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1.
rev.cuid. (Bucaramanga. 2010) ; 13(3): 1-14, 20220831.
Article in Portuguese | LILACS, BDENF, COLNAL | ID: biblio-1402491

ABSTRACT

Objetivo: Conhecer o acesso e aguardo pela estomização de pessoas adoecidas por câncer colorretal no nível terciário do Sistema Único de Saúde. Materiais e Métodos: Estudo etnográfico fundamentado na Sociologia da Saúde, com 8 familiares e 14 adoecidos em Centro de Alta Complexidade em Oncologia, Brasil. Os dados foram coletados entre outubro de 2018 a março de 2019, com observação participante e não participante, registro em diário de campo e entrevista semiestruturada. Os depoimentos e notas etnográficas após triangulação foram submetidos a análise indutiva de conteúdo em seis etapas. Resultados: Apreenderam-se "A história do adoecimento entrecortada pelas dificuldades" e "As perdas no processo de paciência-resiliência no percurso". Discussão: Em busca de validações biomédicas foram reportados três tipos de acesso ao sistema médico, assim como os subsentidos "paguei no particular" e atraso diagnóstico mobilizaram via oficial e não oficial no Sistema Único de Saúde. O capital social foi analisado como premente no adoecimento, uma rede de contatos sem a qual o acesso dos usuários é impactado. No nível terciário enquanto aguardam pela estomização desvelou-se a resiliência não como recurso heroico, mas como recurso pessoal e coletivo diante do percurso dificultoso e da semi-reclusão na instituição total onde vivenciam medos, fadiga e dores. Conclusão:O acesso contou com mobilização relacional e uma gama de vias até a internação com parte do percurso na saúde suplementar, já o aguardo pela estomização mitiga a paciência ao passo que torna a resiliência um recurso benéfico na espera pela programação cirúrgica.


Introduction: The access of people with colorectal cancer to surgical treatment with stomization implies a difficult itinerary through the network of care, and when accessing the tertiary level in an apprehensive preoperative waiting. Objetive: To know the access and waiting for stomization of people sick with colorectal cancer at the tertiary level of the Brazilian Unified Health System. Materials and Methods:Ethnographic study based on the Sociology of Health, with 8 relatives and 14 patients in a High Complexity Oncology Center, Brazil. Data were collected between October 2018 to March 2019, with participant and non-participant observation, field diary recording, and semi-structured interview. Statements and ethnographic notes after triangulation were subjected to inductive content analysis in six steps. Results:"The history of illness interspersed with difficulties" and "The losses in the process of patience-resilience along the way" were apprehended. Discussion: Three types of access were reported, as well as the sub-meanings "I paid privately" and the diagnostic delay mobilized by official and unofficial means in the Unified Health System. Social capital is pressing, a network without which users' access is impacted. At the tertiary level while waiting for stomization, resilience was unveiled not as a heroic resource, but as a personal and collective resource. Conclusion: The access counted on relational mobilization and a range of paths to hospitalization with part of the journey in supplementary health, while the waiting for stomization mitigates patience making resilience a beneficial resource in the wait for surgical programming.


Introducción: El acceso de las personas con cáncer colorrectal al tratamiento quirúrgico con estomización implica un difícil itinerario a través de la red asistencial, y al acceder al nivel terciario en una aprensiva espera preoperatoria. Objetivo: Conocer el acceso y el aguante de las personas afectadas por el cáncer colorrectal en el nivel terciario del Sistema Único de Salud. Materiales y Métodos: Estudio etnográfico basado en la Sociología de la Salud, con 8 familiares y 14 pacientes en Centro Oncológico de Alta Complejidad, Brasil. Los datos se recogieron entre octubre de 2018 y marzo de 2019, con observación participante y no participante, registro de diario de campo y entrevista semiestructurada. Los testimonios y las notas etnográficas, tras la triangulación, se sometieron a un análisis de contenido inductivo en seis etapas. Resultados: Se aprende "La historia del adoctrinamiento entrecortado por las dificultades" y "Las pérdidas en el proceso de pacificación-resiliencia en el curso". Discusión: Se reportaron tres tipos de acceso, así como los subsentidos "pagué en el privado" y el atraso diagnóstico se movilizaron vía oficial y no oficial en el Sistema Único de Salud. El capital social es apremiante, una red de contactos sin la cual el acceso de los usuarios se ve afectado. En el nivel terciario, mientras aguantan por la estomatología, la resistencia se revela no como un recurso heroico, sino como un recurso personal y colectivo. Conclusión: El acceso a la movilización relacional y a una gama de vías hasta la internación con parte del curso en la salud suplementaria, ya que la espera por la estomización mitiga la pacificación haciendo de la resiliencia un recurso benéfico en la espera por el programa quirúrgico.


Subject(s)
Sociology, Medical , Unified Health System , Colorectal Neoplasms , Medicalization , Health Services Accessibility
2.
Horiz. meÌüd. (Impresa) ; 22(3): e1977, jul.-sep. 2022. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1405050

