ABSTRACT
The aim of study is to report the results of our experience about ultra-low rectum carcinomas treated with anterior resection and colo-anal anastomosis. The surgery still represents the treatment of choice for the cancer of the rectum. The problems concern the conservation of the sphincter functions (anal and urethral), and sexual function and the reduction of the locoregional recurrences. From 2005 to 2007, 33 patients underwent surgery for low and ultralow rectal carcinoma (30 treated with neoadjuvant radio-chemotherapy, and 3 only with surgery). In 16 of these we have performed a colo-anal anastomosis, in 11 an ultralow colorectal anastomosis and in 7 a Miles resection. We report our updated results.
Subject(s)
Anal Canal/surgery , Carcinoma/surgery , Colectomy/methods , Colon/surgery , Rectal Neoplasms/surgery , Aged , Anastomosis, Surgical/methods , Carcinoma/pathology , Carcinoma/therapy , Chemotherapy, Adjuvant , Female , Humans , Male , Middle Aged , Radiotherapy, Adjuvant , Rectal Neoplasms/pathology , Rectal Neoplasms/therapy , Retrospective Studies , Treatment OutcomeABSTRACT
Cancer of the rectum has been for more years burdened with a heavy rate of local relapse about 30%. The introduction of total meso-rectum excision has reduced the rate of up to 5-8%. Later more studies proved how the preoperative radiotherapy was able to reduce the rate of local relapse. The Authors introduce studies about downstaging after neoadjuvant chemoradiotherapy for rectal cancer and discuss about their own series from 2005 to 2007.
Subject(s)
Adenocarcinoma/therapy , Neoadjuvant Therapy/methods , Neoplasm Recurrence, Local/prevention & control , Rectal Neoplasms/therapy , Adenocarcinoma/drug therapy , Adenocarcinoma/pathology , Adenocarcinoma/radiotherapy , Adenocarcinoma/surgery , Chemotherapy, Adjuvant , Digestive System Surgical Procedures , Humans , Neoplasm Staging , Radiotherapy, Adjuvant , Rectal Neoplasms/drug therapy , Rectal Neoplasms/pathology , Rectal Neoplasms/radiotherapy , Rectal Neoplasms/surgery , Rectum/surgery , Retrospective Studies , Treatment OutcomeSubject(s)
Critical Care , Liver Cirrhosis/physiopathology , Hemodynamics , Humans , Liver Cirrhosis/metabolismABSTRACT
The treatment of sepsis involves, in addition to the aggression of the septic focus by antibiotic and surgical means, the support of physiological functions, in particular the metabolic-nutritional support. The Authors base the description of the relevant aspects of metabolic-nutritional support in sepsis on the results of studies performed in their Clinical Research Center and in other Centers.
Subject(s)
Nutritional Physiological Phenomena , Sepsis/metabolism , Fat Emulsions, Intravenous , Humans , Postoperative Complications , Sepsis/etiologyABSTRACT
The effects of body position (sitting versus supine) on respiratory and haemodynamic patterns were evaluated in nine patients who have undergone upper abdominal surgery. Posture showed no significant influence upon arterial blood gas tensions, while in the sitting position mean central venous oxygen tension lowers and arterial-venous oxygen content difference rises. In seated patients cardiac output was notably reduced. Pulmonary gas exchange analysis, according to Riley's method, showed that the sitting position allows a higher alveolar ventilation-pulmonary capillaries perfusion ratio, as well as a lower degree of venous admixture.
