Diseases of the colon and rectum
-
The only possibility of a surgical cure in patients with locally advanced primary or recurrent rectal cancer would be an extended resection such as pelvic exenteration and sacral resection. The aim of this study was to evaluate the safety, tolerability, and survival benefits of these procedures. ⋯ Pelvic exenteration and sacral resection for primary or recurrent rectal cancer are tolerable procedures with a low mortality rate. Although they provide a survival benefit if curative resection is possible, the associated morbidity remains high and should be followed up closely.
-
Both topical diltiazem, a calcium channel blocker, and glyceryl trinitrate, a nitric oxide donor, lower anal pressure and heal two-thirds of chronic anal fissures. This study evaluated the efficacy of diltiazem for fissures that failed to heal with glyceryl trinitrate. ⋯ Topical 2 percent diltiazem is effective treatment for glyceryl trinitrate-resistant chronic anal fissures. Side effects, mainly perianal itching, may occur in 10 percent of patients but are generally tolerated.