IntroductionChanges in immune function after surgery may influence overall outcome, length of hospital stay, susceptibility to infection and perioperative tumour dissemination in cancer patients. Our aim was to elaborate on postoperative differences in the immune status and the intensity of the systemic inflammatory response between two groups of prospectively enrolled patients with colorectal cancer, namely patients undergoing laparoscopically assisted or open colorectal surgery.Material and methodsBlood samples from 77 patients were taken before surgery and then 3 h, 24 h and 4 days after surgery. The inflammatory response was determined by leukocyte counts, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and procalcitonin levels (PCT). Immune status was determined by phenotypic analysis of lymphocyte populations and the activation of mononuclear cells. CD64 expression and cytokine expression were also determined.ResultsPatients undergoing laparoscopically assisted surgery had less intraoperative blood loss (p = 0.002), earlier resumption of diet (p = 0.002) and shorter hospital stay (p = 0.02). Numbers of total leukocytes (p = 0.12), CRP (p = 0.002) and PCT (p = 0.23) were remarkably higher 4 days after surgery in patients who underwent an open colorectal procedure. There was an important decrease in monocyte HLA-DR expression 3 h after surgery in patients undergoing laparoscopically assisted surgery (p = 0.03).ConclusionsOur study suggests that minimally invasive surgery provides better short-term clinical outcomes for patients with resectable colorectal cancer. The acute inflammatory response is less pronounced. Post-surgical immunological disturbance in both groups is similar, but we observed a divergent effect of different surgical approaches on the expression of HLA-DR on monocytes. However, our results corroborate the results of previous studies.

Rad analizira kako je (zlo)upotreba koncepcija o međunarodnom društvu u kontekstu spoljne politike SAD i drugih zapadnih zemalja legitimizovala navodnu odbrambenu ulogu intervencionističke imperijalne politike prema tzv. odmetničkim, slabim ili propalim državama i raznorodnim nedržavnim akterima koji osporavaju univerzalnu vrednost liberalnog poretka. Polazna pretpostavka autora je da asimetrična priroda sukoba krajem 20. i u ranom 21. veku, u spoju sa idejnim postavkama o međunarodnom društvu, demokratskom miru i podeli sveta na liberalan centar i "necivilizovanu" periferiju, uslovljava osmišljavanje i vođenje ratova kao disciplinskog sredstva zapadne imperijalne kontrolne politike planetarne periferije. Stoga je težište analize stavljeno na pokazatelje ugradnje metodologije rada policije, krivičnog pravosuđa i kazneno-popravnog sistema u ontološku ravan vojnih intervencija koje sprovode SAD, samostalno ili u ad hoc koalicijama sa zapadnim i regionalnim silama. Autor zaključuje da je rat kao društvena praksa u 21. veku izgubio tradicionalne ontološke odlike i poprimio strukturna obeležja kontrolne politike kriminala, te time razvrgao etički okvir u diskurzivnom i praktičnom tretmanu neprijateljskih država i njihovih vojnika, kao i nedržavnih aktera. Ključne reči: rat, vojna intervencija, međunarodno društvo, liberalni poredak, politika kontrole, SAD, Zapad. 1 Autor je naučni saradnik u Institutu za međunarodnu politiku i privredu, Beograd.