Rectal Cancer Treatment and Survival – Comparison of Two 5 – Year Time Intervals

In last two decades there was a huge step forward concerning rectal cancer treatment. The aim of our study was comparison of two time intervals regarding the methods of treatment and results of radical rectal cancer surgery. 407 patients operated on for rectal cancer were included in study. Those were patients with elective radical resection of solitary rectal tumor who survived first month after the operation. Patients were divided in two groups regarding the time of operation. In group one were patients operated on between 1996 and 2000 and in group two patients operated on between 2001 and 2005. We compared our results in both intervals with special interest about type of operation considering localization of the tumor, local recurrence and cancer related survival. Significant differences were found between two groups. There were more sphincter saving operations in second group, less local recurrences and better survival than in first group. This study observed significant improvements at recurrence rates and total survival for patients operated on rectal cancer

15. svetovni kongres o raku prebavil

The 15th World Congress on Gastrointestinal Cancer took place from 3 to 6 July 2013 in Barcelona. This is a global event addressing individual types of gastrointestinal cancer in accordance with the latest recommendations and findings, from diagnosis to treatment. The focus is on individual management of each patient and the importance of a multidisciplinary approach, including the most recently discovered molecular mechanisms. Over 60 world-renowned lecturers, all experts in their fields, presented the latest findings and recommendations or lead small targeted groups of physicians who attended sessions on specific topics. At the Congress, the participants were also given the opportunity to present their research results, with their abstracts being published in the Annals of Oncology. Two Slovenian abstracts were presented, both from the field of postsurgical treatment of gastric cancer. In the following pages, we will present only some of the new findings and the outlines presented at the Congress.Ni abstrakta

15th World Congress on Gastrointestinal Cancer

The 15th World Congress on Gastrointestinal Cancer took place from 3 to 6 July 2013 in Barcelona. This is a global event addressing individual types of gastrointestinal cancer in accordance with the latest recommendations and findings, from diagnosis to treatment. The focus is on individual management of each patient and the importance of a multidisciplinary approach, including the most recently discovered molecular mechanisms. Over 60 world-renowned lecturers, all experts in their fields, presented the latest findings and recommendations or lead small targeted groups of physicians who attended sessions on specific topics. At the Congress, the participants were also given the opportunity to present their research results, with their abstracts being published in the Annals of Oncology. Two Slovenian abstracts were presented, both from the field of postsurgical treatment of gastric cancer. In the following pages, we will present only some of the new findings and the outlines presented at the Congress

Hepatocelični rak - možnost resekcije jeter

Resekcija jeter (RJ) je ostala glavna oblika terapije pri solitarnem hepatoceličnem raku (HCC), pri bolnikih z ohranjeno funkcijsko rezervo jeter in v primernem splošnem stanju. Izpopolnjene slikovne preiskave so pripomogle k boljši izbiri bolnikov. Kirurgija jeter je napredovala: uporabne so številne tehnike transekcije jetrnega tkivadosegljive so različne naprave, ki omogočajo hitrejše in natančnejše operiranje v brezkrvnem operativnem polju. Izboljšana kirurška tehnika, vzdrževanje nizkega centralnega venskega pritiska in napredek pri negi bolnika po operaciji so omogočili, da se je smrtnost po operaciji jeter v izbranih serijah znižala celo do 0%. Barcelona Clinic Liver Cancer (BCLC) klasifikacija poleg zamejitve bolezni, nudi priporočila tudi glede izbora terapije. Kirurško terapijo omejuje zgolj na bolnike z zgodnjim stadijem raka. Namen tega prispevka je raziskati, ali je v sedanjem času mogoče RJ opraviti s sprejemljivimi kratko- in dolgoročnimi rezultati tudi pri bolnikih s takšnim HCC, pri katerem so prisotni številni in veliki tumorji, ki makroskopsko vdirajo v žile.Liver resection (LR) has remained the main form of therapy for solitary hepatocellular cancer (HCC) in patients with preserved functional liver reserves and in good general condition. Advanced imaging has contributed to a better selection of patients. Liver surgery has advanced as there are many techniques of liver tissue transection useful and different instruments are available, which enable faster and more accurate surgery in the bloodless operating field. Improved surgical technique, maintenance of low central venous pressure and advancement in patient postoperative care have provided that mortality rates after liver surgery in selected series lowered as far as to 0%. The Barcelona Clinic Liver Cancer (BCLC) classification apart from disease control also offers recommendations with regard to therapy selection. It limits surgical therapy only to patients with early stage liver cancer. The purpose of this article is to research whether at present time it is perhaps better to perform radioiodine therapy with acceptable short- and long-term results even in patients with HCC, where there are numerous and large tumours present, macroscopically invading the veins

Ponovne operacije jeter pri recidivu zasevkov raka debelega črevesa in danke: prikaz primera

Half of colorectal cancer patients may develop liver metastases. Multidisciplinary management is the basis for successful treatment, and liver resection represents the only potentially curative form of therapy. Despite a successful surgery, liver metastases may later recur. In such cases, it is wise to restart treatment with a combination of chemotherapy and target drugs, and to plan repeat liver resections. After the treatment, some patients can live for years without disease recurrence.Pri polovici bolnikov z rakom debelega črevesa in danke se lahko pojavijo zasevki v jetrih. Multidisciplinarna obravnava predstavlja temelj uspešnega zdravljenja, resekcija jeter pa je edina potencialno kurativna oblika terapije. Kljub uspešni operaciji pa se lahko jetrni zasevki kasneje ponovijo. Tudi v takšnem primeru je smiselno znova začeti zdravljenje, ki zajema kombinacijo kemoterapije, tarčnih zdravil in načrtovanja ponovnih jetrnih resekcij. Nekateri bolniki živijo brez ponovitve obolenja več let po začetku zdravljenja

