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Tytuł:
Intraoperative neuromonitoring of hypogastric plexus branches during surgery for rectal cancer – preliminary report
Autorzy:
Wałęga, Piotr
Romaniszyn, Michał
Wałęga, Maciej
Szymon Świrta, Jarosław
Nowak, Wojciech
Powiązania:
https://bibliotekanauki.pl/articles/1393195.pdf
Data publikacji:
2017
Wydawca:
Index Copernicus International
Tematy:
rectal cancer
neuromonitoring
rectal resection
complications
Opis:
Aim: The aim of this study was to present our preliminary experience with intraoperative neuromonitoring during rectal resection. Materials and methods: We qualified 4 patients (2 women, 2 men; age 42 – 53 years) with rectal cancer for surgery with intraoperative neuromonitoring. In all patients, functional tests of the anorectal area were performed before surgery. Action potentials from the sphincter complex in response to nerve fiber stimulation were recorded with electrodes implanted before surgery. Moreover, we inserted a standard, 18FR Foley’s urinary catheter to which a T-tube was connected to allow urine outflow and measurement of pressure changes in the bladder induced by detrusor contractions during stimulation. Results: Setting up neuromonitoring prolonged surgery time by 30 to 40 minutes, or even by 60 to 80 minutes in the case of the first two patients. Neuromonitoring itself took additional 20 to 30 minutes during surgery. In all patients, we stimulated branches of the inferior hypogastric plexus in their anatomical position during dissection. In three patients, we evoked responses both from the bladder and the sphincter in all planes of stimulation. In one patient, there was no response from the left side of the bladder, and in the same patient, we observed symptoms of neurogenic bladder. Conclusions: Based on the available literature and our own experience, we state that monitoring of bladder pressure and electromyographic signals from rectal sphincters enables visualization and preservation of autonomic nervous system structures, both sympathetic and parasympathetic. Intraoperative signals seem to be correlated with clinical presentation and functional examinations after surgery. In order to objectify our results, it is necessary to perform functional examinations before and after surgery in a larger group of patients.
Źródło:
Polish Journal of Surgery; 2017, 89, 2; 69-72
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Evaluation of the Early Results of a Loop Stoma with a Plastic Rod in Comparison to a Loop Stoma Made with a Skin Bridge
Autorzy:
Dziki, Łukasz
Mik, Michł
Trzciński, Radzisław
Buczyński, Jarosław
Darnikowska, Justyna
Spychalski, Michał
Wierzbicka, Anna
Dziki, Adam
Powiązania:
https://bibliotekanauki.pl/articles/1395192.pdf
Data publikacji:
2015-03-01
Wydawca:
Index Copernicus International
Tematy:
ileostomy
complications
skin patch
rectal cancer
Opis:
Loop stoma allows reducing the percentage of anastomotic leak and re-operation caused by this complication. Our department has performed the loop stoma on a skin bridge since 2011. The aim of the study was to evaluate the early results of treatment after the skin bridge loop stoma creation in comparison with the stoma made on a plastic rod. Both groups had 20 patients. Material and methods. The study involved 40 patients with ileostomy, operated 2010-2013. We evaluated 20 patients with a loop ileostomy on a plastic rod, compared to 20 other patients with a skin bridge ileostomy. The study included 24 men and 16 women. Median age was 68.3. All evaluated patients were previously operated due to rectal cancer. Results. It has been shown that the surgical site infection is more common in the group with a plastic rod (5 vs 1 patient). Inflammation of the skin around the stoma occurred in 18 patients (90%) in the first group, while no such complication was found in patients in the second group. The average number of exchanged ostomy wafers was 2,9 per week in the first group of patients, and 1,1 in the second group (p 0,05). Conclusions. The creation of the skin bridge stoma allows for tight fit of the ostomy appliance immediately after surgery completion. The equipment has stable and long-lasting contact with the skin, no skin inflammatory changes occur. Also the surgical site infection rates are lower in this group of patients. As perioperative patient does not require an increased number of ostomy appliance, the cost of treatment can be considered as an important aspect.
