scholarly journals COLONIC CANCER

2016 ◽  
Vol 23 (03) ◽  
pp. 251-256
Author(s):  
Tajammal Abbas Shah
Keyword(s):  
Rectal Bleeding ◽  
Colonic Cancer ◽  
Primary Anastomosis ◽  
Abdominal Mass ◽  
Staging System ◽  
Sigmoid Resection ◽  
Tnm Staging ◽  
End Colostomy ◽  
A Prospective Study ◽  
Surgical Unit

A prospective study was conducted to see presentation and management of coloniccancer presenting to a surgical unit in a teaching hospital at Faisalabad. Objectives: To knowdifferent presenting symptomatology like abdominal mass, pain, intestinal obstruction, alteredbowel habits, rectal bleeding, age co-relation, sex distribution, anatomic location among coloniccancer patients and management done for these patients. Study Design: A prospective study.Period: February 2009 to March 2010 for one year. Material and Methods: Total 8 patients werediagnosed and treated for colonic cancer presenting in a single surgical ward. Patients with ageabove 14 years were included in study while patients presenting with trauma and metastaticdisease for other carcinoma were excluded. Results: Among 8 patients diagnosed for coloniccancer, age’s range from 26 to 50 years at maximum, 2 patients (25 %) were males and 6 patients(75 %) were females. Only one patient (12.5%) presented with single complaint of left iliac fossamass, 2 patients (25 %) with only single complaint of rectal bleeding as a presenting symptomwhile all other 5 patients (62.5%) presented with more than one or two symptoms at the sametime. Among 5 patients presented with more than one symptom all had presented with abdominalmass associated with additional symptoms like, one patient (12.5%) developed intestinalobstruction with left sided abdominal mass, another one patient (12.5%) left sided abdominalmass with alternate diarrhea and constipation, another one patient (12.5%) right sided masswith pallor, one patient (12.5%) had constipation with left sided mass while another one patient(12.5%) developed abdominal pain, weight loss and palpable left sided abdominal mass. Patientswere staged according to TNM staging system. All patients were above stage II and Dukes B. Allpatients were operated in Surgical Unit II at Allied Hospital Faisalabad. Left hemi-colectomy wasdone for 2 patients; right hemi-colectomy was done for single patient presented with mass andanemia on right side, sigmoid resection with colostomy for one patient, Hartmann’s procedurefor another one patient and single stage resection with primary anastomosis for one patient. 2patients underwent abdomino-perineal resection with end colostomy. Conclusion: This studytells that majority of the patients with colon cancer presented with left sided abdominal mass andother associated symptom, the age’s range from 26 to 50 years. Disease affected 6 females out oftotal 8 patients. Two patients underwent APR with end colostomy while other patients were treatedwith alternate procedures like primary anterior resection with anastomosis or end colostomy

What are Rates of Sigmoid Resection with Primary Anastomosis and Diverting Loop Ileostomy Versus end Colostomy in the Real World? Results of a Colorectal Surgery Collaborative Audit

2017 ◽  
Vol 152 (5) ◽  
pp. S1227-S1228
Author(s):  
Christy E. Cauley ◽  
Ruchin Patel ◽  
Peter Fagenholz ◽  
Sadiqa Mahmood ◽  
David L. Berger ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Real World ◽  
Primary Anastomosis ◽  
Loop Ileostomy ◽  
Sigmoid Resection ◽  
The Real ◽  
End Colostomy ◽  
Diverting Loop Ileostomy

Prognostic nomogram to predict overall survival for patients with perihilar cholangiocarcinoma: A population-based study of SEER database (Preprint)

2020 ◽  
Author(s):  
Chendong Wang
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Staging System ◽  
Tnm Staging ◽  
Survival Outcome ◽  
Perihilar Cholangiocarcinoma ◽  
Cox Regression Analysis ◽  
Calibration Curves ◽  
Tnm Staging System ◽  
Net Benefits

BACKGROUND Perihilar cholangiocarcinoma (pCCA) is a highly aggressive malignancy with poor prognosis. Accurate prediction is of great significance for patients’ survival outcome. OBJECTIVE The present study aimed to propose a prognostic nomogram for predicting the overall survival (OS) for patients with pCCA. METHODS We conducted a retrospective analysis in a total of 940 patients enrolled from the Surveillance, Epidemiology, and End Results (SEER) program and developed a nomogram based on the prognostic factors identified from the cox regression analysis. Concordance index (C-index), risk group stratification and calibration curves were adopted to test the discrimination and calibration ability of the nomogram with bootstrap method. Decision curves were also plotted to evaluate net benefits in clinical use against TNM staging system. RESULTS On the basis of multivariate analysis, five independent prognostic factors including age, summary stage, surgery, chemotherapy, together with radiation were selected and entered into the nomogram model. The C-index of the model was significantly higher than TNM system in the training set (0.703 vs 0.572, P<0.001), which was also proved in the validation set (0.718 vs 0.588, P<0.001). The calibration curves for 1-, 2-, and 3-year OS probabilities exhibited good agreements between the nomogram-predicted and the actual observation. Decision curves displayed that the nomogram obtained more net benefits than TNM staging system in clinical context. The OS curves of two distinct risk groups stratified by nomogram-predicted survival outcome illustrated statistical difference. CONCLUSIONS We established and validated an easy-to-use prognostic nomogram, which can provide more accurate individualized prediction and assistance in decision making for pCCA patients.

