ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Adjuvant postoperative radiation therapy has been suggested for adenocarcinoma of the rectum and sigmoid colon to reduce the incidence of local recurrences. Determination of this incidence is necessary to optimally employ such adjuvant therapies. Ninety‐nine patients with adenocarcinoma of the rectum or sigmoid who had surgery from 1976‐1984 were reviewed. Follow‐up ranged from one to eight years (average, 4.1 years). Twenty‐three patients had gross unresected residual tumor due to local invasion. Fifteen of the remaining 76 have developed recurrences (20 percent). Two patients (2.6 percent) had local recurrences without concurrent regional or distant metastases. Thus local recurrences rarely are encountered without concurrent regional or distant metastases. Therefore, postoperative radiation therapy to prevent local recurrences is not justified, given the small number of patients potentially benefited. Treatment modalities will need to address regional and distant metastases in addition to local recurrences.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;One thousand fourteen consecutive large intestines were removed at autopsy from persons over the age of 14 years and examined for diverticular disease. Diverticulosis was encountered in 194 patients (19 percent). The lesion appeared early in life, after the second decade. Men were affected more frequently than women before the age of 60 years. Chinese men had significantly more diverticular disease than Malayan men (P<0.01) and Indian men (P<0.02). Chinese men also had significantly more diverticular disease than Chinese women. There was a predominance of right colon involvement, with the disease affecting especially the ascending colon and cecum. This pattern was observed in all three major ethnic groups, and in both the Singapore‐born and foreign‐born Singaporeans. The cause of right‐sided diverticulosis is unknown. It appears that, while adoption of the western diet may influence the prevalence of diverticular disease, the site of predilection is determined more by racial or genetic predisposition. All diverticular examined histologically were false, including 39 (20 percent) solitary diverticula. The distribution of solitary diverticula was similar to that of multiple diverticulosis. It is suggested that solitary and multiple diverticulosis are part of the spectrum of the same disease.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;From 1968 to 1982, 195 patients with invasive cancer of the anal canal were treated (average age, 67±11 years; range, 38 to 85 years; sex ratio [women/men]:5/1). Histology revealed: cloacogenic cancer, 20 cases; squamous cancer, poorly differentiated, 30; moderately differentiated, 68; well differentiated, 77. The initial size of the cloacogenic cancers was smaller than the squamous cancers. Invasion less than half the circumference of the canal was 90 and 74 percent, respectively. No patients with cloacogenic cancer presented with positive inguinal nodes; however, there were 22 unilateral and five bilateral positive nodes in the squamous cancers. All 195 patients received radiotherapy as the first treatment. There were no differences among the patients operated on with respect to sterilized operative specimens, postradiotherapy sequelae, perineal recurrences, and/or visceral metastases in the cloacogenic and squamous cancers. Five‐year survival was better in cloacogenic (62 percent) than in squamous cancers (56 percent); this diffeernce was not significant, and was related to the initial size of the tumor. The number of patients with no evidence of disease and good anal function was significantly related to the initial size of the tumor, and was independent of the histologic findings.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Formulation of pelvic cysts after proctectomy is an entity which is described in this paper with the cause supposed to be due to descent of the ovary from an intraperitoneal to an extraperitoneal position at the time of proctectomy. A simple surgical technique for fixing the ovary out of the pelvis to prevent this complication is described.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;This study was to assess the effect of stapled colorectal anastomoses on local recurrence, disease‐free survival, and survival following curative resection for Dukes' B and C adenocarcinoma. Data were derived from two randomized prospective trials of the National Surgical Adjuvant Breast and Bowel Project designed to evaluate the efficacy of adjuvant therapy in colorectal cancer. Of 1111 patients with colonic anastomoses, 255 were stapled mechanically. There were no significant differences in disease‐free survival, survival, or local tumor recurrence among patients subjected to stapled or handsewn anastomoses. Of the 181 patients undergoing anterior resection for rectal cancer, 82 anastomoses were fashioned with staples. No significant disadvantage in disease‐free survival, survival, or local recurrence could be attributed to use of the mechanical stapling devices. Twelve percent of patients undergoing stapled rectal anastomoses developed a local recurrence as a first sign of treatment failure compared with 19 percent for the handsewn group. No significant differences in the length of distal margins were detectable. The average time on study was 41 months. The use of stapled anastomoses for carcinoma of the colon or rectum is not associated with an adverse effect on long‐term outcome.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Three cases of secondary amyloidosis are reported, two in patients who had unequivocal Crohn's disease and one in whom the clinical course was that of Crohn's disease, but with histologic findings that were more suggestive of ulcerative colitis. All had evidence of renal failure. A prospective study of 177 patients with inflammatory bowel disease of greater than five years' duration was carried out in an attempt to establish the incidence of secondary amyloidosis, using rectal biopsy and simple renal function tests. No new cases were found. Neither was there evidence of renal failure due to other conditions. In the absence of renal dysfunction, a search for secondary amyloidosis probably is not justified.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;A 60‐year‐old man developed repeated spermatic fluid collection in the small pelvis following abdominoperineal resection and radiotherapy for carcinoma of the rectum. The “spermatocele” was due to a fistula originating in the vasoseminal vesicle junction. This complication has not been described previously.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID