• Title/Summary/Keyword: Colorectal surgery

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Incidence of incisional hernia following liver surgery for colorectal liver metastases. Does the laparoscopic approach reduce the risk? A comparative study

  • Ahmed Hassan;Kalaiyarasi Arujunan;Ali Mohamed;Vickey Katheria;Kevin Ashton;Rami Ahmed;Daren Subar
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.2
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    • pp.155-160
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    • 2024
  • Backgrounds/Aims: No reports to compare incisional hernia (IH) incidence between laparoscopic and open colorectal liver metastases (CRLM) resections have previously been made. This is the first comparative study. Methods: Single-center retrospective review of patients who underwent CRLM surgery between January 2011 and December 2018. IH relating to liver surgery was confirmed by computed tomography. Patients were divided into laparoscopic liver resection (LLR) and open liver resection (OLR) groups. Data collection included age, sex, presence of diabetes mellitus, steroid intake, history of previous hernia or liver resection, subcutaneous and peri-renal fat thickness, preoperative creatinine and albumin, American Society of Anesthesiologists (ASA) score, major liver resection, surgical site infection, synchronous presentation, and preoperative chemotherapy. Results: Two hundred and forty-seven patients were included with a mean follow-up period of 41 ± 29 months (mean ± standard deviation). Eighty seven (35%) patients had LLR and 160 patients had OLR. No significant difference in the incidence of IH between LLR and OLR was found at 1 and 3 years, respectively ([10%, 19%] vs. [10%, 19%], p = 0.95). On multivariate analysis, previous hernia history (hazard ratio [HR], 2.22; 95% confidence interval [CI], 1.56-4.86) and subcutaneous fat thickness (HR, 2.22; 95% CI, 1.19-4.13) were independent risk factors. Length of hospital stay was shorter in LLR (6 ± 4 days vs. 10 ± 8 days, p < 0.001), in comparison to OLR. Conclusions: In CRLM, no difference in the incidence of IH between LLR and OLR was found. Previous hernia and subcutaneous fat thickness were risk factors. Further studies are needed to assess modifiable risk factors to develop IH in LLR.

Psychosocial Adjustment in Korean Colorectal Cancer Survivors

  • Sun, Hyejin;Lee, Jia
    • Journal of Korean Academy of Nursing
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    • v.48 no.5
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    • pp.545-553
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    • 2018
  • Purpose: The increasing survival rate of colorectal cancer demands various nursing interventions and continuous care for patients to adapt to their psychosocial daily lives. The purpose of this study was to identify factors associated with psychosocial adjustment in colorectal cancer survivors. Methods: A cross-sectional descriptive study with face-to-face interviews was conducted of 156 colorectal cancer survivors after surgery visiting an outpatient cancer clinic at a tertiary hospital in S city, Korea. Posttraumatic growth, health-promoting behavior, length of treatment, difficulty in activities of daily living, and having a stoma were entered into the linear regression model. Results: The strongest factor influencing the level of psychosocial adjustment was health-promoting behavior (${\beta}=.33$, p<.001), followed by difficulty in activities of daily living (${\beta}=-.24$, p=.001), posttraumatic growth (${\beta}=.20$, p=.004), and having a stoma (${\beta}=-.19$, p=.004). Conclusion: Nursing interventions for psychosocial adjustment in colorectal cancer survivors need to include the contents for posttraumatic growth, as well as health-promoting behavior, and activities of daily living.

Somatic Mutations of K-Ras and BRAF in Thai Colorectal Cancer and their Prognostic Value

  • Chaiyapan, Welawee;Duangpakdee, Pongsanae;Boonpipattanapong, Teeranut;Kanngern, Samornmas;Sangkhathat, Surasak
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.329-332
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    • 2013
  • Background: The study aimed to determine the incidence of K-ras and BRAF mutations in colorectal cancers (CRCs) in Thai patients and evaluate association with clinicopathological parameters including treatment outcomes in terms of event free survival (EFS). Materials and Methods: Two-hundred colorectal cancer specimens were collected for studies of K-Ras codon 12, 13 and 61, and BRAF codon 600 by polymerase chain reaction and direct nucleotide sequencing. Results: The overall incidence of K-Ras mutations in our patients was 23%. K-ras mutation frequencies in CRC stages (AJCC) I, II, III and IV were 6.7%, 16.1%, 23.3% and 26.6%, respectively (p-value>0.05). The three most common mutation forms were G12D, G12V and G13D. K-Ras mutation status was associated with poorer EFS in stage I-III CRCs (p-value 0.03). Conclusions: The study found a lower mutation frequency of K-Ras and BRAF compared to reports involving other ethnic groups. However, K-Ras mutations did have a negative prognostic value in early-stage CRCs.

