LAR, TME, and ostomies.

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JP66
Posts: 21
Joined: Sun Jan 21, 2024 8:42 am
Facebook Username: joseph peck
Location: Westchester, NY

LAR, TME, and ostomies.

Postby JP66 » Tue Jan 30, 2024 9:42 am

So, I'm scheduled for a meeting with my surgical oncologist in a couple weeks so I'm looking for any advice from the people active here these days, but I also have a couple questions prior.

1) This forum lists LAR under terminology but has no reference to TME (Total Mesorectal Excision). Is LAR the same as TME or is there some other acronym I missed?
2) Has anyone here had a TME without an ostomy?
3) Has anyone here had their ostomy reversed after only 3 months healing or who or how did people figure when it was safe to perform a reversal?


I know these are likely old questions that have been answered before, but time is a precious thing these days so I'm going with the "easy" route to start. I will, of course, say "thanks" to any and all that respond.

Joe
- Male 57 y/o
- TIIIbN+M1
- Stage IV (diagnosed 10/23)
- MSI status - ?
- KRAS non-mutant
- surgery - TME planned post chemo
- Modified Neo-adjuvant Therapy (I'm not sure why they call it "modified" although my guess is the chemo is FOLFIRINOX and not FOLFOX)
- tumor 3.9 cm craniocaudal length, 7.4 cm from AV, moderately differentiated
- 01/24 completed 27 treatments radiation+Xeloda
- CEA 8,10,11/23 1.8,1.3,1.6
- dihydroxi vit D 70.9 pg/ml

User avatar
Peregrine
Posts: 255
Joined: Tue Mar 01, 2022 1:18 am

Re: LAR, TME, and ostomies.

Postby Peregrine » Tue Jan 30, 2024 11:54 am

JP66 wrote:So, I'm scheduled for a meeting with my surgical oncologist in a couple weeks so I'm looking for any advice from the people active here these days ...Joe

Joe -

I have some information on LAR, TME, and other related topics that I could share with you, but it would take some time for me to organize it and put it all together.

It would help for me to know when the meeting with your surgical oncologist will take place and by which date you would like to have some feedback.

Also, it would help to know if your surgical oncologist will be planning a lymphadenectomy procedure for removing your two enlarged Common Iliac Lymph Nodes (CILNs).

Thanks.

JP66
Posts: 21
Joined: Sun Jan 21, 2024 8:42 am
Facebook Username: joseph peck
Location: Westchester, NY

Re: LAR, TME, and ostomies.

Postby JP66 » Tue Jan 30, 2024 2:58 pm

Peregrine wrote:
JP66 wrote:So, I'm scheduled for a meeting with my surgical oncologist in a couple weeks so I'm looking for any advice from the people active here these days ...Joe

Joe -

I have some information on LAR, TME, and other related topics that I could share with you, but it would take some time for me to organize it and put it all together.

It would help for me to know when the meeting with your surgical oncologist will take place and by which date you would like to have some feedback.

Also, it would help to know if your surgical oncologist will be planning a lymphadenectomy procedure for removing your two enlarged Common Iliac Lymph Nodes (CILNs).

Thanks.


February 19th for meeting so certainly no rush on finding links if you've got some. You have already provided me a wealth of information for which I have no way to say thanks other than just say "thanks" . . . again :)

When last I spoke with the surgeon, the plan was no lymphadenectomy just TME.

My MSK surgical oncologist that I dropped had mentioned the possibility of a no ostomy procedure, my Whittingham doctor (Dr. Dong) did not, hence my question.
- Male 57 y/o
- TIIIbN+M1
- Stage IV (diagnosed 10/23)
- MSI status - ?
- KRAS non-mutant
- surgery - TME planned post chemo
- Modified Neo-adjuvant Therapy (I'm not sure why they call it "modified" although my guess is the chemo is FOLFIRINOX and not FOLFOX)
- tumor 3.9 cm craniocaudal length, 7.4 cm from AV, moderately differentiated
- 01/24 completed 27 treatments radiation+Xeloda
- CEA 8,10,11/23 1.8,1.3,1.6
- dihydroxi vit D 70.9 pg/ml

User avatar
CRguy
Posts: 10471
Joined: Sun Feb 10, 2008 6:00 pm

Re: LAR, TME, and ostomies.

Postby CRguy » Tue Jan 30, 2024 8:49 pm

JP66 wrote:So, I'm scheduled for a meeting with my surgical oncologist in a couple weeks so I'm looking for any advice from the people active here these days, but I also have a couple questions prior.
1) This forum lists LAR under terminology but has no reference to TME (Total Mesorectal Excision). Is LAR the same as TME or is there some other acronym I missed?

