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PubMed1985

[Multiple cancers of the colon and rectum. Incidence and results of surgical treatment].

Out of 1,528 patients operated upon for cancer of the colon or rectum between 1964 and 1984, synchronous carcinomas were observed in 63 patients, metachronous carcinomas in 36 patients and both synchronous and metachronous carcinomas, in 3 patients. Synchronous carcinomas were double in 59 patients and triple in 4 patients. In 80 p. 100 of the cases, the lesions were confined to the same surgical segment or to an adjacent segment. Rectal locations were less frequent (18 p. 100). Preoperative diagnosis was made in only 40 p. 100 of cases. Ninety-three p. 100 had resection, 81 p. 100 with a curative intent. Associated benign polyps were found on the resected specimen in 58 p. 100 of the cases. The resectability rate (93 p. 100) and 5-year survival rate (55 p. 100 of all operated patients and 67 p. 100 of those who underwent curative resection) were similar to those observed in our personal series of single carcinomas of the colon. A second cancer of the colon or rectum occurred in 36 patients. The time interval between the first and second carcinomas ranged from 1 to 24 years and the mean interval time was 6.3 years. Three of the 36 patients developed a third metachronous lesion. The distribution of the sites of successive carcinomas was similar to that of synchronous carcinomas; the second carcinoma was located in the rectum in 8 p. 100 of cases. Diagnosis of the second carcinoma was made through routine periodic colonoscopy in one third of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

Extended resections for carcinoma of the colon and rectum.

Eighty-four of 1,081 patients with carcinoma of the colon and rectum operated upon at our institution between 1951 and 1980 had extended resections involving adjacent organs. The types of presenting symptoms or the duration had no affect on the survival time of these patients. Survival time was most significantly correlated with pathologic penetration and Dukes' stage. The operative mortality was 5.9 per cent with a complication rate of 28.5 per cent. The nature of the individual organs involved did not affect the survival time. Patients with carcinoma of the colon and rectum extending to adjacent organs can undergo resection with a five year survival rate comparable with all patients with surgically treated carcinoma of the colon and rectum.

Abdominal Neoplasms↗
PubMed1979

[Cryosurgical treatment of polypi of the rectum and colon (author's transl].

UNLABELLED: Single cases of genuine colon rectum polypi, histologically adenomatous, adeno-villous and villous tumours have been treated with cryosurgery. INDICATION: Relapses after polyectomy showing malignant degeneration; malignantly degenerated polypi, treatment of the basis of sessile lesions; sessile polypi up to 1 cm in diameter; extensive polyposis--polyposis of the rectum. After an initial regression of the polypous changes growth can be stated and quickly developing degenration leading to the formation of a carcinoma of the rectum and to stenoses of the lumen. It was only partially possible to clarify the cause of the growth in animal experiments. Primary application of low temperatures in polyposis recti and in primarily malignant degenerated polypi have to be avoided.

Cell Transformation, Neoplastic↗
PubMed1979

[Perineo-transano-abdominal resection of the rectum (author's transl)].

The operative procedure described by the author, is a combined perineal and abdominal procedure for resection of the rectum. The first step is a perineal approach: patient placed in lithotomy position. The rectum is dissected free of the sphincter ani muscle. The second step perineal and abdominal: patient being placed in a semilithotomy position draped for work in the abdomen and at the same time, in perineum: the sigmoid brought down preferably if it found free of any pathology. On 18 cases of cancer, of the rectum, even some of large volume: when the inferior limit of the lesion was from 6 to 12 mc, above the anus, this procedure was carried on with good post-operative results.

Abdomen↗
PubMedDate not supplied

[Perineal hernia of the rectum (author's transl)].

A case of perineal hernia of the rectum is presented; this case has been successfully treated by a fixation of the rectum to the sacrum by analogy with the treatment of the prolapsus of the rectum.

Barium Sulfate↗
PubMedDate not supplied

Rare tumors of the intestines and rectum.

Some rare tumors of the intestines and rectum (eight cases) have been presented and discussed. All were successfully managed without operative mortality. I have presented some observations deduced from these cases which might aid in the diagnosis of such rare tumors--the importance of palpating the terminal ileum in any abdominal operation and the necessity for a frozen section biopsy from suspicious schistosomal masses of the sigmoid colon or the rectum before deciding to resect them. I have discussed cases of carcinoma of the rectum where microscopic schistosomal deposits were spotted and stressed that in such cases it is a mere coincidental association.

Adenocarcinoma↗
PubMed1983

Geographic patterns of oesophagus, stomach, colon and rectum cancer mortality in Slovakia.

The deaths caused by the mentioned four basic cancer sites of the gastrointestinal tract represented almost one third of all deaths from cancer in Slovakia during the decade 1968--1977. The age-adjusted rates and trends showed substantial increase of the mortality from colon cancer in both sexes as well as from rectum and oesophagus cancer in men and simultaneously significant decrease of stomach cancer in men and women together with quite unchanged rates of rectum and oesophagus cancer mortality in women during the investigated period. Study of the geographic distribution of standardised mortality rates of these cancer sites revealed the existence of great differences in the frame of the individual sites as well as the tendency of substitute the decreasing mortality rates of stomach cancer with those of colon and rectum especially in the western part of the country. The possible advantages and perspectives of the investigation of the geographic patterns of cancer mortality in adequately great territorial units in this country are discussed.

