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Author: U. Metzger
Publisher: Springer Science & Business Media
ISBN: 3642824323
Category : Medical
Languages : en
Pages : 170
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Book Description
One reason for failure to cure solid tumors by surgery appears to be the impossibility of controlling metastases that are present but latent at the time of operation. This failure is a common clinical experience with aggressive neoplasms. but it is not always appreciated in tumors with longer survival times. e. g .• breast and colon cancer. In addition. recent evidence indicates that after resection of a primary tumor micrometas tases from it might be enhanced by suppression of immune and reticu loendothelial functions of the host. Other factors, such as increase of coagulability and stress in the perioperative period, can also promote tumor growth. The development of new metastases might be facilitated by cells forced into the circulation during operative manipulations. Such events could be important for the outcome of treatment and it is suggested that preventive measures should be directed to this systemic component of solid tumors. Radical surgery can reduce the number of tumor cells to a subclinical 3 6 stage (10 to 10 cells) in which chemotherapy might be more effective than in advanced stages. Chemotherapy, on the other hand, might aggravate the surgical morbidity by influencing the wound healing pro cess, by decreasing the immune response, and/or by toxicity to the bone marrow and to the gastrointestinal tract, for example.
Author: U. Metzger
Publisher: Springer Science & Business Media
ISBN: 3642824323
Category : Medical
Languages : en
Pages : 170
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Book Description
One reason for failure to cure solid tumors by surgery appears to be the impossibility of controlling metastases that are present but latent at the time of operation. This failure is a common clinical experience with aggressive neoplasms. but it is not always appreciated in tumors with longer survival times. e. g .• breast and colon cancer. In addition. recent evidence indicates that after resection of a primary tumor micrometas tases from it might be enhanced by suppression of immune and reticu loendothelial functions of the host. Other factors, such as increase of coagulability and stress in the perioperative period, can also promote tumor growth. The development of new metastases might be facilitated by cells forced into the circulation during operative manipulations. Such events could be important for the outcome of treatment and it is suggested that preventive measures should be directed to this systemic component of solid tumors. Radical surgery can reduce the number of tumor cells to a subclinical 3 6 stage (10 to 10 cells) in which chemotherapy might be more effective than in advanced stages. Chemotherapy, on the other hand, might aggravate the surgical morbidity by influencing the wound healing pro cess, by decreasing the immune response, and/or by toxicity to the bone marrow and to the gastrointestinal tract, for example.
Author: Joseph Ragaz
Publisher: Springer Science & Business Media
ISBN: 3642826717
Category : Medical
Languages : en
Pages : 172
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Book Description
Despite recent advances in adjuvant therapies of cancer, the regi mens of postoperative adjuvant chemotherapy treatment which are presently available fail to cure the majority of cancer patients. Pre operative (neoadjuvant) chemotherapy represents a new approach in drug scheduling, based on sound theoretical, pharmacokinetic, and experimental principles. The preoperative timing of chemotherapy before definitive sur gery is not a minor change in the therapy of cancer. To be successful, large numbers of practitioners and their patients must participate. Substantial alterations of many aspects of the present management of cancer will have to follow. Therefore, before such therapy can be fully and routinely implemented, results of the novel treatment and its rationale have to be carefully evaluated. In preoperative treatment, other features will likely gain impor tance. For the first time, clinicians have a chance to follow the in vivo response of the tumor exposed to preoperative chemotherapy. The subsequent histological assessment of the tumor sample may likely become an important prognostic guide, permitting more re fined individual approaches to the planning of postoperative adju vant treatment. The value of such a treatment strategy can already be appreciated in the clinical setting, as seen from the therapy of osteosarcoma. Furthermore, preoperative chemotherapy might render previously inoperable tumors operable and hence resectable with a curative intention. The preoperative reduction of tumor bulk may also effectively decrease the need for more radical operations, permitting a more uniform adoption of conservative surgery.