ABSTRACT

RESUMEN El cáncer colorrectal (CCR) es la segunda causa de muerte por cáncer en los Estados Unidos y Europa; en el Perú alcanza el cuarto lugar, tanto en incidencia como en mortalidad. La colonoscopía es el patrón de referencia de las pruebas de screening, con una sensibilidad y especificidad para identificar pólipos y cáncer por encima del 98 %; sin embargo, es una prueba invasiva, que debe repetirse con cierta frecuencia y su implementación es costosa; tiene bajas tasas de cumplimiento y un riesgo de perforación de 1 por cada 1000 a 10 000 colonoscopias. Estas limitaciones hacen que no tenga éxito como herramienta de detección precoz en términos de costos de implementación en muchos países. Una alternativa es el uso de los biomarcadores plasmáticos de tumor, los cuales son productos moleculares metabolizados y secretados por el tejido neoplásico. Estas pruebas están fundamentadas en la obtención de proteínas o ácidos nucleicos, y representan una herramienta para la detección precoz, pronóstico, supervivencia y predicción de la respuesta al tratamiento del CCR. El objetivo del presente trabajo es analizar la utilidad de los biomarcadores plasmáticos basados en proteínas para la detección precoz del CCR. Asimismo, se propone una combinación de biomarcadores que incluye el antígeno carcinoembrionario, la ciclooxigenasa 2, el inhibidor tisular de metaloproteinasa-1 y el autoanticuerpo p53 para maximizar los beneficios de la detección precoz de lesiones premalignas y cáncer colorrectal, y minimizar el número de pacientes con pruebas falsas positivas e investigaciones invasivas con potenciales complicaciones.


ABSTRACT Colorectal cancer (CRC) is the second leading cause of cancer death in the United States and Europe. In Peru, it ranks fourth for both incidence and mortality. Colonoscopy is the gold standard for screening tests, showing high sensitivity and specificity to identify polyps and cancer (> 98 %). However, it is an invasive procedure, which should be repeated at certain intervals, is expensive, and has low compliance rates and a perforation risk of 1 per 1,000 to 10,000. These limitations make it useless as an early detection tool in terms of implementation costs in many countries. An alternative is the use of plasma tumor biomarkers, which are molecular products metabolized and secreted by neoplastic tissue. These tests are based on proteins or nucleic acids, and represent a tool for the early detection, prognosis, survival and prediction of the response to CRC treatment. The objective of this research work is to analyze the usefulness of protein-based plasma biomarkers for the early detection of CRC. Moreover, a combination of biomarkers that includes carcinoembryonic antigen, cyclooxygenase 2, tissue inhibitor of metalloproteinase-1 and p53 autoantibodies is proposed to maximize the benefits of early detection of premalignant lesions and colorectal cancer, and minimize the number of patients with false-positive results and invasive procedures with potential complications.

3.
J. coloproctol. (Rio J., Impr.) ; 42(2): 187-189, Apr.-June 2022. ilus
Article in English | LILACS | ID: biblio-1394417

ABSTRACT

Introduction: McKittrick-Wheelock syndrome is a rare condition that arises from a hypersecretory state secondary to large colorectal tumors, mainly villous adenomas, leading to an electrolytic disorder associated with chronic diarrhea that usually persists for years. It is a relatively unknown disease that can lead to severe complications such as acute kidney injury, severe hyponatremia, and hypokalemia. In fact, it causes death in most untreated cases. Surgical removal of the tumor is the most successful treatment, and symptoms tend to disappear after proper management. Case Report: A 62-year-old man with a 2-year history of mucoid diarrhea preceded by abdominal pain presented with acute kidney injury, hyponatremia, and hypokalemia. A digital rectal examination and sigmoidoscopy were performed, and revealed a large laterally-spreading tumor in the rectum. Further investigation showed a rectal tubulovillous adenoma with secondary McKittrick-Wheelock syndrome. An anterior resection of the rectum with a colonic J-pouch and a diverting ileostomy were performed, and the patient improved with the resolution of the renal failure and electrolyte disturbances. The histopathological analysis revealed an invasive rectal adenocarcinoma. Discussion: McKittrick-Wheelock syndrome is a condition with a low incidence that needs early intervention and proper diagnosis. It is of extreme importance that this disease is included in the differential diagnoses for chronic diarrhea associated with an electrolytic disorder. (AU)


Subject(s)
Humans , Male , Middle Aged , Rectal Neoplasms/complications , Water-Electrolyte Imbalance/etiology , Adenocarcinoma/complications , Diarrhea/etiology , Acute Kidney Injury/etiology , Syndrome
4.
Arq. gastroenterol ; 59(2): 296-303, Apr.-June 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1383839

ABSTRACT

ABSTRACT Background: The nutritional status of patients with colorectal cancer (CRC) impacts on treatment response and morbidity. An effective evaluation of the body composition includes the measurements of fat and visceral fat-free mass and is currently being used in the diagnosis of the nutritional status. The better understanding regarding nutritional tools for body composition evaluation in CRC patients may impact on the outcome. Methods: Systematic review conducted according to Preferred Items of Reports for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A literature search was performed using the BVS (LILACS), PubMed, Embase, Cochrane, Scopus, and Web of Science databases. Results: For the initial search, 97 studies were selected and 51 duplicate manuscripts were excluded. Thus, 46 were reviewed and seven studies included with a total of 4,549 patients. Among them were one clinical trial, one prospective study (cohort), two retrospective cohort and two cross-sectional studies. All studies included body composition evaluated by computed tomography, one with bioelectrical impedance, one with handgrip strength, and two employed mid-arm muscle circumference and body mass index. Conclusion: Current evidence suggests that computed tomography has better accuracy in the diagnosis of sarcopenia, visceral fat, and myopenia among individuals with CRC. Further studies are needed to identify cutoff points for these changes aggravated by CRC.


