Benign Neoplasms of the Colon and Rectum
Philip H. Gordon, Santhat Nivatvongs, Lee E. Smith, Scott Thorn Barrows, Carla Gunn, Gregory Blew, David Ehlert, Craig Kiefer, Kim Martens in Neoplasms of the Colon, Rectum, and Anus, 2007
The concept that carcinomas of the colon and rectum derived from benign adenoma was observed by C. Dukes of St. Mark’s Hospital, London, in 1926. Numerous studies, based on tumor registry reports, hospital records, pathology reports, surgical specimens, and colonoscopy show a coexistence of adenomas and adenocarcinomas of the colon and rectum ranging from 13% to 62%. Colonoscopy has revolutionized the management of large bowel polyps. Most polyps throughout the entire colon and rectum can be excised through the colonoscope with minimal morbidity. Polyps of the colon and rectum that are too numerous for colonoscopy and polypectomies should have an abdominal colectomy with ileorectal anastomosis or proctocolectomy with ileal pouch-anal anastomosis or an ileostomy. M. Miettinen et al studied all the mesenchymal neoplasms involving the rectum and anus coded as leiomyoma, leiomyosarcoma, smooth muscle neoplasm, schwannomas, neurofibromas, nerve sheath, stromal neoplasm.
Malignant Neoplasms of the Rectum
Philip H. Gordon, Santhat Nivatvongs, Lee E. Smith, Scott Thorn Barrows, Carla Gunn, Gregory Blew, David Ehlert, Craig Kiefer, Kim Martens in Neoplasms of the Colon, Rectum, and Anus, 2007
The general mechanisms of spread for carcinoma of the rectum are similar to those of the colon, but because of the rectum’s location within the pelvis, it is appropriate to elaborate on these mechanisms, especially as they may pertain to treatment. Many carcinomas of the rectum produce no symptoms initially and are discovered only as part of a routine proctosigmoidoscopy. An intravenous pyelogram is still advised by some surgeons in patients with carcinoma of the rectum to outline the anatomy of the ureters, evaluate renal function, and reveal obstructive uropathy. Ultrasonographic images of the normal colon and rectum identify five distinct layers: mucosa, mucosa and muscularis mucosae, submucosa plus interface between submucosa and muscularis propria, muscularis propria minus the interface between the submucosa and muscularis propria, and serosa and perirectal fascia. The operation, which entails removal of the sigmoid colon and anastomosis of the proximal sigmoid or descending colon to the proximal rectum, is probably better-called a sigmoid resection.
Malignant Neoplasms of the Rectum
Philip H. Gordon, Santhat Nivatvongs in Principles and Practice of Surgery for the Colon, Rectum, and Anus, 2007
It has become customary in textbooks on colon and rectal surgery to divide malignant neoplasms of the colon and rectum into separate chapters. We have continued this tradition but recognize that the division is purely arbitrary. Consequently, this chapter will omit topics that the two subjects have in common-epidemiology, etiology, pathogenesis, and much of the pathology except those features that are characteristic of the rectum. These topics are discussed in detail in Chapter 23. General assessment of the patient is similar, but certain items will be highlighted. Therapeutic options in specific circumstances will differ and consequently will be discussed in detail.
Prevalence and clinical characteristics of phantom rectum syndrome after rectum resection in Chinese patients
Published in The Pain Clinic, 2001
Chen-Hwan Cherng, Chih-Shung Wong, Shung-Tai Ho, Cheng-Jong Chang
Phantom syndrome is a common sequela after limb amputation, whereas phantom rectum syndrome after rectum resection was rarely reported. This study attempted to examine the prevalence and characters of phantom rectum syndrome in Chinese patients. From the hospital records, eighty-one cases received rectum resection for carcinoma of the rectum were included. A written inquiry by a questionnaire was used. The data were obtained by the responded questionnaire. Chi-squared and Fisher's exact tests were used for data analysis. Of 81 cases collected, 55 cases responded and entered the study. The prevalence of phantom rectum syndrome was 40%, and in 55% of these or 22% of all patients this phantom sensation was painful. The age (53.0 ± 14.6 years, p < 0.05) of the patients with painful phantom rectum syndrome was significantly lower than that of the patients with non-painful phantom rectum syndrome (64.4 ± 6.9 years) and the patients without phantom rectum syndrome (62.8 ± 11.1 years). Patients with high educational level exhibited higher occurrence of painful phantom rectum syndrome. A higher prevalence of phantom rectum syndrome and painful phantom rectum syndrome were observed in patients with preoperative pain. The phantom rectum syndrome after rectum resection in Chinese patients really exists and the occurrence of painful phantom rectum syndrome is related to young age, high educational level and preoperative pain.
Acute heat injury to the normal swine rectum
Published in International Journal of Hyperthermia, 1988
D. J. Li, S. L. Qiu, S. L. Zhou, H. L. Liu
Intracavitary hyperthermia was applied to the rectum of normal pigs at 43°, 44°, 45°, 46°, 47° and 48°C for 30 min. A score of temperature-induced histological changes of each specimen was made 48 h after heating. The scores from each specimen and temperature were used for regression analysis. Judging from the regression lines of the scores obtained for rectum and oesophagus, we conclude that the thermosensitivity of the rectum is about 1°C higher than that of the oesophagus. It suggested that 43°C/30 min could be a safe dose for normal rectum. The thermosensitivity of swine rectum is discussed.
Measurement of Rectal Dose during HDR Brachytherapy using the new MO
Published in Journal of Nuclear Science and Technology, 2008
Kwan Ian, Howie Andrew, Lerch Michael, Lee Bongsoo, Yaw Sinn Chin, Joseph Bucci, Vladimir Perevertaylo, Anatoly Rosenfeld
In HDR prostate brachytherapy, post-treatment complications occur due to overdosing the rectum wall and urethra. An area of concern regarding treatment is related to how the rectal wall dose is calculated using treatment planning systems. Treatment planning systems can calculate the dose delivered to the rectal wall, assuming that the rectum is filled with water equivalent material. This assumption is not always correct, as the rectum is emptied before treatment begins. The aim of this research is to quantify the difference in the dose measured in an ‘empty’ rectal phantom, and in a rectal phantom filled with water equivalent material. Results indicate that the dose measured by the MOSkin and RadFET in an empty rectum is approximately 10–15% lower than the dose measured dose in a full rectum, and the dose calculated by the PLATO TPS, which assumes that the rectum is full. This could have implications on the design of HDR treatment plans.
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