Role of Interventional Managements for Malignant Colorectal Obstruction (소화관 폐색을 동반한 대장암 환자에서 중재적 치료의 역할)

  • Eun Soo Kim
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.1-5
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    • 2013
  • Incidence of colorectal cancer has been increasing in Korea probably due to the westernized life style. Although the technical development of colonoscopy and introduction of screening examination has led to the detection of early colorectal cancer, considerable patients still have clinical symptoms of colorectal obstruction. Most of these patients are old and they have advances stage of cancer or severe co-morbidities. In addition, the emergency operation under poor preparation state of colon can lead to serious mortality or complications. Since the introduction of colorectal stent, there have been a large number of studies for recent 10 years. It seems that the role of colorectal stent in the palliative indication or bridge to surgery has been recognized. A well designed, randomized prospective study with long term data is necessary to support the role of colorectal stent in the malignant colorectal obstruction.

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MicroRNA-451 Inhibits Growth of Human Colorectal Carcinoma Cells via Downregulation of Pi3k/Akt Pathway

  • Li, Hong-Yan;Zhang, Yan;Cai, Jian-Hui;Bian, Hong-Lei
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3631-3634
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    • 2013
  • MicroRNAs (MiRNAs) play important roles in coordinating a variety of cellular processes and abnormal expression has been linked to the occurrence of several cancers. The miRNA miR-451 is downregulated in colorectal carcinoma (CRC) cells, suggested by several research groups including our own. In this study, synthetic miR-451 mimics were transfected into the SW620 human CRC cell line using Lipofectamine 2000 and expression of miR-451 was analyzed by real time PCR, while expression of CAB39, LKB1, AMPK, AKT, PI3K and Bcl2 was analyzed by Western blot, and cell growth was detected by MTT assay. In comparison to the controls, a significant increase in the expression of miR-451 was associated with significantly decreased expression of CAB39, LKB1, AMPK, AKT, PI3K and Bcl2. The capacity of cell proliferation was significantly decreased by miR-451 expression, which also inhibited cell growth. Our study confirmed that miR-451 has a repressive role in CRC cells by inhibiting cell growth through down-regulating the P13K/AKT pathway.

The Nutritional Intakes of the Colorectal Cancer Patients in Daegu, Kyungpook Area Korea (대구$\cdot$경북지역 대장직장암 환자의 식품 및 영양섭취상태)

  • Suh Soo-Won;Koo Bo-Kyung;Jeon Su-Han;Lee Hye-Sung
    • Journal of Nutrition and Health
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    • v.38 no.9
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    • pp.717-738
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    • 2005
  • The present study was conducted to analyze the status of food and nutrients intakes of the colorectal cancer patients in the Daegu$\cdot$Kyungpook area and to find dietary risk factors related to the occurrence of colorectal cancer in this community. The case subjects (123) were selected from the patients recently diagnosed as colorectal cancer at Kyunrpook National University Hospital, the control subjects (182) were selected from the patients of the Department of Orthopedic Surgery at the same hospital and from the healthy volunteers who did not have any gastrointestinal diseases. The food consumption survey was done by individual interviews using semi-quantitative food kequency questionnaire and nutrients intakes were analysed by CAN program. The results of the study suggested that dietary factors which are speculated as the risk factors of colorectal cancer in Daegu$\cdot$Kyungpook area were high consumption of cereals and oils low consumption of fruits and mushrooms, high consumption of energy and fat, especially animal fat, low consumption of dietary fiber, high percentage of energy intake from cereals and potatoes, high intakes of protein, fat, vitamin A and cholesterol from egg, low intake of calcium from vegetables, and high intake of iron from meats and eggs. These findings might be useful for the nuation education to prevent colorectal cancer in the community. However it is recommended to conduct more extensive and systematic survey to reconfirm these dietary risk factors under taking into consideration of the dietary characteristics in this region.