RESUMO Contexto: O estado nutricional de pacientes com câncer colorretal (CCR) tem impacto na resposta ao tratamento e na morbidade. Uma avaliação eficaz da composição corporal inclui as medidas de gordura visceral e massa livre de gordura e está sendo usada atualmente no diagnóstico do estado nutricional. O melhor entendimento das ferramentas nutricionais para avaliação da composição corporal em pacientes com CCR pode impactar no desfecho. Métodos: Revisão sistemática conduzida de acordo com as diretrizes itens preferidos de relatórios para revisões sistemáticas e meta-análise (PRISMA). Foi realizada uma pesquisa bibliográfica nas bases de dados BVS (LILACS), PubMed, Embase, Cochrane, Scopus e Web of Science. Resultados: Para a busca inicial, 97 estudos foram selecionados e 51 manuscritos duplicados foram excluídos. Assim, 46 foram revisados e sete estudos incluídos, com um total de 4.549 pacientes. Entre eles estavam um ensaio clínico, um estudo prospectivo (coorte), dois estudos retrospectivos de coorte e dois estudos transversais. Todos os estudos incluíram composição corporal avaliada por tomografia computadorizada (TC), um com impedância bioelétrica, um com força de preensão manual e dois empregaram a circunferência muscular do braço e o índice de massa corporal. Conclusão: As evidências atuais sugerem que a TC tem melhor acurácia no diagnóstico de sarcopenia, gordura visceral e miopenia em indivíduos com CCR. Mais estudos são necessários para identificar pontos de corte para essas alterações agravadas pelo CCR.

5.
Rev. méd. Chile ; 150(5)mayo 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1409845

ABSTRACT

In Chile, colorectal cancer ranks third in incidence and fifth in mortality. Half of these patients have liver metastases at the diagnosis, and only 30% of them are resectable. Despite the development of many complex hepatobiliary procedures to achieve the total resection of metastases, the long-term survival with these techniques is not good. Liver transplantation is an alternative to treat unresectable liver metastasis from colorectal cancer with a good outcome. Several prognostic scores allow the selection of patients with good tumor biology. These patients have better overall and disease-free survival after liver transplantation. The use of immunosuppressive treatment doesn't increase recurrence, and even the pattern of tumor growth is slower in liver transplant recipients. The purpose of this review is to summarize the current evidence in this topic and to highlight the need for a formal protocol for liver transplantation for unresectable colorectal liver metastases, using living donors or marginal grafts to avoid competition with the rest of the national waiting list.

6.
Article in English | LILACS | ID: biblio-1410587

ABSTRACT

Intestinal obstruction is the most frequent clinical manifestation of colon tumors, most of which are located in the descending and recto-sigmoid colon. Emergency bowel obstruction surgery is associated with high mortality and morbidity risks and the ideal approach remains controversial. Multi-stage procedures and the use of stents as bridges for surgery are promising options. A case of a 61-year-old patient with an acute obstructive abdomen secondary to colorectal neoplasm is presented, with emphasis on its diagnosis and treatmen (AU)


Obstrução intestinal é a manifestação clínica mais frequente de tumores de cólon sendo esses, em sua maioria, localizados no cólon descendente e reto-sigmoide. A cirurgia de emergência para obstrução intestinal é associada a altos riscos de mortalidade e de morbidade e a abordagem ideal permanece controversa. Procedimentos em vários estágios e o uso de stents como ponte para cirurgia são opções promissoras. É apresentado um caso de paciente de 61 anos, com abdome agudo obstrutivo secundário à neoplasia colorretal, com ênfase em seu diagnóstico e tratamento (AU)


Subject(s)
Humans , Female , Middle Aged , Colorectal Neoplasms/surgery , Colorectal Neoplasms/diagnosis , Colectomy , Abdomen, Acute/diagnosis , Intestinal Obstruction/therapy
7.
Biomédica (Bogotá) ; 42(supl.1): 154-171, mayo 2022. tab, graf
Article in Spanish | LILACS | ID: biblio-1394003

ABSTRACT

Introducción. El cáncer colorrectal tiene una alta incidencia en la población mundial. Diversas vías moleculares están involucradas en su desarrollo, entre ellas, la inestabilidad cromosómica, la inestabilidad microsatelital y la epigenética. Objetivo. Hacer la caracterización molecular de 44 individuos con cáncer colorrectal esporádico. Materiales y métodos. El análisis de mutaciones en los genes APC, KRAS, TP53 y BRAF se hizo mediante secuenciación de Sanger; la inestabilidad microsatelital se determinó mediante electroforesis capilar utilizando cinco marcadores de repetición corta en tándem (Short Tandem Repeat) y el estado de metilación del promotor del gen MLH1 se hizo con la técnica MS-PCR (Methylation-Specific PCR). Resultados. La frecuencia de mutación de los genes APC, KRAS y TP53 fue del 18,1, 25 y 4,5 %, respectivamente; las mutaciones detectadas se localizaron con mayor frecuencia en el colon derecho. La frecuencia de inestabilidad microsatelital fue del 27,2 % y el 73,1 % en los tumores con metilación en el gen MHL1, y el 91,6 % de los tumores con inestabilidad microsatelital presentaba metilación en el gen MLH1. En el grupo de tumores con estabilidad microsatelital, las mutaciones en los genes APC, KRAS y TP53 fueron más frecuentes que en el grupo de tumores con inestabilidad microsatelital. La metilación del gen MLH1 fue la alteración más predominante. Conclusiones. En los pacientes con cáncer colorrectal evaluados se demostró la presencia de alteraciones moleculares en las diferentes vías genéticas, las cuales son comunes en su carcinogénesis. Los pacientes presentaron un perfil de mutaciones diferente al de otras poblaciones. Los hallazgos obtenidos en este estudio confirman la heterogeneidad molecular descrita en el desarrollo del cáncer colorrectal.


