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Nearly a third of patients with large bowel cancers (colorectal cancer) spread to the liver (liver metastases) within five years of diagnosis of bowel cancer. The affected part of the liver can be removed surgically in a quarter of such patients who develop liver spread from bowel cancer. About a seventh of these patients, in whom the affected part of the liver is suitable for removal, develop cancer involvement of lymph glands draining the liver (hepatic lymph node). Such patients are associated with poor survival even after removal of the affected part of the liver and the involved nodes. This Cochrane review attempted to answer the question of whether removing the part of the liver is better than other forms of treatment (such as no treatment, chemotherapy, heat destructive therapy using radiofrequency waves, ie, radiofrequency ablation) in such patients but did not find any randomised clinical trial addressing the issue. Currently, there is no evidence from randomised clinical trials for optimal management of these patients. High quality randomised clinical trials are feasible and are necessary to determine the optimal management of patients with colorectal liver metastases with hepatic node involvement.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Patients with cancer of the large bowel are often anaemic and sometimes receive transfusions which may be harmful. The medication erythropoietin can be used to increase hemoglobin levels in a variety of situations and several studies have looked at this in patients who have surgery for their large bowel cancer. This systematic review of four studies found there is insufficient evidence to support the use of erythropoietin in the preoperative and post‐operative period for improving anaemia and decreasing blood transfusions. There was also no evidence that the medication was the cause of increased complications or deaths. Future studies or erythropoietin in large bowel cancer surgery should increase the dose or duration of treatment.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Expert-reviewed information summary about the treatment of small intestine cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 30, 2016

No strong evidence about whether removal of bowel obstruction and cancer should be done in one step or as a staged procedure, when people have cancer in the left colon. Colorectal (bowel) cancer is common. It can obstruct the bowel, causing severe dilation of the intestine and the stomach, pain and vomiting. Surgery is used to try to remove the obstruction, as well as the cancer. When the cancer is in the right colon, the obstruction and cancer are usually removed simultaneously. If the cancer is in the left colon or in the rectum, however, it may be better for the patient to have the obstruction and the cancer removed in separate surgical procedures.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Colorectal cancer is one of the most common cancers in industrialised countries, in both female and male persons. Treatment involves surgical removal (resection) of the segment of the bowel containing the tumor and wide tumorfree margins. Lymph nodes in the area are also removed (lymphadendectomy). conventional surgery which is the mainstream treatment of colorectal cancer and has good survival rates for stage‐1 tumors. Other diseases that can require removal of sections of the large bowel include inflammatory diseases such as diverticulitis, Crohn's disease, ulcerative colitis, familial adenomatous polyposis (FAP) and rectal prolapse.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

SBO is one of the most common emergent complications of general surgery. Intra‐abdominal adhesions are the most frequent complication of abdominal surgery. SBO due to postoperative intra‐abdominal adhesions is associated with a high rate of rehospitalisation and huge costs. Thus, non‐operative management is preferred. Chinese herbal medicine is frequently used to treat adhesive SBO in China. This review examined five randomised trials with five different Chinese herbal medicines, involving a total of 664 participants. All trials were conducted and published in China. None of the trials mentioned adverse effects. The methodological limitations in these studies are quite obvious, and any conclusions based on their results should be made with caution. This systematic review did not find sufficient evidence to support the objective efficacy and safety of TCM for adhesive SBO patients. Further high‐quality trials evaluating oral TCM for adhesive SBO are urgently needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Expert-reviewed information summary about constipation, impaction, bowel obstruction, and diarrhea as complications of cancer or its treatment. The management of these problems is discussed.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 6, 2016

Expert-reviewed information summary about the treatment of rectal cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: May 19, 2017

Expert-reviewed information summary about the treatment of colon cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: February 27, 2017

Expert-reviewed information summary about the treatment of unusual cancers of childhood such as cancers of the head and neck, chest, abdomen, reproductive system, skin, and others.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 23, 2017

