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Query: UMLS:C0699790 (colon cancer)
 28,837 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It is the practice of some gynecologists and general surgeons to preoperatively evaluate the colon with a barium enema (BE) examination to exclude potential intestinal involvement or coexistent disease in patients undergoing pelvic or hernia operations. This practice appears to be based on anecdotal data with few studies specifically evaluating its usefulness. We retrospectively evaluated the records of 190 patients at William Beaumont Army Medical Center during 1986 to 1987 who received a preoperative BE prior to total abdominal hysterectomy (TAH) or inguinal hernia repair (IHR). The tumor registry charts of 59 patients diagnosed with carcinoma of the colon and rectum during the same period were also cross-checked to determine if any were detected during preoperative evaluation for TAH or IHR. BE findings were considered significant if they altered surgical management or asymptomatic carcinoma was detected. Of 86 patients screened before TAH by BE, eight had abnormal findings with subsequent colonoscopy revealing four with adenomatous polyps, one of which required surgical resection. Of 104 patients screened before IHR by BE, 15 had abnormal findings with subsequent colonoscopy revealing five patients with adenomatous polyps and two with adenocarcinoma. Screening preoperative BE had a low yield of clinically significant findings, which was even lower in the subgroup with carcinoma. There was no apparent relationship between findings and age in our study. Our results suggest that the use of routine preoperative BE has a low yield and should be performed only if clinical symptoms or findings suggest a need for this study.
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PMID:The yield of barium enema in patients undergoing inguinal hernia repair or abdominal hysterectomy. 190 94

Cancer in inguinal hernias is rare. The author reports the first case of thymoma metastatic to an inguinal hernia sac (saccular) and the 13th case of colon cancer in an inguinal hernia (intrasaccular); both cases presented clinically as incarcerated hernias.
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PMID:Cancer in inguinal hernias. 235 48

Whether patients over age 40 should have a barium contrast enema (BCE) examination for possible identification of an unsuspected colon carcinoma before elective inguinal herniorrhaphy remains an unanswered question. We reviewed the medical records of all patients over age 40 who had inguinal herniorrhaphy at our institution between January 1980 and December 1984. Of 80 patients, 46 received a preoperative barium enema. One asymptomatic colon carcinoma (2.1%) was discovered. The reported incidence of asymptomatic colon cancer found by BCE in association with inguinal hernia ranges from 0 to 2.5%. We conclude that if there is a cause and effect relationship between asymptomatic colon cancer and inguinal hernia, the mechanism is as yet unknown.
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PMID:Preoperative barium contrast enema in patients with inguinal hernia. 377 59

A review of the literature reveals that inguinal hernias rarely cause colonic obstruction. Three examples of colonic obstruction associated with inguinal hernia are presented. In two of the patients carcinoma of the colon in the hernia sac was responsible for the obstruction, while in the third, the hernia itself was the cause. Careful clinical and radiographic evaluation is recommended in all patients presenting with inguinal hernia and large bowel dilatation to the level of the hernia, to rule out the presence of an obstructing lesion within the hernia.
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PMID:Colonic obstruction within inguinal hernia. 729

In a prospective study we evaluated patients with diagnoses of (1) inguinal hernia (n = 57), (2) gall bladder stones (n = 80), and (3) carcinoma of the colon (n = 76). The whole group included 213 patients who underwent clean, clean-contaminated or contaminated operations. All wound infections and postoperative bacterial infections such as pneumonia or urinary infection, were recorded. The patients were asked for risk factors at the time of hospitalization: 7.1% of all patients admitted an intake of alcohol of more than 60 g/day, and 15.6% of the patients smoked more than 20 cigarettes/day. We found a four times higher risk of postoperative infection for patients with an intake of more than 60 g alcohol/day. The rate of infection for smokers of more than 20 cigarettes/day is twice as high as for non-smokers or persons who smoke fewer than 20 cigarettes/day.
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PMID:[Do nicotine and alcohol abuse effect the occurrence of postoperative bacterial infections?]. 847 96

Colon carcinoma is an unusual tumor during childhood. The authors report a case of metastatic colonic adenocarcinoma diagnosed in a 14-year-old boy during inguinal hernia repair. To the authors' knowledge, this is the first reported case of this rare disease presenting as an inguinal hernia.
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PMID:Colon carcinoma discovered in an adolescent during inguinal hernia repair. 905 5

