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1.
Chirurgia (Bucur) ; 115(5): 595-599, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33138896

RESUMO

Introduction: Recent evidence suggests the need to proceed with a surveillance colonoscopy in patients above the age of 40 years who undergo appendicectomy for acute appendicitis, given the higher risk of an underlying colonic tumor. After anecdotally observing a substantial variability in terms of adaptation of these recommendations by the on-call surgical teams, we performed a clinical audit regarding our relevant endoscopic follow-up compliance rates to identify areas for improvement of our practise. Materials Methods: We performed a retrospective review of the electronic records of all patients above 40 years who had appendicectomy for acute appendicitis within a 3-year period in our institution, assessing as primary outcome the actual performance of a follow-up colonoscopy and the detected endoscopic findings. Results: Our results demonstrated that more than 80% of our patients did not have an endoscopic follow-up, as suggested by the current evidence. In addition, with respect to the subspecialisation of the parent surgical team, it seems that non-colorectal teams had lower compliance regarding the arrangement of endoscopic surveillance, when compared to specialist colorectal team. Conclusions: Emergency surgical teams need to be further educated with respect to the current practise recommendations concerning the appropriate endoscopic follow-up after the performance of appendicectomy for acute appendicitis. Establishment of dedicated bundles of postoperative care, as well as clear relevant guidance from the gastrointestinal/emergency surgery societies would be of great value in this direction.


Assuntos
Apendicectomia , Apendicite , Neoplasias do Colo/diagnóstico , Colonoscopia , Vigilância da População , Doença Aguda , Fatores Etários , Apendicite/complicações , Apendicite/cirurgia , Neoplasias do Colo/complicações , Detecção Precoce de Câncer , Humanos , Auditoria Médica , Estudos Retrospectivos
2.
Pan Afr Med J ; 36: 200, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32952844

RESUMO

Colo-rectal intussusception is rare in adults and is often secondary to malignant lesions, rarely benign lesions such as colonic lipomas can also be the cause. We present the case a 60-year-old man who presented to the emergency department with acute abdominal pain. On physical examination, the abdomen was distended with diffuse tenderness. CT scan of the abdomen revealed a colo-rectal intussusception secondary to a rectal lipoma with parietal pneumatosis of the invaginated loop. An emergency laparotomy was performed. Intraoperatively the radiological findings were confirmed. A rectosigmoid resection (Hartmann's procedure) taking off the lipoma and the invaginated segment of the colon was performed and the patient had an unevent full recovery. Histopathology confirmed a 6cm sub-mucosal lipoma without evidence of malignancy. As the diagnosis of a benign disease in patients presenting with colonic intussusception can only be made on pathological examination, this entity should be managed as a malignant lesion due to the high incidence of malignancy.


Assuntos
Neoplasias do Colo/diagnóstico , Intussuscepção/etiologia , Lipoma/diagnóstico , Neoplasias Retais/diagnóstico , Neoplasias do Colo/complicações , Humanos , Intussuscepção/diagnóstico , Intussuscepção/cirurgia , Laparotomia , Lipoma/complicações , Masculino , Pessoa de Meia-Idade , Neoplasias Retais/complicações , Tomografia Computadorizada por Raios X
3.
Life Sci ; 260: 118392, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32898523

RESUMO

AIMS: We aimed to investigate the impact of cancer cachexia and previous aerobic exercise training (AET) on cardiac function and structure in tumor bearing mice. MAIN METHODS: Colon adenocarcinoma cells 26 (CT26) were subcutaneously injected in BALB/c mice to establish robust cancer cachexia model. AET was performed on a treadmill during 45 days, 60 min/5 days per week. Cardiac function was evaluated by echocardiography and cardiac morphology was assessed by light microscopy. The protein expression levels of mitochondrial complex were analyzed by Western blotting. The mRNA levels of genes related to cardiac remodeling and autophagy were analyzed by quantitative Real-Time PCR. KEY FINDINGS: Our data confirms CT26 tumor bearing mice as a well-characterized and robust model of cancer cachexia. CT26 mice exhibited cardiac remodeling and dysfunction characterized by cardiac atrophy and impaired left ventricle ejection fraction paralleled by cardiac necrosis, inflammation and fibrosis. AET partially reversed the left ventricle ejection fraction and led to significant anti-cardiac remodeling effect associated reduced necrosis, inflammation and cardiac collagen deposition in CT26 mice. Reduced TGF-ß1 mRNA levels, increased mitochondrial complex IV protein levels and partial recovery of BNIP3 mRNA levels in cardiac tissue were associated with the cardiac effects of AET in CT26 mice. Thus, we suggest AET as a powerful regulator of key pathways involved in cardiac tissue homeostasis in cancer cachexia. SIGNIFICANCE: Our study provides a robust model of cancer cachexia, as well as highlights the potential and integrative effects of AET as a preventive strategy for reducing cardiac damage in cancer cachexia.


