Search

Objectives: endorectal ultrasound (EUS) is currently accepted as the best technique for the preoperative study of patients with rectal tumors, and surgical decisions depend increasingly on EUS staging. The main pitfalls in staging rectal tumors are over- or understaging as well as errors in imaging lymph nodes. Being aware of such errors and their causes may help to improve the overall results. The aim of the present study was to evaluate the accuracy of EUS in staging rectal neoplasms, and to study potential sources of error., Methods: from May 1996 to December 1998, 120 patients with rectal tumors were studied preoperatively by EUS. The uTNM classification described by Hildebrandt and coworkers was used. The EUS findings were compared prospectively with the results of pathological examination. When there was no correlation, both the specimen and the EUS findings were carefully reviewed to look for potential sources of error., Results: 41 out of 120 patients were classified as uT1, 10 as uT2, 60 as uT3 and 9 out of 120 as uT4. 31 patients had positive lymph nodes (uN1). On comparing these data with the results of the pathological report, we found 90% accuracy in staging rectal wall penetration, and 70% accuracy in the diagnosis of lymph nodes. Errors were due basically to technical problems, characteristics of the tumor itself, and difficulties in staging lymph nodes., Conclusions: it is important to identify the potential source of errors as well as the current limitations of EUS to improve the overall results with this technique.

A case of solitary neurofibroma located in the mid-portion of the esophagus in a 61-year-old woman is reported. She was operated with the diagnosis of benign tumor of the esophagus (leiomyoma). The microscopic examination of the tumor tissue found nervous cells. The immunohistochemistry analysis confirmed neurofibroma.

The authors present a case report of a cholecystostomized high surgical-risk patient with gallstones in gallbladder and biliary duct treated with continuous monoctanoin infusion through a Pezzer's tube. They analyze the biological characters of such substance as solvent agent, its management and the results of treatment.

The objective of this study is to evaluate the response of the subpopulations of lymphocytes and IGs to the administration of total parenteral nutrition for 7 days in 26 patients suffering from malnutrition, 12 of whom had digestive neoplasia and 14 non-neoplastic gastrointestinal disorders. Following the total parenteral nutrition, a significant increase in the percentage of T-helper lymphocytes was noted, and an improvement in the OKT4/OKT8 quotient, as well as in the IgA and the C4 fraction of the complement. The existence of neoplastic conditions did not have a significant effect on the variations in the parameters studied. The presence of lipids in the parenteral nutrition diet did not affect the subpopulations of lymphocytes.