Źródło:
Polish Journal of Surgery; 2015, 87, 1; 31-34
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Knowledge and Awareness of Colorectal Cancer
Autorzy:
Lewandowski, Miłosz
Lipiński, Przemysław
Bednarski, Igor
Mik, Michał
Dziki, Adam
Powiązania:
https://bibliotekanauki.pl/articles/1391790.pdf
Data publikacji:
2020
Wydawca:
Index Copernicus International
Tematy:
awareness
colon cancer
colonoscopy
colorectal cancer
rectal cancer
stomy
Opis:
Introduction: Colorectal cancer (CRC) is the third most common malignancy in men and the second most common in women. The disease constitutes a significant civilization and social problem. The aim: The aim of the study is to assess the sudy group’s awareness and knowledge about CRC, as well as about its diagnostics and treatment. Material and methods: An online questionaire form was distributed in the study group regarding issues related to CRC, and followed by statistical analysis and interpretation of the obtained survey results. Results: After analysis, we found that a significant percentage of the surveyed sample group had basic knowledge and awareness in the area of CRC, whereas about half of the respondents did not consider themselves sufficiently informed about the disease. Conclusions: Considering the scale of the problem posed by CRC, it is necessary to undertake broader action to promote knowledge about this disease and to carry out this type of research on a larger and more socioeconomically diverse population.
Źródło:
Polish Journal of Surgery; 2020, 92, 2; 34-41
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Factors determining the quality of life in patients undergoing radical surgery due to malignant tumors of the rectum
Autorzy:
Błaszkowski, Tomasz
Kładny, Józef
Al-Amawi, Tariq
Kaczmarek, Krystian
Kwietniak, Marcin
Wojtasik, Piotr
Halczak, Mirosław
Michalak, Tomasz
Jezierski, Karol
Chmialak, Mariusz
Powiązania:
https://bibliotekanauki.pl/articles/1391544.pdf
Data publikacji:
2021
Wydawca:
Index Copernicus International
Tematy:
Rectal cancer
Quality of life
Colostomy
Radiotherapy
Opis:
Introduction: Rectal cancer is one of the most common malignancies in developed countries. However, despite the increasingly better preoperative diagnostics, adaptation of surgical techniques to the location and advancement of the tumor, the combination of surgical treatment with neoadjuvant therapy and adjuvant treatment, standardized control tests, Poland still has not obtained satisfactory results regarding long-term survival. In addition, the effects of the therapy often differ significantly from those expected by patients and the doctors treating them. Aim of the study: To evaluate the effects of rectal cancer treatment among patients of the General and Oncological Surgery Clinic of the Pomeranian Medical University in Szczecin. The impact of numerous factors on postoperative quality of life was analyzed. Material and methods: Between 2007 - 2015, 263 radical resection procedures were performed in patients with diagnosed rectal cancer. Retrospectively, based on medical records, a database was created covering a range of clinical data. Information about death dates of some patients was obtained at the Registry Office in Szczecin. A survey supplementing clinical data and standardized quality of life assessment forms (EORTC QLQ - C30 and CR29) were sent to 120 living patients. A telephone conversation was carried out with some patients who did not respond to the surveys. Finally, data from 90 people was collected, which represents 75% of the patients enrolled in the study. Patients quality of life was assessed using EORTC questionnaire evaluation guides. Results: The patients quality of life worsened the most as a result of anorectal dysfunction. Incontinence of gases and stool, urgency and difficulty in defecation were demonstrated primarily in patients undergoing low rectal resection and irradiation. Patients undergoing radiotherapy, as a result of persistent low anterior resection syndrome, were forced to partially or completely withdraw from professional activity and to limit the pursuit of their interests. Their contacts with family, friends and acquaintances have also deteriorated. The presence of the intestinal stoma significantly affected the deterioration of the reception of the body's own image. However, no relation was found between the existence of the fistula and other aspects of the patients everyday life, including functioning in life and social roles. Conclusions: Due to the acceptable postoperative quality of life of patients with fistula and numerous imperfections of sphincter preserving techniques, operations resulting in terminal ostomy should not be considered as an extremity, and in the case of tumors of the lower rectum with unaffected sphincters, they should be considered as alternative methods for low anterior resection.
