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Recommendations of Association of Polish Surgeons and Polish Society of Oncological Surgery Gastrointestinal Fistulae in Patients Treated for Malignancy - Diagnostics and Treatment

100%

Szawłowski A., Pertkiewicz M., Drews M., Dziki A., Krasnodębski I., Kulig J., Lampe P., Stojcev Z., Wallner G., Zegarski W.

Polish Journal of Surgery

2008

vol. 80

issue 12

694-711

Postoperative gastrointestinal fistulae occur more often in patients undergoing surgical treatment for oncological reasons than non-oncological reasons. Fistula is associated with a number of serious sequelae and complications: fluid and electrolyte abnormalities, acid-base abnormalities, local and systemic infection and progressive cachexia that increase morbidity, treatment duration and mortality. Development of fistula additionally delays or prevents specific treatment in oncology. For a patient, a fistula is associated with both physical and mental suffering resulting from concern over further therapy.Although the introduction of advanced surgical techniques, intensive postoperative care, total parenteral nutrition and modern enteral nutrition, resulted in decreased postoperative mortality, however the number of patients with gastrointestinal fistulae hospitalized in the departments of surgery is not decreasing. This may result from the fact that many patients still present for treatment in the advanced phase of their malignancy (clinical stage III/IV according to International Union Against Cancer - UICC) and consequently in worse general status, which poses a high risk of postoperative complications and requires more extensive procedures in progressively older patients. Thus gastrointestinal fistulae still remain a serious clinical problem. Main components of treatment of fistulae include: adequate draining, fighting of infections, artificial nutrition and drugs that decrease gastrointestinal secretion (e.g. somatostatin) that are intended to create conditions for spontaneous fistula healing. Some cases may require an early or late surgical intervention.

Charakterystyka rakowiaków w materiale Katedry i Zakładu Patomorfologii w Zabrzu SUM w Katowicach

63%

Smędowski A., Leopold A., Stęplewska K.

Annales Academiae Medicae Silesiensis

2009

vol. 63

issue 4

46-52

INTRODUCTION Argentaffi noma (Carcinoid) is neuroendocrine neoplasm being able to develop in diff erent organs of the body. The morbidity rate is taking out about 1 - 2 cases to 100 000 persons per year. MATERIAL AND METHODS The aim of this study was to describe characteristic features of carcinoids’ group diagnosed in Institute of Pathomorphology in Zabrze. This research was based on analysis of 61 histopatological slides. In preparations a type of carcinoids were being assessed. RESULTS • 61 cases were analysed (43 from women, 18 from men) • In the examination there were recognised 34 typical and 16 atypical carcinoids of bronchi and 9 invasive and 1 noninvasive carcinoid within the scope of the digestive system • The medium age of patients amounted to 52.5 ± 13.6 • In studied cases a relation is appearing between the type of the carcinoid and the location and with presence of metastases and also the location and the district blood count CONCLUSIONS Carcinoid is a rarely recognised type of neoplasm. Histologic type, location in the body and the age and sex of the patient determine the clinic features of this neoplasm.

WSTĘP Rakowiak (carcinoid) jest nowotworem neuroendokrynnym rozwijającym się w różnych narządach organizmu. Zachorowalność na rakowiaka wynosi około 1-2 przypadki na 100 000 osób na rok. MATERIAŁ I METODY Celem pracy była charakterystyka grupy rakowiaków, rozpoznanych w Katedrze i Zakładzie Patomorfologii SUM w Zabrzu w latach 1993- 2008, pod względem podtypów histopatologicznych. W przygotowaniu pracy wykorzystano analizę preparatów histopatologicznych, oceniając typ rakowiaków. WYNIKI • Przeanalizowano 61 przypadków rakowiaków • Średni wiek pacjentów wynosił 52,5 ± 13,6 (43 kobiety, 18 mężczyzn) • W badaniu histopatologicznym rozpoznano 34 typowe i 16 atypowych rakowiaków oskrzeli oraz 9 inwazyjnych i 1 nieinwazyjny rakowiak w zakresie układu pokarmowego • W badanych przypadkach występuje zależność pomiędzy typem rakowiaka a lokalizacją oraz zdolnością do dawania przerzutów, jak również pomiędzy lokalizacją a parametrami morfologii krwi obwodowej WNIOSKI Rakowiak jest rzadko rozpoznawanym typem nowotworu. Typ histologiczny, lokalizacja w organizmie oraz wiek i płeć pacjenta determinują klinikę tego nowotworu.

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1 Annales Academiae Medicae Silesiensis

1 Polish Journal of Surgery

1 2009

1 2008

1 Drews M.

1 Dziki A.

1 Krasnodębski I.

1 Kulig J.

1 Lampe P.

1 Leopold A.

1 Pertkiewicz M.

1 Smędowski A.

1 Stojcev Z.

1 Stęplewska K.

1 Szawłowski A.

1 Wallner G.

1 Zegarski W.

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Recommendations of Association of Polish Surgeons and Polish Society of Oncological Surgery Gastrointestinal Fistulae in Patients Treated for Malignancy - Diagnostics and Treatment

Charakterystyka rakowiaków w materiale Katedry i Zakładu Patomorfologii w Zabrzu SUM w Katowicach