RESUMEN
Angiosarcomas are rare tumors that usually entail a poor prognosis because of extensive invasiveness and high rates of distant metastasis. Gastrointestinal tract involvement is uncommon but may cause digestive bleeding. A definitive diagnosis requires histological and immunohistochemical testing. Metastatic lesions to the gut usually have a typical morphology, which must be identified in order to avoid delay in the diagnosis and potential treatment of this malignant condition.
Asunto(s)
Hemangiosarcoma , Humanos , Hemangiosarcoma/diagnóstico , Hemangiosarcoma/patología , Hemangiosarcoma/terapia , Aorta/patología , BiopsiaRESUMEN
BACKGROUND: Anastomotic dehiscence is a common complication of anterior resection. In this work, we evaluate the management of the pelvic cavity after low rectal resection using vacuum closure (VAC) with a gastroscope, and we establish factors that determine the success of closure and analyzed the rate of ileostomy closure after leakage was resolved. PATIENTS AND METHODS: This is a descriptive case series analysis conducted at a tertiary hospital. Twenty-two patients with low colorectal anastomosis leakage or opening of the rectal stump after anterior resection for rectal cancer were included. They were treated with VAC therapy. RESULTS: The total number of endoscopic sessions was 3.1 ± 1.9 in the anterior resection with anastomosis group and 3.2 ± 1.8 in the Hartmann group. In 11 patients the therapy was administered in an ambulatory setting. The mean time to healing was 22.3 ± 14.7 days. Full resolution was achieved in 19 patients (followed-up 1 year). Ileostomy closure was carried out in 5 patients (38.46%) during follow-up. None of these patients showed leakage signs. Statistically significant differences were obtained depending on the onset of therapy, with better results in patients who underwent earlier vacuum-assisted therapy (before the sixth week after initial surgery), P = .041. CONCLUSIONS: VAC therapy is an alternative to surgery that can be safely administered in an ambulatory setting. Early administration in the 6 weeks following surgery is an independent predictive factor for successful closure; however, colonic transit was only recovered in a small percentage of patients.
Asunto(s)
Fuga Anastomótica/cirugía , Terapia de Presión Negativa para Heridas/métodos , Neoplasias del Recto/cirugía , Anciano , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dehiscencia de la Herida Operatoria/cirugíaAsunto(s)
Azatioprina/uso terapéutico , Inmunodeficiencia Variable Común/complicaciones , Enfermedad de Crohn/tratamiento farmacológico , Inmunosupresores/uso terapéutico , Corticoesteroides/uso terapéutico , Azatioprina/efectos adversos , Infecciones por Campylobacter/complicaciones , Enfermedad de Crohn/complicaciones , Gastritis/complicaciones , Gastritis/tratamiento farmacológico , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/tratamiento farmacológico , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Inmunosupresores/efectos adversos , Masculino , Persona de Mediana EdadAsunto(s)
Bacteriemia/etiología , Colitis Ulcerosa/tratamiento farmacológico , Enfermedad de Crohn/tratamiento farmacológico , Inmunosupresores/efectos adversos , Listeriosis/etiología , Bacteriemia/microbiología , Colitis Ulcerosa/complicaciones , Colitis Ulcerosa/inmunología , Enfermedad de Crohn/complicaciones , Enfermedad de Crohn/inmunología , Susceptibilidad a Enfermedades , Humanos , Huésped Inmunocomprometido , Inmunosupresores/uso terapéutico , Mucosa Intestinal/microbiología , Mucosa Intestinal/patología , Masculino , Meningitis por Listeria/etiología , Adulto JovenRESUMEN
No disponible
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Listeriosis/diagnóstico , Listeria monocytogenes/patogenicidad , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Síndrome del Colon Irritable/tratamiento farmacológico , Susceptibilidad a Enfermedades/inducido químicamente , Inmunosupresores/efectos adversosAsunto(s)
Colitis Ulcerosa/complicaciones , Infecciones por Citomegalovirus/etiología , Citomegalovirus/patogenicidad , Complicaciones Posoperatorias , Reservoritis/etiología , Adulto , Colitis Ulcerosa/terapia , Colitis Ulcerosa/virología , Infecciones por Citomegalovirus/diagnóstico , Humanos , Masculino , Proctocolectomía Restauradora , PronósticoAsunto(s)
Inhibidores de la Angiogénesis/uso terapéutico , Hemorragia Gastrointestinal/tratamiento farmacológico , Radioterapia/efectos adversos , Enfermedades del Recto/tratamiento farmacológico , Talidomida/uso terapéutico , Coagulación con Plasma de Argón/métodos , Enfermedad Crónica , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/terapia , Humanos , Proctitis/tratamiento farmacológico , Proctitis/etiología , Proctoscopía , Enfermedades del Recto/etiología , Enfermedades del Recto/terapiaRESUMEN
No disponible
Asunto(s)
Humanos , Talidomida/uso terapéutico , Hemorragia Gastrointestinal/cirugía , Proctitis/cirugía , Argón , Endoscopía Gastrointestinal/métodos , Traumatismos por Radiación/cirugía , Radioterapia/efectos adversosRESUMEN
No disponible