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At least 739 records · Page 41Linked to original sources
PubMed1998

Abdominoinguinal incision in adenocarcinoma of the sigmoid or cecum: report of two cases.

PURPOSE: This study illustrates a technique allowing resection of a sigmoid adenocarcinoma with lateral fixation and a cecal adenocarcinoma with involvement of the psoas muscle and ureter. METHODS: The abdominoinguinal incision, an incision used in the resection of a sarcoma of the lower abdominal quadrants, was applied in the case of a sigmoid adenocarcinoma with posterolateral fixation and infiltration of the anterior abdominal wall and in a case of a cecal adenocarcinoma involving the right psoas muscle and ureter. RESULTS: In the first case, resection of the tumor mass en bloc with resection of the sigmoid and lower anterior abdominal wall muscles, including the inguinal ligament, was performed. Reconstruction of the muscular fascial defect was done with the rotation of a right rectus abdominis flap. The patient was well 12 months later. In the second case, the cecal carcinoma was resected en bloc with the right psoas and ureter; a right nephrectomy was also performed. This patient was well eight months later. CONCLUSIONS: The abdominoinguinal incision may provide the exposure needed to allow the resection of a sigmoid or a cecal adenocarcinoma with posterolateral fixation, often considered unresectable with conventional abdominal incisions.

Adenocarcinoma↗
PubMed2002

Surgery for colon and rectal cancer.

Radical surgery remains the only potentially curative treatment for colorectal cancer. Major changes in the principles of rectal cancer resection have been recently described (total mesorectum excision) whereas there have been few changes in the principles of colonic cancer resection. This chapter presents surgical procedures for curative treatment of colorectal cancer in both the elective and emergency settings.

Colonic Neoplasms↗
PubMed2001

Chromogranin A in human neuroendocrine tumors: an immunohistochemical study with region-specific antibodies.

Antibodies to six specific regions of the chromogranin A (CgA) molecule were used to study their immunoreactivity in human neuroendocrine (NE) tumors. Tissue specimens from endocrine pancreatic tumors (n = 14), duodenal carcinoids (n = 2), bronchial carcinoids (n = 5), ileal carcinoids (n = 5) appendix carcinoids (n = 2), medullary thyroid carcinomas (n = 6), parathyroid adenomas (n = 2), and pheochromocytomas (n = 8) were analyzed. The results showed that the NE tumor types expressed varying numbers of CgA fragments. A variation in frequency of the expression of immunoreactive cells was sometimes seen also within the same tumor type. The midportion fragment CgA 176-195 (chromacin) was the only fragment expressed in all tumors. Benign and malignant tumors expressed different patterns, being especially true of insulinomas and pheochromocytomas. These findings suggest that region-specific antibodies to CgA fragments can be used as a diagnostic tool for the characterization of NE tumors.

Adenoma↗
PubMed2002

Multivisceral resection for locally advanced primary colon and rectal cancer: an analysis of prognostic factors in 201 patients.

OBJECTIVE: To review a single-center experience with 201 multivisceral resections for primary colorectal cancer to determine the accuracy of intraoperative prediction of potential curability, to identify prognostic factors, and to examine the effect of surgical experience on immediate outcome and long-term results. SUMMARY BACKGROUND DATA: Locally advanced colorectal cancer may require an intraoperative decision for en bloc resection of surrounding organs or structures to achieve complete tumor removal. This decision must weigh the risk of complications and death of multivisceral resection against a potential survival benefit. Little is known about prognostic factors and the influence of surgical experience on the outcome of multivisceral resection for colorectal cancer. METHODS: Patients undergoing multivisceral resection for primary colon or rectal cancer between 1982 and 1998 were identified from a prospective database. Patients were followed up according to a standard protocol. RESULTS: Multivisceral resection was performed in 201 of 2,712 patients with a median age of 64 years. Postoperative rates of complications and death in 201 patients were 33% and 7.5%, respectively. A potentially curative resection was possible in 130 of 201 patients (65%) and histologic tumor infiltration was shown in 44% of patients with curative resection. Intraoperative assessment of curability was unreliable. After curative resection, the local recurrence rate was 11% and the overall 5-year survival rate was 51%. Multivariate analysis identified intraoperative blood loss (relative risk 1.7-6.4, P <.001), age 64 years or older (RR 3.7; P <.001), and UICC stage as independent prognostic factors (RR 2.0; P =.009). No prognostic significance was found for histologic tumor infiltration, the number of resected organs, or surgical experience. CONCLUSIONS: Multivisceral resection is safe, and long-term survival after curative resection is similar to that after standard resection. Because palliative resections cannot be predicted accurately at the time of surgery, every effort should be made to achieve complete tumor resection. Major blood loss but not surgical experience per se is an independent prognostic factor.

Aged↗
PubMedDate not supplied

Immunohistochemical studies on the localization of cancer associated antigens DU-PAN-2 and CA19-9 in carcinomas of the digestive tract.

