• 제목/요약/키워드: Cancer patients just after surgery

검색결과 21건 처리시간 0.024초

수술 직후 암 환자의 희망증진 간호를 위한 이론 모델 개발 : 현실적 희망 (A Theoretical Model of Hope Enhancing the Cancer Patients just after Surgery: Realistic Hope)

  • 김달숙;박인숙
    • 성인간호학회지
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    • 제18권1호
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    • pp.115-124
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    • 2006
  • Purpose: The purpose of this study was to propose a theoretical model of hope commonly held by the cancer patients just after surgery, under the assumptions that hope of those patients is not only realistic and disease oriented but in dialectical circulation. Method: A theoretical model was generated through 4 steps: exploring a hope structure by synthesizing the relevant hope structures expressed in Kim and Tae's studies, in-depth literature review, examining the meanings of the concepts consisted of the structure in use and their causal relations in logical adequacy, proposing a theoretical structure through synthesizing the causal relations, and diagramming the structure. Results: The proposed theoretical model involves concepts such as Cancer Related Uncertainty (CRU), Efforts to Find out the Possibility of Cure or Recovery (EFPCR), and Hopefulness or Hopelessness. The 'EFPCR' is stipulated as 'Behaviors Related to Looking for Evidences or Cues (BRLEC)' and 'Formation of Cognitive Schema (FCS)'. In the model, Hopefulness is directly influenced by 'CRU in low', which is affected by 'FCS in good' from the result of EFPCR started with 'CRU in increase' while 'CRU with increase' from the result from EFPCR has direct effect on Hopelessness. Conclusion: The theoretical model would be used to enhancing hope of the cancer patients in post-operation.

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Changes of Quality of Life after Gastric Cancer Surgery

  • Kong, Horyon;Kwon, Oh Kyung;Yu, Wansik
    • Journal of Gastric Cancer
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    • 제12권3호
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    • pp.194-200
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    • 2012
  • Purpose: The aim of this study was to evaluate chronological change of quality of life after surgery in patients with gastric cancer during one year postoperatively. Materials and Methods: Quality of life data were obtained from 272 gastric cancer patients who underwent curative gastrectomy between September 2008 and February 2011 at the Kyungpook National University Hospital. The Korean versions of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core (QLQ) 30 with gastric cancer-specific module, the EORTC QLQ-STO22 were used to assess quality of life. All patients had no evidence of recurrence or metastasis during the first postoperative year. Patients were asked to complete the questionnaire, by themselves preoperatively, 3-, 6-, 9-, and 12-months postoperatively. Results: Physical functioning score and role functioning score significantly decreased at first 3 months after surgery and the significant differences were noticed until 12 months after surgery. Emotional functioning score started with the lowest score before surgery and significant improvement was shown 6 months after surgery. Most symptom scores and STO-22 scores were highest at 3 months after surgery and gradually decreased, thereafter. Eating restriction, anxiety, taste, body image scores was highest at 3 months after surgery without significant decrease afterwards. Conclusions: Most scales worsened after surgery and gradually recovered afterwards with some differences in rate of recovery. However the scales did not fully recover by 1 year period. Further follow-up after 1 year would be helpful in determining which scales are permanently damaged and which are just taking longer time to recover.

위암(胃癌)의 동서의학적(東西醫學的) 진치(診治) 개황(槪況) (An Outlook of the Oriental and Western Medical Diagnosis and Treatment on Gastric Cancer)

