Low acyl-CoA synthetase 5 expression in colorectal carcinomas is prognostic for early tumour recurrence.

It has been shown that the metabolism of long chain fatty acids is involved in colorectal carcinogenesis. Acyl-CoA synthetases (ACSL) activate free fatty acids by synthesis of acyl-CoA thioesters. ACSL isoform 5 (ACSL5) is involved in enterocytic differentiation and maturation by regulating both pro-apoptotic and anti-proliferative effects.

Coincidence of active Crohn's disease and florid endometriosis in the terminal ileum: a case report.

Crohn's disease (CD), a variant of chronic inflammatory bowel disease, frequently affects the terminal ileum and coecal region. The clinical symptoms are often subtle and depend on the inflammatory activity of disease. In women of child-bearing age, florid intestinal endometriosis can simulate CD.

[Recurrent micro-satellite stable colonic cancer: prolonged survival of 16 years without adjuvant therapy].

Long-term survival in malignant disease is often linked to intensified therapeutic interventions. We report the case of a colonic cancer in a 78 years old female patient, who underwent her first operation in 1987 for a symptomatic T4 carcinoma. Since then, the patient has always denied any form of follow-up examination and adjuvant therapy.

[In vivo ICG fluorescence photometry for quantification of warm ischemia damage of to the liver in a rat model].

The clearance of indocyanine green (ICG) from the peripheral blood has been used for the study of hepatic function in clinical and experimental investigations. We describe a method of simultaneous, semiquantitative measurement of the kinetics of ICG in the peripheral blood, liver, kidney and bile system following intraoperative bolus injection. The method is based on the fluorescence of ICG in the near infrared spectrum.

[Update on incisional hernia. Parastomal hernia].

Parastomal herniation is a frequent complication when an artificial anus is constructed. As a tunnel through the abdominal wall is nonphysiological, there is an inherent trend to enlargement of the aperture with any artificial stoma. However, none of the technical modifications tried has proved reliable in reducing the incidence of parastomal herniation.

[Sigmoid diverticulitis. Extent of resection and choice of procedure].

Diverticular disease of the colon ranks in prevalence equal to diabetes or coronary heart disease. Surgical treatment of colonic diverticulitis is in general very successful. Therapeutic options have broadened in recent years: while improved diagnostic modalities allow a pre-surgical containment of the disease process by percutaneous techniques, minimally-invasive surgical procedures can replace conventional surgery in many cases without a change in the risk of complications.

[Outcome quality in oncological surgery].

The term "quality" is a new buzzword used in connection with diagnostic and therapeutic activities. In the context of surgery, the term is usually restricted to the subdivision "quality of results." The specific circumstances surrounding a patient threatened by a malignant tumor justify separate consideration of oncologic surgery.

Childbirth and incontinence: a prospective study on anal sphincter morphology and function before and early after vaginal delivery.

Purpose: Disturbance of anal continence is a well-known problem after vaginal delivery. However, only few and incongruent data on the incidence and pathogenesis of postpartum incontinence are available. This study examined the effects of vaginal delivery on anal continence prospectively.

Recurrent inguinal hernia: disease of the collagen matrix?

The aim of this study was to investigate the collagen matrix in recurrent inguinal hernias. Total ribonucleic acid (RNA) was extracted from skin fibroblasts of three groups (control group I = healthy skin; control group II = plain skin scar; recurrent inguinal hernia group = skin of recurrent inguinal hernias; each n = 5). Reverse transcription-polymerase chain reaction (RT-PCR) and Northern blot analysis were used to investigate the expression of procollagen type I/- III, MMP-1, and MMP-13 mRNAs.

[Tumor surgery and quality of life--reconstructive rectal surgery].

Numerous innovations in recent years have allowed a variable therapeutic approach for rectal cancer with a concomitant drastic reduction in extirpations. This development was paralleled by an increasing research into postoperative quality of life in colorectal cancer. This showed that a very ambitious preservation of the sphincter does not automatically lead to good quality of life.

Collagen distribution and expression of matrix metalloproteinases 1 and 13 in patients with anastomotic leakage after large-bowel surgery.

Purpose: Despite improved surgical techniques, anastomotic leakage is still a serious complication in colorectal surgery, resulting in increased morbidity and mortality. Based on recent studies showing a disturbance of the collagen synthesis in hernia patients, this pilot study was designed to find out whether there are any hints of disorders concerning the collagen metabolism in patients developing anastomotic leakage after colonic surgery.

Methods: Ten samples of colonic tissue from patients who developed anastomotic dehiscence after surgery for colonic cancer were compared with 14 specimens from patients with uncomplicated anastomotic healing.

Functional impairment and complaints following incisional hernia repair with different polypropylene meshes.

The influence of mesh material on the clinical outcome of hernia repair has often been neglected, although recent studies have clearly demonstrated the importance of mesh properties for integration in the abdominal wall. Of particular significance are the amount of mesh material and the pore size. In the following study, patients received different mesh types with distinct amounts of polypropylene and of various pore sizes for incisional hernia repair.

