Multivariate analysis of recurrence after anterior resection for colorectal carcinoma
Article Abstract:
Two hundred and seventy-eight patients underwent surgery to remove a cancerous tumor in the colon and rectum and to form an artificial opening between the colon and the outside of the body to permit the continued functioning of the digestive tract. The interaction between the margin of extra tissue adjacent to the tumor that was removed and the distance from the tumor to the verge of the anus was studied. Out of the 258 patients who were followed, 66 percent were still free of cancer five years later. Forty-nine patients had suffered recurrence of the cancer in the original site and the cancer had spread to other parts of the body in 42 patients. Recurrence in the original location increased with age and with the degree of development of the cancer. The cancer recurred twice as frequently in patients who had a passage surgically created between the colon and the outside of the body. The cancer spread to different parts of the body much more frequently in patients who had margins of tissue around the tumor exceeding 3.5 centimeters surgically removed. Forty-four percent of patients whose tumors were within 14 centimeters of the verge of the anus and were removed with at least a 3.5 centimeter margin suffered recurrence of the cancer in a new location. Thus removal of large margins of tissue around cancers of the colon and rectum may contribute to metastasis, the spread of the cancer to different parts of the body.
Publication Name: American Journal of Surgery
Subject: Health
ISSN: 0002-9610
Year: 1989
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Liver resection without blood transfusion
Article Abstract:
Fifty-eight resections of the liver (removal of a portion or segment) were studied to identify ways of minimizing the need for blood transfusions. Isolation of the functional parts of the liver from blood vessel connections (vascular isolation prior to parenchymal division, VIP) before resection was found to significantly decrease the need for transfusions. Methods of accomplishing this included compressing these functional parts, closing off blood flow through the veins, cutting the blood vessels where they enter the liver, or cutting the main vein carrying blood from the liver. Two of 34 patients with VIP needed blood transfusions, while 18 of 24 patients without VIP required blood transfusions.
Publication Name: American Journal of Surgery
Subject: Health
ISSN: 0002-9610
Year: 1989
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