  • 김병주;문구
    • 대한한의학회지
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    • 제17권2호
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    • pp.100-116
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    • 1996
  • Gastric cancer shows the most high friquency in cancers that occurs in Korea. The western medicine treatment for gastric cancer has radiation and surgery, chemical treatment. While, oriental medicine cures the gastric cancer by herb-drugs, acupunture , moxa and srigma. With just one way of treating gastric cancer can't be effective remedy. Because each medicine has a strength and weakness. Thus, it is effective treatment when two medicine combins and supplement each other. We got the following result about a trend of oriental and westernal combination treatment for gastric cancer through studing records. 1. The western medicine treats gastric cancer patient with surgery first and right after surgery. They need on assembly treatent such as chemical and immune treatment. In oriental medicine, they treats gastric cancer patients with differentiation of symptone and signs and treatment(辨證施治)[for example:incoordination between liver and stomach(肝胃不和), insufficiency of spleen and stomach(脾胃虛弱), stagnation of blood stasis and toxic agent(瘀毒內阻), deficiency of yin by stomach heat(胃熱傷陰), reinforcing both qi and blood(氣血雙虧), stagnation of damp-phlegm(痰濕凝結)] and cure for them by acupuncture and stigma, too. 2. In combination with oriental and western medical treatment principle of gastric cancer by each stage is as follows. First stage and second stage gastric cancer is cured with radical surgery mainly. After operation, the herb of invigoration of the spleen(健脾), coordination of the stomach(和胃), and smoothing the liver and regurating the circulation of qi(疏肝理氣), is used for good gastroenteric condition. The second stage patients can be concidered using in combination with chimical treatment. The third stage gastric cancer is treated with radical surgery or with temporizing surgery. After those surgery, herb-drugs treatment is used jointly. The fourth stage patients who have no extensively metastasis or local contraindication can undergo temporizing and curcuit surgical operation. Herb-drugs and chemical treatments are used together for patients after operating. If he has operating contraindication, he would be treated with herb-drugs and chemical treatment. 3. In case of using in combination with oriental and western medical treatment as follows. As for herb-drugs with chemical treatment, reinforcing both qi and blood(補益氣血), invigorate the spleen and the stomach(健脾和胃), reinforcing liver and kidney(滋補脾腎), clear out the heat and relieve the toxic agent(淸熱解毒), can be used and with radiation treatment, clear out the heat and relieve the toxic agent(淸熱解毒), promoting the production body fluid and moisturizing the vicera(生津潤燥), reinforcing both qi and blood(補益氣血), invigorate the spleen and the stomach (健脾和胃), reinforcing liver and kidney(滋補肝腎) etc, can be used. 4. According to the research of oriental and western medical combination treatment are the 5-year-survival degree with oriental and western medicine combination treatment was for better than that just with oriental or western medical treatment. Especially, it has good effect on the third, fourth stage gastric cancer. That is, the middle and the end of stage gastric cancer. 5. The merits of oriental and western medicine combination treatment are lengthers one's life and diminish the bad effect of chemical treatment and radiation treatment be near completion, prevent from relapsing, maintain the balance in their eveirenment of body and improve immunity.

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Clinical Significance of Serum Vascular Endothelial Growth Factor and Complement 3a Levels in Patients with Colorectal Cancer in Southern Iran

  • Mehrabani, Davood;Shamsdin, Seyedeh Azra;Dehghan, Alireza;Safarpour, Alireza
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권22호
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    • pp.9713-9717
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    • 2014
  • Background: Colon cancer (CRC) is perhaps the second most common cause of cancer mortality. This study determined the clinical significance of serum vascular endothelial growth factor (VEGF) and serum complement 3a (C3a) levels in patients with CRC in Fars province, southern Iran. Materials and Methods: Between June 2010 and June 2012, 110 patients with CRC of both genders and different age groups were divided into 3 groups. Group A included patients who had just undergone surgery; Group B had undergone chemotherapy after surgery; and Group C had undergone chemotherapy and radiotherapy after surgery. Twenty one healthy subjects with normal colonoscopy were considered as a control group. ELISA was undertaken to determine VEGF and C3a levels before and after treatment measures. Results: The mean age of patients was $53.9{\pm}14.1$ years. Considering VEGF level, a significant decrease was visible after treatment measures in groups A and B, but not Group C. For VEGF level, the difference was not statistically significant between two genders and various age groups before and after treatment. No significant difference was found for VEGF level between patients and normal group before any treatment. Regarding C3a levels in 101 subjects, they significantly decreased after treatment measures. Before and after treatment, the difference was statistically significant between two genders, but was not statistically significant among various age groups. Conclusions: As VEGF and C3a levels were significantly lower in patients after treatment, these may be beneficial markers in assessment of CRC therapy especially in early stages.

