RESUMO
Regional Oncological Dispensary, Kostroma The study included 388 cancer patients (group 1) and 381 cases of other pathologies (group 2). Surgery on lymphoid organs was performed in 121 patients (31%) in group 1 and 150 in group 2. It was concluded that such intervention in the immune system was not an oncological hazard. That phenomenon might be accounted for by the specificity of immune response in patients suffering from such diseases.
Assuntos
Sistema Linfático/cirurgia , Neoplasias/epidemiologia , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Epidemiologia/estatística & dados numéricos , Feminino , Humanos , Sistema Imunitário/cirurgia , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Neoplasias/imunologia , Federação Russa/epidemiologiaRESUMO
In the last decade mini-invasive surgery has consistently developed with good results, but also with some unjustified clinical applications. This review is aimed at defining evidence based indications and procedures ('clinical practice') and those still worthy of controlled studies in oncologic centers with expertise in mininvasive surgery ('clinical research'). At present, diagnostic and staging laparoscopy and thoracoscopy represent the 'standard' for different tumors. Conversely, therapeutic indications according to evidence based medicine criteria are still limited. Tumors treatment by mini-invasive surgery requires 'expertise' on the part of the surgical team; this can be achieved by extensive training of a correct use of instruments and methods following the general surgical principles of traditional 'open surgery'.
Assuntos
Procedimentos Cirúrgicos Minimamente Invasivos , Neoplasias/cirurgia , Equipamentos para Diagnóstico , Humanos , Sistema Imunitário/cirurgia , Laparoscopia/efeitos adversos , Laparoscopia/normas , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/normas , Neoplasias/diagnóstico , Medição de RiscoAssuntos
Quimera , Sistema Imunitário/fisiologia , Camundongos Mutantes/imunologia , Modelos Biológicos , Animais , Linfócitos B/fisiologia , Sistema Imunitário/citologia , Sistema Imunitário/cirurgia , Tolerância Imunológica , Região Variável de Imunoglobulina/genética , Síndromes de Imunodeficiência/etiologia , Síndromes de Imunodeficiência/genética , Tecido Linfoide/transplante , Camundongos , Linfócitos T/fisiologia , Transplante HeterólogoRESUMO
BACKGROUND: To determine the immunosuppressive effect of surgery for urologic cancers, multiple variables of immune function were measured serially before and after operation in patients with urologic cancer. METHODS: Peripheral blood was obtained before operation and at postoperative day 7 and 14 from 20 patients with bladder cancer, renal pelvic, or ureteral cancer, or renal cell carcinoma. RESULTS: In patients with bladder cancer who were undergoing radical cystectomy with use of intestine for urinary diversion, the serum level of immunosuppressive acidic protein (IAP) increased, and serum levels of immunoglobulin (Ig)A, IgG, and IgM decreased after operation. In contrast, the number of CD25+ lymphocytes significantly increased. Transurethral resection of bladder cancer also resulted in an increase in serum IAP level, however, the number of CD4+ and human leukocyte-associated HLA-DR+ lymphocytes increased. In patients with renal pelvic or ureteral cancer undergoing nephroureterectomy with cuff, the level of serum IAP increased and serum IgG level decreased after operation. By contrast, the number of CD3+ lymphocytes increased. In patients with renal cell carcinoma, radical nephrectomy led to a significant increase in the number of CD8+ lymphocytes. CONCLUSIONS: These findings suggest that surgical stress in patients with urologic cancer may result in both suppression and stimulation of host immunity.