scholarly journals METHOD OF INTESTINAL DECOMPRESSION IN TREATMENT OF RECTAL CANCER COMPLICATED BY INTESTINAL OBSTRUCTION

2016 ◽  
Vol 15 (6) ◽  
pp. 66-69
Author(s):  
E. V. Kalinin ◽  
E. A. Suleimanov
Keyword(s):  
Rectal Cancer ◽  
Intestinal Obstruction ◽  
Intestinal Decompression

scholarly journals Recurrent Intestinal Obstruction after Radiation Therapy: A Case Report and Review of the Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
James Nguyen ◽  
Amani Jambhekar ◽  
Ziyad Nasrawi ◽  
Prasad Gudavalli
Keyword(s):  
Rectal Cancer ◽  
Case Report ◽  
Small Bowel ◽  
Intestinal Obstruction ◽  
Loop Ileostomy ◽  
Neoadjuvant Chemoradiation ◽  
Ileocolic Anastomosis ◽  
Neoadjuvant Radiotherapy ◽  
Diverting Loop Ileostomy ◽  
Radiation Induced

Introduction. In patients who have undergone resection for rectal cancer after neoadjuvant radiotherapy, loop ileostomy is commonly performed with few serious complications. In rare cases, if this irradiated small bowel is strictured, reversal of the affected ileostomy can have dire consequences. We present a case of a 62-year-old male with recurrent intestinal obstruction after closure of his loop ileostomy. Case Report. RC is a 62-year-old male who initially presented with rectal cancer and underwent neoadjuvant chemoradiation prior to a laparoscopic low anterior resection with diverting loop ileostomy. He underwent elective reversal of his ileostomy and developed persistent postoperative obstruction. He underwent resection of the prior reversal site with normal-appearing dilated proximal bowel loops and collapsed distal bowel loops. He again developed an obstructive picture and underwent resection of the prior anastomosis with creation of an ileocolic anastomosis, after which he recovered well postoperatively. Conclusion. In patients who receive radiation adjuvant therapy for colon cancer, radiation-induced stricture should be considered as a cause of small bowel obstruction postoperative. In the setting of a longstanding ileostomy, evaluation of a defunctionalized distal ileum may be necessary to evaluate potential obstruction from radiation changes.

Risk evaluation of postoperative complication in patients undergoing rectal cancer surgery.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 756-756
Author(s):  
Hiroshi Miyakita ◽  
Sotaro Sadahiro ◽  
Toshiyuki Suzuki ◽  
Akira Tanaka ◽  
Kazutake Okada ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Postoperative Complications ◽  
Intestinal Obstruction ◽  
Risk Score ◽  
Surgical Stress ◽  
Infectious Complications ◽  
Risk Scores ◽  
Rectal Cancer Surgery ◽  
Stoma Creation ◽  
Severity Scores

756 Background: Colorectal cancer patients with postoperative complications have poor long-term outcomes. Rectal cancer is associated with a higher incidence of complications than colon cancer. Reliable predictors of complications would facilitate determination of surgical procedures such as stoma creation. We examined the relations between five kinds of risk score and postoperative complications in patients(pts) with rectal cancer. Methods: The subjects were 261 pts with cStage II/III rectal cancer from 2003 to 2013. We categorized complications into all complications, leakage, infectious complications and intestinal obstruction. Estimation of physiologic ability and surgical stress comprehensive risk scores (E-PASS CRS), surgical Apgar scores (SAS), prognostic nutritional index (PNI), colorectal physiological and operative severity scores for the enumeration of mortality and morbidity (CR-POSSUM), and neutrophil-lymphocyte ratios (NLR) were assessed. Clavien-Dindo (CD) Grade 3a or higher requiring surgically invasive treatment were considered complications. For leakage, CD Grade 3b or higher were considered complications. Results: Complications occurred in 56 pts (21%), leakage (L) in 12 (14%), infectious complications (IC) in 19 (7%), and intestinal obstruction (IO) in 16 (6%). E-PASS CRS significantly correlated with all complications (OR 3.45; p < 0.001), IC (OR 0.26; p = 0.008), L (OR 4.94; p = 0.027), and IO (OR 3.92; p = 0.007). PNI correlated with all complications (OR 0.38; p = 0.002) and IO (OR 3.08; p = 0.024). NLR correlated with all complications (OR 0.40; p = 0.003), IC (OR 0.25; p = 0.004), L (OR 8.66; p < 0.001), and IO (OR 3.86; p = 0.007). SAS correlated with IC (OR 0.19; p = 0.004). CR-POSSUM correlated with all complications, (OR 2.26; p = 0.009), IC (OR 5.02; p < 0.001), and IO (OR 0.28; p = 0.014). Multivariate analysis revealed E-PASS CRS (OR 6.17 p = 0.020) and NLR (OR 7.11 p = 0.011) were independent risk factors for L. Conclusions: Five kinds of risk score were all useful for assessing the risk of complications in rectal cancer. NLR was the only risk factor for leakage that could be used before surgery. Our results suggest NLR might be an auxiliary means of evaluating the need for creation of diverting stoma.