Thanks for pointing that out. We have now added TME to the >>>>>> Terminology and abbreviations topic
The LAR is the surgical approach to the site. TME is the exact surgical procedure done once you get there.


2) Has anyone here had a TME without an ostomy?
TME is usually performed with temp ileostomy to allow healing of the lower bowell before being "put to use again" :shock:

3) Has anyone here had their ostomy reversed after only 3 months healing or who or how did people figure when it was safe to perform a reversal?
personally had mine reversed (aka "takedown") about 6 months later because I was undergoing adjuvant chemo post-op ... AND ... pushing a lot of intestinal content
(aka chemo diarrhea) past a newly healing major intestinal surgery =>>> NOT a good idea ... SO the ostomy bag took the shit hit so to speak :mrgreen:


I know these are likely old questions that have been answered before, but time is a precious thing these days so I'm going with the "easy" route to start.
I will, of course, say "thanks" to any and all that respond.
Joe

You are most welcome Joe ... BUTT ... really no need to spend your time thanking us :wink:
spend it doing MORE of what you are doing now = getting all the info and putting it to good use for YOUR Journey

Cheers and Harmony
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

User avatar
Peregrine
Posts: 255
Joined: Tue Mar 01, 2022 1:18 am

LAR, TME, ILEOSTOMY links

Postby Peregrine » Tue Feb 13, 2024 9:07 am

LOW ANTERIOR RESECTION (LAR)
A. Wikipedia article
https://en.m.wikipedia.org/wiki/Lower_anterior_resection (2023)

B. Cancer website links
https://www.mskcc.org/cancer-care/patient-education/about-your-low-anterior-resection-surgery (2024) ****

:arrow: https://www.lifeextension.com/protocols/cancer/cancer-surgery (2012) **** :!:
:arrow: https://www.lifeextension.com/magazine/2009/12/preventing-surgery-induced-cancer-metastasis (2009) **** :!:

https://www.intuitive.com/en-us/patients/procedures/colorectal/rectal-resection (2022) da Vinci robot

https://radiopaedia.org/articles/anterior-resection-of-the-rectum (2021)

https://ales.amegroups.org/article/view/5138/html (2019)

https://accesssurgery.mhmedical.com/content.aspx?sectionid=187827849 (2018)

https://www.stmarkshospital.nhs.uk/wp-content/uploads/2017/09/smh-patient-leaflets-anterior-resection-of-the-rectum.pdf (2017)

https://basicmedicalkey.com/low-anterior-rectal-resection-laparoscopic-technique/ (2016]

https://abdominalkey.com/open-technique-for-low-anterior-resection (2016)

https://www.sciencedirect.com/topics/nursing-and-health-professions/rectum-anterior-resection (2009)

https://www.colorectalsurgeonsnewcastle.com.au/anterior-resection-lambton-nsw.html

https://www.surgeoncolorectal.co.uk/procedures/low-anterior-resection

https://www.laparoscopyhospital.com/laparoscopic-low-anterior-resection.php

C. PubMed articles
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8717072/ (2021)

https://pubmed.ncbi.nlm.nih.gov/29471614/ (2018)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991969/ (2016)

https://pubmed.ncbi.nlm.nih.gov/26928124/ (2016)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4336173 (2015)

D. ColonTalk threads
https://coloncancersupport.colonclub.com/search.php?keywords=%22low%22anterior+resection&terms=all&author=&sc=1&sf=titleonly&sr=posts&sk=t&sd=d&st=0&ch=300&t=0&submit=Search

TOTAL MESORECTAL EXCISION (TME)
A. Wikipedia article
https://en.m.wikipedia.org/wiki/Total_mesorectal_excision (2024)

B. Cancer website links
https://stanfordhealthcare.org/medical-treatments/c/cancer-surgery/types/mesorectal-excision-surgery.html(2024)

https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2024.1303686/full* (2024)

https://emedicine.medscape.com/article/1893507-overview (2023)

https://www.pelicancancer.org/our-research/bowel-cancer-research/completed-research/total-mesorectal-excision-tme (2023)

https://www.sciencedirect.com/topics/medicine-and-dentistry/total-mesorectal-excision (2022)

https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0039-3402776 (2020)

https://www.tandfonline.com/doi/full/10.1080/00015458.2020.1745529 (2020)

https://www.facs.org/media/qmlbffh0/webinar_standard_5_7_tme.pdf (2020)

https://link.springer.com/chapter/10.1007/978-981-13-7197-4_4 (2020)

https://www.facs.org/media/ynobcwy0/rectum_operative_standard_oscs_manual.pdf (2018)

http://www.amazon.co.uk/Manual-Total-Mesorectal-Excision-Brendan/dp/1444117165 (2013)

https://journals.sagepub.com/doi/10.1177/107327480301000303 (2003)

