ABSTRACT
Oesophageal perforation is commonly a rare diagnosis which is associated with a high mortality rate. Decisive for a good clinical outcome are localisation and depth of the perforation, risk factors, the time until diagnosis and a rapid therapy. The data we collected agree with those in the published papers. In cases of an early diagnosis sometimes an endoscopic therapy is possible. In -cases of surgical therapy the smallest intervention is the most favourable. A resection with the necessity for a later reconstruction is considered as the ultima ratio.
Subject(s)
Esophageal Perforation/surgery , Esophagus/injuries , Adolescent , Adult , Aged , Aged, 80 and over , Diagnosis, Differential , Esophageal Perforation/diagnosis , Esophageal Perforation/etiology , Esophageal Perforation/mortality , Esophagoscopy , Female , Hospital Mortality , Humans , Iatrogenic Disease , Male , Middle Aged , Patient Care Team , Postoperative Complications/etiology , Postoperative Complications/mortality , Risk Factors , Rupture , Syndrome , Young AdultABSTRACT
During the last decade no gastrointestinal tumor underwent such profound modifications in diagnostics and therapy as rectal cancer (total mesorectal excision, multimodal therapy). Despite all efforts and continuous improvements in the results of oncological treatment, local recurrence of rectal carcinoma is still a considerable problem. Optimized surgery methods and multimodal therapies allow a local recurrence rate lowered to about 6%. Without surgical intervention the 5-year survival rate after local recurrence is approximately 4%, and the median survival time in a palliative situation is about 13 months and often associated with considerable restriction of quality of life. Morbidity after complex pelvic surgery is still high, but its mortality rate in highly professional surgical centers has reached an acceptable level of about 6%. Surgical oncology today has the ability for remarkable improvement in the prognosis of locally recurrent rectal cancer. After R0 resection the 5-year survival rate is nearly 30%.
Subject(s)
Neoplasm Recurrence, Local/surgery , Rectal Neoplasms/surgery , Combined Modality Therapy , Diagnostic Imaging , Disease-Free Survival , Humans , Neoplasm Invasiveness , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/pathology , Neoplasm Staging , Palliative Care , Prognosis , Rectal Neoplasms/mortality , Rectal Neoplasms/pathology , Reoperation , Sensitivity and SpecificityABSTRACT
A 60-year-old man was admitted for surgical treatment with a diagnosis of distal oesophageal carcinoma. A lymph node metastasis in the area of the hepatoduodenal ligament was suspected by preoperative CT scan and endosonographic examination. During the course of the oesophagectomy, a saccular tumour encircling the common hepatic artery was shown. The vessel and surrounding tumour were resected en bloc. Histology demonstrated a completely thrombosed true aneurysm of the common hepatic artery.
Subject(s)
Aneurysm , Hepatic Artery , Ligaments , Aneurysm/diagnosis , Aneurysm/surgery , Endosonography , Esophageal Neoplasms/diagnostic imaging , Esophageal Neoplasms/surgery , Esophagectomy , Humans , Male , Middle Aged , Radiography, Abdominal , Radiography, Thoracic , Tomography, X-Ray ComputedABSTRACT
In this report, we present a PCR protocol for rapid identification of enterohemorrhagic Escherichia coli on a LightCycler instrument. In a multiplex assay, the genes encoding Shiga toxin 1 and Shiga toxin 2 are detected in a single reaction capillary. A complete analysis of up to 32 samples takes about 45 min.
