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Journal articles on the topic 'Rectum'
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1
REZENDE JUNIOR, Herminio Cabral de, Rogério Tadeu PALMA, Giovanna Canato TOLOI, Carlos Augusto Real MARTINEZ, and Jaques WAISBERG. "CARCINOEMBRYONIC ANTIGEN LEVELS IN THE PERIPHERAL AND MESENTERIC VENOUS BLOOD OF PATIENTS WITH RECTAL CARCINOMA." Arquivos de Gastroenterologia 50, no. 4 (December 2013): 264–69. http://dx.doi.org/10.1590/s0004-28032013000400005.
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ContextThe serum carcinoembryonic antigen (CEA) is an important prognostic factor in colorectal cancer, however the rectum presents different routes of venous drainage, stating that the level of CEA in peripheral and mesenteric rectal tumors may be different, depending on the location of the tumor in the rectal segment.ObjectiveThe goal of this study was to evaluate the relationship between the peripheral and mesenteric venous levels of CEA and the association between these levels and the tumour location in the rectums of patients successfully operated on for rectal carcinoma.MethodsThirty-two patients who were surgically treated for rectal carcinoma were divided into patients with tumours located in the upper rectum (n = 11) or lower rectum (n = 21). The CEA values were assessed by electrochemiluminescence immunoassay. Serum and mesenteric CEA levels were associated with the tumour anatomopathological characteristics: location, histological type, cellular differentiation grade, depth of invasion into the rectal wall, angiolymphatic invasion, tumour, node, and metastasis staging; and the CEA index (≤1.0 or ≥1.0 ng /mL).ResultsAnalysis of the serum CEA values using clinical and anatomopathological parameters revealed no significant association with tumour location, histological type, cellular differentiation grade, depth of invasion into the intestinal wall, and tumour, node, and metastasis staging. The mesenteric CEA levels were significantly associated with the tumour location (P = 0.01). The CEA values in the mesenteric venous blood and the presence of angiolymphatic invasion (P = 0.047) were significantly different. A significant relationship was found between the CEA index value and the rectal tumour location (P = 0.0001).ConclusionsThe CEA levels were higher in the mesenteric vein in tumours located in the upper rectum and in the presence of angiolymphatic invasion. CEA drainage from lower rectum adenocarcinomas preferentially occurs through the systemic pathway.
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Shafik, Ahmed, and Olfat El-Sibai. "Effect of Magnetic Stimulation on the Contractile Activity of the Rectum in Humans." American Surgeon 66, no. 5 (May 2000): 491–94. http://dx.doi.org/10.1177/000313480006600513.
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Magnetic stimulation (MS) has been used to activate the neuromuscular tissue by inducing an electric field. Based on the results of a recent study on a canine model (Eur Surg Res 1998;30:268–72), which demonstrated that sacral MS effected a rectal and vesical pressure rise and a drop of rectal neck (anal canal) pressure, thereby achieving evacuation, the test was performed on 28 healthy volunteers (mean age, 36.6 years; 18 men and 10 women). The rectal, rectal neck, and vesical pressures were recorded during sacral MS with a magnetic coil while the rectum was empty and distended by a balloon. Electromyographic activity of the two rectus abdominis muscles was determined to exclude the possible interference of intra-abdominal pressure with the MS recordings. Stimulation parameters were set at 70 per cent intensity, 40-Hz frequency, and 1-to 2-second burst length. Sacral MS effected significant rectal and vesical pressure rise ( P < 0.01 and P < 0.01, respectively) and drop of rectal neck pressure ( P < 0.01). Intermittent stimulation induced balloon expulsion from the rectum. The two rectus abdominis muscles did not show change in electromyographic activity during MS, indicating that the rectal and vesical pressure rise was not due to increased intra-abdominal pressure. Sacral MS induced rectal evacuation with no adverse effects. The method is simple, easy, safe, and noninvasive and is suggested to be applied for the treatment of the inertic or neuropathic rectum. As the vesical pressure proved to be elevated too, MS might also be used for rectal and vesical evacuation in patients with spinal cord lesions.
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Goldsmid, S. E., C. R. Bellenger, P. R. Hopwood, and J. T. Rothwell. "Colorectal blood supply in dogs." American Journal of Veterinary Research 54, no. 11 (November 1, 1993): 1948–53. http://dx.doi.org/10.2460/ajvr.1993.54.11.1948.
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Summary To determine blood supply in the area, dye or radioopaque contrast material was injected into the named arteries supplying the terminal colon and recturn in 10 dogs. The cranial rectal artery appeared to supply most of the blood to the terminal colon and rectum. The middle and caudal rectal arteries supplied variable and relatively insignificant amounts. The intrapelvic rectum had a less adequate blood supply than did the terminal colon or proximal rectum. A ventral midline laparotomy and pubic osteotomy were performed in an additional 11 dogs to provide access to the terminal colon and rectum. When the cranial rectal artery was ligated and the coloreetal junction was transected and anastomosed, the intrapelvic rectum developed marked congestion, edema, and discoloration. Rectal fluorescence, after iv administration of fluorescein, was either poor or absent. Histologically, partial- to full-thickness mucosai necrosis was evident in most tissue specimens taken from the rectum, and muscle necrosis was evident in some. These findings suggest that, in dogs, the cranial rectal artery should be preserved if at all possible and, if the cranial rectal artery is ligated, most of the intrapelvic rectum should be resected to ensure adequate blood supply to the anastomosis.
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Umamaheswar Rao, O., and M. Chinna Eswaraiah. "Screening and evaluation of ethanolic extract from Casuarina equisetifolia inflorescence on isolated chick rectum, frog rectum and frog rectus abdominus muscle for identification of muscarinic and nicotinic receptor’s action." Journal of Drug Delivery and Therapeutics 8, no. 6-s (December 15, 2018): 9–13. http://dx.doi.org/10.22270/jddt.v8i6-s.2068.
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The present experiments were undertaken to justify the use of an ethanolic extract from inflorescence of Casuarina equisetifolia, Family: Casuarinaceae, influencing the nicotine responses on isolated chick rectum and frog rectum (Smooth Muscles) and frog rectus abdominus muscle (Skeletal Muscle). The isolated tissues were mounted in organ bath filled with physiological solution and was suitably aerated. After equilibration, responses were taken to different doses of nicotine (log doses) till a ceiling response was obtained. A sub-maximal dose of nicotine was selected and responses to this dose was taken and ensured that there is reproducibility of response. The drum was allowed to move for 1min., different concentrations of extracts into the organ baths were added and allowed to act for 1min without flushing the baths, then the sub-maximal dose of nicotine was added and allowed to act for 1min. this procedure was repeated (without extract) till the original response was obtained. The inference drawn from these experiments, the ethanolic extract of inflorescence of Casuarina equisetifolia antagonised the action of nicotine on isolated chick rectum, relaxed the effect of nicotine on frog rectum and it potentiated the effect of nicotine on frog rectus abdominus muscle. The nicotine receptors of rectus abdominus is activated, perhaps by the prevention of hydrolysis of acetylcholine by the extract. Based on the results obtained from the isolated chick rectum the ethanolic extract is having antinicotinic activity and it may act on the nicotinic acetylcholine receptors (nAChRs) as well as muscarinic acetylcholine receptors (mAChRs) on other isolated tissues. The extract might contain ganglionic blocking activity or non-specific activity or membrane stabilising activity also.
Keywords: Nicotine, Ethanolic extract, Inflorescence of Casuarina equisetifolia, Isolated Chick Rectum, Isolated Frog Rectum and Isolated Frog Rectus Abdominus Muscle.
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von Breitenbuch, Philipp, Pompiliu Piso, and Hans J. Schlitt. "Safety of rectum anastomosis after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy." Journal of Surgical Oncology 118, no. 3 (September 2018): 551–56. http://dx.doi.org/10.1002/jso.25189.
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AbstractBackground and ObjectivesIn highly selected patients with peritoneal carcinomatosis, cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) can be an aggressive but worthwhile treatment regimen. Resection of the rectosigmoid is frequently performed with CRS. The aim of the study was to assess the safety of the rectal anastomosis in this setting.MethodsBetween 2005 and 2016, 436 patients underwent CRS/HIPEC. Clinical data were analyzed with respect to the morbidity associated with a rectum resection.ResultsIn 436 patients, 174 rectum resections (40%) were performed with CRS, including 149 anterior resections of the rectosigmoid, 23 low anterior rectum resections, and 2 abdominoperineal rectum excisions. A total of 141 rectum anastomoses were performed; 33 patients received a permanent ostomy, and 48 patients received a protective ileostomy. After changing the operation technique of the rectum anastomosis, the number of protective ileostomies decreased from 65% to 20%. The overall postoperative morbidity was 31%. Rectal anastomotic leakages were seen in only 5% of cases.ConclusionsAnastomotic leakages of the rectum are rarely seen after CRS/HIPEC. HIPEC performed immediately after surgery seems to have no negative effect on the rectum anastomosis. Performing rectum anastomoses after CRS/ HIPEC appears to be a safe procedure.
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Vukas Radulovic, Nina, Maria Bullarbo, and Erling Ekerhovd. "A Case of Chronic Ectopic Pregnancy Manifested by Rectal Bleeding." Case Reports in Obstetrics and Gynecology 2017 (2017): 1–3. http://dx.doi.org/10.1155/2017/5974590.
