Background: Although awareness via cancer screenings and the knowledge of therapy modalities has increased, the burden of colorectal cancer (CRC) is much more pronounced in developing countries. Objective: This study was aimed to estimate serum carcinoembryonic antigen (CEA) levels in preoperative CRC patients and to determine the associations between serum CEA levels and tumor node metastasis (TNM) stage. Patients and methods: This cross-sectional study included 36 patients with CRC (stages IV) attending at Department of General Surgery, Zagazig University Hospitals. Patients scheduled preoperatively for sigmoidoscopy were prepared by an enema and examined by using standard video endoscopes. The CEA levels were estimated preoperatively for all patients. Results: CEA level among the studied cases ranged from 0 to 23 ng/dl with mean 6.39 ng/dl and median 4.5ng/ml. Also 58.3% had CEA level ≤ 5 ng/ml. There were no statistical significance relations between the CEA and age or sex distribution. But there was a statistical significance increase in frequency of smoking among cases had CEA level >5 ng/ml. There was no statistical significance relation between site and diameter of lesions and CEA level among the studied cases. Conclusions: It could be concluded that there is a meaningful link between TNM stage and CEA level. However, normal levels of CEA will not rule out CRC diagnosis, and these patients should be investigated in detail.
Background: Sentinel lymph node biopsy (SLNB) has become the standard method for axillary staging of breast cancer with reliable accuracy and less morbidity compared with axillary lymph node dissection (ALND) aiming to minimize the rate of patients with negative axillary status who undergo ALND and restricted only to patients with positive axillary lymph node. Objective: To compare the results of SLN dissection only and that of ALN dissection regarding the morbidity and locoregional recurrence. Patients and methods: A hundred patients with histologically confirmed invasive breast cancer T1/T2N0M0 and SLN positive for metastases (≤3 SLNs) were entered the study and divided randomly into two groups. Group I: Fifty (50) patients underwent SLN dissection only. Group II: Fifty (50) patients underwent SLN dissection and ALN dissection. Exclusion criteria: Patients with >3 positive SLNs, patients with matted nodes, patients with gross extranodal disease and patients received neoadjuvant hormonal therapy or chemotherapy. Statistical analysis: SPSS version 15. Results: Adverse surgical effects were reported in both groups. In SLND group (6%) had seroma while in ALND group (16%) had seroma, wound infection was (4%) in SLND and (8%) in ALND, postoperative parasthesia after 1 year was (16%) in SLND and (44%) in ALND, postoperative lymphoedema after 1 year was (4%) in SLND and (10%) in ALND and axillary recurrence was (2%) in SLND and no recurrence in ALND. Conclusion: SLND mapping and excision is the standard of care for axillary staging for patients with early invasive breast cancer and clinically node-negative disease.
Background: Gastric cancer is the fourth most common cancer worldwide. Laparoscopic Gastrectomy is technically demanding surgery and its adequacy for lymph node clearance is controversial. The present work aims to evaluate feasibility and effectiveness of the laparoscopic method in treating gastric cancer. Methods: A total sample of 15 patients presenting with non-metastatic cancer stomach were included in the study. Ages less than 15 years or older than 70 were excluded. Laparoscopic total gastrectomy and esophagojejunostomy was performed for proximal types of cancer, while laparoscopic subtotal gastrectomy with gastrojejunostomy and entero-enterostomy was done for distal stomach cancer. Results: Mean age was 55.87+7.37 with male predominance (80%) and 26.7% were diabetics. Distal stomach cancer was the most prevalent type (73.3%). Total gastrectomy was done in 3 patients, subtotal gastrectomy in 11 patients, partial gastrectomy in 1 patient of Gist tumor. The mean operative time was 251.87+24.14 while average blood loss ranged from 150 to 310ml. Chest infection occurred in 2 patients, while wound infection and anastomotic leakage occurred in 1 patient each. Surgical margins were clear in 100% of patients (14.8+2.42 lymph node dissected). Adenocarcinoma was the commonest pathological type (60%). Mean hospital stay was 6.53 days while time to start oral feeding ranged from 2 to 5 days.
Conclusion:Total laparoscopic gastrectomy is safe and effective, and offers some advantages as low intra-operative blood loss and overall complication rates; few wound-related complications; quick recovery of gastrointestinal motility and a short hospital stay, but with a long operating time.
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