[Role of surgical biliary bypass for palliation of pancreatic cancer - a retrospective study of 107 cases].

Unlabelled: BACKGROUNDS AND STUDY AIMS: At the time of diagnosis most patients with pancreatic cancer are still irresectable for cure. The aim of this study was to evaluate surgical palliation, in particular against the background of endoscopic stent placement.

Patients And Methods: This retrospective study analyses the therapeutic results in 107 patients with an irresectable pancreatic carcinoma operated on between 1990 and 1998.

Increased distribution of collagen type III and reduced expression of matrix metalloproteinase 1 in patients with diverticular disease.

Diverticular disease is an increasingly common clinical problem especially in Western industrialized countries, but the mechanism by which the disease develops remains unclear. Based on studies showing a structural change in the colonic wall in these patients, we examined whether there are any disorders concerning the collagen metabolism in patients with diverticular disease. Samples of colonic tissue from 13 patients with diverticulitis were compared to 14 controls.

Limited value of positron emission tomography in treatment of pancreatic cancer: surgeon's view.

We aimed to assess, from a surgical point of view, the value of positron emission tomography (PET) in the routine preoperative diagnostic evaluation of a pancreatic mass. In particular, we were interested in PET's ability to distinguish a malignancy from a nonmalignant process and its impact on surgical decision making. We documented prospectively the results of preoperative ultrasonography, computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP), and PET in terms of a correct diagnosis of malignancy in 103 patients.

Comparison of colonic J-pouch reconstruction and straight coloanal anastomosis after intersphincteric rectal resection.

The tendency towards sphincter-preserving resection for distal rectal cancers has led to the technique of straight coloanal anastomosis (CAA) and colonic J-pouch anal anastomosis (CPA) after low anterior resection. The aim of the present study was to compare complication rate, anorectal physiology and functional results after both types of reconstruction after ultra-low intersphincteric resection. A total of 31 patients who had undergone CPA were followed up prospectively using anorectal manometry and a standardised questionnaire and were compared with 63 patients who had undergone CAA and were followed up in the same way.

[Evidence-based surgery of rectal carcinoma].

The surgery of rectal cancer has seen significant development in recent years. When there is a multitude of therapeutic options available, it is essential to identify what can be considered a proven standard or, at least, what has to be included in planning a surgical treatment. Therefore, at this point of time a distal resection margin of 2 cm, total mesorectal excision, en-bloc resection of adherent structures, colonic pouch reconstruction after very deep resections and limitation of local excision to T1/G1 tumors have to be regarded as standards of the surgical strategy.

Pancreatoblastoma: ultrastructural and image DNA cytometric analysis.

Background: Since the first description of a pancreatoblastoma as a malignant pancreatic tumour of childhood in 1957, approximately 60 cases have been reported. We present the symptoms, pathology, and therapy of this rare tumour in a 17-year-old girl.

Case Report: The patient initially presented with upper gastro-intestinal bleeding.

[Risk factors for anastomosis dehiscence after very deep colorectal and coloanal anastomosis].

Introduction: Very low colorectal anastomoses are considered to be more prone to complications than other anastomoses. We aimed to analyze possible risk factors for the surgically most relevant complication, anastomotic leakage.

Methods: Uni- and multivariate analysis of the relation between leakage and 18 patient- and procedure-dependent variables were performed in 98 patients after very low colorectal or coloanal anastomosis.

Vascular organization in the mesorectum: angiography of rectal resection specimens.

The technical advances in rectal cancer surgery are known as the total mesorectal excision. The resection in an anatomically defined plane under direct vision and with sharp dissection distinguishes it conventional rectal surgery. The result must be a complete mesorectum without deep gouges.

The repair of large parastomal hernias using a midline approach and a prosthetic mesh in the sublay position.

Parastomal herniation is a very frequent complication in enterostomy. The therapeutic strategy consists of three approaches: local fascial repair, relocation of the stoma, and a variety of more elaborate procedures, many of which also involve the use of nonabsorbable meshes. Despite this multitude of available techniques, recurrence rates are high, and long-term complications, especially after mesh implantation, are frequent.

[Primary liposarcoma of the stomach wall--a rare mesenchymal tumor].

Introduction: Primary liposarcoma of the stomach wall is rare. Only eight cases have been described so far.

Material And Method: Here we report the ninth case, occurring in a 74-year-old woman who presented with weight loss and a therapy-resistant ulcer of the stomach wall.

[Multiorgan surgery in rectal cancer--extended therapy or improvement of prognosis?].

About 10% of rectal cancers have to be treated by a multivisceral resection. Within a period of 14 years we performed 103 of these operations, 60 for primary cancers, 43 for recurrent cancers with a significant increase in the latter. The total or partial removal of 204 extra-rectal organs allowed for a R0 resection in 67% of cases.