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Ectopic pregnancy resulting in perforation of the rectum and rectal bleeding is clinically rare. We report an extremely rare case of chronic ectopic pregnancy with decreasing low levels of serum β-HCG resulting in rectal bleeding. A 31-year-old woman, gravida 3, para 3, with moderate abdominal pain and rectal bleeding was diagnosed with a tubal pregnancy. The tube was adherent to the rectum. Following salpingo-oophorectomy, the perforation of the rectum was sutured. Biopsies from the rectum as well as the tube confirmed chronic ectopic pregnancy. This case illustrates that diagnosing ectopic pregnancy is sometimes extremely challenging and it underlines the importance of follow-up consultations when the final diagnosis has not yet been reached.
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Fabrizio, Piro, Cosentino Daria, Piro Ugo, Tocci Gabriella, and Marafioti Luigi. "Preventing Rectal Toxicity in Prostate Cancer: Diet and Supplement Alternative to Enemas or Rectal Spacer." IgMin Research 2, no. 3 (March 27, 2024): 171–76. http://dx.doi.org/10.61927/igmin161.
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Background: Rectal toxicity is an important side effect of prostate cancer irradiation affecting 25% of patients. The role of dosimetric variables has a set of dose-volume constraints and curves to estimate the risk of rectal damage. The rectum position at the time of CT planning is different from the position during radiotherapy. Three methods are available to achieve optimal rectum position: enema; prostate cancer spacer; fiber-/fat-free diet. Methods: A 70.2 Gray radiation divided into 26 hypo-fractions was administered to 115 patients with prostate cancer by VMAT referred to a single center in Italy. To empty the rectum, all patients were administered a fiber-/fat-free diet and those with Eating Disorders (ED) were also added with activated charcoal (2 tablets/day) and a macrogol-based medical device (2 sachets/day). During treatment, the volumetric amount of rectum in the target was measured by comparing control-CT with simulation-CT, and acute toxicity was also checked. Results: The rectum position during control-CT in diet-only patients (29) predicted toxicity recorded during treatment, while in the ED group rectum position was adherent to position during simulations. Rectal volume target > 0.25 cc receiving a dose > V70 caused acute G3 toxicity that attenuated or worsened with rectal displacement. Acute rectal toxicity occurred in 6/29 (20.68%) patients (1 G3, 5 G1) in the diet-only group, while only in 1/86 (1.16%) patients (G1) in the ED group. No chronic toxicity was recorded in either group. Conclusion: Prostate cancer patients treated with VMAT, diet, charcoal, and macrogol emptied the rectum optimally and reduced incidence and severity of acute rectal toxicity, also with benefit on late toxicity.
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Costales-Carrera, Alba, Asunción Fernández-Barral, Pilar Bustamante-Madrid, Orlando Domínguez, Laura Guerra-Pastrián, Ramón Cantero, Luis del Peso, Aurora Burgos, Antonio Barbáchano, and Alberto Muñoz. "Comparative Study of Organoids from Patient-Derived Normal and Tumor Colon and Rectal Tissue." Cancers 12, no. 8 (August 15, 2020): 2302. http://dx.doi.org/10.3390/cancers12082302.
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Colon and rectal tumors, often referred to as colorectal cancer, show different gene expression patterns in studies that analyze whole tissue biopsies containing a mix of tumor and non-tumor cells. To better characterize colon and rectal tumors, we investigated the gene expression profile of organoids generated from endoscopic biopsies of rectal tumors and adjacent normal colon and rectum mucosa from therapy-naive rectal cancer patients. We also studied the effect of vitamin D on these organoid types. Gene profiling was performed by RNA-sequencing. Organoids from a normal colon and rectum had a shared gene expression profile that profoundly differed from that of rectal tumor organoids. We identified a group of genes of the biosynthetic machinery as rectal tumor organoid-specific, including those encoding the RNA polymerase II subunits POLR2H and POLR2J. The active vitamin D metabolite 1α,25-dihydroxyvitamin D3/calcitriol upregulated stemness-related genes (LGR5, LRIG1, SMOC2, and MSI1) in normal rectum organoids, while it downregulated differentiation marker genes (TFF2 and MUC2). Normal colon and rectum organoids share similar gene expression patterns and respond similarly to calcitriol. Rectal tumor organoids display distinct and heterogeneous gene expression profiles, with differences with respect to those of colon tumor organoids, and respond differently to calcitriol than normal rectum organoids.
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Spencer, Nick J., Aoife Kerrin, Vladimir P. Zagorodnyuk, Grant W. Hennig, Melodie Muto, Simon J. Brookes, and Orla McDonnell. "Identification of functional intramuscular rectal mechanoreceptors in aganglionic rectal smooth muscle from piebald lethal mice." American Journal of Physiology-Gastrointestinal and Liver Physiology 294, no. 4 (April 2008): G855—G867. http://dx.doi.org/10.1152/ajpgi.00502.2007.
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The mechanosensitive endings of low-threshold, slowly adapting pelvic afferents that innervate the rectum have been previously identified as rectal intraganglionic laminar endings (rIGLEs) that lie within myenteric ganglia. We tested whether the aganglionic rectum of piebald-lethal (sl/sl) mice lacks rIGLEs and whether this could explain impaired distension-evoked reflexes from this region. Extracellular recordings were made from fine rectal nerves in C57BL/6 wild-type and sl/sl mice, combined with anterograde labeling. In C57BL/6 mice, graded circumferential stretch applied to the rectum activated graded increases in firing of slowly adapting rectal mechanoreceptors. In sl/sl mice, graded stretch of the aganglionic rectum activated similar graded increases in rectal afferent firing. Stretch-sensitive afferents responded at low mechanical thresholds and fired more intensely at noxious levels of stretch. They could also be activated by probing their receptive fields with von Frey hairs and by muscle contraction. Anterograde labeling from recorded rectal nerves identified the mechanoreceptors of muscular afferents in the aganglionic rectal smooth muscle. A population of afferents were also recorded in both C57BL/6 and sl/sl mice that were activated by von Frey hair probing, but not stretch. In summary, the aganglionic rectum is innervated by a population of stretch-sensitive rectal afferent mechanoreceptor which develops and functions in the absence of any enteric ganglia. These results suggest that in patients with Hirschsprung's disease the inability to activate extrinsic distension reflexes from the aganglionic rectum is unlikely to be due to the absence of stretch-sensitive extrinsic mechanoreceptors.
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D'Sa, Saskia, Charmaine Mziray-Andrew, and Prashanth Porayette. "An Unusual Case of Gastric Heterotopia Presenting as Rectal Prolapse." ACG Case Reports Journal 11, no. 1 (January 2024): e01250. http://dx.doi.org/10.14309/crj.0000000000001250.
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ABSTRACT Heterotopic gastric mucosa (HGM) involving the rectum is an uncommon finding. It is especially rare in young children. Rectal prolapse is an uncommon presentation of HGM. We report a case of HGM in the rectum of a 2-year-old previously healthy girl, who presented with rectal prolapse and painless bleeding. Endoscopic mucosal resection was performed to completely resect the lesion after the patient failed to respond to proton pump inhibitors. This case underscores the importance of considering HGM involving the rectum as a cause of rectal prolapse in young pediatric patients.
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Hedrick, Samantha G., Marcio Fagundes, Sara Case, Jackson Renegar, Marc Blakey, Mark Artz, Hao Chen, Ben Robison, and Niek Schreuder. "Validation of rectal sparing throughout the course of proton therapy treatment in prostate cancer patients treated with SpaceOAR®." Journal of Applied Clinical Medical Physics 18, no. 1 (November 30, 2016): 82–89. http://dx.doi.org/10.1002/acm2.12010.
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AbstractThe purpose of this study was to investigate the consistency of rectal sparing using multiple periodic quality assurance computerized tomography imaging scans (QACT) obtained during the course of proton therapy for patients with prostate cancer treated with a hydrogel spacer. Forty‐one low‐ and intermediate‐risk prostate cancer patients treated with image‐guided proton therapy with rectal spacer hydrogel were analyzed. To assess the reproducibility of rectal sparing with the hydrogel spacer, three to four QACTs were performed for each patient on day 1 and during weeks 1, 3, and 5 of treatment. The treatment plan was calculated on the QACT and the rectum V90%, V75%, V65%, V50%, and V40% were evaluated. For the retrospective analysis, we evaluated each QACT and compared it to the corresponding treatment planning CT (TPCT), to determine the average change in rectum DVH points. We were also interested in how many patients exceeded an upper rectum V90% threshold on a QACT. Finally, we were interested in a correlation between rectum volume and V90%. On each QACT, if the rectum V90% exceeded the upper threshold of 6%, the attending physician was notified and the patient was typically prescribed additional stool softeners or laxatives and reminded of dietary compliance. In all cases of the rectum V90% exceeding the threshold, the patient had increased gas and/or stool, compared to the TPCT. On average, the rectum V90% calculated on the QACT was 0.81% higher than that calculated on the TPCT. The average increase in V75%, V65%, V50%, and V40% on the QACT was 1.38%, 1.59%, 1.87%, and 2.17%, respectively. The rectum V90% was within ± 1% of the treatment planning dose in 71.2% of the QACTs, and within ± 5% in 93.2% of the QACTs. The 6% threshold for rectum V90% was exceeded in 7 out of 144 QACTs (4.8%), identified in 5 of the 41 patients. We evaluated the average rectum V90% across all QACTs for each of these patients, and it was found that the rectum V90% never exceeded 6%. 53% of the QACTs had a rectum volume within 5 cm3 of the TPCT volume, 68% were within 10 cm3. We found that patients who exceeded the threshold on one or more QACTs had a lower TPCT rectal volume than the overall average. By extrapolating patient anatomy from three to four QACT scans, we have shown that the use of hydrogel in conjunction with our patient diet program and use of stool softeners is effective in achieving consistent rectal sparing in patients undergoing proton therapy.
