The aim of this randomized multicenter trial was to assess the rate symptomatic anastomotic leakage in patients operated on with low anterior resection for rectal cancer and who were intraoperatively a defunctioning stoma or not.

Abstract Objective Surgical technique and peri‐operative management of rectal carcinoma have developed substantially in the last decades. Despite this, morbidity mortality after anterior resection rectum are still important problems. The aim this study was to identify risk factors for anastomotic leakage assess role a temporary stoma need urgent re‐operations relation leakage. Patients methods In nine‐year period, from 1987 1995, total 6833 patients underwent elective Sweden. A random sample...

High macrophage infiltration has been correlated to improved survival in colorectal cancer (CRC). Tumor associated macrophages (TAMs) play complex roles tumorigenesis since they are believed hold both tumor preventing (M1 macrophages) and promoting (M2 activities. Here we have applied an immunohistochemical approach determine the degree of infiltrating with a M1 or M2 phenotype clinical specimens CRC relation prognosis, general but also subgroups defined by microsatellite instability (MSI)...

Health-related quality of life (HRQoL) assessment is important in understanding the patient's perspective and for decision-making health care. HRQoL often impaired patients with stoma. The aim was to evaluate rectal cancer permanent stoma compared without stoma.711 operated abdomino-perineal resection or Hartman's procedure a control group (n = 275) anterior were eligible. Four QoL questionnaires sent by mail. Comparisons mean values between groups made Student´s independent t test....

Colorectal cancer (CRC) is the second most common cause of death in western world. An effective screening program leading to early detection disease would severely reduce mortality CRC. Alterations gut microbiota have been linked CRC, but potential microbial markers for use CRC has largely unstudied. We used a nested case–control study 238 subjects explore clbA+ bacteria harboring pks pathogenicity island, afa‐C+ diffusely adherent Escherichia coli afa‐1 operon, and Fusobacterium nucleatum...

PURPOSE: The aim of this study was to assess the risk for permanent stoma after low anterior resection rectum cancer. METHODS: In a nationwide multicenter trial 234 patients undergoing were randomly assigned group with defunctioning stomas (n = 116) or no 118). median age 68 years, 45% women, 79% had preoperative radiotherapy, and 4% International Union Against Cancer cancer stage IV. analyzed regard presence stoma, type time point at which constructed considered as permanent, reasons...

Abstract Purpose: The aim of this study was to relate the CpG island methylator phenotype (CIMP; characterized by extensive promoter hypermethylation) cancer-specific survival in colorectal cancer, taking into consideration relevant clinicopathologic factors, such as microsatellite instability (MSI) screening status and BRAF V600E mutation. Experimental Design: Archival tumor samples from 190 patients Northern Sweden Health Disease Study (NSHDS) 414 Colorectal Cancer Umeå (CRUMS), including...

An active stroma is important for cancer cell invasion and metastasis. We investigated the expression of fibroblast activation protein (FAP) in relation to patient prognosis colorectal cancer. Colorectal specimens from 449 patients were immunohistochemically stained with a FAP antibody evaluated tumor center front using semiquantitative four-level scale. was expressed by fibroblasts 85-90 % tumors examined. High versus no/low associated poor (multivariate hazard ratio, HR = 1.72; 95 CI...

Mutations in KRAS, BRAF, PIK3CA and PTEN expression have been focus to predict the effect of epidermal growth factor receptor-blocking therapy colorectal cancer (CRC). Here, information on these four aberrations was collected combined a Quadruple index used evaluate prognostic role factors CRC.We analysed mutation status BRAF two separate CRC cohorts, Northern Sweden Health Disease Study (NSHDS; n=197) Colorectal Cancer Umeå (CRUMS; n=414). A created, where positivity specifies cases with...

Cancer-associated fibroblasts expressing fibroblast activation protein (FAP) have been implicated in the invasive behavior of colorectal cancer. In this study, we use FAP expression as a marker and analyze effect activated on cancer migration invasion experimental cell studies. We also investigated pattern cancer-associated during transformation from benign to malignant tumors. immunohistochemical analyses, was expressed all samples examined, whereas normal colon, hyperplastic polyps, or...

Anastomotic leakage following anterior resection for rectal cancer may result in death. The aim of this study was to yield an updated, population-based estimate postoperative mortality and evaluate possible interacting factors.

The aim of this study was to determine whether parastomal hernia (PSH) rate can be reduced by using synthetic mesh in the sublay position when constructing permanent end colostomy. secondary investigate possible side-effects mesh.Prevention PSH is important as it often causes discomfort and leakage from stoma dressing. Different methods prevention have been tried, including several techniques. incidence high; up 78%.Randomized controlled double-blinded multicenter trial. Patients undergoing...

BACKGROUND: It is still not clear whether anastomotic leakage after anterior resection for rectal cancer affects long-term functional outcome. OBJECTIVE: This study aimed to evaluate how following influences defecatory, urinary, and sexual function. DESIGN: In this retrospective population-based cohort study, patients were identified through the Swedish Colorectal Cancer Registry, which was also used information on exposure variable covariates. SETTINGS: A nationwide register including...

Abstract Aim Accumulated data suggest that routine use of defunctioning stoma in low anterior resection for rectal cancer may cause kidney injury, bowel dysfunction and a higher risk permanent stomas. We aim to study whether avoidance diverting selected patients is safe reduces adverse consequences. Methods SELSA multicentre international prospective observational nesting an open‐label randomized clinical trial. All with primary planned are eligible. Patients operated curative intent, aged...

Abstract Purpose Defunctioning stoma (DS) has been suggested to mitigate the consequences of anastomotic leak (AL) after low anterior resection. Stoma reversal (SR) is commonly delayed for nonmedical reasons in many healthcare systems. This study investigated impact elapsed time from AR SR on postoperative 90-day complications. The secondary aim was explore independent factors associated with a SR. M&M multicenter retrospective cohort included rectal cancer patients who underwent...

It is controversial whether division of the inferior mesenteric artery close to aorta influences risk anastomotic leakage, especially in elderly and unfit. This population-based study was carried out evaluate independent association between a high arterial ligation leakage anterior resection for rectal cancer.All patients who had cancer from 2007 2009 inclusive were identified Swedish Colorectal Cancer Registry. The tie evaluated logistic regression model, with adjustment confounders....

Abstract Aim Fashioning a defunctioning stoma is common when performing an anterior resection for rectal cancer in order to avoid and mitigate the consequences of anastomotic leakage. We investigated permanent prevalence, factors influencing outcome complication rates following reversal surgery. Method Patients who had undergone between 2007 2013 northern healthcare region were identified using Swedish Colorectal Cancer Registry followed until end 2014 regarding outcome. Data retrieved by...

Three p53 DNA polymorphisms (BstU I and Msp restriction fragment length (RFLPs) in exon 4 intron 6 respectively, a 16 bp duplication 3) their haplotype combinations were studied patients with colorectal cancer compared ulcerative colitis healthy controls. There only minor differences between controls, the significant difference was observed distribution of BstU I-Msp haplotypes. When single studied, significantly lower frequency found cancer. The protective effect more pronounced A1 alleles,...

This prospective study assessed methods of detecting intraperitoneal ischemia and inflammatory response in patients with without postoperative complications after anterior resection the rectum.In 23 operated on rectum for rectal carcinoma, lactate, pyruvate, glucose levels were monitored postoperatively six days by using microdialysis catheters applied two locations: intraperitoneally near anastomosis, central abdominal cavity. A reference catheter was placed subcutaneously pectoral region....