Assuntos
Caquexia/etiologia , Neoplasias do Colo/complicações , Cardiopatias/terapia , Condicionamento Físico Animal , Remodelação Ventricular , Animais , Caquexia/patologia , Neoplasias do Colo/patologia , Cardiopatias/etiologia , Cardiopatias/patologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Células Tumorais Cultivadas , Ensaios Antitumorais Modelo de Xenoenxerto
4.
Medicine (Baltimore) ; 99(34): e21764, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846803

RESUMO

RATIONALE: Triple or more primary malignancies are rare, with only 23 previous cases including breast cancer reported in the English language studies between January 1990 and December 2019. PATIENT CONCERNS: The patient was a 67-year-old woman with a mass in her right breast. She had a previous history of uterine and colon cancer. Both ultrasonography and mammography revealed a Breast Imaging Reporting and Data System (BI-RADS) category 3 breast lesion, in which proliferative nodules are more likely. Given her previous history of 2 malignancies, her doctors strongly recommended a biopsy. DIAGNOSIS AND INTERVENTIONS: The biopsy pathology suggested intraductal breast cancer. Mastectomy and sentinel lymph node biopsy were performed. The postoperative pathological diagnosis was invasive ductal carcinoma, grade II, stage I. The sample was positive for estrogen receptor and progesterone receptor and negative for cerbB-2. No radiotherapy or chemotherapy was administered except for endocrine therapy. A follow-up at 19 months showed no breast recurrence or distant metastases. OUTCOMES: No recurrence or distant metastasis occurred within the 19-month, 11-year, and 20-year follow-ups for breast, colon, and uterine cancers, respectively. LESSONS: To our knowledge, this is the first review of triple or more primary malignancies including breast cancer. These malignancies occur predominantly in older female patients. The most prevalent tumors of triple or more primary malignancies including breast cancer occur in the colon, uterus, and lung. A favorable prognosis is associated with early-stage malignancies.


Assuntos
Neoplasias da Mama/complicações , Neoplasias do Colo/complicações , Neoplasias Uterinas/complicações , Idoso , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Feminino , Humanos , Mamografia , Mastectomia , Biópsia de Linfonodo Sentinela
6.
Am J Emerg Med ; 38(8): 1697.e1-1697.e3, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32546319

RESUMO

Adult intussusception is an uncommon cause of abdominal pain and poses diagnostic challenges for emergency physicians due to its varied presenting symptoms and time course. We report a case of chronic colocolic intussusception secondary to a lead point submucosal lipoma. Dedifferentiating intussusception with or without a lead point is important in determining appropriate management.


Assuntos
Doenças do Colo/etiologia , Neoplasias do Colo/complicações , Intussuscepção/etiologia , Lipoma/complicações , Dor Abdominal/etiologia , Adulto , Doenças do Colo/diagnóstico , Doenças do Colo/diagnóstico por imagem , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/diagnóstico por imagem , Humanos , Intussuscepção/diagnóstico , Intussuscepção/diagnóstico por imagem , Lipoma/diagnóstico , Lipoma/diagnóstico por imagem , Masculino , Tomografia Computadorizada por Raios X
7.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 49(2): 245-248, 2020 May 25.
Artigo em Chinês | MEDLINE | ID: covidwho-233630

RESUMO

OBJECTIVE: To explore the feasibility of radical resection for cancer patients complicated with coronavirus disease 2019 (COVID-19). METHODS: The management and clinical outcome of a sigmoid cancer patient with COVID-19 were analyzed. RESULTS: The inflammation indicators and fever of this patient were effectively controlled and the lung lesions remained stable after active anti-viral treatment, then the radical colorectomy was performed after the viral negative conversion for twice. CONCLUSIONS: The case indicates that radical resection can be performed in SARS-CoV-2 patients with twice-negative SARS-CoV-2 nucleic acid testing results.