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Jones, Alun E., and Guy F. Nash. "Novel use of the Heald anal stent after transanal endoscopic microsurgery." Surgical Techniques Development 1, no. 1 (August 31, 2011): 15. http://dx.doi.org/10.4081/std.2011.e15.
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Distension of the rectum following transanal endoscopic microsurgery (TEMS) increases rectal intra-luminal pressure and may promote pelvic sepsis by contaminating the rectal defect. We describe the first use of a Heald anal stent to decompress the rectum following TEMS. Transanal endoscopic microsurgery (TEMS) is an increasingly popular method of resecting rectal neoplasms with minimal morbidity and mortality. Following excision of the lesion, the defect in the rectal wall is usually repaired by a continuous suture. However there is no evidence to suggest defect closure is superior to leaving this to heal by secondary intention. Distension of the rectum post-operatively increases rectal intra-luminal pressure and may promote pelvic sepsis by contaminating the rectal defect.
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Yoo, Ri-Na, Hyeon-Min Cho, Bong-Hyeon Kye, Yoon-Suk Lee, and Yi-Suk Kim. "Reappraisal of the Lymphatic Drainage System of the Distal Rectum: Functional Lymphatic Flow into the Presacral Space and Its Clinical Implication in Rectal Cancer Treatment." Biomedicines 11, no. 2 (January 19, 2023): 274. http://dx.doi.org/10.3390/biomedicines11020274.
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Understanding the source and route of pelvic metastasis is essential to developing an optimal strategy for controlling local and systemic diseases of rectal cancer. This study aims to delineate the distribution of lymphatic channels and flow from the distal rectum. In fresh-frozen cadaveric hemipelvis specimens, the ligamentous attachment of the distal rectum to the pelvic floor muscles and the presacral fascia were evaluated. Using indocyanine green (ICG) fluorescence imaging, we simultaneously evaluated the gross anatomy of the lymphatic communication of the distal rectum. We also investigated the lymphatic flow in the pelvic cavity intraoperatively in rectal cancer patients who underwent radical rectal resection with total mesorectal excision (TME). In fresh cadavers, multiple small perforating lymphovascular branches exist in the retrorectal space, posteriorly connecting the mesorectum to the presacral fascia. The lymphatic flow from the distal rectum drains directly into the presacral space through the branches. In patients who underwent TME for rectal cancer, intraoperative ICG fluorescence signals were seen in the pelvic sidewalls and the presacral space. This anatomical study demonstrated that the lymphatic flow from the distal rectum runs directly to the pelvic lateral sidewalls and the presacral space, suggesting a possible route of metastasis in distal rectal cancer.
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Plakhotnyi, Roman О., Іryna V. Кerechanyn, Larysa Ya Fedoniuk, Nataliia V. Kovalchuk, Oksana V. Dehtiariova, and Gagandeep Singh. "COMPERATIVE STRUCTURE OF MUCOSA COAT OF THE PIG`S AND THE HUMAN`S RECTUM." Wiadomości Lekarskie 74, no. 7 (2021): 1718–21. http://dx.doi.org/10.36740/wlek202107128.
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The aim: To determine whether the pig could be used as biomodel for study and reconstruction of rectal pathology for development the new approaches for prevention and treatment of rectal diseases. Materials and methods: For the research the rectum of 8 vietnamese pot-bellied pigs were used. Via macro- and microscopy the structure of mucosa coat of the pig`s and human`s rectum was compared. Results: Mucosa coat`s peculiarities of pig`s and human`s rectum in comparative aspect are described in this article. With the help of traditional methods, known as macroscopy the structure of the pig`s rectal mucosa was study and compared wih macrostructure of human`s rectum. The microstucture of pig`s rectal mucosa was study due to histological method too. The macro- and microscopy demonstrated that structure of pig`s and human`s rectal mucosa are similar and includes same structural components. Conclusions: Thus, the research proved that pigs can be used as biomodels in biomedical research for creating various new methods and applications in approaching the prevention and treatment of rectal pathology in humans.
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Chen, Ji-Hong, Hanaa S. Sallam, Lin Lin, and Jiande D. Z. Chen. "Colorectal and rectocolonic reflexes in canines: involvement of tone, compliance, and anal sphincter relaxation." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 299, no. 3 (September 2010): R953—R959. http://dx.doi.org/10.1152/ajpregu.00439.2009.
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Distention of the proximal colon may have inhibitory or excitatory effects on the rectum and vice versa. The reflexes between the proximal colon and the rectum have not been well studied due to difficulties in accessing the proximal colon. The aim of this study was to investigate the reflex responses and their mechanisms between the proximal colon and the rectum in consideration of distention-related changes in tone and compliance of these regions as well as anal sphincter relaxation in a canine model. Proximal colon/rectal tone, compliance, and anal sphincter relaxation were investigated in six dogs chronically implanted with a proximal colon cannula while in the fasting state and during proximal colon distention or rectal distention. It was found that: 1) both rectal distention and proximal colon distention significantly and substantially decreased the compliance of the opposite regions, and guanethidine abolished proximal colon distention-induced changes in rectal compliance; 2) rectal/proximal colon distension decreased proximal colonic/rectal tone, and guanethidine abolished both of these inhibitory effects; 3) the anal sphincter was more sensitive to rectal distention than proximal colon distention; and 4) the minimal distention pressure required to induce anal inhibitory reflex was lower for rectal distention than proximal colon distention. It was concluded that distention-related changes in tone and compliance suggest the long inhibitory reflexes between the proximal colon and the rectum with the sympathetic involvement in rectal responses. The anal sphincter is more sensitive to the distention of the rectum than that of the proximal colon.
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Korotkikh, N. N., M. S. Olshanskiy, and O. V. Kazarezov. "ANATOMO-ANGIOGRAPHIC FEATURES OF RECTUM BLOOD SUPPLY AND THEIR CLINICAL SIGNIFICANCE." Koloproktologia, no. 3 (September 30, 2016): 31–36. http://dx.doi.org/10.33878/2073-7556-2016-0-3-31-36.
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The results of research of anatomy of rectal arteries by an angiography method are presented. AIM. To study “in vivo” specific features of anatomy of rectal arteries in rectum blood supply and to justify the usefulness of endovascular interventions in patients with rectal cancer. MATERIALS AND METHODS. The analysis angiograms of 123 patients of various age and sex is carried out. RESULTS. The superior rectal artery is the main source of rectum blood supply. Middle rectal arteries are an additional source. In vivo bilateral asymmetry with primary development of the left vessel is observed.. The inferior rectal arteries are visualized less than in one third part of cases. Rectal artery have a extensive network of anastomoses with other pelvis vessels. CONCLUSIONS. The results justify the anatomical possibility and feasibility of endovascular methods in rectal cancer therapy considering individual features of rectum blood supply.
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Kapur, Raj P., Lusine Ambartsumyan, and Caitlin Smith. "Are We Underdiagnosing Hirschsprung Disease?" Pediatric and Developmental Pathology 23, no. 1 (November 20, 2019): 60–71. http://dx.doi.org/10.1177/1093526619889434.
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Hirschsprung disease (HSCR) is conventionally defined as aganglionosis of the distal rectum and a variable length of proximal contiguous bowel with a transition zone of ganglionic, but neuroanatomically abnormal, bowel located immediately upstream. Recent improvement in our understanding of the pathology and genetics of HSCR and relevant animal models indicates highly variable expressivity. The spectrum of intestinal neuropathology includes patients with very short-segment aganglionosis, limited to the distal 1 to 2 cm of the rectum, and possibly patients with no true aganglionic segment, but nonphysiological transition zone pathology in their distal rectums. The presence or absence of submucosal ganglion cells in a rectal biopsy is not sufficient to exclude these patients, in whom submucosal nerve hypertrophy and/or abnormal cholinergic mucosal innervation may be the only diagnostic clues. In addition, diagnosis or exclusion of HSCR by rectal biopsy now relies in part on mucosal patterns of calretinin immunohistochemistry, with less emphasis on submucosal tissue adequacy and assessment of cholinergic innervation. These recent trends in the surgical pathology approach to rectal biopsies may miss patients at the phenotypically milder end of the malformation spectrum, with profound implications for subsequent management, prognosis, and genetic counseling.
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Li, Wei, Binghu Jiang, Lifeng Zhou, and Wenhua Liao. "Focal hemolymphangioma of the rectum: A case report and literature review." Medicine 102, no. 51 (December 22, 2023): e36666. http://dx.doi.org/10.1097/md.0000000000036666.