Colonic Neoplasms↗
PubMed1984

The use of computerized tomography scan in the staging and follow-up study of carcinoma of the rectum.

We have reviewed the CT scans of 30 patients who were evaluated for either primary or recurrent carcinoma of the colon and rectum in the pelvis. The results of our experience have shown that pelvic CT scans can provide accurate information regarding the extramural extension of carcinoma of the rectosigmoid undetected by other means. CT scans can detect significant ureteral pathology as accurately as can IVP and have essentially replaced the IVP in the preoperative evaluation of carcinoma of the rectum. Inflammation of the perirectal musculature, either by the effect of the local tumor or secondary to preoperative radiation, can make it difficult to determine if these structures are invaded by tumor. Tumor involvement, however, can be proved using CT localization and percutaneous fine needle aspiration biopsy techniques. During radiation therapy and chemotherapy, CT scans may also assist in treatment planning and may be the most reliable way of observing the objective response of the recurrent tumor in the pelvis. Finally, in the patient in whom the recurrent tumor does not produce abnormally high levels of CEA, the CT scan may be the only method by which the early and treatable recurrence may be detected. It is, therefore, appropriate to recommend that pelvic CT scan be a routine test for every patient who has had abdominoperineal resection or low anterior resection for carcinoma of the rectum and rectosigmoid.

Anus Neoplasms↗
PubMed1984

[Clinical manifestations of squamous cell carcinoma of the rectum].

The report deals with an evaluation of the data on 107 cases of squamous cell carcinoma of the rectum. 63 patients (58.8%) had proctological diseases in their case histories. Anal carcinoma is being misdiagnosed at out-patient hospitals as some other proctologic lesion in 34.9%. This fact points to the staff's lack of knowledge of the clinical picture of squamous cell carcinoma of the rectum. Abdominal-perineal extirpation of the rectum was the most frequent procedure used in the treatment of squamous cell carcinoma.

Adenocarcinoma↗
PubMed1983

Massive hemorrhage from benign solitary ulcer of the rectum.

A case of massive hemorrhage from benign nonspecific ulcer of the rectum necessitating operative intervention is reported. A 42-yr-old woman developed massive hemorrhage from a benign ulcer of the rectum. At laparotomy, a pedunculated fibroid was found to be pressing on the rectum at the site of the ulcer. After hysterectomy and double-barrel colostomy, bleeding ceased and the ulcer healed. The colostomy was closed 3 months later and the patient has remained asymptomatic for 5 yr.

Adult↗
PubMed1984

Surgical management of diffuse cavernous hemangioma of the colon, rectum and anus.

Operative approaches which attempt to spare the rectal sphincter mechanism in patients with diffuse cavernous hemangioma of the sigmoid colon, rectum and anal canal have associated high morbidity and have failed to provide continence in at least 2 per cent of the patients. Sphincter-saving operations should be reserved for the rarer lesions which spares the lower part of the rectum and anal canal. Abdominoperineal resection by the combined synchronous approach with temporary vascular control of the hypogastric vessels provides a safe effective method of managing patients with diffuse cavernous hemangioma of the sigmoid colon, rectum and anus.

Anus Neoplasms↗
PubMed1981

[Isolated tumor of the rectum as primary manifestation of Burkitt lymphoma (author's transl)].

Burkitt tumors are malignant lymphoblastic lymphomas occurring predominantly in Africa in children and young adults and involving in many cases the intestinal tract; these tumors occur rather seldom outside Africa. A case report is given of a white 21 old female suffering from this disease; that first manifestation was an isolated ulcerating tumor of the rectum without involvement of other organs of lymph nodes. Diagnosis was confirmed by rectum biopsy. X-ray therapy, cytostatic therapy and amputation of the rectum did not prevent a fast progression of the disease and final death, which is the usual course of the disease when it occurs outside Africa.

Adult↗
PubMed1982

[Solitary ulcer of the rectum].

The Author reports a case of solitary ulcer of the rectum. The most likely pathogenetic hypothesis seems to be linked to hypertonia of the fasciae of the puborectal muscle and the consequent traumatic and ischaemic attacks on the mucosa of the rectal ampulla anterior wall. Diagnosis of solitary ulcer of the rectum is essentially a differential diagnosis versus ulcerated carcinoma and the various inflammatory and infectious ulcerative diseases of the rectum. The rapid evolution of the reported case towards complete cure occurs in only 6% of cases, whereas chronic evolution or the rise of complications is characteristic.

Adrenal Cortex Hormones↗
PubMed1982

Benign solid teratoma of the ovary with rupture into the rectum.

