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http://www.webmedcentral.com/images/Header_Logo.giftext/html2010-09-23T21:04:54+01:00http://www.webmedcentral.com/Mr. Sridhar DharamavaramEndoscopic Detection and Removal of Recto-sigmoid Myomatous (Leiomyoma) Tumour
http://www.webmedcentral.com/article_view/525
Colonic Myomatous tumours; (Leiomyosarcoma and Leiomyoma) are a rare conditions. Only 3% of these smooth muscle tumours arising from colon are gastrointestinal leiomyomas and constitute about 0.1% of rectal tumours (1, 2). Most of these tumours are incidentally diagnosed on routine large bowel endoscopic examination (1, 5). Rarity of this tumour delays early diagnosis but once identified it should be resected to avoid complications like bleeding and mechanical obstruction. For most leiomyomas, surgical excision is treatment of choice (1). We describe a patient who underwent endoscopic detection and resection of Recto-sigmoid leiomyoma.text/html2013-02-01T06:27:46+01:00http://www.webmedcentral.com/Dr. Teinye G DouglasBody Mass Index and Serum Albumin as Predictors of Outcome in Colorectal Cancer Patients
http://www.webmedcentral.com/article_view/3982
Background: Colorectal cancer is predominantly a disease of the elderly in whom the incidence of malnutrition has been estimated at about 5-6% between the ages of 70 and 80 and 8-12% over the age of 80. Most patients with colorectal cancer admitted for elective surgery appear well nourished on admission but leave hospital looking under-nourished. We attempt to quantify this in an effort to understand which direction further studies and even clinical intervention might take. Study design: Case notes of fifty patients who have undergone resection surgery for colorectal cancer at The James Cook University Hospital over a five year period were reviewed and data extracted. The prevalence of malnutrition and the effects of preoperative BMI and serum albumin on length of hospital stay, days off food and complications were studied. Results: The prevalence of malnutrition (BMI < 20kg/m2) was 6.0%. More patients were obese/overweight (48%) than were malnourished. There was no correlation between BMI on admission and length of hospital stay (P = 0.88).Conclusion: There were more overweight/obese than undernourished patients on admission. The BMI on admission did not affect the length of hospital stay. The drop in albumin concentration had a negative correlation with the number days off food. Hypoalbuminaemia did not increase the rate of wound infection.text/html2011-01-26T20:35:52+01:00http://www.webmedcentral.com/Mr. David C SmithSafety And Efficacy of Stenting In Large Bowel Obstruction - A Review Of Clinical Practice
http://www.webmedcentral.com/article_view/1512
AIM/IntroductionSelf-Expanding Metallic Stents (SEMS) have been used as bridge to definitive surgery or for palliation in large bowel obstruction. It is employed as an alternative to emergency surgery with low complication and stoma rates.Patients and methodsData was collected retrospectively on patients who underwent colonic stenting from December 2000 to August 2009. Patient demographics, indication, location of stricture, complications and survival were included in the assessed data.ResultsSeventy-five patients with a mean age of 72 years were identified. Fourteen (19%) patients had the procedure as a bridge to surgery and the remaining 61 (81%) patients had a palliative procedure. In 47 (63%) patients the stricture was in the sigmoid colon. Successful stenting was achieved in 60 (80%) patients. The aetiology was benign in 5 (7%) patients. Complications occurred in 6 patients with migration in 3 (4%), expulsion in 2 (3%) and perforation in one (1%) patient. There was no stent-related mortality.ConclusionColonic stenting is a useful intervention that reduces the morbidity and mortality associated with emergency surgery for large bowel obstruction. In this series the procedure had a high success and low complication rates.
text/html2011-09-30T11:58:01+01:00http://www.webmedcentral.com/Prof. Theodoros E PavlidisCurrent Surgical Management of Colorectal Cancer Liver Metastases: A Mini Review
http://www.webmedcentral.com/article_view/2278
Background: Colorectal cancer is responsible for 10% of cancer related deaths and is the third most common cancer type in men and the second in women. Metastatic disease will develop in nearly 60% of patients with colorectal cancer, half of which will be located in the liver. At least 30% of the patients who underwent potentially curative primary tumor resection have liver micrometastases.Data sources: A PubMed search of relevant articles published up to 2010 was performed to identify current information about colorectal liver metastases regarding diagnosis and management with emphasis to surgery.Results: Hepatectomy is the only potentially curative option resulting in 5-year survival for one third of the patients, but only 10-30% of the patients are suitable for a radical procedure. Indications include ability to resect the tumor without residual disease, with removal of at least 1 cm of healthy tissue and clear margins, and the absence of extrahepatic metastatic disease. Specialized centers achieve mortality rate less than 5% and morbidity 20-50%. 5-year survival following hepatic resection is 25-40% with mean survival of 28-40 months.Conclusion: Current management of colorectal cancer liver metastases requires a multidisciplinary approach. Operative strategies and novel techniques that achieve wider excision areas with minimal blood loss make hepatectomy safe and effective.Keywords: Advanced colorectal cancer, liver metastases, hepatic metastasis, hepatectomy, surgical management, curative resection