Intussusception after Colonoscopy: A Case Report and Review of Literature

  • Hassan, Wan Amir Wan;Teoh, William
    • Clinical Endoscopy
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    • v.51 no.6
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    • pp.591-595
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    • 2018
  • Intussusception after colonoscopy is an unusual complication. A MEDLINE search revealed only 7 reported cases. We present a report of a 28-year-old man who developed abdominal pain several hours after routine colonoscopy and in whom computed tomography (CT) revealed colocolic intussusception. We postulate that this condition is iatrogenic and induced by suctioning of gas on withdrawal of the colonoscope. A common observation among the reported cases was abdominal pain several hours after colonoscopy and right-sided intussusception. All cases had colonoscopy reaching the right side of the colon. Treatment for adult intussusception remains controversial with regard to reduction versus resection, especially given the high association with a pathological cause and malignancy. Among the 8 reported cases, only the current case did not require surgery. A combination of benign colonoscopy, CT, and the clinical picture should provide sufficient information to initially choose a more conservative treatment approach.

Hereditary Colorectal Cancer (유전성 대장암)

  • Kim, Duck-Woo
    • Journal of Genetic Medicine
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    • v.7 no.1
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    • pp.24-36
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    • 2010
  • Colorectal cancer is one of the most steeply increasing malignancies in Korea. Among 398,824 new patients recorded by the Korea Central Cancer Registry between 2003 and 2005, 47,915 cases involved colorectal cancers, accounting for 12.0 % of all malignancies. In 2002, total number of colorectal cancer cases had accounted for 11.2 % of all malignancies. Hereditary syndromes are the source of approximately 5% to 15% of overall colorectal cancer cases. Hereditary colorectal cancers are divided into two types: hereditary nonpolyposis colorectal cancer (HNPCC), and cancers associated with hereditary colorectal polyposis, including familial adenomatous polyposis (FAP), Peutz-Jeghers syndrome, juvenile polyposis, and the recently reported hMutYH (MYH)-associated polyposis (MAP). Hereditary colorectal cancers have unique clinical features distinct from sporadic cancer because these are due to germline mutations of the causative genes; (i) early age-of-onset of cancer, (ii) frequent association with synchronous or metachronous tumors, (iii) frequent association with extracolonic manifestations. The management strategy for patients with hereditary colorectal cancer is quite different from that for sporadic cancer. Furthermore, screening, genetic counseling, and surveillance for at-risk familial member are also important. A well-organized registry can plays a central role in the surveillance and management of families affected by hereditary colorectal cancers. Here, we discuss each type of hereditary colorectal cancer, focusing on the clinical and genetic characteristics, management, genetic screening, and surveillance.

Fentanyl Increases Colorectal Carcinoma Cell Apoptosis by Inhibition of NF-κB in a Sirt1-dependent Manner

  • Zhang, Xiu-Lai;Chen, Min-Li;Zhou, Sheng-Li
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.10015-10020
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    • 2014
  • Background: Fentanyl is used as an analgesic to treat pain in a variety of patients with cancer and recently it has become considered to also act as an antitumor agent. The study present was designed to investigate the effects of fentanyl on colorectal cancer cell growth and plausible mechanisms. Materials and Methods: The human colorectal carcinoma cell line HCT116 was subcutaneously injected into nude mice. The viability of HCT116 was tested by MTT assay, and apoptosis by flow cytometry and caspase-3 activity. The expression of Sirt1 and NF-${\kappa}B$ were evaluated by Western blotting and the levels of Sirt1 and NF-${\kappa}B$ by fluorescence method. SiRNA was used to silence and Ad-Sirt1 to overexpress Sirt1. Results: Our data showed that fentanyl could inhibit tumor growth, with increased expression of Sirt1 and down-regulation of Ac-p65 in tumors. Compared with control cells without treatment, HCT116 cells that were incubated with fentanyl had a higher apoptotic rate. Moreover, fentanyl could increase expression and activity of Sirt1 and inhibitor expression and activity of NF-${\kappa}B$, which might be mechanisms of fentanyl action. Conclusions: Fentanyl increased colorectal carcinoma cell apoptosis by inhibition of NF-${\kappa}B$ activation in a Sirt1-dependent manner.