C. PubMed articles.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188504 (2020)

https://pubmed.ncbi.nlm.nih.gov/32351336/ (2020)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5788513/ (2017)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4336908/ (2015)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725422 (2015)

https://pubmed.ncbi.nlm.nih.gov/17046842/ (2007)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2789502 (2007)

https://pubmed.ncbi.nlm.nih.gov/14691716/ (2004)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3211930/ (2004)

https://pubmed.ncbi.nlm.nih.gov/12772517/ (2003)

D. ColonTalk threads
https://coloncancersupport.colonclub.com/search.php?keywords=total+mesorectal+excision&terms=all&author=&sc=1&sf=firstpost&sr=posts&sk=t&sd=d&st=0&ch=300&t=0&submit=Search

SPHINCTER SPARING RESECTION
A. Wikipedia article
https://en.m.wikipedia.org/wiki/Internal_anal_sphincter

B. Cancer website links
https://www.ummhealth.org/umass-memorial-medical-center/services-treatments/surgery/services-we-provide/colon-and-rectal-surgery/sphincter-sparing-surgery (2024)

https://health.ucdavis.edu/surgery/specialties/colorectal/treatments-and-services/sphincter-sparing-colorectal-surgery.html (2024)

https://lacolon.com/services-and-procedures/sphincter-sparing-surgery (2023)

https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.996866/full (2022)

https://www.phukethospital.com/healthy-articles/sphincter-sparing-surgery (2021)

C. PubMed articles
https://pubmed.ncbi.nlm.nih.gov/37849259/ (2023)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8507715/ (2021)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392569/ (2020)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392564 (2012)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2789515/ (2007)

D. ColonTalk threads
https://coloncancersupport.colonclub.com/search.php?keywords=%2Bsparing+%2Bsphincter&terms=all&author=&sc=1&sf=all&sr=posts&sk=t&sd=d&st=0&ch=300&t=0&submit=Search

ANASTOMOSIS SURGERY
A. Wikipedia article
https://en.m.wikipedia.org/wiki/Surgical_anastomosis (2023)

B. Cancer website links
https://my.clevelandclinic.org/health/treatments/24035-anastomosis (2022)

https://www.science.org/doi/10.1126/scirobotics.abj2908 (2022)

https://bmcsurg.biomedcentral.com/articles/10.1186/s12893-020-01044-8 (2021)

https://abdominalkey.com/bowel-stapling-and-closure-techniques/ (2020)

C. PubMed articles
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947093/ (2023)

https://pubmed.ncbi.nlm.nih.gov/36967334/ (2023)

https://pubmed.ncbi.nlm.nih.gov/35080901/ (2022)

https://pubmed.ncbi.nlm.nih.gov/35548666/ (2022)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9209641 (2022)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8610633/ (2021)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8610639/ (2021)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8700187 (2021)

D. ColonTalk threads
https://coloncancersupport.colonclub.com/search.php?keywords=anastomosis&terms=all&author=&sc=1&sf=titleonly&sr=posts&sk=t&sd=d&st=0&ch=300&t=0&submit=Search

ILEOSTOMY SURGERY
A. Wikipedia article
https://en.m.wikipedia.org/wiki/Ileostomy (2024)

B. Cancer website links
https://www.ostomy.org/ileostomy/ (2024)

https://www.uptodate.com/contents/overview-of-surgical-ostomy-for-fecal-diversion (2024)

https://www.nhsinform.scot/tests-and-treatments/surgical-procedures/ileostomy (2024)

https://www.nhs.uk/conditions/ileostomy/how-its-done/ (2023)

https://www.cancerresearchuk.org/about-cancer/bowel-cancer/treatment/treatment-colon/surgery-colon/having-ileostomy (2022)

https://www.oncolink.org/cancers/gastrointestinal/rectal-cancer/ileostomy (2022)

https://my.clevelandclinic.org/health/treatments/21726-ileostomy (2021)

https://www.cancer.net/navigating-cancer-care/how-cancer-treated/surgery/types-ostomy/ileostomy (2021)

https://www.cancer.org/cancer/managing-cancer/treatment-types/surgery/ostomies/ileostomy/what-is-ileostomy.html (2019)

https://www.healthline.com/health/ileostomy (2018)

https://cancer.ca/en/treatments/tests-and-procedures/colostomy-and-ileostomy (2018)

