Background: Finding the appropriate treatment for advanced rectal cancer patients represents a challenge for surgeons. Determining the right diagnosis and the proper treatment requires multidisciplinary collaboration. Our aim is to present a case with advanced stage rectum cancer, who received successful multidisciplinary treatment.Material and method: A prospective multidisciplinary research is being conducted at our Department from 2018 within which patients with malignant rectal cancer are examined. Patients’ treatment is realized by the same multidisciplinary team. The patient’s preoperative investigations included MRI and a lymph node map designated by radiologists.Results: In case of a 60-year-old patient the preoperative MRI showed a stenotic formation in the middle level of the rectum that penetrated the seminal vesicle. During surgery, we found a 10x10 cm stenotic, perforated rectal cancer, which penetrated the bladder, seminal vesicle, prostate and sacrum, respectively a metastatic lesion in the livers 8th segment. During surgery R2 recto-sigmoid resection was performed with colostomy. The patient was mobilized on the first postoperative day and bowel movements were regained on the second day. The patient left the hospital on the eighth postoperative day.Conclusions: Adequate treatment of patients with advanced rectal cancer can be achieved only through multidisciplinary co-operation. Preoperative radiological examinations are mandatory. A map representing the positive colorectal lymph nodes, implemented by the radiologists, can significantly help the surgeons and pathologists.
Objective: To evaluate and compare laparoscopic and conventional open procedures for bilateral inguinal hernia surgical repair, using clinical, intraoperative, and postoperative criteria. Methods: Forty-three patients with bilateral inguinal hernia were included in a retrospective study, between 2014–2017. All patients underwent conventional open or laparoscopic bilateral hernioplasty, and were divided into two groups: a conventional open group (COG) and a laparoscopy group (LG). Clinical, intraoperative, and postoperative outcomes were reviewed. Results: In the laparoscopic hernioplasty group, there was a significantly shorter hospitalization period (p = 0.026), less postoperative pain (p = 0.03), and a prompt return to work (p = 0.043) compared to the conventional open procedure. On the other hand, patients who underwent hernioplasty with the Progrip-type synthetic mesh developed a lower pain score, an earlier return to work, and a quick start to normal physical activities in comparison with other mesh types used for the treatment of bilateral inguinal hernias. For patients who underwent conventional open procedure, there was a significantly shorter operating time (p = 0.042). Conclusion: Laparoscopic bilateral inguinal hernioplasty is a time-consuming and technically demanding procedure. However, the current study underlines the benefits of this type of surgery. This technique presents comparable clinical, intraoperative, and postoperative results with the conventional open surgery.
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