http://library.um.ac.id/free-contents/downloadpdf.php/buku/focus-groups-as-qualitative-research-by-morgan-david-l-11476.pdf

Focus groups as qualitative research / by Morgan, David L.

Background Oncologic resection techniques affect outcome for colon cancer and rectal cancer, but standardized guidelines have not been adopted. The National Cancer Institute sponsored a panel of experts to systematically review current literature and to draft guidelines that provide uniform definitions, principles, and practices. Methods Methods were similar to those described by the American Society of Clinical Oncology in developing practice guidelines. Experts representing oncology and surgery met to review current literature on oncologic resection techniques for level of evidence (I-V, where I is the best evidence and V is the least compelling) and grade of recommendation (A-D, where A is based on the best evidence and D is based on the weakest evidence). Initial guidelines were drafted, reviewed, and accepted by consensus. Results For the following seven factors, the level of evidence was II, III, or IV, and the findings were generally consistent (grade B): anatomic definition of colon versus rectum, tumor-node-metastasis staging, radial margins, adjuvant R0 stage, inadvertent rectal perforation, distal and proximal rectal margins, and en bloc resection of adherent tumors. For another seven factors, the level of evidence was II, III, or IV, but findings were inconsistent (grade C): laparoscopic colectomy; colon lymphadenectomy; level of proximal vessel ligation, mesorectal excision, and extended lateral pelvic lymph node dissection (all three for rectal cancer); no-touch technique; and bowel washout. For the other four factors, there was little or no systematic empirical evidence (grade D): abdominal exploration, oophorectomy, extent of colon resection, and total length of rectum resected. Conclusions The panel reports surgical guidelines and definitions based on the best available evidence. The availability of more standardized information in the future should allow for more grade A recommendations.

Guidelines 2000 for Colon and Rectal Cancer Surgery

Background Laparoscopic resection of colorectal cancer is widely used. However, robust evidence to conclude that laparoscopic surgery and open surgery have similar outcomes in rectal cancer is lacking. A trial was designed to compare 3-year rates of cancer recurrence in the pelvic or perineal area (locoregional recurrence) and survival after laparoscopic and open resection of rectal cancer. Methods In this international trial conducted in 30 hospitals, we randomly assigned patients with a solitary adenocarcinoma of the rectum within 15 cm of the anal verge, not invading adjacent tissues, and without distant metastases to undergo either laparoscopic or open surgery in a 2:1 ratio. The primary end point was locoregional recurrence 3 years after the index surgery. Secondary end points included disease-free and overall survival. Results A total of 1044 patients were included (699 in the laparoscopic-surgery group and 345 in the open-surgery group). At 3 years, the locoregional recurrence rate was 5.0% in the ...

https://www.nejm.org/doi/pdf/10.1056/NEJMoa1414882

A Randomized Trial of Laparoscopic versus Open Surgery for Rectal Cancer

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Problem-Based Learning: An Approach to Medical Education

The generation of reactive oxygen radicals in mammalian cells profoundly affects numerous critical cellular functions, and the absence of efficient cellular detoxification mechanisms which remove these radicals can result in several human diseases. Growing evidence suggests that reactive oxygen species (ROS) within cells act as second messengers in intracellular signaling cascades which induce and maintain the oncogenic phenotype of cancer cells. ROS are tumorigenic by virtue of their ability to increase cell proliferation, survival, cellular migration, and also by inducing DNA damage leading to genetic lesions that initiate tumorigenicity and sustain subsequent tumor progression. However, it is also known that ROS can induce cellular senescence and cell death and can therefore function as anti-tumorigenic agents. Therefore, the mechanisms by which cells respond to reactive oxygen species depends on the molecular background of cell and tissues, the location of ROS production and the concentration of individual ROS species. Carcinoma cells produce ROS at elevated rates in vitro, and in vivo many tumors appear persistent to oxidative stress. Thus, the finding that a diet rich in antioxidants or the elimination of ROS by antioxidant compounds prevents the development of certain cancers provided the setting for subsequent investigation of the tumorigenic actions of reactive oxygen species. This review outlines the current knowledge on the various roles of ROS in tumor development and progression.

