Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Rectum”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 451 records · Page 25Linked to original sources
PubMed1994

[Mechanical sutures in resection of the rectum in carcinoma].

In the period between January 1, 1992, and January 1, 1994, on the 3rd Department of the 1st Surgical Clinic, Clinical Center in Belgrade, 116 pt's has been operated due to a rectal carcinoma. In all of these pt's an anterior resection of the rectum and a colorectal stapled anastomosis was performed. Colorectal anastomosis was performed using an American EEA stapler on the different segments of the rectum. Overall, a 30 or 25.86% intraperitoneal anastomosis have been performed, 18 (15.51%) were done on the medium third of the rectum and ultra low anastomosis were performed in 68 pt's (58.63%). In our group there was 6 pt's with the anastomotic leakage and a leakage occurred only in the group of pt's with ultra-low colorectal anastomosis. In three pt's after conservative treatment a spontaneous healing of the anastomosis happened while in the other three pt's an explorative laparatomy with loop ileostomy had to be performed. One patient died during the postoperative treatment. The patient died on the second postoperative day due to a mesenteric thrombosis and gangrene of the intestines.

Colon↗
PubMed1996

[Lower anterior (mesenteric) resection of the rectum].

The immediate and late results of 283 operations for anterior resection of the rectum in carcinoma are analysed. Low anterior resection of the rectum with division of the lateral ligaments and middle rectal arteries was performed in 28 (9.9 +/- 1.8%) of these patients. Due to the high incidence of anastomosis incompetence, the formation of colostomy in low anterior resections is obligatory. The discussed operation is justified oncologically and does not yield in radical character to rectal extirpation and abdomino-anal resection of the rectum with the pull-through procedure.

Anastomosis, Surgical↗
PubMed1977

Leiomyosarcoma of the rectum and prostate.

A 47-year-old man with leiomyosarcoma involving the rectum and prostate was treated by radical abdominoperineal resection. This case appears to be unique in that leiomyosarcoma was present in both the rectum and the prostate. The literature is reviewed, highlighting some interesting clinical features of this condition. The prognosis for leiomyosarcoma of both rectum and prostate is poor.

Humans↗
PubMed1996

[A new approach of functional recto-anal exploration: the compliance of the rectum and the anal canal].

We have developed an original method of determining the rectal and the anal compliance. The rectum must serve as a fecal reservoir. This storage function requires that the rectum must be distensible. The anal canal must become easily looser for defecation. These features are not explored by the usual rectoanal manometric recordings. Very few investigations about the compliance are carried out. In our procedure, exploration balloons are connected via polyethylene tubes to pressure transducers, direct-writing electrical recorder and pump under the command of the computer. The pressure generated is as high as the distensibility is poor, as the compliance is decreased. The pressure/volume curve shows the compliance. The procedure is different for the rectum on the one hand, and for the anal canal on the other. The rectal device consists of a balloon at the end of the tube. It shall be inflated until only 60 ml., and then deflated at the same rythm, which is constant during each test. The first test takes place at the speed of 30 ml. per minute; so the inflation lasts 2 mn and the deflation the same time, afterwards the second test lasts one mn for each one, and finally the third one 40 seconds in the same way. For the anal canal, the balloon, ring shaped around the tube, measuring an inch in length, is inflated at only 12 ml. For the first test the inflation and deflation rate of speed is 3 ml per mn, afterwards 6 ml./mn then 9 ml./mn. and thereafter 12 ml./mn/; these series are done in randomized order. In both procedures, an additional relaxation test at the maximum of inflation takes place for 2 minutes. We have explored ten healthy volunteers and 120 patients suffering from various digestive diseases. The curves show the rectal compliance, and in the case of the anus a relaxation, which seems to be an active opening, occurs for a distension of 5-8 ml, i.e. 19-21 mn in diameter. In pathology, the excess of compliance is observed in patients with incontinence, whereas an inadequate compliance is seen in the dyschesia, descending perineum and prolapse, traumatic or surgical injuries, etc. This exploration will be a useful guide for the choice of the convenient treatment and the follow-up.

Adult↗
PubMed1996

[Has amputation of the rectum by pure perineal approach or Lisfranc operation still a role in the treatment of rectal cancer?].

