BACKGROUND Tailgut cyst is a congenital enterogenous cyst that rarely undergoes malignant transformation.Its clinical manifestations mainly correlate to the mass effect caused by the development of cysts and the infec...BACKGROUND Tailgut cyst is a congenital enterogenous cyst that rarely undergoes malignant transformation.Its clinical manifestations mainly correlate to the mass effect caused by the development of cysts and the infections that originate from these.Furthermore,the complete resection of this cyst is curative.We report our diagnostic and treatment experience with one case of malignant transformation of a perianal tailgut cyst,which was initially misdiagnosed as perianal abscess.CASE SUMMARY A 72-year-old woman visited our institution with complaints of a refractory nonhealing lesion on the right hip,which repeatedly broke and suppurated for more than 70 years,and aggravated in 4 mo.The patient was given a diagnosis of refractory perianal abscess with repeated incision and drainage procedures.Computed tomography of the pelvic cavity revealed a giant perianal cyst.Subsequent biopsy revealed a tumor with moderate-to-severe glandular epithelial dysplasia,and suggested that this was derived from the developmental cysts in the posterior rectal space.After further clarifying the nature and extent of the tumor by magnetic resonance imaging,total cystic resection was performed.Postoperative histopathological examination confirmed the malignancy,dictating the investigators to add postoperative chemotherapy to the treatment regimen.CONCLUSION The malignant transformation of perianal tailgut cysts is very uncommon,and this should be differentiated from perianal abscess.Complete surgical removal is curative,and postoperative pathology may determine the necessity of additional postoperative chemotherapy or radiotherapy,which may be beneficial for preventing local recurrence and metastasis.展开更多
Objective To compare the short-term efficacy indicators of laparoscopic technique and open surgery in patients with rectal cancer surgery,and to further evaluate the safety and efficacy of laparoscopic rectal cancer s...Objective To compare the short-term efficacy indicators of laparoscopic technique and open surgery in patients with rectal cancer surgery,and to further evaluate the safety and efficacy of laparoscopic rectal cancer surgery.Methods This study adopted a prospective multicenter,open-label,non-randomized concurrent control method to analyze patients who received rectal cancer surgery from 10 colorectal tumor centers across the country from January 2017 to December 2018.The two groups of patients received laparoscopic-assisted surgery and conventional open surgery respectively.All surgeons were selected according to relevant standards and participated in the two groups of operations at the same time.Comprehensive evaluation and analysis of the operation and postoperative recovery,postoperative pathological results,survival information,postoperative related functional scores and other indicators.Results In the open surgery group,the proportion of tumors with a maximum diameter of more than 5 cm was higher(χ^(2)=0.089,P=0.018),and the proportion of T4 was higher(χ^(2)=0.478,P<0.001).In the laparoscopic group,the proportion of more than 12 harvested lymph nodes was higher(χ^(2)=0.248,P<0.001).There were no significant differences in the length of postoperative hospital stay,intraoperative blood loss,time to first flatus after operation,time to first out of bed,time to first liquid diet,and preservation rate of anal sphincter between the two groups,but in the laparoscopic surgery group the operation time was shorter(t=6.750,P<0.001)and postoperative pain was less(t=0.896,0.63,0.964,and 0.989 on postoperative days 1,2,and 3,respectively,all P<0.001).The incidence of grade 2–4 adverse complication in the two groups was 12.5%and 14.6%,respectively,with no statistical difference(χ2=0.061,P=0.105),but the incidence of incision infection was lower in the laparoscopy group(χ^(2)=0.19,P<0.001).There was no significant difference in 3-year disease-free survival between the two groups(HR=1.089,95%CI=0.962–1.232,P=0.170).Multivariate analysis suggested that intraoperative blood loss,T stage,N stage,nerve invasion,and postoperative sepsis were independent prognostic factors for disease-free survival.Wexner score,IPSS score and LARS score were not statistically different between the two groups.Conclusion The pathological results and short-term outcomes of laparoscopic surgery for rectal cancer are comparable to those of conventional open surgery,and laparoscopic surgery is safe and feasible for rectal cancer patients.展开更多
Introduction Restorative proctocolectomy with ileal pouch–anal anastomosis(IPAA)has been a standard of surgical management of medically refractory ulcerative colitis(UC),UC with neoplasia,or familial adenomatous poly...Introduction Restorative proctocolectomy with ileal pouch–anal anastomosis(IPAA)has been a standard of surgical management of medically refractory ulcerative colitis(UC),UC with neoplasia,or familial adenomatous polyposis.While IPAA significantly improves patients’health-related quality of life,complications are common.Common complications include anastomotic leaks,abscesses,pouch strictures,pouchitis,and fistulas[2,3].展开更多
Purpose Colorectal cancer is a common malignant tumor worldwide.In China,the ratio of rectal cancer to coloncancer in terms of incidence is close to 1:1.Low rectal cancer accounts for more than half of all cases of re...Purpose Colorectal cancer is a common malignant tumor worldwide.In China,the ratio of rectal cancer to coloncancer in terms of incidence is close to 1:1.Low rectal cancer accounts for more than half of all cases of rectal cancer.In recent years,the proportion of rectal cancer has trended downward,however the incidence of rectal cancer inyounger adults is increasing.The CACA Guidelines for Holistic Integrative Management of Rectal Cancer were editedto help improve the diagnosis and comprehensive treatment in China.Methods This guideline has been prepared by consensuses reached by the CACA Committee of Colorectal CancerSociety,based on a careful review of the latest evidence including China’s studies,and referred to domestic and internationalrelative guidelines,also considered China’s specific national conditions and clinical practice.Results The CACA Guidelines for Holistic Integrative Management of Rectal Cancer include the epidemiology of rectalcancer,prevention and screening,diagnosis,treatment of nonmetastatic and metastatic rectal cancer,follow-up,and whole-course rehabilitation management.Conclusion Committee of Colorectal Cancer Society,Chinese Anti-Cancer Association,standardizes the diagnosisand treatment of rectal cancer in China through the formulation of the CACA Guidelines.展开更多
