Investigations of Pathological Conditions and Circulation during Oncological Reconstructive Surgeries

Abstract

Cancer has a major impact on society across the world. In 2012, an estimated 14.1 million new cases of cancer occurred worldwide, of these 7.4 million cases were in men and 6.7 million in women. The four most common cancers occurring worldwide are: lung, female breast, colorectal and prostate cancer. These four account for around 4 in 10 of all cancers diagnosed worldwide. In our study we mainly focused on breast and head/neck (oesophagus, hypopharyngs) cancers. Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% of the total cancer cases and 14% of the cancer deaths. Oesophageal cancer is the eighth most common cancer worldwide (3,2% of the total), and the sixth most common cause of death from cancer (4,9% of the total). The early diagnosis would be essential in all cases, to prevent further complications and the development of metastases. Unfortunately, in most of the cases, the specific symptoms occur only at the advanced stage, so the role of the screening programs and of the suitable tumour markers are high. The importance of the tumour markers should be also emphasized in the postoperative period, for early detection or exclusion of the recurrence of the cancer or for the detection of a second tumour. There are a lot of attempt to find new markers, but still, it is very important to do researches on this field and improve the diagnostic tool for cancers. Beside the early diagnosis and adequate therapy, reconstruction of the defects after oncological ablative surgeries is also a big challenge for the plastic-reconstructive surgeons. One optional procedure is the reconstruction with autologous tissues, when the own tissue of the body is used for reconstruction. In these cases different flaps can be chosen: local flap, regional flap or free tissue transfer. Although, the success rates of free tissue transfer are high, there are still some cases, where the insufficient microcirculation, caused by ischemia-reperfusion injury (IRI), leads to partial flap loss and results in the reoperation of the patient. In addition, the flap/limb can become irremediable because its poor circulation, and it may make the reconstruction more difficult or impossible. For these reasons the detection of biochemical changes and microcirculatory disorders in flaps during ischemia-reperfusion (I/R), are of high importance.