Źródło:
Polish Journal of Surgery; 2021, 93, 3; 1-9
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Influence of Obesity on Anastomotic Leakage After Anterior Rectal Resectionperformed Due to Cancer
Autorzy:
Piecuch, Jerzy
Wiewióra, Maciej
Szrot, Monika
Jopek, Janusz
Krzak, Albert
Haza, Szymon
Sosada, Krystyn
Powiązania:
https://bibliotekanauki.pl/articles/1395570.pdf
Data publikacji:
2015-03-01
Wydawca:
Index Copernicus International
Tematy:
obesity
rectal cancer
anterior resection
anastomotic leakage
Opis:
Anterior resection for rectal cancer carries the risk of serious complications, especially fistulas at the site of anastomosis. Numerous factors have been shown to impact anastomotic leakage. The results of studies on the influence of obesity on the frequency of anastomotic leakage after rectal resection performed due to cancer have been contradictory. The aim of the study was to evaluate the relationship between body mass index (BMI) and frequency of anastomotic leakage after anterior rectal resection performed due to cancer. Material and methods. This retrospective analysis included 222 subsequent patients who had undergone anterior resection due to cancer with an anastomosis formed with a mechanical suture. The patients were divided into 3 groups depending on their BMI quartile as follows: Group I, BMI < 23.8 kg/m2 (lower quartile); group II, BMI between 23.8 and 29.38 kg/m2 (middle quartile); and group III, BMI > 29.38 kg/m2 (upper quartile). Results. Anastomotic leakage occurred in 8 (3.6%) patients. Fistulas occurred in 4 out of 61 patients (6.56%) in group I, which was the highest incidence of fistulas for all 3 groups. In group II, fistulas occurred in 2 out of 55 patients (3.63%), and similarly, in group III, they occurred in 2 out of 106 patients (1.87%). The differences found in the frequency of fistulas between groups were not statistically significant (p=0.31). The logistic regression analysis did not show any relationship between leakage and age (p = 0.55; OR = 1.02; 95% CI: 0.95 - 1.1), sex (p = 0.97; OR = 0.97; 95% CI: 0.22 - 4.25) or BMI (p = 0.27; OR = 0.58; 95% CI: 0.22 - 1.53). Conclusions. The results of our study show that BMI did not have any influence on the frequency of anastomotic leakage after anterior rectal resection performed due to cancer.
Źródło:
Polish Journal of Surgery; 2015, 87, 3; 124-128
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Local Antibiotic Therapy in Rectal Cancer Surgery
Autorzy:
Morawiec, Zbigniew
Pawlak, Mariusz
Kołacińska, Agnieszka
Dziki, Adam
Powiązania:
https://bibliotekanauki.pl/articles/1397022.pdf
Data publikacji:
2012-12-01
Wydawca:
Index Copernicus International
Tematy:
rectal cancer
infectious complications
local antibiotic use
Opis:
Infectious complications and their consequences are still key issues in rectal cancer surgery. Currently, intravenous antibiotic administration is a recognized method for lowering the rate of these complications. The aim of the study was to assess the efficacy of complementary application of a gentamicin-impregnated sponge in the perineal wound or in the vicinity of intestinal anastomosis after abdominoperineal resection or low anterior resection. Material and methods. 112 patients with primary rectal cancer were enrolled in this study. 42 patients were treated with a gentamicin sponge and drainage (group A) and 70 individuals were treated with drainage alone (group B). In the aforementioned groups a routine short-term regimen of antibiotic prophylaxis was used. We applied gentamicin-impregnated sponges in 27 patients in whom anterior resection was performed and in 15 patients from the abdominoperineal resection group (64% and 36%, respectively). In the control group, 44 anterior resections and 26 abdominoperineal resections were carried out (63% and 37%, respectively). Results. We did not observe statistically significant differences in the incidence of suppurative complications (intraabdominal abscess, perineal wound infection): 4 cases (9.52%) in group A and 9 (12.58%) in group B and anastomotic leakage with clinical manifestation after low anterior resection: 1 case (3.7%) in group A and 2 (4.5%) in group B. Postoperative fever of unknown origin was noted more often in group B: 23 patients (32.8%) versus 10 patients (23.8%) in group A and this difference was statistically significant (p<0.05). Hospitalization after surgery was also significantly longer in group B (9-37 days, median 11 days) as compared with group A (8-26 days, median 13 days) (p<0.05). Conclusions. Local antibiotic therapy in rectal cancer surgery lowered the incidence of postoperative fever of unknown origin and permitted shorter hospitalization after surgery. Local gentamicin application in rectal cancer surgery did not change significantly the rate of infectious complications.
