Complications after sphincter-saving resection in rectal cancer patients according to whether chemoradiotherapy is performed before or after surgery.

PURPOSE: The aim of the present study was to compare the influence of preoperative chemoradiotherapy (CRT) with postoperative CRT on the incidence and types of postoperative complications in rectal cancer patients who underwent sphincter-saving resection. PATIENTS AND METHODS: We reviewed 285 patients who received preoperative CRT and 418 patients who received postoperative CRT between January 2000 and December 2006. RESULTS: There was no between-group difference in age, gender, or cancer stage. In the pre-CRT group, the mean level of anastomosis from the anal verge was lower (3.5 +/- 1.4 cm vs. 4.3 +/- 1.7 cm, p < 0.001) and the rate of T4 lesion and temporary diverting ileostomy was higher than in the post-CRT group. Delayed anastomotic leakage and rectovaginal fistulae developed more frequently in the pre-CRT group than in the post-CRT group (3.9% vs. 1.2%, p = 0.020, 6.5% vs. 1.3%, p = 0.027, respectively). Small bowel obstruction (arising from radiation enteritis) requiring surgical intervention was more frequent in the post-CRT group (0% in the pre-CRT group vs. 1.4% in the post-CRT group, p = 0.042). Multivariate analysis identified preoperative CRT as an independent risk factor for fistulous complications (delayed anastomotic leakage, rectovaginal fistula, rectovesical fistula), and postoperative CRT as a risk factor for obstructive complications (anastomotic stricture, small bowel obstruction). The stoma-free rates were significantly lower in the pre-CRT group than in the post-CRT group (5-year stoma-free rates: 92.8% vs. 97.0%, p = 0.008). CONCLUSION: The overall postoperative complication rates were similar between the pre-CRT and the Post-CRT groups. However, the pattern of postoperative complications seen after sphincter- saving resection differed with reference to the timing of CRT.

Salt stress inhibits germination and early seedling growth in cabbage (Brassica oleracea capitata L.).

Salinity induced inhibition in germination and early stages of cabbage (Brassica oleracea capitata L.) [two varieties (autumn cabbage and spring cabbage)] were measured in response to increasing NaCl concentration. The salinity (NaCl) concentrations in solution were 0 (control), 4.7, 9.4 and 14.1 dS m(-1). Different concentrations of salt stress had considerable effect on germination, germination rate (1/t50, where t50 is the time to 50% of germination), root and shoot lengths, root, shoot and plant fresh weight of cabbage. Final germination in cabbage (autumn cabbage and spring cabbage) showed significant inhibition with increasing salt stress up to 14.1 dS m(-1) NaCl. The required time for germination increased with increasing concentration of salt. The seedling growth was strongly inhibited by all salt levels, particularly at 14.1 dS m(-1). Furthermore Root growth was more affected then shoots growth by salt stress. Fresh weights of root, shoot and plant were also severely affected by different salinity treatments. Linear regression revealed a significant negative relationship between salinity and final germination, germination rate, root and shoot lengths and fresh weights of roots, shoots and plants.