Wos İndeksli Açık & Kapalı Erişimli Yayınlar

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    Anorectal function and outcomes after transanal minimally invasive surgery for rectal tumors
    (2015) Karakayali, Feyza Y.; Tezcaner, Tugan; Moray, Gokhan; 26622116
    Background: Transanal endoscopic microsurgery is a minimally invasive technique that allows full-thickness resection and suture closure of the defect for large rectal adenomas, selected low-risk rectal cancers, or small cancers in patients who have a high risk for major surgery. Our aim, in the given prospective study was to report our initial clinical experience with TAMIS, and to evaluate its effects on postoperative anorectal functions. Materials and Methods: In 10 patients treated with TAMIS for benign and malignant rectal tumors, preoperative and postoperative anorectal function was evaluated with anorectal manometry and Cleveland Clinic Incontinence Score. Results: The mean distance of the tumors from the anal verge was 5.6 cm, and mean tumor diameter was 2.6 cm. All resection margins were tumor free. There was no difference in preoperative and 3-week postoperative anorectalmanometry findings; only mean minimum rectal sensory volume was lower at 3 weeks after surgery. The Cleveland Clinic Incontinence Score was normal in all patients except one which resolved by 6 weeks after surgery.The mean postoperative follow-up was 28 weeks without any recurrences. Conclusion: Transanal minimally invasive surgery is a safe and effective procedure for treatment of rectal tumors and can be performed without impairing anorectal functions.
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    Histopathological Changes of Neoadjuvant Chemoradiation and Relation with the Pre-Treatment Tumor Stage in Rectal Carcinoma
    (2017) Ozgun, Gonca; Atalay, Fatma Oz; Ugras, Nesrin; Yerci, Omer
    Objective: Neoadjuvant chemoradiotherapy has considered one of the standard treatment modalities for locally advanced rectal cancers. Chemoradiotherapy has a variety of different effects and responses on tumor, tumor bed and peritumoral tissues. The purpose of the present study was to evaluate the stromal responses in tumor bed between the different treatment modalities and different clinical T stages. Methods: Fifty-seven consecutive patients with median age of 62.4 years were treated for rectal adenocarcinoma between January 2005 and July 2012 in Uludag University Medical Faculty. Twenty-three of the patients were treated with neoadjuvant chemoradiation therapy and following surgery, 34 patients treated with surgery only. Results: When we compared the stromal responses in the tumor bed between the two different treatment modalities, the amount of fibrosis and intensity of inflammatory cell infiltration were found considerably marked. The existence of calcification, hemosiderin-laden macrophages and mucin lakes were found also significant marked. There was no difference found in between the patients with different clinical stages which were received neoadjuvant CRT. Conclusion: The stromal response in the tumor bed increases with the neoadjuvant chemoradiotherapy but the excess of the response doesn't have any relation with the clinical T stage.