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Rationale: Gastrointestinal hemolymphangiomas are very rare, especially in the rectum. Only 3 cases of rectal hemolymphangioma, all of which are diffuse lesions, have been reported in the English literature on PubMed. Our case is the first focal lesion of the rectum. It is important for radiologists to correctly identify the imaging features of rectal hemolymphangiomas. Patient concerns: A 51-year-old woman visited our hospital because of intermittent constipation for 3 years. Diagnoses: Colonoscopy revealed a prominent lesion on the left anterior wall of the lower rectum. Transvaginal color Doppler ultrasonography showed that the posterior vaginal wall area had a mixed-echo mass, and blood flow signals of the dots and stripes could be seen. Pelvic magnetic resonance imaging showed that the cystic space-occupying lesion in the region between the left anterior wall of the lower rectum and the posterior wall of the middle and lower vagina had a clear boundary. Interventions: The patient underwent surgery to remove the rectal lesions. The surgical specimen was finally diagnosed as local hemolymphangioma by pathological analysis. Lessons: Localized hemolymphangioma of the rectum is very rare, and imaging examination is essential for the diagnosis and evaluation of the extent of lesion invasion.
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Plakhotnyi, Roman О., Іryna V. Кerechanyn, Larysa Ya Fedoniuk, Tеtiana I. Trunina, and Lylia M. Yaremenko. "COMPARATIVE MORPHOLOGY OF THE PIG`S RECTUM AND HUMAN`S RECTUM VIA 3D RECONSTRUCTION." Wiadomości Lekarskie 73, no. 11 (2020): 2354–57. http://dx.doi.org/10.36740/wlek202011106.
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The aim: To define an ability to use pig as biomodel for experimental and clinical studies in order to develop new approaches of treatment of the rectal pathology. Materials and methods: For the research two groups were used. I group includes 50 humans (27 females and 23 males), II group includes 8 vietnamese pot-bellied pigs. After magneresonance Imaging the 3D reconstruction of rectum was made. Results and conclusions: Topography, structure, age and gender peculiarities of pig`s and human`s rectum in comparative aspect are described in this article. With the help of modern methods, namely 3D reconstruction, the structure of the pig`s and human`s rectum was reconstructed. The morphological parameters, such as size of anorectal and rectosigmoid angles, the length of the rectum and its parts, were determinated. The 3D reconstruction demonstrated that size of anorectal and rectosigmoid angles, the length of the pig`s rectum are morphologicaly identical to the same parametres of human`s rectum. Thus, it is proved that pigs can be used as biomodels in experimental and clinical studies for development the new methods of treatment the rectal pathology in humans.
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Solovyov, A. E. "TREATMENT OF SEVERE RECTAL INJURY WITH DAMAGE TO THE EXTERNAL SPHINCTER IN CHILDREN." Russian Journal of Pediatric Surgery 23, no. 2 (July 9, 2019): 101–5. http://dx.doi.org/10.18821/1560-9510-2019-23-2-101-105.
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Material and methods. Over 30 years, under supervision there were 6 children of 3 and 18 years, with severe injuries of the rectum and anus. In the diagnosis there was used history, examination, catheterization of the bladder, ultrasound, vaginal and rectoscopy, x-ray diagnostic methods. Results and discussion. Two 3 and 6 years old girls were raped. All had damage not only to the perineum and vagina, but also to the vaginal-rectal septum, rectum, and sphincter. In one child, damage to the rectum and anus occurred during surgery for rectal atresia. Surgical intervention was performed by perineal access. In three adolescents, an injury to the pelvic organs with damage to the rectum, anus, and pelvic bones was a consequence of traffic accidents. Two of them died from traumatic brain injury. The author presents three clinical observations. Conclusion. Combined injuries of the rectum and sphincter are serious injuries. Signs of shock, internal bleeding, open and closed fractures may come to the fore. Assistance to injured children should be carried out in specialized institutions. The main method of the treatment of severe injuries of the sphincter of the rectum is the closure of the sphincter defect
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Варивода, Євген, Богдан Дзісь, Богдан Кондрацький, Олександра Стасишин, Валерія Красівська, Ольга Гуменюк, Ігор Гайдучок, et al. "Інфузійна фармакотерапія для корекції електролітів у плазмі крові серед оперованих хворих на рак прямої кишки після передньої резекції прямої кишки у ранньому післяопераційному періоді." Actual Problems of Medicine and Pharmacy 3, no. 1 (May 12, 2022): 1–12. http://dx.doi.org/10.52914/apmp.v3i1.41.
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In 30 cancer patients with rectal cancer after anterior resection of the rectum, a clinical study of the effect of intravenous infusions of the complex drug Sorbilact multifunctional action on plasma electrolytes in operated patients in the early postoperative period. Studies have shown that intravenous infusions of Sorbilact normalize plasma electrolytes in operated patients with rectal cancer after anterior resection of the rectum in the early postoperative period. Normalization of electrolytes in blood plasma in operated patients is confirmed by the presence in the infusion of Sorbilact ions of potassium, sodium, chloru. Sorbilact infusion is recommended for widespread medical use in cancer patients with rectal cancer after anterior resection of the rectum, especially in the early postoperative period.
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Menchaca Marines, Mario C., Hans‐Georg Posselt, and Karl Ludwig Waag. "Ectopic Gastric Mucosa in Rectum." Journal of Pediatric Gastroenterology and Nutrition 7, no. 2 (March 1988): 293–97. http://dx.doi.org/10.1002/j.1536-4801.1988.tb09521.x.
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SummaryA 3‐year‐old boy with rectal bleeding and colicky abdominal pain is described in whom heterotopic gastric mucosa in the rectum was found. Increased uptake of 99mTc‐pertechnetate was demonstrated in two sites: rectum and left colon. However, gastric mucosa could be identified by endoscopic and histologic examination in the rectum only. The patient was asymptomatic after the operation and during follow‐up, over 14 months.
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Yabunaka, Koichi, Gojiro Nakagami, Kazunori Komagata, and Hiromi Sanada. "Ultrasonographic follow-up of functional chronic constipation in adults: A report of two cases." SAGE Open Medical Case Reports 5 (January 1, 2017): 2050313X1769423. http://dx.doi.org/10.1177/2050313x17694234.
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Chronic constipation is a disorder frequently encountered in clinical practice. Here, we describe the use of ultrasonography as a new approach to the follow-up of adult patients with functional chronic constipation. Specifically, we report two cases of functional chronic constipation: fecal retention in the rectum and not fecal retention in the rectum. In the not fecal retention in the rectum patient, ultrasonography showed no evidence of fecal retention in the rectum, including no rectal fecaloma, whereas in the fecal retention in the rectum patient, fecal retention in the rectum was clearly recognized. Moreover, ultrasonography can guide the choice of laxative, enema, or appropriate manual maneuver to treat chronic constipation. As a simple and noninvasive method for assessing functional chronic constipation in adults, ultrasonography not only provides important clinical information but can also aid in determining the location of fecal retention.
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Park, Byung-Soo, Sung Hwan Cho, Hyuk Jae Jung, Gyung Mo Son, and Hyun Sung Kim. "Hartmann's Reversal Through Transanal Hand-Sewn Anastomosis With Rectal Mucosectomy for a Challenging Case: Case Report." International Surgery 105, no. 4 (April 1, 2021): 797–800. http://dx.doi.org/10.9738/intsurg-d-21-00020.1.
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Introduction Despite the advances in surgical techniques, Hartmann's reversal is often considered a difficult procedure, and the stoma cannot be restored in up to 40% of the cases. We report a patient with a challenging case of severe dense adhesions and a short rectal stump who recovered successfully after undergoing Hartmann's reversal through rectal mucosectomy and transanal hand-sewn anastomosis. Case presentation A 39-year-old man had multiple bowel injuries, including rectum, bladder, and ureter laceration, due to a stab wound. He underwent Hartmann's procedure with a short rectal stump. One year and 9 months later, Hartmann's reversal was performed. In the operative field, severe dense adhesions were observed in the pelvic cavity. Therefore, complications, including fistula, were likely to occur. Thus, we minimized the dissection around the rectal stump and avoided stapled anastomosis. Proctotomy was performed behind the rectal stump, and the proximal colon was inserted into the rectum. Rectal mucosectomy was performed for the rectum above the expected anastomosis site. Colorectal hand-sewn anastomosis was performed on the rectum, 3 cm from the anal verge. The patient recovered well after the surgery, and has remained healthy, without any discomfort, except for frequent defecation. Conclusion Rectal mucosectomy and transanal hand-sewn anastomosis were performed in a complex case of Hartmann's reversal, resulting in the patient's successful recovery without complications. This study recommends the preceding surgical technique for similar cases.
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ABM Moniruddin, Shakila Jannat, Halima Khatun Doly, Md Masudar Rahman, MA Rouf, Sayeed Bin Sharif, Md Sabbir Raihan, Tanvirul Hasan, Sabera Sultana, and Rifat Newaz Sharif. "Inter-Sphincteric Resection of Rectum for Ulcerated S-100 Negative Large Granular Cell Tumour." KYAMC Journal 14, no. 03 (January 16, 2024): 181–87. http://dx.doi.org/10.3329/kyamcj.v14i03.70612.