Introduction: Colorectal cancer has a high incidence in the world population. Different molecular pathways, such as chromosomal instability, microsatellite instability, and epigenetics are involved in its development. Objective: To perform molecular characterization in 44 individuals with sporadic colorectal cancer. Materials and methods: We conducted mutation analyses of the APC, KRAS, TP53 y BRAF genes using Sanger sequencing techniques; microsatellite instability was determined by capillary electrophoresis with five STR genetic markers while the methylation status of the MHL1 promotor gene was analyzed using methylation-specific PCR. Results: APC, KRAS, and TP53 genes mutation frequency was 18.1%, 25%, and 4.5%, respectively; the somatic mutations detected were located more frequently in the right colon. The frequency of microsatellite instability was 27.2% and 73.1% of the tumors had the MHL1 gene methylated while 91.6% of microsatellite instability-positive tumors had the methylated MLH1 gene. The mutation profile of microsatellite stability tumors APC, KRAS, and TP53 genes was more frequent than in the microsatellite instability-positive tumors. The methylation of the MLH1 gene was the most predominant molecular alteration. Conclusions: We identified molecular alterations in different genetic pathways of the colorectal cancer patients evaluated, which are common in the carcinogenesis of this cancer. These patients showed a different mutational profile compared to other populations. Our findings confirm the molecular heterogeneity described in the development of colorectal cancer.


Subject(s)
Colorectal Neoplasms/genetics , Oncogenes , Genes, Tumor Suppressor , Genetic Heterogeneity , Microsatellite Instability , Epigenomics
8.
J. coloproctol. (Rio J., Impr.) ; 42(1): 14-19, Jan.-Mar. 2022. tab
Article in English | LILACS | ID: biblio-1375763

ABSTRACT

Objective: To determine the impact of the quality of colonoscopy examination for colorectal cancer screening. Methods: Retrospective observational study ofmedical records from patients treated at the endoscopy and colonoscopy service of Hospital Universitário Evangélico Mackenzie (Curitiba, PR, Brazil) from January 2019 to January 2020. Results: The analysis was based on 337 medical records from patients with adenomas identified during colonoscopy, and 1,385 medical records from patients without adenomas. The estimated occurrence rate of diagnosis of adenoma during colonoscopy in the target population of the study was of 19.6%, with a 95% confidence interval ranging from 17.7 to 21.5%. Of the 337 patients with adenoma, 136 (40.4%) presented the advanced form. Statistical analysis indicated a significant association between the quality of colonoscopy preparation and test completion. Conclusion: The quality of colonoscopy images is a critical factor for colorectal cancer screening, as it leads to higher rates of adenoma detection and test completion. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Polyps , Colorectal Neoplasms/diagnosis , Adenoma , Mass Screening , Sensitivity and Specificity , Colonoscopy , Endoscopy
9.
J. coloproctol. (Rio J., Impr.) ; 42(1): 68-76, Jan.-Mar. 2022. ilus
Article in English | LILACS | ID: biblio-1375751

ABSTRACT

Introduction: The gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. Even though it can be found in any location of the digestive tract, the colorectal GIST is rare. With this study, we aim to review the current knowledge regarding the prognosis and management of colorectal GIST. Methods: A literature search was conducted in PubMed, and 717 articles were collected. After analyzing these studies, 60 articles were selected to use in this review. Results: The mitotic index, as well as tumor size and location were identified as good discriminators of prognosis in various studies. Surgery remains the only curative therapy for potentially resectable tumors. However, even after surgical resection, some patients develop disease recurrence and metastasis, especially those with highrisk tumors. Therefore, surgical resection alone might be inadequate for the management of all colorectal GISTs. The discovery of GIST's molecular pathway led to a shift in its therapy, insofar as tyrosine kinase inhibitors became part of the treatment schemes for this tumor, revolutionizing the treatment's outcome and prognosis. Discussion/Conclusion: The controversy concerning colorectal GIST prognosis and treatment can be, in part, attributed to the limited number of studies in the literature. In this review, we gathered the most recent knowledge about the prognosis and management of GIST in this rare location and propose two algorithms for its approach. Lastly, we highlight the importance of an individualized approach in the setting of a multidisciplinary team. (AU)


Subject(s)
Humans , Rectum , Colon , Gastrointestinal Stromal Tumors/therapy , Gastrointestinal Neoplasms/secondary , Prognosis , Gastrointestinal Stromal Tumors/surgery , Neoplasm Metastasis
10.
Säo Paulo med. j ; 140(2): 244-249, Jan.-Feb. 2022. tab
Article in English | LILACS | ID: biblio-1366048

ABSTRACT

ABSTRACT BACKGROUND: The coronavirus disease-19 (COVID-19) pandemic has changed the course of diseases that require emergency surgery. OBJECTIVE: To evaluate the effect of the COVID-19 pandemic on colorectal cancer disease stage. DESIGN AND SETTING: Retrospective analysis in the city of Rize, Turkey. METHODS: This was a comparative analysis on two groups of patients with various symptoms who underwent surgical colorectal cancer treatment. Group 1 comprised patients operated between March 11, 2019, and December 31, 2019; while group 2 comprised patients at the same time of the year during the COVID-19 pandemic. RESULTS: Groups 1 and 2 included 56 and 48 patients, respectively. The rate of presentation to the emergency service was higher in Group 2 (P < 0.02). The stage of the pathological lymph nodes and the rate of liver metastasis was higher in Group 2 (P < 0.004 and P < 0.041, respectively). The disease stage was found to be more advanced in Group 2 (P < 0.005). The rate of postoperative complications was higher in Group 2 (P < 0.014). CONCLUSION: The presentation of patients with suspicious findings to the hospital was delayed, due both to the fear of catching COVID-19 and to the pandemic precautions that were proposed and implemented by healthcare authorities worldwide. Among the patients who presented to the hospital with emergency complaints and in whom colorectal cancer was detected, their disease was at a more advanced stage and thus a higher number of emergency oncological surgical procedures were performed on those patients.


