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Related Concept Videos

Assessment of the Rectum and Anus01:25

Assessment of the Rectum and Anus

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Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
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Lower GI Series: Barium Enema01:23

Lower GI Series: Barium Enema

268
A Barium Enema, or a lower GI series, is a specialized radiographic examination designed to visualize the lower gastrointestinal tract, specifically the colon and rectum. This procedure is instrumental in diagnosing various conditions such as colorectal cancer, polyps, diverticulosis, and inflammatory bowel disease.
Procedure Details
The examination begins by inserting a lubricated rectal tube into the patient's rectum to administer a radiopaque barium solution. The barium flow is carefully...
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Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

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Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
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Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

Radiological Investigation III: Pulmonary Angiogram and PET Scan

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Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
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Endoscopic Procedures II: Colonoscopy01:25

Endoscopic Procedures II: Colonoscopy

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The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
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Related Experiment Video

Updated: Jul 1, 2025

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
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[Watch and Wait for Rectal Cancer].

Carolin Kastner1, Michael Meir1, Sven Flemming1

  • 1Klinik und Poliklinik für Allgemein-, Viszeral-, Transplantations-, Gefäß- und Kinderchirurgie, Universitätsklinikum Würzburg, Würzburg, Deutschland.

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For rectal cancer patients achieving a clinical complete response (cCR) after neoadjuvant therapy, a "watch-and-wait" approach may omit immediate surgery. This strategy requires careful patient selection and surveillance to detect local regrowth.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Gastroenterology

Context:

  • Approximately 30% of colorectal carcinomas (CRC) are rectal. Neoadjuvant therapy downstages tumors in 50-60% of cases, achieving a clinical complete response (cCR) in 10-30%.
  • Radical rectal resection carries significant perioperative risks, including low anterior resection syndrome (LARS) and temporary ostomy.
  • The emergence of a clinical complete response (cCR) after neoadjuvant therapy prompts reevaluation of the risk-benefit of immediate organ resection.

Purpose:

  • To establish standards for the safe oncological implementation of a non-operative

Summary:

  • This paper addresses key questions for the
  • Impact

Impact:

  • Defines criteria for patient selection for non-operative management.
  • Outlines optimal timing for initial restaging after neoadjuvant therapy.
  • Establishes surveillance protocols for early detection of tumor recurrence.