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World J Gastroenterol ; 17(28): 3342-6, 2011 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-21876623


AIM: To clarify the usefulness of the self-expanding metallic stents (SEMS) in the management of acute proximal colon obstruction due to colon carcinoma before curative surgery. METHODS: Eighty-one colon (proximal to spleen flex) carcinoma patients (47 males and 34 females, aged 18-94 years, mean = 66.2 years) treated between September 2004 and June 2010 for acute colon obstruction were enrolled to this study, and their clinical and radiological features were reviewed. After a cleaning enema was administered, urgent colonoscopy was performed. Subsequently, endoscopic decompression using SEMS placement was attempted. RESULTS: Endoscopic decompression using SEMS placement was technically successful in 78 (96.3%) of 81 patients. Three patients' symptoms could not be relieved after SEMS placement and emergent operation was performed 1 d later. The site of obstruction was transverse colon in 18 patients, the hepatic flex in 42, and the ascending colon in 21. Following adequate cleansing of the colon, patients' abdominal girth was decreased from 88 ± 3 cm before drainage to 72 ± 6 cm 7 d later, and one-stage surgery after 8 ± 1 d (range, 7-10 d) was performed. No anastomotic leakage or postoperative stenosis occurred after operation. CONCLUSION: SEMS placement is effective and safe in the management of acute proximal colon obstruction due to colon carcinoma, and is considered as a bridged method before curative surgery.

Colo/patologia , Colo/cirurgia , Drenagem/métodos , Obstrução Intestinal/cirurgia , Stents , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Colo/complicações , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Colonoscopia , Feminino , Humanos , Obstrução Intestinal/etiologia , Obstrução Intestinal/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
Zhonghua Wei Chang Wai Ke Za Zhi ; 11(5): 421-3, 2008 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-18803040


OBJECTIVE: To evaluate the long-term efficacy of endoscopic excision for rectal carcinoids. METHODS: Clinical data of 91 patients with rectal carcinoids treated by endoscopic excision from 2000 to 2007 were analyzed retrospectively. RESULTS: The average size of the primary tumor was 0.8 cm(range 0.3 to 2.3 cm). All the tumors were localized within the submucosal layer showing typical histology without lymphatic or vessel infiltration. Follow-up was available for 80 patients with mean 32.5 months (range 6 to 96 months). There was no recurrence in 65 patients with tumor size < 1.0 cm. Recurrence occurred in 3 cases among 25 patients with tumor size from 1.0 to 2.0 cm, and 1 died of hepatic metastasis. The 1-, 3-, and 5-year survival rates of the patients were 100%, 98.0%, and 91.4% respectively. CONCLUSIONS: Tumor size and depth of invasion are two important prognostic factors of rectal carcinoids. Endoscopic excision is useful for rectal carcinoid patients with tumor size < 1.0 cm and located within the submucosal layer.

Tumor Carcinoide/cirurgia , Endoscopia , Neoplasias Retais/cirurgia , Adulto , Idoso , Tumor Carcinoide/patologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Retais/patologia , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem