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Basic anatomic principles of pediatric colorectal and reconstructive surgery
Published in Alejandra Vilanova-Sánchez, Marc A. Levitt, Pediatric Colorectal and Pelvic Reconstructive Surgery, 2020
The internal anal sphincter is under involuntary control. It is the continuation of the muscularis propria (colon circular layer, smooth muscle). Innervation is by pelvic splanchnics (S2−S4, parasympathetic, no voluntary control). There is no pudendal innervation. It is normally contracted, serving the role of a closed sphincter which can relax at the appropriate time.
Spontaneous intestinal perforation
Published in Prem Puri, Newborn Surgery, 2017
Thinning of the muscularis propria has been observed at the site of perforation 22,23 and variably attributed to either congenital deficiency of the muscle, localized increase in intraluminal pressure, or transient focal ischemia in utero. 22,24
Gastroenteropancreatic neuroendocrine tumors (neoplasms)
Published in Philip E. Harris, Pierre-Marc G. Bouloux, Endocrinology in Clinical Practice, 2014
Maxime Palazzo, Philippe Ruszniewski, Dermot O’Toole
Resection is considered in tumors >10 mm, usually with endoscopic resection. In patients with lesions involving the muscularis propria, a wedge resection may be performed. This procedure was formerly associated with antrectomy, to prevent chronic gastrin stimulation.82
Current status and advances in esophageal drug delivery technology: influence of physiological, pathophysiological and pharmaceutical factors
Published in Drug Delivery, 2023
Ai Wei Lim, Nicholas J. Talley, Marjorie M. Walker, Gert Storm, Susan Hua
The average thickness of the esophageal wall is approximately 1.87 to 2.70 mm in the dilated state and 4.05 to 5.68 mm in the contracted state (Xia et al., 2009). The thickness of the esophageal wall has also been reported to be slightly larger in males (5.26 mm) compared to females (4.34 mm) (Xia et al., 2009). The wall of the esophagus is comprised of the mucosa, submucosa, and muscularis propria (Figure 1). In healthy individuals, the mucosa is composed of three layers – non-keratinized, stratified squamous epithelium; lamina propria (composed of connective tissue); and muscularis mucosa (Scott-Brown et al., 2008; Orlando, 2010; Standring, 2020). The muscularis mucosa is composed primarily of smooth muscle, with a combination of striated muscles at the upper part of the esophagus. The submucosa layer consists of predominantly blood vessels, lymphatic vessels, minor salivary glands, connective tissues, and autonomic nerve plexus (i.e. submucosal plexus). The muscularis propria is formed by a mixture of striated and smooth muscles and is responsible for motor functions of the esophagus.
Overview of predictive and prognostic biomarkers and their importance in developing a clinical pharmacology treatment plan in colorectal cancer patients
Published in Expert Review of Clinical Pharmacology, 2022
Madison M. Crutcher, Adam E. Snook, Scott A. Waldman
Stage at diagnosis is considered the most significant predictor of survival in CRC. Traditionally, the staging of solid tumors is determined from the TNM staging system. This system is comprised of tumor size or depth (T1-4), spread to regional lymph nodes (N0-3), and the presence of any distant metastasis (M0-1). In CRC, stage I disease is defined as growth through the muscularis mucosa into either the submucosa or muscularis propria with no lymph node spread. Stage II tumors are tumors invading through the muscularis propria again with no lymph node spread compared to stage III tumors which are tumors of any depth with spread to regional lymph nodes. Stage IV tumors are tumors of any size, with or without lymph node spread, with distant metastases [5]. This staging is established after surgical resection of the tumor and its associated lymph nodes combined with cross-sectional imaging to establish the presence or absence of distant metastasis.
Quality of pathology reporting and adherence to guidelines in rectal neuroendocrine neoplasms: a Belgian national study
Published in Acta Clinica Belgica, 2022
Bruno Waked, Filip De Maeyer, Saskia Carton, CUYLE Pieter-Jan, Timon Vandamme, Chris Verslype, Pieter Demetter, Ivan Borbath, Liesbet Van Eycken, Anne Hoorens, Karen Geboes, Nancy Van Damme, Suzane Ribeiro
We gathered a total of 686 pathology reports with a diagnosis of rectal NEN over a 12 year period (2004–2015), counting for a total of 683 patients as three patients each had two synchronous rectal NEN. Analysis showed 8 double reports. Sixteen reports were excluded because they concerned a rectum adenocarcinoma (4 cases), a prostate carcinoma (1 case), a neuroendocrine tumor from another site of origin (4 sigmoid, 3 colon and 1 small bowel) or uncertainty about the site of origin (2 cases). In one case, no tumor was found. Finally, 667 patients with 670 rectal NEN remained. Table 3 shows the increasing annual incidence. We see an exponential growth in reporting of the Ki67 index. Although grade of differentiation was the most important factor historically, reporting was poor, improved from 2009 onwards, but stagnated in the range of 50–55%. Reporting of tumor size was rather average and improved slightly, from 55% to 60%. Reporting of muscularis propria involvement, lymphovascular and perineural invasion was poor without much improvement over the years, remaining below 20%.