대장암(大腸癌)의 동서의(東西醫) 결합(結合) 진치근황(診治近況) (An Outlook of the Oriental and Western Medical Diagnosis and Treatment on Large Bowel Cancer)

  • 김병주;문구
    • 대한한방종양학회지
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    • 제5권1호
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    • pp.1-17
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    • 1999
  • Large bowel cancer shows the 4-5th frequency in cancers that occurs in Korea. The western medicine cures the Large bowel cancer by radiation, surgery and chemotherapy. While, Oriental medicine cures the Large bowel cancer by Herb-drugs, acupuncture, moxa and et al. With just one way of treating Large bowel cancer can't be effective remedy. Because each medicine has a strength and weakness, it is effective treatment when two medicine combines and supplement each other. We got the following result about a trend of oriental and western combination treatment for Large bowel cancer through studding records. 1. In Large bowel cancer, colon cancer is referred hematochezia(腸風下血), rectal cancer is refereed enterotoxin(腸毒), and anal cancer is accumulation of pathogens in yin(結陰). 2. The western medicine treats Large bowel cancer patient with surgery first. They need on assembly treatment such as chemical, radiation and immune treatment. In oriental medicine, they treats Large bowel cancer patients with differentiation of symptom and signs and treatment(辨證施治) for example, insufficiency of spleen and stomach(脾胃虛弱), collapse of the spleen-ql(脾氣下陷), stagnation of blood stasis and toxic agent(瘀毒內結), reinforcing both qi and blood(脾血下陷), stagnation of damp-phlegm(痰濕凝結) and cure for them by acupuncture and moxa too. 3. In combination with oriental and western medical treatment princple of Large bowel cancer by each stage is as follows. First stage is cured with radical surgery and herb-drugs without chemotherapy. The intermediate and terminal stage patients is used radiation before surgery, or after palliative surgery cour with chemotherapy, radiation and Herb-drugs. In terminal stage patients, unable for surgery, is used combination between chemotherapy, palliative radiation and Herb-drugs. 4. After radiation surgery, the terminal stage patients who have extensively lymph node metastasis or local contraindication is able to undergo combination of Herb-durgs and chemotherapy. 5. The cure-effect with oriental and western medicine combination treatment was better than that just with oriental or western medical treatment. 6. The merits of oriental and western medicine combination treatment lengthen one's life and diminish the bad effect of chemotherapy and complete radiation treatment, prevent from relapsing, maintain the balance in their environment of body and improve immunity.

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Internal Mammary Sentinel Lymph Node Biopsy after Neoadjuvant Chemotherapy in Breast Cancer

  • Bi, Zhao;Chen, Peng;Liu, Jingjing;Liu, Yanbing;Qiu, Pengfei;Yang, Qifeng;Zheng, Weizhen;Wang, Yongsheng
    • Journal of Breast Cancer
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    • 제21권4호
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    • pp.442-446
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    • 2018
  • Purpose: The definition of nodal pathologic complete response (pCR) after a neoadjuvant chemotherapy (NAC) just included the evaluation of axillary lymph node (ALN) without internal mammary lymph node. This study aimed to evaluate the feasibility of internal mammary-sentinel lymph node biopsy (IM-SLNB) in patients with breast cancer who underwent NAC. Methods: From November 2011 to 2017, 179 patients with primary breast cancer who underwent operation after NAC were included in this study. All patients received radiotracer injection with modified injection technology. IM-SLNB would be performed on patients with internal mammary sentinel lymph node (IMSLN) visualization. Results: Among the 158 patients with cN+ disease, the rate of nodal pCR was 36.1% (57/158). Among the 179 patients, the visualization rate of IMSLN was 31.8% (57/179) and was 12.3% (7/57) and 87.7% (50/57) among those with $cN_0$ and cN+ disease, respectively. Furthermore, the detection rate of IMSLN was 31.3% (56/179). The success rate of IM-SLNB was 98.2% (56/57). The IMSLN metastasis rate was 7.1% (4/56), and all of them were accompanied by ALN metastasis. The number of positive ALNs in patients with IMSLN metastasis was 3, 6, 8, and 9. The pathology nodal stage had been changed from $pN_1/pN_2$ to $pN_{3b}$. The pathology stage had been changed from IIA/IIIA to IIIC. Conclusion: Patients with visualization of IMSLN should perform IM-SLNB after NAC, especially for patients with cN+ disease, in order to complete lymph nodal staging. IM-SLNB could further improve the definition of nodal pCR and guide the internal mammary node irradiation.

