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At least 1,117 records · Page 62Linked to original sources
PubMed1986

[Value of preoperative study methods in midrectal cancer. Microscopy versus macroscopy].

A retrospective analysis was made of data pre-operatively obtained from 110 patients who had undergone curative, palliative or exploratory surgery for midrectal carcinoma, between 1972 and 1983. Macroscopic tumour findings obtained from rectoscopy, in that context, were found to provide a clue to loco-regional spread (p = between 0.0001 and 0.0162). On the other hand, no information as to loco-regional spread proved to be recordable by histological typing of mid-rectum carcinomas, but for tubulo-papillary carcinoma (p = 0.0153). Grading could provide a clue as to possible lymph node involvement (p = 0.0205). A clearly differentiated prognosis could be usually made by macroscopic tumour appearance (p = 0.0001 to 0.0657). Histological typing was of no value for prognostication (p larger than 0.337), while the value of grading proved to be extremely low (p = 0.1819). Incidence of locally delimited recurrences could not be safely forecast at all, neither by macroscopic assessment (p larger than 0.119) nor by microscopy (p larger than 0.161). The information obtainable from macroscopic findings on both present phase and prognosis was generally greater than that recorded from histological processing of biopsy material (p = 0.0470) and should, therefore, by no means be neglected in pre-operative reconnaissance.

Adenocarcinoma↗
PubMed1977

[Clinical value of rectal digital examination in early diagnosis of colorectal cancer (author's transl)].

A prospective study was carried out on a series of 1500 patients of a gastro-enterological and surgical unit in order to evaluate critically the accuracy of rectal digital examination as a single tool in the early diagnosis of colorectal tumours. The patients in this study were explored independently by two investigators, first by rectal digital palpation and afterwards by means of the proctosigmoidoscope. Endoscopy confirmed the presence of 239 tumours, 96 of these being diagnosed histologically as carcinoma. Comparative analysis of the results of physical and endoscopic examination demonstrated that digital palpation provided a correct diagnosis in 58 out of 239 tumours, equivalent to an accuracy of 24.3% for tumours within the reach of the rectoscope, and 10% for all colorectal tumours. Hence, rectal examination should not be used as single diagnostic tool in screening for large bowel cancer. A multiphasic screening system, including investigations for occult blood, proctosigmoidoscopy, endoscopic polypectomy and determination of colon-embryonic-antigen levels is discussed to obtain better results in general health screening, early diagnosis and avoidance of incurable colorectal carcinomas and the early detection of recurrence.

Colonic Neoplasms↗
PubMed1987

[The efficacy of temporary retention chemotherapy of the treatment of polyps in the remnant rectum of familial polyposis after total colectomy and ileorectostomy--a case report].

A case of familial polyposis is reported. The patient was a 24-year-old woman on whom total colectomy followed by ileorectostomy had been performed. However, there were multiple polyps remaining in the remnant rectum. For the treatment of these residual polyps, a new chemotherapeutic method known as Temporary Retention Chemotherapy (TRC), originally devised by us for the treatment of advanced gastric cancer, was applied. A balloon catheter was inserted and fixed into the rectum via the anus for the treatment of the rectal tumors. Through the catheter, high-dose 5-fluorouracil (5-FU) solution was injected into the rectum and retained there for one hour before being discarded. During the therapy, the patient was asked to change her position of recumbency at certain intervals, so that the 5-FU solution could act evenly on the lesions in question. This therapy was repeated twice a week, and followed by routine endoscopic studies. A total dose of 5,700 mg of 5-FU was necessary for obtaining a complete response of the remnant lesions. 6 months later, 4 polyps were found, and TRC was again applied, resulting in disappearance of the polyps again after the therapy. So far, no side-effect have been noted as a result of this therapy. She is currently still alive without any residual polyps, carcinoma or metastasis 6 years after the operation.

Adenomatous Polyposis Coli↗
PubMed1979

Colonoscopy in lower gastro-intestinal haemorrhage.

The value of colonoscopy in the diagnosis and management of lower gastro-intestinal haemorrhage was assessed in 107 patients who were examined during a 2-year period. The main indications were to define uncertain radiological findings, to further investigate the cause of bleeding in patients with normal barium studies and to carry out polypectomy. Radiological lesions were confirmed in 27, defined in 12, and refuted in 14 patients. Twenty-eight lesions were demonstrated on colonoscopy which were not diagnosed by barium enema or sigmoidoscopy. A diagnosis was made by colonoscopy in more than two-thirds of the patients with frank blood loss and normal radiographs. In cases of occult bleeding it was farless helpful. Colonoscopy significantly improved diagnosis and management of gastro-intestinal bleeding when the cause was in doubt after standard investigations. In addition, 37 polyps were removed through the colonoscope from 30 patients.