Subject(s)
Humans , Colorectal Neoplasms/surgery , COVID-19/surgery , Retrospective Studies , Pandemics , SARS-CoV-2
11.
Article in Portuguese | LILACS | ID: biblio-1369019

ABSTRACT

RESUMO: Obstrução intestinal é a manifestação clínica mais frequente de tumores de cólon sendo esses, em sua maioria, localizados no cólon descendente e reto-sigmoide. A cirurgia de emergência para obstrução intestinal é associada a altos riscos de mortalidade e de morbidade e a abordagem ideal permanece controversa. Procedimentos em vários estágios e o uso de stents como ponte para cirurgia são opções promissoras. É apresentado um caso de paciente de 61 anos, com abdome agudo obstrutivo secundário à neoplasia colorretal, com ênfase em seu diagnóstico e tratamento. (AU)


ABSTRACT: Intestinal obstruction is the most frequent clinical manifestation of colon tumors, most of which are located in the descending and recto-sigmoid colon. Emergency bowel obstruction surgery is associated with high mortality and morbidity risks and the ideal approach remains controversial. Multi-stage procedures and the use of stents as bridges for surgery are promising options. A case of a 61-year-old patient with an acute obstructive abdomen secondary to colorectal neoplasm is presented, with emphasis on its diagnosis and treatment. (AU)


Subject(s)
Humans , Female , Middle Aged , Colorectal Neoplasms , Colectomy , Abdomen, Acute , Intestinal Obstruction/surgery , Megacolon/diagnosis
12.
Rev. bras. enferm ; 75(2): e20210751, 2022. tab, graf
Article in English | LILACS-Express | LILACS, BDENF | ID: biblio-1407412

ABSTRACT

ABSTRACT Objectives: to analyze colorectal cancer mortality trends in women in Brazil and its regions and states. Methods: ecological, time-series study with trend analysis of deaths caused by colorectal cancer in women in Brazil and its regions and states between 2008 and 2019. Polynomial regression was used to treat the data. Results: 48,225 deaths of women caused by colorectal cancer were examined. There was an increasing mortality trend in Brazilian women, with regional differences that resulted from socioeconomic, political, and cultural inequalities. The South Region stood out with the highest rate (7.32) in 2008, which increased to 8.65 in 2019, followed by the Southeast Region, whose rates were 6.72 and 9.05 in 2008 and 2019, respectively. Conclusions: colorectal cancer mortality increased, which indicates the need to expand public policies oriented toward screening and early diagnosis of colorectal cancer in women.


RESUMEN Objetivos: analizar las tendencias de mortalidad por cáncer colorrectal de mujeres en Brasil, Estados y Regiones. Métodos: estudio ecológico, de series temporales, con análisis de tendencia de decesos por cáncer colorrectal en mujeres, entre 2008 y 2019. Para análisis de tendencia se utilizó el modelo de regresión polinomial. Resultados: se analizaron 48.225 decesos de mujeres por cáncer colorrectal. Se observó tendencia creciente de mortalidad en las mujeres brasileñas, con diferencias regionales debidas a desigualdades de estándares socioeconómicos, políticos y culturales. Se manifiesta un aumento en la Región Sur, con tasa de 7,32 en 2008 incrementando a 8,65 en 2019, siguiéndole la Región Sudeste, con tasas de mortalidad de cáncer colorrectal de 6,72 y 9,05 en 2008 y 2019. Conclusiones: se observa aumento de tasas de mortalidad por cáncer colorrectal, demostrándose necesidad de incrementar las políticas públicas orientadas a estrategias de rastreo y diagnóstico precoz del cáncer colorrectal en mujeres.


RESUMO Objetivos: analisar as tendências da mortalidade por câncer colorretal em mulheres no Brasil, Estados e Regiões. Métodos: estudo ecológico, de séries temporais, com análise de tendência dos óbitos por câncer colorretal de mulheres, no período de 2008 a 2019. Para análise de tendência, foi utilizado o modelo de regressão polinomial. Resultados: analisaram-se 48.225 óbitos de mulheres por câncer colorretal. Houve tendência crescente da mortalidade em mulheres brasileiras, com diferenças regionais, em razão das desigualdades nos padrões socioeconômicos, políticos e culturais. Destacando um aumento na Região Sul, com as maiores taxas, de 7,32 em 2008 para 8,65 em 2019, seguida pela Região Sudeste, com taxas de mortalidade por câncer colorretal de 6,72 e 9,05 em 2008 e 2019, respectivamente. Conclusões: observa-se um aumento das taxas de mortalidade por câncer colorretal, demonstrando a necessidade do incremento das políticas públicas direcionadas às estratégias de rastreamento e diagnóstico precoce do câncer colorretal em mulheres.

13.
Rev. gaúch. enferm ; 43: e20210123, 2022. tab
Article in English | LILACS-Express | LILACS, BDENF | ID: biblio-1409395

ABSTRACT

ABSTRACT Objective: To evaluate fatigue and health-related quality of life of colorectal cancer patients undergoing chemotherapy. Method: Descriptive study conducted with 69 patients between January and September/2019 in a public hospital in Minas Gerais. Instruments used: sociodemographic and clinical questionnaire, Quality of Life Questionnaire-Core30 and Piper Fatigue Scale, analyzed according to measures of frequency, mean and standard deviation by the software PSPP. Results: Most patients were women over 60 years old, married, retired and housewives, with an average level of education. The scores of general health status, social, physical, emotional and role functioning were considered satisfactory (means 50 to 70), cognitive function was good (mean higher than 70); the most prevalent symptoms were loss of appetite, fatigue, pain and insomnia. As for fatigue, all dimensions had a mean value <4, considered mild fatigue. Conclusion: Quality of life had satisfactory scores and fatigue was classified as mild in patients undergoing chemotherapy.


