Moderately differentiated colorectal adenocarcinoma as a lymph node metastatic phenotype: comparison with well differentiated counterparts

<p>Abstract</p> <p>Background</p> <p>The differences between the metastatic property of moderately (Mod) and well (Wel) differentiated colorectal adenocarcinoma remain unclear. Since Mod is unable to form complete acini, therefore an epithelial-mesenchymal transition (EMT) can occur in that structure. Herein, we hypothesized that Mod metastasizes more easily than the Wel counterparts.</p> <p>Methods</p> <p>The medical records of 283 consecutive patients with Mod (n = 71) or Wel (n = 212) who underwent surgery were reviewed between January 1, 2001, and December 31, 2003, for actual 5-year overall survival. We examined the differences between the clinicopathological characteristics of the Mod and the Wel groups.</p> <p>Results</p> <p>The lymph node involvement (<it>p </it>< 0.0001), lymphatic permeation, venous permeation, depth of invasion, liver metastasis, and carcinomatous peritonitis were significantly higher in the Mod group in comparison to the Wel group. The independent risk factors by a logistic regression analysis for lymph node involvement were as follows: lymphatic permeation, liver metastasis, and Mod (<it>p </it>= 0.0291, Relative Risk of 1.991: 95% Confidence Interval: 1.073-3.697). A Kaplan-Meier survival curve showed that Mod had a trend towards a poor survival (<it>p </it>= 0.0517).</p> <p>Conclusion</p> <p>Mod metastasizes to the lymph nodes more easily in comparison to Wel. Therefore, patients with Mod may be considered the existence of lymph node involvement.</p

Chirurgia : il filo di Arianna : casi clinici didattici per gli studenti del corso di laurea in Medicina e chirurgia

Il libro contiene casi clinici di chirurgia adatti allo sviluppo del senso clinico dello studente degli ultimi anni di medicina e chirurgi

Gastric antrum and dumping syndrome. Possible pathogenetic correlations.

On the basis of the observation that the dumping syndrome is seen very rarely now compared to the past, experimental and clinical research was carried out with a view to explaining this phenomenon. These studies showed that it is possible that the gastric antrum plays a basic role in the pathogenesis of the dumping syndrome

[Selective anterior vagotomy of the duodenum. Propositions, technics andexperimental results].

Previous studies have demonstrated that changes in endoduodenal pressure may cause pancreatic alterations in biliary diseases. Anterior selective vagotomy of the duodenum was devised to reduce duodenal motility. An experimental study showed that such a surgical procedure is followed by a marked decrease in the overall duodenal kinesis, with disappearance of the highest pressure peaks

[Surgery of biliary lithiasis. II. Choice of operation and results].

A pre-and intraoperative diagnostic protocol offering morphological and functional evaluation of the bile ducts, Oddi's sphincter, duodenum, and pancreas was employed to classify 633 patients with biliary lithiasis into 6 groups and hence the therapeutic application of 6 surgical techniques, namely: 1) cholecystectomy alone; 2) choledocholithotomy plus closure of the choledoch; 3) choledocholithotomy plus Kehr drainage; 4) papillosphincterotomy alone; 5) papillosphincterotomy plus anterior seclective duodenal vagotomy; 6) hepaticojejunostomy, so as to ensure a rational choice of the best operation fro each situation. Comparison with the literature and prior personal results substantiated the soundness of this approach, as shown by a marked reduction of complications, mortality and residual disease on both short and medium-term follow-up