The prognosis of rectal cancer(RC) is strictly related to both T and N stage of the disease at the time of diagnosis. RC staging is crucial for choosing the best multimodal therapy: patients with high risk locally adv...The prognosis of rectal cancer(RC) is strictly related to both T and N stage of the disease at the time of diagnosis. RC staging is crucial for choosing the best multimodal therapy: patients with high risk locally advanced RC(LARC) undergo surgery after neoadjuvant chemotherapy and radiotherapy(NAT); those with low risk LARC are operated on after a preoperative short-course radiation therapy; finally, surgery alone is recommended only for early RC. Several imaging methods are used for staging patients with RC: computerized tomography, magnetic resonance imaging, positron emission tomography, and endoscopic ultrasound(EUS). EUS is highly accurate for the loco-regional staging of RC, since it is capable to evaluate precisely the mural infiltration of the tumor(T), especially in early RC. On the other hand, EUS is less accurate in restaging RC after NAT and before surgery. Finally, EUS is indicated for follow-up of patients operated on for RC, where there is a need for the surveillance of the anastomosis. The aim of this review is to highlight the impact of EUS on the management of patients with RC, evaluating its role in both preoperative staging and follow-up of patients after surgery.展开更多
Colon cancer rarely combines with abscess of the abdominal wall. We here describe a case treated by extensive surgery, biological mesh abdominal wall repair and negative pressure therapy. A 58-year-old woman presented...Colon cancer rarely combines with abscess of the abdominal wall. We here describe a case treated by extensive surgery, biological mesh abdominal wall repair and negative pressure therapy. A 58-year-old woman presented with a locally advanced right colon cancer with abdominal wall abscess and no evidence of distant metastasis. Extended right hemicolectomy was performed with en-bloc excision of the bladder dome, the right annex and full thickness removal of the anterior abdominal wall including the abscess. Abdominal wall repair was perfomed by a biological mesh (PermacolTMBiologic Implant) and to facilitate healing the patient was then treated with Vacuum-Assisted Closure (V.A.C.?) Therapy. Histology showed a mucinous moderately differentiated adenocarcinoma without nodal metastases (n = 57). Surgical margins including the abdominal wall was tumor free. The postoperative clinical course was uneventful. VA.C.? Therapy treatment reported excellent results in terms of active promotion of the granulation tissue, this allowing for a subsequent placement of a skin graft. Patient is alive and disease-free one year after surgery. The present case shows some peculiar characteristics such as the size of the initial lesion, the abdominal wall abscess and the use of innovative devices such as biological mesh and V.A.C.? Therapy. We demonstrate that extensive surgery for locally advanced colon cancer, in high-volume centers, provides favorable results in terms of survival and quality of life.展开更多
文摘The prognosis of rectal cancer(RC) is strictly related to both T and N stage of the disease at the time of diagnosis. RC staging is crucial for choosing the best multimodal therapy: patients with high risk locally advanced RC(LARC) undergo surgery after neoadjuvant chemotherapy and radiotherapy(NAT); those with low risk LARC are operated on after a preoperative short-course radiation therapy; finally, surgery alone is recommended only for early RC. Several imaging methods are used for staging patients with RC: computerized tomography, magnetic resonance imaging, positron emission tomography, and endoscopic ultrasound(EUS). EUS is highly accurate for the loco-regional staging of RC, since it is capable to evaluate precisely the mural infiltration of the tumor(T), especially in early RC. On the other hand, EUS is less accurate in restaging RC after NAT and before surgery. Finally, EUS is indicated for follow-up of patients operated on for RC, where there is a need for the surveillance of the anastomosis. The aim of this review is to highlight the impact of EUS on the management of patients with RC, evaluating its role in both preoperative staging and follow-up of patients after surgery.
基金Supported by A grant from Ministero Salute-Ricerca Oncologica-RECAM-2006-353005PRIN 2007-prot.2007EN8F7T-004+1 种基金Conven-zione CEINGE-Regione Campania.POR Campania FSE 2007-2013,Project CREMEPRIN 2010-2011-prot.2010K34C45_006
文摘AIM: To investigated the molecular cause of very early-onset ulcerative colitis (UC) in an 18-mo-old affected child.
文摘Colon cancer rarely combines with abscess of the abdominal wall. We here describe a case treated by extensive surgery, biological mesh abdominal wall repair and negative pressure therapy. A 58-year-old woman presented with a locally advanced right colon cancer with abdominal wall abscess and no evidence of distant metastasis. Extended right hemicolectomy was performed with en-bloc excision of the bladder dome, the right annex and full thickness removal of the anterior abdominal wall including the abscess. Abdominal wall repair was perfomed by a biological mesh (PermacolTMBiologic Implant) and to facilitate healing the patient was then treated with Vacuum-Assisted Closure (V.A.C.?) Therapy. Histology showed a mucinous moderately differentiated adenocarcinoma without nodal metastases (n = 57). Surgical margins including the abdominal wall was tumor free. The postoperative clinical course was uneventful. VA.C.? Therapy treatment reported excellent results in terms of active promotion of the granulation tissue, this allowing for a subsequent placement of a skin graft. Patient is alive and disease-free one year after surgery. The present case shows some peculiar characteristics such as the size of the initial lesion, the abdominal wall abscess and the use of innovative devices such as biological mesh and V.A.C.? Therapy. We demonstrate that extensive surgery for locally advanced colon cancer, in high-volume centers, provides favorable results in terms of survival and quality of life.
