RESUMO
PURPOSE: To compare perioperative colorectal cancer care and survival in patient cohorts operated in 2005 and in 2010 in Lithuania. METHODS: Comparative observational cohort study was performed. The study was conducted in the three Lithuanian cancer hospitals. Patients, who underwent curative surgery for colorectal cancer in 2005 and 2010, were included. Demographic characteristics, distribution of the tumors, preoperative diagnostics and staging, surgical treatment, the quality of pathological examination, morbidity, and mortality were analyzed. One- and 5-year overall survival data were compared between the groups. RESULTS: Colorectal cancer diagnostics and treatment improved from 2005 to 2010 significantly. The disease was identified as stage III-IV for 45 vs. 48% of the patients; however, computed tomography staging scan was performed only for 5.9 vs. 17.8% in 2005 and 2010, respectively. Laparoscopic operations were performed 1.5 vs. 10.5% and abdominoperineal resections-42.7 vs. 31.7% in 2005 and 2010, respectively. The number of harvested lymph nodes was mentioned in 55.8 vs. 97.7% of the cases, whereas more than 12 lymph nodes were examined in 18 vs. 66.6% of cases after histological examination. The overall 5-year survival was 52.1 vs. 63.1% (p < 0.0001), while the 5-year survival of the patients with stage IV of disease was 4.2 vs. 17.8% in 2005 and 2010, respectively. CONCLUSION: Preoperative investigation, surgical treatment, pathological examination, and postoperative course are associated with improved overall survival in colorectal cancer patients, undergoing curative surgery in the resource-limited settings.
Assuntos
Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/cirurgia , Estimativa de Kaplan-Meier , Assistência Perioperatória , Idoso , Neoplasias Colorretais/diagnóstico , Cirurgia Colorretal , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Morbidade , Fatores de Tempo , Resultado do TratamentoRESUMO
Anastomotic leak in colorectal surgery is not very unusual. The over-the-scope clipping (OTSC) system (Ovesco), which was originally developed to treat intestinal perforation and was tested with animals, might be the choice for the patient. We presented the case of a 63-year-old man with chronic coloenteric fistula. Conservative treatment was unsuccessful. The orifice was then closed with two subsequent clips, and the patient recovered well. To our knowledge, this is the first successful case of coloenteric fistula treatment with Ovesco.
