Aim. The aim of this study was to see the clinical, pathological, and demographic profile of young patients with stomach carcinoma besides association with p53. Patients and Methods. Prospective study of young patients with stomach carcinoma from January 2005 to December 2009. A total of 50 patients with age less than 40 years were studied. Results. Male female ratio was 1 : 1.08 in young patients and 2.5 : 1 in older patients. A positive family history of stomach cancer in the first degree relatives was present in 10% of young patients. Resection was possible only in 50% young patients. 26% young patients underwent only palliative gastrojejunostomy. The most common operation was lower partial gastrectomy in 68%. Amongst the intraoperative findings peritoneal metastasis was seen in 17.4% in young patients. 50% young patients presented in stage IV as per AJCC classification (P value .004; sig.). None of the patients presented as stage 1 disease in young group. Conclusion. Early detection of stomach carcinoma is very important in all patients but in young patients it is of paramount importance.
a p o l l o m e d i c i n e 1 2 s ( 2 0 1 5 ) S10-S29 S17 seen in 75% of patients at three months which improved and reached 60% at the median follow-up of 9.2 months.
Background Many publications describe the advantages of the creation of ghost ileostomy (GI) to prevent the need for formal covering ileostomy in more than 80% of carcinoma rectum patients. However, none of the papers describes exactly how to ultimately remove the GI in these 80% of patients in whom it doesn't need formal maturation. Aim To describe and evaluate the ghost ileostomy release down (GIRD) technique in terms of feasibility, complications, hospital stay, procedure time etc. in patients with low anterior resection/ultra-low anterior resection (LAR/uLAR) with GI for carcinoma rectum. Method The present was a prospective cohort study of patients with restorative colorectal resections with GI for carcinoma rectum, Postoperatively the patients were studied with respect to ease and feasibility of the release down of GI and its complications. The data was collected, analyzed and inference drawn. Results A total of 26 patients needed the GIRD and were included in the final statistical analysis of the study. The procedure was done between 7th to 16th postoperative days (POD) and was successful in all patients without the need of any additional surgical procedure. None of the patients required any local anesthetic injection or any extra analgesics. The average time taken for procedure was 5-minutes and none of the patients had any significant difficulty in GI release. There were no immediate postprocedure complications. Conclusion The GIRD technique is a simple, safe, and quick procedure done around the 10th POD that can easily be performed by the bedside of patient without the need of any anesthesia or additional analgesics.
Rectal cancer is one of the most common tumors in industrialized countries (40 cases in every 100,000 individuals) and one of the most common malignant tumors of 1 the gastrointestinal tract , comprising nearly 30% of all colorectal cancers. Globally, rectal cancer is the third most 2,3 common cancer in men . In the developed countries, it is the second most common tumor after lung cancer. Many improvements have been made over the past 20 years in the surgical, radiologic and oncologic treatment of rectal cancer. However, this neoplasm continues to have a highly variable outcome and is associated with a poor prognosis owing to the high risk of metastasis and local recurrence. After surgical treatment, local recurrence rates for rectal [4][5][6][7][8] cancer vary from 3% to 32% . The success of tumor excision depends largely upon accurate tumor staging and appropriate surgicaltechnique.EUS is mostly accurate both in the evaluation of early stages (T1 and T2) and in demonstrating the perirectal spread of tumor (T3 tumors), however, it has several limitations: BACKGROUND: Rectal cancer is one of the most common tumors in industrialized countries and one of the most common malignant tumors of the gastrointestinal tract. OBJECTIVE: To compare the diagnostic accuracy of MDCT and ECMRI in preoperative staging of rectal cancers and correlation with intraoperative and histo-pathologic staging of resected specimen with respect to depth of tumor invasion (T-staging), lymph node metastasis (N-staging), and extra rectal spread (M-staging). METHODS: The study was a prospective one and consisted of 68 patients with biopsy proved rectal carcinoma. Patients were randomly selected for either of these two staging modalities (i.e., MDCT or ECMRI) using a random number table. MDCT and ECMRI findings were compared with intraoperative and histopathologic (reference standard) findings. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of each diagnostic modality were assessed. RESULTS: The diagnostic accuracies of MDCT and ECMRI for T1/T2 lesions were 75% and 87.5%, respectively, the difference being significant. For T3 lesions, the diagnostic accuracies of MDCT and ECMRI were 85.2% and 100%, respectively. The diagnostic accuracy of both for T4 lesions was found to be 100%. Both ECMRI and MDCT were found to be almost equally accurate and specific in detecting perirectal lymph node involvement. CONCLUSION: Endorectal coil MRI is superior to MDCT in local (T) staging of tumor and has overall more diagnostic accuracy, sensitivity and specificity than MDCT. ECMRI has a less tendency to under-stage the disease. However, both ECMRI and MDCT are almost equally accurate and specific in detecting perirectal lymph node involvement. JMS 2012;15(1):32-38.
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