scholarly journals COLODUODENAL FISTULA IN RIGHT COLORECTAL CANCER: CASE REPORT AND REVIEW OF THE LITERATURE

Author(s):  
Patricia Ciriano Hernández ◽  
Carlos Martínez Pinedo ◽  
Rafael Picón Rodríguez ◽  
Elisa Jiménez Higuera ◽  
Daniel Sánchez Peláez ◽  
...  

In spite of the high incidence of colorectal cancer, cases of right colon cancer presenting with local invasion are not common. This is even more infrequent if we focus on duodenal invasion and presence of duodenal fistula. We present the case of a patient admitted to our hospital due to severe weight loss, malnutrition and bowel obstruction. The patient was diagnosed of advanced right colon cancer with coloduodenal fistula and concomitant liver metastasis. According to diagnosis, palliative surgery was performed

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e22037-e22037
Author(s):  
Giovanni Corso ◽  
Valeria Pascale ◽  
Giuseppe Flauti ◽  
Daniele Marrelli ◽  
Franco Roviello

e22037 Background: Oncogenic mutations, such as KRAS, in colorectal cancer patients are considered standard molecular biomarkers that predict the clinical benefit for the targeted intervention with EGFR inhibitors. In addition, these mutations are associated with specific anatomical area in the colon tumor development, as BRAF mutations with the microsatellite instability. Methods: In this translational study we aim to assess the mutation frequencies of the EGFR [hotspot area and polyadenine deletions (A13_del)], KRAS, BRAFV600E, and PIK3CA oncogenes in a series of 280 colorectal cancer patients. Microsatellite instability phenotype is considered in this series. All patients' clinicopathological data were considered for statistical analysis and associations. Results: In this study, we verified multiple associations between oncogenic mutations and specified clinicopathological tumor features. Respectively, we identified the following significant results: 1) EGFR A13_deletions are associated with right colon carcinoma (22.2% vs. 3.3%; p<0.005), mucinous histotype (16% vs. 7.8%; p=0.042), G3 grading (19% vs. 7.3%; p=0.024) and microsatellite instability status (p<0.005); 2) PIK3CA mutations are related mucinous histotype (12% vs. 4.4%; p=0.021) 3) KRASG12 and KRASG13mutations are correlated respectively with the left (91.4% vs. 59.3%) and right (40.7% vs. 8.6%) colon cancer development (p<0.005), and finally 4) microsatellite instability is associated with right colon tumors (28.4% vs. 5.5%; p<0.005). Conclusions: Mostly, we verified a high frequency rate of the KRASG13 and EGFR A13_del oncogene mutations in right colon cancer; whereas KRASG12 codon mutation occurs more frequently in left colon cancers. In particular, we assessed that right colon cancer is associated with specific molecular characteristics, in comparison to left colon tumors. These evidences, in association with specific clinicopathological data, can delineate novel approaches for the colorectal cancer classification and targeted intervention.


2018 ◽  
Vol 23 (2) ◽  
pp. 12-16
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage ◽  
Stephen L. Demeter

Abstract Under California Labor Code Section 3212.1, firefighters, forestry and fire protection workers, peace officers, and first responders receive a potentially rebuttable presumption of compensability for certain conditions, including cancer and leukemia. This case example illustrates the need for accurate clinical, causation, apportionment, and impairment assessments that are based on the facts, current science, and appropriate use of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). A retired California firefighter in his mid-sixties presented for an impairment evaluation for the sequelae of his colon cancer; six years earlier, he was diagnosed with stage 1 colorectal cancer and received neoadjuvant chemotherapy and radiation therapy, followed by surgical resection with a diverting colostomy and take-down surgery. He is morbidly obese (body mass index, 45) and has hypertension. He reported fecal frequency, urgency, and incontinence and stated he had problems with erectile dysfunction (ED) before his diagnosis of colon cancer, but after diagnosis and treatment the problem worsened to impotence. The author presents impairment assessments of this case example according to the AMA Guides, Fifth Edition vs the Sixth Edition. According to the fifth edition, this individual's impairment for lower gastrointestinal tract impairment is 17% whole person impairment (WPI), and this is combined with 5% WPI for ED, resulting in 21% WPI. According to the sixth edition, the lower gastrointestinal tract impairment of 14% is combined with 5% WPI for ED, leading to an 18% WPI.


