ABSTRACT
AIM: To assess safety of rectum removal with distal sacral resection. MATERIAL AND METHODS: The short-term results of surgical treatment of primary and recurrent locally advanced rectal and anal cancer with sacral fixation have been analyzed. 32 patients underwent combined operations with sacral resection at the level of S2-S5. In 12 patients only one point of tumor fixation (F1) was revealed, 10 patients had two points of fixation (F2), three patients had three fixation points (F3) and in 7 cases the tumor was fixed to four points (F4) of fixation to different pelvic structures. RESULTS AND DISCUSSION: Mean intraoperative blood loss and surgery time was 551±81 ml and 320±20 min in cases of sacral fixation only that was significantly lower compared with F2 cases - 1278±551 ml and 433±45 min, F3 cases - 2200±600 ml and 620±88 min, F4 cases - 2157±512.5 ml and 519±52,3 min, respectively (Ñ<0.05). Complications requiring surgical intervention occurred in 9% patients (n=3). Among 23 patients with intact bladder and ureters urinary disorders occurred in 42% (n=10). Resection margin was negative along posterior surface of the specimen in all cases. CONCLUSION: Advanced surgery with distal sacral resection is advisable for radical removal of locally advanced and recurrent rectal and anal canal cancer fixed to the sacrum with negative resection margin. These operations are feasible in specialized centers and should be performed by specially trained oncological or colorectal surgeon.
Subject(s)
Adenocarcinoma , Anus Neoplasms , Digestive System Surgical Procedures , Neoplasm Recurrence, Local , Postoperative Complications , Rectal Neoplasms , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Anus Neoplasms/pathology , Anus Neoplasms/surgery , Digestive System Surgical Procedures/adverse effects , Digestive System Surgical Procedures/methods , Feasibility Studies , Female , Humans , Male , Margins of Excision , Middle Aged , Neoplasm Invasiveness , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/surgery , Neoplasm Staging , Operative Time , Outcome and Process Assessment, Health Care , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Rectal Neoplasms/pathology , Rectal Neoplasms/surgery , Russia , Sacrum/pathology , Sacrum/surgerySubject(s)
Influenza A virus/immunology , Influenza B virus/immunology , Influenza Vaccines/adverse effects , Administration, Intranasal , Adolescent , Adult , Antibodies, Viral/blood , Antibody Specificity , Humans , Immunoglobulin A, Secretory/blood , Influenza Vaccines/administration & dosage , Influenza Vaccines/immunology , Vaccines, Combined/administration & dosage , Vaccines, Combined/adverse effects , Vaccines, Combined/immunology , Vaccines, Inactivated/administration & dosage , Vaccines, Inactivated/adverse effects , Vaccines, Inactivated/immunologyABSTRACT
Vaccination activity and safety of inactivated influenza centrifugal divaccine have been studied in groups of subjects aged 18 to 22, 15 to 16, and 9 to 14 years. The vaccine tested contained either a standard dose (6-8 micrograms) or double a dose (12-16 micrograms) of the haemagglutinin (HA) of influenza viruses A(H1N1) and A(H3N2). The double antigenic load of the vaccine did not enhance its reactogenicity for adults or adolescents aged 15 to 16 years. It enhanced, however, the production of antihaemagglutinine antibodies to the vaccine strains. The range of the antibodies formed and their persistence were independent on the virus dose. The increased dose (12-16 micrograms) of HA decreased the humoral immune response in school children aged from 11 to 14 years. Neither standard nor double dose of the vaccine caused any changes in the biochemical or haematological parameters of blood and urine. No allergic response was registered by the indirect mast cell degranulation (IMCD) test in rats.
