[Two cases of ileocecal carcinoid found by total colonoscopy and a review of the literature on 16 cases].

We report 2 cases of ileocecal carcinoid with review of the literature recently reported in Japan. Both cases were diagnosed as carcinoid by colonoscopic biopsy after ileocecal tumors had been pointed out by computed tomography. We performed curative operation with lymph node dissection. Since multiple lymph node metastases were shown in both cases pathologically, they were closely followed after surgery, but no recurrence has been shown. Since SSTR2a stain was strongly positive in both cases, octreotide, the effectiveness of which was verified in the PROMID study might be administered if necessary. As ileocecal carcinoid has a tendency to metastasize to other organs, careful surveillance by colonoscopy and early detection are required. Furthermore, development of effective drugs following octreotide and further investigation including biological and histopathological analysis of neuroendocrine tumors including carcinoid are necessary.

Oral rehydration solution for providing water and electrolytes following laparoscopic cholecystectomy and recovery of intestinal function.

BACKGROUND/AIMS: Oral rehydration solution (OS-1: Na+ 50mEq/L, K+ 20mEq/L, Cl- 50mEq/L, and glucose 1.8%) was administered orally to patients from the early phase following laparoscopic cholecystectomy to assess its effects on water and electrolyte supplementation and recovery from postoperative intestinal paralysis. METHODOLOGY: OS-1 group (n = 22) received OS-1 orally and KN3B group (n = 22) received KN3B (an intravenous maintenance solution) intravenously. The OS-1 group was instructed to consume approximately 1000-1500mL of OS-1 postoperatively from as soon as oral intake was possible up to before lunch on postoperative day 1. RESULTS: The average dose in the OS-1 group (1178 +/- 319 mL) was significantly lower than that in the KN3B group (1371 +/- 196 mL), but within the target dose. The two solutions were equally effective and safe for water and electrolyte supplementation. The time for 50% of patients to pass bowel gas after surgery (indicating recovery from intestinal paralysis) was significantly shorter in the OS-1 group (14.00 hours) than in the KN3B group (23.75 hours). CONCLUSIONS: Oral rehydration solution (OS-1), administered from the early postoperative phase, is safe and effective for the provision of water and electrolytes and promotes early recovery from intestinal paralysis as assessed by the passage of bowel gas following laparoscopic cholecystectomy.