very low anterior resections (VLAR).
  • The research concluded that the level of distal resection is a significant risk factor for developing LARS, emphasizing that LARS should be taken seriously in post-SSRC patients.
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The management of rectal cancer recognizes surgical resection as the most important step towards a permanent cure. Respecting the oncological principles, functional preservation represents a priority in achieving an acceptable quality of life for the patient. This study aimed to compare the results after low anterior resection (LAR) versus very low anterior resection (VLAR), in terms of postoperative outcome.

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Early evidences of niche shifts in estuarine fishes following one of the world's largest mining dam disasters.

Mar Pollut Bull

May 2020

Laboratório de Ictiologia, Departamento de Oceanografia, Universidade Federal do Espírito Santo, Vitória, ES 29075-910, Brazil.

The Fundão dam collapse occurred on November 2015 in Mariana city (Brazil), provoking a series of ecological impacts over the Doce river basin and its nearshore environment. However many impacts over fishery target fauna (fish and shrimp) are still unknown or underestimated due to the lack of baseline data in the region. In the present study we assessed the isotopic niches modeled from δC and δN signatures of six estuarine fish species before and after the impact to assign potential shifts at the population- and community-level.

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Aim: The present study was designed to assess the impact of neo-adjuvant chemoradiotherapy on the possibility of utilizing sphincter preserving techniques in rectal cancer surgery.

Background: For both patients and surgeons anal sphincter preserving surgery serves as the ideal procedure to treat rectal cancer.

Patients And Methods: Patients with rectal cancer who were admitted to Shohadaye Tajrish hospital between 2001 and 2011 and underwent sphincter preserving or non-preserving surgery were identified.

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