Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0028961 (oliguria)
 1,847 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective analysis of the results of treatment of advanced rectal cancer of the pelvis with regional intraarterial infusion of 5-fluorouracil (5-FU) is reported. A special technic for positioning the catheters selectively in the internal iliac arteries justifies this analysis. Four patients with primary inextirpable rectal cancer and 10 patients with locally recurrent rectal cancer have been treated. No immediate mortality was noted. Relief of pain was noted in two-thirds of the patients. An objective tumor response was noted in three patients with locally recurrent disease. In one patient with primary inoperable cancer it was possible to extirpate the tumor after infusion therapy. An improvement in quality of life during the first 2 months after therapy was achieved in half of the patients as judged by their performance. Complications were not serious. Hematomas with infection were seen in one patient, two patients had septicemia, and three patients had transient oliguria. Transient thrombocytopenia was reported in two patients. The results indicate that infusion therapy produces a reasonable response such as palliation of pain. Only minor complications were seen and easily controlled. The advantages of infusion therapy are that it can be given in a reasonable time with only a short hospital stay.
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PMID:Intraarterial infusion chemotherapy (5-fluorouracil) in patients with inextirpable or locally recurrent rectal cancer. 45 69

Anastomotic leakage is the most common major complication after mid-low rectal cancer surgery. Due to lack of knowledge regarding the virtual mechanisms of anastomotic leakage, not much can be done to prevent its development. The aim of the present review was to discuss the prevention, early diagnosis, and treatment of anastomotic leakage after rectal cancer surgery. For patients with risk factors, such as anastomotic site within 4 cm from anus, obese men, lack of blood supply of the anastomotic site, neoadjuvant chemo radiotherapy, or patients with severe co-morbidity, aggressive preventive strategy should be adopted. The effectiveness of diverting stoma, preoperative bowel preparation, and transanal decompression are still in debate. The combination of fluorescence imaging to assess anastomotic perfusion and selective preservation of the left colic artery can be used in the future to prevent anastomotic leakage intraoperatively. With increasing use of neoadjuvant chemo radiotherapy and diverting stoma, more than half of the leaks present in a more subtle and insidious manner, including ileus, diarrhea, anal discharge of pus, mild fever, accelerated heart rate, tachypnea, and oliguria. Surgeons should be more cautious regarding these insidious clinical presentations. Computed tomography scan and endoscopy are among the most important diagnostic workups that can early diagnose leakage and indicate the size of the defect and extent of infection. For patients presenting with diffuse peritonitis, emergency surgical exploration is mandatory along with fluid resuscitation. For those with limited infection, appropriate treatment plan should be made after consideration of the extent of infection, methods to eradicate the infectious source, strategies following adjuvant therapy, and the possibility and necessity of re-establishing bowel continuity.
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PMID:[Early diagnosis and treatment of anastomotic leak after rectal cancer surgery]. 2968 8

Introduction: In 2018, the colon cancer was the 5th type of neoplasia regarding the cancer mortality and the rectal cancer was the 10th. The survival of patients with colorectal cancer operated in emergency still remains unsatisfactory, the death being due to local recurrences and to metastases. The aim of this study is to evaluate some correlations of overall survival with clinic and paraclinic features, tumor or treatment characteristics in order to identify prognostic factors, for cases with colorectal tumors that underwent emergency surgery. Material and Methods: We performed a retrospective analysis on 431 patients with colorectal cancer operated in emergency between 2008-2017, excluding 40 patients with postoperative deaths, with a follow-up period of at least one year. There were correlations of some clinic and paraclinic features, tumor or treatment characteristics with the overall survival. Results: In the univariate statistical survival analysis, a statistically significant association was obtained with: the age 61 years (p_value = 0.000049), abdominal surgical history (p_value = 0.031725), heart disease (p_value = 0.000007), atrial fibrillation (p_value = 0.007496), preoperative diagnosis (p_value = 0.034352), cachexia (p_value = 0.000000), oliguria (p_value = 0.000000), anemia (p_value = 0.000006) hydro-electrolytic disorders (p_value = 0.000001), tumor localization (p_value = 0.000030), invasion into other organs (p_value = 0.000000), appearance of "frozen pelvis" (p_value = 0.000000), peritoneal carcinomatosis (p_value = 0.000000), liver metastases (p_value = 0.000000), type of surgery (p_value = 0.000000), lymph node dissection (p_value = 0.000001), liver biopsy (p_value = 0.043483), stoma reversal (p_value = 0.000000 ), serial interventions (p_value = 0.000000), pTNM (p_value = 0.000000), tumor grading (p_value = 0.007069). The Cox multivariate regression analysis revealed that: the age 61 years - HR = 1,026, 95% CI (1,012, 1,039) (p value = 0.000139), cachexia - HR = 1,358, 95% CI (1,046, 1,764) (p value = 0.021617), peritoneal carcinomatosis - HR = 2.346, 95% CI (1.163, 4.732) (p_value = 0.017253), disease stage - HR = 36.745, 95% CI (14.778, 91.366) (p_ value = 0.000000), intervention type - HR = 0.187, 95% CI (0.045, 0.779) (p_ value = 0.021281) and serial interventions - HR = 0.282, 95% CI (0.144.0.551) (p_ value = 000213) are independent prognostic factors. Conclusions: The prognostic factors for patients with colorectal cancers operated in emergency are: the age 61, the presence of abdominal surgical history and associated cardiac conditions, especially atrial fibrillation, diagnosis of diastatic perforation imminence, cachexia, oliguria, hydro-electrolytic disorders at admission, rectal tumors, tumor invasion in other organs, the appearance of "frozen pelvis", the presence of liver metastases or peritoneal carcinomatosis, undifferentiated tumors, stage IV, practicing an internal derivation or not performing lymph node dissection. The age over 61, cachexia, as well as peritoneal carcinomatosis, stage III or IV are independent risk factors the Hartmann procedure and the serial interventions are independent protective factors.
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PMID:Analysis of Prognostic Factors in Complicated Colorectal Cancer Operated in Emergency. 3215 97