Diseases of the colon and rectum
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Comparative Study
Individual cutoff levels of carcinoembryonic antigen and CA 242 indicate recurrence of colorectal cancer with high sensitivity.
This study was designed to identify the sensitivity and specificity associated with recurrent colorectal cancer, principally hepatic metastases, with individual cutoff levels of carcinoembryonic antigen; identify the corresponding data for CA 50 and CA 242; compare these findings with standard cutoff levels, clinical examinations, and patients' personal health assessments; and identify the time between increasing serum levels and detection of actual relapses, particularly hepatic metastases. ⋯ With individual cutoff levels, both carcinoembryonic antigen and CA 242 had high sensitivity and acceptable specificity for indicating recurrent colorectal cancer. Because most (29/33) patients with recurrent disease identified within 3 years after surgery and all 8 with hepatic metastases identified during the sampling period were indicated by carcinoembryonic antigen with the individual cutoff, that method was established as the best for postoperative surveillance.
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomized, controlled trial of carbon dioxide insufflation during colonoscopy.
Insufflation of air is a cause of discomfort during and after colonoscopy. Although this can be minimized by good technique, the use of carbon dioxide insufflation may provide further benefits. Carbon dioxide is rapidly absorbed and excreted through the lungs. We hypothesized that carbon dioxide would alleviate post-colonoscopy discomfort. ⋯ Because there was significantly less abdominal pain ten minutes after colonoscopy in the group in whom carbon dioxide was used, carbon dioxide should be considered as an insufflating gas for colonoscopy.
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Sacral neuromodulation is a novel treatment for selected urinary and bowel dysfunctions. A new method is described for electrode implantation, the "minimally invasive sacral neuromodulation implant technique." ⋯ The minimally invasive sacral neuromodulation implant technique seems to be a safe procedure-making sacral neuromodulation implant easier, faster, and safer, in as much as complications could be potentially reduced.
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This study aimed to evaluate the impact of surgery-associated variables on recurrence rates after sigmoid resection for diverticulitis. ⋯ Colorectal (rather than colosigmoid) anastomosis was the single predictor of lower recurrence rates after elective sigmoid resection for uncomplicated diverticulitis.