Assuntos
Neoplasias do Colo , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Betacoronavirus/isolamento & purificação , Neoplasias do Colo/complicações , Neoplasias do Colo/cirurgia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Gerenciamento Clínico , Humanos , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Resultado do Tratamento
8.
Gan To Kagaku Ryoho ; 47(2): 301-303, 2020 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-32381969

RESUMO

A 67-year-old woman presented with bloody stools to a local physician. Lower gastrointestinal endoscopy revealed a type 3 all-circumferential tumor at descending colon. She was diagnosed with descending colon cancer and referred to our hospital for surgery. Preoperative computed tomography(CT)revealed a horseshoe kidney. We performed single-incision laparoscopic colectomy for descending colon cancer(cT3cN0cM0, cStageⅡa)complicated by a horseshoe kidney. The surgery was performed safely without any additional injuries. In patients with horseshoe kidneys, abnormalities have been reported in the running of the blood vascular system and the renal pelvis and ureter systems. Thus, sufficient understanding of the anatomic abnormality by preoperative examinations, such as 3D-CT, is essential for performing surgery safely.


Assuntos
Neoplasias do Colo/cirurgia , Rim Fundido , Laparoscopia , Idoso , Colectomia , Colo Descendente , Neoplasias do Colo/complicações , Feminino , Rim Fundido/complicações , Humanos , Pelve Renal
9.
Anticancer Res ; 40(5): 2969-2974, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32366450

RESUMO

BACKGROUND: Although oncological results for resection of colon cancer with inferior mesenteric artery (IMA) ligation at its origin (high tie) or immediately below the left colic artery (low tie) are similar, injury of the superior hypogastric plexus may be caused when the IMA is tied at its origin, thus impairing defecatory functions. AIM: The importance of IMA tie location on defecatory dysfunction in patients undergoing laparoscopic sigmoidal resection without preoperative radiation therapy was studied. PATIENTS AND METHODS: From February 2013 to December 2018, 56 consecutive patients submitted to curative laparoscopic resection for stage II and III, M0, sigmoidal cancer were randomized to a high or low tie of the IMA. All demographic data and information on symptoms and comorbidity, intra- and post-operative outcomes and defecatory function before and after surgery [according to the following scales: Fecal Incontinence Quality of Life (FIQL) scale, Jorge-Wexner incontinence and Agachan-Wexner constipation scores] were collected into a computerized database. RESULTS: All patients completed the questionnaires. The educational and social status, and lifestyle habits (defined as active or sedentary) of our groups were similar. A significant difference in total score of FIQL scale was observed between the high and low tie groups at 1 month [88±6 and 93±7, p=0.005, confidence interval for the difference between mean values (CIΔ)=1.706-9.065] and 6 months (93±7 and 97±6, p=0.030, CIΔ=0.390-7.547). The Jorge-Wexner incontinence scores showed a significant decrease in patients of the high group (1 month: 0.59±0.76 and 6 months: 0.62±0.79, respectively) when compared to those of the low tie group (1 month 0.17±0.38 and 6 months 0.17±0.38, respectively) (p=0.008 and p=0.006 at 1 and 6 months, respectively). At 1, 6 and 12 months, the overall Agachan-Wexner constipation scores were significantly higher in patients of the high tie group when compared to those of the low tie group (1 month: 5.1±1.1 and 4.3±0.86, p=0.002, CIΔ=-1.350--0.316; 6 months: 7.4±1.4 and 6.2±1.4, p=0.003, CIΔ=-1.959--0.436; and 12 months: 7.2±1.3 and 6±1.1, p=0.001, CIΔ=-1.840--0.576, respectively). CONCLUSION: Patients affected with stage II and III sigmoidal cancer had a better fecal continence at the short- to medium-term and less abdominal pain in the medium- to long-term when a low tie technique was utilized.


