ABSTRACT
Laparoscopic resections of colon cancer may affect survival. To address the effects of pneumoperitoneum on tumor cell biology, we developed an experimental model. Mice were injected with colonic tumor cells. Local and systemic effects of pneumoperitoneum were evaluated. Treated mice were randomly assigned to a control group, an open cecectomy group, or a laparoscopic-simulated cecectomy group. When a tumor inoculum was injected into the peritoneal cavity, the frequency of tumors was not significantly different for mice in the laparoscopic-simulated and open cecectomy groups (60% vs 62%, respectively). There was no significant difference in survival time between the laparoscopic-simulated and open cecectomy groups, with median survivals of 24 days versus 22 days, respectively. Finally, when tumor cells were injected subcutaneously, the frequency of tumor nodules and the size and weight of tumors were not different between the two surgical groups. Laparoscopic-simulated cecectomy does not appear to adversely effect local factors or favorably affect systemic factors influencing tumor growth or survival.
Subject(s)
Adenocarcinoma/surgery , Colonic Neoplasms/surgery , Neoplasm Seeding , Pneumoperitoneum, Artificial , Animals , Disease Models, Animal , Mice , Mice, Inbred BALB C , Pneumoperitoneum, Artificial/adverse effects , Random Allocation , Tumor Cells, CulturedABSTRACT
Dysphagia and recurrent gastroesophageal reflux complicate use of the Angelchik prosthesis. The authors developed an inflatable silicone device, similar to the Angelchik prosthesis, that may allow for the adjustment of the total pressure exerted around the gastroesophageal junction after implantation. To estimate its potential to prevent gastroesophageal reflux in humans, we used a short-term porcine model in which we measured the effective lower esophageal sphincter pressure in 10 anesthetized pigs using a computerized, three dimensional pressure vector volume analysis. Anesthesia and mobilization of the gastroesophageal junction did not modify the three dimensional pressure vector volume at the lower esophageal sphincter. Implantation of the deflated device significantly increased effective lower esophageal sphincter three dimensional pressure vector volume compared with baseline. Inflation of the device with 30 ml of saline further increased lower esophageal sphincter pressure significantly. Deflation of the device returned the pressure to the pre-inflation values. Using an animal model and short-term implantation, this new antireflux device appeared to offer the potential ability to adjust the pressure selectively at the gastroesophageal junction postoperatively. An added future feature of this device may be the ease of insertion using laparoscopic techniques. Long-term animal implantation studies and clinical trials are required to help establish the safety and efficacy of this device in humans.
Subject(s)
Esophagogastric Junction/surgery , Gastroesophageal Reflux/surgery , Prostheses and Implants , Prosthesis Implantation/methods , Animals , Gastroesophageal Reflux/prevention & control , Laparoscopy , Silicones , SwineABSTRACT
Hyperparathyroidism due to parathyroid carcinoma is rare. The natural history of this neoplastic disease is poorly understood for the extremely small number of cases reported in literature. The Authors observed three cases and discuss the clinical features illustrating how to recognize and treat this neoplasia.
Subject(s)
Carcinoma , Parathyroid Neoplasms , Aged , Carcinoma/diagnosis , Carcinoma/surgery , Female , Humans , Hyperparathyroidism/diagnosis , Hyperparathyroidism/etiology , Male , Middle Aged , Parathyroid Glands/pathology , Parathyroid Neoplasms/diagnosis , Parathyroid Neoplasms/surgeryABSTRACT
A preliminary study has been carried out on 10 patients suffering from cancer of the colon and rectum, all subjected to radical surgery. The clinical effectiveness of two alternative techniques of postoperative artificial nutrition, EPEN and TPN, are compared. The results confirm that enteral nutrition is technically applicable and well tolerated in the immediate post-operative period in these patients; it also presents a lower cost, it is more manageable and present a lower incidence of complications compared to TPN while offering similar metabolic and nutritional results.
Subject(s)
Colonic Neoplasms/surgery , Enteral Nutrition , Parenteral Nutrition, Total , Postoperative Care/methods , Rectal Neoplasms/surgery , Adult , Aged , Enteral Nutrition/adverse effects , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Parenteral Nutrition, Total/adverse effectsABSTRACT
The Authors report an uncommon cavernous hemangioma of the small bowel. Pathological and clinical features are compared with those of the literature. Considering the difficulty of diagnosis, they remark the importance of histological exam as the only reliable diagnostic tool and surgery as the only therapy.
Subject(s)
Hemangioma, Cavernous , Ileal Neoplasms , Aged , Hemangioma, Cavernous/diagnosis , Hemangioma, Cavernous/surgery , Humans , Ileal Neoplasms/diagnosis , Ileal Neoplasms/surgery , MaleABSTRACT
The Authors report a case of diaphragmatic cyst. They remark the difficulty of clinical diagnosis and briefly discuss the hypothesis on its origin.
