ABSTRACT
An original method of surgical treatment of synchronous primary-multiple bladder and prostate cancer was used in 10 cases. Ureterocutaneostomy with pelvic-iliac lymphodissection appeared to be the simplest means of urine diversion after cysto-prostate-vesiculoectomy, particularly, in apparent concomitant pathology, basal renal insufficiency or blockade. Urine diversion is best assured via ureterosigmorectoanastomosis which is optimal as far as social rehabilitation of the patient is concerned.
Subject(s)
Cystectomy , Neoplasms, Multiple Primary/surgery , Prostatectomy , Prostatic Neoplasms/surgery , Urinary Bladder Neoplasms/surgery , Urinary Diversion/methods , Aged , Anastomosis, Surgical , Colon, Sigmoid/surgery , Female , Humans , Lymph Node Excision , Male , Middle Aged , Neoplasm Staging , Neoplasms, Multiple Primary/pathology , Neoplasms, Multiple Primary/rehabilitation , Prostatic Neoplasms/pathology , Prostatic Neoplasms/rehabilitation , Rectum/surgery , Treatment Outcome , Ureter/surgery , Ureterostomy , Urinary Bladder Neoplasms/pathology , Urinary Bladder Neoplasms/rehabilitationABSTRACT
More than 20 years have passed since the introduction of surgical techniques based on distal myocutaneous flaps or microvascular flaps in the reconstruction after head and neck cancer resections. The experience gained from the beginning of these techniques until today, has improved the possibility to better predict functional impairment of swallowing in patients and its possible recovery. This contributes to a better counselling of the patient and better prediction concerning his/her quality of life. Despite the time passed and good progress in the development of microsurgical techniques, the literature shows that many differences still remain among Authors concerning choice of flap and its inset in relation to the anatomical sites and the extent of resection. Many other variables may condition post-operative swallowing (pre- or post-operative radiotherapy, general conditions of the patient ...) thus contributing to a more difficult comparison of the different series reported in the literature. Personal experience is based upon surgical treatment in >60 patients with advanced bucco-pharyngeal cancer, all of whom evaluated post-operatively by video-endoscopy and video-fluoroscopy. In summary, data collected both from personal experience and the literature show that difficulties still remain in correct evaluation of swallowing in these patients. This is mainly due not only to lack of a commonly accepted scheme of classification to quantify the anatomical defect but also to differences between Authors concerning choice of the type of flap and the mode of inset.
Subject(s)
Deglutition , Mouth Neoplasms/rehabilitation , Mouth Neoplasms/surgery , Neoplasms, Multiple Primary/rehabilitation , Neoplasms, Multiple Primary/surgery , Pharyngeal Neoplasms/rehabilitation , Pharyngeal Neoplasms/surgery , Humans , Oral Surgical Procedures/methods , Recovery of FunctionSubject(s)
Head and Neck Neoplasms/rehabilitation , Maxillofacial Prosthesis Implantation , Maxillofacial Prosthesis , Carcinoma, Basal Cell/rehabilitation , Carcinoma, Basal Cell/surgery , Carcinoma, Squamous Cell/rehabilitation , Carcinoma, Squamous Cell/surgery , Eye, Artificial , Head and Neck Neoplasms/surgery , Humans , Magnetics/instrumentation , Male , Melanoma/rehabilitation , Melanoma/surgery , Middle Aged , Neoplasms, Multiple Primary/rehabilitation , Neoplasms, Multiple Primary/surgery , Orbital Implants , Palatal Obturators , Treatment OutcomeSubject(s)
Carcinoma, Squamous Cell/surgery , Esophageal Neoplasms/surgery , Hypopharyngeal Neoplasms/surgery , Tongue Neoplasms/surgery , Abdominal Muscles/transplantation , Aged , Anastomosis, Surgical/methods , Carcinoma, Squamous Cell/rehabilitation , Esophageal Neoplasms/rehabilitation , Humans , Hypopharyngeal Neoplasms/rehabilitation , Lymph Node Excision , Male , Neoplasms, Multiple Primary/rehabilitation , Neoplasms, Multiple Primary/surgery , Skin Transplantation/methods , Surgical Flaps , Tongue Neoplasms/rehabilitationABSTRACT
A case of a primary synchronous lung cancer is presented. Both tumors were removed via a simultaneous both sided posterior lateral thoracotomy. The radical surgical procedure produced respiratory insufficiency resulting in grave adaptation problems and the need to put the patient on a respirator. Rehabilitation allowed the patient to overcome the initial problems allowing light physical work without dyspnea.
Subject(s)
Carcinoma, Squamous Cell/surgery , Lung Neoplasms/surgery , Neoplasms, Multiple Primary/surgery , Thoracotomy/methods , Carcinoma, Squamous Cell/rehabilitation , Humans , Lung Neoplasms/rehabilitation , Male , Middle Aged , Neoplasms, Multiple Primary/rehabilitationABSTRACT
The authors investigated social and occupational rehabilitation of patients treated at N.N. Petrov Research Institute of Oncology for cancer recurrences in colon and rectum (96 cases), for metachronic neoplasms (40 cases), and also for patients accepted for coloplasty after Hartmann operation (11 cases). The term of hospitalization in cancer recurrences was 15.9 +/- 2.5 months; in metachronic tumors, 77.1 +/- 9.9 months; and for the patients accepted for coloplasty, from 6 to 12 months. The period of patients' survival after radical operations in cases of metachronic tumors is twice as long as in recurrences and approaches, on the average, five years. The patients operated upon for their metachronic tumors are characterized by a high degree of social and occupational readaptation (about 80%) in comparison with patients with tumor recurrences (30%). All the patients who had undergone coloplasty were subsequently completely readapted from a social point of view, which was due to the elimination of a fecal fistula.