Assuntos
Neoplasias do Colo/complicações , Neoplasias do Colo/cirurgia , Artéria Mesentérica Inferior/cirurgia , Idoso , Feminino , Humanos , Masculino , Artéria Mesentérica Inferior/patologia , Estudos Prospectivos
10.
J Stroke Cerebrovasc Dis ; 29(8): 104872, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32434727

RESUMO

BACKGROUND: Acute, recurrent subdural hematoma (SDH) is a rare entity in the absence of trauma. Atraumatic SDH may be due to vascular disorders, coagulopathies, or intracranial hypotension. It is a rare complication of disseminated intravascular coagulation (DIC), with no prior reports in patients with intracranial metastatic colon cancer (MCC). Rapid resolution of the initial acute SDH with contralateral recurrence has not yet been reported in the literature. We present a case of rapidly resolving and recurrent, contralateral acute SDH from DIC secondary to MCC. CASE DESCRIPTION: A 77-year-old woman with MCC presented with severe, acute onset headache. She progressed to unresponsiveness, dilated right pupil, and Glasgow Coma Scale (GCS) score of 4T. Initial computed tomography (CT) of the head demonstrated a right, 17-mm SDH with a right-to-left midline shift. Repeat CT head 8 hours later revealed resolution of the right SDH. She was extubated with notable clinical improvement. Laboratory examination showed international normalized ratio of 3.4, leukocytosis, and thrombocytopenia. The next morning, she became lethargic, GCS score of 3, with bilateral fixed pupils and dilated to 5-mm, and she was then reintubated. Repeat CT head demonstrated a new left SDH with bilateral uncal herniation. A small hyperdense focus in the left parietal region was suspicious for intraparenchymal hematoma versus a hemorrhagic metastatic focus. Shortly after, she was extubated due to do not resuscitate status, and she then passed away. CONCLUSIONS: To our knowledge, this is the first case illustrating rapidly resolving and recurrent, contralateral acute SDH from DIC in a patient with MCC. Clinical recognition of this phenotypic pattern should raise the question of an underlying coagulopathy.


Assuntos
Neoplasias Encefálicas/complicações , Neoplasias do Colo/complicações , Coagulação Intravascular Disseminada/etiologia , Hematoma Subdural Agudo/etiologia , Idoso , Neoplasias Encefálicas/secundário , Neoplasias do Colo/patologia , Progressão da Doença , Coagulação Intravascular Disseminada/diagnóstico , Evolução Fatal , Feminino , Hematoma Subdural Agudo/diagnóstico por imagem , Humanos , Recidiva , Fatores de Tempo
11.
Cochrane Database Syst Rev ; 5: CD012864, 2020 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-32361988

