[The abdominal route in the surgical treatment of recto-sigmoid neoplasms].
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The aim of this study was to determine whether there is a relationship between sedentary occupation and the occurrence of rectal and sigmoid cancer. 105 patients with histologically proven rectal cancer were questioned. 55 patients with gastric carcinoma and 99 patients with cholelithiasis served as control groups. The percentage of patients with a sedentary occupation is significantly higher in the group with rectal cancer. In addition, the mean duration of the sedentary occupation is also longer. A direct relationship between the sedentary occupation and the tumor stage is obvious. It is concluded that a sedentary occupation-which leads to changes in the motility of the large bowel-had to be considered a risk factor in the occurence of rectal and sigmoid cancer.
A rare case is reported of coexistence of aortic abdominal aneurysm with sigmoid tumour. Emergency surgical treatment was instituted.
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PURPOSE: To evaluate the accuracy of spiral hydro-CT in the diagnosis and preoperative staging of colo-sigmoideal neoplasms and the impact of this technique on therapeutic decisions. MATERIALS AND METHODS: Sixty patients with colo-sigmoideal neoplasms, 16 in caecum-ascending colon, 2 in transverse colon, 14 in descending colon, and 28 in sigmoid colon, diagnosed with fiberoptic colonoscopy and histopathological specimen, under-went spiral hydro-CT with IV contrast medium administration. Local invasion (T factor) and nodal involvement (N factor) were evaluated. In all cases, the CT reports were compared with the result of the histopathological examination of the surgical specimen. TNM and Dukes staging classifications were applied. RESULTS: Local invasion was correctly identified in 80% of cases. There was overstaging in 18.3% and understaging in 1.7% of the patients. Sensitivity, specificity and accuracy for nodal involvement were 57.9%, 67.5% and 63.3%, respectively. There was overstaging in 23.3% and understaging in 15% of patients. With Dukes classification, CT correctly staged 38.8% of patients. Significant differences were detected in different stages. The stage with the highest concordance was A/B1 with 58.8% (10/17), whereas the one with the lowest concordance was B2 with 9.1% (2/22). All of the three patients in stage D were correctly staged and none of the patients with stage C was overstaged. CONCLUSIONS: Spiral hydro-CT with intravenous contrast medium administration, despite the limits in the correct evaluation of local depth invasion and nodal involvement, proved useful for selecting patients likely to benefit from surgery.
The authors consider the association of colonic neoplasia and hernia of abdominal wall. Such association, although not so frequent, was formerly remarked in literature 23 times; with the personal casuistic contribution of the authors, who recently observed a case thereof in an old patient woman, such remarks amount to 24. The authors describe the case they have the opportunity to observe, and report the experience of the other authors thereabout, through a careful reviewing of the literature starting from 1930 up to our time.
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