Small-bowel tumors: epidemiologic and clinical characteristics of 1260 cases from the connecticut tumor registry.

Objective: To examine the epidemiology and clinical characteristics of small-bowel cancer.

Design: Patients with small-bowel tumors reported between 1980 and 2000, studied retrospectively.

Setting: Data from the Connecticut Tumor Registry.

Laparoscopic gastric wedge resection for Dieulafoy's disease following preoperative endoscopic localization with India ink and endoscopic clips.

Background: Dieulafoy's lesion is a vascular malformation, usually of the stomach but occasionally of the small or large bowel. It is an uncommon, but clinically significant, source of upper gastrointestinal hemorrhage. Three cases have been reported in the literature of laparoscopic gastric wedge resection of these lesions by using intraoperative endoscopic localization.

The postoperative surveillance of patients with colon cancer and rectal cancer.

Background: Colon cancer is relatively common; however, the results of treatment have marginally improved over the last half century. Though about 85% of patients have colorectal tumors resected with curative intent, a significant number of these patients will eventually die from cancer. As a result, many clinicians have advocated intensive follow-up in such patients as an attempt to increase survival.

Management of disorders of the posterior pelvic floor.

Introduction: Constipation is a relatively common problem affecting 15 percent of adults in the Western world, and over half of these cases are related to pelvic floor disorders. This article reviews the clinical presentation and diagnostic approach to posterior pelvic floor disorders, including how to image and treat them.

Methods: A Pubmed search using keywords "rectal prolapse," "rectocele," "perineal hernia," and "anismus" was performed, and bibliographies of the revealed articles were cross-referenced to obtain a representative cross-section of the literature, both investigational studies and reviews, that are currently available on posterior pelvic floor disorders.

Management of parastomal ulcers.

Management of surgically placed ostomies is an important aspect of any general surgical or colon and rectal surgery practice. Complications with surgically placed ostomies are common and their causes are multifactorial. Parastomal ulceration, although rare, is a particularly difficult management problem.

Anastomotic disruption after large bowel resection.

Anastomotic disruption is a feared and serious complication of colon surgery. Decades of research have identified factors favoring successful healing of anastomoses as well as risk factors for anastomotic disruption. However, some factors, such as the role of mechanical bowel preparation, remain controversial.

Management of less common tumors of the colon, rectum, and anus.

The majority of colorectal and anal malignancies are adenocarcinomas and squamous cell cancers, respectively. Despite the predominance of these neoplasms in these locations, rare histiotypes of the colon, rectum, and anus do occur. These histotypes include but are not limited to lymphoma, melanoma, diffuse cavernous hemangioma, and sarcomas, such as leiomyosarcoma or Kaposi's sarcoma.

The demographics, histopathology and patterns of treatment of anal cancer in Connecticut: 1980-2000.

Objectives: Examine the epidemiology and clinical characteristics of anal cancer in the State of Connecticut.

Materials And Methods: The Department of Health Connecticut Tumor Registry resources were utilized for the years 1980-2000.

Results: A total of 646 anal cancers (410 females, 236 males) were diagnosed (mean age: 63.

Colorectal manifestations of collagen vascular disease.

Background: The collagen vascular diseases are a collection of conditions, which are thought to be secondary to pathologic alterations in the immune system. Deposition of immune complexes in blood vessel walls resulting in either ischemia or thrombosis is the most widely accepted pathologic mechanism. The lack of familiarity with this subgroup of disease can lead to unnecessary surgical intervention.

The role of arachidonic acid regulatory enzymes in colorectal disease.

Purpose: Nonsteroidal anti-inflammatory drugs have a wide ranging effect on diseases of the colon and rectum. Interestingly, nonsteroidal anti-inflammatory drugs seem to play a beneficial role in colorectal cancer chemoprevention and adenoma regression, but may have a deleterious effect in inflammatory bowel disease. Prostaglandin inhibition is central to both the beneficial and toxic effects of this class of drugs.

Laparoscopic ventral hernia repair using a two (5-mm) port technique.

Objective: High recurrence rates have been documented after primary repair of incisional hernias. Laparoscopic ventral and incisional hernia repairs have been performed with very low rates of recurrence. We have modified the standard technique of laparoscopic repair in patients with small incisional and ventral hernias.

The management of rectal cancer in the elderly.

Introduction: The majority of patients with rectal cancer are elderly. Due to the increasingly aging population the number of people with colorectal cancer is increasing. As medical advances in the areas of local therapy, radiation therapy, and surgical technique, such as, laparoscopy are made more elderly patients are offered various types of treatment for rectal cancer.

Efficacy of dextran solutions in vascular surgery.

The purpose of this paper is to discuss the role and efficacy of dextran in vascular procedures using evidence-based data from the review of surgical literature. A medline search using "dextran,'' "vascular surgery,'' and "antiplatelet therapy'' as keywords was performed for English-language articles. Further references were obtained through cross-referencing the bibliography cited in each work.

Colorectal cancer presenting as surgical emergencies.

Colorectal Cancer (CRC) is a major cause of cancer morbidity and mortality. Surgery is considered the first line therapy for CRC, and is generally encountered by many surgeons under elective conditions. Unfortunately, colorectal cancer may present acutely as a surgical emergency.

Surgical treatment of achalasia: current status and controversies.

Objective: To review the current management of achalasia, and the controversies regarding the different treatment options.

Methods: A review of the literature was performed. The key words used were esophageal achalasia, Heller myotomy, endoscopic balloon dilatation, laparoscopic Heller myotomy, and fundoplication.

Assessment and management of the obese patient.

Background: The perioperative care of the clinically severe obese patient presents numerous unique challenges. As an increasing number of people in North America fall into the category of the clinically severe obese, the care of these patients will become increasingly more challenging and prevalent. These patients have unique issues with regards to cardiovascular, pulmonary, and thromboembolic complications.

Do vascular surgery patients need a cardiology work-up? A review of pre-operative cardiac clearance guidelines in vascular surgery.

Objectives: to outline the appropriate pre-operative cardiac work-up for patients who are scheduled for major peripheral vascular surgery.

Design: review of the literature.

Materials And Methods: a review of the literature focusing on studies that have correlated the pre-operative cardiac work-up patients receive to the cardiac morbidity and mortality following vascular surgery.

Incidental gallbladder carcinoma associated with a cholecystoduodenal fistula.

The development of a cholecystoduodenal fistula may complicate 5% of all patients with cholelithiasis. It has been theorized that a cholecystoduodenal fistula may represent a significant risk factor in the development of gallbladder carcinoma because of the chronic reflux of duodenal contents. We report the case of a patient with a cholecystoduodenal fistula and an early gallbladder cancer to support this theory.