فهرست مطالب
Iranian Journal of Colorectal Research
Volume:7 Issue: 1, Mar 2019
- تاریخ انتشار: 1398/01/21
- تعداد عناوین: 8
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Page 1The significance of nodal metastasis as a prognostic factor in colorectal cancer is universally recognised and accepted. This article discusses the various factors that govern lymph node harvest and how to improve that. We will discuss the outcome of lymph node harvest as a possible form of auditing the surgical technique and the pathologist dedication.Keywords: Lymph Node, Colorectal Cancer, Pathologist
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Page 2Colorectal cancer (CRC) is still the third most common cancer in the world, which is the fourth cause of cancer-related mortality. It is caused either due to strong genetic factors such as familial adenomatous polyposis (FAP) and hereditary non-polyposis colon cancer or due to modified metabolic factors such as obesity and diabetes, which represents insulin resistance condition. Non-alcoholic fatty liver disease (NAFLD) is increasing not only in Western countries but also in Asian countries. This disease has been included in the metabolic disease family such as diabetes, hypertension, obesity, and dyslipidemia. Some studies have shown that there is a strong association between NAFLD and the risk of CRC development through the presence of an adenomatous polyp. However, there is currently no consensus on whether routine screening colonoscopy should be done in all NAFLD patients with respects to its cost and invasiveness.Keywords: Non-Alcoholic Fatty Liver Disease, Colorectal Cancer, Colonoscopy
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Page 3BackgroundNasogastric decompression is routinely used for intestinal drainage or decompression after gastrectomy. However, nowadays its efficacy is under debate.ObjectivesThe purpose of this study was to investigate the efficacy and necessity of nasogastric decompression in radical gastrectomy for gastric cancer.MethodsTwo PubMed and EMBASE electronic databases were retrieved by November 2018. A prospective randomized controlled trial (RCT) and comparison of nasogastric decompression with and without nasogastric decompression after gastrectomy are required for eligible studies.ResultsA total of 1,885 cases were included in 13 randomized controlled studies. There were 941 cases in nasogastric decompression group and 944 cases in non-nasogastric decompression group after gastrectomy. The patients in non-nasogastric decompression group had significantly shorter time of bowel sound return (WMD = -0.20, 95% CIs = -0.38 - 0.02, P = 0.03), shorter time of first oral intake (WMD = -0.58, 95% CIs = -0.92 - 0.24, P = 0.0007), faster tolerance to semi-solid diet (WMD = -0.65, 95% CIs = -0.96 - 0.34, P < 0.0001), and shorter time of postoperative hospital stay (WMD = -0.99, 95% CIs = -1.70 - 0.27, P = 0.007). No statistically significant differences were observed in the first time to passage of flatus, vomiting, mortality rates, total complications, gastrointestinal complications, wound complications, respiratory complications, anastomosis or duodenal stump fistula, and general complications.ConclusionsThe routine nasogastric decompression was not recommended for patients after elective gastrectomy.Keywords: Nasogastric Decompression, Gastrectomy, Meta-Analysis
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Page 4BackgroundColorectal cancer is one of the most common causes of mortality in the world.ObjectivesThe aim of this study was to investigate the histopathologic changes including hyperchromatism, tissue lymphocyte infiltrations (TILs), aberrant crypt foci (ACF), microvessel density (MVD), p53, Bcl-2 and CD31 changes during colorectal cancer development.MethodsSubcutaneous injections of dimethyl hydrazine DMH were administered to rats (40 mg/kg body weight) for 10 weeks. Rats were fed by food and water until 40th week and sacrificed two by two within 10, 15, 20, 25, 30 and 40 weeks after the start of treatment. Thin paraffinized sections were applied to anti-CD31, anti-Bcl-2 and anti-p53 staining procedures. MVD and ACF were reported as mean value of three HPFs.ResultsHyperchromatism, TILs and angiogenesis were the most common initial histologic changes which started at 10th week of DMH treatment. Hyperchromatism’s severity increased earlier than other changes and reached the highest value at the 25th week. The highest value of all variants occurred in the 40th week except the TILs which started to achieve the highest value in week 30 and increased until 40th week. A diminished amount of p53 was observed at week 40, however, increased intensity of CD31 and Bcl-2 were seen between 30th and 40th week.ConclusionsIn conclusion, TILs and angiogenesis might be the important earliest factors contributing to colorectal cancer progression.Keywords: Colorectal Cancer, Tumor-Infiltrating Lymphocytes (TILs), Angiogenesis, Hyperchromatism, Microvessel Density (MVD), Aberrant Crypt Foci (ACF)
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Page 5BackgroundCrohn’s disease (CD) has significant effects on quality of life. There is a paucity of information regarding how surgery for CD affects male sexual function.ObjectivesTo determine the effects of surgery for CD on male sexual function.MethodsA survey was sent to male patients who had surgery for CD at a tertiary care institution between January 1st, 2011 and July 1st, 2016. The survey included the Patient Health Questionnaire (PHQ-9), short inflammatory bowel disease questionnaire (SIBDQ), and the international index of erectile function (IIEF-5). A retrospective chart review was performed. Statistical analysis was performed using Fischer’s exact test and two-sided t-test.ResultsThe survey was sent to 149 men and twenty-one patients (14%) responded. The mean age of respondents was 54.9 years. On analysis of patients who completed the IIEF-5, 12 patients (63%) met criteria for erectile dysfunction (ED). Ten patients subjectively reported worsened sexual function following surgery (48%). Men who had previously undergone surgery for CD were more likely to have ED (P = 0.01). Patients who met criteria for depression were more likely to have ED (P = 0.006). Men with more CD symptoms were more likely to have ED: the mean SIBDQ score for men with ED was 4.5, while the mean score for men without ED was 5.8 (P = 0.01).ConclusionsMen who undergo surgery for CD experience high rates of sexual dysfunction, with many men reporting their sexual functioned worsened following surgery. More research needs to be done to further characterize sexual dysfunction in men with CD.Keywords: Crohn’s Disease, Surgery, Outcomes
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Page 6IntroductionSquamoid eccrine carcinoma is a very rare carcinoma with few reported cases in the literature. As a result, there is limited guidance on management and follow-up of these cases.Case PresentationWe describe the case of a 39 year-old male with a large painful squamoid eccrine carcinoma of the right lower abdominal wall with inguinal nodal involvement. He underwent radical resection, superficial groin dissection, transposition of a sartorius muscle flap, and a pedicled anterolateral thigh perforator flap for reconstruction. The postoperative course was uneventful apart from a postoperative seroma which was treated with aspiration. He underwent adjuvant radiation following full recovery from his procedure.ConclusionsOur case study represents a rare, large squamoid eccrine carcinoma of the abdominal wall treated with radical resection, superficial groin dissection, transposition of a sartorius muscle flap, and a pedicled anterolateral thigh perforator flap for reconstruction. Due to the limited number of reported cases, there are no guidelines for management of squamoid eccrine carcinomas. With this case report we aim to increase awareness of this rare carcinoma, and to summarize the existing literature on management of squamoid eccrine carcinoma.Keywords: Eccrine, Porocarcinoma, Sweat Gland Carcinoma
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