[Clinical aspects and diagnosis of multiple primary synchronous cancer of the large intestine].
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Incidence of large bowel cancer under predominant genetic influence is estimated to occupy about one tenth of general large bowel cancer population. They are defined to include hereditary gastrointestinal polyposes (adenomatosis coli, Peutz-Jeghers syndrome and juvenile polyposis) and the non-polypotic familial (hereditary) large bowel cancer (Cancer Family Syndrome and allied conditions). The strategy for the genetic cancer high-risk group under these conditions based on the central registration system was described. Our experiences indicated the approach was actually effective for the polyposes a and was also promising for the non-polyposis familial of large bowel cancer.
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Metabolic acidosis and hypopotassemia after whole gut irrigation (WGI) with 0.9% sodium chloride are probably caused by the following effects: 1. Sodium, chloride and fluid resorption with following renal compensatory mechanisms and inhibition of the ADH incretion and the renin-angiotensin-aldosterone System--2. Washing-out effect of the intestinal mucosa with loss of potassium-rich intestinal juice and protein. At the beginning of anaesthesia, 20 h after WGI, compensatory mechanisms did not reach a reconstitution of the balanced initial situation. Therefore, patients whose state is critical should be monitored carefully during WGI. Further investigations will develop an indifferent irrigation fluid to avoid serious complications of massive water resorption during WGI.
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