OBJECTIVETo assess the effect of preoperative long course radiotherapy (RT) on anastomotic leakage (AL) after low anterior resection(LAR) for rectal cancer.

METHODSMedline, EMBASE, China National Knowledge Infrastructure,the Cochrane Library databases and other databases were searched for relevant studies. Correlation between preoperative long course RT and AL after LAR for rectal cancer was examined. Review Manager 5.2 software was used to pool raw data and test the heterogeneity of existing studies and to calculate the incorporated odds ratio (OR) and 95% confidence interval (95%CI). Finally, forest plots and funnel plots were created to allow for visual comparison of the results or the effect of publication bias.

RESULTSA total of 881 studies were identified and 10 studies (n=7829) were eligible for the meta-analysis, including 2581 cases of preoperative RT, and 5248 cases of surgery alone without RT. There was no significant difference in anastomotic leakage rate between the two groups (OR:1.17, 95%CI:0.98-1.39, P=0.09).

CONCLUSIONSPreoperative long course RT did not increase the risk of postoperative AL after LAR in patients with rectal cancer.

Anastomotic Leak ; etiology ; Humans ; Postoperative Complications ; etiology ; Preoperative Care ; Radiography ; Rectal Neoplasms ; diagnostic imaging ; surgery

No abstract available.
Diagnosis, Differential ; Endosonography ; Female ; Humans ; Incidental Findings ; *Intestinal Mucosa/pathology/radiography/surgery ; Intestinal Polyps/*diagnosis/pathology/radiography/surgery ; Middle Aged ; Neoplasms, Fibroepithelial/*diagnosis/pathology/radiography/surgery ; Predictive Value of Tests ; Rectal Neoplasms/*diagnosis/pathology/radiography/surgery ; Tomography, X-Ray Computed

Anastomotic stenosis of the colon is not an uncommon finding; however, its frequency varies from one study to another. Traditionally, postoperative colonic stenosis is managed surgically. However, endoscopic therapy has recently become the preferred treatment modality over traditional surgery. Good short-term success has been achieved with use of endoscopic balloon dilation; however, restenosis may occur over time in 14% to 25% of patients. The current report showed the effectiveness and usefulness of an insulated-tip knife (IT-knife) for electrocautery therapy of a patient with symptomatic anastomotic colonic stenosis.
Aged ; Colonoscopy ; Constriction, Pathologic/*therapy ; Electrocoagulation/instrumentation/*methods ; Humans ; Male ; Middle Aged ; Rectal Neoplasms/radiography/*surgery ; Sigmoid Neoplasms/radiography/*surgery ; Tomography, X-Ray Computed

Multiple primary malignancy was reported firstly by Billroth in 1889. Recently, multiple primary malignancies are considered to increase due to improved survival rate of cancer patients, advanced diagnostic tools, and increased use of chemotherapy and radiotherapy. In Korea, several cases of triple primary malignancies were reported. However, four primary malignancies in gastro-intestinal tract was rarely reported. Recently, we experienced a 70 year-old male who was diagnosed with metachronous four primary malignancies in rectum, ascending colon, stomach, and ampulla of Vater. We report this rare case of metachronous four primary malignancies with a review of literature.
Adenocarcinoma/*diagnosis/pathology/surgery ; Adenocarcinoma, Mucinous/diagnosis/surgery ; Aged ; Ampulla of Vater/*pathology ; Colonic Neoplasms/diagnosis/surgery ; Common Bile Duct Neoplasms/*diagnosis/pathology/surgery ; Gastrointestinal Neoplasms/*diagnosis/pathology/radiography ; Humans ; Male ; Neoplasms, Second Primary/*diagnosis/pathology ; Rectal Neoplasms/diagnosis/surgery ; Stomach Neoplasms/diagnosis/pathology/surgery ; Tomography, X-Ray Computed

OBJECTIVE: To assess the follow-up results after negative findings on unenhanced hepatic MR imaging in rectal cancer patients who have undergone locally curative surgery. MATERIALS AND METHODS: From all pertinent imaging reports and medical records, we selected 255 patients who had negative results on unenhanced hepatic MR imaging. When selecting patients who had undergone curative resection, the following patients were excluded from the study: 1) patients in whom extrahepatic metastases were detected on preoperative staging work-ups, 2) patients in whom the surgery was judged to be non-curative due to peritoneal seeding or local aggressiveness. Cases with follow-up periods of less than 18 months were also excluded, as these cases were considered insufficient to confirm the negative outcomes. Thus, a total of 149 patients were ultimately enrolled in our study. The follow-up results of unenhanced MR imagings were assessed according to the assumption that the newly developed hepatic metastases had been false-negative lesions on preoperative MR image. RESULTS: During a median follow-up period of 29.3 months, 25 hepatic metastases were detected in 13 patients (8.7%), which indicated a negative predictive value of 91.3%. CONCLUSION: Unenhanced hepatic MR imaging provides a high negative predictive value with regard to the detection of hepatic metastasis in the preoperative evaluation of rectal cancer.
Adenocarcinoma/*diagnosis/radiography/*secondary/surgery ; Adult ; Aged ; Aged, 80 and over ; Carcinoembryonic Antigen/blood ; Digestive System Surgical Procedures ; False Negative Reactions ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms/*diagnosis/radiography/*secondary/surgery ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Predictive Value of Tests ; Rectal Neoplasms/*pathology ; Retrospective Studies ; Survival Analysis ; *Tomography, X-Ray Computed ; Treatment Outcome ; Tumor Markers, Biological/blood