Źródło:
Polish Journal of Surgery; 2012, 84, 12; 613-617
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
A systematic review and meta-analysis of laparoscopic versus robotic rectal surgery with primary anastomosis
Autorzy:
Rubinkiewicz, Mateusz
Witowski, Jan
Zbroja, Karolina
Rozmus, Kamil
Krzywoń, Julia
Truszkiewicz, Katarzyna
Powiązania:
https://bibliotekanauki.pl/articles/1391854.pdf
Data publikacji:
2020
Wydawca:
Index Copernicus International
Tematy:
laparoscopic
meta-analysis
rectal cancer
robotic
systematic review
Opis:
Purpose: Rectal cancer is one of the most common malignancies of the gastrointestinal tract. The gold standard method is surgical resection. The approach to rectal cancer is still controversial. Nowadays, robotic approach gains popularity in comparison to traditional laparoscopy. However, there is lack of studies assessing rectal resections with primary anastomosis. Methods: We performed a systematic review and meta-analysis according to the PRISMA guidelines. The primary outcomes of interest were morbidity and short-term complications. Results: An initial reference search yielded 1250 articles. Finally, we chose six studies covering 1580 patients that we included in the quantitative analysis. In our study, we demonstrated that laparoscopic and robotic surgery are non-inferior to one another in terms of morbidity (RR=1.1 95% CI: 0.89-1.39), major complication rate (RR=1.01, 95% CI: 0.60-1.69) or in length of hospitalization (MD=0,15 95% CI: -0.60−0.90). The latter has slight advantage in quality of mesorectal excision (RD = -0.19, 95% CI: -0.35 − -0.03. I2=69%) and anastomotic leakage rate (OR=2.25, 95% CI: 1.23-4.09, I2=0%). Conclusion: In certain cases Robotic Surgery provide better quality of resected specimen and lower leakage ratio, nevertheless due to heterogeneity the results are uncertain. There is substantial need for large randomized controlled studies.
Źródło:
Polish Journal of Surgery; 2020, 92, 1; 5-11
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Evaluation of risk factors for postoperative complications in rectal cancer patients
Autorzy:
Zeman, Marcin
Czarnecki, Marek
Grajek, Maciej
Idasiak, Adam
Tukiendorf, Andrzej
Czarniecka, Agnieszka
Powiązania:
https://bibliotekanauki.pl/articles/1391899.pdf
Data publikacji:
2020
Wydawca:
Index Copernicus International
Tematy:
anastomotic leak
anterior resection
postoperative complications
rectal cancer
Opis:
Introduction: The complications of surgical treatment for rectal cancer, particularly anastomotic leaks after anterior resection, are a significant clinical problem. We retrospectively analysed preoperative factors that may affect the occurrence of complications. Meterial and Methods: A total of 392 rectal cancer patients were included in a retrospective analysis. A total of 257 anterior resections (AR) and 135 abdominoperineal resections (APR) were performed. The risk factors for early postoperative complications were analysed by logistic regression and receiver operating characteristic curves. Results: The significant risk factors for severe complications (grade 3B and higher on the Clavien-Dindo scale) in the multivariate analysis were neutrophil to lymphocyte ratio > 5 (P = 0.047) in the AR group, age of the patients (P = 0.031) in the APR group, and coronary artery disease in both groups (P = 0.03, P = 0.011, respectively). There were no risk factors for anastomotic leaks in the AR group before the analysis was divided into early and late leaks. In the univariate analysis, the statistically significant risk factors for early leaks were preoperative neutrophil to lymphocyte ratio > 5 and peripheral blood platelet count, while late leaks were associated with coronary artery disease; however, in the multivariate analysis, these factors were not statistically significant. Conclusions: The risk factors for severe postoperative complications were neutrophil to lymphocyte ratio > 5, advanced age of the patients and coronary artery disease. The different risk factors for early and late anastomotic leaks after anterior resection may indicate their different aetiologies.
Źródło:
Polish Journal of Surgery; 2020, 92, 5; 24-30
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Satisfaction with life and disease acceptance by patients with a stomy related to surgical treatment of the rectal cancer – determinants of quality of life?