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Non-neural granular cell tumor was first described in 1991 as an unusual primitive, polypoid variant of the conventional GCT (granular cell tumor). To date, this neoplasm remains as a rare entity and the cell of origin is uncertain. While the histological features are similar to the conventional (traditional) GCTs, it represents a distinct entity, as it is negative for S-100 and lacks true nerve sheath differentiation. We report here a case of a 49-year-old male patient with S-100 negative, vimentin positive large benign, ulcerated, bleeding non-neural GCT in the lower rectum. We confirmed the diagnosis histopathologically and immunohistochemically. We treated it by ISRR (Inter-Sphincteric Resection of Rectum) and primary colo-anal anastomosis. We find no other report of non-neural GCT located in the rectum in surgical literature. This is probably the first case of non-neural GCT identified in the rectum. This case report is presented here to document a non-neural GCT located in the rectum for the first time ever reported, and also to highlight the optimum best surgical approach, as we deemed here for this large ulcerated bleeding tumor in the rectum. This rectal non-neural GCT posed here as an unusual differential diagnosis from such more common neoplastic bleeding lesions in the rectum as carcinoma rectum, hemorrhoid, rectal polyp, etc. Here we like to discuss our experience, reviewing in brief the available literature implicating the biological behavior, histopathological and immunohistochemical features, differential diagnosis and therapeutic considerations of neural and non-neural GCTs. KYAMC Journal Volume: 14, No: 03, October 2023: 181-187.
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Schmidt, Daniel R., Mandar Bhagwat, Daniel I. Glazer, Ming-Hui Chen, Maryam Moteabbed, Elizabeth McMahon, Marian J. Loffredo, Clare M. Tempany, and Anthony V. D’Amico. "MRI-Based Radiotherapy Planning to Reduce Rectal Dose in Excess of Tolerance." Prostate Cancer 2022 (February 3, 2022): 1–9. http://dx.doi.org/10.1155/2022/7930744.
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Background and Purpose. Chronic rectal toxicity significantly decreases the quality of life for men who receive radiotherapy for prostate cancer. The most significant predictor of rectal toxicity is rectal dose-volume exceeding tolerance. To minimize the volume of rectum in the high dose field, it is essential to accurately define the prostate-rectum interface. This can be challenging to do by computed tomography (CT) imaging alone. The current study was undertaken to formally demonstrate in a clinical trial setting that image-guided intensity-modulated radiation therapy (IG-IMRT) planning using magnetic resonance imaging (MRI) can reduce the volume of rectum exceeding 70 Gy, a validated metric that predicts the risk of late rectal toxicity. Materials and Methods. This prospective single-arm study enrolled 15 men treated with IG-IMRT for localized prostate cancer. All participants received a dedicated 3 Tesla MRI examination of the prostate in addition to a pelvic CT examination for treatment planning. Two volumetric modulated arc therapy (VMAT) plans with a prescription dose of 79.2 Gy were designed using identical constraints based on CT- and MRI-defined consensus volumes. The volume of rectum exposed to 70 Gy or more was compared using the Wilcoxon paired signed rank test. Results. For CT-based treatment plans, the median volume of rectum receiving 70 Gy or more was 9.3 cubic centimeters (cc) (IQR 7.0 to 10.2) compared with 4.9 cc (IQR 4.1 to 7.8) for MRI-based plans. This resulted in a median volume reduction of 2.1 cc (IQR 0.5 to 5.3, P < .001). Conclusions. Using MRI to plan prostate IG-IMRT to a dose of 79.2 Gy reduces the volume of rectum receiving radiation dose in excess of tolerance (70 Gy or more) and should be considered in men who are at high risk for late rectal toxicity and are not good candidates for other rectal sparing techniques such as hydrogel spacer. This trial is registered with NCT02470910.
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Cormio, Luigi, Ilkka Perttilä, Osmo Saarinen, Esko Tierala, Stig Nordling, and Mirja Ruutu. "Spontaneous Perforation of the Rectum by Carcinoma of the Prostate. Case Report." Tumori Journal 79, no. 4 (August 1993): 280–82. http://dx.doi.org/10.1177/030089169307900412.
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A case of spontaneous perforation of the rectum by a locally advanced prostatic carcinoma is described. The mechanisms of rectal involvement by prostatic carcinoma are discussed, focusing attention on the difficulties in differential diagnosis with primary carcinoma of the rectum.
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Traoré, Hamadoun, Saâd Mohammed Amine, Choukri Elm’hadi, Rachid Tanz, and Hassan Errihani. "Synchronous Rectal Adenocarcinoma and Urothelial Carcinoma of the Bladder: Fortuitous Association or Oncogenetic Predisposition?" Scholars Journal of Medical Case Reports 12, no. 06 (June 6, 2024): 1037–40. http://dx.doi.org/10.36347/sjmcr.2024.v12i06.016.
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Synchronous primary cancers involving the rectum and the bladder are quite rare and poorly reported in the literature. We report the case of a 58-year-old non-smoking patient who presented with proctalgia with diarrhea and rectal bleeding, as well as pollakiuria and hematuria. Pelvic magnetic resonance imaging showed the presence of two tissue masses involving the rectum and the bladder, in addition to a bone lesion in the pelvis. The biopsy of the three sites (rectum, bladder and bone) was in favor of a rectal adenocarcinoma and urothelial carcinoma of the bladder, with absence of signs of malignancy for bone involvement. The PET-Scan did not show any distant lesion. The patient was treated with a trans-urethral resection of the bladder, and concomitant radio-chemotherapy for the rectum. We are going to do a review of the literature concerning this association.
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Zhang, Yingjie, Xiangbin Zhang, Jing Li, Liang Zeng, Xuetao Wang, Xiaohong Wu, Yan Li, Xiaoyu Li, and Renming Zhong. "Analysis of the Influence of Peripheral Anatomical Changes for CBCT-Guided Prostate Cancer Radiotherapy." Technology in Cancer Research & Treatment 20 (January 1, 2021): 153303382110163. http://dx.doi.org/10.1177/15330338211016370.
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Purpose: To analyze the influence of the bladder and rectum filling and the body contour changes on the prostate target dose. Methods: A total of 190 cone-beam CT (CBCT) image data sets from 16 patients with prostate cancer were used in this study. Dose reconstruction was performed on the virtual CT generated by the deformable planning CT. Then, the effects of the bladder filling, rectal filling, and the patient’s body contour changes of the PCTV1 (the prostate area, B1) and PCTV2 (the seminal vesicle area, B2) on the target dose were analyzed. Correlation analysis was performed for the ratio of bladder and rectal volume variation and the variation of the bladder and rectal dose. Results: The mean Dice coefficients of B1, B2, bladder, and rectum were 0.979, 0.975, 0.888 and 0.827, respectively, and the mean Hausdorff distances were 0.633, 1.505, 2.075, and 1.533, respectively. With the maximum volume variations of 142.04 ml for the bladder and 40.50 ml for the rectum, the changes of V100, V95, D2, and D98 were 1.739 ± 1.762 (%), 0.066 ± 0.169 (%), 0.562 ± 0.442 (%), and 0.496 ± 0.479 (%) in PCTV1 and 1.686 ± 1.051 (%), 0.240 ± 0.215 (%), 1.123 ± 0.925 (%), and 0.924 ± 0.662 (%) in PCTV2, respectively. With a 10% increase in the volume of the bladder and rectum, the V75, V70, and V65 of rectum increased at 0.73 (%), 0.71 (%), and 1.18 (%), and the V75, V70, and V65 of bladder changed at −0.21 (%), −0.32 (%), and −0.39 (%), respectively. Conclusion: Significant correlations were observed between the volume variation and the dose variation of the bladder and rectum. However, when a bladder and rectal filling protocol was adopted, the target dose coverage can be effectively ensured based on CBCT guidance to correct the prostate target position.
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Davoodabadi, Hasan, Mohammad Aldraji, Abdolhosein Davoodabadi Farahani, Parnian Soltani, and Mehdi Alemrajabi. "Pull-Through in Patients after Pelvic Anastomosis Leak Following Proctectomy: A Cross-Sectional Study." Journal of Coloproctology 41, no. 01 (March 2021): 042–46. http://dx.doi.org/10.1055/s-0041-1724058.
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Abstract Introduction Colorectal cancer is the second most common type of cancer and the third leading cause of mortality due to cancers. Anastomosis leak after proctectomy is a dangerous complication that must be managed carefully. The aim of the present study was to assess the procedure of resection and pull-through of the new rectum after anastomosis leak in patients after proctectomy. Methods and Materials This was a cross-sectional study. Patients who visited the Firoozgar Hospital between 2015 and 2018 for rectal cancer surgery and had anastomosis leak entered the study. All patients underwent resection of the residue of rectum and pull-through of colon. Results In the present study, out of the 110 cases who underwent proctectomy, 12 patients with postoperative anastomosis leak were reported. Five (41.7%) were male and 7 (58.3%) were female. The mean age of the patients was 41.5 ± 4.3 years (33–51). Resection of the new rectum and pull-through anastomosis were performed for these 12 patients. No major intraoperative complication occurred. Postoperative course was uneventful in all patients. Discussion Resection of residue of rectum and pull-through in patients with anastomosis leak can be done after rectal cancer surgery. This method is superior to abdominopelvic resection in many aspects, especially regarding accessibility to the new rectum by rectal exam or endosonography to assess recurrence or a relative continence after closure of ostomy.