scholarly journals Mucinous Rectal Adenocarcinoma in a Background of Chronic Schistosomiasis: A Case Report and Review of the Literature

2019 ◽  
Vol 1 (2) ◽  
pp. 01-03
Author(s):  
Ifeanyi Umoke
Keyword(s):  
Rectal Cancer ◽  
Case Report ◽  
Intestinal Obstruction ◽  
Schistosoma Mansoni ◽  
Schistosoma Japonicum ◽  
Colonic Cancer ◽  
Rectal Adenocarcinoma ◽  
Cirrhotic Liver ◽  
Review Of The Literature

Reports have revealed the existence of colonic cancer with chronic bowel schistosomiasis. The specie most frequently involved is Schistosoma japonicum. Few cases have, however, shown Schistosoma mansoni as the involved specie. There seems to be an association between rectal cancer and Schistosoma mansoni infestation. Despite earlier studies that refuted any association between schistosomiasis and colonic cancer, more reports are lending credence to the claim that chronic colonic schistosomiasis, especially with S. Japonicum, may induce colonic cancer and the case with are reporting also point to the fact that S. Mansoni may also be implicated. We report a case of a 35-year-old man with a rectal cancer (pT3N0M0) associated with Schistosoma mansoni. He presented with intestinal obstruction and operation revealed a cirrhotic liver with hepatic schistosomiasis.

scholarly journals Bowel decompression in the treatment of patients with acute colonic obstruction

2019 ◽  
Vol 23 (3) ◽  
pp. 420-424 ◽  
Author(s):  
V.V. Nepomniashchyi
Keyword(s):  
Motor Activity ◽  
Intestinal Obstruction ◽  
Motor Function ◽  
Colonic Obstruction ◽  
Acute Intestinal Obstruction ◽  
Intestinal Lumen ◽  
Intestinal Intubation ◽  
Number Of Patients ◽  
Intestinal Decompression ◽  
Medical Histories

According to literature data acute intestinal obstruction is characterized by a great number of neglected forms comprising 5–70% cases with the given pathology. A number of radiological signs in the way of Kloiber’s bowls and intestinal arches simply confirm this and testify of colon motor activity decompensation. To date there are no objective diagnostic criteria providing indications to intestinal decompression before the operation. Intestinal intubation, its types and indications to its fulfilment are based only on the experience and intuition of the operating surgeon. Aim — to define clinical efficiency of the intestinal wall impaired contractility diagnostics method in the treatment of patients with acute colonic obstruction. Medical histories analysis of 166 patients with obstructive intestinal obstruction was carried out. Assessment of intestinal motor activity compensation was carried out with the help of echographic criteria — the number of enlarged small bowel loops, intestinal lumen width, wall thickness, distance between Kerckring folds, number of peristaltic movements per minute. According to the suggested method 3 groups of patients were distinguished — with compensated motor activity (32 (19%) patients), with sub-compensated motor activity (61 (36.5%) patients) and with intestinal decompensated motor activity (73 (44.4%) patients). Wherein the greater number of patients with obstructive ileus (135 (81%) patients) got into the hospital with sub- and decompensated intestinal motor function. In the group of patients with compensated muscular tone intestinal decompression was not carried out, in the second group with sub-compensated intestinal tone decompression was carried out simultaneously in 13 (7.8%) patients, and in 9 (5.4%) a nasojunal probe was installed for 2–3 days, in the third group intestinal intubation was done in 63 (38%) patients. Post-operative mortality was 3.2%. Thus, echographic criteria allow establishing the degree of intestinal impaired motor function before the operation in patients with acute intestinal obstruction which decompression depends upon its state.

scholarly journals Intestinal Obstruction: An Overview of Aetiology, Evaluation and Management

2019 ◽  
Vol 17 (2) ◽  
pp. 89-95
Author(s):  
ABM Khurshid Alam ◽  
Kazi Lsrat Jahan ◽  
Mohammad Ali
Keyword(s):  
Intestinal Obstruction ◽  
Clinical Symptoms ◽  
Abdominal Distension ◽  
Initial Study ◽  
Abdominal Adhesions ◽  
Radiologic Imaging ◽  
Vascular Compromise ◽  
Intestinal Decompression ◽  
Bowel Rest ◽  
Bowel Decompression

