[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.

[Structural and functional features of the ovaries as a risk factor for ovarian cancer in infertile women]. / Strukturno-funktsional'nye osobennosti iaichnikov kak faktor riska raka iaichnikov u zhenshchin s besplodiem.

In examining 502 female patients with cancer of the ovaries (OC) infertility was identified in 21.9 percent of cases. The prevalent form of infertility was tubal infertility (92.7%), there were but a few instances of the endocrine form (1.8%). The infertile women were studied for their hormonal and receptorial status (receptors of estradiol and progesterone). It has been established that women with the endocrine variant of infertility present with more prominent hormonal inadequacies in the hypophysis-ovaries system and manifest changes in the receptorial status of the ovaries than those with tubal infertility; the findings in the latter have not been shown to be different from controls. In endocrine infertility OC is in fact not encountered, which fact can be related to morphological features of the ovaries giving origin to endocrine disturbances, and to a decline in the receptorial status and absence of ovulation.

[Enhancement of efficiency in the chemotherapy of ovarian cancer]. / Puti povysheniia éffektivnosti khimioterapii raka iaichnikov.

As many as 308 patients with stage IV ovarian carcinoma (OC) were examined to assess effectiveness of employing platinum drugs (CP and CAP)-based chemotherapy regimens depending on the degree of differentiation of tumor cells, on the extent to which the process has been disseminated, and on the cytostatics regimens adopted. Standard chemotherapy regimens permitting maintaining the standard "intensity" of the cytostatic dose have been shown to improve OC treatment results, especially in those patients presenting with medium and high-grade (poorly differentiated) tumors. Patients with low-grade tumors derive benefit when placed on the above chemotherapy at 4 weeks intervals whereas those with medium- and high-grade tumors benefit from treatments on a 3-week interval schedule.

[The surgical treatment of large ventral hernias in middle-aged and elderly patients]. / Khirurgicheskoe lechenie bol'shikh ventral'nykh gryzh u bol'nykh pozhilogo i starcheskogo vozrasta.

Changes of intra-abdominal pressure, the degree of abdominal wall stretching, the strength of connection of the tissues and the quality of the operative wound, central hemodynamics, and the indices of external breathing were studied depending on the type of hernioplasty in 44 animals (dogs) and 420 patients with large ventral hernias. The authors suggest a method for surgical treatment of ventral hernias by twisted aponeurotic sutures applied under control of intraabdominal pressure. With the use of this method the number of complications in the main group reduced 3.5 times. With an increase of intraabdominal pressure by more than 1.5 times as compared to the initial value, slackening incisions of the anterior walls of the sheath of the rectus abdominis muscle are recommended. The length of the incisions is controlled by the values of intraoperative tensiomanometry. The number of recurrences with the of the suggested method was 6%.