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Ikpegbu, Ekele, Uchenna Nlebedum, and Chikera Ibe. "Morpho-histochemistry of the distal intestines and rectum of African catfish (Clarias gariepinus)." Journal of Agricultural Sciences, Belgrade 59, no. 3 (2014): 287–300. http://dx.doi.org/10.2298/jas1403287i.
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The morphology of the farmed African catfish distal intestines and rectum was investigated. The samples were dissected out and the tissue slices were passed through graded ethanol, cleared in xylene, embedded in paraffin wax, sectioned and stained for light microscopy. Grossly, the intestine was subdivided into proximal, middle, distal and rectal regions based on palpable thickness and diameter of the regions. No intestino-rectal valve was observed; hence the rectum was not well defined. The histology revealed the presence of tunica mucosa of simple columnar cells, lamina propria of collagen fibres and muscularis mucosae of smooth muscle fibres; submucosa of loose connective tissues and blood vessels; tunica muscularis of smooth muscles in an inner circular and outer longitudinal arrangement; and a serosa in all regions except the rectum and anus that presented tunica adventitia. The mucosal folds were fingerlike to orange leaf shaped ingrowths into the lumen on a transverse section. They decreased in complexity and height but increased in width towards the rectum. The lining epithelium of the intestinal tract was comprised of the absorptive simple columnar cells containing goblet cells and intraepithelial lymphocytes. Some rectal simple columnar epithelium contained supranuclear vacuoles while others contained non-vacuolated cytoplasm. The goblet cells contained neutral and acid mucins, and increased in number progressively towards the rectum. The anal tunica muscularis contained mostly skeletal muscles.
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Medvednikov, A. A., A. V. Shelekhov, V. V. Dvornichenko, S. M. Plenkin, and S. I. Radostev. "Quality of life of patients with rectal cancer after surgical treatment." Pelvic Surgery and Oncology 9, no. 4 (November 13, 2019): 37–42. http://dx.doi.org/10.17650/2686-9594-2019-9-4-37-42.
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Objective: to analyze functional surgical outcomes in patients with distal rectal cancer and their quality of life at different time-points postoperatively.Materials and methods. This retrospective study included all patients with rectal cancer that underwent either abdominoanal resection of the rectum (with their sigmoid colon brought down into the anal canal) or low intraabdominal resection of the rectum with the formation of a mechanical coloanal anastomosis in Irkutsk Regional Oncology Dispensary between 1999 and 2012. Study participants were divided into two groups: the experimental group included patients who had low intraabdominal resection of the rectum, whereas the control group consisted of patients who had abdominoanal resection of the rectum. We evaluated 5-year survival and patients' quality of life (using the Wexner and FIQL scales).Results. One year postoperatively, 17 patients (25 %) from the control group had unsatisfactory sphincter function (Wexner score 11–20). Sixty-three patients from the control group (95 %) reported fecal incontinence of varying severity. In the experimental group, 40 patients out of 88 (45 %) that survived during the first year had normal sphincter function. The remaining patients had solid stool incontinence or inability to retain feces for a long time (Wexner score <10).Conclusions. Low resections of the rectum ensured better functional outcomes and patients' quality of life than abdominoanal resections of the rectum did.
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Popa, Călin, Virgiliu-Mihail Prunoiu, Paul Puia, Diana Schlanger, Mircea-Nicolae Brătucu, Victor Strâmbu, Eugen Brătucu, et al. "Specific Septic Complications after Rectal Cancer Surgery: A Critical Multicentre Study." Cancers 15, no. 8 (April 17, 2023): 2340. http://dx.doi.org/10.3390/cancers15082340.
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The postoperative septic complications in gastrointestinal surgery impact immediate as well as long-term outcomes, which lead to reinterventions and additional costs. The authors presented the experience of three surgery clinics in Romania regarding the specific septic complications occurring in patients operated on for rectal cancer. The study group comprised 2674 patients who underwent surgery over a 5-year period (2017–2021). Neoplasms of the middle and lower rectum (76%) were the majority. There were 85% rectal resections and 15% abdominoperineal excisions of the rectum. In total, 68.54% of patients were operated on laparoscopically, and 31.46% received open surgery. Without taking wound infections into account, 97 (3.67%) patients had abdominal-pelvic septic complications. The aim was to evaluate the causes of the complications. The percentage of suppurations after surgery of the rectum treated by radiochemotherapy was considerably higher than after surgery of the non-radiated upper rectum. The fatality rate was 5.15%. The risk of fistulas was significantly associated with the preoperative treatment, tumour position and type of intervention. Sex, age, TNM stage or grade were not significant at 0.05 the threshold. The risk of fistulas is reduced with low anterior resection, but the gravity of these complications is higher in the lower rectum compared with the superior rectum. Preoperative radiochemotherapy is a contributing factor to septic complications.
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Raj, K. P., A. Ziogas, A. R. Barleben, M. J. Stamos, and J. A. Zell. "Use of tumor site as a prognosticator: Population-based analysis of rectosigmoid and rectum cancers." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): 4123. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.4123.
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4123 Background: The study examines the prognostic significance of tumor location exclusively in rectosigmoid and rectal cancers. Although tumor location has traditionally been regarded as a prognostic determinant, data in support of this claim are lacking. We set out to determine this using data from a large population-based California Cancer Registry (CCR). Methods: A retrospective analysis of surgically treated cancer cases involving the rectum and rectosigmoid from 1994–2006 with a follow-up until January 2008 in CCR was conducted. Sub-site tumor location of the cancers involving the rectum was either defined as rectosigmoid or mid/distal rectum. Site-specific survival analyses were conducted by Kaplan-Meier method and hazard ratio calculated using Cox proportional hazard ratios (HR). Results: A total of 33,418 rectal cancer cases were identified, including 12,407 (37.1%) rectosigmoid cancers and 21,011 (62.9%) mid/distal rectum cancers. No significant differences by tumor location were noticed for age, gender, stage, histological type, grade or socioeconomic status. Fewer rectosigmoid cancers received radiation (81.9% vs. 62.3% p=<0.0001)) compared to mid/distal rectum cancers. After adjustment for treatment and relevant clinical factors, an improved rate of CRC-specific survival was noticed in non-metastatic rectosigmoid cancers when compared to cancers involving the mid/distal rectum. A significant decrease in mortality was observed in Stage-I [HR- 0.74(0.63–0.86)], Stage-II [HR-0.76(0.69–0.85)] and Stage-III [HR- 0.90 (0.83–0.98)] rectosigmoid cancers when compared to mid/distal rectum cancers. Number of lymph nodes examined (>12 vs. <12) was an independent prognostic factor for survival in Stage-II patients [HR-0.74 (0.63–0.87)]. Conclusions: Among locoregional cases, rectosigmoid cancers were found to have an improved CRC-specific survival compared to mid/distal rectum cancers, which was independent of other relevant clinical factors. [Table: see text] No significant financial relationships to disclose.
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Ng, Clinton, Mark Danta, Gillian Prott, Caro-Anne Badcock, John Kellow, and Allison Malcolm. "Modulatory influences on antegrade and retrograde tonic reflexes in the colon and rectum." American Journal of Physiology-Gastrointestinal and Liver Physiology 287, no. 5 (November 2004): G962—G966. http://dx.doi.org/10.1152/ajpgi.00460.2003.
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Tonic reflexes in the colon and rectum are likely to be important in health and in disorders of gastrointestinal function. The aim of this study was to evaluate the fasting and postprandial “colorectal” and “rectocolic” reflexes in response to 2-min isobaric distensions of the colon and rectum, accounting for enteric sensation, compliance, and distending balloon volume. In 14 healthy fasting subjects, a dual barostat assembly was positioned (descending colon and rectum). A 2-min phasic distension was performed in the colon and rectum in random order while the opposing balloon volume was recorded. Sensation (phasic distension) and compliance (ramp distension) were also determined. The experiment was repeated postprandially. Colonic distension resulted in significant rectal tonic contraction in the fasting (rectal volume change: −35.4 ± 8.4 ml, P < 0.01) and postprandial (−22.2 ± 8.4 ml, P < 0.01) states. After adjustment for colonic sensitivity, for compliance, and for distending balloon volume, the rectal volume change remained significant; the extent of the tonic response, however, correlated significantly with increasing pain score ( P < 0.01). In contrast, rectal distension did not produce a significant tonic response in the colon (fasting: −6.5 ± 7.3 ml; postprandial: 2.7 ± 7.3 ml), either unadjusted or adjusted for rectal sensitivity, compliance, and distending balloon volume. In conclusion, the colorectal reflex, but not the rectocolic reflex, can be readily demonstrated both before and after a meal in response to a 2-min isobaric distension in the colon and rectum, respectively. Although the presence of the colorectal reflex does not depend on colonic sensitivity or the volume of the distending colonic balloon, these factors modulate the reflex, especially in the fasting state.