Autorzy:
Nowicki, Andrzej
Marciniak, Justyna
Farbicka, Paulina
Banaszkiewicz, Zbigniew
Powiązania:
https://bibliotekanauki.pl/articles/1394425.pdf
Data publikacji:
2015
Wydawca:
Index Copernicus International
Tematy:
rectal cancer
stomy
disease acceptance
satisfaction with life
Opis:
Satisfaction with life and disease acceptance by patients with a stomy related to surgical treatment of the rectal cancer depend on multiple factors. Such factors as social support, life conditions and time that elapsed after stomy creation, are very important in this context. The aim of the study was to conduct an early evaluation of life satisfaction and disease acceptance by patients with a stomy related to surgical treatment of the rectal cancer. Material and methods. The study was conducted at Dr. Jan Biziel University Hospital No. 2 in Bydgoszcz and at the prof. F. Łukaszczyk Oncology Centre in Bydgoszcz in 2014. The final analysis included 96 subjects aged 41-87 years (median 59 years). Satisfaction With Life Scale (SWLS) and Acceptance of Illness Scale (AIS) adapted by Zygfryd Juczyński, were used in this study. Results. Most patients had satisfaction with life score of 5 or 6, 23 (24%) and 28 (29.2%) subjects, respectively. Twenty nine (30.2%) study subjects had low satisfaction level, while 16 (16.7%) had high satisfaction level. Average disease acceptance score was 23.2 points. Most patients, 71 (74%) had a moderate disease acceptance score, while the lowest number of subjects, 9 (9.4%), had high disease acceptance score. None of the study subjects who were under the care of a psychologist (14/100%) did not have a low acceptance level. Conclusions. Half of the study subjects had a moderate level of satisfaction with life. Most patients with stomy related to surgical treatment of the rectal cancer in an early postoperative period had moderate level of the disease acceptance. Patients with high level of satisfaction with life, accept the disease better. Few patients who used help by a psychologist, were two- and three-fold more likely to have higher level of satisfaction with life and disease acceptance, respectively.
Źródło:
Polish Journal of Surgery; 2015, 87, 9; 434-442
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Laparoscopic Abdominoperineal Resection Of The Rectum – How Is It Done; Initial Results
Autorzy:
Grous, Aleksander
Uryszek, Mariusz
Ciesielski, Adam
Dib, Naser
Tarnowski, Wiesław
Powiązania:
https://bibliotekanauki.pl/articles/1396411.pdf
Data publikacji:
2013-10-01
Wydawca:
Index Copernicus International
Tematy:
rectal cancer
laparoscopy
abdominoperineal resection of the rectum
Opis:
The abdominoperineal resection of the rectum is a classical operation performed in case of patients diagnosed with rectal cancer. The development of laparoscopic techniques in recent years, introduced yet another method of treatment, considering patients with rectal cancer- laparoscopic abdominoperineal resection of the rectum. The aim of the study was to present initial treatment results considering the above-mentioned patients. Material and methods. The study group comprised 25 patients (16 male and 9 female) diagnosed with low-rectal cancer, subjected to surgery by means of the above-mentioned method. Mean patient age amounted to 66 years. Three (12%) patients required conversion to classical surgery (laparotomy), while one patient required reoperation, due to presacral vascular bleeding. Complications were observed in 10 (40%) patients. Average hospitalization was 7 days. In case of all patients the radial margin was negative, and mean number of removed lymph nodes amounted to 9.6. Mortality was not observed during the perioperative period. Due to the initial character of the study analysis (mean observation period in case of 68% of patients was shorter than 2 years), oncological results were not subject to evaluation. Conclusions. Laparoscopic abdominoperineal resections are considered as technically difficult operations, requiring significant experience of the operating team. However, they enable the patient to take advantage of the many assets of minimally invasive surgery, with comparable rates of postoperative complications.
