Soner Akbaba | PubMed Health

PubMed2005

Restorative proctocolectomy for familial adenomatous polyposis coexisting with colorectal cancer.

The aim of this study was to assess whether restorative proctocolectomy was suitable as an initial procedure for selected familial adenomatous polyposis patients with coexisting colorectal cancer. Six malignancy patients who underwent restorative proctocolectomy for familial adenomatous polyposis were reviewed. At the time of restorative proctocolectomy, cancer was not suspected in four patients. The two remaining familial adenomatous polyposis patients had a known associated colorectal cancer. Operative procedures, pathological findings, complications and long-term follow-up were evaluated. All patients were Stage I-II cancers. There was no mortality or pouch failure. No evidence of tumor recurrence was found and all the patients are still alive and disease-free in follow-up (mean 28 months). As an initial procedure, restorative proctocolectomy for patients with familial adenomatous polyposis with coexisting Stage I-II colorectal cancer seems to be a dependable procedure.

Adenomatous Polyposis Coli↗

PubMedDate not supplied

Nasogastric decompression after total gastrectomy.

BACKGROUND/AIMS: Although it is clearly known that there is no need of routine nasogastric decompression after some abdominal operations, we still do not know whether it is necessary for esophageal anastomosis. Traditionally, nasogastric decompression is mandatory after total gastrectomy complemented with esophagojejunostomy. METHODOLOGY: Consecutive 66 patients with gastric cancer who underwent total gastrectomy and esophagojejunostomy were prospectively evaluated. Patients were divided into two groups, those with nasogastric decompression and those without decompression. RESULTS: Postoperative complications were similar among the groups. Vomiting, distention, belching, hiccupping, dysphagia complaints were similar among the groups, but sore throat (100% vs. 22%, p<0.001), nausea (32% vs. 13%, p=0.054), fever (35% vs. 16%, p=0.068) and pulmonary complications (26% vs. 9%. p=0.072) were much more in the nasogastric decompression than the no-tube group. Starting oral feeding and postoperative hospital stay were similar in both groups. CONCLUSIONS: Omission of nasogastric decompression after elective total gastrectomy complemented with esophagojejunostomy did not increase postoperative complications, on the contrary it decreased postoperative fever and pulmonary problems, and improved patient comfort by decreasing sore throat and nausea. Therefore, we do not recommend the routine use of nasogastric tubes after total gastrectomy complemented with esophagojejunostomy.

Adult↗