Slaid 47 Treatment of malignant tumors.

Modern treatment of tumors, as a rule, combined. It happens radical when the tumor together with ways of an innidiation is removed; palliative when the tumor is removed, but metastasizes and symptomatic when carry out treatment only on symptoms at inoperable patients aren't removed.

The main method of treatment - surgical. Radical operation is carried out, as a rule, in the absence of the remote metastasizes

The operation executed within healthy tissues is considered radical. Thus rules of an ablastics and antiblastics for an exception of a contact innidiation are followed.

Ablastics ? a complex of measures on prevention of dissemination during surgery tumor cells.

It is necessary:

n To perform the incisions only within the notoriously healthy tissue

n Avoid mechanical injury to the tumor tissue

n Quickly bandaging venous vessels extending from education

n Tie a ribbon hollow body above and below the tumor (prevention of cell migration to the lumen)

n To remove the tumor as a single block with tissue and regional lymph nodes

n Before handling the tumor to limit wound wipes

n After removal of the tumor to change tools, gloves, napkins.

Slaid 48Antiblastics- complex measures on destruction during the operation of certain tumor cells, cut off from the main mass.

Physical antiblastic: The use of electrocautery ; The use of laser; The use of cryodestruction ; The irradiation of the tumor before surgery and in early postoperative period

Chemical antiblastic: Treatment of the wound surface after removal of the tumor 700 alcohol; Intravenous administration of anticancer chemotherapy drugs on the operating table; Regional perfusion of chemotherapeutic anticancer drugs

Slaid 49 Zoning -you must remove not only the tumor formation, but the entire area, which may be cancer cells.

When exophytic the growth of the tumor need to step back from the visible boundaries of education 5-6 cm.

When endophytic ? not less than 8-10 cm

Along with the organ or part of it removed all of the lymph vessels and nodes of this area

Fallarrest for greater radicality is necessary to remove the lymph nodes along with the fascial tissue of the entire case, preferably, together with the fascia.

Slaid 50the patient 56 years. Cancer of the maxillary sinus was installed in 2014. Stage 2. performed resection of the upper jaw in the border city of Russia. after surgery received chemoradiation treatment. after 1 year the recurrence. he proposed surgical treatment. And, with the consent of the patient produced by the combined removal of recurrent tumor of the left maxillary sinus with exenteration of the orbit, the edge of the frontal bone resection, resection of the anterior wall of the sphenoid sinus, the pterygoid process underlying bone grafting of the defect Fazio-cervical-pectoral flap for Crow. The defect of the soft palate is sutured. The operation was conducted for 2.5 hours.

Slaid 51 SURGICAL TREATMENT(movie)

The patient 45 years old, was admitted on an emergency basis in a serious condition, hypotonia. Woman fibroid is 10 years. The surgery flatly refused. Was engaged in business. Relatives brought her to the hospital taking advantage of her unconscious state. After bringing her in "feeling" within a few days an operation was performed - removal of all existing tumors. Uterus, ovaries could not be seen. All in a single mass. The tumor size is impressive. The total mass of the distant tumors was 14 kg. Originally thought about sarcoma. In the end it turned out the fibroids with blood circulation.

Slaid 52 SURGICAL TREATMENT (movie)

Patient 5 years old with a brain tumor,made a craniotomy, the tumor getroproperty with a full removal of the tumor, with subsequent restoration of function of limbs.

Slaid 53 Radiation therapy. It is based that tumor cells are in continuous division, and in this state they are more sensitive to beams. Only the X-ray therapy, and was many years ago carried out now ? Y-or B-beams. Radiation therapy is shown at 2-3 stages of a disease when regional lymph nodes are involved in process. Complications of radiation therapy:

LOCAL: Jet epidermic, Radiation dermatitis, Radiation indurative edema, Necrotic radiation ulcer

TOTAL (radiation sickness): Weakness, Loss of appetite, nausea, vomiting

Tachycardia, shortness of breath, Leukopenia, thrombocytopenia, anemia

Next Chemotherapy. It is shown at a dissimination (multiple distributions) of process. It can be used as independent radical treatment, for example, at leucosis, or as addition to expeditious treatment. As a rule, it is conducted some courses of a poly chemotherapy, i.e. treatment at once by several preparations.

The basic principles of a poly chemotherapy (PHT) are:

1) PHT of subjects is more effective, than the tumor since the mitosis goes on the periphery of a tumor is less;

2) PHT of subjects is more effective, than it is more than dose of preparations;

3) PHT of subjects is more effective, than to exchange the tumor is differentiated;

4) PHT is carried out under strict control of level of leucocytes and platellets.

The expressed leucio-thrombocytopenia, hepatic renal failure since chemo therapy are inactivated by a liver can be complications of a chemo therapy and are removed by kidneys.

Next Hormone therapy. Distinguish a specific hormone therapy and nonspecific. The last (Prednisolon) will be out at a complex cancer therapy of a mammary gland, some general cancer diseases. A specific hormone therapy is carried out at a cancer of hormonal organs.

Slaid 54Prophylaxis of malignant tumors.

1. Individual: smoking termination, moderate alcohol intake, personal hygiene.

2. The solution of ecological problems fights with carcinogens.

3. Treatment of chronic diseases.

4. Excision of benign tumors.

5. Full medical examination of the population and early detection of tumors.

Slaid 55Dispensary observation.

Patients with precancerous diseases and malignant tumors are subject to a dispensary observation at the oncologist.

They make 4 clinical groups:

1) patients with precancerous diseases;

2) the patients with the diagnosed malignant tumor who are subject to special treatment;

3) patients after the carried-out radical treatment;

4) the inoperable patients who are subject to an expected treatment.

Date: 2016-06-13; view: 171