Comparative take a look at of the pre and post intervention facts on colon rectal most cancers 3

Determine

The classification in accordance the differentiation grade of the tumor become done and the outcomes confirmed a hundred and twenty cases or 36.4% wherein the tumor became differentiated well, in a hundred thirty cases or forty% the tumor become pretty differentiated, in forty instances or 12% it was differentiated not nicely and in 40 sufferers or 12% become no longer differentiated.
The type in accordance the residual tumor changed into also carried out and the effects confirmed that a resection r0 changed into finished in 250 sufferers or seventy six%, r1 in 20 patients or 6% and r2 in other 60 patients or 18%. (discern)

Statistical analysis
1. The statistical analysis executed with the z test showed that the better sensitivity of the scanner in detection of the lymphonodus and metastasis evaluating to the abdominal x-ray has a statistical fee (p< 0,05)
2. The statistical assessment through the wilcoxon take a look at between the pre and post intervention degrees suggests a discordance between the level ii and ii with a statistical fee of (p< 0,001)

Discussion
Te colon rectal most cancers is one of the maximum common malign pathologies of the gastro – intestinal tract and it is accompanied via a very high mortality. Te survival charge relies upon on the degree of the tumor. Many authors have proven a excessive increase of the survival fee with 5 years via a great diagnostic process and remedy inside the early levels of this pathology.

From the above written information it's far obvious the high significance of the early diagnostic revealing of the colon rectal cancer. The diverse examination methods have to generally tend:
A- to be as more accurate as possible in detecting or with the exception of of this pathology
B- to carry out a actual pre intervention staging on the way to pick out the most right surgical approach.
The sufferers' survival rate in accordance many authors relies upon on how radical the surgical intervention is and this is expressed via the r class (residual tumor). This category facilitates additionally to select the maximum appropriate and accurate schemes of the submit intervention neo adjuvant therapy (chemo and radio remedy).
In our collection we have analyzed the objective exam information, extraordinary styles of the images and fibro colonoscopy comparing those outcomes with the intra intervention findings.

1- pre intervention exam
A- objective examination--- our information indicates a excessive sensitivity inside the primary tumor dedication, both palation and rectal contacté. The sensitivity is better whilst they are getting analyzed together. This indicates regardless of the computerized remedy technology, the traditional methods are still critical and of excessive significance. The during and careful exam of the sufferers who are unsure of the lifestyles of the colon rectal cancer is a vital situation.
If our records was compared to those of different authors a excessive sensitivity of our series of facts is seen. We are of the opinion that that is due to the advanced levels in that our sufferers gift themselves for examination and for this reason the chance of the number one tumor detection all through the objective examination is higher.
B- stomach x-ray – the x-ray is a easy examining method, with a lower price and no longer volatile for the sufferers.
C- in our series of consequences it is obvious a excessive sensitivity regarding the colon tumors, and there may be no sensitivity in locating the rectum tumors. If we make a evaluation of our information with the ones of other authors it's far distinctive a excessive sensitivity in our statistics regarding the colon tumors but the sensitivity towards the rectum tumors is very low. This suggests that x-ray is important to be executed in all sufferers which are in doubt of a colon rectal cancer, but its consequences ought to be interested in reserves into consideration. The better sensitivity in our records like for the objective exam, we think, appears because of the superior stages of the tumor in our collection.
D- trans rectal x-ray – the above referred to data suggests the need of the trans rectal x-ray inside the sufferers with ca recti. It's far essential in particular in the pre intervention staging and the assessment of the possibility for an intensive treatment.
E- ct-scanner – the scanner sensitivity is the highest from all different examinations undertaken in this examine. It facilitates not most effective inside the dedication of the number one tumor however also within the right evaluation of all additives that serve for the pre intervention staging of the colon rectal most cancers. In our series the ct – scanner has classified some of the patients ended in put up intervention degree ii within the degree iii. That is defined by using the truth that ct – scanner has interpreted part of the lymphonodus as metastasis that in the submit intervention resulted reactive.
F- fibro colonoscopy - fibro colonoscopy is a manner that often is widely wide-spread with issue by means of the sufferers. It's far very sensitive and its reliability is getting improved in a awesome manner as compared to our preceding studies.
This boom of the reliability is suffering from the improvement of the colonoscopies exam evaluating to the preceding studies. This is because of more capable examiners and additionally of a higher preparation of the colon. Colonoscopy ought to be done now not handiest within the sufferers where a primary tumor has been detected with other strategies, however in all sufferers wherein there's a clinical uncertainty of the presence of the colorectal most cancers, and for the put up intervention follow up, as well. The blessings of the colonoscopy in opposition to the scanner stay in the possibility that the colonoscopy gives for a histological confirmation of the diagnosis, while the scanner has the benefit of a big possibility for a extra specific pre intervention exam. A blended assessment of the colonoscopy, biopsy and scanner records permits a more particular pre intervention willpower of the colon rectal tumor stage.
G- pre intervention biopsy – the pre intervention biopsy has been carried out on all sufferers with colonoscopy. False negativity recognized is due to the fact the biopsy was no longer taken within the proper location, due to the small quantities of the biopsy or a superficial treatment with fewer cuts by using the anatomist and pathologist. The development of those 3 steps might cause a lower of the false negativity. False negativity shows that not always we ought to totally depend on the biopsy consequences, however a complex judge and dialogue must cause the decision for a surgical intervention contemplating all the available factors we've got.