Gastrointestinal Hemorrhage↗
PubMed1985

[Intestinal involvement in Behçet's syndrome].

Intestinal lesions in Behçet's syndrome are much more common in Japan than in the Western World. Colonic or ileo-colonic lesions develop after several years of recurrent aphthae and are manifested by acute complications, such as perforation or massive haemorrhage, or by protracted haemorrhagic diarrhoea with progressive deterioration of the patient's general condition. Radiological and endoscopic findings are similar to those of severe acute colitis, such as ulcerative colitis or Crohn's disease. The diagnosis of Behçet's syndrome involving the bowel rests on the presence of numerous extra-intestinal lesions and of extensive colonic ulceration often located in otherwise healthy parts of the mucosa. Histology shows, beside a non-specific inflammatory infiltrate affecting the entire wall of the colon, lesions of vasculitis and perivasculitis with images of leucocytoclasia and fibrinoid necrosis. Surgery is often necessary, requiring wide intestinal resections and long-term derivation ileostomies because of the high incidence of recurrent ulcers at the site of anastomosis, where fistulae may also develop.

Behcet Syndrome↗
PubMed1988

[Malignant melanoma in the anorectal region--a report of two cases].

Case 1. A 61-year-old male, suffering from an anorectal tumor with anal bleeding, underwent an abdominoperineal rectal amputation with an R3 lymphadenectomy. The tumor was a Stage I (H0, P0, N0, S0) malignant melanoma. Despite DAV (DTIC, ACNU, and VCR) therapy, liver metastasis was detected 1 year later and the patient died 1.5 years after the operation. Case 2. A 80-year-old female, complaining of bloody stool, was diagnosed to have an anorectal malignant melanoma. She was at Stage IV and underwent an abdominoperineal rectal amputation with an R3 lymphadenectomy. The tumor 4.5 X 2.7 X 1.2 cm in size, was diagnosed to be at Stage IV (pm, n2+). She is still alive 4 years later without having received sufficient chemotherapy.

Aged↗
PubMed1977

[Functional disorders of distal colon in children (author's transl)].

Functional disorders of the distal part of the colon in neonates and infants should be diagnosed by X-ray investigations (defecograms), double-suction biopsies (Erlanger children suction biopsy apparatus), anorectal and sigmoidal manometry and coloscopic functional investigations. 90% of all disorders of the distal colon can be diagnosed by manometric studies, in 40% X-ray investigations will lead to an exact diagnosis, in 12% double suction biopsies and in 10% coloscopic investigations establish the right diagnosis. The double suction biopsy is important for the exclusion of aganglionosis. Either a conservative or a surgical treatment is necessary, depending on the primary lesion. Wash outs, sphinctertraining, toilet training are necessary in cases of prolonged constipation following sigmaresection with restmegacolon, in cases of rectal inertia syndrom, and in cases of overflow incontinence. A pressure reducing operation (a sphincteromyotomy) is indicated in ultrashort aganglionic segments, in special cases of elongated sigma, in cases of prolonged constipation after sigma resection and with disturbed reflex mechanism, in cases of sphincter inhibition syndrome, and in children with paradox reflex mechanism. A resection is indicated in Hirschsprung disease, mechanical obstruction of the bowel, very large and severe cases of sigma elongatum and in cases of overflow-incontinence.

Biopsy↗
PubMed1988

[Primary clinical, endoscopic and histologic findings in solitary rectal ulcer].

This study presents clinical, endoscopical and histological primary findings of solitary ulcer of the rectum obtained in 24 patients. Solitary ulcer of the rectum is preferably a disease of young women. The main symptom is recurrent rectal bleeding. Endoscopically in 50% of all cases mucosal ulcerations can be observed. The other cases are non-ulcerous lesions with uncharacteristic endoscopical findings. The majority of the lesions are within 6-8 cm of the anal margin. In 44% of the patients there are findings, which are suspicious of preexisting rectal prolapse. The histological main criterion is a fibromuscular hyperplasia of the lamina propria. Full agreement of endoscopical and histological diagnosis at primary examination could be obtained in only 17% of the cases.

Adult↗