Colorectal carcinoma is the major tumor (incidence) in the Italian population, with almost 52,000 diagnoses estimated for 2012: almost 20,000 deaths were recorded for colorectal cancer (of which 55% among men), neoplasm in second place in mortality due to cancer (11% in males, 12% in females) and between second and third place in the various ages of life. the aim of the present study is that through the analysis of the results obtained to seek further indications for the surgical treatment of early neoplasm. Materials and methods: From January 2010 to December 2017 consulted the database of the AOU Polyclinic University of Catania were observed in 37 cases of neoplasm in the seat in the sigma-rectum, the patients selected for this analysis had a mean age of 72 years (range 74-70). on the clinical examination there was blood in the stool accompanied or not by diarrhea and constipation, asthenia, malaise, rapid weight loss and anemia. The surgical technique of the intervention included the removal of the neoplasm and the surrounding tissue that circumscribes it for at least 1 cm.fig (1, 2) the position of the sick gynecologic with more pronounced trendeleburg if the site of the neoplasm was in most cases or posterior or laterally. Results: The neoplasm was located on average between 4 and 10 cm from the anal rhyme, such neoplasm had a max diameter of between 3-5 cm, the macroscopic appearance of the tumors was 70% vegetative and polypoid or pedunculate and sessile for the remaining 30%. the definitive histological examination confirmed the ultrasound diagnosis with a demonstrated sensitivity of 95% .The microscopic investigation showed an extension of the neoplasm limited to the superficial layers of the wall in 11% for T1 tumors and 37% for T2 tumors. In these cases in which this extension was present, relapses occurred after local resection and lymphatic and venous invasion and under mucosa were present on the anatomical piece. Discussion: Local excision is an appropriate method for T1 rectal tumors without high risk characteristics and was performed by trans-anal excision or a trans-anal endoscopic microsurgical approach. the operation included the removal of the neoplasm. In depth the resection involved the mucosa and under mucosa involving the entire posterior and lateral wall until reaching the rectal fat. This radicality was aimed at histological purposes to have histological elements of absence of lymphatic invasion and vascular. . Genetic profiles performed with liquid biopsy to identify specific disease recovery markers still in the study phase provided the first responses identifying specific tumor genetic alterations. Conclusions The local root resection offers the advantages of a surgery without all the complications involved in a major resection. Currently this surgical method is indicated in a limited series of cases, although the percentage of clinical observations of early diagnosis is increasing in cost.
|Titolo:||The radical anal trans excision in the initial neoplasm of the rectum|
GRAZIANO, GIORGIO MARIA PAOLO (Corresponding)
DI CATALDO, Antonio [Membro del Collaboration Group]
GRAZIANO, Antonino [Membro del Collaboration Group]
|Data di pubblicazione:||2018|
|Appare nelle tipologie:||1.1 Articolo in rivista|