摘要:

&NA;Complications following 178 low anterior resections for rectal carcinoma with the EEA autosuture device are reported prospectively. The operative mortality was 2.8 percent. Clinical anastomotic leakage developed in 27 patients, but in none of the 30 patients over 76 years of age. Two of the five hospital deaths were related to leakage. Long‐term steroid treatment and previous pelvic radiotherapy were associated with increased risk of leakage. Severe stenosis following anastomotic leakage was seen in one patient. Intraoperative diverting colostomy was done in 16 patients, but no benefit could be demonstrated. It was concluded that use of the upper sigmoid colon for anastomosis probably is not associated with a higher mortality and morbidity than that after more extensive resections reported in the literature. Future randomized trials should exclude very old patients, in whom no leak was seen, when the upper sigmoid colon was used for stapling after low anterior resection.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;Twenty patients diagnosed as having levator syndrome were treated with electrogalvanic stimulation (EGS). Many of these patients had previously been treated unsuccessfully with other methods. While 60 percent of patients had good or excellent response to EGS when assessed immediately after therapy, a subsequent telephone survey revealed that one third of this group experienced recurrence. Of the group of 20 patients, only five (25 percent) remained symptom‐free. Though results in this study were less favorable than other reports, EGS may still serve as a valuable adjunct in the treatment of levator syndrome.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;The histopathology of 304 patients registered in the Canadian Familial Polyposis Registry (CFPR) with a diagnosis of supposed adenomatous polyposis (AP) was reviewed. The diagnosis was changed in 17 (5.6 percent) of these patients. Group 1 consisted of nine patients who had adenocarcinomas plus multiple tubular adenomas (seven) or metaplastic polyps (two). Eight patients who had no colon cancer comprised Group 2. In these patients, the diagnosis was changed to lymphoid polyposis (2), metaplastic polyps (3), isolated adenomas (2), or juvenile polyposis (1). All 17 patients had had previous colonic resections. Following the change in diagnosis, this treatment was considered inappropriate in 11 patients. Treatment, prognosis, and follow‐up of patients and affected family members depend on the type of polyposis syndrome diagnosed. Correct histologic assessment of polyps prior to initial surgery is essential.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;The effect of an intraluminal tube on the healing of an inadequately constructed colonic anastomosis was evaluated. An anastomosis using a single suture was constructed in 78 rats divided into four experimental groups. In one, a latex tube was sited intraluminally at the level of the anastomosis and removed transanally after, six days. In the second, a soft tube consisting of rat duodenum preserved in 5 percent formalin was similarly sited and allowed to pass spontaneously. In the third group, the formalin tube was placed outside the colon surrounding the anastomosis. The fourth group was a control. The mortality, of the latex intraluminal tube group was 48 percent, the intraluminal duodenum in formalin group 29 percent (significantly less than the control group,P<.02), the extraluminal tube around the anastomosis group 100 percent, and the control group 75 percent (P<.02). There was no significant difference among the experimental groups in the mean breaking strength of the colonic anastomosis in the 28‐day survivors.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;Based on the adenoma‐carcinoma sequence the authors studied whether determination of serum carcinoembryonic antigen (CEA) provided any conclusions concerning malignant transformation of a colorectal adenoma. In 32 patients with single or multiple adenomas, serum CEA did not differ from 119 healthy individuals. In 43 percent, a decrease of CEA could be observed after polypectomy, while it increased in 22 percent or remained unchanged in 35 percent. No correlation was found between adenoma volume and serum CEA. There was a tendency toward a higher serum CEA level in patients with villous adenoma as compared with those with tubular structure. CEA concentrations were independent from the degree of cellular atypia, but polypectomy was followed by a decrease of serum CEA in villous adenoma or of moderate cellular atypia, reflecting a possible influence on production or shedding of CEA by these subtypes of adenoma. The results indicate, therefore, that serum CEA is not able to recognize the malignant potential of colorectal adenoma.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;The characteristics of 702 colorectal cancer patients are described in relation to the presence or absence of a family history of colorectal cancer in near relatives. No statistically significant associations were found between those with a family history of colorectal cancer and age at detection, sex, country of birth, religion, number of cancers (single, synchronous, or metachronous), previously removed benign colorectal polyps, and adenomatous polyps found in the resection specimen. The family history rate of colorectal cancer for colon cancer cases was statistically significantly higher than for rectal cancer cases (&khgr;12=3.8,P=0.5) and there was a gradient of decreasing risk from colon to rectum. The family history rate of colorectal cancer in parents of those who were less than 50 years old was twice that of those 50 or older (P=.07), consistent with the view that earlier age of onset is a characteristic of those with a family history of colorectal cancer. There was a statistically significantly higher family history rate of colorectal cancer in respondents who knew of the disease compared with those who did not (&khgr;12=5.5,P<.05). It is unclear if this effect represents recall bias or self‐selection bias. In contrast, the rates for a family history of heart disease and stroke were similar, irrespective of the respondent's knowledge of their colorectal cancer status. Thus in the Melbourne study, the family history rate of colorectal cancer was higher in colon cancer than in rectal cancer, there was a decreasing gradient of risk from colon to rectum, and a tendency for earlier age of onset of colorectal cancer in those with a history of this cancer in a parent.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;Anticarcinoembryonic antigen (CEA) antisera which showed no reactions with normal adult feces were prepared in guinea pigs. Using these, levels of CEA in feces from patients with colorectal carcinoma were measured by gel diffusion and rocket immunoelectrophoresis. Sixteen of 22 (73 percent) patients with carcinoma of the colon or rectum (Dukes' A 4/6, B 6/8, C 6/7, D 0/1) had detectable CEA in their feces, while none was detected in the feces of four patients with gastric ulcers or in hose of 22 normal volunteers. Five of the 16 fecal CEA‐positive patients showed no elevation of plasma CEA levels. Measurements using a commercial CEA kit (Abbott Laboratories) could not detect the differences between fecal CEA values of patients with colorectal carcinoma and benign diseases, or those of normal volunteers. These results suggest that measurement of fecal CEA by specific anti‐CEA antisera will be valuable in screening and diagnosis of colorectal carcinoma.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;Persistent rectovaginal fistulas occurring with ulcerative colitis are unusual manifestations that complicate surgical or medical treatment of the primary disease. Prior to the development of ileal pouch proceduress many cases were traditionally managed with a total colectomy and permanent ileostomy. The authors are aware of no previous study using concurrent fistula repair combined with ileal pouch construction to manage this complex problem. The successful simultaneous repair of a chronic rectovaginal fistula with ileal pouch reconstruction in a patient with intractable ulcerative colitis is reported.

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;The case of a 73‐year‐old man who developed acute colonic pseudoobstruction (Ogilvie's syndrome) following chemotherapy for lymphoma is reported. Cecal dilatation resolved after a single colonoscopic decompression. Following his next course of chemotherapy, colonic dilatation again developed. The recurrence was treated successfully by introducing a fenestrated colonoscopic overtube transanally for continous decompression. The literature concerning acute, colonic pseudo‐obstruction is reviewed. The colonoscopic overtube is a convenient and effective treatment for recurrent colonic distention

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

&NA;The whipworm (Trichuris trichiura) is an occasional finding in anorectal disease. All cases of anorectal discharge should include a test for ova and parasites. Trichuris infestations can be eliminated by the use of mebendazole (Vermox®), a specific drug which has almost no side effects. It should be remembered that structural diseases of the anorectum occurring during an infection such as fissure, fistula, and abscess, may persist after the infection has been cured and usually must be treated surgically

ISSN:0012-3706    

出版商:OVID    

年代:1987

数据来源: OVID