Resection of the liver for colorectal carcinoma metastases - A multi-institutional study of long-term survivors

In this review of a collected series of patients undergoing hepatic resection for colorectal metastases, 100 patients were found to have survived greater than five years from the time of resection. Of these 100 long-term survivors, 71 remain disease-free through the last follow-up, 19 recurred prior to five years, and ten recurred after five years. Patient characteristics that may have contributed to survival were examined. Procedures performed included five trisegmentectomies, 32 lobectomies, 16 left lateral segmentectomies, and 45 wedge resections. The margin of resection was recorded in 27 patients, one of whom had a positive margin, nine of whom had a less than or equal to 1-cm margin, and 17 of whom had a greater than 1-cm margin. Eighty-one patients had a solitary metastasis to the liver, 11 patients had two metastases, one patient had three metastases, and four patients had four metastases. Thirty patients had Stage C primary carcinoma, 40 had Stage B primary carcinoma, and one had Stage A primarycarcinoma. The disease-free interval from the time of colon resection to the time of liver resection was less than one year in 65 patients, and greater than one year in 34 patients. Three patients had bilobar metastases. Four of the patients had extrahepatic disease resected simultaneously with the liver resection. Though several contraindications to hepatic resection have been proposed in the past, five-year survival has been found in patients with extrahepatic disease resected simultaneously, patients with bilobar metastases, patients with multiple metastases, and patients with positive margins. Five-year disease-free survivors are also present in each of these subsets. It is concluded that five-year survival is possible in the presence of reported contraindications to resection, and therefore that the decision to resect the liver must be individualized. © 1988 American Society of Colon and Rectal Surgeons

Comparison of three blood culture media with tryptic soy broth

Four consecutive studies comparing commercially prepared bottles that contained brain heart infusion, brucella (vented and unvented), and Trypticase soy broths with Tryptic soy broth failed to demonstrate significant differences in rates of isolation of organisms from blood. Statistically significant differences between bottles were limited to the average times required to detect growth of viridans streptococci in one study and of all organisms in another.</jats:p

Effect of storage of the du Pont lysis-centrifugation system on recovery of bacteria and fungi in a prospective clinical trial

A commercially available lysis-centrifugation system was compared with a conventional biphasic brain heart infusion medium in a prospective clinical study of 5,125 fungal blood cultures. Recovery rates were compared between two time periods to assess the effect of 25 degrees C storage before processing by the lysis-centrifugation system. The lysis-centrifugation tubes processed within 9 h showed a significantly higher yield (3.4 versus 1.49%) for yeasts (Candida glabrata), filamentous fungi (Histoplasma capsulatum), and bacteria (8.84 versus 7.34%) (Klebsiella pneumoniae and Serratia marcescens) than did those processed after 9 h.</jats:p

Effect of volume of blood cultured on detection of bacteremia

The rates of recovery of bacteria from vented vacuum blood culture bottles containing 50 and 100 ml of a soybean-casein digest broth were compared. Overall, more isolates were recovered from the larger bottle; moreover, gram-negative bacilli and especially Pseudomonas aeruginosa were recovered significantly more frequently (P less than 0.01) from the 100-ml bottle.</jats:p