Micropouch vertical banded gastroplasty - new technique evaluation

In this study, 500 patients underwent the micropouch vertical banded gastroplasty [VBG], the median age was 35 years with a median preoperative BMI of 70 kg/m. The micropouch was constructed using single TLH55 stapler through a mini incision. The outlet of the tubular micropouch was banded with a prolene mesh. 98% of the patients showed a good control of their weight within five years and 2% started to gain weight after the first year. The mean operating time was 35 minutes. The use of small single stapler allowed the procedure through a mini incision. The incidence of intraoperative gastroesophageal perforation was 0.6%. The incidence of postoperative leak was 0.2%. Thirty patients were complaining of solid food intolerance. The mortality rate was 0.6%

Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer

The combination of fluorouracil and leucovorin has until recently been standard therapy for metastatic colorectal cancer. Irinotecan prolonge survival in patients refractory to treatment with fluorouracil and leucovorin. We tried to compare a combination of irinotecan, fluorouracil and leucovorin with bolus doses of fluorouracil and leucovorin as first-line therapy for metastatic colorectal cancer. Between January 2000 to December 2001, 30 patients with metastatic colorectal cancer were enrolled, 15 received irinotecan [125mg/m[2]/week x 4 weeks q 6 weeks], 5-FU [500 mg/m[2]/week x 4 weeks q6 weeks iv bolus], and LV [20 mg/m[2]/week x4 weeks q 6 week iv bolus] and 15 patients received 5-FU [425mg/m[2]/d x 5 days q 4 weeks iv bolus] and LV [20mg/m[2]/d x 5 days q 4 weeks iv bolus]. End points included progression -free survival and overall survival. The progression-free survival was longer for the triple-drug therapy than for the two-drug therapy [7 months versus 4 months]. The median survival was also longer in the triple-drug therapy [14 months versus 12 months]. Grade 3/4 neutropenia and mucositis were more common with the two-drug therapy, whereas grade3/4 diarrhea and vomiting were more with the triple-drug therapy. Combining irinotecan with 5-FU/LV was associated with higher rates of tumor regression, progression-free survival and overall survival, and this regimen should be tested as adjuvant treatment in stage III colon cancer

Neoadjuvant chemotherapy using vinorelbine,epirubicin, and methotrexate [VEM] in locally advanced breast cancer

To evaluate the role of VEM regimen in downstaging patients with locally advanced breast cancer to allow surgery

Patients and Methods: Between January 2000 to January 2002, 16 patients with locally advanced breast cancer were enrolled, they received VEM regimen [Vinorelbine 25 mg/irf, epirubicin 35 mg/rrf, and methotrexate 20 mg/m" given at day 1 and 8 every 28 days]. Responding patients after 4 courses received 2 more courses and then referred to surgery

Results: Downstaging was obtained in 86% of the patients with a pathological complete response ;raite of 8%. At 3D months mf follow-up, median survival Unas not teen reached. The most common lhematoI0jpc loxicity was neutropenia grade %

Conclusion: VEM represents an effective and well tolerated regimen for patients with locally advanced breast cancer

Peritoneovenous shunt for treatment of intractable cirrhotic ascites: an unfulfilled promise?

Peritoneovenous shunt [PVS] is widely used for the treatment of cirrhotic ascites whether intractable ascites or not. Between February 996 and August 1998, PVSs were inserted in 22 patients [14 men and 8 women] with intractable cirrhotic ascites. The mean follow up period was 20 months. All patients were non-responsive to standard medical management. Nine patients were alive and palliated, seven of them with working shunts. Thirteen patients died within the first year, five of them died with non functioning shunts. Despite palliation, complications with PVSs were high and survival was limited. This modality was recommended only in patients with cirrhotic intractable ascites not responding to standard medical or surgical management