Browsing by Subject "Rectum"

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  • Pisano, Michele; Zorcolo, Luigi; Merli, Cecilia; Cimbanassi, Stefania; Poiasina, Elia; Ceresoli, Marco; Agresta, Ferdinando; Allievi, Niccolo; Bellanova, Giovanni; Coccolini, Federico; Coy, Claudio; Fugazzola, Paola; Martinez, Carlos Augusto; Montori, Giulia; Paolillo, Ciro; Penachim, Thiago Jose; Pereira, Bruno; Reis, Tarcisio; Restivo, Angelo; Rezende-Neto, Joao; Sartelli, Massimo; Valentino, Massimo; Abu-Zidan, Fikri M.; Ashkenazi, Itamar; Bala, Miklosh; Chiara, Osvaldo; de' Angelis, Nicola; Deidda, Simona; De Simone, Belinda; Di Saverio, Salomone; Finotti, Elena; Kenji, Inaba; Moore, Ernest; Wexner, Steven; Biffl, Walter; Coimbra, Raul; Guttadauro, Angelo; Leppäniemi, Ari; Maier, Ron; Magnone, Stefano; Mefire, Alain Chicom; Peitzmann, Andrew; Sakakushev, Boris; Sugrue, Michael; Viale, Pierluigi; Weber, Dieter; Kashuk, Jeffry; Fraga, Gustavo P.; Kluger, Ioran; Catena, Fausto; Ansaloni, Luca (2018)
    Obstruction and perforation due to colorectal cancer represent challenging matters in terms of diagnosis, life-saving strategies, obstruction resolution and oncologic challenge. The aims of the current paper are to update the previous WSES guidelines for the management of large bowel perforation and obstructive left colon carcinoma (OLCC) and to develop new guidelines on obstructive right colon carcinoma (ORCC). Methods: The literature was extensively queried for focused publication until December 2017. Precise analysis and grading of the literature has been performed by a working group formed by a pool of experts: the statements and literature review were presented, discussed and voted at the Consensus Conference of the 4th Congress of the World Society of Emergency Surgery (WSES) held in Campinas in May 2017. Results: CT scan is the best imaging technique to evaluate large bowel obstruction and perforation. For OLCC, selfexpandable metallic stent (SEMS), when available, offers interesting advantages as compared to emergency surgery; however, the positioning of SEMS for surgically treatable causes carries some long-term oncologic disadvantages, which are still under analysis. In the context of emergency surgery, resection and primary anastomosis (RPA) is preferable to Hartmann's procedure, whenever the characteristics of the patient and the surgeon are permissive. Rightsided loop colostomy is preferable in rectal cancer, when preoperative therapies are predicted. With regards to the treatment of ORCC, right colectomy represents the procedure of choice; alternatives, such as internal bypass and loop ileostomy, are of limited value. Clinical scenarios in the case of perforation might be dramatic, especially in case of free faecal peritonitis. The importance of an appropriate balance between life-saving surgical procedures and respect of oncologic caveats must be stressed. In selected cases, a damage control approach may be required. Medical treatments including appropriate fluid resuscitation, early antibiotic treatment and management of co-existing medical conditions according to international guidelines must be delivered to all patients at presentation. Conclusions: The current guidelines offer an extensive overview of available evidence and a qualitative consensus regarding management of large bowel obstruction and perforation due to colorectal cancer.
  • Murphy, Neil; Ward, Heather A.; Jenab, Mazda; Rothwell, Joseph A.; Boutron-Ruault, Marie-Christine; Carbonnel, Franck; Kvaskoff, Marina; Kaaks, Rudolf; Kuehn, Tilman; Boeing, Heiner; Aleksandrova, Krasimira; Weiderpass, Elisabete; Skeie, Guri; Borch, Kristin Benjaminsen; Tjonneland, Anne; Kyro, Cecilie; Overvad, Kim; Dahm, Christina C.; Jakszyn, Paula; Sanchez, Maria-Jose; Gil, Leire; Huerta, Jose M.; Barricarte, Aurelio; Ramon Quiros, J.; Khaw, Kay-Tee; Wareham, Nick; Bradbury, Kathryn E.; Trichopoulou, Antonia; La Vecchia, Carlo; Karakatsani, Anna; Palli, Domenico; Grioni, Sara; Tumino, Rosario; Fasanelli, Francesca; Panico, Salvatore; Bueno-de-Mesquita, Bas; Peeters, Petra H.; Gylling, Bjorn; Myte, Robin; Jirstrom, Karin; Berntsson, Jonna; Xue, Xiaonan; Riboli, Elio; Cross, Amanda J.; Gunter, Marc J. (2019)
    BACKGROUND & AIMS: Colorectal cancer located at different anatomical subsites may have distinct etiologies and risk factors. Previous studies that have examined this hypothesis have yielded inconsistent results, possibly because most studies have been of insufficient size to identify heterogeneous associations with precision. METHODS: In the European Prospective Investigation into Cancer and Nutrition study, we used multivariable joint Cox proportional hazards models, which accounted for tumors at different anatomical sites (proximal colon, distal colon, and rectum) as competing risks, to examine the relationships between 14 established/suspected lifestyle, anthropometric, and reproductive/menstrual risk factors with colorectal cancer risk. Heterogeneity across sites was tested using Wald tests. RESULTS: After a median of 14.9 years of follow-up of 521,330 men and women, 6291 colorectal cancer cases occurred. Physical activity was related inversely to proximal colon and distal colon cancer, but not to rectal cancer (P heterogeneity = .03). Height was associated positively with proximal and distal colon cancer only, but not rectal cancer (P heterogeneity = .0001). For men, but not women, heterogeneous relationships were observed for body mass index (P heterogeneity = .008) and waist circumference (P heterogeneity = .03), with weaker positive associations found for rectal cancer, compared with proximal and distal colon cancer. Current smoking was associated with a greater risk of rectal and proximal colon cancer, but not distal colon cancer (P heterogeneity = .05). No heterogeneity by anatomical site was found for alcohol consumption, diabetes, nonsteroidal anti-inflammatory drug use, and reproductive/menstrual factors. CONCLUSIONS: The relationships between physical activity, anthropometry, and smoking with colorectal cancer risk differed by subsite, supporting the hypothesis that tumors in different anatomical regions may have distinct etiologies.
  • Räsänen, Janne; Hiltunen-Back, Eija; Puolakkainen, Mirja; Pasternack, Rafael (2020)
    Lymphogranuloma venereum (LGV) on Chlamydia trachomatiksen genotyyppien L1–L3 aiheuttama seksitauti. Se voi aiheuttaa nivusimusolmukkeiden kivuliaan tulehduksen lisäksi akuutin proktiitin eli peräsuolitulehduksen. LGV-proktiitti voi muistuttaa kliiniseltä kuvaltaan ja histologiselta löydökseltään tulehduksellista suolisto¬sairautta (IBD). Kuvaamme kolme potilastapausta, joissa kaikissa pitkittyneen peräsuolivaivan taustalta löytyi lymphogranuloma venereum.