Lymph node evaluation and survival after resection of colorectal cancer

Recent studies have demonstrated that lymph nodes ratio (LNR) might provide a significant prognostic role for colorectal cancer. We retrospectively analyzed the data of the patients with colorectal cancer and assessed a possible correlation between lymph node parameters and survival. We conducted a retrospective chart review of patients who underwent a radical colon surgery involving removal of mesocolic lymph nodes due to colorectal cancer. Prognostic significance of the removed lymph node number (LNs), metastatic LNs, lymph node ratio (LNR) and other factors were compared. This retrospective study included 190 patients (117 males and 73 females). The estimated survival period was found to be 87.70 months [confidence interval (CI) of 95% (80.64-94.76)]. LNR, LNs and N stage were found to have significant correlation with survival. Among these factors, LNR had the biggest correlation (r = 0 .138, P =0.028). Multivariate regression analysis of survival with lymph node parameters showed that LNR and N stage were significantly correlated with survival. However, LNR was found to be the most significant prognostic factor [P >0.0001, 95% CI; 3.12 (1.55-5.75)]. LNR is a better prognostic factor in patients with colorectal cancer compared to lymph node stage and number. [Med-Science 2017; 6(2.000): 182-8

Congenital Cervical Teratoma:Anaesthetic Management (The EXIT Procedure)

Ex utero intrapartum treatment (EXIT) is a procedure performed during caesarean section with preservation of fetal-placental circulation, which allows the safe handling of fetal airways with risk of airways obstruction. This report aimed at describing a case of anaesthesia for EXIT in a fetus with cervical teratoma. A 30-year-old woman, 70 kg, 160 cm, gravida 2, para 1, was followed because of polyhydramniosis diagnosed at 24 weeks′ gestation. During a routine ultrasonographic examination at 35 weeks′ gestation, it was noticed that the fetus had a tumoral mass on the anterior neck, the mass had cystic and calcified components and with a size of was 10 x 6 x5 cm. The patient with physical status ASA I, was submitted to caesarean section under general anaesthesia with mechanically controlled ventilation for exutero intrapartum treatment (EXIT). Anaesthesia was induced in rapid sequence with fentanyl, propofol and rocuronium and was maintained with isoflurane in 2.5 at 3 % in O 2 and N 2 O (50%). After hysterotomy, fetus was partially released assuring uterus-placental circulation, followed by fetal laryngoscopy and tracheal intuba-tion. The infant was intubated with an uncuffed, size 2.5 endotracheal tube. Excision of the mass was performed under general anaesthesia. After surgical intervention, on the fourth postoperative day, the infant was extubated and the newborn was discharged to the pediatric neonatal unit and on the seventh day postoperatively to home without complications. Major recommendations for EXIT are maternal-fetal safety, uterine relaxation to maintain uterine volume and uterus-placental circulation, and fetal immobility to help airway handling. We report one case of cervical teratoma managed successfully with EXIT procedure

Effects of the general anaesthetic agent, propofol, on erythrocyte deformability

Arslan, Mustafa/0000-0003-4882-5063WOS: 000276730200003PubMed: 20437820Objectives: Propofol is an anesthetic agent frequently used for sedation and general anesthesia. The purpose of our study was to investigate the effect of propofol, a general anesthetic, on erythrocyte deformability in rats. Methodology: The study was performed on 20 male and 20 female rats, with 10 rats in each study group and 10 rats in each control group. The rats in the study group were administered propofol (150 mg.kg(-1)) intraperitoneally, and the rats in the control group were administered SF. Erythrocyte packs were prepared using heparinized total blood samples. Deformability measurements were done by erythrocyte suspensions in PBS buffer. A constant flow filtrometer system was used to measure erythrocyte deformability, and the relative resistance was calculated. Results: The use of propofol resulted in the increase in the relative resistance, which is an indicator for the erythrocyte deformability in both male and female rats (p=0.002, p=0.042, respectively). Conclusion: A negative change in the erythrocyte deformability may cause a functional deterioration in blood flow and tissue perfusion (Fig. 1, Ref. 23). Full Text (Free, PDF) www.bmj.sk