Bowel function and quality of life after local excision or total mesorectal excision following chemoradiotherapy for rectal cancer.

BACKGROUND: Local excision for rectal cancer is expected to offer a better functional outcome than conventional surgery. The aim of the present study was to compare quality of life and bowel function in patients with rectal cancer who underwent either local excision or conventional surgery after chemoradiotherapy. METHODS: This was a retrospective multicentre study. Patients who underwent local excision were compared with those who had mesorectal excision. Quality of life and bowel function were investigated using validated questionnaires (European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, EORTC QLQ-CR29 and Memorial Sloan-Kettering Cancer Center Bowel Function Instrument) at a median follow-up of 49 (range 13-95) months. Further analysis was undertaken of data from patients who underwent local excision alone compared with those requiring subsequent radical surgery. Statistical significance was set at P < 0·010. RESULTS: The mean constipation score was significantly better in the local excision group than in the mesorectal excision group (3·8 (95 per cent c.i. 0·3 to 7·2) versus 19·8 (12·1 to 27·4); P < 0·001). Compared with patients who underwent mesorectal excision, those who had local excision had less sensation of incomplete emptying (mean score 3·7 (3·4 to 4·0) versus 2·8 (2·5 to 3·1); P < 0·001) and second bowel movements within 15 min (mean score 3·6 (3·3 to 3·9) versus 3·0 (2·7 to 3·3); P = 0·006). Patients who underwent local excision alone scored better than those who had mesorectal excision, particularly for bowel function, who, in turn, scored better than patients requiring subsequent radical surgery following local excision. CONCLUSION: Patients who underwent local excision had a better quality of life and bowel function than those who underwent mesorectal excision.

[Hepatitis B vaccination with the plasma-derived Hevac-B Pasteur vaccine. A comparison of 2 populations: hospital personnel and hemodialysis patients]. / Vaccinazione anti epatite B con vaccino plasmaderivato Hevac-B Pasteur. Confronto tra due popolazioni: personale ospedaliero ed emodializzati.

A vaccination experiment using plasma-derived Hevac-B anti-hepatitis vaccine was conducted on two groups at high risk of HBV infection: hospital staff and hemodialyzed subjects. The qualities of the vaccine and the most important directions on how to use it rare briefly presented with a report on the protocol and the results of the vaccine cycle in both groups. It is concluded that the Hevac-B vaccine is efficacious in healthy subjects at risk, but gives an unsatisfactory result in immune deficient subjects, like those under haemodialysis.

[Comparison of Merck and Pasteur plasma-derived hepatitis B vaccines in 2 populations of hemodialysis patients]. / Confronto tra la vaccinazione anti-epatite B con vaccini plasmaderivati Merck e Pasteur in due popolazioni di emodializzati.

In reporting the preliminary data on the anti-B hepatitis vaccination study, the paper compares the two plasma-derived vaccines on the market, Pasteur Hevac-B and HB-Vax M.S.D. in two groups of hemodialyzed subjects. It briefly described the properties of the two vaccines and examines the respective vaccination protocols, doses and administration methods. After reporting the data on the two groups considered and the results in each one, the paper concludes that the M.S.D. vaccine is the most efficacious for hemodialyzed subjects.