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PubMed1989

Association between alcohol consumption and cancer of the sigmoid colon: observations from a Japanese cohort study.

A 17-year follow up of 265,118 Japanese adults aged 40 years and above revealed a close association between cancer of the sigmoid colon (n = 91) and alcohol consumption: relative risk (RR) for drinkers versus non drinkers was 4.38 (90% CI 1.75-10.97) in men and 1.92 (1.13-3.26) in women. In men, attributable risk was 74% and RRs in non, infrequent, occasional, and daily drinkers were 1.00, 2.03, 3.83, and 5.42, respectively. RRs of daily consumption versus non-consumption in men for cancers of mouth, pharynx, oesophagus, stomach, proximal colon, sigmoid colon, and rectum were 2.27, 2.44, 2.29, 0.92, 0.98, 5.42, and 1.39, respectively. A combined effect of alcohol and smoking was evident for cancers of the upper digestive tract but almost absent for those of the lower digestive tract.

Adult↗
PubMed1995

[Measurement of the sigmoid colon and its relationship with volvulus].

Sigmoid volulus occurs more frequently in Turkish people than the European. The anatomy of the sigmoid colon plays an important role in the etiology. In our study various measurements of the sigmoid colon of 25 preserved cadavers were taken and the results were interpreted according to the frequency of sigmoid volvulus in this country.

Colon, Sigmoid↗
PubMed2001

Primary vs. secondary anastomosis after sigmoid colon resection for perforated diverticulitis (Hinchey Stage III and IV): a prospective outcome and cost analysis.

PURPOSE: Our hypothesis was that in patients with perforated sigmoid colon diverticulitis and peritonitis (Hinchey Stage III and IV) a one-stage sigmoid colon resection is safe and cost effective when performed by an experienced colorectal surgeon. We evaluated outcome and cost of one-stage vs. two-stage sigmoid colon resection after diverticulitis perforation and peritonitis. METHODS: Patients undergoing emergency resection for perforated sigmoid colon diverticulitis and peritonitis (Hinchey Stage III and IV). Outcome, costs, and insurers reimbursement were compared between 13 patients undergoing sigmoid colon resection and primary anastomosis (Group A) and 42 patients undergoing sigmoid colon resection with Hartmann's procedure and secondary descendorectostomy (Group B). RESULTS: Group A patients were comparable to Group B patients in age, gender, preoperative risk and severity of peritonitis (Mannheim Peritonitis Index and C-reactive protein). Operating room time for sigmoid colon resection with primary anastomosis (3.3 +/- 1.2 hours) was identical to the time for sigmoid colon resection with colostomy (3.3 +/- 1 hour), and morbidity and mortality, intensive care unit, and in-hospital stay were not significantly different between the two groups. In Group B patients' intestinal continuity was restored 169 +/- 74 days after the primary resection in 32 of 42 patients only (78 percent). The second procedure took on average 1.4 hours longer than the first procedure. Patients in Group B received more antibiotics (2.2 vs. 2) albeit for a shorter period of time (4.5 vs. 5.7 days, P = not significant). Overall expenses for restoration of intestinal continuity were between 74 and 229 percent higher for Group B patients than for Group A patients. Reimbursement was 18,191 +/- 16,761 SFr (Group A) and 41,321 +/- 26,983 SFr (Group B) respectively. CONCLUSION: With meticulous surgical technique and extensive intraoperative lavage, perforated sigmoid colon diverticulitis with peritonitis can be treated by a one-stage sigmoid colon resection and anastomosis with a low mortality and morbidity. A one-stage procedure is considerably cheaper and patients are rehabilitated faster and to a higher percentage.

Adult↗
PubMed1996

Factors influencing the development of sigmoid colon cancer. Bacteriologic and biochemical studies.

BACKGROUND: Cancer of the sigmoid colon is especially sensitive to environmental factors such as food. The authors have conducted a series of studies with food as the external environmental factor and intestinal microflora as the internal environment factor in relation to sigmoid colon carcinogenesis. METHODS: Thirteen males who had previously undergone surgery for sigmoid colon cancer, and who later developed new epithelial neoplasia of the colon, were chosen as the high risk (HR) group. Fourteen males of similar age, whose large bowel was entirely normal by total colonoscopy, were chosen as the control (CONT) group. Food constituents were analyzed by a dietician. Fecal bile acids, cholesterol metabolites, degradation products of amino acids, pH, water content, and bacterial flora were quantitatively analyzed. RESULTS: Although the HR group consumed slightly more carbon hydrate, fiber, and calcium, as a whole, there was no significant difference in food constituents, especially animal fat, between the two groups. Concentrations of bile acids and cholesterol metabolites were not different between the groups, with the exception of a higher level of cholestanol in the HR group. Succinic, lactic, propionic, and isovaleric acids were abundant in the HR group. Fecal pH and amounts of hydrogen sulfide and cresol also were higher in the HR group. The total amount of bacteria, lecithinase-negative Clostridia, and Lactobacillus, were also more abundant in the HR group. CONCLUSIONS: The feces of the HR group was abundant in such substances as sigmoid colon cancer promoters, and appeared unrelated to food constituents. Resident flora of the HR group were abundant in enzymatically active anaerobes. Because agents carcinogenic to the colon and rectum exist ubiquitously, microflora play a key role in sigmoid colon carcinogens by producing promoters.