2- pre intervention staging – our collection information shows exclusive sensitivity of the used exam techniques relying on the tumor stage and also on its localization. The scanner and fibro colonoscopy live on the first place. While the stomach x-ray and trans rectal facts and those of the goal exam have been analyzed together the sensitivity is high. This high sensitivity of the closing two factors (abdominal x-ray and objective exam) is result of the advanced degrees of the tumor of the provided patients; inside the instances of sufferers with degree i and ii tumor the sensitivity is lower. To get a completely correct pre intervention staging is necessary and important to apply the obtained data from all examinations.
Three- the comparison of the pre and put up intervention stage. In our series data it's far clear a variance between levels ii and ii, for tiers i and iv there is a good correlation of the outcomes. This transformation as above mentioned, we assume comes from the wrong interpretation of the lymphonodus from the ct scanner which end result reactive inside the very last biopsy.
4- the tumor degree and differentiation grade. It's miles clear from our information that the higher differentiation grades tumors are provided in advanced tiers. The reasons that impact these outcomes is impossible to get recognized by using our facts, but those indicates a low degree of the medical culture of the populace, for the shortage of the unveiling guidelines and techniques in that route, for the low level of the number one fitness care as nicely.
Five- r classification (residual tumor). R category has been used inside the last 10 years. It allows judging of the unconventional degree of the intervention prognosis of the disease and the want for a neo adjuvant remedy. In our information even inside the advanced levels the novel interventions are the maximum used techniques, what suggests the competence and ability of our surgeons who are capable of using the most advanced surgical strategies. This classification serves now not handiest for what above cited but is also a take a look at for the professional schooling (history) of every healthcare professional.

Conclusions
- all of the inspecting methods used on this take a look at display sensitivity inside the detection of the colon rectal most cancers.
- fibro colonoscopy, biopsy and scanner are the most convincing and comfortable methods with a excessive sensitivity.
- the acquired consequences from all inspecting strategies are vital for a most accurate pre intervention staging.
- the variation between pre and put up intervention tiers became one-of-a-kind for the stages ii and iii.
- the pre intervention staging classifies a part of the tumors of degree ii into the stage iii.
- regardless of the differentiation grade of tumors, they are present more inside the ranges iii, iv displaying “now not appropriate remedy”.
- the r classification lets in to choose on the radicalism of the intervention, ailment analysis, need for a neo adjuvant therapy and serves as a test for the extent of the surgical techniques.

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