It has been predicted that minimally invasive therapy will have dramatic consequences for the specialty of general surgery, as demonstrated by the diffusion of laparoscopic cholecystectomy. To investigate the determinants of the diffusion in Denmark of five laparoscopic technologies (cholecystectomy, appendicectomy, surgery for colon cancer, surgery for inguinal hernia and fundoplication), questionnaires on seventeen factors' influence on the adoption (stimulating or impeding) were sent to fifty-nine hospitals. Fifty hospitals (85%) responded. Overall, 98% adopted laparoscopic cholecystectomy in Denmark between 1991 and 1995, whereas the remainder of the technologies were adopted by 7-65% of hospitals performing these operations. Large and specialized hospitals were the earliest adopters. The factors, nature of technology (minimally invasive versus conventional), training (appropriate training courses), competition (between specialties and between hospitals) and media attention have stimulated the diffusion, whereas three budget factors (budget for investment, budget for operation and public regulation) usually had an impeding effect. Stimulating factors prevail for all laparoscopic technologies indicating that some guidance of the adoption and use of new health technologies might be necessary. In Denmark, one of the suggested health policies to secure timely guidance is the establishment of an early warning system.
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PMID:Diffusion of laparoscopic technologies in Denmark. 1018 25

A case of distant metastasis to mesh-plug prosthesis in gastrointestinal cancer is presented herein. An 88-year-old man had received mesh-plug repair with high ligation for a recurrence of a right inguinal hernia. Six months later, advanced gastric cancer and advanced transverse colon cancer were detected, and therefore a distal gastrectomy and partial colectomy were performed. Two weeks after the operation, the patient complained of right groin tenderness, and the mesh-plug prosthesis was removed to control any infection. A histopathological investigation demonstrated adenocarcinoma in the plug prosthesis. The patient died of carcinomatosis peritonei 45 days after the last operation.
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PMID:Distant peritoneal metastasis to a mesh-plug prosthesis in a gastrointestinal cancer patient: report of a case. 1460 60

The use of prosthetic mesh has become the standard of care in the management of hernias because of its association with a low rate of recurrence. However, despite its use, recurrence rates of 1% have been reported in primary inguinal repair and rates as high as 15% with ventral hernia repair. When dealing with difficult recurrent hernias, the two-layer prosthetic repair technique is a good option. In the event of incarcerated or strangulated hernias, however; placement of prosthetic material is controversial due to the increased risk of infection. The same is true when hernia repairs are performed concurrently with potentially contaminated procedures such as cholecystectomy, appendectomy, or colectomy. The purpose of this study is to report our preliminary results on the treatment of recurrent hernias by combining laparoscopic and open techniques to construct a two-layered prosthetic repair using a four ply mesh of porcine small intestine submucosa (Surgisis, Cook Surgical, Bloomington, IN, USA) in a potentially infected field and a combination of polypropylene and ePTFE (Gore-Tex, W.L. Gore and Associates, Flagstaff, AZ, USA) in a clean field. From September 2002 to January 2004, nine patients (three males and six females) underwent laparoscopic and open placement of surgisis mesh in a two layered fashion for either recurrent incisional or inguinal hernias in a contaminated field. A total of eight recurrent hernia repairs were performed (five incisional, three inguinal) and one abdominal wall repair after resection of a metastatic tumor following open colectomy for colon carcinoma. Six procedures were performed in a potentially contaminated field (incarcerated or strangulated bowel within the hernia), two procedures were performed in a contaminated field because of infected polypropylene mesh, and one was in a clean field. Mean patient age was 56.4 years. The average operating time was 156.8 min. Operative findings included seven incarcerated hernias (four incisional and three inguinal), one strangulated inguinal hernia, and one ventral defect after resection of an abdominal wall metastasis for a previous colon cancer resection. In two of the cases, there was an abscess of a previously placed polypropylene mesh. All procedures were completed with two layers of mesh (eight cases with surgisis and one with combination of polypropylene/ePTFE). Median follow up was 10 months. Complications included two seromas, one urinary tract infection, two cases of atelectasis and one prolonged ileus. There were no wound infections. The average postoperative length of stay was 7.8 days. There have been no mesh-related complications or recurrent hernias in our early postoperative follow-up period. The use of a new prosthetic device in infected or potentially infected fields, and the two-layered approach shows promising results. This is encouraging and provides an alternative approach for the management of difficult, recurrent hernias.
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PMID:Preliminary results of a two-layered prosthetic repair for recurrent inguinal and ventral hernias combining open and laparoscopic techniques. 1660 18

Acute appendicitis in a hernia sac occurs exceptionally. An 80-year-old male patient underwent emergency surgery for an incarcerated right inguinal hernia found to contain a gangrenous appendix. His brief improvement after an emergency herniotomy with appendectomy was followed by intestinal obstruction caused by advanced colon cancer. The unique features and individualized management of the four published types of Amyand hernia are reviewed. Rather than simply being an anatomical curiosity, Amyand hernias require individualized attention to decide how to manage both the appendix and the hernia. Clinical scrutiny, a high index of suspicion for surgical comorbidities, and a common sense approach may improve outcomes.
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PMID:Amyand hernia: what lies beneath--a proposed classification scheme to determine management. 1818 92


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