Results of local excision in rectal cancer. Is there good evidence?
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Humans↗
Biomedical subjects
D Matos
Publications and source records attributed to D Matos.
[Squamous cell carcinoma of the canal anal].
BACKGROUND: Anal cancer is an uncommon malignancy accounting for only a small (4%) percentage of intestinal cancer. The authors described the clinical aspects and the treatment of the patients with squamous cell carcinoma of the canal anal. PATIENTS: Eleven patients with squamous cell carcinoma treated among 1995 and 1999, were analyzed retrospectively. Nine were women and two were men. The mean age was 57.6 years old (range 35-82 years old). RESULTS: The most common symptoms were rectal bleeding, local tumor and pain. Six of them had previous anal benign disease and two had metastases at the diagnosis. All were submitted to systemic chemotherapy with 5-fluorouracil and mitomycin and radiotherapy with 4500 cGy. Four patients had residual disease after chemo radiation and salvage surgery with abdominoperineal resection was done. Three patients had recurrence and four died from the disease. CONCLUSION: Most of our patients were women. The chemo radiation can be a curable treatment in patients with local disease; conversely in patients with residual disease, abdominoperineal resection must be done. Although anal cancer is an often curable disease, four patients died because the diagnosis was done in advanced stage.
Adult↗
[Comparative experimental study of colocolic anastomosis with manual suture and biofragmentable ring].
BACKGROUND: The authors undertook an experimental trial, in order to compare one layer interrupted sutured large bowel anastomosis with that of biofragmentable anastomotic ring (BAR). This device creates an inverted serosa-to-serosa anastomosis. It is designed to fragment after hydrolysis and it is passed within the faeces after healing of the anastomosis. Fourteen dogs were operated on, having been performed 28 anastomoses, 14 with conventional way and 14 with the BAR, both in the same bowel, on alternate sequence and 10cm from each other. MATERIAL AND METHODS: Performing time, technical difficulties, postoperative complications and the healing anastomotic quality were studied. Histological examination was done not only by traditional technique but also by using computerized program, in order to measure the amount of inflammatory infiltration at the anastomosis site. RESULTS: All dogs tolerated the operation well and postoperative period was uneventful. At laparotomy, after an average time of 33 days, perianastomotic adherence was mostly noted in the sutured anastomosis. Anastomotic index had no significant difference in both methods, but inflammatory change was mostly detected in sutured anastomosis, on which the amount of edema infiltration was significantly higher. CONCLUSIONS: Based on these results, the authors conclude that the BAR anastomosis appears to be a safe alternative, uniform, more rapid and easy technique, with better healing. No difference in the clinical results was noted.
Anastomosis, Surgical↗
[Initial experience with the AKA-2 and AKA-4 device for intestinal compression anastomosis in colorectal surgery].
A prospective study was undertaken to analyse the results of sutureless colorectal anastomosis, by using an anastomotic compression device designed by Russians, the AKA gun. Ten patients were submitted do colorectal resection, 5 for retrosigmoid cancer, 3 for familial adenomatous polyposis and 2 for rectal procidentia. No mortality. Anastomotic leakage occurred in 1 patient which was treated by a defunctioning colostomy and had a good recovery. Clinical, radiologic and endoscopic postoperative controls were within normality. Comparisons are made between the sutureless anastomosis technique and the traditional ones. Initial results are regarded, by the authors, as encouraging and so they intend to go on the study.
Adult↗