Author: C. S. Pitchumoni
Publisher: Springer Science & Business Media
ISBN: 1441916237
Category : Medical
Languages : en
Pages : 660
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Book Description
As aging trends in the United States and Europe in particular are strongly suggestive of increasingly older society, it would be prudent for health care providers to better prepare for such changes. By including physiology, disease, nutrition, pharmacology, pathology, radiology and other relevant associated topics, Geriatric Gastroenterology fills the void in the literature for a volume devoted specifically to gastrointestinal illness in the elderly. This unique volume includes provision of training for current and future generations of physicians to deal with the health problems of older adults. It will also serve as a comprehensive guide to practicing physicians for ease of reference. Relevant to the geriatric age group, the volume covers epidemiology, physiology of aging, gastrointestinal physiology, pharmacology, radiology, pathology, motility disorders, luminal disorders, hepato-biliary disease, systemic manifestations, neoplastic disorders, gastrointestinal bleeding, cancer and medication related interactions and adverse events, all extremely common in older adults; these are often hard to evaluate and judge, especially considering the complex aging physiology. All have become important components of modern medicine. Special emphasis is be given to nutrition and related disorders. Capsule endoscopy and its utility in the geriatric population is also covered. Presented in simple, easy to read style, the volume includes numerous tables, figures and key points enabling ease of understanding. Chapters on imaging and pathology are profusely illustrated. All chapters are written by specialists and include up to date scientific information. Geriatric Gastroenterology is of great utility to residents in internal medicine, fellows in gastroenterology and geriatric medicine as well as gastroenterologists, geriatricians and practicing physicians including primary care physicians caring for older adults.
Author: Paul H. Sugarbaker
Publisher: Springer Science & Business Media
ISBN: 1461538823
Category : Medical
Languages : en
Pages : 405
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Book Description
Gastric cancer has been one of the great malignant scourges affecting man kind for as long as medical records have been kept. Until operative resection pioneered by Bilroth and others became available, no effective treatment was feasible and death from cancer was virtually inevitable. Even with resection by total gastrectomy, the chances of tumor eradication remained small. Over recent years, however, the situation has been changing. Some changes have resulted from better understanding of the disease, early detec tion, and better management techniques with applied clinical research, but the reasons for other changes are poorly understood. For example, the incidence of gastric cancer is decreasing, especially in westernized societies, where it has fallen from one of the most common cancers to no longer being in the top five causes of cancer death. Still it remains the number one killer of adult males in Japan and Korea. Whether the reduced incidence in western societies is a result of dietary changes or methods of food preservation, or some other reason, is as yet uncertain. Improvements in outcome have been reported from mass screening and early detection; more refined techniques of establishing early diagnosis, tumor type, and tumor extent; more radical surgical resection; and resection at earlier stages of disease.
Author: P. Hohenberger
Publisher: Springer Science & Business Media
ISBN: 3642562906
Category : Medical
Languages : en
Pages : 206
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Book Description
Included here is a discussion of the pathophysiological aspects and risks of laparoscopic staging (such as trocar metastases) on the basis of international experience.
Author: Daniela Lazar
Publisher: BoD – Books on Demand
ISBN: 9535109146
Category : Medical
Languages : en
Pages : 308
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Book Description
Gastric cancer is the second most common cause of cancer-related death in the world. There are no screening tests available for its diagnosis, therefore patients usually presents in late stages, associated with poor prognosis. Currently, many efforts are made toward new advances in the treatment strategies. The book makes an insight into the assessment of premalignant lesions, current management of early gastric cancer, risk and protective factors in gastric carcinogenesis. "Gastric cancer" provides a detailed description of the morphologic classification, molecular changes and epigenetic alterations of this tumor. The book describes the role of different diagnostic tools in the preoperative assessment of patients and the most important factors contributing to the prognosis. Moreover, it describes the current surgical and chemotherapeutic options for gastric neoplasm. This publication may open new and interesting gates for further research concerning carcinogenesis, genetic and epigenetic alterations, signaling pathways, H. pylori infection, the discovery of protective factors against gastric cancer and of revolutionary therapies of this tumor.