RESUMEN Objetivo: Evaluar la fatiga y la calidad de vida relacionada con la salud de los pacientes con cáncer colorrectal sometidos a quimioterapia. Método: Estudio descriptivo, realizado con 69 pacientes entre Enero y Septiembre/2019 en un hospital público de Minas Gerais. Instrumentos utilizados: cuestionario sociodemográfico y clínico, Quality of Life Questionnaire-Core30 y Piper Fatigue Scale, analizados según medidas de frecuencia, media y desviación estándar por el software PSPP. Resultados: La mayoría eran mujeres, mayores de 40 años, casadas, jubiladas y amas de casa, con un nivel medio de educación. Los puntajes del estado general de salud, las funciones social, física, emocional y desempeño del papel se consideraron satisfactorias (media 50 a 70), la función cognitiva fue buena (media superior a 70); los síntomas más prevalentes fueron pérdida de apetito, fatiga, dolor e insomnio. En cuanto a la fatiga, todas las dimensiones tienen una media de <4, considerada fatiga leve. Conclusión: La calidad de vida presentaba puntuaciones satisfactorias y la fatiga se clasificó como leve en pacientes sometidos a quimioterapia.


RESUMO Objetivo: Avaliar a fadiga e a qualidade de vida relacionada à saúde de pacientes com câncer colorretal em quimioterapia. Método: estudo descritivo, realizado com 69 pacientes entre janeiro a setembro/2019, em um hospital público de Minas Gerais. Instrumentos utilizados: questionário sociodemográfico e clínico, Quality of Life Questionnaire-Core30 e Escala de Fadiga de Piper, analisados segundo medidas de frequência, média e desvio padrão pelo softwarePSPP. Resultados: A maioria era mulheres, acima de 60 anos, casadas, aposentadas, donas de casa, com médio nível de escolaridade. Os escores de estado geral de saúde, das funções social, física, emocional e desempenho de papel foram considerados satisfatórios (médias50-70), da função cognitiva foi boa (média>70); sintomas mais prevalentes foram perda de apetite, fadiga, dor e insônia. Quanto à fadiga, todas as dimensões tiveram média <4, considerado fadiga leve. Conclusão: A qualidade de vida apresentou escores satisfatórios e a fadiga foi classificada como leve nos pacientes em quimioterapia.

14.
Rev. méd. Urug ; 38(1): e38106, 2022.
Article in Spanish | LILACS-Express | LILACS, BNUY, UY-BNMED | ID: biblio-1389673

ABSTRACT

Resumen: Introducción: el cáncer colorrectal es una patología oncológica frecuente, con una tendencia de la mortalidad en aumento en nuestro medio. Ha existido un notable avance de la cirugía laparoscópica, también aplicada a la cirugía oncológica colorrectal. Es imperioso analizar el impacto de esta técnica sobre la radicalidad oncológica y en la sobrevida. Objetivos: determinar las características clínicas de pacientes con cáncer colorrectal en la Clínica Quirúrgica A. Describir nuestra experiencia con el abordaje laparoscópico y el convencional de la cirugía oncológica colorrectal. Comprobar si se cumplen los estándares de calidad, en base a: índice de conversión, resultados a corto plazo (morbimortalidad) y calidad oncológica. Método: estudio descriptivo, retrospectivo, en un período de 5 años (1 de junio de 2015 al 1 de junio de 2020). Se recabaron datos de todos los pacientes operados de cáncer colorrectal de forma electiva, con criterio pretendidamente curativo. Resultados: se registraron 61 pacientes, 32 hombres (52%), con una edad promedio de 63 años. Se realizaron 32 (52%) cirugías convencionales, y 29 (48%) laparoscópicas. El índice de conversión fue de 17%. La tasa de morbilidad fue de 29,5%, siendo el índice de falla de sutura de 12,5%. La tasa de mortalidad a 30 días fue de 8%. La media de tiempo operatorio y de recuento ganglionar fue similar para ambos abordajes. Conclusiones: el abordaje laparoscópico del cáncer colorrectal es factible y seguro con buenos resultados oncológicos a mediano y largo plazo, sumado a las ventajas de la cirugía mini invasiva. Nuestros resultados son comparables con estándares de calidad a nivel internacional.


Summary: Introduction: colorectal cancer is frequent condition which evidences growing mortality rates in our country. A dramatic improvement in laparoscopic surgery is evident, and it also applies to colon cancer surgery. Analyzing the impact of this technique on oncologic radicality and survival is of the essence. Objectives: to determine the clinical characteristics of patients with colorectal cancer in the Surgical Clinic A. To describe our experience in the laparoscopic and conventional approaches to colon cancer surgery. To prove whether quality standards are observed based on: conversion rates, short term results (morbimortality) and oncologic quality. Method: descriptive, retrospective study in a five-year period (June 1, 2015 to June 1, 2020). Data was collected for all patients who underwent elective colon cancer surgery with curative purposes. Results: 61 patients were recorded, 32 (52%) of which were men, with an average age of 63 years old. Thirty-two (52%) conventional and 29 (48%) laparoscopic surgeries were performed. The conversion rate was 17%. Morbimortality was 29.5%, being the suture failure rate 12.5%. 30-day mortality rate was 8%. Average surgical time and lymph node count was similar for both approaches. Conclusions: laparoscopic approach of colorectal cancer is feasible and safe in the mid and long term, and the advantages of a minimally invasive surgery are worth considering. Our results are comparable to international quality standards.