Reactive oxygen species in tumor progression.

• The records of 100 consecutive cases of hydatid disease of the liver that were treated surgically were reviewed to determine the complications and the results of different surgical procedures applied. Of those, 74% had single cyst and in 70% the disease was confined to the right lobe of the liver. Marsupialization and omentoplasty were the most commonly used techniques, followed by cystectomy, tube drainage, and cystojejunostomy. Infection in the remaining cavity was the most common postoperative complication. The complication rates were higher in marsupialization and tube drainage when compared with omentoplasty and cystectomy. Omentoplasty and cystectomy led to a shorter hospitalization period. All of the patients who underwent omentoplasty or cystectomy had good results whereas only 28.1% of those on whom marsupialization was done and 27.3% of the patients who underwent tube drainage had good results. The overall mortality was 3%. (Arch Surg115:847-850, 1980)

Surgical treatment of hydatid disease of the liver.

PURPOSE: To evaluate the long-term effectiveness of percutaneous treatment of liver hydatid cysts. MATERIALS AND METHODS: Thirty-one patients (19 female patients and 12 male patients; age range, 8-78 years; mean age, 41 years) with 57 liver hydatid cysts underwent percutaneous treatment. The cysts were treated with hypertonic saline (15% NaCl) and/or absolute alcohol. Sonographic and/or fluoroscopic guidance was used. RESULTS: Repeated sonography revealed a gradual decrease in cyst size. Volume reduction was 18%-99% (mean, 83%). With the disappearance of the fluid component, pseudotumor appearance occurred. In all treated cases, the cyst wall became irregular and thicker during follow-up. No mortality occurred. No abdominal dissemination was encountered during follow-up. Major complications were infection of the cavity, hypersensitivity reaction, and development of biliary fistula. One cyst recurred 11 months after primary drainage. CONCLUSION: Long-term results indicate that percutaneous treatment of liv...

Liver hydatid disease: long-term results of percutaneous treatment.

Le kyste hydatique du foie est encore endemique dans certaines zones du monde. Le diagnostic du kyste hydatique non complique repose essentiellement sur la suspicion clinique. L'echographie et/ou la tomodensitometrie sont les outils diagnostiques les plus importants. Ces examens sont utiles pour determiner les complications et dans la schema therapeutique. Le traitement moderne du kyste hydatique va de l'intervention chirurgicale au drainage percutane et a la therapeutique medicale. La chirurgie represente le traitement de choix. On peut la realiser par voie traditionnelle ou par voie laparoscopique. Le drainage percutane et l'injection de serum hypertonique ou de l'alcohol dans le kyste pourraient etre un traitement alternatif a la chirurgie dans des cas selectionnes. A present, nous traitons les kystes du type I et du type II par la ponction percutanee echo-guidee et les kystes du type III et du type IV (exceptes les kystes completement calcifies) par la chirurgie. Les kystes du type III pourraient en fait etre traites d'une maniere ou d'une autre selon la presence ou pas d'un contenu drainable. Nous croyons que l'approche laparoscopique doit etre limitee aux kystes non-compliques.

Diagnosis and treatment of uncomplicated hydatid cyst of the liver.

Cystic echinococcosis is endemic in certain parts of the world The growth of the cyst is often slow, and the liver and lungs are the most frequently involved organs Diagnosis is based on clinical signs and symptoms and epidemiological data, while ultrasonography is important for the classification of hydatid cysts Although certain types of hydatid cysts are successfully treated by percutaneous aspiration, injection, and reaspiration, surgery remains the treatment of choice We reviewed the current trends in the diagnosis and management of cystic echinococcosis, with special emphasis on hepatic and pulmonary involvement

Iskender Sayek

Papers

Surgical treatment of hydatid disease of the liver.

Liver hydatid disease: long-term results of percutaneous treatment.

Diagnosis and treatment of uncomplicated hydatid cyst of the liver.

Cystic hydatid disease: current trends in diagnosis and management.

Coenzyme Q10 concentrations and antioxidant status in tissues of breast cancer patients