Maxillary resection for cancer, zygomatic implants insertion, and palatal repair as single-stage procedure: report of three cases

  • Salvatori, Pietro;Mincione, Antonio;Rizzi, Lucio;Costantini, Fabrizio;Bianchi, Alessandro;Grecchi, Emma;Garagiola, Umberto;Grecchi, Francesco
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제39권
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    • pp.13.1-13.8
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    • 2017
  • Background: Oronasal/antral communication, loss of teeth and/or tooth-supporting bone, and facial contour deformity may occur as a consequence of maxillectomy for cancer. As a result, speaking, chewing, swallowing, and appearance are variably affected. The restoration is focused on rebuilding the oronasal wall, using either flaps (local or free) for primary closure, either prosthetic obturator. Postoperative radiotherapy surely postpones every dental procedure aimed to set fixed devices, often makes it difficult and risky, even unfeasible. Regular prosthesis, tooth-bearing obturator, and endosseous implants (in native and/or transplanted bone) are used in order to complete dental rehabilitation. Zygomatic implantology (ZI) is a valid, usually delayed, multi-staged procedure, either after having primarily closed the oronasal/antral communication or after left it untreated or amended with obturator. The present paper is an early report of a relatively new, one-stage approach for rehabilitation of patients after tumour resection, with palatal repair with loco-regional flaps and zygomatic implant insertion: supposed advantages are concentration of surgical procedures, reduced time of rehabilitation, and lowered patient discomfort. Cases presentation: We report three patients who underwent alveolo-maxillary resection for cancer and had the resulting oroantral communication directly closed with loco-regional flaps. Simultaneous zygomatic implant insertion was added, in view of granting the optimal dental rehabilitation. Conclusions: All surgical procedures were successful in terms of oroantral separation and implant survival. One patient had the fixed dental restoration just after 3 months, and the others had to receive postoperative radiotherapy; thus, rehabilitation timing was longer, as expected. We think this approach could improve the outcome in selected patients.

분화된 갑상선암의 치료 (Treatment of Differentiated Thyroid Cancer)

  • 송영기
    • 대한핵의학회:학술대회논문집
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    • 대한핵의학회 2002년도 제23차 연수교육
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    • pp.77-95
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    • 2002
  • During the last several decades, prognosis of differentiated thvroid cancers improved markedly, mainly due to refinement of surgical techniques and routine use of radioactive iodine. Total or neat-total thyroidectomy is to be performed as the first line of treatment. Routine remnant ablation just after surgery decreases recurrence and increases survival. After then patients are maintained on suppressive dose of thyroid hormone to keep endogenous TSH below normal. Regular follow-up of the patients with serum thyroglobulin measurement and iodine whole body scan after thyroid hormone withdrawal or under recombinant human thyrotropin stimulation select high risk patients with recurrence or metastatic disease and treatment with therapeutic dose of radioactive iodine prolongs survival and sometimes leads cure. Currently recommended diagnostic and therapeutic strategies, present controversies and future directions are discussed.