Źródło:
Polish Journal of Surgery; 2013, 85, 10; 569-575
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Skuteczność postępowania wielospecjalistycznego u kobiet operowanych z powodu raka odbytnicy
The effectiveness of multimodality management of the rectal cancer in females
Autorzy:
Szynglarewicz, Bartłomiej
Matkowski, Rafał
Ochenduszkiewicz, Urszula
Sydor, Daniel
Forgacz, Józef
Pudełko, Marek
Kornafel, Jan
Powiązania:
https://bibliotekanauki.pl/articles/908194.pdf
Data publikacji:
2006
Wydawca:
Medical Communications
Tematy:
adnexectomy
anterior resection
hysterectomy
rectal cancer
total mesorectal excision (TME)
Opis:
Rectal cancer incidence among females in Poland increases. Surgery remains the mainstay of treatment. Anterior resection with total mesorectal excision (TME) is the preferred option in the most cases. Some patients have locally advanced tumours or synchronous gynaecologic abnormalities and need extended resections. Objective: Aim of the study was the evaluation of incidence and pattern of concomitant gynaecologic lesions and analysis of impact of multimodality co-operation between surgeon and gynaecologist on functional and oncological outcomes. Material and methods: Consecutive 34 women (age 35-81, mean 59.6) underwent R0 resection with sphincter-preserving TME from 01.1998 to 12.1999 and were studied prospectively. Follow-up period was five years. Results: 9% females underwent hysterectomy or adnexectomy previously. At the time of surgery 36% had abnormal internal genitalia: 15% at the uterus, 6% at ovaries, 6% at uterus and ovaries, in 9% adherence to the rectum was found. In 3% malignant infiltration was microscopically confirmed. No postoperative mortality was noticed. Anastomotic leakage developed in 9%, postoperative bleeding in 3%, delayed wound healing in 12%, prolonged bowel paralysis in 3%, anterior resection syndrome in 6%, urological disturbances in 9%. Isolated local recurrences were found in 6%. 64% five-year overall survival was achieved. Survival rate was 91.7% in Dukes A, 63.6% in B and 36.4% in C (p<0.05). Conclusions: Numerous females with rectal cancer have gynaecologic abnormalities and need extended resections. Due to adequate co-operation of surgeon and gynaecologist and optimal multimodality management, acceptable postoperative morbidity and optimising oncological outcomes can be achieved.
Zapadalność kobiet na raka odbytnicy w Polsce wzrasta. Podstawą leczenia jest postępowanie operacyjne. Wraz z postępem chirurgii preferowaną opcją w większości przypadków są różne odmiany resekcji przedniej z techniką całkowitego wycięcia mezorektum (TME). U części kobiet obecne są synchroniczne zmiany w narządzie rodnym wymagające resekcji. Cel: Celem pracy była ocena częstości występowania i charakteru tych zmian oraz skuteczności wieloprofilowego postępowania i współpracy śródoperacyjnej ginekologa i chirurga w aspekcie wyników czynnościowych i onkologicznych. Materiał i metody: Prospektywnej analizie poddano grupę kolejnych 34 kobiet (wiek 35-81 lat, średnia 59,6), u których wykonano resekcję R0 z zaoszczędzeniem zwieraczy metodą TME od 01.1998 do 12.1999. Okres obserwacji kontrolnej wynosił 5 lat. Wyniki: 9% kobietom już wcześniej usunięto narząd rodny. 36% pacjentek wymagało jego resekcji jednoczasowo z odbytnicą: 15% kobiet miało zmiany w macicy, 6% w przydatkach, 6% w macicy i przydatkach, u 9% stwierdzono naciek narządu rodnego. W 3% potwierdzono mikroskopowo infiltrację nowotworową. Śmiertelności pooperacyjnej nie zanotowano. Nieszczelność zespolenia stwierdzono u 9% pacjentek, krwawienie pooperacyjne u 3%, zaburzenia gojenia rany u 12%, przedłużoną atonię jelit u 3%, zespół resekcji przedniej u 6%, powikłania urologiczne u 9% chorych. Izolowane wznowy miejscowe wystąpiły u 6% kobiet. Uzyskano 64% 5-letnich przeżyć całkowitych. Przeżycie osiągnęło wartość 91,7% w stadium Dukes A, 63,6% w B i 36,4% w stadium C (p<0,05). Wnioski: Znaczna część kobiet z rakiem odbytnicy ma zmiany w narządzie rodnym wymagające leczenia operacyjnego. Optymalne wielospecjalistyczne postępowanie prowadzone dzięki współpracy ginekologa i chirurga pozwala na osiągnięcie dobrych wyników onkologicznych przy akceptowalnym ryzyku powikłań.
