RESUMEN
There are presented results of treatment of 347 patients with colorectal cancer. Laparoscopic surgery had been planned for 92 (26.5%) patients (study group). In 79 (85.9%) patients surgery was performed completely by laparoscopy, 13 (14.1%) patients underwent conversion. In 255 (73.5%) patients surgery was carried out from an open access (control group). The authors showed the effectiveness of the use of minimally invasive techniques in treatment for colorectal cancer.
Asunto(s)
Colectomía/métodos , Neoplasias del Colon/cirugía , Laparoscopía , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias del Colon/patología , Neoplasias Colorrectales/cirugía , Conversión a Cirugía Abierta/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Resultado del TratamientoRESUMEN
The article presents the results of surgery outcomes in 127 elderly patients with colon cancer. The patients were divided into two groups: the main group (prospective, n = 52) and control group (retrospective, n = 75). The combined preoperative nutritive status assessment by BMI and a prognostic hypotrophy index were used. It included the optimization of nutritive support on all stages and an early tube removal, an enteral feeding during postoperative period. It was stated, that it significantly reduced the level of complications, period of intensive care unit stay on 2 days and a hospital stay on 4 days in main group. All the patients of the main group improved the quality of life during 7 days (EORTC QIQ CR29). Proposed nutritive support program allowed improvement of the quality of life and positive treatment outcomes in elderly patients with colon cancer.
Asunto(s)
Neoplasias del Colon , Apoyo Nutricional/métodos , Complicaciones Posoperatorias/prevención & control , Desnutrición Proteico-Calórica , Anciano , Anciano de 80 o más Años , Colectomía/efectos adversos , Colectomía/métodos , Colon/patología , Colon/cirugía , Neoplasias del Colon/complicaciones , Neoplasias del Colon/patología , Neoplasias del Colon/cirugía , Femenino , Evaluación Geriátrica/métodos , Humanos , Tiempo de Internación , Masculino , Estadificación de Neoplasias , Evaluación Nutricional , Estado Nutricional , Atención Perioperativa/métodos , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/psicología , Desnutrición Proteico-Calórica/complicaciones , Desnutrición Proteico-Calórica/diagnóstico , Desnutrición Proteico-Calórica/terapia , Calidad de Vida , Resultado del TratamientoRESUMEN
Colorectal cancer (CRC) is one of the commonest malignancies of Western countries, with approximately half the incidence occurring in patients > 70 years of age. Elderly CRC patients, however, are insufficient to fully examined, therefore, they receive inadequate treatment and underrepresented in clinical trials. The International Society of Geriatric Oncology created a task force with a view to assessing potential for developing guidelines for the treatment of elderly (geriatric) patients. A review of the evidence presented by the task force members confirmed the paucity of clinical trial data in elderly people and the lack of evidence-based guidelines. However, recommendations have been proposed on the basis of the available data and on the emerging evidence that treatment outcomes for fit, elderly CRC patients can be similar to those of younger patients. This gives hoped that such efforts will pave the way for formal treatment guidelines based upon solid scientific evidence in the future.
Asunto(s)
Neoplasias Colorrectales/terapia , Geriatría/normas , Oncología Médica/normas , Guías de Práctica Clínica como Asunto , Factores de Edad , Anciano , Anciano de 80 o más Años , Terapia Combinada/normas , HumanosRESUMEN
Our investigation was carried out on an assumption that end results among patients radically-treated for colorectal cancer might be improved by use of enteroabsorption. The study group included 17, controls--13 patients with diagnostically verified stage I-III tumors. Mixed sorbent (microcellulose + polysorb) (6g) was administered, once a week, on the average of 20 days after operation. Immunological vigor was assayed 3 weeks after surgery: immunoglobulin levels--by turbodimetric method, cellular profile of lymphocytes--monoclonal antibodies to cell markers CD3, CD4, CD8, CD16 and CD22. As a result of adjuvant treatment CD22 (B-lymphocytes) concentration increased significantly--from 17.70 to 21.66 (22%), while CD16 (innate killers) both in absolute numbers (19%) and by percentage points (9%). Circulating immunocomplex levels in the sorbent-treatment group were significantly lower (37.44 ths units) than in control (48 ths units) (average 28%). No relapse or metastases were reported in either group.
