scholarly journals ONCOLOGICAL OPERATIONS IN EMERGENCY SURGERY (CLINICAL CASE)

2021 ◽  
pp. 29-33
Author(s):  
K.V. Atamanov ◽  
◽  
V.E. Voitsitsky ◽  
O.A. Tkachuk ◽  
V.A. Lebedeva ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Postoperative Complications ◽  
Intestinal Obstruction ◽  
Clinical Case ◽  
Positive Outcome ◽  
Acute Intestinal Obstruction ◽  
Major Surgery ◽  
Number Of Patients ◽  
Combined Interventions

The increase in the incidence of colorectal cancer cannot go unnoticed. The number of patients with its complications in general surgical hospitals is growing steadily. The main ones include acute intestinal obstruction, bleeding, tumor destruction with paracancerous abscess formation or perforation. This limits the possibilities of carrying out the radical treatment of oncoproctological patients significantly, and reduces the number of resection interventions considerably. The incidence of postoperative complications in emergency patients is statistically higher than after elective surgeries. The most fatal is the failure of the enterocolonic anastomosis, usually requiring relaparotomy and often colostomy. With regional tumors, combined interventions are necessary, a prerequisite for which is the availability of trained specialists. The article presents a clinical case of performing a major surgery with a positive outcome for complicated colon cancer in a hospital on duty.

Outcomes of Surgical and Nonsurgical Treatment for Colorectal Cancer in Nonagenarian Patients

2021 ◽  
pp. 000313482199506
Author(s):  
Youngbae Jeon ◽  
Kyoung-Won Han ◽  
Won-Suk Lee ◽  
Jeong-Heum Baek
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Postoperative Mortality ◽  
Nonsurgical Treatment ◽  
Perioperative Outcomes ◽  
Rank Test ◽  
Kaplan Meier ◽  
Number Of Patients

Purpose This study is aimed to evaluate the clinical outcomes of surgical treatment for nonagenarian patients with colorectal cancer. Methods This retrospective single-center study included patients diagnosed with colorectal cancer at the age of ≥90 years between 2004 and 2018. Patient demographics were compared between the operation and nonoperation groups (NOG). Perioperative outcomes, histopathological outcomes, and postoperative complications were evaluated. Overall survival was analyzed using Kaplan-Meier methods and log-rank test. Results A total of 31 patients were included (16 men and 15 women), and the median age was 91 (range: 90‐96) years. The number of patients who underwent surgery and who received nonoperative management was 20 and 11, respectively. No statistical differences in baseline demographics were observed between both groups. None of these patients were treated with perioperative chemotherapy or radiotherapy. Surgery comprised 18 (90.0%) colectomies and 2 (10.0%) transanal excisions. Short-term (≤30 days) and long-term (31‐90 days) postoperative complications occurred in 7 (35.0%) and 4 (20.0%) patients, respectively. No complications needed reoperation, such as anastomosis leakage or bleeding. No postoperative mortality occurred within 30 days: 90-day postoperative mortality occurred in two patients (10.0%), respectively. The median overall survival of the operation group was 31.6 (95% confidence interval: 26.7‐36.5) and that of NOG was 12.5 months (95% CI: 2.4‐22.6) ( P = 0.012). Conclusion Surgical treatment can be considered in carefully selected nonagenarian patients with colorectal cancer in terms of acceptable postoperative morbidity, with better overall survival than the nonsurgical treatment.

Effect of young age (<50) on clinical, pathologic features and survival of patients with colorectal cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14025-e14025
Author(s):  
Jamal Zidan ◽  
Jehad Abu Salah ◽  
Adi Sharabi-Nov
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Medical Center ◽  
Young Patients ◽  
Young Group ◽  
Old Patients ◽  
Pathological Characteristics ◽  
Pathologic Features ◽  
Number Of Patients ◽  
Significant Difference