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Joshi, Arbin. "Anorectal Gastrointestinal Stromal Tumour: A Case Treated with Radical Surgery." Journal of Nepal Health Research Council 16, no. 1 (March 18, 2018): 99–101. http://dx.doi.org/10.3126/jnhrc.v16i1.19376.
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Gastrointestinal Stromal Tumour involving rectum and anal canal is an extremely rare entity. This is a case report of a 47 years lady presented with fresh rectal bleed associated with rectal pain and foul smelling rectal mucus discharge. On rectal examination, she had a firm mass palpable about 1.5 cm from anal verge. Considering the size of the tumour and its close proximity with cervix and involvement of levator muscles, extralevator abdominal perineal excision of rectum was undertaken with good recovery after surgery. It was followed by imatinib therapy.
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AL-Ubaide, Amer Fakhree, and Raid M. Al-Ani. "Bleeding Per Rectum: A Retrospective Study of 120 Cases." AL-Kindy College Medical Journal 20, no. 1 (April 1, 2024): 32–36. http://dx.doi.org/10.47723/y9neg550.
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Background: Lower gastrointestinal bleeding is one of the common problems seen worldwide, could be serious and occur at any age. Several studies conducted all over the world verified that there were variations in frequencies of etiologies of bleeding per rectum in their population, however, in the Middle East and Asia, the etiology of rectal bleeding differs from the West. Objectives: To assess the causes of bleeding per rectum and to find if there is an association between rectal bleeding and various variables. Subjects and methods: This was a retrospective cross-sectional study of 120 patients with bleeding per rectum for one year were studied in Al Ramadi Teaching Hospital, Ramadi City, Iraq. The patients underwent a full history and thorough physical examination. In all cases, initial digital rectal examination and proctoscopy were performed. Patients presented with a noticeable diagnosis of massive bleeding from the rectum were not included in our study. Results: There were 84 males (64%) with male to female ratio of 2.33: 1. The median age of patients was 38 years (age ranged from 15-81 years). The main age group was ≤ 50 years (n = 95, 79.2%). The hemorrhoid was the most common cause of rectal bleeding (n = 95, 79.2%). The second cause was anal fissure which was found in 26 cases (21.6.5 %). Colorectal carcinoma was seen in 14 patients (11.67%), and most of them (n = 13) were above 50 years of age. There was no significant association between the rectal bleeding causes and the gender. However, there were highly significant differences between the causes and the age and bowel habits of the patients (P-value = 0.0001). Conclusion: Hemorrhoids were the most prevalent cause of rectal bleeding. The patient's age and bowel habit might be determined the cause of bleeding per rectum.
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Devall, Matthew A., Xiangqing Sun, Stephen Eaton, Gregory S. Cooper, Joseph E. Willis, Daniel J. Weisenberger, Graham Casey, and Li Li. "A Race-Specific, DNA Methylation Analysis of Aging in Normal Rectum: Implications for the Biology of Aging and Its Relationship to Rectal Cancer." Cancers 15, no. 1 (December 22, 2022): 45. http://dx.doi.org/10.3390/cancers15010045.
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Approximately 90% of colorectal cancer (CRC) develop over the age of 50, highlighting the important role of aging in CRC risk. African Americans (AAs) shoulder a greater CRC burden than European Americans (EA) and are more likely to develop CRC at a younger age. The effects of aging in AA and EA normal rectal tissue have yet to be defined. Here, we performed epigenome-wide DNA methylation analysis in the first, large-scale biracial cohort of normal rectum (n = 140 samples). We identified increased epigenetic age acceleration in EA than AA rectum (p = 3.91 × 10−4) using linear regression. We also identified differentially methylated regions (DMRs) associated with chronological aging in AA and EA, separately using DMRcate. Next, a consensus set of regions associated with cancer was identified through DMR analysis of two rectal cancer cohorts. The vast majority of AA DMRs were present in our analysis of aging in rectum of EA subjects, though rates of epigenetic drift were significantly greater in AA (p = 1.94 × 10−45). However, 3.66-fold more DMRs were associated with aging in rectum of EA subjects, many of which were also associated with rectal cancer. Our findings reveal a novel relationship between race, age, DNA methylation and rectal cancer risk that warrants further investigation.
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Aleshin, D. V., D. G. Shakhmatov, E. S. Surovegin, E. P. Goncharova, O. Yu Fomenko, and O. I. Sushkov. "Idiopathic megacolon: relationship between clinical features and diagnostic tests results." Koloproktologia 23, no. 2 (June 21, 2024): 35–45. http://dx.doi.org/10.33878/2073-7556-2024-23-2-35-45.
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AIM: to assess the relationship between clinical features and diagnostic tests results in idiopathic megacolon/megarectum patients.PATIENTS AND METHODS: the retrospective analysis of clinical manifestations and diagnostic tests included 157 patients with idiopathic megacolon/megarectum in 2002-2023. The diagnosis of megacolon/megarectum was verified with a barium enema, Hirschsprung’s disease was excluded byanorectal manometry and (if needed) rectal Swenson’s biopsy.RESULTS: the rate of integral parameter “abdominal discomfort” and Wexner constipation scale rate do not significantly correlate with barium enema, gut transit test, defecography and rectal compliance test results, besides of sigmoid colon width (p = 0.03). The rate of integral parameters “defecation difficulties” correlates with rectum width (p < 0.001) and do not correlate with gut transit time, results of defecography and rectal compliance test (p > 0.05). Distal contrast retention during gut transit test is associated with rectum width only (p < 0.01). The parameters of defecography do not correlate neither clinical features nor other diagnostic tests results (p > 0.05).CONCLUSION: there was not significant relationship between rate of abdominal discomfort, Wexner constipation scale rate and diagnostic tests results. The rate of integral parameters “defecation difficulties” significantly correlates with rectum width (based on barium enema) only. Rectum width seems to be most important parameter to assess the rectum function and in a minor degree — rectal compliance test. The defecography do not correlate either with the severity of clinical symptoms or with the results of other diagnostic methods, which casts doubt on the appropriateness of using this diagnostic test in patients with megacolon.
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Sonje, Preeti Dnyandeo, Neelesh Subhash Kanasker, and P. Vatsalaswamy. "Surgical Importance of Middle Rectal Artery." National Journal of Clinical Anatomy 08, no. 04 (October 2019): 165–68. http://dx.doi.org/10.1055/s-0039-3401901.
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Abstract Background Middle rectal artery is one of the important arteries supplying the rectum, along with the superior and inferior rectal arteries. Study of middle rectal artery was undertaken as it is important in surgeries of rectal carcinoma. Materials and Methods For the present study, 40 pelvises, fixed in 10% formalin, were procured from the Department of Anatomy of Dr. D. Y. Patil Medical College, Pune, Maharashtra, India. Sagittal section of pelvis was taken and dissection was performed following the steps according to the Cunningham’s manual. Results Variations were found in the origin of middle rectal artery such as those arising from the internal pudendal artery in nine cases. In two cases, it was arising from the common stem of internal pudendal and inferior gluteal arteries. It was seen arising from the inferior vesical artery in one case, while in two cases the middle rectal artery was arising from the obturator artery. Conclusion This is the artery that penetrates the fascia of the rectum which is important in mesorectal excision in cases of rectal carcinoma. It forms anastomosis with superior rectal artery. In low anterior resection of rectum, the middle rectal artery is always exposed.
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S, Bhusal. "Rectal Carcinoma." Gastroenterology & Hepatology International Journal 8, no. 1 (February 16, 2023): 1–9. http://dx.doi.org/10.23880/ghij-16000205.
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Rectum is the distal part of the large intestine, placed between the sigmoid colon and large gut. It serves as a temporary reservoir for fecal contents. Rectal carcinoma is the second most common cancer of large intestine accounting for 28% of the cases. Large numbers of cases are asymptomatic in early stages. Extension of rectal tumors into adjacent organs or into the lumen of GI tract leads to symptomatic presentation. In regard to the improved access to and use of screening and standard treatment, overall incidence rate has decreased by approximate 3% per year during the past decade. The location and adjacent structure to the rectum makes the treatment of rectal carcinoma different to that of tumors located in other part of GI Tract. In this article, the anatomy and physiology of rectum, risk factors, pathogenesis, clinical types, clinical features, screening, diagnosis, spread, staging and treatment of rectal carcinoma are reviewed along with the prognosis.
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Benson, Al B., Alan P. Venook, Mahmoud M. Al-Hawary, Mustafa A. Arain, Yi-Jen Chen, Kristen K. Ciombor, Stacey Cohen, et al. "NCCN Guidelines Insights: Rectal Cancer, Version 6.2020." Journal of the National Comprehensive Cancer Network 18, no. 7 (July 2020): 806–15. http://dx.doi.org/10.6004/jnccn.2020.0032.
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The NCCN Guidelines for Rectal Cancer provide recommendations for the diagnosis, evaluation, treatment, and follow-up of patients with rectal cancer. These NCCN Guidelines Insights summarize the panel discussion behind recent important updates to the guidelines. These updates include clarifying the definition of rectum and differentiating the rectum from the sigmoid colon; the total neoadjuvant therapy approach for localized rectal cancer; and biomarker-targeted therapy for metastatic colorectal cancer, with a focus on new treatment options for patients with BRAF V600E– or HER2 amplification–positive disease.
