[Operative and interventional therapy of fibroids]. / Operative und interventionelle Therapie des Uterus myomatosus.

Myomas are the most frequent benign, solid tumours of the female genital tract in women of reproductive age. These tumours are estrogen dependent and their incidence rises with increasing age. A large number are asymptomatic, while others often cause bleeding disturbances or displacement complaints. Increasingly more women with uterus myomatosus desire to have children at a later age. In addition, progressively more women with myoma conditional complaints who have finished their family planning wish to retain their uterus. While the trend towards preserving organs has increased with the spread of minimal-invasive endoscopic techniques, minimal invasive radiological and non-invasive techniques are still searching for a place in the wide spectrum of treatment available today.

Perioperative levels of interleukin-1beta and interleukin-6 in women with breast cancer.

OBJECTIVE: Proinflammatory cytokines, such as Interleukin-1beta and Interleukin-6, are known to play an important biological role in trauma, sepsis and malignant disease. Surgery can modulate the immune system, especially in patients with malignant diseases, by influencing the serum levels of Interleukin-1beta and Interleukin-6. It is known that cytokine levels depend on the grade of tissue injury. We have investigated the serum levels of Interleukin-1beta and Interleukin-6 during the perioperative period in women with breast cancer undergoing simple mastectomy or segmental resection. The aim of the study was to analyse whether breast cancer surgery influences cytokine expression in the peripheral blood and whether the concentrations of the measured interleukines differ according to the surgical method. METHODS: Blood samples of 45 women with breast cancer (Stage I and II) undergoing simple mastectomy (n = 16) or segmental resection (n = 29) were collected at six different times: before (T1), during (T2), three hours after (T3), one day after (T4), three days (T5) and five days after (T6) surgery. The serum levels of Interleukin-1beta and Interleukin-6 were measured by ELISA. RESULTS: In both groups Interleukin-1beta serum concentrations (p < 0.05) increased significantly on the first day after surgery. On the third day after surgery the concentrations of Interleukin-1b decreased to the preoperative level. A significant difference in Interleukin-1beta concentrations as a consequence of the surgical method was not detectable. Changes in the serum levels of Interleukin-6 within the measurement period were not observed. CONCLUSIONS: Surgery in patients with breast cancer leads to increased Interleukin-1beta serum levels on the first postoperative day. It has been shown that elevated Interleukin-1beta and Interleukin-6 levels are correlated with a high rate of recurrence. Therefore, this may be of consequence to patients with malignant diseases. The method of surgery for both types, however, had no influence on the peripheral cytokine expression. Therefore, a nearly equal influence on the immune system can be stated.