2010 ◽  
Vol 14 (3) ◽  
pp. 147-154 ◽  
Author(s):  
Ji Yeon Kim ◽  
Eun Sun Jang ◽  
So Youn Park ◽  
Ju Hee Park ◽  
Hyuk Yoon ◽  
...  

2020 ◽  
Vol 189 (6) ◽  
pp. 543-553 ◽  
Author(s):  
Inger T Gram ◽  
Song-Yi Park ◽  
Lynne R Wilkens ◽  
Christopher A Haiman ◽  
Loïc Le Marchand

Abstract The purpose of this study was to examine whether the increased risk of colorectal cancer due to cigarette smoking differed by anatomical subsite or sex. We analyzed data from 188,052 participants aged 45–75 years (45% men) who were enrolled in the Multiethnic Cohort Study in 1993–1996. During a mean follow-up period of 16.7 years, we identified 4,879 incident cases of invasive colorectal adenocarcinoma. In multivariate Cox regression models, as compared with never smokers of the same sex, male ever smokers had a 39% higher risk (hazard ratio (HR) = 1.39, 95% confidence interval (CI): 1.16, 1.67) of cancer of the left (distal or descending) colon but not of the right (proximal or ascending) colon (HR = 1.03, 95% CI: 0.89, 1.18), while female ever smokers had a 20% higher risk (HR = 1.20, 95% CI: 1.06, 1.36) of cancer of the right colon but not of the left colon (HR = 0.96, 95% CI: 0.80, 1.15). Compared with male smokers, female smokers had a greater increase in risk of rectal cancer with number of pack-years of smoking (P for heterogeneity = 0.03). Our results suggest that male smokers are at increased risk of left colon cancer and female smokers are at increased risk of right colon cancer. Our study also suggests that females who smoke may have a higher risk of rectal cancer due to smoking than their male counterparts.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15609-e15609
Author(s):  
Chenyu Sun ◽  
Xianwei Guo ◽  
Kelly Kozma ◽  
Chandur Bhan ◽  
Na Hyun Kim

e15609 Background: Colorectal cancer (CRC) is one of the most diagnosed cancers and the second leading cause of cancer-related death worldwide. Globally, more than 1.8 million people are diagnosed of colorectal cancer (CRC) in 2018. In advanced CRC patients, bevacizumab plus 5-fluorouracil-based or platinum-based therapy has become one of the standard first-line chemotherapy regimen. A recent study also found that antibiotic exposure could be inversely associated with the mortality in metastatic colorectal cancer (mCRC) patients treated with bevacizumab. However, subgroup analysis of this study was no sufficient. Therefore, we conducted a secondary analysis based on the data of this study from Dryad database. Methods: In this retrospective cohort study, 147 mCRC patients treated with bevacizumab were included. All data was obtained from Dryad database (https://doi.org/10.5061/dryad.ft5sk66). Patients were divided into follow subgroups: (1) left colon vs right colon; (2) BMI < 18.5 vs BMI 18.5-24 vs BMI≥24;(3) Age < 45 vs Age≥45, (4) no surgery vs palliative surgery vs radical surgery, (5) bevacizumab plus FOLFIRI vs bevacizumab plus capeOX/FOLFOX vs bevacizumab plus other chemotherapy regimen. Specific survival of each subgroup was analyzed through the Kaplan-Meier curve, and the survival curves of the variables were compared using the log-rank test. Results: Survival analysis found no statistically significant differences of the cumulative survival rates between left colon cancer and right colon cancer, (58.9% vs 62.5%, respectively; χ2 = 0.043, P = 0.836), groups of different BMI (57.9% of BMI < 18.5 vs 55.2% of 18.5≤BMI < 24 vs 70.7% of BMI ≥24,χ2 = 3.026, P = 0.220), Age < 45 group and Age≥45 group (54.8% vs 61.2%, respectively; χ2 = 0.001, P = 0.976), surgical treatments (No surgery 59.0% vs Palliative surgery 57.6% vs Radical Surgery 61.3%; χ2 = 1.885, P = 0.390), as well as groups of different chemotherapy regimens (66.7% of FLOFIRI vs 52.0% of CapeOX/FOLFOX vs 59.9% of others; χ2 = 1.572, P = 0.456). Conclusions: Based on the data from this study, we found that different sites of colon cancer, age, BMI, different surgical treatments, and different chemotherapy regimens did not affect the survival outcome of patients with mCRC treated with bevacizumab after antibiotic exposure. Subsequent studies with larger sample size are still needed to further elaborate the effects of different antibiotics on survival outcomes.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Toshio Shiraishi ◽  
Tetsuro Tominaga ◽  
Takashi Nonaka ◽  
Kiyoaki Hamada ◽  
Masato Araki ◽  
...  