Amputation of the rectum by a purely perineal route, the Lisfranc procedure, has been progressively replaced by abdominoperineal methods. In the AFC survey made in 1987, a Lisfranc was used only 26 times in 5,274 patients in the survey. We performed a Lisfranc 8 times from 1980 to 1993 in patients over 80 years of age or with an ASA score equal to or above 3. There was one death due to multiple-organ failure 70 days after the operation. Overall mean survival was 17.8 months and reached 24 months for those who did not have metastasis as the time of the amputation. Quality of life was assessed as good. Two patients had a local recurrence 1 and 3 years after the operation. We thus suggest that amputation of the rectum using the Lisfranc procedure can be used for certain patients in which simple colostomy (with no effect on the rectal syndrome), radiotherapy (variable and limited response), chemotherapy and other palliative procedures (electro-coagulation, laser cryosurgery) would not be indicated. Whenever tumour exeresis appears to be possible, we suggest that this method is the best palliative procedure to propose in elderly patients with several organic disorders and for cancers of the lower third of the rectum. The procedure should not however be attempted in patients with advanced stage cancer and a survival time estimated at less than 6 months.

Adenocarcinoma↗
PubMed1997

Medical management of a full-thickness tear of the retroperitoneal portion of the rectum in a horse with hyperadrenocorticism.

A 30-year-old Morgan-Quarter Horse gelding with hyperadrenocorticism was referred for treatment of a full-thickness tear of the retroperitoneal portion of the rectum. In older horses, the caudal end of the peritoneal space may be farther cranial than is commonly thought. Thus, there is a greater chance that full-thickness rectal tears will involve the retroperitoneal, rather than the peritoneal, portion of the rectum. This horse had a quick recovery and good outcome, despite underlying hyperadrenocorticism that would be expected to impair healing. Although relatively little is known about management and prognosis of full-thickness tears of the retroperitoneal portion of the rectum, results in this horse suggest that medical management may be appropriate.

Abdominal Pain↗
PubMed1997

Gastrointestinal lymphonodular hyperplasia and lymphoid polyps of the rectum--a rare coincidence.

Lymphoid polyps of the rectum are rare lesions. We report on an 8 1/2-year-old boy, who presented with hematochezia and abdominal pain. Flexible endoscopy revealed large sessile polyps of the rectum and lymphonodular hyperplasia of the duodenum, terminal ileum und descending colon. One rectal polyp was excised in toto, microscopically it revealed the typical features of a lymphoid polyp. Based on the distinct follicular architecture, the cytomorphology and the immunohistochemical findings of the lymphatic infiltrate we were able to distinguish this lesion from malignant lymphoma. The coincidence of lymphoid polyps and gastrointestinal lymphonodular hyperplasia gives evidence that both entities are different variations of the same benign lymphoproliferative process. Lymphoid polyps of the rectum should be treated by local excision for diagnostic purposes. Immunohistochemical staining of fresh, nonfixed tissue is a useful ancillary technique in distinguishing these benign lesions from lymphoma of mucosa associated lymphoid tissue (MALT-lymphoma).

Biopsy↗
PubMed1982

Carcinoma of the colon and rectum: the natural history reviewed in 1704 patients.

For 1704 patients with large bowel cancer compiled by the Armed Forces Central Medical Registry, selected prognostic factors were related to five-year or longer survival. The majority of late deaths (those occurring after five years) resulted from cancer in the descending colon, sigmoid colon or rectum rather than from cancer in the right or transverse colon. For example, among all patients with cancer of the rectum, 15.4% of those with Dukes' B tumors and 10.9% of those with Dukes' C tumors died of rectal cancer between five and ten years after diagnosis. When late survival rates were compared, patients with right and transverse colon cancer (8 deaths/93 at risk) fared significantly better than those with left colon and rectal cancer (33 deaths/171 at risk; P = 0.01). Among patients with left-sided colon and rectal carcinoma, a further significant difference in late survival was found when stage of disease was considered: patients with Dukes' A cancers (3 deaths/47 at risk after five years) fared better than those with Dukes' C cancers (21 deaths/74 at risk) (P = 0.002). For Dukes' B and C stages of disease, patients with left colon and rectal cancer fared worse than those with right and transverse colon lesions after 60 months. Of all patients who died of large bowel cancer after five years, 69% had a recurrence of cancer by 60 months, and most late recurrences were located in the descending and sigmoid colon and in the rectum. These results show differences in survival after five years with respect to both site of cancer in the colon and stage of initial disease. Our findings indicate that many left-sided large bowel cancers have a slowly progressive natural history.

Adenocarcinoma↗
PubMed1993

Colon and rectum cancer. Patterns of spread and implications for workup.