Aortoduodenalna fistula tri godine nakon aorto-bifemoralne premosnice: prikaz slučaja i pregled literature

Secondary aortoenteric fistulas (SAEF ) are a relatively rare but dangerous complication of aortal reconstructive surgery. We present a patient that underwent aortobifemoral bypass three years before developing the signs of aortoenteric fistula, and we reviewed the literature on the topic. Since the clinical signs are nonspecific, physicians should have a high index of suspicion for SAEF in patients who underwent aortal reconstructive surgery. The most useful diagnostic tools for stable patients are upper gastrointestinal endoscopy and computed tomography scan with contrast that can, in combination with history and clinical signs, enable accurate diagnosis in more than 90% of patients. Unstable patients with suspected aortoenteric fistula should undergo exploratory laparotomy. The treatment of choice is open surgery with graft excision, wide debridement of infected tissue, bowel repair or resection followed by an extra-anatomic bypass or in situ placement of a new graft. Early postoperative mortality remains high, around 30% in most analyses. Currently there are no guidelines for the diagnosis and management of SAEF , so individualized approach is necessary for each patient.Sekundarne aorto-enteralne fistule su rijetka ali opasna komplikacija aortne rekonstruktivne kirurgije. Prikazuje se bolesnik kod kojega su se razvili simptomi aorto-enteralne fistule tri godine nakon ugradnje aorto-bifemoralne premosnice, uz pregled literature. S obzirom na to da su klinički znaci vrlo nespecifični kod ovih bolesnika, važno je rano posumnjati na moguć razvoj sekundarne aorto-enteralne fistule kod bolesnika koji su bili podvrgnuti aortnoj rekonstruktivnoj kirurgiji. Od dijagnostičkih metoda najkorisnije su ezofagogastroduodenoskopija i kompjutorizirana tomografija s kontrastom koji, u kombinaciji s anamnezom i kliničkim znacima, omogućavaju postavljanje dijagnoze u preko 90% bolesnika. U nestabilnih bolesnika kod kojih postoji sumnja na razvoj ovoga stanja indicirana je eksplorativna laparotomija. U liječenju metoda izbora je laparotomija, ekscizija proteze, debrideman upaljenog tkiva, popravak defekta na crijevu ili resekcija zahvaćenog segmenta, te ekstraanatomska premosnica ili postavljanje nove proteze. Poslijeoperacijska smrtnost je oko 30%. Kako zasad nema smjernica za dijagnostiku i liječenje bolesnika sa sekundarnim aorto-enteralnim fistulama nužan je visoko individualizirani pristup za svakog bolesnika

Repeat liver surgeries in the recidive of colorectal cancer metastases - a case study

Pri polovici bolnikov z rakom debelega črevesa in danke se lahko pojavijo zasevki v jetrih. Multidisciplinarna obravnava predstavlja temelj uspešnega zdravljenja, resekcija jeter pa je edina potencialno kurativna oblika terapije. Kljub uspešni operaciji pa se lahko jetrni zasevki kasneje ponovijo. Tudi v takšnem primeru je smiselno znova začeti zdravljenje, ki zajema kombinacijo kemoterapije, tarčnih zdravil in načrtovanja ponovnih jetrnih resekcij. Nekateri bolniki živijo brez ponovitve obolenja več let po začetku zdravljenja.Half of colorectal cancer patients may develop liver metastases. Multidisciplinary management is the basis for successful treatment, and liver resection represents the only potentially curative form of therapy. Despite a successful surgery, liver metastases may later recur. In such cases, it is wise to restart treatment with a combination of chemotherapy and target drugs, and to plan repeat liver resections. After the treatment, some patients can live for years without disease recurrence

Rak želodca : kaj morate vedeti o bolezni

“Kaj morate vedeti o bolezni ?” je podnaslov te publikacije. Zato boste v njej našli odgovore o nastanku te te bolezni, kot tudi znakih in simptomih, diagnostiki, ter zdravljenju, in še veliko več

Smernice za obravnavo bolnikov z rakom debelega črevesa in danke

No abstract.Ni abstrakta

Biopsy of resectable liver metastases of colorectal cancer – an unnecessary and dangerous method

Če se pri bolniku, ki je bil operiran zaradi raka debelega črevesa in danke (RDČD), na novo pojavi tumor v jetrih, je mogoče že na podlagi tega sklepati, da gre za zasevek. Še več, diagnozo je mogoče z 99 % verjetnostjo potrditi na podlagi slikovnih in biokemičnih preiskav. Kljub temu nekateri vztrajajo, da je za potrditev diagnoze potrebna perkutana tankoigelna biopsija (PTB). Nepotrebnost in nevarnost tega postopka pri resektabilnih jetrnih zasevkih RDČD bomo poskušali utemeljiti s pregledom literature in analizo naše serije bolnikov.If in the patient who underwent surgery for colorectal cancer (CC) a newly developed tumour is detected in the liver, it is possible to assume immediately that it is a metastasis. Moreover, it is possible to confirm the diagnosis with 99% probability based on imaging and biochemical screening. Despite this some insist that diagnosis needs to be confirmed with percutaneous core needle biopsy (PCNB). With a review of the literature and an analysis of our series of patients, we will try to show why this procedure is unnecessary and dangerous in patients with resectable liver metastases of CC