RESUMO

BACKGROUND: Colorectal cancer is the third most commonly diagnosed cancer worldwide. A diagnosis of colorectal cancer and subsequent treatment can adversely affect an individuals physical and mental health. Benefits of physical activity interventions in alleviating treatment side effects have been demonstrated in other cancer populations. Given that regular physical activity can decrease the risk of colorectal cancer, and cardiovascular fitness is a strong predictor of all-cause and cancer mortality risk, physical activity interventions may have a role to play in the colorectal cancer control continuum. Evidence of the efficacy of physical activity interventions in this population remains unclear. OBJECTIVES: To assess the effectiveness and safety of physical activity interventions on the disease-related physical and mental health of individuals diagnosed with non-advanced colorectal cancer, staged as T1-4 N0-2 M0, treated surgically or with neoadjuvant or adjuvant therapy (i.e. chemotherapy, radiotherapy or chemoradiotherapy), or both. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 6), along with OVID MEDLINE, six other databases and four trial registries with no language or date restrictions. We screened reference lists of relevant publications and handsearched meeting abstracts and conference proceedings of relevant organisations for additional relevant studies. All searches were completed between 6 June and 14 June 2019. SELECTION CRITERIA: We included randomised control trials (RCTs) and cluster-RCTs comparing physical activity interventions, to usual care or no physical activity intervention in adults with non-advanced colorectal cancer. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, performed the data extraction, assessed the risk of bias and rated the quality of the studies using GRADE criteria. We pooled data for meta-analyses by length of follow-up, reported as mean differences (MDs) or standardised mean differences (SMDs) using random-effects wherever possible, or the fixed-effect model, where appropriate. If a meta-analysis was not possible, we synthesised studies narratively. MAIN RESULTS: We identified 16 RCTs, involving 992 participants; 524 were allocated to a physical activity intervention group and 468 to a usual care control group. The mean age of participants ranged between 51 and 69 years. Ten studies included participants who had finished active treatment, two studies included participants who were receiving active treatment, two studies included both those receiving and finished active treatment. It was unclear whether participants were receiving or finished treatment in two studies. Type, setting and duration of physical activity intervention varied between trials. Three studies opted for supervised interventions, five for home-based self-directed interventions and seven studies opted for a combination of supervised and self-directed programmes. One study did not report the intervention setting. The most common intervention duration was 12 weeks (7 studies). Type of physical activity included walking, cycling, resistance exercise, yoga and core stabilisation exercise. Most of the uncertainty in judging study bias came from a lack of clarity around allocation concealment and blinding of outcome assessors. Blinding of participants and personnel was not possible. The quality of the evidence ranged from very low to moderate overall. We did not pool physical function results at immediate-term follow-up due to considerable variation in results and inconsistency of direction of effect. We are uncertain whether physical activity interventions improve physical function compared with usual care. We found no evidence of effect of physical activity interventions compared to usual care on disease-related mental health (anxiety: SMD -0.11, 95% confidence interval (CI) -0.40 to 0.18; 4 studies, 198 participants; I2 = 0%; and depression: SMD -0.21, 95% CI -0.50 to 0.08; 4 studies, 198 participants; I2 = 0%; moderate-quality evidence) at short- or medium-term follow-up. Seven studies reported on adverse events. We did not pool adverse events due to inconsistency in reporting and measurement. We found no evidence of serious adverse events in the intervention or usual care groups. Minor adverse events, such as neck, back and muscle pain were most commonly reported. No studies reported on overall survival or recurrence-free survival and no studies assessed outcomes at long-term follow-up We found evidence of positive effects of physical activity interventions on the aerobic fitness component of physical fitness (SMD 0.82, 95% CI 0.34 to 1.29; 7 studies, 295; I2 = 68%; low-quality evidence), cancer-related fatigue (MD 2.16, 95% CI 0.18 to 4.15; 6 studies, 230 participants; I2 = 18%; low-quality evidence) and health-related quality of life (SMD 0.36, 95% CI 0.10 to 0.62; 6 studies, 230 participants; I2 = 0%; moderate-quality evidence) at immediate-term follow-up. These positive effects were also observed at short-term follow-up but not medium-term follow-up. Only three studies reported medium-term follow-up for cancer-related fatigue and health-related quality of life. AUTHORS' CONCLUSIONS: The findings of this review should be interpreted with caution due to the low number of studies included and the quality of the evidence. We are uncertain whether physical activity interventions improve physical function. Physical activity interventions may have no effect on disease-related mental health. Physical activity interventions may be beneficial for aerobic fitness, cancer-related fatigue and health-related quality of life up to six months follow-up. Where reported, adverse events were generally minor. Adequately powered RCTs of high methodological quality with longer-term follow-up are required to assess the effect of physical activity interventions on the disease-related physical and mental health and on survival of people with non-advanced colorectal cancer. Adverse events should be adequately reported.


Assuntos
Neoplasias Colorretais/complicações , Exercício Físico , Saúde Mental , Aptidão Física , Idoso , Ansiedade/etiologia , Neoplasias do Colo/complicações , Neoplasias do Colo/psicologia , Neoplasias do Colo/terapia , Neoplasias Colorretais/psicologia , Neoplasias Colorretais/terapia , Depressão/etiologia , Depressão/terapia , Fadiga/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo
12.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 49(2): 245-248, 2020 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-32391672

RESUMO

OBJECTIVE: To explore the feasibility of radical resection for cancer patients complicated with coronavirus disease 2019 (COVID-19). METHODS: The management and clinical outcome of a sigmoid cancer patient with COVID-19 were analyzed. RESULTS: The inflammation indicators and fever of this patient were effectively controlled and the lung lesions remained stable after active anti-viral treatment, then the radical colorectomy was performed after the viral negative conversion for twice. CONCLUSIONS: The case indicates that radical resection can be performed in SARS-CoV-2 patients with twice-negative SARS-CoV-2 nucleic acid testing results.


