Between 1978 and 1981, 73 patients with colonic or rectal cancer were randomized to have their anastomoses made by either a single interrupted layer of braided polyester sutures, or by a circular stapling instrument. Of these operations, 20 were considered to have been palliative, the remaining 53 being potentially curative. The incidence of local recurrence in the latter group was analyzed in relation to initial septic and anastomotic complications. The 53 patients were followed for a median of 36 months (range, 1 to 87); 24 were alive and well and 22 had died of disseminated cancer or unrelated causes. Seven patients died with local recurrent disease proved at laparotomy or autopsy after a median of 33 months (range, 3 to 72). Thirty anastomoses were stapled and 23 sutured; of the seven patients who died with local recurrent disease, six had stapled anastomoses (Fisher's exact probability F2 = 0.12; log rank chi-square = 3.53, 0.05 less than P less than 0.10). Two patients who died with locally recurrent disease had had clinically apparent anastomotic leaks and one other patient had had a radiologically demonstrated leak. This compares with a total of seven leaks (clinical or radiologic) in the remaining group of 46 patients with no recurrence (Fisher's exact probability F2 = 0.11). These results tend to support the hypothesis that anastomotic leaks may lead to locally recurrent disease, particularly after stapled anastomoses.
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Updates Surg
January 2025
Pancreatic and Endocrine Surgical Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.
The presence of an aberrant right hepatic artery (a-RHA) could influence the oncological and postoperative outcomes after pancreaticoduodenectomy (PD). A comparative study was conducted, including patients who underwent PD with a-RHA or with normal RHA anatomy. The primary endpoints were R1 resection in all margins (pancreatic, anterior, posterior, superior mesenteric artery, and portal groove), overall survival (OS), and disease-free survival (DFS).
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January 2025
S.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China; Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, China; Department of Urology, Medical University of Vienna, Austria, Vienna. Electronic address:
Background And Objective: Bacillus Calmette-Guérin (BCG) reduces disease recurrence and progression in intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC). BCG-associated adverse events during instillations are common, leading to treatment cessation. Prophylactic use of quinolones in conjunction with BCG instillations is one approach for reducing BCG-associated adverse events.
View Article and Find Full Text PDFVet Clin North Am Equine Pract
January 2025
Michigan State University, Large Animal Clinical Sciences, College of Veterinary Medicine, East Lansing, MI, USA. Electronic address:
Horses are particularly susceptible to developing exertional rhabdomyolysis (ER) characterized by muscle stiffness, pain, and reluctance to move. Diagnosis requires establishing abnormal increases in serum creatine kinase activity when horses exhibit clinical signs. The 2 main categories of ER include sporadic ER arising from extrinsic causes and chronic ER that arises from intrinsic continuous or episodic abnormalities in muscle function.
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Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, People's Republic of China.
Background: The prevalence of inflammatory bowel disease (IBD) among Chinese adolescents has continued to increase in recent years. Adolescents with IBD interrupted their schooling due to the diagnosis and treatment of the disease. And when the condition stabilises, they will return to school.
View Article and Find Full Text PDFGastroenterol Clin North Am
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Division of Gastroenterology and Hepatology, Oregon Health & Science University, Portland, OR, USA. Electronic address:
Recurrent acute pancreatitis (RAP) is a complex syndrome that presents variably, with many cases remaining idiopathic after thorough diagnostics. For evaluating structural etiologies, endoscopic ultrasound and MR cholangiopancreatography are preferred over endoscopic retrograde cholangiopancreatography (ERCP) given their more favorable risk profile and sensitivity. The diagnostic work-up remains paramount since treatment should focus on addressing underlying causes such as early cholecystectomy for gallstone pancreatitis.
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