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[en] The analysis of 22 patients operated in the period from 2016 to 2018 for colon tumors with the use of laparoscopic technologies, was performed. In ten cases, the laparoscopic stage was changed to open surgical intervention. All patients with a conversion had a tumor of the left colon. The structure of completely laparoscopic surgery included right hemicolectomy, sigmoidectomy, proctectomy, and transanal TME. The problem of introducing laparoscopic techniques into the surgery of colorectal cancer lies not only in the development of manual skills, but also in solving administrative and organizational issues aimed at ensuring the continuity of the educational process and sufficient surgical activity. The learning curve for performing colorectal resections, even with the use of simulation techniques for the development of manual skills and the use of educational video materials, significantly exceeds 10 operations. Essential assistance in mastering this type of surgical interventions is provided by working with a mentor. The selection of patients for operations in the rectum and the left colon for such parameters as BMI, tumor size, adhesions in the abdominal cavity — significantly reduce the frequency of conversions.
[en] Hirschsprung's disease of the adult is an infrequent entity of unknown incidence. Surgery is the treatment of choice, but many available options include techniques applied in newborns and children or those used in other pathologies such as idiopathic megacolon of the adult or Chagasic megacolon. Due to the nature of the disease, the alternatives more frequently used are the anorectal miectomy and the Duhamel's procedure. We decided to present a case of short segment Hirschsprun's disease and another of ultra - short segment in young adults and discuss treatment options, due to the rare number of reports, patients and surgical experiences reported in the literature
[en] Neoadjuvant radiochemotherapy has been proven superior to adjuvant treatment in reducing the rate of local recurrence without impairing cancer related survival or the incidence of distant metastases in standard protocols of neoadjuvant radiochemotherapy. The present study aimed at addressing the effects of an intensified neoadjuvant radiochemotherapy on long term cancer related and disease free survival. A total of 387 patients underwent oncologic resection for rectal cancer in our institution between January 2000 and December 2009. There were 106 patients (27.4%) who received an intensified radiochemotherapy protocol completely and without excluding criteria (study group). A matched pair analysis was performed by comparing the study group with patients undergoing primary surgery and postoperative radiochemotherapy, if necessary and possible (control group). Matching was carried out in descending order for UICC stage, R-status, tumor height, T-, N-, V-, L-, M- and G-category of the TNM-system according to the histopathological staging. Follow-up data included local recurrence rate, cancer related and disease free survival. In the study group histopathological work-up of the specimen revealed a treatment response in terms of tumor regression in 92.5% (98/106) of these patients. Undergoing intensified neoadjuvant RCT the actuarial cancer related and disease free survival was 67.9% and 70.4%, local recurrence was 5.7% after an observation period of 4.3 ± 2.55 years. In the control group cancer related and disease free survival was 71.7% and 82.7%, local recurrence was 4.7% after an observation period of 3.8 ± 3.05 years revealing no statistical significant difference between the two groups. Moreover, estimated 5-year results of cancer related survival (66.7% vs 67.9% (controls)), the disease free survival (66.7% vs 79.9% (controls)) as well as subgroup analysis of UICC 0-III and UICC IV patients showed no difference between the study and control group as well. In our study, intensified neoadjuvant radio-chemotherapy shows a high rate of tumor regression. The resulting inferior histopathological tumor stage shows the same long term local control and systemic tumor control as the control group with a primary more favorable tumor stage
[en] Full text: Objective: To assess the diagnostic value of CEA CA199 and CA50 for colorectal neoplasm by logistic regression and ROC curve. Methods: The subjects include 75 patients of colorectal cancer, 35 patients of benign intestinal disease and 49 health controls. CEA CA199 and CA50 are measured by CLIA ECLIA and IRMA respectively. The area under the curve (AUC) of CEA CA 199 CA50 and logistic regression results are compared. [Result] In the cancer-benign group, the AUC of CA50 is larger than the AUC of CA199 Compared with the AUC of combination of CEA CA199 and CA50 (0.604),the AUC of combination of CEA and CA50 (0.875) is larger and it is also larger than any other AUC of CEA CA199 or CA50 alone. In the cancerhealth group, the AUC of combination of CEA CA199 and CA50 is larger than any other AUC of CEA CA199 or CA50 alone. No matter in the cancer-benign group or cancerhealth group. The AUC of CEA is larger than the AUC of CA199 or CA50. Conclusion: CEA is useful in the diagnosis of colorectal cancer. In the process of differential diagnosis, the combination of CEA and CA50 can give more information, while the combination of three tumor markers does not perform well. Furthermore, as a statistical method, logistic regression can improve the diagnostic sensitivity and specificity. (author)
[en] Condyloma acuminatum, a benign disease caused by a filtrable virus, occurs predominantly in the perianal and genital areas. The lesions are noninvasive but are subject to recurrence. In rare instances, a more aggressive from of this disease, known as 'giant condyloma acuminatum' or 'Buschke-Lowenstein tumor', occurs. In this form, infiltration of the lesion into surrounding structures takes place. This tumor has been reported to occur principally in the genitourinarv tract. The authors experienced a case of giant condyloma acuminatum originating from rectum in 67 years old male patient which recurred 3 months after electrofulguration.
[en] Clinical examination of foals and small ponies with abdominal disorders is limited by the inability to perform rectal palpation. In these patients, radiographic evaluation of the abdomen may contribute to the clinical diagnosis and may help to localize the site of abdominal diseases. The technique for lateral standing survey and contrast radiography of the abdomen in foals and the normal radiographic anatomy are described
[en] Purpose: To correlate the endosonographic and color Doppler flow imaging alterations observed in irradiated rectal cancers with the pathologic features of radiation response, and to evaluate the potential impact of altered blood flow on the integrity of the surgical anastamosis. Methods and Materials: Endosonography with color and pulsed wave Doppler was performed on 20 rectal cancer masses before and after high dose preoperative radiation (XRT). Pre- and post-XRT observations included comparing alterations in tumor size, sonographic echotexture, color Doppler flow, and pulsatility indices. Comparisons were made with pathologic findings in the irradiated specimens and with the incidence of anastomotic failure. Results: Compared to pre-XRT observations, irradiated rectal cancers decreased in size and became either mixed in echogenicity with less apparent color Doppler flow (16 of 20) or unchanged in color Doppler flow and echotexture (4 of 20). Those with less flow (16 of 20) were imaged later (mean = 90.2 ± 12.1 days) than those without change in color Doppler flow (mean = 21.7 ± 2.7 days). Pathologically, the group of four without change in color Doppler signal had features of acute inflammation which were not observed in 16 of 20 imaged later. Based on pulsatility index measurements, both high and low resistance vessels were detected and confirmed by immunohistochemical staining, and features of postradiation obliterative vasculitis were observed. Only one primary anastomosis in 14 patients with decreased flow failed. Conclusions: The sonographic and color Doppler flow imaging alterations observed within irradiated rectal cancer correlated with changes of postradiation obliterative vasculitis. The apparent diminished local blood flow within high and low resistance vessels post-XRT did not result in an increased incidence of anastomotic failures
[en] Appearance of spreading skin metastases in colorectal cancer and of anal canal is infrequent. The aim of present paper was to show an interesting case of skin metastasis related to an advanced carcinoma of anal canal infiltrating rectum