Resumo: Introdução: o câncer colorretal é uma patologia oncológica frequente, com tendência crescente da mortalidade em nosso meio. Houve um avanço notável na cirurgia laparoscópica, também aplicada à cirurgia do câncer colorretal. É imperativo analisar o impacto dessa técnica na excisão radical do tumor e na sobrevivência dos pacientes. Objetivos: determinar as características clínicas dos pacientes com câncer colorretal na Clínica Cirúrgica A. Descrever nossa experiência com a abordagem laparoscópica e convencional da cirurgia do câncer colorretal. Verificar se os padrões de qualidade foram obedecidos considerando: taxa de conversão, resultados de curto prazo (morbimortalidade) e qualidade oncológica. Método: estudo descritivo, retrospectivo, no período 01 de junho de 2015 a 01 de junho de 2020. Foram coletados dados de todos os pacientes com câncer colorretal operados eletivamente, com os critérios presumidamente curativos. Resultados: foram registrados 61 pacientes, 32 (52%) homens, com média de idade de 63 anos. Foram realizadas 32 (52%) cirurgias convencionais e 29 (48%) laparoscópicas. A taxa de conversão foi de 17%. A morbidade foi de 29,5%, com um índice de falha de sutura de 12,5%. A mortalidade em 30 dias foi de 8%. O tempo operatório médio e a contagem de linfonodos foram semelhantes para ambas as abordagens. Conclusões: a abordagem laparoscópica do câncer colorretal é viável e segura com bons resultados oncológicos em médio e longo prazo, somados às vantagens da cirurgia minimamente invasiva. Nossos resultados são comparáveis aos padrões internacionais de qualidade.


Subject(s)
Colorectal Neoplasms/surgery , Laparoscopy , Colorectal Surgery , Treatment Outcome , Hospitals, University
15.
Rev. baiana enferm ; 36: e43943, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1376476

ABSTRACT

Objetivo: avaliar e correlacionar os domínios da qualidade de vida de pacientes com metástase hepática de câncer colorretal em tratamento quimioterápico. Método: estudo transversal, observacional, com 106 pacientes selecionados em três hospitais do Sul do Brasil. Os dados foram coletados com o Quality of Life Questionnaire Core 30 e Quality of Life Questionnaire Colorectal Liver Metastases, analisados descritivamente e pelo teste de correlação de Spearman. Resultados: a vida sexual (45,08%), função emocional (43,08%) e fadiga (40,15%) tiveram os piores escores com o Quality of Life Questionnaire Colorectal Liver Metastases. Todas as correlações entre os domínios são significativas, demonstrando que um domínio com escore baixo interfere em todos os demais. Conclusão: os pacientes com metástase hepática de câncer colorretal em tratamento quimioterápico apresentaram alteração nos domínios de qualidade de vida.


Objetivo: evaluar y correlacionar los dominios de calidad de vida de pacientes con metástasis hepática de cáncer colorrectal sometidos a quimioterapia. Método: estudio observacional transversal con 106 pacientes seleccionados en tres hospitales del sur de Brasil. Los datos fueron recolectados mediante el Quality of Life Questionnaire Core 30 y Quality of Life Questionnaire Colorectal Liver Metastases, analizados descriptivamente y mediante la prueba de correlación de Spearman. Resultados: la vida sexual (45,08%), la función emocional (43,08%) y la fatiga (40,15%) tuvieron las peores puntuaciones con el Quality of Life Questionnaire Colorectal Liver Metastases. Todas las correlaciones entre los dominios son significativas, demostrando que un dominio con una puntuación baja interfiere en todos los demás. Conclusión: los pacientes con metástasis hepática por cáncer colorrectal sometidos a quimioterapia mostraron cambios en los dominios de calidad de vida.


Objective: to evaluate and correlate the quality of life domains of patients with liver metastasis of colorectal cancer undergoing chemotherapy. Method: cross-sectional, observational study with 106 patients selected in three hospitals in southern Brazil. Data were collected using the Quality of Life Questionnaire Core 30 and Quality of Life Questionnaire Colorectal Liver Metastases, analyzed descriptively and by Spearman's correlation test. Results: sexual life (45.08%), emotional function (43.08%) and fatigue (40.15%) had the worst scores with the Quality of Life Questionnaire Colorectal Liver Metastases. All correlations between the domains are significant, demonstrating that a domain with a low score interferes in all others. Conclusion: patients with liver metastasis from colorectal cancer undergoing chemotherapy showed changes in quality of life domains.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Quality of Life , Colorectal Neoplasms , Liver Neoplasms/secondary , Cross-Sectional Studies , Surveys and Questionnaires , Sociodemographic Factors , Liver Neoplasms/psychology , Liver Neoplasms/drug therapy
16.
Clinics ; 77: 100099, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1404299

ABSTRACT

Abstract The impact of Multivisceral Liver Resection (MLR) on the outcome of patients with Colorectal Liver Metastasis (CRLM) is unclear. The present systematic review aimed to compare patients with CRLM who underwent MLR versus standard hepatectomy regarding short- and long-term outcomes. MLR is a feasible procedure but has a higher risk of major complications. MLR did not negatively affect long-term survival, suggesting that an extended resection is an option for potentially curative treatment for selected patients with CRLM.

17.
J. venom. anim. toxins incl. trop. dis ; 28: e20210067, 2022. graf
Article in English | LILACS, VETINDEX | ID: biblio-1365078

ABSTRACT

Background: Melittin has shown antiproliferative effects on tumor cells. Therefore, it comprises a valuable compound for studies on cancer treatment. To the best of our knowledge, no studies have reported melittin effects on bone metastasis. Herein, we propose an approach based on intrametastatic melittin injection to treat bone metastases in colorectal cancer. Methods: Following the characterization of melittin and antiproliferative tests in vitro, a single dose was injected through intrametastatic route into the mouse bone metastasis model. Following treatment, metastasis growth was evaluated. Results: A single dose of melittin was able to inhibit metastasis growth. Histological analysis showed necrosis and inflammatory processes in melittin-treated metastasis. Except by mild weight loss, no other systemic effects were observed. Conclusion: Our data suggest that melittin might be a promising agent for the future development of treatment strategies aiming to reduce the bone metastasis skeletal-related impact in colorectal cancer patients with bone metastasis.(AU)