Źródło:
Ginekologia Onkologiczna; 2006, 4, 2; 108-114
1731-5379
Pojawia się w:
Ginekologia Onkologiczna
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Sexual dysfunctions following low anterior resection of the rectum in rectal cancer patients
Autorzy:
Włodarczyk, Marcin
Sobolewska, Justyna
Nowak, Artur
Szewczyk, Martyna
Kluska, Piotr
Dzika, Katarzyna
Darnikowska, Justyna
Mik-Wojtczak, Joanna
Włodarczyk, Jakub
Sobolewska-Włodarczyk, Aleksandra
Trzciński, Radzisław
Dziki, Łukasz
Powiązania:
https://bibliotekanauki.pl/articles/1391931.pdf
Data publikacji:
2019
Wydawca:
Index Copernicus International
Tematy:
sexual dysfunction
rectal cancer
low anterior resection
surgical treatment outcomes
Opis:
Introduction. Low anterior resection of the rectum (LAR) is a treatment of choice in patients with diagnosed low rectal cancer. Rectal cancer surgery has a close relationship with the urinary-sexual organs and also with related nerves and nerve plexus. Thus, the sympathetic and parasympathetic nerves of the pelvic area may be damaged. As a result of this, the important point is the sexual function loss following rectal surgeries. The aim of the study was to investigate the sexual disorders in patients with rectal cancer who underwent LAR. Materials and methods. In this retrospective study the sexual activity, comfort of the experience, quality of sexual life (QoSL) during 3 periods were analyzed: before surgery, a month after and half a year after surgery. Analysis of demographic characteristics, comorbidities, previous surgeries, toumor characteristics and adjuvant therapy as was performed. Results. Most patients (64/100, 64%) expressed that LAR operation has strongly affected their QoSL, 32 patients reported the mild decrease in QoSL, while only 4 patients stated that did not experience any changes in QoSL. QoSL was assessed in 3 different periods of time: before the operation, 1 month after and 6 months after the operation (22,6±3.7 vs. 11.3±7,9 vs. 17,0±6.3; p<0.0001 respectively). The decreased QoSL one and six months after the surgery were significantly lower in patients with diagnosed hypertension and higher BMI (p=0.0283). Conclusions. Sexual disorders after LAR for rectal cancer are often underestimated and it is very important to be aware of them. In our study, it was determined that male sex, higher BMI and hypertension are related to impair of sexual dysfunction after LAR. We observed that the most severe complaints related to sexual activity occur one month after the procedure, after 6 months in most of the patients' sexual disorders were decreased approaching the initial state.
Źródło:
Polish Journal of Surgery; 2019, 91, 3; 21-26
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Low-Anterior-Resection Syndrome. How Does Neoadjuvant Radiotherapy and Low Resection of the Rectum Influence the Function of Anal Sphincters in Patients with Rectal Cancer? Preliminary Results of a Functional Assessment Study
Autorzy:
Romaniszyn, Michał
Richter, Piotr
Walega, Piotr
Kenig, Jakub
Nowak, Marcin
Nowak, Wojciech
Powiązania:
https://bibliotekanauki.pl/articles/1396730.pdf
Data publikacji:
2012-04-01
Wydawca:
Index Copernicus International
Tematy:
rectal cancer
low anterior resection
neoadjuvant radiotherapy
anal sphincter function
Opis:
The aim of the study was to assess the influence of neoadjuvant radiotherapy and resection of the rectum on the functional parameters of anal sphincters.Material and methods. 20 patients with rectal cancer, qualified for low anterior rectal resection with neoadjuvant radiotherapy were enrolled in the study group. The study protocol included an anorectal manometry, electromyography and fecal incontinence questionnaire (FISI) before radiotherapy, after radiotherapy, and after the operation.Results. Of the 20 patients 12 were included in the final analysis, because 8 patients were re-qualified to abdomino-perineal resection of the rectum after neoadjuvant treatment. There were no significant changes in anal pressures assessed 5 to 8 days after radiotherapy. In 3 cases (25%) pathological changes in RAIR reflex were found in the manometric examination. After low anterior resection mean basal anal pressures were significantly lower, whereas squeeze anal pressures did not change significantly. In 7 patients (58%) the RAIR reflex was pathological or even absent after low anterior resection. Changes in manometric parameters correlated with FISI incontinence assessment after the operation. In electromyographic examination action potentials of motoric units of the external anal sphincter were still present both after radiotherapy, and after operation.Conclusions. Fecal incontinence after low anterior resection of the rectum seems to be caused mostly by changes in autonomic functionality of anal sphincters and lack of compliance of the neorectum, since the influence of neoadjuvant radiotherapy and the operation itself on the somatic innervation of anal sphincters seems to be minimal.
