The aim of this study was to determine the long-term effects of administering preoperative radiochemotherapy to patients with carcinoma of the lower rectum. The outcomes of 29 patients who underwent curative surgery for carcinoma of the lower rectum after receiving radiochemotherapy in the form of 40.5 Gy accelerated hyperfractionation and a total dose of 3 400 mg 5-fluorouracil given as suppositories, with or without hyperthermia, and 48 patients who underwent surgery alone, were retrospectively compared. The tumors in all the patients were histologically diagnosed as stage T3. The cumulative 5-year survival rate and 5-year local recurrence-free rate of the patients treated with radiochemotherapy plus surgery were significantly better than those of the patients treated by surgery alone, the respective values being 80.5% vs 59.8% (P = 0.0325) and 95.7% vs 61.4% (P = 0.0041). Dehiscence of the perineal wound, anastomotic leakage, and postoperative ileus occurred at similar frequencies in both groups; however, perineal wound healing after abdominoperineal resection was delayed in the patients treated with radiochemotherapy plus surgery at 42.7 days vs 25.4 days (P = 0. 0062). In conclusion, although the wound healing was delayed, preoperative radiochemotherapy is considered to be beneficial for patients with carcinoma of the lower rectum.

Osteochondroma rarely develops from the carpal bones. We report a first case in which a dorsal osteochondroma of the lunate caused attritional rupture of the tendon of the extensor indicis proprius and a tendon of the extensor digitorum communis of index finger.

Addition of hyperthermia resulted in a greater degree of tumor necrosis and was considered to be useful as a preoperative treatment for rectal carcinoma.

We present here two cases wherein we performed radiolunate fusion using vascularized radius graft with the vascular pedicle of the fourth extensor compartment artery (fourth ECA) for the treatment of Bain's grade 2A Kienböck disease with incongruity of the radiolunate joint. The dorsodistal radius graft was levered out and mobilized on the pedicle of the fourth ECA; then the vascularized dorsodistal radius was shifted 1 cm distally and bridges were created between the radius and the lunate. The radiolunate joint was completely fused in both cases at three months after surgery. The capitolunate joint maintained congruity after surgery. The Mayo wrist score was 75 points, and the DASH (JSSH version) score for the two cases was 2.5 and 4.2 points, respectively. Radiolunate fusion using the vascularized radius bridging procedure is one of the satisfactory methods for treating advanced Kienböck disease, especially in Bain's grade 2A cases.

No abstract