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M Sprechler

Publications and source records attributed to M Sprechler.

18 recordsLinked to original sources
PubMed1994

Recording of patients with colorectal cancer on a database: results and advantages.

OBJECTIVE: To describe a computer based system for auditing patients with colorectal cancer, to give results obtained from 1977-89, and to point out some of its advantages in terms of record keeping, evaluation of results and education of junior staff. DESIGN: Open study. SETTING: District hospital. SUBJECTS: All patients who presented with colorectal cancer. INTERVENTIONS: An initial form was filled in when the patient was discharged from hospital or died, and follow up forms were completed at each visit. MAIN OUTCOME MEASURES: Morbidity, mortality, and completion of follow up. RESULTS: 803 patients underwent 799 primary operations for colorectal cancer, of which 589 (73.3%) were potentially curative. Operative mortality was 7% (n = 56), and there were 45 leaks after 648 anastomoses (6.9%). The five year cure rate after potentially curative resections were for carcinoma of the rectum 98/196 (50%) and for carcinoma of the colon loo/212 (47%). Of 273 emergency admissions 76 required immediate operation; a quarter died postoperatively and 2 (3%) developed anastomotic leaks. There was no consistent correlation between Dukes' stage and the development of recurrences or metastases after potentially curative resections of carcinoma of the rectum, but numbers were small. CONCLUSIONS: Much valuable information can be gained from such a database. It takes a lot of extra work, but we feel that it is justified in terms of improved record keeping, evaluation of results, and education of junior staff.

Adult↗
PubMed1985

Postoperative survival of patients with potentially curable cancer of the colon.

The association between histopathologic findings and postoperative survival in 442 patients with potentially curable carcinomas of the colon has been analyzed using Cox's regression model. The prognostic variables included in the study were age, sex, stage of disease according to Dukes' classification and Broders' grading, as well as presence/absence at the time of operation of venous and nerve invasion. The overall five-year postoperative survival rate was 46.6 percent. Using a model including all prognostic factors, sex and Dukes' classification were not found to be associated with survival. Broders' grading and/or nerve invasion yielded only a borderline statistical significance in the model that included all factors. The invasion of veins was almost always associated with invasion of nerves.

Adult↗
PubMed1983

Venous and nerve invasion as prognostic factors in postoperative survival of patients with resectable cancer of the rectum.

The histopathologic and clinical findings in 682 patients with carcinoma of the rectum have been analyzed. Invasion of veins and nerves by primary growth was found in 38.9 and 34.9 per cent, respectively. The five-year survival rate for patients with resectable tumors was 49 per cent. The age, Dukes' staging, and presence and/or absence of liver metastases, of venous invasion, and of nerve invasion were found to be of statistically significant importance for the prognosis. Sex was found to be on the borderline of significance and Broders' grading was even less significant. Invasion of veins was found statistically significant more frequently than nerve invasion, but the present investigation revealed the importance of the invasion of veins as well as of nerves. When venous invasion was observed, liver metastases developed over three times as frequently in these patients as when metastases were not demonstrated. In contrast to Dukes' staging. Broders' grading can be applied to tumor biopsies preoperatively. The importance of venous and nerve invasion for the selection of patients for adjuvant therapy after termination of surgical treatment is discussed.

Adolescent↗
PubMed1975

Urologic complications after operations for anorectal cancer, with an evaluation of preoperative intravenous pyelography.

Urologic complications arose in 23.7 per cent of 569 patients who underwent abdominoperineal or low anterior resection for anorectal cancer. No radomization of the two operations was attempted, low anterior resection being performed whenever resection 5 cm below the tumor was possible. Complications were more frequent after abdominoperineal resection and in men. Preoperative intravenous pyelography was performed in the cases of 541 of the patients, including 60 who underwent palliative colostomy. The pyelograms of 30 per cent of these patients were abnormal. The abnormalities were anatomic variations of the urinary tract in 25 per cent and urologic diseases in 75 per cent. None of the postoperative urologic complications was related to an abnormal preoperative pyelogram. No relation was found between the radicality of abdominoperineal and low anterior resection and the pyelographic signs of tumor involvement.

Anus Neoplasms↗
PubMedDate not supplied

Acute obstruction in cancer of the colon and rectum.

Results after operations for acute obstruction of the large intestine due to cancer were analyzed during a 10-year period and compared with the results after operations for nonobstructive tumors during the same period. The following conclusions could be deduced: 1) Cancer is more often obstructive in the colon than in the rectum. Cancers of the splenic flexure are relatively more often obstructive than cancers in other parts of the colon. 2) Postoperative morbidity (and probably mortality) is higher and the five-year survival shorter in patients with obstructive cancers of the large intestine than in those without obstruction. Obstructive Dukes' A tumors are very few. 3) The early morbidity and mortality after acute cecostomy are probably not higher than after acute transversostomy, if the cecostomy wound is left open. The cecostomy carries a risk of peritoneal contamination. 4) Cecostomy does not relieve obstruction in 5-10 per cent of the patients, while transversostomy seems always to be effective. Emergency exploratory laparotomy for obstructive cancer of the large bowel instead of a blind cecostomy reduces the number of patients who need two operations by 10 per cent. 5) Hernias are frequent at the sites of previous spontaneously closed cecostomies. 6) Antibiotic bowel preparation seems not to be effective shortly after decompressive colostomy.

Adult↗