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1.
G Chir ; 20(10): 429-32, 1999 Oct.
Artículo en Italiano | MEDLINE | ID: mdl-10555413

RESUMEN

An analysis of prospectively collected data of 56 patients submitted to bilateral hernia repair is reported. Simultaneous repair was performed in 32 patients (Group S) while a sequential repair in 24 (Group D). Mean operating time was longer for the combination of two sequential repairs than for simultaneous repair (132 min +/- 8.9 vs 123 min +/- 11, p < 0.001). Mean hospital stay was similar in unilateral and bilateral repairs (18.0 hrs +/- 4 vs 21.2 hrs +/- 3.4, p = ns). Ther were no difference in complications between the two groups. Time taken to return to full activity was nearly double in the combination of two sequential repairs than in simultaneous repair (25 days, sd +/- 4 vs 16 days +/- 3, p < 0.001), while postoperative analgesia requirements were similar. The Authors conclude that bilateral simultaneous anterior tension free repair under local anesthesia is the treatment of choice in case of bilateral inguinal hernias.


Asunto(s)
Hernia Inguinal/cirugía , Factores de Edad , Anestesia Local , Femenino , Humanos , Masculino , Métodos , Persona de Mediana Edad , Resultado del Tratamiento
2.
Dis Colon Rectum ; 42(11): 1464-6, 1999 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-10566535

RESUMEN

PURPOSE: The aim of this study was to analyze the outcome of patients with inguinal metastases from rectal cancer. METHODS: Clinical records and data concerning the follow-up of patients referred to our institution for rectal cancer were reviewed retrospectively. Patients were divided into four groups based on the time interval between first admission and appearance of inguinal metastases. All patients were followed up until death. Age, gender, tumor stage, and disease-free intervals were examined to assess their impact on prognosis. RESULTS: Patients with rectal adenocarcinoma (N = 863) were observed from 1965 to 1990. In 21 patients the biopsy-proven diagnosis was of adenocarcinoma metastasizing to the inguinal nodes. Of these 21 patients, 15 were males. The mean age was 69.3 (range, 52-84) years. Primary lesions were exclusively T3, and no patient was found to have negative mesorectal lymph nodes. Survival from the time of diagnosis of inguinal metastases ranged from 2 to 42 (mean, 14.8) months. Patients with a disease-free interval of 12 months or more had a statistically significant longer survival time. CONCLUSIONS: Inguinal lymph-node metastases from rectal carcinoma occur as a consequence of locally advanced primary tumors or recurrent pelvic malignancy. Because of the frequency of distant metastases and the consequent poor prognosis, only systemic chemotherapy and radiotherapy should be considered. In patients who seem to be free of local recurrence and distant metastases, groin dissection is suggested for debulking and control of disease.


Asunto(s)
Neoplasias Abdominales/secundario , Adenocarcinoma/secundario , Fluorouracilo/uso terapéutico , Conducto Inguinal , Ganglios Linfáticos/patología , Neoplasias del Recto/patología , Neoplasias Abdominales/mortalidad , Neoplasias Abdominales/terapia , Adenocarcinoma/mortalidad , Adenocarcinoma/terapia , Anciano , Anciano de 80 o más Años , Biopsia , Femenino , Estudios de Seguimiento , Humanos , Escisión del Ganglio Linfático , Metástasis Linfática , Masculino , Persona de Mediana Edad , Pronóstico , Radioterapia Adyuvante , Neoplasias del Recto/mortalidad , Neoplasias del Recto/terapia , Estudios Retrospectivos , Tasa de Supervivencia
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