C. Pubmed articles
https://www.ncbi.nlm.nih.gov/books/NBK519003 (2023)

https://pubmed.ncbi.nlm.nih.gov/26706610/ (2016)

D. ColonTalk threads
https://coloncancersupport.colonclub.com/search.php?keywords=%2Bileostomy+%2Bsurgery+-reversal&terms=all&author=&sc=1&sf=titleonly&sr=posts&sk=t&sd=d&st=0&ch=300&t=0&submit=Search

ILEOSTOMY CARE
B. Cancer website links
https://www.mskcc.org/cancer-care/patient-education/diet-guidelines-people-ileostomy (2022)

https://www.mskcc.org/cancer-care/patient-education/caring-for-your-ileostomy-colostomy (2022)

https://www.nhs.uk/conditions/ileostomy/recovery (2019)

D. ColonTalk threads
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=58013&p=456986#p456986

https://coloncancersupport.colonclub.com/search.php?keywords=%2Bileostomy+-reversal&terms=all&author=&sc=1&sf=titleonly&sr=posts&sk=t&sd=d&st=0&ch=300&t=0&submit=Search

ILEOSTOMY REVERSAL
B. Cancer website links
https://www.mskcc.org/cancer-care/patient-education/about-your-ileostomy-closure-surgery-01 (2024) ***

https://www.ostomycanada.ca/ostomy-journey/ileostomy/reversal/ (2024)

https://www.bladderandbowel.org/bowel/stoma/stoma-reversal/ (2024)

https://www.medicalnewstoday.com/articles/ileostomy-reversal (2023)

https://my.clevelandclinic.org/health/procedures/ostomy-reversal (2023)

https://www.webmd.com/colorectal-cancer/colostomy-ileostomy-reversal (2023)

https://www.drugs.com/cg/ileostomy-reversal-ambulatory-care.html (2023)

https://myhealth.alberta.ca/health/AfterCareInformation/pages/conditions.aspx?hwid=abq3780 (2022)

https://www.bostonoab.org/ostomy-reversal/ (2022)

https://teachmesurgery.com/consent/general/reversal-loop-stoma/ (2021)

https://connect.mayoclinic.org/discussion/ileostomy-reversal-coming-up-what-will-be-my-new-normal/ (2020)

https://www.ostomy.org/facts-ostomy-reversals/ (2018)

https://www.stgeorges.nhs.uk/wp-content/uploads/2013/11/Reversal-of-ileostomy.pdf (2014)

https://jamanetwork.com/journals/jamasurgery/fullarticle/1107170 (2011)

C. Pubmed articles
https://www.hindawi.com/journals/srp/2020/9876527/ (2020)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4349917/ (2015)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522985/ (2015)

D. ColonTalk threads
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=58897&p=464147&hilit=reversal+takedown+threads#p464147

https://coloncancersupport.colonclub.com/search.php?keywords=%2Bileostomy+%2Breversal&terms=all&author=&sc=1&sf=titleonly&sr=posts&sk=t&sd=d&st=0&ch=300&t=0&submit=Search

LOW ANTERIOR RESECTION SYNDROME (LARS)
A. Wikipedia article
https://en.m.wikipedia.org/wiki/Low_anterior_resection_syndrome (2024)

B. Cancer website links
https://colorectalsurgery.wustl.edu/patient-care/low-anterior-resection-syndrome (2024)

https://www.uptodate.com/contents/low-anterior-resection-syndrome-lars (2023)

https://fightcolorectalcancer.org/blog/low-anterior-resection-syndrome/ (2022)

https://mayoclinic.elsevierpure.com/en/publications/bowel-dysfunction-after-low-anterior-resection-for-colorectal-can (2022)

https://coastcolorectal.com.au/wp-content/uploads/2020/03/ImproveBowelAfterSurgery.pdf (2020)

https://journals.lww.com/dcrjournal/fulltext/2020/03000/international_consensus_definition_of_low_anterior.4.aspx (2020)

C. PubMed articles
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7469998/ (2020)

https://www.ncbi.nlm.nih.gov/books/NBK559931 (2020)

https://pubmed.ncbi.nlm.nih.gov/32032141/ (2020)

https://www.coloplastprofessional.co.uk/education-library/themes/lars/ (2019)

https://connect.mayoclinic.org/discussion/dealing-with-lars (2018)

https://healthfully.com/316594-ileostomy-reversal-diet.html (2017)

D. ColonTalk threads
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=45808&p=333117&hilit=low+anterior+resection+syndrome#p333117

https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=62507&p=498376#p498376


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