ISSN:
1432-2323
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Description / Table of Contents:
Résumé La guérison du cancer colique nécessite que l'intervention chirurgicale surmonte deux obstacles: les complications post opératoires et la récidive du processus tumoral. La récidive survient généralement au cours des cinq années qui suivent l'opération. Les complications opératoires, elles, sont le fait de l'infection. Il est rare que l'infection entraîne la mort; plus souvent en altérant l'endothélium vasculaire elle favorise la thrombose artérielle et veineuse. Elle est la source d'une morbidité très importante qu'elle se développe au sein de la cavité abdominale ou au niveau de la paroi abdominale. Plusieurs méthodes permettent de l'éviter: 1) La réduction du nombre des germes dans l'intestin (préparation pré-opératoire). 2) La diminution du nombre des germes susceptibles en cours d'intervention de contaminer le champ opératoire (technique aseptique). 3) La destruction des agents bactériens contaminant la paroi.
Notes:
Abstract A patient undergoing surgery for carcinoma of the large bowel has 2 hurdles to negotiate before claiming a cure. The first is postoperative complications and the second, recurrence of the tumor. Recurrence of the tumor will occur almost always within the first 5 years. Postoperative complications are mainly related to infection. Infection on its own is rarely responsible for the death of the patient, but by damaging the vascular endothelium may predispose to arterial or venous thrombosis. More commonly, sublethal sepsis is the cause of considerable morbidity whether within the abdominal wound or the intraperitoneal cavity. One or more of 3 basically different methods are employed to control infection in large bowel surgery: (1) reduction in the number of microorganisms in the large bowel; (2) reduction in the number of microorganisms contaminating the wound, whether within or without the peritoneal cavity; and (3) destruction of microorganisms contaminating the wound. The authors have relied on reducing the number of microorganisms contaminating the wound by strict attention to wound protection and aseptic surgery, and the destruction of microorganisms that actually reach the wound. To this end, excellent results with antibiotics have been obtained by combining meticulous aseptic surgery with the use of cefazolin and metronidazole administered a short time prior to surgery.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF01654683
Permalink
