RESUMEN
The dynamics of cell-mediated immunity indices in 83 patients with rectal tumors who underwent surgery or received combined treatment (preoperative radiation + surgery) was followed. Cellular immunity was assessed on the basis of PHA-induced blastogenic reaction of lymphocytes (BRL) and spontaneous rosette-formation. In rectal tumor patients, particularly at stage IV, the level of PHA-induced BRL and the total number of rosette-forming cells (RFC) were lower than in healthy donors. Surgery did not produce any significant changes in cell-mediated immunity parameters: level of PHA-induced BRL decreased by 16,7%, while total RFC number increased by 17.2% in (mostly low-affinity forms). Preoperative radiation resulted in a significant decrease in lymphocyte ability to undergo PHA-induced blast-transformation (45%) and spontaneous rosette formation, high-affinity lymphocytes being most sensitive to ionizing radiation. Their fraction decreased by half.
Asunto(s)
Neoplasias del Recto/inmunología , Adulto , Anciano , Eritrocitos/inmunología , Femenino , Humanos , Inmunidad Celular , Activación de Linfocitos/efectos de los fármacos , Linfocitos/inmunología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Cuidados Preoperatorios , Dosificación Radioterapéutica , Neoplasias del Recto/terapia , Formación de RosetaRESUMEN
Under analysis were 40 case histories and records of dissections of patients dead of diffuse peritonitis after operations for rectum cancer. It was established that in 1/3 of observations technical defects were responsible for peritonitis. Measures for the prevention of peritonitis are proposed when infection in the abdominal cavity is revealed during operation. An atypical course of peritonitis, not pronounced signs of pathological abdominal cavity results in diagnostic errors. Diagnosis of cardiovascular insufficiency is established in most cases. Peritonitis in patients treated with the use of preoperative irradiation is characterized by the inert course without leukocytosis in many cases. The main efforts should be directed to prophylaxis, i. e. an improvement of the operation technique, struggle against hospital infections, suppression of the microbial flora in the abdominal cavity which appears due to technical errors during surgery.
Asunto(s)
Peritonitis/diagnóstico , Complicaciones Posoperatorias/diagnóstico , Neoplasias del Recto/cirugía , Adulto , Antibacterianos/farmacología , Líquido Ascítico/microbiología , Bacterias/efectos de los fármacos , Bacterias/aislamiento & purificación , Presión Sanguínea , Femenino , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Peritonitis/microbiología , Peritonitis/prevención & controlAsunto(s)
Neoplasias del Recto/cirugía , Anciano , Femenino , Humanos , Masculino , Métodos , Persona de Mediana Edad , Neoplasias del Recto/radioterapiaAsunto(s)
Exenteración Pélvica , Neoplasias del Recto/cirugía , Humanos , Masculino , Persona de Mediana EdadAsunto(s)
Neoplasias del Recto/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Métodos , Persona de Mediana Edad , Metástasis de la NeoplasiaRESUMEN
A comparative study of the results of treatment in 264 patients treated surgically and in 236 patients subjected to a combination treatment, using an intensive concentration gammatherapy (500 rad daily up to 3000 rad), has demonstrated that preoperative irradiation does not result in a higher postoperative mortality. In the combination therapy all kinds of surgery performed for rectal cancer seem to be feasible.
Asunto(s)
Neoplasias del Recto/terapia , Estudios de Evaluación como Asunto , Humanos , Dosis de Radiación , Neoplasias del Recto/radioterapia , Neoplasias del Recto/cirugíaAsunto(s)
Hemodinámica , Neoplasias del Recto/fisiopatología , Adulto , Anciano , Volumen Sanguíneo , Hemoglobinas/análisis , Humanos , Hipotensión/etiología , Persona de Mediana Edad , Complicaciones Posoperatorias , Dosificación Radioterapéutica , Neoplasias del Recto/radioterapia , Neoplasias del Recto/cirugía , Recto/cirugíaRESUMEN
In 53 patients with rectal cancer, subjected to an intensive preoperative gamma therapy, and 14 patients, treated only surgically, washings from the abdominal cavity obtained intraoperatively were studied cytologically. Cancer cells were detected in every second patient of both groups. The frequency of their detection was conditioned by cancer localization in the rectum and a degree of its intraparietal spread. The data obtained indicate the efficacy of intensive preoperative irradiation that causes a radiation damage of tumor cells disseminated intraabdominally during the operative intervention.