The preoperative evaluation of patients diagnosed as having colon or rectum cancer is influenced by the anatomic location of the primary tumors; the knowledge that 10-25% of patients harbor detectable metastases at time of initial diagnosis; the observation that as many as one-third of patients with isolated metastases may achieve significant survival benefit by aggressive surgery; and the need to accurately stage low rectum cancers to permit selection of appropriate surgery. Patients are evaluated by colonoscopy, air-contrast barium enema when required, computed tomography, and serum carcinoembryonic antigen. Magnetic resonance imaging, especially of the pelvis, may be useful, and endorectal ultrasound has an important role in staging low rectum cancer. A thorough preoperative evaluation is essential in selecting appropriate operative therapy and for sequencing surgery with available adjuvant treatments.

Colonic Neoplasms↗
PubMed1982

Results of extended surgery for cancer of the rectum and sigmoid.

The clinical records of 61 patients who underwent extended surgery, including resection of parietes or other viscera, from 1965 to 1977 for cancer of the rectum and sigmoid were reviewed. Abdominoperineal resection was performed in 41 patients, anterior resection in 18 and Hartmann's resection in 2. The postoperative mortality rate was 8.2 per cent, the non-lethal morbidity rate 30.3 per cent, but 4 patients presented multiple complications. The 5-year survival rate was evaluated separately for patients with and without microscopic evidence of neoplastic involvement of the simultaneously excised structures; in the first group it was 32 per cent, in the second 75 per cent. Local or distant recurrence occurred in 66 per cent of patients with microscopic infiltration and in 24 per cent of patients without microscopic infiltration. These results compare favourably with those reported after ordinary resections of Dukes' C cancers of the rectum and sigmoid, and seem to justify the use of extended surgery when cancer of the rectum and sigmoid has invaded contiguous structures.

Adult↗
PubMed1984

Survival and recurrence after sphincter saving resection and abdominoperineal resection for carcinoma of the middle third of the rectum.

Sphincter saving resections (SSR) are being performed with increasing frequency in patients with carcinoma of the lower two-thirds of the rectum. It is not clear, however, whether local and distant recurrence and long term survival after these operations will be comparable with those following abdominoperineal resection (APER). In this retrospective study, we have compared survival and recurrence in patients with carcinoma of the middle third of the rectum (7.5-12 cm from the anal verge) who were treated by APER (n = 83) or low SSR (n = 71). There was a higher proportion of men in the APER group, the mean age was higher and APER patients had tumours with less favourable pathological features. To minimize bias between the two groups, patients with tumours with similar pathological characteristics were compared. The overall cancer specific 5-year survival rate after SSR was 74 per cent and after APER was 62 per cent; the overall recurrence rates were 27 per cent after SSR and 41 per cent after APER; the incidence of local recurrence was 11 per cent after SSR and 8 per cent after APER. In these comparisons and when the patients' tumours were matched for one or two pathological variables, no significant difference was found between the two groups. These results suggest that patients with carcinoma of the middle third of the rectum who are treated by SSR will fare as well as patients who are treated by APER, with respect both to recurrence and to survival. A prospective controlled trial, however, is required to provide final proof of these points.

Aged↗
PubMed1984

Smooth muscle neoplasms of the rectum and anal canal.

Forty-eight patients who presented to St. Mark's Hospital, London between 1948 and 1979 with smooth muscle neoplasms of the rectum or anal canal have been reviewed. Twenty-six tumours arose from the muscularis mucosae of the rectum. These lesions were small, asymptomatic and did not recur after local removal. Eighteen tumours arose from the muscularis externa of the rectum. Local excision of these resulted in a high local recurrence rate regardless of the degree of differentiation of the tumour but long-term survival figures were similar whether the tumours were treated by local or radical techniques. However, the prognosis did relate to the degree of tumour differentiation, being worst in the poorly differentiated group. In four cases the smooth muscle tumour arose from the internal sphincter of the anal canal.

Adult↗
PubMed1985

The results of surgical treatment of cancer of the rectum by radical resection and extended abdomino-iliac lymphadenectomy.

At St Mark's Hospital survival after radical surgery for cancer of the rectum has not changed significantly over the past 30 years. The technique of extended abdomino-iliac lymphadenectomy was developed in an attempt to improve prognosis in patients considered to have particularly unfavourable tumours. Between 1960 and 1981 the technique was used in 75 patients with a single adenocarcinoma of the rectum. Two patients died postoperatively and 52 patients developed complications; a mortality and morbidity similar to those seen after conventional surgery at this hospital. Five-year survival rate showed no improvement over that achieved by conventional techniques; disappointingly this was also the case for patients with Dukes' C1 tumours. The results of this study suggest that an improvement in survival in patients with cancer of the rectum is unlikely to be achieved by any extension of conventional radical surgery.

