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Aspects on local recurrence after rectal cancer surgery

Kodeda, Karl (författare)
Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery
 (creator_code:org_t)
ISBN 9789162884086
Göteborg : University of Gothenburg, 2012
Engelska.
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)
Abstract Ämnesord
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  • Background: Local recurrence after rectal cancer surgery has a profound impact on affected patients’ lives. The overall aim of this thesis was to acquire a deeper understanding of local recurrence after rectal cancer surgery, with a long-term hope of minimising the incidence and mitigating the effects. Methods: Analysis of quality assurance data from the Swedish Rectal Cancer Registry, review of medical records and analysis of tumour DNA with array-comparative genomic hybridisation and quantitative polymerase chain reaction. Results: The majority of studied patients were symptomatic when diagnosed with local recurrence, deemed incurable, not well palliated and had a poor outcome. Aspects on the surgical management could partly explain a difference in local recurrence rate between regions. The local recurrence rate was significantly lower in patients that had perioperative rectal washout than in those who had not. The favourable outcome also remained after adjustment for known confounding factors. DNA in primary rectal carcinomas in tumours that subsequently recurred locally differed from DNA in tumours that did not recur. Conclusions: Local recurrence after rectal cancer surgery is still a reality in modern day medicine and is associated with intractable symptoms and premature death. Genetic differences might be contributory to the pathogenesis but the quality of surgery is of fundamental importance. Rectal washout is an integral part of good medical practice and should be performed routinely.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Nyckelord

Rectal neoplasms
Neoplasms recurrence
local
Methodology
Rectal washout
Rectal irrigation
Anterior resection
Quality assurance registry
Follow-up
Array-CGH
Tumour DNA

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Kodeda, Karl
Om ämnet
MEDICIN OCH HÄLSOVETENSKAP
MEDICIN OCH HÄLS ...
och Klinisk medicin
och Cancer och onkol ...
MEDICIN OCH HÄLSOVETENSKAP
MEDICIN OCH HÄLS ...
och Klinisk medicin
och Kirurgi
Av lärosätet
Göteborgs universitet

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