RESUMEN
Data continue to grow regarding the safety and technical feasibility of laparoscopically assisted total mesorectal excision (TME). As this minimally invasive alternative to open colonic resection becomes more popular, it is inevitable that information on the benefits and complications associated with it will continue to expand. Portal vein thrombosis (PVT) has been reported after a variety of laparoscopic procedures. We report a case of superior mesenteric, splenic and portal vein thrombosis following laparoscopically assisted TME. To our knowledge, this complication of laparoscopic TME has not been previously reported in the literature. PVT should be ruled out in patients who present with vague abdominal symptoms. The course of this complication, while potentially devastating, is usually benign and responds well to lysis and/or anticoagulation.
Asunto(s)
Adenocarcinoma/cirugía , Procedimientos Quirúrgicos del Sistema Digestivo/efectos adversos , Vena Porta , Neoplasias del Recto/cirugía , Trombosis de la Vena/etiología , Humanos , Laparoscopía , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Trombosis de la Vena/diagnóstico , Trombosis de la Vena/diagnóstico por imagenRESUMEN
In this work we report the results of 27 patients who underwent a second surgical operation for local disease recurrence after colorectal surgery for cancer. We describe the different intervention we performed and for everyone of them we analyze intraoperative mortality and morbidity, long term survival and quality of life related.
Asunto(s)
Recurrencia Local de Neoplasia/cirugía , Neoplasias del Recto/cirugía , HumanosRESUMEN
INTRODUCTION: The goal in the treatment of rectal cancer is the recovery of the disease with the best fecal continence and quality of life. The Authors compared quality of life and manometric results in patients treated with neo-adjuvant chemotherapy and rectal low anterior resection (LRA). METHODS: From January 1998 to March 2002 50 patients with advanced (T3-T4) rectal cancer underwent neo-adjuvant chemotherapy. Subsequently 41 of them underwent LRA with colon pouch (19) or without the pouch (22). After few months the quality of life was evaluated through a questionnaire. Later they underwent manometric evaluation measuring resting, squeeze and rectal compliance. RESULTS: The manometric results and the questionnaire scores agreed in 75% of patients. In detail, patients with hypotonic sphincter had a better (one could say good) quality of life if a LAR with pouch had been performed respect to the patients without pouch. CONCLUSION: Performing LAR with colon pouch after neoadjuvant chemotherapy in patients with hypotonic sphincter improves quality of life. Preoperative anorectal manometry could select patient who would benefit from pouch construction.
Asunto(s)
Reservorios Cólicos , Manometría , Calidad de Vida , Neoplasias del Recto/fisiopatología , Neoplasias del Recto/cirugía , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Quimioterapia Adyuvante , Femenino , Humanos , Masculino , Terapia Neoadyuvante , Valor Predictivo de las Pruebas , Dosificación Radioterapéutica , Radioterapia Adyuvante , Neoplasias del Recto/tratamiento farmacológico , Neoplasias del Recto/radioterapia , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
The Authors present a case of congenital dilatation of the common bile duct in adult life, selecting this lesion from the cystic dilatations of biliary tract group. The type I of biliary tract cystic dilatations is, in fact, considered a clinical-pathological situation apart, that, because of his frequence and his peculiar characteristics especially present in the adult, puts particular problems regarding his arrangement an treatment. The most recent aspects of etiophatogenetic and therapeutic problems of this lesion are treated. The increased risk of neoplastic degeneration in the adult, the recognition of an anomalous pancreaticobiliary duct junction as etiophatogenetic fondamental cause and the necessity of a radical exeretic treatment in in opposition to the old therapheutic orientations are especi-5ally considered.
Asunto(s)
Conducto Colédoco/embriología , Conducto Colédoco/patología , Colangiopancreatografia Retrógrada Endoscópica , Conducto Colédoco/diagnóstico por imagen , Conducto Colédoco/cirugía , Dilatación Patológica/congénito , Dilatación Patológica/diagnóstico por imagen , Dilatación Patológica/cirugía , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The Authors report their experience, referred to the last 10 years (1980-1989), concerning 169 cases of anterior resection of the rectum. Manual and mechanical anastomoses were performed in 83 and 86 cases, respectively. Immediate and long-term complications are evaluated considering the type of anastomosis used, while results are correlated to the stage of the tumor.