AbstractSingle-incision laparoscopic surgery (SILS) has the potential to improve perioperative outcomes, including less postoperative pain, shorter operation time, less blood loss, and shorter hospital stay. However, SILS is technically difficult and needs a longer learning curve. Between April 2016 and September 2019, a total of 198 patients with clinical stage I/II right colon cancer underwent curative resection. In the case of the SILS approach, an organ retractor was usually used to overcome SILS-specific restrictions. The patients were divided into two groups by surgical approach: the SILS with organ retractor group (SILS-O, n = 33) and the conventional laparoscopic surgery group (LAC, n = 165). Clinical T status was significantly higher in the LAC group (p = 0.016). Operation time was shorter and blood loss was lower in the SILS-O group compared to the LAC group (117 vs. 197 min, p = 0.027; 10 vs. 25 mL, p = 0.024, respectively). In the SILS-O group, surgical outcomes including operation time, blood loss, number of retrieved lymph nodes, and postoperative complications were not significantly different between those performed by experts and by non-experts. Longer operation time (p = 0.041) was significantly associated with complications on univariate and multivariate analyses (odds ratio 2.514, 95%CI 1.047–6.035, p = 0.039). SILS-O was safe and feasible for right colon cancer. There is a potential to shorten the learning curve of SILS using an organ retractor.


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tianfang Xia ◽  
Zhenguo Pan ◽  
Jie Zhang ◽  
Guo Xu

Abstract Background We compared the advantages and disadvantages of modified triangular anastomosis and tubular anastomosis for digestive tract reconstruction in patients undergoing laparoscopic-assisted radical resection of right colon cancer. Methods This was a retrospective cohort analysis of 92 cases of laparoscopic-assisted resection of right colon cancer, treated from June 2017 to June 2018, at the Huai’an No. 1 People’s Hospital in China. Patients were divided into a modified triangular anastomosis group (n = 33) and a tubular anastomosis group (n = 59). In the modified triangular anastomosis group, digestive tract reconstruction was conducted using side-to-side anastomosis of the ileo-transverse colon with a 60-mm linear stapler. The common entry hole was closed with a running suture. The tubular anastomosis group underwent end-to-side anastomosis of the ileo-transverse colon with a tubular stapler anchor placed at the end of the ileum. Results At baseline and perioperatively, there were no significant between-group differences in age, sex, body mass index, tumor location, pathological stage, or tumour size (P > 0.05). There were also no significant between-group differences in operation time, estimated blood loss, the number of harvested lymph nodes, the first postoperative flatulence time, hospitalisation time, or postoperative complications (P > 0.05); however, the total cost of hospitalization for the triangular anastomosis group was significantly lower than the tubular anastomosis group (P < 0.05). Conclusion Modified triangular anastomosis is a safe and feasible procedure for laparoscopic-assisted radical resection of right colon cancer. These results affirm the safety and effectiveness of total laparoscopic radical resection of right colon cancer. Given the equivalent outcomes between the two procedures, the modified triangular procedure may be more a more cost-effective option for clinical application.


Author(s):  
A. Haddad ◽  
D. Bel Haj Yahia ◽  
Y. Chaker ◽  
H. Maghrebi ◽  
A. Daghfous ◽  
...  

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