Assuntos
Neoplasias do Colo , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Betacoronavirus/isolamento & purificação , Neoplasias do Colo/complicações , Neoplasias do Colo/cirurgia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Gerenciamento Clínico , Humanos , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Resultado do Tratamento
13.
Gan To Kagaku Ryoho ; 47(4): 643-645, 2020 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-32389970

RESUMO

Abdominal computed tomography(CT)revealed ileus due to sigmoid colon cancer in a 68-year-old man with abdominal pain, and endoscopic decompression using a transanal ileus tube was attempted. The blood test on the following day showed a marked increase in CRP 46.13mg/dL. Abdominal contrast CT was performed, and mesenteric ischemia was confirmed. Emergency surgery was performed on the same day. The ileum, and ascending, transverse, and descending colon appeared mottled and necrotic and were excised. A specialized diet started on the 5th postoperative day, and parenteral nutrition was used for a long period of time, due to the possibility of short bowel syndrome. The ileostomy and colostomy was closed 57 days after the operation. The patient finished parenteral nutrition on the 88th postoperative day without obvious nutritional absorption disorder and was discharged on the 94th postoperative day as oral intake only. We reported a case of ileus due to colon cancer with non-occlusive mesenteric ischemia(NOMI).


Assuntos
Neoplasias do Colo , Íleus , Isquemia Mesentérica , Idoso , Neoplasias do Colo/complicações , Descompressão Cirúrgica , Humanos , Íleus/etiologia , Vértebras Lombares , Masculino , Isquemia Mesentérica/complicações
14.
Gan To Kagaku Ryoho ; 47(4): 649-651, 2020 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-32389972

RESUMO

In September 2015, a 90-year-old woman presented with abdominal pain and emesis as the chief complaints. Except for WBC counts of 10,420/mL, CRP levels of 5.69mg/dL, and ALP levels of 359 IU/L, no other abnormal values were noted, and CEA and CA19-9 tumor marker levels were normal at 3.9 ng/mL and 5.7 U/mL, respectively. Abdominal CT showed intussusception of the right colon and a solid tumor at the presenting portion. Surgery for suspected intussusception caused by colon cancer was performed. Surgical findings revealed a protruding lesion at the ascending colon that extended to the transverse colon, and the intussusception was intrusive up to the ascending colon at the end of the intestinal ileum. Thus, resection of the right half colon and dissection of lymph nodes were performed. Resected specimens revealed a type 1 tumor measuring 65×50×30mm in diameter at the ascending colon. Histopathologic findings revealed tub1>tub2, SS, ly0, v0, PM0, DM0, N0 (0/27)Stage Ⅱa tumor. The postoperative course was favorable, and the patient was discharged on postoperative day 12. We report about a rare case of intussusception caused by ascending colon cancer.


Assuntos
Colo Transverso , Neoplasias do Colo , Intussuscepção , Idoso de 80 Anos ou mais , Colo Ascendente , Neoplasias do Colo/complicações , Feminino , Humanos , Íleo , Intussuscepção/etiologia
16.
Clin Nucl Med ; 45(6): 459-460, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32332308

RESUMO

Endogenous Clostridium septicum endophthalmitis is a rare and fulminant ocular infection, usually encountered in immunocompromised or diabetic patients. It is also highly associated with both gastrointestinal and hematologic malignancies. We describe herein the detection of an adenocarcinoma of the cecum on PET/CT with F-FDG in a patient with an active endogenous C. septicum endophthalmitis of the right eye. FDG PET/CT should be considered for all patients with endogenous endophthalmitis to exclude an occult malignancy, especially colorectal cancer.