Intestinal obstruction occurs when there is an interruption in the forward flow of intestinal contents. This interruption can occur at any point along the length of the gastrointestinal tract, and clinical symptoms often depend on the level of obstruction. Intestinal obstruction is most commonly caused by intra-abdominal adhesions, malignancy, or intestinal herniation. The clinical presentation generally includes colicky abdominal pain, vomiting, abdominal distension and constipation. Radiologic imaging can confirm the diagnosis. Although radiography is often the initial study, non-contrast computed tomography is recommended if the index of suspicion is high or if suspicion persists despite negative radiography. Management of uncomplicated obstructions includes fluid resuscitation with correction of metabolic derangements, intestinal decompression, and bowel rest. Evidence of vascular compromise or perforation, or failure to resolve with adequate bowel decompression is an indication for surgical intervention. Journal of Surgical Sciences (2013) Vol. 17 (2): 89-95

scholarly journals Oncological outcomes of obstructed locally advanced rectal cancer in the era of multi-modal therapy

2018 ◽  
Vol 5 (11) ◽  
pp. 3695
Author(s):  
Joshua Franklyn ◽  
Gigi Varghese ◽  
Rajat Rghunath ◽  
Tunny Sebastian ◽  
Mark Ranjan Jesudason
Keyword(s):  
Rectal Cancer ◽  
Intestinal Obstruction ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Free Survival ◽  
Oncological Outcomes ◽  
Number Of Patients ◽  
Disease Free

Background: The management of locally advanced rectal cancer is multi-modal. In India, a number of patients present with features of intestinal obstruction and are diverted prior to initiation of chemo-radiation therapy. The purpose of this paper is to study the demographics and oncological outcomes of obstructed locally advanced rectal cancer (OLARC) requiring pre-therapy diversion colostomy in comparison with patients who did not need pre-treatment diversion (non-obstructed group).Methods: This is a retrospective analysis of a prospective data-base. Patients diagnosed with non-metastatic locally advanced adenocarcinoma of the rectum in a colorectal unit of a tertiary care teaching hospital between August 2012 and December 2014 were analyzed. Data was collected from hospital records and telephonic interviews.Results: Two hundred and thirteen patients were diagnosed to have locally advanced rectal cancer.  One hundred and fifty patients (70.4%) did not have features of intestinal obstruction and received NACRT upfront and 63 (29.6%) required pre-therapy diversion colostomy. Thirty-nine patients (61.9%) completed therapy (neo-adjuvant chemo-radiotherapy followed by Surgery and adjuvant chemotherapy) in the obstructed group, compared to 127(84.7%) in the non-obstructed group (0<0.05) who completed all components of cancer directed therapy.  The 3-year overall survival (OS) of the obstructed and non-obstructed groups was 59% vs 90% (p<.001) and the disease-free survival (DFS) was 51% and 76% (p<0.01) respectively.Conclusions: In the era of multi-modal therapy, patients with obstructed locally advanced rectal cancer have worse oncological outcomes with respect to overall and disease-free survival.

scholarly journals THE ROLE OF HYPOTHERMIA IN ACUTE ADHESIONS INTESTINAL OBSTRUCTION

ASJ. ◽  
2021 ◽  
Vol 1 (50) ◽  
pp. 13-16
Author(s):  
M. Magomedov ◽  
M. Magomedov
Keyword(s):  
Intensive Care ◽  
Intestinal Obstruction ◽  
Acute Intestinal Obstruction ◽  
Study Group ◽  
Ischemic Damage ◽  
Laboratory Parameters ◽  
Results Of Treatment ◽  
Intestinal Contents ◽  
Intestinal Decompression

Results of intensive care of 68-patients (39- male, 28 female, aged from 23 to 86 years) with intestinal obstruction are summarized. All the patients were divided into two groups: 1st (study) group consisted of 30 patients who have been treated with hypothermal enteral sanation, patients of 2nd group (38 have been treated with intestinal decompression only. Results of treatment were compared by clinical and laboratory parameters. It is demonstrated that intestinal intubation and hypothermal sanation at acute intestinal obstruction are effective methods for elimination of toxic intestinal contents, prevent ischemic damage and stimulate peristalsis of intestinum. The positive final results after this treatment are demonstrated. Lethality was 10,5 and – 21%.

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