ISSN:0022-4790    

DOI:10.1002/jso.2930500202

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

摘要:

AbstractThe blood flow in an experimental adenocarcinoma in the rat liver was determined with the133Xe‐washout technique before and after hepatic artery ligation (HAL). There was an initial reduction of the washout of 50%. This was further reduced after 1 day by 50%, which was maintained for 7 days. Seven days after HAL or sham procedures the133Xe‐washout was of similar magnitude in the liver tumours, although after the sham procedure the tumours were larger (3.4 g vs. 1.5 g). The estimated tumour blood flow was then approximately 0.04 ml × min−1× g−1. The influence on normal liver parenchyma of HAL was a reduction at 30 minutes, which was maintained for 7 days. Postacton®—a synthetic vasopressin—did not influence the133Xe‐washout in normal liver parenchyma in non‐tumour, as well as in tumour‐bearing animals. There was no influence of Postacton® on the133Xe‐washout in the liver tumours. Thirty minutes after HAL Postacton® gave a reduction of blood flow in normal liver parenchyma of tumour‐bearing animals, which is thus only from the portal vein. In tumours Postacton® did not significantly reduce the tumour blood flow immediately after

ISSN:0022-4790    

DOI:10.1002/jso.2930500203

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

摘要:

AbstractRadical en bloc resection has gained acceptance in the management of locally advanced colorectal carcinoma. Total pelvic exenteration has been advocated as treatment for rectosigmoid cancers involving adjacent genitourinary structures. We report a series of 10 patients who underwent total cystectomy with en bloc segmental colorectal resection and restoration of intestinal continuity. All margins, including the distal colorectal margin of resection, were pathologically uninvolved by tumor. The median follow‐up on these patients was 44 months and the mean survival was 42.5 months. The local recurrence rate (20%) and survival rates are comparable to those in reports describing pelvic exenteration for colorectal cancer. Our patients had normal postoperative bowel function. An extended colorectal resection, including a total cystectomy with rectal sphincter preservation, is occasionally possible when tumor‐negative resection margins can be achieved. By restoring intestinal continuity, such an operation provides an improved quality of life, and more importantly, fulfills the criteria for an oncologically sound operation. © 1992 Wiley‐Lis

ISSN:0022-4790    

DOI:10.1002/jso.2930500204

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

摘要:

AbstractIntraoperative radiation therapy (IORT) was delivered to remnant rat liver after partial hepatectomy to determine the chronic effects of treatment on survival, blood chemistry, liver weight, and histology. Survival at one year was 100%. Remnant liver weight was markedly increased in all animals. Liver function appeared to be unaltered in all groups and at all observation times. Inflammatory cell infiltration occurred immediately after treatment in ail animals, showing a slight progression until day 45; by day 180 the values had returned to baseline. Vascular changes were seen early in all groups, then progressively decreased; the vascular score was back to baseline at days 180 and 365. Nuclear alterations were observed in both irradiated and nonirradiated hepatic cells; in all cases these were limited to isolated or focal areas of hepatocytes. There was little fibrosis formation and by day 180 all scores were back to baseline. We conclude that the chronic effects of whole liver IORT after one‐third hepatectomy are minimal in the rat and are similar to those observed after surgeryalone. © 1992 Wiley‐Liss,

ISSN:0022-4790    

DOI:10.1002/jso.2930500205

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

ISSN:0022-4790    

DOI:10.1002/jso.2930500206

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

摘要:

AbstractThe association between surgical stress‐related depression in bactericidal activities of neutrophils and the occurrence of postoperative infections was investigated. Bactericidal activities of neutrophils were measured in 19 patients undergoing esophagectomy, 15 gastrectomy, and 16 cholecystectomy. Five patients had complications of infection following esophagectomy. In 45 patients with no postoperative infections, intracellular killing index (KI) and superoxide anion production (SOP) levels decreased on postoperative day 1 while myeloperoxidase (MPO) activity increased on days 1–3. In 5 patients with esophageal cancer and postoperative infections, decreases in KI and SOP were less prominent, as compared to findings in 14 esophageal cancer patients without such problems but the MPO activity decreased on days 1–3. This evidence suggests that postoperative septic complications are not directly associated with surgical stress‐related transient depression of bactericidal activities immediately after surgery but rather with neutrophil‐mediated tissue injuries based on degranulation. © 1992 Wiley

