Peritoneal carcinomatosis is,after liver metastases,the second most frequent cause of death in colorectal cancer patients and at the present time,is commonly inserted and treated as a stage Ⅳ tumour.Because there is ...Peritoneal carcinomatosis is,after liver metastases,the second most frequent cause of death in colorectal cancer patients and at the present time,is commonly inserted and treated as a stage Ⅳ tumour.Because there is no published data that outlines the impact of new therapeutic regimens on survival of patients with peritoneal surface diffusion,the story of carcinomatosis can be rewritten in light of a new aggressive approach based on the combination of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.Also if these treatment perhaps allow to obtain better results than standard therapies,we suggest,that a large prospective randomised control trial is needed to compare long-term and progression-free survival under the best available systemic therapy with or without cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.展开更多
The evolution of loco-regional treatments has occurred in the last two decades and has deeply changed the natural history of primitive and secondary peritoneal surface malignancies.Several phase Ⅱ-Ⅲ studies have pro...The evolution of loco-regional treatments has occurred in the last two decades and has deeply changed the natural history of primitive and secondary peritoneal surface malignancies.Several phase Ⅱ-Ⅲ studies have proved the effectiveness of the combination of cytoreductive surgery with peritoneal chemohyperthermia.Cytoreductive surgery allows the reduction of the neoplastic mass and increases tumoral chemosensitivity.The development of chemohyperthermia finds its origins in the necessity to exceed the limits of intraperitoneal chemotherapy performed in normothermia.It permits a continuous high concentration gradient of chemotherapeutic drugs between the peritoneal cavity and the plasma compartment to and a more uniform distribution throughout the abdominal cavity compared to systemic administration.展开更多
The accidental ingestion of a foreign body(FB)is a relatively common condition.In the present study,we report a peculiar case of rectal perforation,the first to our knowledge,caused by the inadvertent ingestion of a b...The accidental ingestion of a foreign body(FB)is a relatively common condition.In the present study,we report a peculiar case of rectal perforation,the first to our knowledge,caused by the inadvertent ingestion of a blister pill pack.The aim of this report is to illustrate the difficulties of the case from a diagnostic and therapeutic viewpoint as well as its unusual presentation.A 75-year-old woman,mentally impaired,arrived at our emergency department in critical condition.The computed tomography scan revealed a substantial abdominopelvic peritoneal effusion and free perigastric air.The patient was therefore submitted to an urgent exploratory laparotomy;a 2-cm long,full-thickness lesion was identified in the anterior distal part of the intraperitoneal rectum.Hence,we performed a Hartmann's procedure.Because of her critical condition,the patient was eventually transferred to the Intensive Care Unit,where she died after 10 d,showing no surgical complication.The ingestion of FBs is usually treated with observation or endoscopic removal.Less than 1%of FBs are likely to cause an intestinal perforation.The intestinal perforation resulting from the unintentional ingestion of an FB is often a difficult challenge when it comes to treatment,due to its late diagnosis and the patients'deteriorated clinical condition.展开更多
文摘Peritoneal carcinomatosis is,after liver metastases,the second most frequent cause of death in colorectal cancer patients and at the present time,is commonly inserted and treated as a stage Ⅳ tumour.Because there is no published data that outlines the impact of new therapeutic regimens on survival of patients with peritoneal surface diffusion,the story of carcinomatosis can be rewritten in light of a new aggressive approach based on the combination of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.Also if these treatment perhaps allow to obtain better results than standard therapies,we suggest,that a large prospective randomised control trial is needed to compare long-term and progression-free survival under the best available systemic therapy with or without cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
文摘The evolution of loco-regional treatments has occurred in the last two decades and has deeply changed the natural history of primitive and secondary peritoneal surface malignancies.Several phase Ⅱ-Ⅲ studies have proved the effectiveness of the combination of cytoreductive surgery with peritoneal chemohyperthermia.Cytoreductive surgery allows the reduction of the neoplastic mass and increases tumoral chemosensitivity.The development of chemohyperthermia finds its origins in the necessity to exceed the limits of intraperitoneal chemotherapy performed in normothermia.It permits a continuous high concentration gradient of chemotherapeutic drugs between the peritoneal cavity and the plasma compartment to and a more uniform distribution throughout the abdominal cavity compared to systemic administration.
文摘The accidental ingestion of a foreign body(FB)is a relatively common condition.In the present study,we report a peculiar case of rectal perforation,the first to our knowledge,caused by the inadvertent ingestion of a blister pill pack.The aim of this report is to illustrate the difficulties of the case from a diagnostic and therapeutic viewpoint as well as its unusual presentation.A 75-year-old woman,mentally impaired,arrived at our emergency department in critical condition.The computed tomography scan revealed a substantial abdominopelvic peritoneal effusion and free perigastric air.The patient was therefore submitted to an urgent exploratory laparotomy;a 2-cm long,full-thickness lesion was identified in the anterior distal part of the intraperitoneal rectum.Hence,we performed a Hartmann's procedure.Because of her critical condition,the patient was eventually transferred to the Intensive Care Unit,where she died after 10 d,showing no surgical complication.The ingestion of FBs is usually treated with observation or endoscopic removal.Less than 1%of FBs are likely to cause an intestinal perforation.The intestinal perforation resulting from the unintentional ingestion of an FB is often a difficult challenge when it comes to treatment,due to its late diagnosis and the patients'deteriorated clinical condition.
