[Quality of life, symptoms of dyschezia, and anatomy after correction of rectal motility disorder]. / Qualité de vie, symptômes de dyschésie et anatomie après correction d'un trouble de la statique rectale par voie basse.

AIM OF THE STUDY: To evaluate the quality of life of patients suffering from dyschezia and its correlation with symptomatic complaints and anatomical abnormalities, before and after elective surgery for rectal static disorder. PATIENTS AND METHODS: A prospective study was conducted using a general quality of life questionnaire (SF36) and a constipation specific score (PAC-QoL), a dyschezia symptom score, and defecography. RESULTS: Thirty-eight female dyschesic patients (mean age 54 years) underwent surgery for rectocele with (n=16) or without (n=14) internal rectal prolapse, an isolated internal rectal prolapse (n=3), or a total rectal prolapse (n=5). Preoperative quality of life was low, correlated with the intensity of dyschezia. Seven months after surgery, quality of life and dyschezia improved independently of the amplitude of the anatomical correction. More items improved in the constipation specific score than on the quality of life questionnaire; they were correlated with the course of dyschezia symptoms. Neither incontinence nor irritable bowel syndrome affected evolution of the symptoms. CONCLUSION: Surgery improved initially low quality of life and symptomatic complaints in patients with dyschezia and a rectal static disorder, independently of anatomic repair. Differences in changes observed in the PAC-QoL and SF36 suggest different fields of application.

[beta2-Microglobulin in cancer patients (author's transl)]. / La beta2-Microglobulineen pathologie cancéreuse.

Cancerembryonic antigen (CEA) and beta2-microglobulin (beta2m) have been measured in cancer patients and patients with benign diseases. Of 168 patients with intestinal cancer, almost 90% had increasing concentrations of either CEA or beta2m or both. In 29 patients at different stages of pancreatic cancer there was a high incidence of increased values in the more severe cases. In 60 patients with histologically classified colorectal cancer the TNomegaMomega group of 19 patients had 47% and 42% of elevated beta2m and CEA respectively. A significant correlation of beta2m or CEA to extension of disease was noted. In benign intestinal disease like cirrhosis and pancreatitis both beta2m and CEA is commonly elevated. Of 26 breast cancer patients, seven had elevated CEA and five had elevated beta2m values before treatment. In the patients with extraganglionary metastasis almost 90% had high beta2m or CEA or both. Of 40 patients with uterine cancer, 26 were found to have increased values of beta2m or CEA or both. Finally, 140 colorectal cancer patients, 62 patients with breast cancer and 10 patients with uterine cancer have been followed longitudinally.