Stage B patients with a small number of examined nodes may be understaged. Thus, these patients might be considered for adjuvant therapy because of their poorer life expectancy than other stage B patients. For stage C patients, the number of recovered nodes does not seem to affect long-term outcome.
Pain and bleeding mostly caused by piles, fissures, and retained staples were the most frequent causes for reoperation after stapled hemorrhoidopexy. Reintervention was associated with a high bleeding and soiling rate, but was effective in treating pain and other symptoms in the majority of patients. Because of the wide spectrum of different interventions required, a failed or complicated stapled hemorrhoidopexy might be better treated by an experienced colorectal surgeon.
A rare case of a pilonidal cyst with the fistulous tract situated inside the anal canal is described. This is the sixth such case in the medical literature.
A combination of sclerotherapy, rubber band ligation and infrared coagulation was performed in 7850 patients seen an outpatient clinic over a period of 9 years. The most common symptom was bleeding followed by prolapse, pain and itching. Results were considered satisfactory in 7100 patients (90.5%); 750 (9.5%) required a formal hemorrhoidectomy. Complications were mild to moderate pain in 1777 cases (22.6%), severe pain in 157 cases (2.2%), mild hemorrhage in 199 (2.5%) and hemorrhage requiring transfusion in 10 cases (0.1%). In conclusion, non-surgical outpatient treatment has a great impact on patient's perception of the disease and results in considerable savings for the healthcare system.
This study analyzes the usefulness of two diagnostic methods: endorectal echotomography and adenolymphoscintigraphy. Echotomography is an important means for determining the extent of a tumor beyond the rectal wall, whereas lymphoscintigraphy is useful in demonstrating the metastatic locations in lymph nodes. These two modes of evaluation may permit an evaluation of the extent of the tumor and the possible involvement of regional lymph nodes before a surgical operation. Although the case material is limited, the statistical data can lead one to believe that, in the near future, a reasoned choice will be possible between local excision and abdominoperineal resection. The study includes 60 endorectal echotomographies and 26 lymphoscintigraphies (20 with 99mTc colloid and six with 201-Tl colloid).
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