ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;The end‐to‐end anastomosis by stapling for left colonic and rectal resections is proving to be a relatively safe and fast procedure. Results of a survey of the American Society of Colon and Rectal Surgeons reveals 15.1 per cent intraoperative complications, 3.7 per cent early postoperative complications, 0.5 per cent deaths, and 13.8 per cent late complications. The majority of late complications, stenosis and incontinence, were either subclinical or transient for most patients. Technique and prevention of complications are stressed.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Colorectal cancer recurs within the operative field in 10‐20 per cent of patients undergoing potentially curative surgery. In certain subgroups, the recurrence rate is 20‐50 per cent. There are some data to suggest either preoperative or postoperative radiation therapy as an adjuvant to potentially curative surgery can reduce the local operative failure rate. However, since radiation therapy has significant side effects, patient selection to maximize the therapeutic ratio is important. This report defines the criteria at the Massachusetts General Hospital for selection of patients with colorectal cancer for adjuvant radiation therapy, defines radiation therapy‐surgery sequencing alternatives used, and deseribes techniques to reduce radiation side effects.Over a period of three and a half years, 196 patients received adjuvant radiation therapy: 51 patients received either moderate or low dose preoperative radiation therapy to rectal or rectosigmoid cancers, and 161 patients received postoperative radiation therapy to the pelvis or extrapelvic colonic tumor‐lymph node beds. Some patients who received low‐dose preoperative radiation therapy also received moderate‐dose postoperative radiation therapy. We prefer moderate‐dose postoperative radiation therapy as the approach most likely to decrease the local recurrence rate with minimal interference with surgical procedures and late small‐bowel complications. Patients who received postoperative radiation therapy were those without distant metastases, whose primary tumor pathology revealed macroscopic or extensive microscopic transmural tumor penetration into extraperitoneal tissues. Careful case selection, multiple field techniques, the use of reperitonealization, omental flaps, and retroversion of the uterus into the pelvis were combined with postoperative small‐bowel x‐rays, bladder distention, and lateral portals to minimize radiation damage to normal structures.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;It is known that patients with incompletely resected epithelial cancers are at high risk of local recurrence. A prospective study to determine whether elective postoperative radiotherapy can decrease the incidence of local recurrence and thus improve survival of those patients with an incompletely resected tumor was made of 125 irradiated patients with locally advanced colorectal cancer (B2C1, C2) 78 patients had rectosigmoid tumors and 47 had colonic cancers. Complete resection (R0) was performed in 94 patients (75 per cent). Thirteen (10 per cent) had microscopic (R1) and 18 (14 per cent) had gross residual disease (R2).Local control and survival (average follow‐up, 38 months) of patients with microscopic residual cancer (R1) were 84 per cent (11/13) and 77 per cent (10/13) respectively. These results were identical to those obtained in patients without residual disease (R0). Patients with gross residual disease (R2) had a local control of 50 per cent (9/18) and a survival of 39 per cent (7/18). Radiation complication occurred in seven of 125 patients (6 per cent). One patient died, of radiation enteritis. One patient required a nephrostomy. The remaining five patients were treated conservatively. Elective postoperative radiotherapy given to patients who had incomplete resection of a colorectal cancer prevented local recurrence in the majority and may have increased survival.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;With the improvement of instruments, colonoscopy has become applicable also for children. During the past 10 years, pediatric colonoscopies were performed 83 times on 45 infants and children. The value and indications in pediatric colonoscopy are described here. Pediatric colonoscopy is a very significant complement to the conventional clinical and radiologic examinations.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Between January 1975 and December 1979, 58 patients were diagnosed as having villous papilloma of the large howel. A retrospective review was performed and all histologic specimens were re‐examined by one gastrointestinal histopathologist (H.T.). On review, 19 (23 per cent) lesions were reclassified as not being villous papilloma. Results of preoperative biopsy examinations were misleading in 13 of the 29 patients who had biopsy procedures reported by any member of the histopathology department. When the assessment of malignancy in the initial biopsy specimens was compared with that of the final histologic diagnosis, there were ten (34 per cent) false‐negative and three (10 per cent) false‐positive reports. Even when the excised specimens were reviewed for malignancy by a specialist gastrointestinal histopathologist, there were seven (24 per cent) false‐negative results.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Sera from eight patients with biopsy‐proven rectal carcinoma were assayed for creatine kinase (CK). Two of the patients had enzyme activity: one with the BB and the other with an MB isoenzyme. We think that our results may be of interest because the detection of anomalous isoenzymes of CK in serum may serve as a diagnostic marker or as an indicator of the effectiveness of treatment.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID