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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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.
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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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Review Case Reports
Mesenteric phlebosclerosis: a new disease entity causing ischemic colitis.
Nonthrombotic stenosis or occlusion of the mesenteric veins is a rare cause of intestinal ischemia. The aim of this study was to describe a new disease entity causing chronic ischemic colitis. ⋯ These peculiar lesions have not previously been fully described. The cause and pathogenesis still remain unknown. We conclude that such lesions represent a new clinicopathologic disease entity and propose the term "idiopathic mesenteric phlebosclerosis."
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Previous reports have suggested that mucinous colorectal adenocarcinomas are more advanced at diagnosis and have a poorer prognosis than nonmucinous colorectal adenocarcinomas. The purpose of this study was to clarify whether the mucin-producing histologic type of carcinoma is associated with a worse prognosis than nonmucinous, differentiated colorectal adenocarcinoma for patients who undergo curative surgery. ⋯ In patients with colorectal carcinomas who underwent surgery with curative intent and who had colorectal carcinomas of the mucinous histologic type, there was significant correlation with prognosis as measured by overall survival rate after adjustment had been made for major confounders.