There was a significant surgeon-related variation in patient outcome, which is probably related to the surgical technique. Although improved technique may reduce the local recurrence rate, preoperative radiotherapy is still beneficial concerning local control and survival.

Sequential changes of plasma proteins after surgical trauma. Scand. J . d i n . Lab. Invest. 29, suppl. 124, 127-136, 1972. The response of 18 plasma proteins after cholecystectomy has been followed up for 3 weeks. The acute phase reaction has been compared with that after mastectomy. The response to these tissue lesions were very similar but more intense after cholecystectorny. The finding suggest that aa-macroglobulin may be used as an internal standard since no apparent changes appear. The concentration decreases during the first few postoperative days for albumin, a-lipoproteins, transferrin and prealbumin. No common cause is probable. C-reactive protein and antichymotrypsin begin to rise within eight hours. One day later orosomucoid, fibrinogen, haptoglobin and a,-antitrypsin show a strong reaction. Hemopexin, /3,c-globulin, prothrombin, ceruloplasmin, Gc-globulin, a , easily precipitable glycoprotein, plcsminogen and cold insoluble globulin showed a delayed reaction with a moderate increase within a week. The immunoglobulins show insignificact changes. 4 types of operations (herniorrhaphy, appendectomy, thyroidectomy and gastrectomy) utilizing mainly the radial immunodiffusion technique Scand J Clin Lab Invest Downloaded from informahealthcare.com by University of Newcastle on 01/02/15 For personal use only. Scand J Clin Lab Invest Downloaded from informahealthcare.com by University of Newcastle on 01/02/15 For personal use only. * "% of normal" refers to the serum or plasma pool from healthy blood donors. Scand J Clin Lab Invest Downloaded from informahealthcare.com by University of Newcastle on 01/02/15 For personal use only. Scand J Clin Lab Invest Downloaded from informahealthcare.com by University of Newcastle on 01/02/15 For personal use only.

A previous study undertaken by this department showed follow-up to be of little value in tracing curable recurrences in patients with colorectal cancer who had curative operations. The aim of the present investigation was to determine if more intensified follow-up would result in earlier diagnosis of recurrences and thus lead to earlier and more effective treatment. Altogether 599 patients with colorectal cancer were treated between 1973 and 1977. The 363 (61 per cent) patients who were operated upon for cure entered the study and were followed up until December 1979. The same incidence of recurrence was seen in both series, but, with the more detailed protocol, they were more frequently detected before symptoms developed. However, the rate of curative reoperation for recurrence was not changed and only few patients survived after such reoperations. The conclusion is that the previous protocol is as efficient as the detailed one while no effective treatment of disseminated disease exists.

There was a significant surgeon-related variation in patient outcome, which is probably related to the surgical technique. Although improved technique may reduce the local recurrence rate, preoperative radiotherapy is still beneficial concerning local control and survival.

Shift in morbidity pattern to a greater proportion of patients with proctitis at diagnosis and a shorter time from onset of symptoms to diagnosis had no influence on the relapse rate. Indeterminate colitis has a worse prognosis than definite ulcerative colitis. Considering the documented efficacy of sulfasalazine, the high relapse rate calls for studies of the effectiveness of such treatment in everyday practice.