ABSTRACT
AIM: To analyse clinical and long-term oncologic results after laparoscopic complete mesocolic excision (CME) for colonic cancer over a 10-year period. METHODS: Consecutive patients who received laparoscopic CME at our hospital from 2007 to 2017 were prospectively registered and retrospectively analysed. In total, 341 patients were included with tumour-nodal-metastasis (TNM) stages 0-III. RESULTS: The mean age of the patients was 71.9 years. The median length of stay was 5 d. The mean lymph node harvest was 17.8. The mortality rate was 1.2%. Fifteen patients were reoperated on for anastomotic leaks. The local recurrence rate was 2.3%. Five-year TTR and cancer-specific survival CSS were 83.1% and 90.3%. The location of the tumour was not a significant variable for survival in unadjusted and adjusted survival analysis. TNM stage and anastomotic leaks were significant variables with respect to survival. CONCLUSION: Laparoscopic CME results in acceptable complication rates and long-term oncologic results. It is important to avoid anastomotic leaks because of their negative effect on survival.
ABSTRACT
PURPOSE: The purpose of this study was to establish estimates of incidence and fatality rates, and to identify likely etiologies of first attack acute pancreatitis (FAAP) in an urban Norwegian population. MATERIAL AND METHODS: A total of 874 patients were discharged with a diagnosis of acute pancreatitis from the two hospitals in this region between 1.1.1996 and 31.12.2006. Patient records were reviewed and patients with a verifiable FAAP were identified. Demographic variables, likely etiology, and outcome were registered. RESULTS: FAAP was verified in 567 (65%) of the patients (300 women and 267 men) with a median age of 58 years (range 7-98). The average yearly incidence rate of FAAP was 14.6/100 000 and the gender-specific incidence rates increased yearly by approx. 6% (p = 0.006). There was a decline in diagnoses by s-Amylase from approx. 90% to 62% in 2006 and an increase in diagnoses obtained by CT (p < 0.001). The case fatality rate was low (3.5%), but higher among men (5.8%) than women (2%, p = 0.037). The case fatality rate was lowest among patients with gallstones (0.7%) and higher among patients with alcohol (9%), miscellaneous (10.4%), and non-assessed etiology (6.6%) of FAAP (p < 0.05). Male gender, increasing age, and etiology (alcohol, miscellaneous causes, and non-assessed) were associated with increased case fatality rate in an adjusted regression model (p < 0.001). CONCLUSIONS: The incidence rate of FAAP is low and differs from that of official registries. The case fatality rate is low, but related to gender, age, and likely etiology of FAAP.
Subject(s)
Pancreatitis/epidemiology , Pancreatitis/etiology , Acute Disease , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Alcoholism/complications , Amylases/blood , Child , Child, Preschool , Female , Gallstones/complications , Humans , Incidence , Logistic Models , Male , Middle Aged , Norway/epidemiology , Pancreatitis/diagnosis , Pancreatitis/mortality , Retrospective Studies , Sex Factors , Tomography, X-Ray Computed , Young AdultABSTRACT
We undertook this study in rats to ascertain the influence of muscle coverage on tibial fracture healing. 30 rats were randomly assigned to three intervention groups. Following a mid-diaphyseal osteotomy in the left tibia, reamed nailing was performed in all animals. In one group (A), the antero-lateral muscles were detached from the fractured bone, while the anterolateral compartment was excised in another group (B). In the third group (C), the muscle compartment was resected, and the superficial gluteal muscle was mobilized and transposed over the fractured area. Muscle intervention, like that in group A and C, had no effect on the blood flow. The fibular nerve was resected in all the rats. At 4 weeks, we studied the healing bones in each group clinically, radiologically and mechanically. At 4 weeks, radiographs in two planes revealed a clearly visible fracture line in the three experimental groups. Mechanical testing of the healing fractures showed significantly lower bending moment and bending rigidity in group B than in groups A and C. No difference in mechanical characteristics was detected between the healing bones in groups A and C. This animal study indicates that in tibial fractures, an extensive muscle tissue defect may have negative effects on early bone healing.