Author: Josef E. Fischer
Publisher:
ISBN: 9781608317400
Category : Chirurgie
Languages : en
Pages : 2562
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Book Description
"The scope of Fischer's Mastery of Surgery, Sixth Edition, is consistent with the broad training of a general surgeon, providing extensive coverage of vascular surgery as well as of common thoracic, breast, esophageal, endocrine, colorectal, gastric, pancreatic, liver, and biliary procedures. Each procedural chapter reviews the essentials of diagnosis, anatomy, and pre-operative planning, but focuses most heavily on step-by-step depictions and descriptions of procedures. Each chapter concludes, as is traditional for this classic text, with an editorial commentary which strives to put the chapter in a broad context and provide helpful critiques of the most recent literature. The sixth edition will include a dozen new chapters, including endovascular treatment of varicose veins, fasciotomy, and thoracic aortic transaction. The vascular section has been completely reorganized and will incorporate both open and endovascular procedures. For the first time, the sixth edition is in full color."--Provided by publisher.
Author: M.W. Büchler
Publisher: Springer Science & Business Media
ISBN: 3540274499
Category : Medical
Languages : en
Pages : 284
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Book Description
Rectal cancer is one of the most prevalent cancers world-wide. It is also a paradigm for multimodal management, as the combination of surgery, chemotherapy and radiotherapy is often necessary to achieve the optimal outcome. Recently, international experts met in Heidelberg, Germany to discuss the latest developments in the management of rectal cancer, including the anatomic and pathologic basis, staging tools, surgical concepts including fast-track surgery and laparoscopic resection, functional outcome after surgery and the role of radio- and chemotherapy. This monograph summarizes this meeting and gives an extensive overview of the current concepts in management of rectal cancer.
Author: Emel Canbay
Publisher: Springer
ISBN: 3319129376
Category : Medical
Languages : en
Pages : 127
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Book Description
This book has been designed to provide the full description of the comprehensive management of peritoneal surface malignancies as a new emerging specialty. Combined treatment of cytoreductive surgery (CRS) and hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) introduced by our leader Paul H. Sugarbaker are performed to treat peritoneal metastases by surgeons all around the world. Therefore this book is focused on detailed surgical anatomy of the peritoneum, preoperative clinical assessment of the peritoneal surface malignancy, patient preparation and operation room equipments, different surgical procedures for CRS and reconstruction, intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) and neoadjuvant intraperitoneal chemotherapy, early postoperative intraperitoneal chemotherapy (EPIC) and molecular basis of peritoneal surface malignancies. The chapter on molecular mechanisms of the formation of peritoneal carcinomatosis provides insight into a rapidly expanding knowledge within this speciality. This book should be valuable for surgical oncologists who deal with multimodal treatment for peritoneal surface malignancies, as well as for the trained peritonectomy surgeons. For the senior surgeons, it will also introduce new techniques and approaches in this field such as dealing with the omental cakes and massive organ involvement that requires multi-organ resection.
Author: Maurie Markman
Publisher: Springer Science & Business Media
ISBN: 1592592198
Category : Medical
Languages : en
Pages : 363
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Book Description
Maurie Markman and a panel of distinguished clinicians and leading clinical investigators comprehensively review the current status of regional antineoplastic drug delivery in the management of malignant disease. These authorities present a critical analysis of both the rationale and limitations of regional therapy and discuss potential clinical trials designed to explain the effectiveness of this method of therapy in special settings. Their presentations describe many exciting and innovative strategies for using regional drug delivery in anticancer therapy, including coverage of such areas of special interest as colorectal, skin, lung, pancreatic, ovarian, and gastrointestinal cancers. Comprehensive and authoritative, Regional Chemotherapy: Clinical Research and Practice offers surgical and medical oncologists and clinical cancer investigators a gold-standard review of the current role and future development of this increasingly powerful weapon in the battle against cancer.
