International journal of colorectal disease
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Int J Colorectal Dis · Aug 2009
Total mesorectal excision for rectal cancer in an unselected population: quality assessment in a low volume center.
The aim of this study was to review the results and long-term outcome after total mesorectal excision (TME) for adenocarcinoma of the rectum in an unselected population in a community teaching hospital. ⋯ Patients with rectal cancer can safely be treated with TME in a community teaching hospital and leads to a good overall survival and an excellent local control. In patients aged above 80, treatment-related mortality is an important competitive risk factor, which obscures the positive effect of modern rectal cancer treatment.
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Int J Colorectal Dis · Jul 2009
ReviewColorectal cancer screening in Europe: differences in approach; similar barriers to overcome.
Worldwide diagnoses of bowel cancer approximate an estimated one million new cases per year, comprising 9% of all cancer cases, and this has continued to increase over the last 25 years. With the association between cancer risk and increasing age, together with the suggestion that by 2015 there will be a 22% increase in the proportion of the population aged over 65 years and a 50% increase in the proportion of people aged over 80 years, there is likely to be a significant increase in the demand on cancer services throughout Europe and the rest of the world. This article discusses the current state of bowel cancer screening within Europe.
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Int J Colorectal Dis · Jun 2009
Perioperative fluid retention and clinical outcome in elective, high-risk colorectal surgery.
There is some controversy regarding concepts currently propagated for an optimal perioperative fluid management in colorectal surgery. We wanted to analyze the association of net intraoperative and postoperative fluid balances with postoperative morbidity and length of stay. ⋯ If guided by established standards, even large perioperative fluid retentions do not appear to be associated with a worse outcome after extended colorectal surgery. Epidural analgesia may provide a significant benefit in those high-risk patients.
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Int J Colorectal Dis · Apr 2009
Clinical TrialTwo-stage hepatectomy (R0) with portal vein ligation--towards curing patients with extended bilobular colorectal liver metastases.
Patients with bilobular colorectal liver metastases (CRLM) experience poor prognosis, especially when curative resection cannot be achieved. However, resectability in these patients is often limited by low future remnant liver volume (FRLV). The latter can be enhanced by a two-stage liver resection, using portal vein ligation to induce liver hypertrophy. The aim of this prospective pilot study was to evaluate safety, secondary resectability, and time to recurrence of two-stage hepatectomy with portal vein ligation (PVL) and complete surgical clearance of the FRLV in patients with bilobular CRLM. ⋯ Two-stage hepatectomy with PVL and complete surgical clearance of FRLV is safe even after intensified systemic chemotherapy resulting in a curative resection rate of 58.3% (73.7% of re-explored cases).