摘要:

&NA;Proper classification of colorectal cancer has been critical in determining prognosis and possible therapy. The Dukes classification has generally been the one most widely used. However, modifications by Dukes himself, as well as by others, have created considerable confusion. This paper attempts to review, in critical detail, the origins for each of the proposed systems and to compare them.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;In a series of 1439 patients with ulcerative colitis, managed by one of the authors (E.S.R.H.), surgical resection was performed on 374 patients (26 per cent): colectomy, 273 (subtotal colectomy and mucous fistula, 172, colectomy and primary ileorectal anastomosis, 101); proctocolectomy, 61; and miscellaneous procedures, 40. Of the 172 patients undergoing subtotal colectomy and mucous fistula, 93 (54 per cent) subsequently required rectal excision, 33 (19 per cent) had ileorectal anastomosis performed as a second procedure, and in 46 (27 per cent) subsequently developed as a mucous fistula. Two hundred seventy‐three patients were at risk for the development of rectal, cancer after subtotal colectomy; ten patients (3.6 per cent) subsequently developed rectal cancer. The cumulative probability of developing rectal cancer after subtotal colectomy reached 17 per cent at 27 years from disease onset. The tumors were more advanced in stage and of higher grade malignancy than those of a parallel general series of patients with rectal cancer uncomplicated by inflammatory bowel disease. Colectomy and ileorectal anastomosis has been successful for most patients. However, the experience of this series highlights the danger of carcinomatous transformation in the retained rectum, the requirement for regular long‐term follow‐up, the need for markers of precancerous change, and the value, where relevant, of prophylactic proctectomy.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;A fourth case of ileostomy adenocarcinoma is presented. Previous cases are reviewed, and the pathology is discussed with reference to a possible evolution from dysplastic epithelium. Future reports of this rare complication of ileostomy may provide further clues as to the pathogenesis

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;Primary adenocarcinoma arising at a colostomy or ileostomy site is very rare, and only three cases have been reported following surgical treatment of ulcerative colitis. A 38‐year‐old man who developed an adenocarcinoma originating at the site of a colonic stoma and producing a large fungating tumor mass in the surrounding abdominal wall is described. This occurred 19 years after Miles' operation for a carcinoma of the rectum

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;Intestinal pseudo‐obstruction is an illness characterized by obstructive symptoms for which there is no mechanical cause. It is becoming increasingly recognized, and there is now a greater understanding of its classification, pathogenesis, and management. Although usually a disease of adulthood, we describe a case occurring in infancy. The difficulties in diagnosis, and the management of this condition in both the short and long terms, with parenteral nutrition, are discussed.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;A 31‐year‐old woman who had undergone bilateral ureterosig‐moidostomy at age five had a moderately differentiated adenocarcinoma at the anastomotic site that was not detected by preoperative studies or intraoperative palpation. The authors review other reports of anastomotic carcinoma occurring after ureterosigmoidostomy for benign disease and recommend a diagnostic protocol. Whenever the urine is diverted away from the sigmoidostomy (rediversion), the anastomotic site should be resected. Ureterosigmoidostomy should be undertaken only with the understanding that meticulous long‐term follow‐up is mandatory.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;Diverticulitis of the rectum is a rare condition. This report covers patient history, diagnosis, and treatment involved in such a case. The patient presented with a history of rectal pain and muscle spasm of six months' duration. After several available examinations had been completed,i.e., digital examination, sigmoidoscopy, and barium‐enema examination, the diagnosis of a rectal diverticulum was made. Initially, conservative treatment, including high‐fiber diet and sitz baths, proved effective. Approximately nine months later, the patient developed severe rectal pain, unrelieved by previously effective measures. After the above‐described examinations had been repeated, the rectal wall was found to be ulcerated and inflamed, and a diagnosis of diverticulitis of the rectum was made. Antibiotic therapy and evacuation of the 3‐ to 4‐cm mass under anesthesia resulted in subsidence of symptoms and resolution of the mass. Segmental resection will be considered if the diverticulum becomes infected again.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID