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Kudchadkar S, Ahmed S, Mukherjee T, Sagar J. Current guidelines in the surgical management of hereditary colorectal cancers. World J Gastrointest Oncol 2022; 14:833-841. [PMID: 35582097 PMCID: PMC9048527 DOI: 10.4251/wjgo.v14.i4.833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 10/16/2021] [Accepted: 03/04/2022] [Indexed: 02/06/2023] Open
Abstract
Incidence of colorectal cancer (CRC) is on rise. While approximately 70% of all CRC cases are sporadic in nature, 20%-25% have familial aggregation and only < 5% is hereditary in origin. Identification of individuals with hereditary predilection for CRC is critical, as it has an impact on their overall surgical management including surgical timing, approach & technique and determines the role of prophylactic surgery and outcome. This review highlights the concept of hereditary CRC, provides insight into its molecular basis, possibility of its application into clinical practice and emphasizes the current treatment strategies with surgical management, based on the available international guidelines.
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Affiliation(s)
- Shantata Kudchadkar
- Department of Colorectal Surgery, Luton & Dunstable University Hospital NHS Foundation Trust, Luton LU4 0DZ, United Kingdom
| | - Safia Ahmed
- Department of Colorectal Surgery, Luton & Dunstable University Hospital NHS Foundation Trust, Luton LU4 0DZ, United Kingdom
| | - Tanmoy Mukherjee
- Department of Colorectal Surgery, Luton & Dunstable University Hospital NHS Foundation Trust, Luton LU4 0DZ, United Kingdom
| | - Jayesh Sagar
- Department of Colorectal Surgery, Luton & Dunstable University Hospital NHS Foundation Trust, Luton LU4 0DZ, United Kingdom
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Kitaguchi D, Takeshita N, Matsuzaki H, Hasegawa H, Honda R, Teramura K, Oda T, Ito M. Computer-assisted real-time automatic prostate segmentation during TaTME: a single-center feasibility study. Surg Endosc 2020; 35:2493-2499. [PMID: 32430531 DOI: 10.1007/s00464-020-07659-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/15/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Urethral injuries (UIs) are significant complications pertaining to transanal total mesorectal excision (TaTME). It is important for surgeons to identify the prostate during TaTME to prevent UI occurrence; intraoperative image navigation could be considered useful in this regard. This study aims at developing a deep learning model for real-time automatic prostate segmentation based on intraoperative video during TaTME. The proposed model's performance has been evaluated. METHODS This was a single-institution retrospective feasibility study. Semantic segmentation of the prostate area was performed using a convolutional neural network (CNN)-based approach. DeepLab v3 plus was utilized as the CNN model for the semantic segmentation task. The Dice coefficient (DC), which is calculated based on the overlapping area between the ground truth and predicted area, was utilized as an evaluation metric for the proposed model. RESULTS Five hundred prostate images were randomly extracted from 17 TaTME videos, and the prostate area was manually annotated on each image. Fivefold cross-validation tests were performed, and as observed, the average DC value equaled 0.71 ± 0.04, the maximum value being 0.77. Additionally, the model operated at 11 fps, which provides acceptable real-time performance. CONCLUSIONS To the best of the authors' knowledge, this is the first effort toward realization of computer-assisted TaTME, and results obtained in this study suggest that the proposed deep learning model can be utilized for real-time automatic prostate segmentation. In future endeavors, the accuracy and performance of the proposed model will be improved to enable its use in practical applications, and its capability to reduce UI risks during TaTME will be verified.
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Affiliation(s)
- Daichi Kitaguchi
- Surgical Device Innovation Office, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.,Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.,Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Nobuyoshi Takeshita
- Surgical Device Innovation Office, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. .,Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
| | - Hiroki Matsuzaki
- Surgical Device Innovation Office, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Hiro Hasegawa
- Surgical Device Innovation Office, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.,Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Ryoya Honda
- Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Koichi Teramura
- Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Tatsuya Oda
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Masaaki Ito
- Surgical Device Innovation Office, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. .,Department of Colorectal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
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Larsen SG, Pfeffer F, Kørner H. Author response to: Comments on: Norwegian moratorium on transanal total mesorectal excision. Br J Surg 2019; 106:1855. [PMID: 31747073 DOI: 10.1002/bjs.11374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 08/29/2019] [Indexed: 11/10/2022]
Affiliation(s)
- S G Larsen
- Department of Gastroenterological Surgery, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - F Pfeffer
- Department of Gastroenterological Surgery, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - H Kørner
- Department of Gastroenterological Surgery, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
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Barnes TG, Volpi D, Cunningham C, Vojnovic B, Hompes R. Improved urethral fluorescence during low rectal surgery: a new dye and a new method. Tech Coloproctol 2018; 22:115-119. [PMID: 29460054 PMCID: PMC5846816 DOI: 10.1007/s10151-018-1757-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 01/06/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND The aim of this study was to demonstrate highlighting of the urethra during surgery through the use of two different methods: a new near-infrared fluorophore IRDye800BK, and indocyanine green (ICG) mixed with silicone. METHODS Male cadavers from the department of anatomy at the University of Oxford were used to visualise the urethra during near-infrared fluorescence excitation. To assess IRDye800BK, a perineal incision was utilised after infiltrating the urethra directly with an IRDye800BK solution mixed with Instillagel. ICG-silicone was assessed when the urethra was purposely exposed as part of a simulated transanal total mesorectal dissection. ICG was previously mixed with ethanol and silicone and left to set in a Foley catheter. Fluorescence was visualised using an in-house manufactured fluorescence-enabled laparoscopic system. RESULTS IRDye800BK demonstrated excellent penetration and visualisation of the urethra under fluorescence at an estimated tissue depth of 2 cm. An ICG-silicone catheter demonstrated excellent fluorescence without leaving any residual solution behind in the urethra after its removal. CONCLUSIONS The newly described ICG-silicone method opens up the possibility of new technologies in this area of fluorescence guided surgery. IRDye800BK is a promising alternative to ICG in visualising the urethra using fluorescence imaging. Its greater depth of penetration may allow earlier detection of the urethra during surgery and prevent wrong plane surgery sooner.
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Affiliation(s)
- T G Barnes
- Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, Level 6, Headley Way, Headington, Oxford, OX3 9DS, UK.
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
| | - D Volpi
- Department of Oncology, CR-UK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, UK
| | - C Cunningham
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - B Vojnovic
- Department of Oncology, CR-UK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, UK
| | - R Hompes
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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