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Charran, Ordessia, Mitchel Muhleman, Sameer Shah, R. Shane Tubbs, and Marios Loukas. "Ligaments of the Rectum: Anatomical and Surgical Considerations." American Surgeon 80, no. 3 (March 2014): 275–83. http://dx.doi.org/10.1177/000313481408000323.
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The ligaments of the rectum have been the subject of controversy for decades. Not only have their contents and components been a source of contention, but also the very existence of these ligaments has been called into question. This article explores the anatomical features of these ligaments with implications for surgical treatment of rectal prolapse, rectal cancer, and resection of the rectum and mesorectum. A theory about the evolution of the lateral rectal ligaments and the mesorectum in humans and higher mammals is also presented.
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Staiano, Annamaria, and Ennio Del Giudice. "Colonic Transit and Anorectal Manometry in Children With Severe Brain Damage." Pediatrics 94, no. 2 (August 1, 1994): 169–73. http://dx.doi.org/10.1542/peds.94.2.169.
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Objective. This study was conceived to determine the physiologic abnormalities in distal gastrointestinal motility that are responsible for constipation in brain-damaged children. Design. Colonic transit and anorectal manometry were evaluated in 16 children with severe brain damage and constipation (mean age ± SD; 5.1 ± 3.5 years) and the results were compared with findings in 15 age- and sex-atched children with functional fecal retention and normal mental development. Anorectal motility findings also were compared with those from 11 asymptomatic children. The progress of radiopaque markers, as determined by sequential plain abdominal radiographs, was used to evaluate segmental colonic transit times. Results. In children with brain damage, colonic transit was prolonged at the level of left colon in 18.8% of the patients, at both left colon and rectum in 56.2%, and at rectum only in 25% These findings differed (P < .05) from those in children with functional fecal retention wherein transit was prolonged in the left colon and rectum in 20% of the patients and the rectum only in 80%. By anorectal manometry, no significant intergroup differences were detected in anal pressures and in the anorectal motor responses to rectal distention. The rectal compliance in children with severe brain damage was similar to the asymptomatic controls, whereas children with functional fecal retention had increased rectal compliance. Conclusions. This study shows that colonic transit abnormalities in both the left colon and rectum may be responsible for constipation in children with severe brain damage.
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Swiderski, Jen, and Stephen Withrow. "A Novel Surgical Stapling Technique for Rectal Mass Removal: A Retrospective Analysis." Journal of the American Animal Hospital Association 45, no. 2 (March 1, 2009): 67–71. http://dx.doi.org/10.5326/0450067.
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Both benign and malignant rectal masses occur in dogs. The mainstay of treatment is surgical excision with adjuvant therapy based on histopathological diagnosis and completeness of removal. Location of the mass within the rectum helps dictate the approach used. This paper describes the use of a novel technique for removal of rectal masses involving the distal third of the rectum in seven dogs. To perform this technique, the rectum is prolapsed and stay sutures are placed to maintain prolapse. A thoracoabdominal stapling device is placed at the base of the mass with a minimum of 0.5- to 1-cm margins, and the mass is amputated. Mean time to veterinarian follow-up was 564 days, and no dog had recurrence of disease during this time.
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Patil, Shivanand, and M. D. Samudri. "DIFFERENTIAL DIAGNOSIS OF BLEEDING PER RECTUM AND AYURVEDIC STYPTIC MEASURES: A REVIEW." International Journal of Research in Ayurveda and Pharmacy 12, no. 4 (August 28, 2021): 154–60. http://dx.doi.org/10.7897/2277-4343.1204126.
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A greater part of the population has experienced rectal bleeding at any stage of their life span. Bleeding per rectum is the commonest but alarming symptom of all the anorectal complaints of the patients attending OPDs. Many of the general practitioners involved in rural areas, detain per rectal and proctoscopic examination of anorectal primary care patients, consequently, most of the serious illnesses may forego undiagnosed and could become life-threatening and economically overburden the patient. Differential diagnosis plays a key role in treating effectively. Ayurvedic literature has accredited several diseases with symptoms of bleeding per rectum. In most of the pittaja and raktaja variety of pakvashayagata (related to the colon) and gudagata rogas (related to anus & rectum), bleeding per rectum is the commonest symptom. The literature has given the number of etiological factors and many ailments causing bleeding per rectum such as age, habitat, food habits, occupation, and habits. Detailed history regarding these and nature of bleeding, amount of bleeding, colour etc. may certainly help to differentiate the diseases. This article highlights disease wise features and nature of bleeding, recommended investigations and colonoscopic examination which will differentiate and confirm the diagnosis. And also lists out several Ayurvedic styptic medicines which facilitate the cessation of bleeding when used judiciously according to dosha and vyadhi avastha.
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Nadhem, Omar N., Omar A. Salh, and Omar H. Bazzaz. "Lower gastrointestinal bleeding due to rectal Dieulafoy’s lesion." SAGE Open Medical Case Reports 5 (January 1, 2017): 2050313X1774498. http://dx.doi.org/10.1177/2050313x17744982.
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Dieulafoy’s lesion is a relatively rare but serious cause of gastrointestinal bleeding. It usually involves the upper gastrointestinal tract. However, it has recently been reported in different regions of the gastrointestinal tract, including the rectum. Here, we report the case of a female patient who presented with fresh bleeding per rectum for 1 day with low hemoglobin level. Colonoscopy revealed an actively bleeding rectal Dieulafoy’s lesion which was successfully treated with a clip. To our knowledge, there have been few reported cases of lower gastrointestinal bleeding caused by Dieulafoy’s lesion in the rectum.
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Gonçalves, Wagner Gonzaga, Maria do Carmo Queiroz Fialho, Dihego Oliveira Azevedo, José Cola Zanuncio, and José Eduardo Serrão. "Ultrastructure of the Excretory Organs of Bombus morio (Hymenoptera: Bombini): Bee Without Rectal Pads." Microscopy and Microanalysis 20, no. 1 (November 5, 2013): 285–95. http://dx.doi.org/10.1017/s143192761301372x.
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AbstractBumblebees need to keep bodily homeostasis and for that have an efficient system of excretion formed by the Malpighian tubules, ileum, and rectum. We analyzed the excretory organs of Bombus morio, a bee without rectal pads. In addition, we analyzed the rectal epithelium of Melipona quadrifasciata anthidioides which has rectal pads. The Malpighian tubules exhibited two cell types and the ileum four types. However, comparative analysis of the rectum showed that only cells of the anterior region of the rectal epithelium of B. morio are structurally distinct. We suggest that cells of the Malpighian tubules of B. morio have an excretory feature and that cells of ileum have different functions, such as ion absorption and water, organic compound, and protein secretion. In addition, only the anterior region of the rectum of B. morio showed characteristic absorption. We suggest that Malpighian tubules participate in the excretion of solutes and that the ileum and rectal epithelium are responsible for homeostasis of water and solutes, compensating for the absence of rectal papillae. These results contribute to our understanding of the morphophysiology of the excretory organs of bees without rectal pads.
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Sampath, Ananyan, Hemalata Panwar, Neelkamal N. A. Kapoor, and Pramod Kumar Sharma. "Osseous metaplasia in a rectal polyp." BMJ Case Reports 16, no. 9 (September 2023): e254819. http://dx.doi.org/10.1136/bcr-2023-254819.
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Rectal polyps are finger-like projections of the mucosal surface that generally present with complaints of bleeding or mass per rectum. Polyps are classified histopathologically as neoplastic and non-neoplastic. Here, we present one such rare case of a middle-childhood boy who presented with complaints of bleeding per-rectum and revealed a 1.5 cm long rectal polyp. Histopathological examination revealed an osseous change in the rectal polyp. A detailed literature review of reported cases of benign rectal polyps with osseous metaplasia was conducted and consolidated all postulated theories of pathogenesis. This case report shows an interesting incidental finding of osseous metaplasia of the rectal polyp.
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Dinarvand, Peyman, Ashley A. Vareedayah, Nancy J. Phillips, Christine Hachem, and Jinping Lai. "Gastric heterotopia in rectum: A literature review and its diagnostic pitfall." SAGE Open Medical Case Reports 5 (January 1, 2017): 2050313X1769396. http://dx.doi.org/10.1177/2050313x17693968.
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Objectives: The term heterotopia, in pathology, refers to the presence of normal tissues at foreign sites. Gastric heterotopia has been reported anywhere in the gastrointestinal tract. However, the presence of gastric heterotopia in the rectum is very rare. Methods: We, here, report a rare case of a localized 2-cm area of cratered mucosa with heaped-up borders in the rectum of a 51-year-old, asymptomatic woman who underwent screening colonoscopy. Results: Histologic examination of the biopsy from the lesional tissue in rectum demonstrated fragments of rectal mucosa co-mingling with oxyntic- and antral-type gastric mucosa. No intestinal metaplasia or Helicobacter pylori is identified. Conclusion: Patients with gastric heterotopia in rectum usually present with bleeding and/or abdominal pain. Definite treatment of choice is surgical or endoscopic resection, although the lesions also respond to histamine-2 receptor blockers. In this article, most recent literature about gastric heterotopia in rectum is reviewed, following a case presentation about it.