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1.
Tech Coloproctol ; 15 Suppl 1: S75-7, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21901517

RESUMO

INTRODUCTION: Early rectal cancer (ERC) is adenocarcinoma that has invaded into, but not extended beyond, the submucosa. Endoscopic or minimal access surgical procedures, such as laparoscopic resection, have emerged as a useful tool in the surgical treatment of such diseases. The aim of this study is to present and analyze the feasibility, the short- and long-term results of laparoscopic colorectal surgery (LCS) in patients with ERC. PATIENTS AND METHODS: Between 2002 and 4/2011, a total of 164 patients with colorectal cancer underwent laparoscopic surgery (LS). Of these, 7 patients (4.2%) had ERC and underwent laparoscopic anterior resection (LAR). The median follow-up was 41 months. RESULTS: The mean operative time was 2.5 h. None of the laparoscopic procedures was converted to open surgery. Liquids and solid food were started on median postoperative days 1 and 3, respectively. The median length of postoperative stay was 5 days. Postoperative complications occurred in 2 patients (28.5%), including wound infection in one patient (14.2%) and atelectasis in one patient (14.2%). None of the patients required an urgent re-operation. There was no mortality related to LS. CONCLUSIONS: LS for ERC can be used as a strategy sited between endoscopic mucosal resection and open anterior resection with beneficial long- and short-term results. It appears as a technically and oncologically safe procedure when performed by surgeons with sufficient experience in laparoscopic techniques.


Assuntos
Adenocarcinoma/cirurgia , Laparoscopia , Neoplasias Retais/cirurgia , Idoso , Seguimentos , Humanos , Laparoscopia/efeitos adversos , Tempo de Internação , Pessoa de Meia-Idade , Atelectasia Pulmonar/etiologia , Infecção da Ferida Cirúrgica/etiologia , Fatores de Tempo , Resultado do Tratamento
2.
Tech Coloproctol ; 15 Suppl 1: S91-3, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21912949

RESUMO

INTRODUCTION: Patients with breast cancer may present with systemic recurrence in any organ, primarily the bones, lungs, lymph nodes, liver, pleura, and adrenal glands. We report a case of rectal tumor, metastatic from breast cancer, which represents an unusual location of metastasis. CASE PRESENTATION: A 74-year-old woman, operated for lobular breast cancer 5 years ago, but not compliant with the annual follow-up, presented with severe constipation and pseudodiarrhea. Digital examination and anoscopy revealed a mass at the lower rectum, 2 cm distant from the anal verge. CT and MRI scan of the abdomen confirmed this finding and did not reveal metastatic lesions elsewhere. The patient underwent abdominoperineal resection. RESULTS: The postoperative period was uneventful, and the patient was discharged on the 7th postoperative day. The histopathological findings revealed rectal cancer, metastatic from the known invasive lobular breast cancer. CONCLUSIONS: Rectal metastasis from breast cancer is very rare. The presented case emphasizes the need to keep in mind this possibility and at all times associate the emergency condition with the related history of breast cancer.


Assuntos
Neoplasias da Mama/patologia , Carcinoma Lobular/secundário , Neoplasias Retais/secundário , Idoso , Carcinoma Lobular/diagnóstico , Carcinoma Lobular/cirurgia , Feminino , Humanos , Neoplasias Retais/diagnóstico , Neoplasias Retais/cirurgia
3.
Tech Coloproctol ; 8 Suppl 1: s108-11, 2004 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-15655590

RESUMO

BACKGROUND: Large bowel obstruction is occasionally the mode of presentation of advanced colorectal or pelvic malignancies, and a prognostic of poor survival. The choices of treatment range from palliative tube decompression to curative or palliative surgery. METHODS: Twelve out of 500 women with various malignancies and symptomatology of large bowel obstruction were studied. All patients required urgent exploratory laparotomies. RESULTS: The primary site was established intra-operatively to be the colon (2 cases), stomach (2 cases) and ovaries (2 cases). In the remaining 6 cases there was uncertainty about the origin of primary disease. Routine histology and immuno-histochemistry of the specimens revealed the origin of primary malignancy in all cases. CONCLUSIONS: Meticulous histological examination is essential for the establishment of correct diagnosis and selection of the best available treatment in women with pelvic malignancies, presenting with acute bowel obstruction.


Assuntos
Obstrução Intestinal/epidemiologia , Obstrução Intestinal/etiologia , Intestino Grosso/patologia , Cuidados Paliativos/métodos , Neoplasias Pélvicas/complicações , Neoplasias Pélvicas/patologia , Adulto , Distribuição por Idade , Idoso , Terapia Combinada , Feminino , Humanos , Incidência , Obstrução Intestinal/cirurgia , Laparotomia/métodos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Pélvicas/terapia , Prognóstico , Estudos Retrospectivos , Medição de Risco , Análise de Sobrevida
4.
Tech Coloproctol ; 8 Suppl 1: s97-s100, 2004 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-15655657

RESUMO

BACKGROUND: Synchronous and metachronous colorectal carcinoma have an incidence of 2-10%. The purpose of the study was to evaluate the clinical characteristics, the accuracy of diagnostic examinations and the survival of these patients. METHODS: From 1970 to 1999, 1160 patients with colorectal cancer were admitted to our Department. During follow-up examination 50 patients (4.3%) were found to present with multiple primary colon cancers. Fifty-two per cent were synchronous and 48% metachronous tumours. RESULTS: The overall 5-year survival of the patients was 45.87%. Mortality was 10% for multiple primaries, while in patients with single cancer was 4.1%. The overall 5-year survival of the patients with multiple primaries tumours was 46.67%. CONCLUSIONS: Patients with colorectal cancer must be fully studied endoscopically. There has been an improvement in survival in recent years due to better surgical techniques, the introduction of more sophisticated examination methods and the meticulous follow-up of patients at risk.


Assuntos
Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/patologia , Neoplasias Primárias Múltiplas/mortalidade , Neoplasias Primárias Múltiplas/patologia , Adenocarcinoma/cirurgia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha , Neoplasias Colorretais/cirurgia , Feminino , Seguimentos , Grécia/epidemiologia , Humanos , Imuno-Histoquímica , Incidência , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Primárias Múltiplas/cirurgia , Estudos Retrospectivos , Medição de Risco , Distribuição por Sexo , Análise de Sobrevida
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