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At least 1,081 records · Page 60Linked to original sources
PubMed1990

Proctitis.

An overview is given of the various aspects of idiopathic proctitis. Special emphasis is given on the diagnostic possibilities especially the endoscopic appearances. The list of other inflammatory conditions to be considered in the differential diagnosis is long and includes especially infectious disorders, Crohn's disease, post-radiation abnormalities, caustic damage and ischaemic damage. The mainstay of therapy is topical application of measalazine and corticosteroids. In general measalazine appears to be equally effective as corticosteroids.

Aminosalicylic Acids↗
PubMed1990

Endoscopic examination of the colon and rectum distal to a colostomy.

We report results of the endoscopic examination of the colon distal to a colostomy in 85 patients. Almost half had symptoms related to the excluded bowel. Whereas severe colitis or tumor may be asymptomatic, many patients had discomfort, pain, bleeding, and discharge. Endoscopic examination revealed abnormal findings in 80% of the patients. These were as uncomplicated as mucous plugs or as serious as polyps or carcinoma. We found a high incidence of diversion colitis in the excluded colon. Because of these abnormal findings, endoscopy of the bowel distal to a colostomy at regular intervals is recommended. Mucous plugs and scybala should be treated by irrigation, while polyps and carcinoma should be treated as they would in the nondiverted colon. Diversion colitis can be treated medically with local steroids, or surgically. In most cases, even in severe colitis, we recommend closure of the colostomy. Removal of the excluded colon is seldom necessary.

Colonic Diseases↗
PubMed1990

[Examination of the rectosphincteric reflex by means of endoscopic electrical stimulation. A new device].

An endoscopic electrical stimulation method (the new method) for the examination of the rectosphincteric reflex was devised to overcome difficulties attributable to the manometric method using balloon stimulation. Safety of the electrical stimulation under the conditions used routinely, was confirmed symptomatically and histologically. It was found that the optimal parameters of electrical stimulation to obtain the recto-sphincteric reflex were: 1 ms, 20 Hz, 5 to 7mA, and for 3 sec. The degree of the reflex relaxation became less and the time lag of the response to the stimulation became longer, as the distance of the stimulation site from the anal verge was increased. These relationships were significant. In the cases which received anterior resection of the rectum, the rectosphincteric reflex was examined using the new method. In 12 of 39 cases the recto-sphincteric reflex was induced by stimulation at the oral side of the anastomosis. In all of them the reflex was observed at 9 or more months postoperatively. Incidence of postoperative reflex appearance tended to be higher after end-to-end anastomosis than after side-to-end anastomosis. In two cases which received Duhamel-Okamoto's operation and in one which received Soave-Denda's operation, it was possible to analyze the relationship between the stimulating site and presence or absence of the reflex-like phenomenon.

Adult↗
PubMed1986

[Palliative treatment of adenocarcinoma of the rectum by Nd-YAG laser. Immediate and long-term results. Study of factors related to the initial destruction of the tumor].

Fourty-five patients, 28 men, 17 women (mean age 73 +/- 18 yrs) with rectal carcinoma underwent palliative endoscopic neodymium YAG laser therapy. Rectal hemorrhage ceased in 89 p. 100 of affected patients after 3 +/- 2 sessions and a normal rectal transit was restored in 80 p. 100 of affected patients after 3 +/- 1 sessions. Total destruction of intraluminal tumor was achieved in 40 p. 100 of patients after 4 +/- 1 sessions. Symptomatic improvement was more frequent in patients in whom total destruction of intraluminal tumor was achieved (p less than 0.01). Stepwise logistic regression selected 2 independent variables capable of predicting tumoral destruction: the kind of surgical contraindication, more often related to cancer extension (p less than 0.001) and a greater tumor length (p less than 0.03) in patients in whom destruction of intraluminal tumor was incomplete. Twenty-eight patients were subsequently treated after palliation was achieved. Cumulative probability of remaining improved at 6 months when treatment was not stopped was 40 p. 100 (confidence limits to 95 p. 100: 23 p. 100-59 p. 100). Five complications occurred, 3 rectovaginal fistulas and 2 stenosis.

Adenocarcinoma↗
PubMed1987

[Cryotherapy of rectal tumors in the elderly patient].

Until now 29 patients (older than 70 years of age) have been treated by cryotherapy for a rectal carcinoma. In 8 patients the tumour disappeared while in 14 good palliation was achieved. Small tumours of the rectal wall can be treated curatively by cryotherapy. In larger tumours local symptoms can be diminished avoiding a permanent colostomy. Complications due to cryotherapy are rare.

Aged↗
PubMed1989

Screening for large bowel cancer.

Is there a need for yet another screening process to be applied in general practice with all the consequent costs in terms of materials, doctors' time and patient anxieties? What is the evidence for and against screening for colorectal cancer?

Adolescent↗
PubMed1989

[Deep rectal cancer: selection of surgical methods in relation to site and extension].

The procedure of choice for most pT1 and a few pT2 tumors in the lower-third of the rectum is excision or local endoscopic polypectomy. In 602 radically resected low rectal carcinomas, the local recurrence rate for LAR was 18% and for APE 17%. There was no difference in local recurrence for UICC stage I and II tumors with a small (less than or equal to 2 cm) versus a large (greater than or equal to 3 cm) distal margin. However, in UICC stage III B and III C there was a statistically significant difference between a small (56%) and a large (22%) distal margin for LAR, while the local recurrence was 29% for APE. LAR in stage III B + C should be performed only when a distal margin of 3 cm is guaranteed.

Follow-Up Studies↗
PubMed1985

[Cryosurgery in inoperable rectal cancer].

26 patients suffering from nonresectable adeno-carcinoma of the rectum have been treated since Sept. 1980. The mean age was 72 years. The temperature of the probe tip was -160 degrees C. A closed system with liquid nitrogen was used. In 12 patients there was an indication of systemic inoperability, 13 had an irremovable tumour or metastases. 1 patient refused curative operation. Cryosurgery was aimed at reducing the mass of rectal tumours and preventing colostomy. Colostomy could also be avoided in 12 of 14 patients suffering from stenosing tumours. The advantages of cryotherapy are outpatient treatment, no anaesthesia and minimal complications. Generally, this method will yield good results in palliative treatment of inoperable rectal carcinomata.

Adenocarcinoma↗