Search

SummaryA prospective randomized study was launched to compare local resection using transanal endoscopic microsurgery (TEM) with anterior resection for early rectal carcinomas (uT1 Negative low risk) and with peranal submucosal excision for sessile adenomas. Randomized distribution to the operative techniques was used after endoluminal ultrasound staging. The procedures followed were transanal endoscopic microsurgery, deep anterior resection (AR) and peranal submucosal excision (PSE). Patients in the study were: with T1 -carcinoma, n = 25 (TEM-CA) vs n = 28 (AR) and with adenomas, n = 98 (TEM-AD) vs n = 90 (PSE). There was no significant difference in age and sex and intraluminal distribution of rectal cancer between the groups. Blood loss, operation time, hospitalization, analgetic demand, early and late morbidity, mortality, recurrence, 5-year survival rate (for carcinomas) were evaluated. Surgery was performed under general anaesthesia. Significant differences of TEM-CA to AR were found for blood loss,...

Purpose: To compare the performance of virtual and conventional colonoscopy for the detection of colorectal polyps using a multislice spiral CT scanner (MSCT). Materials and Methods: 48 patients (20 women, 28 men, mean age 61.5 5 years) with clinical indication for conventional colonoscopy were prospectively studied using a MSCT (Somatom Volume Zoom, Siemens, Forchheim). Examination was performed after standard oral preparation for colonoscopy and colonic distension with room air and i.v. butylscopolamin. Images were obtained in prone and supine position using a detector configuration of 4 × 1 mm, a table feed of 5 mm/rotation at 140 mAs and 120 kV. Slice thickness and reconstruction increment were 3 and 1.5 mm, respectively. CT data were assessed by two blinded radiologists on a Vitrea workstation (Vital Images, USA) using a software with multiplanar and volume-rendering capabilities. Results: 33 patients had normal findings on conventional colonoscopy. In 15 patients a total of 30 polyps and one carcinoma with stenosis were identified. MSCT-colonography identified the carcinoma and 23 polyps (77%). 3 of 3 polyps were 10 mm or more (100%), 6 of 7 were 5.1 to 9.9 mm (86%) and 14 of 20 were 5 mm or smaller (70%). There were 13 false positive findings for polyps (10 lesions < 6 mm in 5 patients) and no false positive finding of carcinoma. Conclusions: MSCT colonography allows accurate detection of polyps larger than 10 mm. Compared to published results of single-slice CT, multislice CT colonography increases the rate of detection of small colorectal polyps in particular. However, false positive results still remain a problem.

Wegener's granulomatosis is a vasculitis which commonly presents with symptoms referable to the upper airway system, lungs, joints, eyes and kidneys. We present a case in which colitis combined with sinusitis could retrospectively be attributed as the initial manifestations of Wegener's disease.