Rectal cancer accounts for one‐third of all cancers of the large intestine and is an important cause of death worldwide. Radiotherapy and surgery have improved results, but there is still a high proportion of people where the cancer spreads to other parts of the body (distal metastases). In the period before surgery (preoperative period), anti‐cancer drugs (chemotherapy) are given to help destroy smaller tumours and enhance the effects of radiotherapy (high‐energy radiation that targets the cancer). Chemotherapy also has benefits on organs other than the rectum, making the use of these drugs highly desirable in the preoperative period. Therefore, it is possible that adding a second drug to the chemotherapy regimen (e.g. oxaliplatin) may increase these benefits further.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Expert-reviewed information summary about the treatment of anal cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: July 7, 2016

Colorectal (large bowel) cancer including rectal cancer is the third most common cause of cancer deaths in the western world. The risk of developing rectal cancer increases with age and is most common in people around 70 years of age. The treatment consists of complete surgical resection of the tumour and surrounding tissue by a technique called total mesorectal excision (TME), sometimes combined with chemotherapy and radiotherapy. This surgery can be performed by either normal open abdominal surgery with a large incision or by keyhole laparoscopic surgery with several small incisions for the instruments and camera. For colon cancer, laparoscopic surgery is proven to result in faster postoperative recovery, fewer complications and better cosmetic results. These results are expected to be equal for rectal surgery. However, surgery for rectal cancer is technically more difficult than for colon cancer due to the location deeper in the pelvis and close to important nerves. Therefore a complete and safe resection of the tumour should be guaranteed, this is important to reduce the risk of recurrence of the tumour and could be tested by assessing recurrence rates and patient survival in the long term.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Intestinal perforation is a very serious condition in very premature babies. Standard treatment of intestinal perforation is the surgical opening of the abdomen and removal of the unhealthy or dead intestine. Insertion of a drain into the abdomen instead of surgical opening has been tried to treat this condition. This review did not find any significant advantages or harms of insertion of the drain over surgically opening the abdomen; however, there is too little evidence to fully understand the risks and benefits of this approach.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Expert-reviewed information summary about the treatment of pancreatic neuroendocrine tumors (islet cell tumors).

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: August 18, 2017

Expert-reviewed information summary about the treatment of prostate cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: July 7, 2016

Expert-reviewed information summary about the treatment of childhood liver cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: August 18, 2017

Women who have ovarian cancer, (a cancer which develops in the two organs (ovaries) that produce eggs in women) are more likely to have difficulties with food and with eating a nourishing diet in comparison to women with other types of gynaecological cancers. One reason may be because the symptoms of ovarian cancer can be difficult to recognise. Women may have a lack of interest in food, feel full, feel sick or have a painful or swollen abdomen. Some women become thinner in parts of their bodies while becoming bigger around their abdomen due to an abnormal build up of fluid or large tumours. There may be no change in body weight or weight may increase, this can make it difficult to know which women are developing problems due to a poor food intake.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Conventionally, recuperation after bowel surgery followed the patients progress. Mobilisation and expansion of diet after surgery was progressed slowly in a stepwise manner following patients progression. This is because it was believed that faster recovery would be unwise. In recent years, however, a new concept has been introduced, called Enhanced Recovery after surgery (ERAS) or fast track. This program, introduced by Kehlet et al, is based on the principle that reducing the body's stress response after surgery reduces the time needed to recuperate. This is achieved by interventions around the operation, involving good information, better feeding before the operation and better pain treatment, so patients can get out of bed earlier and start a normal diet earlier and thereby reducing the risk of complications. This review investigated whether this intervention is safe and whether it is more effective than the traditional treatment. In order to answer this question, 4 randomised trials were found, comparing these two interventions. We found that ERAS can be viewed as safe, i.e. not resulting in more complications or deaths, and at the same time decreases the days spent in hospital following major bowel surgery. However, the data are of low quality and therefore does not justify implementation of ERAS as the standard method of care yet. More research on other outcome parameters like economical evaluation and quality of life parameters are necessary.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Chronic constipation (inability to achieve satisfactory bowel emptying for a prolonged period with no apparent medical cause) can be an embarrassing and socially restricting problem. There are many possible causes, including an inability to relax the muscles which control bowel movements. ’Biofeedback’, where computer equipment or a rectal balloon is used to show people how to coordinate and use the muscles properly, is often recommended.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

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