ISSN:0022-4790    

DOI:10.1002/jso.2930500207

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

摘要:

AbstractSix male patients with locally advanced esophageal cancer underwent surgical treatment including modified presternal esophagogastroplasty. The main reason for this kind of esophagogastroplasty was anticipated risk of transplant gangrene or anastomotic leak. Esophagoplasty technique provides a possibility for prolonged enteral nutrition and facilitates the further reconstruction in case of partial transplant gangrene. There was no hospital mortality. All patients, despite postoperative complications, began their oral food intake with good tolerance of the regular diet. © 1992 Wiley‐Liss, I

ISSN:0022-4790    

DOI:10.1002/jso.2930500208

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

摘要:

AbstractThirty‐eight patients with node positive squamous cell carcinoma of the esophagus were entered into a pilot clinical study using postoperative adjuvant chemotherapy (cisplatinum 100 mg/m2and methotrexate 150 mg/m2× 4 cycles) with an intent of improving cure rates and overall survival. Patient compliance was excellent and toxicity minimal. At 24 months of follow‐up 22 patients (58%) were disease free, while 14 patients (37%) have relapsed and 2 were lost to follow‐up. A highly significant correlation was noted between the number of nodes involved, the grade of the tumour, and the response to chemotherapy. Patients with poorly differentiated tumours and those with more than 4 nodes involved were more likely to develop recurrent disease (P<0.01 andP<0.005). We conclude that postoperative chemotherapy following resection for carcinoma of the esophagus is well tolerated with minimal side effects. It may also have an impact on improving disease free and overall survival. © 1992 Wiley‐

ISSN:0022-4790    

DOI:10.1002/jso.2930500209

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

摘要:

AbstractAdvances in the surgical treatment of primary malignancies and the recent chemotherapy have led to an expansion of the surgical treatment of met‐static lung tumors. However, multiple pulmonary metastases are often found and may affect both lungs. It is difficult to reach tumors in the posterior parts of the lung when using a common midsternal approach, especially lesions located in the left lower lobe. We performed transsternal simultaneous bilateral thoracotomy on 10 patients with bilateral lung tumors (9 bilateral metastatic pulmonary tumors and 1 bilateral primary lung cancer). This procedure provides a wide operative field and is an effective method of thoracotomy for patients with bilateral lung tumors. In future, this method should be more actively performed for patients in whom it is indicated. © 1992 Wiley‐Liss,

ISSN:0022-4790    

DOI:10.1002/jso.2930500210

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY

摘要:

AbstractManagement of melanoma of the external ear is controversial. Thirty‐one patients treated for this disease were identified at our institution between January 1, 1974 and December 31, 1989. Follow‐up was an average of 7.12 years (range 1–15). Local therapy performed included 16 wedge resections, 3 split thickness skin grafts after excision to the perichondrium, 10 partial and 2 total amputations. There were two local recurrences, four metachronous cervical metastases, and four distant metastases. Three elective and five therapeutic neck dissections were performed. Survivors at 1, 5, and 10 years were 93, 77, and 47%, respectively. There was no relationship between DNA ploidy, local surgical therapy, and eventual recurrence. Clinical stage and tumor thickness demonstrated a statistically significant correlation with likelihood of recurrence (P= .02 and .05). There is no evidence that melanoma of the ear has a poorer prognosis or different prognostic factors than melanoma at other cutaneous sites. In selected cases, local disease can be controlled by excision and skin graft rather than the more aggressive current procedures. © 1992 Wiley‐L

ISSN:0022-4790    

DOI:10.1002/jso.2930500211

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1992

数据来源: WILEY