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Biomedical subjects

A Bakka

Publications and source records attributed to A Bakka.

13 recordsLinked to original sources
PubMed1992

Surgical treatment as a principle in patients with advanced abdominal carcinoid tumors.

Seventy-five patients with advanced abdominal carcinoid tumors (65 midgut, 10 others) have been examined retrospectively to evaluate the role of surgical treatment as a principle, irrespective of stage of disease. Eighteen of 52 patients (35%) exhibited the carcinoid syndrome. Two or more primaries were found in 39% of patients with midgut lesion, 81% of these patients had regional metastases, 5% of these patients had distant lymph node metastases, and 74% of the patients had liver secondaries. All patients underwent operation, an additional 34% of the patients had a further reoperation, 9% of the patients had a second reoperation, 3% of the patients had a third reoperation, and one patient (2%) had a fourth reoperation. Intraoperative debulking (liver excluded) was performed in 33% of the patients, and 48% of the patients had treatment (resection, hepatic artery ligation, embolization) directed at the liver. The postoperative mortality rate was 2% after the primary operation for midgut lesions. The median survival for midgut tumors was 92 months, compared to 40 months for other lesions (not significant). A significantly higher survival rate was revealed for those patients with midgut lesion who were undergoing intraabdominal debulking procedures (liver excluded); median survival was 139 months versus 69 months without debulking. For those patients with liver metastases, median survival after intervention was 216 months and 48 months without such treatment (p less than 0.001). It is concluded that resection of intraabdominal carcinoid tumor masses can be performed in a high proportion of patients. Despite the retrospective, uncontrolled nature of this study, the difference in survival probabilities in favor of aggressive surgical therapy is so marked that it is not unreasonable to conclude that surgery has played a role in prolonging life in these patients.

Adolescent↗
PubMed1991

[Laparoscopic appendectomy].

Laparoscopic techniques have extended into the operative field of surgery. Appendectomies can be performed laparoscopically. The diagnosis of appendicitis is established and the inflamed organ removed directly. The laparoscopic technique reduces the incidence of unnecessary appendectomies and corresponding morbidity. Compared with conventional appendectomy, laparoscopy leads to less post-operative pain and inability to work. We discuss the first nine patients we treated in this way.

Adult↗
PubMed1991

Association between DNA ploidy pattern and cellular atypia in colorectal carcinomas. A new clinical application of DNA flow cytometric study?

Fresh tissue specimens from 406 colorectal carcinomas were analyzed by DNA flow cytometric study, and the DNA ploidy pattern was compared with Dukes' stage, histologic grade, and degree of cellular atypia. Sixty-one percent of the carcinomas had a distinct aneuploid DNA pattern. The proportion of aneuploid carcinomas was significantly higher in the advanced Dukes' stages than in the localized ones. A highly significant association was found between DNA ploidy pattern and degree of cellular atypia, whereas no association was demonstrated between DNA ploidy pattern and histologic grade. This finding might indicate that cellular atypia has a stronger prognostic impact than the growth pattern of the tumor. The authors suggest that flow cytometric DNA quantification may replace assessment of cellular atypia in the histologic evaluation. Furthermore, together with earlier findings by others, these results indicate that the degree of cellular atypia may be conserved during the development from adenomas to carcinomas.

Adenocarcinoma↗
PubMed1991

Bile duct cysts in adults. Pitfalls in diagnosis and management.

Six women have been referred to us for treatment of bile duct cysts during the past 6 years. In three patients the disorder was misdiagnosed by the referring institution, and they were admitted because of continuing severe symptoms; two of them had been treated with internal drainage procedures which led to unnecessary treatment delay and complications. Two patients had developed cyst carcinoma, the most feared complication of cyst disease. It is concluded that clinical symptoms are nonspecific, and the diagnosis is only ascertained after complete cholangiographic imaging of the biliary tree. Primary cyst excision and hepaticojejunostomy is the treatment of choice.

Adult↗
PubMed1990

[Pancreatic duct prosthesis].

Endoprothetic stenting of the pancreatic duct is reported in limited series. Twelve patients are presented here. In five patients with confirmed or suspected pancreatic malignancy, pain and diarrhea subsided or disappeared, and two patients had a temporary gain in weight. Four patients with chronic pancreatitis all experienced relief of symptoms. One patient with a pancreatic abscess improved temporarily. A postoperative pancreatic fistula healed within two weeks. One patient with a stone in the pancreatic duct became temporarily free from pain. Two patients had minor complications. Efficiency of pancreatic drainage is difficult to evaluate. However, all our patients seemed to benefit from the treatment.

Aged↗
PubMed1990

[Acute non-calculous cholecystitis].

We report a ten-year series of 18 patients treated for acute acalculous cholecystitis. 12 were males and six females, ranging in age from 23 to 77 years, with a mean of 64. 13 underwent major surgical procedures, two for multiple injuries. An additional four patients were also treated for multiple injuries. Clinical knowledge and a critical attitude are essential for the diagnosis. Blood tests are unreliable, since the result may be affected by other complications or associated diseases. It is therefore necessary to use diagnostic imaging. The treatment of choice is percutaneous bile drainage.

Acute Disease↗
PubMed1988

Endoscopic treatment of colorectal carcinoma.

All malignant pedunculated polyps of the colon can be removed totally by colonoscopy alone. Resection of the colon is only necessary in those few instances where the cancer portion is poorly differentiated and where there are cancer cells in lymphatic or vascular channels. Malignant well differentiated sessile polyps are adequately managed by the endoscopic technique as well if the polypectomy is believed to have been complete and this can be confirmed by follow-up biopsies after 4-8 weeks. In these patients Laser therapy may also be of value. Endoscopic Laser therapy may be of value as a symptomatic treatment in patients with advanced malignant disease with obstruction or bleeding.

Adenocarcinoma↗
PubMed1988

Routine double contrast barium enema and fiberoptic colonoscopy in the diagnosis of colorectal carcinoma.

The diagnostic efficacy of routine double-contrast barium enema and fiberoptic coloscopy for detection of cancer was retrospectively studied in 303 patients consecutively operated for colorectal adenocarcinoma in a 52-month period from January 1980. Double-contrast barium enema was performed in 180 patients with 184 carcinomas, 157 (85%) of which were revealed by this examination. The detection rate of carcinoma according to site was 89% between cecum and descending colon, 92% in sigmoid colon and 71% in rectum. Fiberoptic colonoscopy was done in 176 patients with 181 carcinomas, 163 (90%) of which were detected by the endoscopical examination. The detection rate of carcinoma according to site was 86% between cecum and descending colon, 90% in sigmoid colon and 95% in rectum. The two methods were equally effective in detecting carcinoma of the colon. Colonoscopy was superior to barium enema in detection of rectal carcinoma.

Adenocarcinoma↗
PubMed1986

Massive gastric bleeding from exulceratio simplex (Dieulafoy).

Massive upper gastrointestinal haemorrhage may be caused by ulcus simplex Dieulafoy. Of 144 patients consecutively operated on for benign gastric ulcer in 1975-1980, 29 were admitted as emergencies because of massive bleeding from the stomach. Six had the Dieulafoy lesion. Identification of the source of bleeding was made by fibreoptic endoscopy in five of these cases, while wide gastrotomy was required in one case. All were successfully treated, one with gastroscopic coagulation and the others surgically. Hitherto there has been no recurrence of bleeding. Diagnostic and therapeutic problems are described. The Dieulafoy lesion may be life-threatening. A century after it was first reported, reminder of the lesion is still necessary, since it probably is more rarely recognized than rare.

Adult↗