Aged↗
PubMed1991

[Bladder replacement with sigmoid colon for bladder cancer].

From 1972 to 1989, 21 patients underwent bladder replacement with sigmoid colon after cystectomy for bladder cancer. A portion of sigmoid colon (about 15 to 20 cm) was isolated and anastomosed to the urethral stump. Then the ureters were implanted in the sigmoid colon via submucosal tunnels. There were 20 men and 1 woman, ranging in age from 24 to 71 years (average 51 years). Preoperative investigations showed that all the cases were free of metastasis. Five years survival rate was 60.7% and there was no operative mortality. There was urethral recurrence in one case and in that case postoperative histopathology revealed carcinoma in situ with tumor. All patients were able to void by themselves without any difficulty. Five patients complained mild incontinence at daytime and all patients had mild incontinence during deep sleep at night, but all of them could maintain their normal daily life like before. The major postoperative complications were: leak at the site of anastomosis (between sigmoid colon and urethra) in 6 cases, hydronephrosis in 2 cases, VUR in 2 cases and bladder stone in 1 case. The patients who underwent bladder replacement with sigmoid colon were well satisfied, because there were no external stoma and the patients could void by themselves. From now, we want to improve our operative method in order to avoid postoperative incontinence.

Adult↗
PubMed1976

Surgical treatment of perforations of the sigmoid colon.

Previous reports show evidence that perforation of the sigmoid colon with diffuse peritonitis, when conventionally treated (i.e. by suture, drainage, and proximal defunctioning colostomy) is associated with a high mortality. Recent investigations, however, indicate that the mortality can be lowered considerably if acute resection or exteriorization of the affected segment of the bowel is performed. Fifteen patients with perforated lesions in the sigmoid colon associated with diffuse peritonitis were treated with drainage and right transverse colostomy during the 10-year period 1963-72 with five deaths. In comparison, during the last years, ten patients with perforation and diffuse peritonitis were treated with acute resection or exteriorization of the affected segment of the bowel without any mortality. Though the two patient series are not completely comparable, the results imply that removal or exteriorization of the affected bowel is to be preferred in the surgical treatment of most perforated lesions in the sigmoid colon, even if the perforation is associated with diffuse peritonitis.

Adult↗
PubMed1981

Granular cell myoblastoma of the sigmoid colon.

A granular cell myoblastoma of the upper sigmoid colon is reported in a 53-year-old male. The tumor was detected during investigation of abdominal pain and was removed by colonoscopic polypectomy. Colonoscopy provides a new method of treatment for these unusual colonic lesions and avoids the need for surgery. To our knowledge the tumor has not been reported previously in the sigmoid colon.

Colon, Sigmoid↗
PubMed1993

Epithelial cell proliferation in the sigmoid colon of patients with adenomatous polyps increases during oral calcium supplementation.

To study the effect of oral supplemental calcium on colonic epithelial proliferation, 17 adenomatous polyp patients received 1.5 g Ca2+ as calcium carbonate daily during 12 weeks, while on a calcium constant diet, based on the patients' habitual diet. Seven subsequently continued calcium supplementation for 9 months without dietary restrictions. Epithelial proliferation rate in colonic biopsies, expressed as labelling index (%), was determined with 5-bromodeoxyuridine and immunohistochemistry. Biopsies were taken from the midsigmoid at time of polyp excision and at the end of the intervention period. Median labelling index increased from 6.1% before to 8.7% after 12 weeks calcium (n = 17, P < 0.02). This was due to increased labelling in the basal third of the crypts (11.9 vs 16%), whereas labelling in mid and luminal compartments was not affected. Labelling index remained increased after 1 year calcium supplementation at 8.8%. Crypt length was not affected by calcium. These results are in contrast to those of others, who have shown a decrease of rectal epithelial proliferation during similar doses of calcium. Therefore, the effect of nutritional intervention on colonic epithelial proliferation should be studied in biopsies taken not only from the rectum, but also from more proximal parts of the colon. Caution with respect to large scale intervention studies with calcium in high risk groups is mandatory.

Administration, Oral↗