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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 22 (2000), S. 21-24 
    ISSN: 1279-8517
    Keywords: Vascular anatomy ; Muscle flap ; Graciloplasty ; Anal function
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Dynamic graciloplasty has recently been developed for reconstruction of anal function in patients who are fecally incontinent in preference to permanent abdominal colostomy. Since the muscular portion of gracilis is wrapped around the neoanus, the length of the gracilis arc influences the functional outcome of graciloplasty. Although dissection of the main pedicle (i.e. the main artery and vein) can facilitate gracilis to have enough muscle arc, it has been unclear whether there are any vessels proximal to the main pedicle or through the origin of the muscle which could support blood flow into the whole of gracilis. In this study, the vascular anatomy of gracilis in both legs of 26 Japanese cadavers was examined. All muscles had a main pedicle, mean maximum diameter 1.08 mm, entering at the proximal one-third of the muscle. However, only 18 muscles (34.6%) had an accessory artery in the proximal portion in addition to the main pedicle. Some arteries always exist at the origin of the muscle, having a mean maximum diameter of 0.34 mm, suggesting that they might be able to support the whole gracilis without supply from the main pedicle.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1437-7772
    Keywords: Rectal cancer ; Adjuvant chemotherapy ; Disease-free survival ; Mitomycin C ; UFT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. This study was conducted to evaluate the significance of postoperative adjuvant chemotherapy using mitomycin C (MMC) and UFT (tegafur; uracil at 1:4 molar ratio) in combination for rectal cancer. Methods. The Japanese Foundation for Multidisciplinary Treatment of Cancer conducted a prospective randomized controlled trial in 834 patients who had undergone curative resection for rectal cancer (T3 or T4 and/or Nl, N2, or N3 according to TNM classification) from February 1986 to December 1988. The patients were randomly allocated to a treatment group (MMC/UFT, 416 patients) and a control group (surgery alone, 418 patients). For the patients in the treatment group, 20 mg of MMC was sprinkled on the operating field upon completion of surgery. MMC was injected intravenously (6 mg/m2) on day 7, and then once a month for months 1–6 after surgery. UFT was administered at 400mg/day, orally, for 1 year, beginning 3 weeks after surgery. Results. There was no difference, in the 5-year survival rate between the two groups, but the 5-year disease-free survival rate in the MMC/UFT group (68.9%) was significantly higher than that (59.3%) in the control group (P = 0.006). The 5-year cumulative local recurrence rate was significantly lower in the MMC/UFT group (11.6%) than in the control group (19.0%) (P = 0.007). Conclusion. We conclude that the adjuvant use of longterm oral UFT and intermittent MMC (i.v.) improves the disease-free survival rate of patients with curatively resected rectal cancer (T3 or T4 and/or N1, N2, or N3).
    Type of Medium: Electronic Resource
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