Asunto(s)
Celulosa/uso terapéutico , Neoplasias Colorrectales/tratamiento farmacológico , Neoplasias Colorrectales/inmunología , Enteroadsorción , Polímeros/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Antígenos CD/efectos de los fármacos , Linfocitos B/efectos de los fármacos , Complejo CD3/efectos de los fármacos , Antígenos CD4/efectos de los fármacos , Antígenos CD8/efectos de los fármacos , Quimioterapia Adyuvante , Neoplasias Colorrectales/patología , Neoplasias Colorrectales/radioterapia , Neoplasias Colorrectales/cirugía , Complemento C3/efectos de los fármacos , Complemento C4/efectos de los fármacos , Femenino , Humanos , Inmunoglobulinas/efectos de los fármacos , Células Asesinas Naturales/efectos de los fármacos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Radioterapia Adyuvante , Receptores de IgG/efectos de los fármacos , Lectina 2 Similar a Ig de Unión al Ácido Siálico/efectos de los fármacosAsunto(s)
Neoplasias Colorrectales/cirugía , Antimetabolitos Antineoplásicos/administración & dosificación , Quimioterapia Adyuvante , Neoplasias Colorrectales/tratamiento farmacológico , Neoplasias Colorrectales/patología , Fluorouracilo/administración & dosificación , Humanos , Estadificación de Neoplasias , Cuidados Paliativos , Terminología como AsuntoRESUMEN
A total of 108 patients have filled in questionnaires on falling asleep, sleeping, night awakenings and other characteristics. Their answers have been analysed and it was concluded that night sleep of patients especially in the postoperative period was characterized by prolonged period of falling asleep (over 30 min in 50% of patients), reduced duration, in 77% of patients night awakenings have been recorded. The use of analgin (1000 mg) in combination with dimedrol (10 mg), promedol (20 mg) for tramal (100 mg) for normalization of sleep in the postoperative period was of little efficacy. Therapy of night sleep disturbances will improve the patients' condition and enhance the efficacy of management after surgical interventions.
Asunto(s)
Trastornos del Inicio y del Mantenimiento del Sueño/tratamiento farmacológico , Difenhidramina/administración & dosificación , Dipirona/administración & dosificación , Quimioterapia Combinada , Humanos , Persona de Mediana Edad , Periodo Posoperatorio , Promedol/administración & dosificación , Trastornos del Inicio y del Mantenimiento del Sueño/diagnóstico , Tramadol/administración & dosificaciónRESUMEN
Enterosorption was used in the preparation of 30 patients for operations for carcinoma of the colon in order to make detoxication of the organism and to reduce the amount of postoperative pyo-inflammatory complications. The effectiveness of detoxication was confirmed by laboratory analysis. The amount of postoperative complications were reduced from 40% to 17.6%, the duration of the postoperative period at the hospital became shorter - 19.3 days instead of 26.7.
Asunto(s)
Infecciones Bacterianas/prevención & control , Colon/microbiología , Neoplasias del Colon/cirugía , Desinfección/métodos , Neoplasias del Recto/cirugía , Recto/microbiología , Esterilización/métodos , Infección de la Herida Quirúrgica/prevención & control , Adsorción , Humanos , Cuidados PreoperatoriosRESUMEN
Polifepan was used for preoperative detoxication by enterosorption in 40 cases of cancer of the large bowel. The results were compared in the study group and controls who had received standard premedication. Postoperative complication frequency dropped 35-10% and postoperative inpatient stay duration--28.3-17.8 days.
Asunto(s)
Neoplasias Intestinales/terapia , Intestino Grueso , Cuidados Preoperatorios/métodos , Adsorción , Animales , Constricción Patológica/terapia , Modelos Animales de Enfermedad , Estudios de Evaluación como Asunto , Humanos , Absorción Intestinal , Lignina/uso terapéutico , Métodos , Complicaciones Posoperatorias/prevención & control , RatasRESUMEN
To determine the necessary extent of surgery in thyroid cancer 128 autopsy reports of patients with thyroid cancer were studied. It was found that in a group of those died from cancer the specific weight of death issues due to papillary cancer, most frequently observed, was small (8.5%), consequently these patients would show a recovery postoperatively. Patients with one lobe involved die following its resection but, as a rule, not because of the process spreading to the second lobe. The prognosis for patients with thyroid cancer largely depends on the histological type of tumor rather than the extent of surgery. All this supports the idea that in appropriate cases it is feasible to continue oneself to the resection of the lateral thyroid lobe for this kind of tumor.