e14025 Background: Colorectal cancer is one of the most common malignancies in both men and women in Israel. Most patients with colon cancer are older than 50 years of age. However young patients are not rare. There is no consensus in the literature regarding the behavior of this disease in young patients. Clinical and pathological characteristics of colon cancer patients treated at Oncology Institute in Ziv Medical Center were retrospectively analyzed. The aim of the present study is to compare clinical and pathological features of colon cancer between young and old patients. Methods: A total of 200 patients with colon cancer were treated at our institute during 8 years. Twenty five (12.5%) of them were <50 years age (young patients) at diagnosis. All clinical and pathological characteristics were taken retrospectively from the hospital files. In situations where the pathological findings were not noted in the chart, review of the stored tumor was requested from the pathology department. Acceptable statistical methods were used for statistical calculations. Results: Among the 200 patients 25 (12.5%) were <50 years age at diagnosis (mean age 41 years) and 175 were >50 years (mean age 70 years). Males were 56% of the young group and 60.1% of the old one. Arab patients were 52% of the young and only 12.6% of the old group although total number of Arabs was 35 of 200 patients. No significant difference was found in stage of tumor at diagnosis between the young group (YG) and the old group (OG). Twenty percent of YG had distant metastases compared to 26.5% in the OG. Histopathological grade 3 tumors were found in 33.3% of the YG versus 7.7% in the OG. Surgery and chemotherapy were done in 96% and 88% in YG versus 95.4% and 69.7% in the OG respectively. In a median follow up period of 96 months 35% of young patients died of their disease compared to 33.1% of the old patients. Conclusions: Young patients with colon cancer were diagnosed at the same stage of the disease as old patients. More tumors were high grade in YG. More patients were candidates for chemotherapy in the YG. Significantly more Arab patients were young at the time of diagnosis than Jewish patients. Further studies with higher number of patients are suggested to clarify our findings.

scholarly journals Proportion of colonic carcinoma in cases presenting with acute intestinal obstruction: a cross sectional study

2021 ◽  
Vol 9 (1) ◽  
pp. 81
Author(s):  
Pauly T. Joseph ◽  
Rajiv Sajan Thomas ◽  
Sutharjivel V.
Keyword(s):  
Colon Cancer ◽  
Intestinal Obstruction ◽  
Dietary Habits ◽  
Colonic Neoplasms ◽  
Acute Intestinal Obstruction ◽  
Colonic Carcinoma ◽  
General Surgeon ◽  
Routine Practice ◽  
Common Cause ◽  
Obstructed Hernia

Background: Acute intestinal obstruction is one of the most common emergencies encountered by the general surgeon in routine practice. Although historically, obstructed hernia has been the most common cause, recent studies have shown that adhesive intestinal obstruction is now the commonest reason. Malignant bowel obstruction is also on the rise especially with the change in dietary habits. This study aims at identifying the proportion of colonic carcinoma in cases presenting with acute intestinal obstruction.Methods: The patients with acute intestinal obstruction which was diagnosed clinically and radiologically were studied. Based on operative and clinical findings along with investigation results, the etiology was identified. The patients having colonic neoplasms were identified and the data was compared with other etiological factors to find out the proportion of colonic carcinoma in the cases.Results: The proportion of colon cancer in patients presenting with acute intestinal obstruction was around 15%. The most common cause was obstructed hernia followed by post-operative adhesions. Males were more commonly affected than females. Most of the cases underwent operative management. The most common age group affected was around 50-60 years.Conclusions: This study confirms that there is a definite rise in the number of cases of colon cancer presenting as acute intestinal obstruction. There is also a skewing of the age at presentation towards younger age groups. Small bowel obstructions were much more common mainly due to adhesions and obstructed herniae.  

Acute intestinal obstruction caused by small bowel intussusception (clinical case)

2020 ◽  
pp. 53-59
Author(s):  
Z. Zaipula ◽  
Magomed Imanaliev ◽  
Abdukamal Huseynov
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Clinical Case ◽  
Acute Intestinal Obstruction ◽  
Small Bowel Intussusception

One of the most difficult to diagnose and rare forms of acute intestinal obstruction is intussusception. This article presents an analysis of a clinical case of acute intestinal obstruction caused by small bowel intussusception in a patient suffering from small-bowel polyposis.

FEATURES OF CONDUCTING INTESTINAL OBSTRUCTION CAUSED BY APPENDICITIS

Vestnik ◽  
2021 ◽  
pp. 176-178
Author(s):  
А.К. Кайрат ◽  
А.Д. Ауескали ◽  
С.Е. Сейсен ◽  
Д.Б. Рахметалы ◽  
Ж.Т. Абдигалиев ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Intestinal Obstruction ◽  
Operating Room ◽  
Acute Intestinal Obstruction

