ABSTRACT
Background: Radiotherapy is an important factor which results in increase of anastomosis leakage. Diverting loop ileostomy has been usually performed after colorectal anastomosis with history of neo-adjuvant radiotherapy to decrease the chance of leakage. Considering this effect, we assessed the feasibility and outcome of human amniotic membrane in rectal anastomosis in dogs previously treated by high-dose radiotherapy
Materials and Methods: Twelve cross-breed male dogs with the age of 6-8 months and weighting 10-15 kg were randomly divided into four groups. Groups 1 and 2 received radiotherapy and 4 weeks later, single layer end to end anastomosis was performed for all the dogs; also, diverting loop ileostomy was placed in groups 1 and 3. Four weeks later, the anastomosis site was resected and sent for pathologic wound healing scoring. Data were analyzed by SPSS 16 software using Mann- Whitney test
Results: Two dogs [of group 1 and 2] died of peritonitis due to anastomosis leakage during the 2[nd] post operation week. There was no statistically significant difference in wound healing between the case and control groups [P-Value: 0.01]
Conclusion: HAM had a protective role in colorectal anastomosis after neo-adjuvant radiation in cases without loop diverting ileostomy. It can be concluded that HAM placement is a feasible technique instead of diverting loop ileostomy in cases with neo-adjuvant radiotherapy and also in the benign colorectal diseases with high risk anastomoses
ABSTRACT
Background: Colorectal carcinoma is the third most common cause of death in Iran. This study was performed in order to determine the appropriate distal clearance margin [DCM] for resection of rectal cancer in patients who undergo neoadjuvant chemoradiotherapy for sphincter preserving procedure. Materials and Methods: This was a cross-sectional study conducted in Shahid Faghihi Hospital of Shiraz University of Medical Sciences from 2006 to 2011. We included all patients with low rectal cancer who underwent neoadjuvant chemoradiotherapy. The medical charts of patientsand disease characteristics were recorded. The local recurrence, recurrence-free survival and mortality rates were compared between those with DCM >/=2cm and DCM <2cm. Results: Overall, 82 patients with a mean age of 56.7 +/- 16.4 years were included. The DCM was found to be >/=2cm in 45 [54.9%] patients and <2cm in 37 [45.1%]. The two study groups were comparable in terms of age [p=0.573], sex [p=0.505], histopathological tumor grade [p=0.165], and distance of tumor to anal verge [p=0.125]. Patients with DCM >/=2cm had a lower local recurrence rate [35.6% vs. 97.3%; p<0.001], a higher recurrence-free survival rate [88.9% vs. 67.6%; p=0.032] and a lower mortality rate [11.1% vs. 32.4%; p=0.027]. Conclusion: Although some studies have showed that DCM<2cm leads to similar results compared to DCM>/= 2cm, our findings revealed that obtaining a distal clearance margin of 2cm for resection of rectal cancer in patients who have undergone neo-adjuvant chemoradiotherapy is associated with a lower local recurrence rate, higher recurrence-free survival rate and lower mortality rate
ABSTRACT
Acut Otitis Media [AOM] is one of the most frequent diseases in children. Antibiotic therapy prevents the complications and decreases the period of the disease. This study was conducted to compare the efficacy of a single dose of intramuscular ceftriaxone and oral amoxicillin in treatment of this infection. This study was carried out on 160 children under 6 years suffering from AOM. They divided in two groups of 80s. The first group was treated with 50-80 mg/kg/day of oral amoxicillin for 10 days and the second group with a single dose [50 mg/kg] of intramuscular ceftriaxone. The patients were evaluated for responding to treatment with the antibiotics, 2 and 4 weeks after the first visit. Our results showed that 58.8% of patients were boys and 41.2% were girls and the efficacy of the two drugs were similar with%80 efficacy [p>0.05]. There was no significant relationship between risk factors and the resolution of the disease. Amoxicillin is as effective as ceftriaxone in the treatment of AMO. Therefore its vsage in the treatment of AOM is recemended