文摘BACKGROUND Tailgut cyst is a congenital enterogenous cyst that rarely undergoes malignant transformation.Its clinical manifestations mainly correlate to the mass effect caused by the development of cysts and the infections that originate from these.Furthermore,the complete resection of this cyst is curative.We report our diagnostic and treatment experience with one case of malignant transformation of a perianal tailgut cyst,which was initially misdiagnosed as perianal abscess.CASE SUMMARY A 72-year-old woman visited our institution with complaints of a refractory nonhealing lesion on the right hip,which repeatedly broke and suppurated for more than 70 years,and aggravated in 4 mo.The patient was given a diagnosis of refractory perianal abscess with repeated incision and drainage procedures.Computed tomography of the pelvic cavity revealed a giant perianal cyst.Subsequent biopsy revealed a tumor with moderate-to-severe glandular epithelial dysplasia,and suggested that this was derived from the developmental cysts in the posterior rectal space.After further clarifying the nature and extent of the tumor by magnetic resonance imaging,total cystic resection was performed.Postoperative histopathological examination confirmed the malignancy,dictating the investigators to add postoperative chemotherapy to the treatment regimen.CONCLUSION The malignant transformation of perianal tailgut cysts is very uncommon,and this should be differentiated from perianal abscess.Complete surgical removal is curative,and postoperative pathology may determine the necessity of additional postoperative chemotherapy or radiotherapy,which may be beneficial for preventing local recurrence and metastasis.
基金supported by Beijing Science and Technology Program[D17110002617004]Beijing Hope Run Special Fund of Cancer Foundation of China[LC2019B14 and LC2021A13].
文摘Objective To compare the short-term efficacy indicators of laparoscopic technique and open surgery in patients with rectal cancer surgery,and to further evaluate the safety and efficacy of laparoscopic rectal cancer surgery.Methods This study adopted a prospective multicenter,open-label,non-randomized concurrent control method to analyze patients who received rectal cancer surgery from 10 colorectal tumor centers across the country from January 2017 to December 2018.The two groups of patients received laparoscopic-assisted surgery and conventional open surgery respectively.All surgeons were selected according to relevant standards and participated in the two groups of operations at the same time.Comprehensive evaluation and analysis of the operation and postoperative recovery,postoperative pathological results,survival information,postoperative related functional scores and other indicators.Results In the open surgery group,the proportion of tumors with a maximum diameter of more than 5 cm was higher(χ^(2)=0.089,P=0.018),and the proportion of T4 was higher(χ^(2)=0.478,P<0.001).In the laparoscopic group,the proportion of more than 12 harvested lymph nodes was higher(χ^(2)=0.248,P<0.001).There were no significant differences in the length of postoperative hospital stay,intraoperative blood loss,time to first flatus after operation,time to first out of bed,time to first liquid diet,and preservation rate of anal sphincter between the two groups,but in the laparoscopic surgery group the operation time was shorter(t=6.750,P<0.001)and postoperative pain was less(t=0.896,0.63,0.964,and 0.989 on postoperative days 1,2,and 3,respectively,all P<0.001).The incidence of grade 2–4 adverse complication in the two groups was 12.5%and 14.6%,respectively,with no statistical difference(χ2=0.061,P=0.105),but the incidence of incision infection was lower in the laparoscopy group(χ^(2)=0.19,P<0.001).There was no significant difference in 3-year disease-free survival between the two groups(HR=1.089,95%CI=0.962–1.232,P=0.170).Multivariate analysis suggested that intraoperative blood loss,T stage,N stage,nerve invasion,and postoperative sepsis were independent prognostic factors for disease-free survival.Wexner score,IPSS score and LARS score were not statistically different between the two groups.Conclusion The pathological results and short-term outcomes of laparoscopic surgery for rectal cancer are comparable to those of conventional open surgery,and laparoscopic surgery is safe and feasible for rectal cancer patients.
文摘Introduction Restorative proctocolectomy with ileal pouch–anal anastomosis(IPAA)has been a standard of surgical management of medically refractory ulcerative colitis(UC),UC with neoplasia,or familial adenomatous polyposis.While IPAA significantly improves patients’health-related quality of life,complications are common.Common complications include anastomotic leaks,abscesses,pouch strictures,pouchitis,and fistulas[2,3].
文摘Purpose Colorectal cancer is a common malignant tumor worldwide.In China,the ratio of rectal cancer to coloncancer in terms of incidence is close to 1:1.Low rectal cancer accounts for more than half of all cases of rectal cancer.In recent years,the proportion of rectal cancer has trended downward,however the incidence of rectal cancer inyounger adults is increasing.The CACA Guidelines for Holistic Integrative Management of Rectal Cancer were editedto help improve the diagnosis and comprehensive treatment in China.Methods This guideline has been prepared by consensuses reached by the CACA Committee of Colorectal CancerSociety,based on a careful review of the latest evidence including China’s studies,and referred to domestic and internationalrelative guidelines,also considered China’s specific national conditions and clinical practice.Results The CACA Guidelines for Holistic Integrative Management of Rectal Cancer include the epidemiology of rectalcancer,prevention and screening,diagnosis,treatment of nonmetastatic and metastatic rectal cancer,follow-up,and whole-course rehabilitation management.Conclusion Committee of Colorectal Cancer Society,Chinese Anti-Cancer Association,standardizes the diagnosisand treatment of rectal cancer in China through the formulation of the CACA Guidelines.
