[Intestinal metastasis of melanoma].
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Adult intussusceptions due to metastatic intestinal-tumor are very rare. A 71-year-old man with an intussusception due to intestinal metastasis of renal carcinoma is reported. To our knowledge, this is the third such patient in the Japanese literature. The patient was suffered from an intestinal obstruction six months after his renal carcinoma was detected. Laparotomy was performed, revealing that he had developed a jejunojejunal intussusception due to metastasis of renal carcinoma. The early diagnosis of metastatic intestinal tumor is difficult. It is important to bear in mind that patients with malignant tumor may already have metastasis.
In a prospective open study of the Proximate ILS circular stapler, the results of 125 intestinal anastomoses in 119 patients were reviewed. Intraoperative leakage was observed in five instances, after intraluminal povidone instillation, necessitating suture-line reinforcement. In three instances, incomplete tissue rings (donuts) were found. Temporary fecal diversion was used in seven of 84 patients with anastomoses made to the rectum or anal canal. Roentgenographic assessment of 79 of these anastomoses using Gastrografin demonstrated a leak in three (3.8%). There was one clinical leak (0.9%) in the series. Three patients died (2.5%), none from anastomotic complications. Transient anastomotic strictures were found in three of 82 operative survivors where the anastomosis was within range of the proctoscope. There were no instances of significant hemorrhage from the anastomosis. No patient required anastomotic revision, and of the 51 survivors of cancer surgery where proctoscopy could evaluate the anastomosis, there was no evidence of local recurrence in the period of follow up (mean 16.3 months). The authors conclude: that the Proximate ILS is a safe, reliable and effective instrument for construction of intestinal anastomoses.
An attempt has been made to estimate the correlation of oncological illnesses in the families within the limits of segregational and correlational analyses, considering the fact of accumulation in the families of probands with autosomal-dominant polyposes of colon of the cases of primary (without preceding polyposes) colon cancer. Significant correlation was found between the hereditary polyposes and primary colon cancer in the families studied. Based on these data, a hypothesis is discussed of the main gene and its modifications on the phenotypical version in the form of primary benign (polyposes) and malignant (cancer) pathology. No significant correlation was found between colon polyposes and cancer of stomach in the families.
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