Urological sequelae of desmoids associated with familial adenomatous polyposis

AbstractThe aim of this retrospective cohort study was to review urological complication rates arising from familial adenomatous polyposis associated desmoid tumours and their management. All patients over a 35-year period were identified from a prospectively maintained polyposis registry database and had an intra-abdominal desmoid tumour. Those without ureteric complications (n  = 118, group A) were compared to those that developed ureteric obstruction (n = 40, group B) for demographics, treatment interventions and survival outcomes. 158 (56% female) patients were identified. Median age at diagnosis was 31 years and desmoids typically occurred 3.6 years after col ectomy for familial adenomatous polyposis. Ureteric obstruction secondary to tumour growth occurred in 25% of cases. There was no significant difference in gender distribution or overall age at desmoid diagnosis between the two groups. In group B, the median age at desmoid diagnosis was significantl y younger in women compared to men (25 and 43 years, respectively) (p = 0.01). Thirty-eight percent of patients already had ureteric obstruction at desmoid diagnosis, the remainder occurred after 48.6 months, but 20 years in two cases. Seventy-three percent (29/40) had ureteric stenting, a long -term requirement for most. Permanent renal injury occurred in six cases but survival between the two groups was not significantly different. Ureteric obstruction occurs fre...
Source: Familial Cancer - Category: Cancer & Oncology Source Type: research

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The use of robotic surgery for common operations, such as colectomy, but also for even simple procedures, such as inguinal and ventral hernia surgery, is increasing rapidly. In 2012, a trial randomized patients with right ‐sided colonic cancer to receive robot-assisted colectomy or laparoscopically assisted colectomy. Of 70 randomized patients, hospital stay, surgical complications, resection-margin clearance, and the number of lymph nodes harvested were similar in both groups. The duration of surgery was longer in the robotic group, and overall hospital costs were also significantly higher.
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
ConclusionsMore extended resections seem not to confer an increase of the overall survival rate.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
ConclusionsRobotic NOSES for colorectal cancer is safe and feasible. However, its long-term outcomes needs further investigation.Legal entity responsible for the studyXu Jianmin, Colorectal Surgery Department, Zhongshan Hospital, Fudan University.FundingHas not received any funding.DisclosureAll authors have declared no conflicts of interest.
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
ConclusionEven though the management of patients having a LVAD is challenging and needs a multidisciplinary approach, reported literatures have shown the safety and feasibility of laparoscopic interventions for colorectal surgeries.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
Jarek Kobiela, Emilio Bertani, Wanda Petz, Cristiano Crosta, Giuseppe De Roberto, Simona Borin, Dario Ribero, Diana Baldassari, Piotr Spychalski, Giuseppe SpinoglioJournal of Minimal Access Surgery 2019 15(4):357-359In robotic right hemicolectomy for colorectal cancer (CRC), appropriate lymphadenectomy and anastomotic leak prevention are critical. Visualisation of lymph nodes and blood flow with near-infrared (NIR) fluorescence DaVinci® imaging system is a recent development. Herein, we present an improved robotic modified complete mesocolic excision (mCME) technique using indocyanine green (ICG) fluorescence. Before ...
Source: Journal of Minimal Access Surgery - Category: Surgery Authors: Source Type: research
Abstract As the use of immune checkpoint inhibitors for several different malignancies becomes more mainstream, their side-effect profile raises new challenges. In 2011, the Food and Drug Administration approved the first checkpoint inhibitor for the treatment of advanced melanoma, and since then, checkpoint inhibitors have demonstrated efficacy in many other tumor types. Given the frequent use of immune checkpoint inhibitors in a wide range of cancers today, the diagnosis and management of their immune-mediated toxicities need special attention. One of the most common is immune-mediated colitis. Workup and manage...
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Oncologist Source Type: research
Although accumulated epidemiological evidence indicates that a good physical fitness level may prevent the development of sporadic colorectal cancer (CRC), few studies have examined the effect of physical fitness level on familial adenomatous polyposis (FAP). This cross-sectional study aimed to examine the relationship between physical fitness and CRC development in patients with FAP. A total of 119 patients (54 male; 65 female) with FAP, aged 17 to 73 years, underwent a step test to induce exercise stress. Predicted maximal oxygen uptake (VO2max) was calculated for each patient by using heart rate as an index of physical...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
CONCLUSIONS: Because of the association between FAP or colon cancer with multifocal CMV-PTC, we confirm that an analysis of APC gene mutation and colonoscopy should be carried-out in these patients when multiple thyroid tumors are found. PMID: 31469036 [PubMed - as supplied by publisher]
Source: Thyroid : official journal of the American Thyroid Association - Category: Endocrinology Tags: Thyroid Source Type: research
CONCLUSION: The study confirms excellent long-term results of surgical approaches with IRA and IPAA, suggesting that the best surgical choice may be an individually and clinically tailored approach, preferably at a young age. PMID: 31452460 [PubMed - as supplied by publisher]
Source: Tumori - Category: Cancer & Oncology Tags: Tumori Source Type: research
AbstractBackgroundThe aim of this study was to evaluate the feasibility of robotic total/subtotal colectomy procedures with the Xi robot and to compare its short-term outcomes with those of conventional laparoscopy.MethodsBetween October 2010 and September 2018, consecutive patients with colonic neoplasia, inflammatory bowel disease, familial adenomatous polyposis or colonic inertia who underwent elective robotic or laparoscopic total/subtotal abdominal colectomy at two specialized centers in Turkey were included. Data on perioperative characteristics and 30-day outcomes were compared between the two approaches.ResultsTher...
Source: Techniques in Coloproctology - Category: Surgery Source Type: research
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