Abdomen↗
PubMed1998

Total mesorectal excision for cancer of the rectum.

The concept of total mesorectal excision (TME) was first described by R. J. Heald in 1982 as a radical cancer operation based on the anatomy of fascial planes and fibrous spaces of the pelvis. The ampulla recti is invested by a fascia propria which is a part of the visceral pelvic fascia. The fascia propria is separated from the parietal pelvic fascia by the pelvirectal fibrous space, which is a compartment of the subperitoneal space of the pelvis. The lateral ligaments of the rectum divides the pelvirectal space into a prerectal and a retrorectal part. TME is defined as the resection of the rectum with its surrounding fatty and lymphatic tissue contained within the visceral sheet of the pelvic fascia. The dissection proceeds in the nearly avascular cleavage plane between the visceral and the parietal fascial sheets, allowing maximal protection of the hypogastric nerves and the inferior hypogastric plexus. Continuity of the prerectal and retrorectal parts of the field of dissection is established by dividing the lateral ligaments of the rectum slightly inside the point where they swing away from the parietal fascia of the pelvic side wall. By following this plane of dissection it is possible to achieve en bloc excision of the total mass of perirectal lymphatic and fatty tissue down to the pelvic floor.

Humans↗
PubMed1985

Mortality from cancer of the stomach, colon and rectum in the city of Naples and the provinces of Campania.

Utilizing data on deaths from 1951 to 1981, this study attempts to verify a time trend for stomach, colon and rectum cancer in the city of Naples. Time trend analysis and cohort analysis have shown an increase of colon rectum cancer mortality affecting cohorts born after 1871 and a decrease of stomach cancer mortality for those born after 1886. A comparison of mortality rates in three geographical areas shows that, while there is not any difference for stomach cancer, the mortality curves relating to cancer of the colon and rectum are higher in the city of Naples than in the province of Naples and the other provinces of Campania.

Colonic Neoplasms↗
PubMed1996

Primary linitis plastica of the rectum: report of four cases and review of the literature.

Primary linitis plastica of the rectum is a rare form of large bowel carcinoma, with only 30 cases having been reported in the English literature to date. Of significance is the fact that it carries a prognosis that is poor compared to other types of colorectal cancers. We report herein the cases of four patients with primary linitis plastica of the rectum who underwent surgery, followed by intensive postoperative chemotherapy using 5-fluorouracil (5-FU) derivatives in our institution. A review of the literature is presented with special reference to the diverse treatment and prognosis of this unusual disease. Although three of the patients died of recurrent cancer, one has survived for 5 years and 10 months despite advanced disease. This is only the third reported case of a patient with linitis plastica of the rectum achieving 5-year survival. We believe that this unexpected long survival could be related to the patient's extensive lymphadenectomy and intensive postoperative chemotherapy using cisplatin and 5-FU derivatives.

Aged↗
PubMed1980

Lindane degradation by cell-free extracts of Clostridium rectum.

For lindane degradation, a cell suspension of Clostridium rectum strain S-17 demands the addition of substrates such as leucine, alanine, pyruvate, a leucine-proline mixture, and molecular hydrogen. In the presence of leucine-proline mixture, lindane decomposed in parallel with isovaleric acid formation, and both lindane degradation and isovaleric acid formation were inhibited by monoiodoacetic acid, suggesting a close relation between lindane degradation and the Stickland reaction. Lindane was degraded by cell-free extracts of C. rectum in the presence of dithiothreitol (DTT). Radiogaschromatograms of n-hexane soluble metabolites from [14C] lindane showed the presence of monochlorobenzene and gamma-3,4,5,6-tetrachlorocyclohexene. Leucine, NADH, and NADPH were somewhat less active than DTT for lindane degradation in cell-free extracts. Reductive dechlorination seemed the major route of lindane degradation in cell-free extracts as well as in the intact cells of C. rectum.

Amino Acids↗
PubMed1997

Primary malignant lymphoma of the rectum with distant metastasis to the stomach: report of a case.

Primary extranodal malignant lymphoma frequently occurs in the gastrointestinal tract: however, it is rarely encountered in the rectum. We report herein the case of an 85-year-old man who underwent abdominoperineal resection for primary malignant lymphoma of the rectum, and 1 year later, developed hematemesis caused by gastric metastasis. To our knowledge this is the first case report of such distant metastasis developing from malignant lymphoma of the rectum.

Aged↗