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1.
Am J Gastroenterol ; 118(9): 1626-1637, 2023 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-36988310

RESUMO

INTRODUCTION: Colorectal cancer (CRC) is one of the major life-threatening complications in patients with Crohn's disease (CD). Previous studies of CD-associated CRC (CD-CRC) have involved only small numbers of patients, and no large series have been reported from Asia. The aim of this study was to clarify the prognosis and clinicopathological features of CD-CRC compared with sporadic CRC. METHODS: A large nationwide database was used to identify patients with CD-CRC (n = 233) and sporadic CRC (n = 129,783) over a 40-year period, from 1980 to 2020. Five-year overall survival (OS), recurrence-free survival (RFS), and clinicopathological characteristics were investigated. The prognosis of CD-CRC was further evaluated in groups divided by colon cancer and anorectal cancer (RC). Multivariable Cox regression analysis was used to adjust for confounding by unbalanced covariables. RESULTS: Compared with sporadic cases, patients with CD-CRC were younger; more often had RC, multiple lesions, and mucinous adenocarcinoma; and had lower R0 resection rates. Five-year OS was worse for CD-CRC than for sporadic CRC (53.99% vs 71.17%, P < 0.001). Multivariable Cox regression analysis revealed that CD was associated with significantly poorer survival (hazard ratio 2.36, 95% confidence interval: 1.54-3.62, P < 0.0001). Evaluation by tumor location showed significantly worse 5-year OS and RFS of CD-RC compared with sporadic RC. Recurrence was identified in 39.57% of CD-RC cases and was mostly local. DISCUSSION: Poor prognosis of CD-CRC is attributable primarily to RC and high local recurrence. Local control is indispensable to improving prognosis.


Assuntos
Neoplasias do Ânus , Neoplasias Associadas a Colite , Doença de Crohn , Neoplasias Retais , Humanos , Neoplasias do Ânus/patologia , Doença de Crohn/complicações , População do Leste Asiático , Prognóstico , Neoplasias Retais/patologia , Estudos Retrospectivos , Neoplasias Associadas a Colite/patologia
3.
Arch Orthop Trauma Surg ; 126(6): 421-4, 2006 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16733753

RESUMO

The operative procedures chosen to treat arthrosis in patients with severe acetabular dysplasia vary among orthopaedic surgeons, particularly in younger patients. We operated on 450 hips with acetabular dysplasia by using the rotational acetabular osteotomy (RAO) method of Ninomiya and Tagawa by Ninomiya (Clin Orthop 247:127-137, 1989). In this report, we describe our technique of performing RAO with hydroxyapatite tricalcium phosphate-composite (HAP-TCP) blocks to achieve good acetabular coverage and the results of this procedure in 16 hips with severe dysplasia, including nine with advanced arthrosis. Adequate coverage of the osteotomized acetabulum was maintained and symptoms, especially pain, showed marked improvement at the latest follow up.


Assuntos
Acetábulo/cirurgia , Fosfatos de Cálcio , Luxação Congênita de Quadril/cirurgia , Hidroxiapatitas , Osteotomia , Próteses e Implantes , Adulto , Feminino , Humanos , Masculino , Procedimentos Ortopédicos/métodos , Rotação
4.
Arch Orthop Trauma Surg ; 122(5): 288-90, 2002 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12070649

RESUMO

We performed revision total hip arthroplasty on 12 patients via the transfemoral approach because difficulty with surgery was anticipated preoperatively. The total hip score improved in all of the patients. Radiographically, there were no radiolucent lines around the acetabular and femoral components, but one hip still showed sinking of the stem by 2 cm. Although the transfemoral approach might seem very aggressive, this is actually a relatively simple method that allows rapid removal of the prosthesis and cleaning of the medullary canal.


Assuntos
Artroplastia de Quadril/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Articulação do Quadril/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Falha de Prótese , Radiografia , Reoperação
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