Assuntos
Adenocarcinoma/complicações , Infecções por Clostridium/diagnóstico por imagem , Clostridium septicum/fisiologia , Neoplasias do Colo/complicações , Endoftalmite/complicações , Fluordesoxiglucose F18 , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Idoso , Infecções por Clostridium/complicações , Feminino , Humanos , Masculino
18.
Biomed Res Int ; 2020: 2948282, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32280686

RESUMO

Growing evidence indicated that the gut microbiota was the intrinsic and essential component of the cancer microenvironment, which played vital roles in the development and progression of colorectal cancer (CRC). In our present study, we investigated the alterations of fecal abundant microbiota with real-time quantitative PCR and the changes of indicators of gut mucosal barrier from 53 early-stage CRC patients and 45 matched healthy controls. We found that the traditional beneficial bacteria such as Lactobacillus and Bifidobacterium decreased significantly and the carcinogenic bacteria such as Enterobacteriaceae and Fusobacterium nucleatum were significantly increased in CRC patients. We also found gut mucosal barrier dysfunction in CRC patients with increased levels of endotoxin (LPS), D-lactate, and diamine oxidase (DAO). With Pearson's correlation analysis, D-lactate, LPS, and DAO were correlated negatively with Lactobacillus and Bifidobacterium and positively with Enterobacteriaceae and F. nucleatum. Our present study found dysbiosis of the fecal microbiota and dysfunction of the gut mucosal barrier in patients with early-stage CRC, which implicated that fecal abundant bacteria and gut mucosal barrier indicators could be used as targets to monitor the development and progression of CRC in a noninvasive and dynamic manner.


Assuntos
Neoplasias do Colo/complicações , Neoplasias Colorretais/complicações , Fezes/microbiologia , Microbioma Gastrointestinal/fisiologia , Idoso , Bactérias/classificação , Bactérias/genética , Carcinogênese , Disbiose/microbiologia , Feminino , Microbioma Gastrointestinal/genética , Humanos , Mucosa Intestinal/metabolismo , Mucosa Intestinal/microbiologia , Masculino , Pessoa de Meia-Idade , Microambiente Tumoral
19.
Psychooncology ; 29(7): 1095-1104, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32281129

RESUMO

OBJECTIVE: Despite the impact that diagnosis and treatment can have on patients' sexual health, very little research has been conducted on the impact of colon cancer on sexual health. The aim of this systematic review was to assess the prevalence of sexual dysfunctions in colon cancer and describe the sociodemographic, clinical, and psychological correlates of sexual dysfunction. METHODS: Four electronic databases (PsycINFO, PubMed, AcademicSearchPremier, Cochrane Library) were searched for studies reporting sexual adjustment outcomes for colorectal cancer patients from January 1990 to July 2019. RESULTS: Of the 380 articles screened, 14 were included in this review. Sexual function is affected by colon cancer: patients' sexual satisfaction decreases significantly, as does the frequency of sexual intercourse. There is an increase in sexual problems (desire, excitement, or pleasure disorders). Male gender, advanced age, distress, and the comorbidities increase sexual disorders. In addition, it appears that partner distress negatively affects patients' sexual health. Taking such difficulties into account appears key for these patients and their partners. They could benefit from better care throughout treatment and in remission. CONCLUSION: The results of this systematic review highlight the importance of taking an interest in the sexual health of patients with colon cancer.


Assuntos
Neoplasias do Colo/complicações , Satisfação Pessoal , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Psicogênicas/psicologia , Saúde Sexual/estatística & dados numéricos , Adulto , Neoplasias do Colo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Orgasmo/fisiologia , Parceiros Sexuais/psicologia
20.
Dis Colon Rectum ; 63(5): 685-692, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32168093