Subject(s)
Animals , Bone and Bones , In Vitro Techniques , Colorectal Neoplasms , Neoplasm Metastasis
18.
Article in Chinese | WPRIM | ID: wpr-943033

ABSTRACT

Hereditary colorectal cancer accounts for approximately 5% of all colorectal cancer cases, mainly including familial adenomatous polyposis and Lynch syndrome. Total proctocolectomy plus ileal pouch-anal anastomosis and total colectomy plus ileorectal anastomosis are two major procedures for familial adenomatous polyposis, however, the exact impact of these two procedures on surgical efficacy, oncologic efficacy as well as functional results still remains uncertain. Segmental colectomy and total colectomy are two major procedures for Lynch syndrome, each of them both has advantages and disadvantages, and there still lacks a consensus about the optimal strategy because of the nature of retrospective study with a relatively insufficient evidence support. As a result, we would make a review about the current surgical treatment status and future perspectives of hereditary colorectal cancer.


Subject(s)
Adenomatous Polyposis Coli/surgery , Anastomosis, Surgical/methods , Colectomy , Colorectal Neoplasms, Hereditary Nonpolyposis/surgery , Humans , Proctocolectomy, Restorative/methods , Retrospective Studies
19.
Article in Chinese | WPRIM | ID: wpr-943028

ABSTRACT

Objective: To analyzed perioperative safety of cytoreductive surgery (CRS) for patients with colorectal cancer peritoneal metastasis (CRPM) and to construct a predictive model for serious advese events (SAE). Methods: A descriptive case-series study was conducted to retrospectively collect the clinicopathological data and treatment status (operation time, number of organ resection, number of peritoneal resection, and blood loss, etc.) of 100 patients with peritoneal metastases from colorectal cancer or appendix mucinous adenocarcinoma who underwent CRS at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2019 to August 2021. There were 53 males and 47 females. The median age was 52.0 (39.0-61.8) years old. Fifty-two patients had synchronous peritoneal metastasis and 48 had metachronous peritoneal metastasis. Fifty-two patients received preoperative neoadjuvant therapy. Primary tumor was located in the left colon, the right colon and the rectum in 43, 28 and 14 cases, respectively. Fifteen patients had appendix mucinous adenocarcinoma. Measures of skewed distribution are expressed as M (range). Perioperative safety was analyzed, perioperative grade III or higher was defined as SAE. Risk factors associated with the occurrence of SAEs were analyzed using multivariate logistic regression. A nomogram was plotted by R software to predict SAE, the efficacy of which was evaluated using the area under the ROC curve (AUC) and correction curves. Results: The median peritoneal cancer index (PCI) score was 16 (1-39). Sixty-eight (68.0%) patients achieved complete tumor reduction (tumor reduction score: 0-1). Sixty-two patients were treated with intraperitoneal hyperthermic perfusion chemotherapy (HIPEC). Twenty-one (21.0%) patients developed 37 SAEs of grade III-IV, including 2 cases of ureteral injury, 6 cases of perioperative massive hemorrhage or anemia, 7 cases of digestive system, 15 cases of respiratory system, 4 cases of cardiovascular system, 1 case of skin incision dehiscence, and 2 cases of abdominal infection. No grade V SAE was found. Multivariate logistic regression analysis showed that CEA (OR: 8.980, 95%CI: 1.428-56.457, P=0.019), PCI score (OR: 7.924, 95%CI: 1.486-42.259, P=0.015), intraoperative albumin infusion (OR: 48.959, 95%CI: 2.115-1133.289, P=0.015) and total volume of infusion (OR: 24.729, 95%CI: 3.956-154.562, P=0.001) were independent risk factors for perioperative SAE in CRS (all P<0.05). Based on the result of multivariate regression models, a predictive nomogram was constructed. Internal verification showed that the AUC of the nomogram was 0.926 (95%CI: 0.872-0.980), indicating good prediction accuracy and consistency. Conclusions: CRS is a safe and effective method to treat CRPM. Strict screening of patients and perioperative fluid management are important guarantees for reducing the morbidity of SAE.


Subject(s)
Adenocarcinoma, Mucinous/therapy , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Appendiceal Neoplasms/surgery , Colorectal Neoplasms/pathology , Combined Modality Therapy , Cytoreduction Surgical Procedures/methods , Female , Humans , Hyperthermia, Induced/methods , Male , Middle Aged , Peritoneal Neoplasms/secondary , Retrospective Studies , Survival Rate
20.
Article in Chinese | WPRIM | ID: wpr-943026

ABSTRACT

In recent years, natural orifice specimen extraction surgery (NOSES) has been widely used in surgery of colorectal cancer. The rapid development of NOSES is mainly attributed to its own great advantages and values, including the reduction of surgical trauma, the acceleration of postoperative recovery and the reduction of adverse psychological reactions for patients. These advantages of NOSES are also important embodiment and perfect interpretation of the organ functional protection. Organ functional preservation is a hot topic in surgery today, and it is also an inevitable requirement for minimally invasive surgery. Essentially, NOSES and organ functional preservation are proposed in the same background, and the goals are highly compatible. NOSES is an important practitioner of organ functional preservation, and organ functional preservation is also the vane of the development of the theoretical system of NOSES. These two items complement each other and together constitute the important element in the development of modern minimally invasive surgery. In order to comprehensively discuss the relationship between NOSES and organ functional protection, we elaborate the important role and value of functional protection in NOSES from five key procedures of colorectal surgery, namely surgical approach, extent of resection, lymph node dissection, digestive tract reconstruction and specimen extraction.


Subject(s)
Colorectal Neoplasms/surgery , Digestive System Surgical Procedures , Humans , Laparoscopy/methods , Natural Orifice Endoscopic Surgery/methods , Specimen Handling , Treatment Outcome
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