Źródło:
Polish Journal of Surgery; 2012, 84, 4; 177-183
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Sacral insufficiency fracture following rectal cancer treatment – case report
Autorzy:
Pikula, A.
Pikula, T.S.
Pastuszak, M.
Powiązania:
https://bibliotekanauki.pl/articles/2098211.pdf
Data publikacji:
2020
Wydawca:
Instytut Medycyny Wsi
Tematy:
sacral fracture
rectal cancer
treatment
carcinoembryonic antigen
magnetic resonance imaging
radiotherapy
Opis:
Introduction and Objective. Locally advanced rectal cancers witha high risk of recurrence need multimodal treatment Rusing neoadiuvant preoperative chemoradiotherapy or preoperative radiotherapy. Both rectal cancer surgery and the additional chemoradiotherapy or radiotherapy may cause late sequelae. The aim of the study is to present a clinical situation in which a pelvic recurrence of rectal cancer has to be distinguished from therapy side effects. Insufficiency fracture (IF) is one of the therapy side-effects. It can cause pain and decrease mobility and it is a well-known late complication to pelvic radiotherapy, but can be misinterpreted as a local recurrence. Conclusions. It is extremely important to distinguish IF from metastases, which may require biopsies and initiation of potentially toxic treatments such as chemotherapy. MRI and CT scans are complementary modalities to make an accurate diagnosis of IF.
Źródło:
Journal of Pre-Clinical and Clinical Research; 2020, 14, 4; 120-122
1898-2395
Pojawia się w:
Journal of Pre-Clinical and Clinical Research
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Does the Choice of Hospital Increase a Chance of Survival in Rectal Cancer?
Autorzy:
Pawlak, Mariusz
Morawiec, Zbigniew
Dziki, Łukasz
Morawiec, Jan
Kolacińska, Agnieszka
Dziki, Adam
Powiązania:
https://bibliotekanauki.pl/articles/1397012.pdf
Data publikacji:
2012-12-01
Wydawca:
Index Copernicus International
Tematy:
rectal cancer
prognostic factors
hospital caseload
5-year survival
local recurrence
Opis:
was to assess the impact of hospital caseload on long-term outcomes of rectal cancer patients. We posed two questions: 1. Does the number of operations carried out in the surgical department influence five year survival and local recurrence rates? 2. Does surgery alone without adjuvant therapy performed in the particular department affect long-term results? Material and methods. 215 consecutive rectal cancer patients treated in six hospitals of the Łódź district between 1994 and 1998 were enrolled into this prospective study. We analyzed patients in whom local excision, low anterior resection, abdominoperineal resection and Hartmann’s procedure were performed. 27 percent of patients received adjuvant therapy such as radio- or chemotherapy or both. Long-term results were compared between high and low volume institutions by means of local recurrence and five year survival rates. Results. In high volume departments; 69.2% of five year survival rates were obtained versus 46.6% for low volume institutions (p=0.00433). Similar differences were noted comparing local recurrence rates between the aforementioned groups: 19.7% versus 36.5%, respectively (p=0.00430). In surgically treated patients who did not receive adjuvant therapy statistically significant differences were found: 76.5% of patients operated on in high volume hospitals survived five years as compared with 42.9% for low caseload institutions (p=0.00013). Local recurrence rates were 15.5% for high caseload institutions and 38.5% for low caseload hospitals (p=0.00042). Conclusions. High volume hospitals achieved better results in rectal cancer patients with regard to five year survival and local recurrence rates. Better outcomes were also obtained in high caseload departments regarding surgically treated patients who did not receive adjuvant therapy.
Źródło:
Polish Journal of Surgery; 2012, 84, 12; 638-645
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Wyświetlanie 1-15 z 18

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