RESUMO

BACKGROUND: Intracorporeal anastomosis is associated with several short-term benefits. However, it is a technically challenging procedure with potential risk OBJECTIVE:: The purpose of this study was to investigate differences in short-term complications and long-term incisional hernia rates after robotic right colectomy with intracorporeal versus extracorporeal anastomoses and standardized extraction sites. DESIGN: This was a historical cohort study. SETTINGS: The study was conducted at a single institution. PATIENTS: All of the patients undergoing robotic right colectomy with intracorporeal anastomosis and a Pfannenstiel extraction site or extracorporeal anastomosis with a vertical midline extraction site from 2013 to 2017 were eligible. Exclusion criteria were conversion to laparotomy for tumor-related reasons or lack of follow-up. INTERVENTION: Intracorporeal or extracorporeal anastomosis was performed, based on availability of the robotic stapler and appropriate bedside assistance. MAIN OUTCOME MEASURES: The primary outcome was incisional hernia, diagnosed either clinically or on postoperative imaging, and analyzed using time-to-event analysis. A Cox proportional hazards model was used for multivariable analysis. Secondary outcomes were analyzed using parametric and nonparametric tests. Statistical significance was set at p < 0.05. RESULTS: Of 164 patients who met all inclusion criteria, 67 had intracorporeal and 97 had extracorporeal anastomoses. Median follow-up time was similar in both groups (14 vs 15 mo; p = 0.73). The 1-year estimated incisional hernia rate was 12% for extracorporeal and 2% for intracorporeal anastomoses (p = 0.007); this difference was confirmed by multivariable modeling. The severity of postoperative complications was similar between the groups, but there was an increase in incisional infections and a shorter length of stay (1 day) for intracorporeal cases. LIMITATIONS: The study was limited by its retrospective, single-surgeon nature. CONCLUSIONS: Right colectomy with intracorporeal anastomosis and a Pfannenstiel extraction site may reduce the rate of incisional hernias compared with extracorporeal anastomosis with a vertical midline extraction site. The intracorporeal approach was also associated with a decreased length of stay but an increase in incisional surgical site infections. These findings have implications for healthcare use and patient-centered outcomes. See Video Abstract at http://links.lww.com/DCR/B147. ANASTOMOSIS INTRACORPÓREAS EN COLECTOMÍAS DERECHAS MÍNIMAMENTE INVASIVAS SE ASOCIAN CON MENOS HERNIAS INCISIONALES Y UNA ESTADÍA HOSPITALARIA MÁS BREVE: nastomosis intracorpórea se asocia con varios beneficios a corto plazo. Sin embargo, es un procedimiento técnicamente desafiante con riesgos potenciales.nvestigar las diferencias en las complicaciones a corto plazo y las tasas de hernia incisional a largo plazo después de la colectomía robótica derecha con anastomosis intracorpórea versus extracorpórea y sitios de extracción estandarizados.Estudio de cohorte histórico.cirujano individual, institución única.Todos los pacientes sometidos a colectomía robótica derecha con anastomosis intracorpórea y un sitio de extracción de Pfannenstiel o anastomosis extracorpórea con un sitio de extracción vertical de la línea media de 2013-2017 fueron elegibles. Los criterios de exclusión fueron la conversión a laparotomía por razones relacionadas con el tumor o la falta de seguimiento.nastomosis intracorpórea o extracorpórea, según la disponibilidad de grapadora robótica y la asistencia adecuada quirúrgica.El resultado primario fue la hernia incisional, diagnosticada clínicamente o en imágenes postoperatorias, y analizada mediante análisis de tiempo hasta el evento. Se usó un modelo de riesgos proporcionales de Cox para el análisis multivariable. Los resultados secundarios se analizaron mediante pruebas paramétricas y no paramétricas. La significación estadística se estableció en p < 0,05.De 164 pacientes que cumplieron con todos los criterios de inclusión, 67 tenían anastomosis intracorpóreas y 97 tenían anastomosis extracorpóreas. La mediana del tiempo de seguimiento fue similar en ambos grupos (14 versus 15 meses, p = 0,73). La tasa de hernia incisional estimada para un año fue del 12% para las anastomosis extracorpóreas y del 2% para las anastomosis intracorpóreas (p = 0,007); esta diferencia fue confirmada por el modelado multivariable. La gravedad de las complicaciones postoperatorias fue similar entre los grupos, pero hubo un aumento de las infecciones incisionales y una estancia más corta (un día) para los casos intracorpóreos.Retrospectiva, cirujano único.a colectomía derecha con anastomosis intracorpórea y un sitio de extracción de Pfannenstiel puede reducir la tasa de hernias incisionales en comparación con la anastomosis extracorpórea con un sitio de extracción vertical en la línea media. El enfoque intracorpóreo también se asoció con una disminución de la duración de la estadía, pero con un aumento de las infecciones del sitio quirúrgico incisional. Estos hallazgos tienen implicaciones para la utilización de recursos médicos y beneficios para pacientes. Consulte Video Resumen en http://links.lww.com/DCR/B147. (Traducción-Dr. Adrian Ortega).


Assuntos
Anastomose Cirúrgica/efeitos adversos , Colectomia/efeitos adversos , Neoplasias do Colo/cirurgia , Hérnia Incisional/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Neoplasias do Colo/complicações , Neoplasias do Colo/patologia , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais
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