Если назвать аппендицит одним из самых главных заболевани в хирургии, то аппендицит с перфорационным перитонитом, абсцесс, сепсис и кишечная непроходимость являются самыми важными его осложнениями. Цель. Определить и проанализировать случаи связанные с аппендицитом послужившими причиной развития острой кишечной непроходимости (далее - ОКН). Материалы и методы Выбраные пациенты проходили лечение в ГКБ №7 г.Алматы с 1 января 2020 по 1 января 2021 г. Пациенты были прооперированы в связи с воспалением аппендикса. Был проведен анализ истории болезней 1227 пациентов с предварительным диагнозом острый аппендицит. Результаты Из числа выбранных пациентов найдено 45 случаев с наличием острой кишечной непроходимости. Из них 33 пациента мужчины (73,3 %), 12 пациентов женщины (26,6%). У 38 случаев (84,4%) вследствие наличия или совокупности следующих факторов была обнаружена ОКН: 1) аппендикс лежащий на петлях кишечника, вызванный спайками; 2) грыжа через кольцо или разрыв верхушки аппендикса; 3) кончик отростка прикреплен к кишечнику вызывая перекрут; 4) перегиб кишечника; 5) сложное образования узлов. Диагностика данного осложнения очень сложна и весьма важна в выборе тактики хирургического лечения и дальнейшего ведения. Выводы В результате исследования было доказано, что аппендицит является важной причиной кишечной непроходимости. Предоперационная диагностика аппендицита осложенного кишечной непроходимостью так же остается важной и актуальной проблемой современной хирургии несмотря на развитие компьютерных методов диагностики. Appendicitis is the cause of multiple bowel-related complications. One of the most important complications of appendicitis for surgery is acute intestinal obstruction (AIO). However, the diagnosis of AIO is important for determining treatment tactics, despite its extreme complexity. The underestimated importance of diagnostics leads to a change in the tactics of surgery directly in the operating room, which, in turn, leads to an increase in the risk of adverse postoperative complications.

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 A Study on Raised Serum LDH Level in Acute Intestinal Obstruction – A Marker of Bowel Gangrene

2020 ◽  
Vol 3 (1) ◽  
pp. 120-123
Author(s):  
Anantha Kumar Nateson ◽  
Suresh Nayak Basavanayak ◽  
Sudarsan Srikanth
Keyword(s):  
Intestinal Obstruction ◽  
Venous Blood ◽  
Cost Effective ◽  
Abdominal Distension ◽  
Serum Levels ◽  
Acute Intestinal Obstruction ◽  
Number Of Patients ◽  
Study Results ◽  
Bowel Gangrene ◽  
Aseptic Conditions

Background: Bowel gangrene is a major abdominal catastrophe associated with high mortality rate. Intestinal obstruction accounts for 20%   of all surgical emergencies around the world. The present study aims to estimate the LDH levels in patients with acute intestinal obstruction and correlate with bowel viability. Subjects and Methods: In this study, the estimation of serum LDH was conducted in 45 cases of acute intestinal obstruction who were admitted in surgical wards. After fulfilling the inclusion and exclusion criteria the study subjects were recruited. All the cases were thoroughly examined. Time of presentation and onset of symptoms were noted. Under aseptic conditions, 3 ml venous blood samples were collected from the study subjects, centrifuged at 3000 rpm and separated serum sample was used for the estimation of lactate dehydrogenase (LDH) and the estimated value of serum LDH is compared with the viability of the bowel intra operatively. Results: The total number of patients presented with obstruction is 45 out of which 25 were found to have elevated LDH which is about 55.56%. Out of 25 patients presented with elevated LDH, 20 patients found to have gangrenous bowel. 60% presented with abdominal pain and 40% had irreducible swelling. Most commonly associated symptoms are vomiting (84%) followed by abdominal distension (40%), obstipation (36%), pyrexia (24%), blood in stools (8%) and diarrhoea (4%). Per rectal examination showed 76% had normal faecal staining, 12% blood stained faeces and 8% empty. Complications observed were anastomotic leak 8%, wound infection 16%, wound gaping 8%, burst abdomen 8%. Conclusion: The present study results indicate that ischemic changes in any part of the bowel can cause elevation in the serum levels of LDH and a higher value of >1000 IU/L strongly indicates an underlying gangrenous change. It is a less invasive, cost effective and easily available diagnostic tool to diagnose bowel ischemia/gangrene. Hence it is more useful in centres where the diagnostic facilities are limited.

scholarly journals Clinical case for diagnosis of textiloma in gastrointestinal tract

2019 ◽  
pp. 62-65
Author(s):  
A. V. Sergeev ◽  
A. N. Katrich
Keyword(s):  
Gastrointestinal Tract ◽  
Intestinal Obstruction ◽  
Clinical Case ◽  
Foreign Bodies ◽  
Clinical Presentation ◽  
Ultrasonic Method ◽  
Diagnostic Value ◽  
Acute Intestinal Obstruction

In the described clinical case we presented features of a clinical presentation, difficulties of textiloma diagnosis which resulted in acute intestinal obstruction in several years after surgery. The high diagnostic value of an ultrasonic method in diagnostics of foreign bodies was shown.

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