ABSTRACT
OBJETIVO: Relatar série de 14 casos de câncer colorretal T4 complicado (perfuração) submetidos à cirurgia curativa, analisando a morbidade, mortalidade e sobrevida dos doentes. MÉTODOS: Os dados completos de 14 pacientes submetidos a esse tipo de operação por adenocarcinoma colorretal T4 complicado entre 1999 e 2007 foram avaliados. Foram analisados os achados epidemiológicos e cirúrgicos. A sobrevida em longo prazo também foi avaliada. RESULTADOS: A mortalidade pós-operatória foi de 14 por cento (n=2). A morbidade global foi de 50 por cento (n=7). Dez ressecções foram R0 (71 por cento). Seis doentes apresentaram linfonodo comprometido (43 por cento) e todos faleceram de recurrência do tumor (4 - 19 meses). Seis doentes (n=6) estavam vivos sem recidiva (entre 18 e 70 meses/seguimento). A sobrevida global em cinco anos foi de 25 por cento (n=3). CONCLUSÃO: A ressecção radical (R0) do câncer colorretal perfurado apresenta altos índices de morbidade e mortalidade. A despeito de uma elevada recurrência tumoral, esse procedimento pode oferecer controle da doença em longo prazo.
AIM: To report on a series of 14 patients with a complicated T4 colorectal cancer (perforated) and describe the outcomes (morbidity, mortality and long-term survival) following curative surgery. METHODS: Complete follow-up data were available on 14 patients who underwent curative surgery from perforated colorectal adenocarcinoma between 1999 and 2007. Both epidemiological and surgical findings were analyzed. Long-term survival was evaluated too. RESULTS: The postoperative mortality was 14 percent (n=2). The overall morbidity was 50 percent (n=7). Ten resections were R0 (71 percent).Lymph node involvement was present in six patients (43 percent), and all of them died due to tumor recurrence (4-19 months). Six patients (50 percent) were alive without tumor recurrence (between 18 and 70 months/follow-up). The overall 5-year survival rate was 25 percent (n=3). CONCLUSION: Radical resection (R0) of pefurated colorectal cancer presents high rates of morbidity and mortality. In spite of its high rate of tumor recurrence, this procedure may offer long-term disease control.
Subject(s)
Humans , Male , Female , Middle Aged , Colorectal Neoplasms , Morbidity , Mortality , Survival Rate , Treatment OutcomeABSTRACT
Pyogenic hepatic abscess by a foreign body is a rare disease and its diagnosis is habitually made during necropsy. The authors present a case of a woman operated because of a pyogenic hepatic abscess, in the interior of which bristle made of material of vegetable origin were encountered and identified in the laboratory as the principal rib of a leaf, known in Brazil as piaçava. The hepatic abscess was drained and the patient was discharged. The probable mechanism for the formation of the hepatic abscess consisted of the accidental ingestion, perforation of the intestines and penetration in the liver.