A case is reported of adenocarcinoma of the ileum following surgical management of ulcerative colitis. In this patient it seems likely that the carcinoma arose in a pre-existing tubulovillous adenoma of rectal origin. This case report draws attention to the need to exclude any possibility of retention of large-intestinal mucosa in the ileostomy when transecting the ileum, either at primary colectomy or when dismantling an ileorectal anastomosis.

Adenocarcinoma↗

PubMedDate not supplied

Palliative operative management in rectal carcinoma.

The results of palliative operative management of 338 patients with rectal carcinoma managed by one of the authors are presented. Postoperative mortality was higher for patients undergoing palliative resection (11.7 per cent) than colostomy bypass (5.3 per cent) or diagnostic laparotomy (6.8 per cent). Cancer specific survival following palliative resection was significantly (P less than 0.001) longer than that following colostomy bypass or diagnostic laparotomy for tumor Stages D1 (local visceral involvement) and D2 (distant metastases). However, in patients with liver or peritoneal metastases alone, cancer specific survival did not differ significantly after the operations of resection or colostomy bypass. The failure to demonstrate improved survival after resection of the primary tumor in these latter two groups with distant metastases indicates the dominant role of volume of tumor tissue present in these situations. The results suggest that longer survival following palliative resection reflects a bias of patient selection towards more favorable cases.

Aged↗

PubMedDate not supplied

Resected ovarian recurrence from colorectal adenocarcinoma: a study of 13 cases.

Thirteen (1.4 per cent) of 882 female patients managed by resection for primary colorectal adenocarcinoma subsequently required for operation for ovarian recurrence. The clinical, pathologic and survival data of this group have been analyzed. Their age (mean +/- s.d., 51.2 +/- 8.4 years) was less (P = 0.004) than that of the total series of female patients (59.4 +/- 13.0 years). Survival varied from 15 to 96 months (mean 17 months) from the ovarian operation. Three patients were still alive with no evidence of recurrence at the time of the review. The low incidence of ovarian recurrence requiring operation does not support recommendations for prophylactic oophorectomy in all patients.

Adenocarcinoma↗