The immunohistochemical localization of DU-PAN-2 antigen and CA19-9 antigen in carcinomas of the digestive tract was studied using an immunoperoxidase technique. Staining for DU-PAN-2 antigen and CA19-9 antigen was observed in 104 (79%) and 96 (73%) of 131 carcinomas of the digestive tract, respectively. Diffuse staining (more than 20% of carcinoma cell stained) for DU-PAN-2 was detected in 14 of 21 (67%) pancreatic carcinomas and 11 of 19 (58%) carcinomas of the biliary tract (including cholangiocarcinoma). Diffuse staining for CA19-9 was detected in 15 (71%) of pancreatic carcinomas and nine (47%) of the carcinomas of the biliary tract. In colon carcinomas, no diffuse staining for DU-PAN-2 was observed, whereas diffuse staining for CA19-9 was found in 41%. There was a positive correlation between the differentiation degree (or grade) of the adenocarcinomas of the colon and the expression of CA19-9, but not that of DU-PAN-2. These immunohistochemical studies showed that DU-PAN-2 antigen is expressed diffusely in most cases of adenocarcinoma of the pancreas and biliary tract and is more specific for adenocarcinomas of the pancreas and biliary tract than CA19-9.

Adenocarcinoma↗
PubMed1988

Concentration and localization of carbohydrate antigen 19-9 in tissues of pancreatic cancer.

Carbohydrate antigen (CA) 19-9 concentration in the tissue-extracts of cancerous and noncancerous pancreatic tissues were determined by radioimmunoassay. Pancreatic cancer tissues revealed significantly elevated CA 19-9 concentrations, when compared with chronic pancreatitis, normal adult pancreas, or fetal pancreas tissues. Metastatic liver tumors from pancreatic cancer also showed extremely high CA 19-9 concentrations, and there was no significant correlation between tissue CA 19-9 concentration and serum CA 19-9 level in patients with pancreatic cancer. In addition, positive localization of CA 19-9 was clearly observed in cancer cells of pancreatic cancerous tissues by immunohistochemical study, confirming the remarkable increase of CA 19-9 concentration in tissues of pancreatic cancer, although CA 19-9 was also partially found in non-malignant pancreatic tissues. The results indicated that CA 19-9 would be produced in great quantities by cancer cells in tissues of pancreatic cancer, and thus could be a valuable tumor associated antigen suggesting its clinical use as a tumor marker for cancer of the pancreas.

Animals↗
PubMed2003

[Tactics and operative procedures in the management of complicated forms of malignant tumors of the left colon and rectum on emergency conditions].

Over the period 1996-2001, a total of 130 patients with complicated cancer of the left colon and 164 patients with complicated cancer of the rectum are subjected to treatment in the Clinic of Emergency Surgery at University Hospital "Queen Joanna", Sofia. Obturation is the commonest form of complication--136 patients (46.2%), followed by perforation either within the tumor or diastatic noted in 21 cases (7.1%), paratumor abscesses and infiltrates in 31 patients (10.5%) and rectohaemorrhage in 12 patients (4.0%). The optimal surgical approach to complicated forms of colorectal cancer of the left colon and rectum remains controversial especially when the patients underwent emergency surgery. Recently there has been a trend towards resection and anastomosis in selected patients. In each patient it's mandatory to make a precise and individual choice of the extend of the operative intervention, consistent with the patient's general condition and contributing to eliminate the life-endangering underlying cause. It must be realized by means of one-stage surgery when it's possible. Authors represent their personal experience with resolve of these actual problems.

Colonic Neoplasms↗
PubMedDate not supplied

Outcomes of emergency surgical treatment in malignant bowel obstructions.

BACKGROUND/AIMS: Malignant bowel obstructions are still a challenging problem for surgeons and carry high morbidity and mortality risk. The aim of this study was to review the presentation and outcomes of malignant bowel obstructions and to identify the risk factors related with poor prognosis. METHODOLOGY: One hundred and twenty-five patients underwent emergency surgical treatment for malignant obstructions between January 1997 and January 2002. Data included age, sex, past medical history, presenting symptoms; physical findings on admission, American Society of Anesthesiologists (ASA) class, operative details, postoperative complications, length of hospitalization and hospital mortality were reviewed retrospectively. RESULTS: Seventy-three (58%) of the patients have poor performance status on admission. Potentially curative resection was performed in 74 (60%) patients. Surgical treatment was palliative in 43 (34%) patients. Extended bowel resections were utilized in 20 (16%) patients. Our hospital mortality rate was 21%, and postoperative morbidity rate was 31%. Coexisting cardiopulmonary diseases, presence of generalized perforation, poor general condition and extended bowel resections appeared to be related with unfavorable outcomes. CONCLUSIONS: Emergency surgical treatment for malignant obstruction may be curative in selected patients with good performance status.

Abdominal Neoplasms↗
PubMed2006

[Radical surgical treatment of cancer of periampullar zone organs].

Experience of treatment was analyzed of 862 patients with cancer of periampullar zone organs, to whom radical tumoral excision was performed in 1972-2005 yrs. Performance of radical operative intervention have permitted to achieve satisfactory late results in patients with tumor of duodenal major papilla and distal part of common biliary duct. Last years better immediate results of operative treatment were achieved due to postoperative mortality lowering.

Adenocarcinoma↗