[Roentgen-surgical interventions in combined treatment of patients, suffering hepatic metastases of noncolorectal cancer].

Results of combined treatment, using roentgen-surgical interventions, of 58 patients, suffering noncolorectal metastatic affection of the liver, complicated in 20 (34.5%) of them by obturation jaundice, were analyzed. While resectability of the metastases, preoperatively chemotherapy (CHT) or chemoembolization of hepatic artery (CHEHA) in 1 - 2 courses were performed, and then - hepatic resection of various volume, adjuvant regional CHEHA or systemic CHT. Median survival of the patients have constituted 31.2 mo. While presence of nonresectable metastases a regional chemoinfusion via hepatic arteries or CHEHA (2 - 3 courses) were performed. Median survival of this group of patients have constituted 15.3 mo. Application of cytostatics for regional therapy have permitted in 4 (6.9%) patients, in whom partial tumor regression was achieved, to perform radical hepatic resection. Complete answer on the treatment was not achieved in any patient, partial answer was noted in 16 (33.3%), the process stabilization - in 20 (41.7%), the tumor progress - in 12 (25.0%). In total 170 endovascular and 41 transcutaneous transhepatic endobiliary interventions were performed. After operation 1 (12.5%) patient died.

[Roentgensurgical interventions in combined treatment of patients for hepatic metastases of colorectal cancer].

The results of combined treatment in 82 patients for hepatic metastases of colorectal cancer, complicated in 14 (17.1%) of them by obturation jaundice, using roentgensurgical interventions, were analyzed. In case of resectable metastases, preoperative chemotherapy and chemoembolization of hepatic artery was conducted, using 1 - 2 courses of oxaliplatin, and further--hepatic resection in various volume (in 23 patients), adjuvant regional chemoembolization or systemic chemotherapy. Median survival of the patients in this group was 32.2 mo. While unresectable metastases presence (in 59 patients), the treatment with the help of regional chemoinfusion via hepatic artery or chemoembolization of hepatic artery (2 - 3 courses), using oxaliplatin or irinotecan, was conducted. Median survival of patients in this group was 16.7 mo. Application of oxaliplatin for treatment with the help of regional therapy have permitted in 8 (9.8%) patients, while partial efficiency of chemotherapy, to perform radical hepatic resection. Complete answer on therapy was noted in 6 (8.6%) patients, the partial--in 19 (27.1%), the state stabilization--in 37 (52.9%), the disease progress--in 8 (11.4%). In total in 82 patients there were performed 217 endovascular and 24 transcutaneous transhepatic endobiliary interventions. Postoperatively 5 (6.1%) patients died.

[Regional vasotropic and hepatotropic therapy in the complex treatment of postoperative purulent peritonitis].

In 8 patients, operated for postoperative spreaded purulent peritonitis, umbilical vein was catheterized, postoperatively angiographic investigation was performed, leaving catheter in tr. coeliacus or a. mesenterica superior, through which regionary hemodilution, using drop infusion of 20 mcg of alprostan during 3-4 days. Additionally, to all the patients intraportal hemodilution with hepatoprotector thiotriazoline infusion was performed. Application of the treatment measures complex proposed had assisted an early restoration of splanchnic microcirculation, significant lowering of endogenic intoxication severity, rapid restoration of hepatic functional activity, reduction of systemic inflammatory answer expression.

[The results of extended and combined operations for locally-spread colon cancer].

The results of combined treatment of 385 cancer recti patients, of whom 202 -- using the staged tactics and chemotherapy, using modified methods of pelvic evisceration and reconstructive-restoration operations with extended lymph node dissection, were analyzed. The main syndromes, characteristic for locally-spread cancer recti are delineated, the surgical treatment concept for this pathology was formulated. The combined approach application had promoted the radical and cytoreductive operations performance rate enhancement, the reduction of palliative operations performance rate, as well as severe complications (hemorrhage and anastomotic sutures insufficiency) occurrence rate, total complications rate -- by 3.8% and lethality -- by 1.9%.