Dimitrios Tsekouras

Collision tumour of the stomach with a cancer to cancer metastasis: a case report

IntroductionCoexistence of a primary gastric lymphoma and a gastric adenocarcinoma is a rare event. The diagnosis is suspected after the pathologic examination of the endoscopic biopsies and definitely documented with the examination of the surgical specimen.Case presentationWe are presenting a rare case of a 77-year-old Greek man with epigastric pain of one and a half month duration, nausea, anorexia and weight loss. The pathologic examination of the endoscopic biopsies and a lymph node biopsy excised at laparotomy, presented the interpenetration of synchronous occurring primary gastric lymphoma and a gastric adenocarcinoma with a documented cancer to cancer metastasis.ConclusionPrognosis of these rare tumours is largely dependent on the stage of the adenocarcinoma at presentation but due to lack of large series there are no data on the biological behavior of these tumours in comparison to adenocarcinoma.

746 INTRAPERITONEAL LEVOBUPIVACAINE REDUCES PAIN AFTER LAPAROSCOPIC CHOLECYSTECTOMY

Methods: This study was designed as a double blind prospective controlled clinical trial on children with minor surgical problems undergoing day care surgery at our Pediatric day care surgical unit. 100 patients in two groups [A = caudal anesthesia (51 patients); B = ordinary anesthesia (49 patients)] were studied, all 12 years old or younger, ASA I and ASA II, in longitudinal fashion, as they were scheduled electively or urgently for surgery. Results: 69.33% of patients were male and 30.67% were female. We want to highlight the case of pyloric stenosis correction and anoplasty cases using caudal anesthesia. The commonest operation was herniotomy for children for both groups A and B. The number of patients received analgesics during 24 hours after surgery in group B (80%) was higher than group A (18%)(P< 0.001). Mean time for first request or need for administration of analgesics in group B (25 min) was less than group A (320 min) (p< 0.0001). Also FLACC scoring was significantly lower in group A (mean = 1) than group B (mean = 8) (p< 0.05). Conclusion: In the present study we demonstrated that caudal anesthesia with bupivacaine at 3mg/kg produce adequate anesthesia for lower abdominal surgery, for surgery at epigastric level, and postoperative analgesia.