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Titolo:
Role of laparoscopy in the initial multimodality management of patients with near-obstructing rectal cancer
Autore:
Koea, JB; Guillem, JG; Conlon, KC; Minsky, B; Saltz, L; Cohen, A;
Indirizzi:
Mem Sloan Kettering Canc Ctr, Dept Surg, New York, NY 10021 USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021 USA Mem Sloan Kettering Canc Ctr, Colorectal Serv, New York, NY 10021 USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021 USA Mem Sloan Kettering Canc Ctr, Gastr & Mixed Tumor Serv, New York, NY 10021USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021USA Mem Sloan Kettering Canc Ctr, Dept Radiat Oncol, New York, NY 10021 USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021 USA Mem Sloan Kettering Canc Ctr, Dept Med Oncol, New York, NY 10021 USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021 USA
Titolo Testata:
JOURNAL OF GASTROINTESTINAL SURGERY
fascicolo: 1, volume: 4, anno: 2000,
pagine: 105 - 108
SICI:
1091-255X(200001/02)4:1<105:ROLITI>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
COLORECTAL-CANCER; LARGE BOWEL; CARCINOMA; SURGERY;
Keywords:
laparoscopy; rectal cancer; multimodality therapy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
13
Recensione:
Indirizzi per estratti:
Indirizzo: Guillem, JG Mem Sloan Kettering Canc Ctr, Dept Surg, 1275 York Ave, New York, NY 10021USA Mem Sloan Kettering Canc Ctr 1275 York Ave New York NY USA 10021
Citazione:
J.B. Koea et al., "Role of laparoscopy in the initial multimodality management of patients with near-obstructing rectal cancer", J GASTRO S, 4(1), 2000, pp. 105-108

Abstract

The purpose of this study was to investigate the role of diagnostic laparoscopy in the multimodality management of locally advanced, near-obstructingrectal cancer. Fourteen patients with near-obstructing adenocarcinoma of the rectum (8 men and 6 women; mean age 49 years) underwent staging laparoscopy and formation of a sigmoid loop colostomy (n = 7), transverse colostomy(n = 4), or ileostomy (n = 3). The mean operative time was 78 minutes (range 67 to 94 minutes). All patients began a regular diet on postoperative day 1 and the median time to discharge was 4 days (range 2 to 8 days). Four patients were found to have diffuse peritoneal carcinomatosis not defined onpreoperative CT scan. These patients died of disease within 6 months. Ten patients with advanced, localized pelvic disease began preoperative combined-modality treatment (5040 cGy external-beam radiation therapy in conjunction with 5-fluorouracil/leucovorin) between 8 and 13 days (median 9 days) following laparoscopy, and all underwent successful resection with clear margins in a median time of 12 weeks following laparoscopy. In the initial management of patients with near-obstructing advanced rectal cancer, laparoscopy can be both therapeutic and diagnostic by clarifying the site of the primary tumor, identifying patients with unsuspected peritoneal disease, and facilitating the formation of a defunctioning stoma with minimal morbidity. This leads to the early commencement of preoperative combined-modality treatment and does not compromise the prospects of subsequent turner resection.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 19:40:02