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위암 환자의 위절제술 후 식도산도의 변화와 운동장애 (A Study of Esophageal Acidity and Motility Change after a Gastrectomy for Stomach Cancer)

  • 김선우;이상호
    • Journal of Gastric Cancer
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    • 제4권4호
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    • pp.225-229
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    • 2004
  • 목적: 위암 환자의 위절제술 후 발생하는 가슴 쓰림, 역류, 비심인성흉통 등 식도증상의 원인규명을 위해 위절제술 후 식도 산도 변화와 운동장애를 알 수 있는 24시간 보행성 식도 산도 검사(일부 환자에서 식도 내압 검사를 병행)를 실시하였다. 대상 및 방법: 2002년 7월부터 2004년 3월까지 위암으로 Billroth I을 시행한 환자와 위전절제술을 시행한 환자 중 무작위로 선택한 15예를 대상으로 술 후 음식 섭취 후 퇴원 전에 24시간 보행성 식도 산도 검사를 시행하였다. 산 역류의 양성 판정은 DeMeester 점수를 사용하여 점수 14.72 이상을 양성으로 하였고, 증상지수는 증상을 보인횟수 중 실제로 산도(pH)가 4 이하였던 경우를 나타내는 것으로 양성판정은 증상지수 $50\%$ 이상인 경우로 하였다. 결과: 무작위로 선택되어 검사한 15예 중 산역류양성 (DeMeester 14.72 이상)을 보인 예는 총 3예($20\%$)로 분석 되었다. 그 중 술 식에 따른 분포는 Billroth I경우는 총 12예 중 3예($25\%$)에서 양성반응을 보였고 위전절제술을 시행한 환자는 3예 중 양성반응을 보인 예가 없었다. 병기에 따른 분포는 각각 I (2예/9예), II (1예/2예), III (0예/3예), IV(0예/1예)였다. 10예에서 식도 내압 검사를 병행하였는데 그 중 7예에서 비특이적 식도운동장애로 분석되었다. 결론: 위암 환자의 위절제술 후 산 역류로 인한 위식도 역류질환이 발생했다. 위암수술로 Billroth I 재건술 후 생기는 위식도역류 증상은 담즙역류뿐만 아니라 위산 역류에 의해서도 생긴다.

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A Promising Method for Tumor Localization during Total Laparoscopic Distal Gastrectomy: Preoperative Endoscopic Clipping based on Negative Biopsy and Selective Intraoperative Radiography Findings

  • Chung, Joo Weon;Seo, Kyung Won;Jung, Kyoungwon;Park, Moo In;Kim, Sung Eun;Park, Seun Ja;Lee, Sang Ho;Shin, Yeon Myung
    • Journal of Gastric Cancer
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    • 제17권3호
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    • pp.220-227
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    • 2017
  • Purpose: Precise localization of tumors and creation of sufficient proximal resection margins are complicated processes during total laparoscopic distal gastrectomy (TLDG) for clinical T1/T2 gastric cancers. Various solutions to this problem have also yielded many disadvantages. In this study, we reviewed a preoperative endoscopic clipping method based on the results of negative biopsy and selective intraoperative radiography. Materials and Methods: A retrospective review of 345 consecutive patients who underwent TLDG and preoperative endoscopic clipping for tumor localization was conducted. During preoperative endoscopy, the endoscopists performed negative biopsies just 1-2 cm selectively above the tumor's upper limit. After confirming the biopsy results, endoscopic metal clips were applied just proximal to the negative biopsy site the day before surgery. Selective intraoperative tumor localization using portable abdominal radiography was performed only when we could not ensure a precise resection line. Results: Negative biopsy was performed in 244 patients. Larger tumor size (P=0.008) and more distally located tumors (P=0.052) were observed more frequently in the negative biopsy group than in the non-negative biopsy group. The non-negative biopsy group had significantly higher frequencies of differentiated tumor types than the negative biopsy group (P=0.003). Of the 244 patients who underwent negative biopsies, 6 had cancer cells in their biopsy specimens. We performed intraoperative radiography in 12 patients whose tumors had difficult-to-determine proximal margins. No tumors were found in the proximal resection margins of any patients. Conclusions: Our tumor localization method is a promising and accurate method for securing a sufficient resection margin during TLDG.