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Annals of Surgical Innovation and Alice saddy case study3: Table 1 The macroscopic examination of the specimen revealed three patients with small sessile polyps 3 - 4 mm in diam- eter missed in the pre-operative CTC near the stenosing colorectal cancer Table 2.
The follow-up colonscopy showed four additional endo- luminal lesions in three patients: Computed Tomographic Colonography CTC is also known as "virtual colonoscopy" and it was introduced in It is considered a noninvasive method of imaging and it allows to explore the colon by employing a helical CT .
Data from literature show that CTC is safer than colonos- copy. Indeed a colonic perforation occurs in 1: There is only one study in literature showing a perforation rate, which is very low, up to 0.
The CTC has recently been proposed as the standard investigation for the pre-operative assessment of the colonic segments proximal to the obstructive cancer, being well tolerated, less invasive and showing good results [4,].
Stenosing colorectal cancers and synchronous lesionsidentified specimen and missed in the pre-operative CTC. Site of stenosing colorectal cancer Site of synchronous lesion Type of synchronous lesions Diameter of synchronous lesions Left colon Left colon Sessile polyp 3 mm Left colon Left colon Sessile polyp 4 mm Left colon Left colon Sessile polyp 3 mm Table 3: Stenosing colorectal cancers and synchronous lesions identified in the follow-up colonoscopy at 3 months after the surgical treatment and missed in the pre-operative CTC Site of stenosing colorectal cancer Site of synchronous lesion Type of synchronous lesions Diameter of synchronous lesions Left colon Ascending colon Sessile polyp 3 mm Left colon Transverse colon Sessile polyp 4 mm Left colon Transverse colon Sessile polyp 8 mm Rectum Left colon Sessile polyp 11 mm Annals of Surgical Innovation and Research3: In the past in all these cases the alternative investigation was an opaque enema.
Nowadays, CTC shows a higher sensitivity making it the choice investigation when the tra- ditional endoscopy cannot be carried out satisfactorily . In those patients with synchronous cancers the most appropriate approach is to remove both lesions at the same time.
Mingyue et al stated in their study that although the syn- chronous lesion is a polyp, it should be removed during surgery, otherwise, in the remaining cases, polyps will be removed during the endoscopic follow-up . In the past, a considerable percentage of CTC presented a high incidence of false positives between Nowadays more modern softwares and new methods for colon cleansing preparation allow a significant reduction of false positives , lowering the percentage till 2.
Moreover the possibility to perform the CTC even with a mild bowel preparation allows to extend the indication of the cancer screening to those patients considered not enough fit to tolerate a complete bowel preparation .
A surgical re-intervention is required when synchronous neoplastic lesions are detected and this increases morbidity and higher compli- cation rates, especially because of peritoneal adhesions. Virtual colonoscopy in stenosing colorectal cancers:Alice Saddy Case Study Problem Statement Philosophy: "People supported first" Problems with the current organizational structure Growth of the company Slowed down processes Changing structure posed as a threat O Presented by: Roman Adduru, Michael Kleinpaste, and Katy Sotiroff.
Introduction Alice Shady Association is Alice Shady was founded form the inception of a committee which raised funds for training program for people with developmental disabilities. Later on it became known as Alice Shady association.
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in by Anita McGahan, Suzanne Purdy A Conjoint Study by Stefan Michel Airport Privatisation in Australia by Michael J. Enright, Flash Ng Alice Saddy: Caring for the Community by Colleen Sharen.
View Allison Smith’s profile on LinkedIn, the world's largest professional community. (PACT) and developed a case study based on real observations, as well as the relevant literature on youth-centered HIV/AIDS and teen pregnancy prevention programs implemented throughout Sub-Saharan Africa.
Alice Saddy Association. January Title: Program Planning Assistant with . Alice Saddy: Caring for the Community case study solution, Alice Saddy: Caring for the Community case study analysis, Subjects Covered Mission statements Nonprofit organizations Organizational change Organizational culture Organizational structure by Colleen Sharen Source.
Alice Saddy: Caring for the Community Case Solution,Alice Saddy: Caring for the Community Case Analysis, Alice Saddy: Caring for the Community Case Study Solution, Human resource manager at Alice Saddy Association (Alice Saddy), a non-profit agency in London, Ontario, Canada, support for people with developmental disa.