scholarly journals Evaluation of the new TNM-staging system for thymic malignancies: impact on indication and survival

2017 ◽  
Vol 15 (1) ◽  
Author(s):  
Michael Ried ◽  
Maria-Magdalena Eicher ◽  
Reiner Neu ◽  
Zsolt Sziklavari ◽  
Hans-Stefan Hofmann
Keyword(s):  
Staging System ◽  
Tnm Staging ◽  
Tnm Staging System

Prospective study of primary anastomosis following sigmoid resection for suspected acute complicated diverticular disease

2001 ◽  
Vol 88 (5) ◽  
pp. 693-697 ◽  
Author(s):  
A. W. Gooszen ◽  
R. A. E. M. Tollenaar ◽  
R. H. Geelkerken ◽  
H. J. Smeets ◽  
W. A. Bemelman ◽  
...  
Keyword(s):  
Prospective Study ◽  
Diverticular Disease ◽  
Primary Anastomosis ◽  
Sigmoid Resection

Does the TNM Staging System for Esophageal Cancer Need Revision?

2006 ◽  
Vol 202 (5) ◽  
pp. 855-856 ◽  
Author(s):  
C.S. Pramesh ◽  
Rajesh C. Mistry ◽  
Nirmala A. Jambhekar ◽  
Sarbani G. Laskar
Keyword(s):  
Esophageal Cancer ◽  
Staging System ◽  
Tnm Staging ◽  
Tnm Staging System

scholarly journals Predictors of Outcome of Non–Muscle-Invasive and Muscle-Invasive Bladder Cancer

2011 ◽  
Vol 11 ◽  
pp. 369-381 ◽  
Author(s):  
Ramy F. Youssef ◽  
Yair Lotan
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Predictive Accuracy ◽  
Staging System ◽  
Tumor Grade ◽  
Invasive Disease ◽  
Tnm Staging ◽  
High Rate ◽  
Recurrence Rates ◽  
Muscle Invasive

Bladder cancer is a major cause of morbidity and mortality. At initial diagnosis, 75% of patients present with non–muscle-invasive disease and 25% of patients have muscle-invasive or metastatic disease.Patients with noninvasive disease suffer from a high rate of recurrence and 10–30% will have disease progression. Patients with muscle-invasive disease are primarily treated with radical cystectomy, but frequently succumb to their disease despite improvements in surgical technique. In non–muscle-invasive disease, multiplicity, tumor size, and prior recurrence rates are the most important predictors for recurrence, while tumor grade, stage, and carcinomain situare the most important predictors for progression. The most common tool that clinicians use to predict outcomes after radical cystectomy is still the tumor-node-metastasis (TNM) staging system, with lymph node involvement representing the most important prognostic factor. However, the predictive accuracy of staging and grading systems are limited, and nomograms incorporating clinical and pathologic factors can improve prediction of bladder cancer outcomes. One limitation of current staging is the fact that tumors of a similar stage and grade can have significantly different biology. The integration of molecular markers, especially in a panel approach, has the potential to further improve the accuracy of predictive models and may also identify targets for therapeutic intervention or patients who will respond to systemic therapies.

scholarly journals Operative Management and Outcomes of Patients with Sigmoid Volvulus at a Tertiary Public Hospital in Malawi

2021 ◽  
Vol 18 (3) ◽  
pp. 176-179
Author(s):  
Ephraim Bitilinyu-Bangoh ◽  
Fatsani Mwale ◽  
Loveness Ulunji Chawinga ◽  
Gift Mulima
Keyword(s):  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Primary Anastomosis ◽  
Length Of Hospital Stay ◽  
Operative Management ◽  
Sigmoid Resection ◽  
Sigmoid Volvulus ◽  
Hartmann’S Procedure ◽  
Hartmann's Procedure ◽  
Kamuzu Central Hospital

Background: Sigmoid Volvulus (SV) is a common cause of acute bowel obstruction in Malawi. We aimed to  describe the surgical  management of SV and its outcomes at Kamuzu Central Hospital, Lilongwe, Malawi. Methods: We retrospectively reviewed records from January 2019 to December 2019 of all SV patients, aged 18 years and above. Data  extracted included age, sex, admission date, surgery date, bowel viability at time of surgery, procedure done, suspected anastomotic leakage, length of hospital stay and mortality. The data was analyzed using STATA 14.0. Results: There were more males (n= 59, 81.9 %) than females. The median (IQR) age was 50.5 (38-60) years. A viable sigmoid colon was present in 61 (84.7%) patients. The commonest procedures done were sigmoid  resection and primary anastomosis (RPA) (59.7%, n=43) and Hartmann’s procedure (HP) (36.1%, n=26). The median length of hospital stay was 5 days in HP, 7 days in RPA and longest in  mesosigmoidopexy (10 days). Suspected anastomotic leakage occurred in 2(4.7%) patients. The overall mortality was 6.9% with all deaths occurring in RPA patients. Conclusion: Mortality is high in SV patients who undergo RPA. We recommend Hartmann’s procedure in cases where the bowel has  significant oedema or is gangrenous.

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