The authors present an unusual case of benign, solid, complex teratoma of the ovary with rupture into the rectum. A young woman, investigated for bowel problems, was found to have a prolapsing tumour in the upper rectum. A diagnosis of benign solid teratoma of the ovary was made by histologic examination of the surgical specimen; the tumour had perforated the rectal wall and protruded into the bowel lumen, a most unusual complication for this type of tumour. Pararectal teratomas can arise from either the ovaries or the soft tissues of the sacrococcygeal region. The latter do, on rare occasions, perforate the rectum. The possible mechanisms of rectal perforation by these teratomas are briefly discussed.

Adult↗
PubMed1982

Indication for, and valuation of computed tomography following anterior resection of the rectum.

During a controlled study, 55 patients who had an anterior resection of the rectum were thoroughly examined, including by computed tomography. The results verified the following statements: 1. The use of CT as a screening-method for early detection of local tumour recurrence following anterior resection of the rectum appears not to be justified. 2. CT is indicated: a) if there is a laboratory or clinical suspicion of recurrence, despite normal findings on proctoscopy; b) to clarify the question of extramural extension if recurrence has been established by proctoscopy. 3. Following anterior resection of the rectum, CT normally demonstrates no remarkable development of scar tissue, unless the anastomosis is inadequate. 4. Following anterior rectal resection every indefinable tissue thickening in the pelvis must be considered a possible tumour recurrence and must be further investigated by needle biopsy.

Carcinoma↗
PubMed1982

Carcinoma of the colon and rectum. Delay in diagnosis.

During the period 1971-1975 284 patients were treated for adenocarcinoma of the colon or rectum; 52% were aged 70 years or more, and 37% had incurable disease at the time of diagnosis. When staged according to Dukes' classification, tumours of the right colon (coecum and ascending colon) were more advanced than those in other parts of the colon and rectum (p less than 0.05). In retrospect, local symptoms from colon and rectum were present in 95% of the patients, whereas 49% had symptoms and signs possibly indicating malignant disease. Local and/or general symptoms of more than six months' duration were noted for 38%. Only 3 patients were asymptomatic at the time of diagnosis. Evidence of at least one risk factor for colorectal cancer was obtained in 11%. Those admitted as emergencies (34%) showed a significantly higher incidence of incurable disease than those admitted electively (p less than 0.01). In 22% of all patients an abdominal mass could be palpated and in 32% a tumour was found on rectal exploration. X-ray examination of the colon was performed on 218 patients, with apparently normal findings in 30. However, in 18 of the latter 30 new scrutiny aroused suspicion of tumour in the large bowel. Before admission only 45 patients had undergone rectosigmoidoscopy. Doctor's delay exceeded 5 months for 45 patients (16%); these tumours did not differ from those of other patients with respect to Dukes' classification.

Adenocarcinoma↗
PubMed1981

Keriorrhoea--the passage of oil per rectum--after ingestion of marine wax esters.

Lepidocybium flavobrunneum, a marine fish of the snake mackerel family, is sometimes sold under the category of 'butterfish'. Ingestion of this fish was observed to be followed by the passage of oil per rectum. The fish was found to contain 23% by weight of lipid and analysis of this, and of the oil passed per rectum, showed that it consisted of wax esters. The high proportion of wax esters in the flesh of the fish, their resistance to digestive enzymes, and their low melting point, result in pooling in the rectum of significant volumes of oil, the lubricant quality of which causes frequent calls to stool. The symptomatology is therefore quite characteristic, but with the quantities normally ingested the condition appears to be harmless, despite reports of toxic effects in experimental animals.

Animals↗
PubMed1981

Prostaglandin E2-mediated secretory diarrhea in villous adenoma of rectum: effect of treatment with indomethacin.

Biochemical and clinical evidence is presented to indicate that prostaglandin (PG)E2 is the mediator of fluid and electrolyte secretion by villous adenomas of the rectum. A 64-yr-old man with a 2-mo history of mucous diarrhea had, on admission, prerenal uremia, severe hyponatremia, and hypokalemia. At sigmoidoscopy an 11 X 11-cm villous adenoma of the rectum was revealed. The rectal fluid discharge was 1800-1825 ml/day, with sodium and potassium concentrations of 150 and 12 mEq/L, respectively. Immunoreactive PGE2 levels in the rectal effluents were high (viz. 1160-1250 pg/ml vs. 200-395 pg/ml) compared with those in stool water from patients with infectious diarrhea. The concentration of vasoactive intestinal polypeptide (VIP) in the tumor was lower (viz. 10.5 pmol/g vs. 100-700 pmol/g) than in normal colonic mucosa. Indomethacin treatment (24 mg X 4 daily) reduced the rectal PGE2 excretion from 2.2 to 0.3 microgram/day and caused a decrease in the rectal fluid loss of 850 ml/day associated with a similar reduction in rectal sodium excretion. Discontinuing medication, a rise in the rectal excretions of PGE2, fluid, and sodium was observed. In conclusion, PGE2 formation in the villous adenoma appears to be the cause of fluid secretion by the abnormal tumor epithelium. The use of PG synthetase inhibitors may facilitate the preoperative correction of severe fluid-electrolyte deficits in patients with large villous adenomas of the rectum.

Adenoma↗