[Main trends in the improvement of surgical treatment results in stomach cancer]. / Osnovnye puti uluchsheniia rezul'tatov khirurgicheskogo lecheniia raka zheludka.

According to the data on the treatment of 964 patients with cardioesophageal cancer, the local recurrence incidence fell dramatically (from 19.7 to 4.8%) in patients who had gone extensive surgery. The results of treatment of 1,209 cases operated on for tumor in the proximal part of the stomach are discussed. Extensive excision of lymph nodes without postoperative complications was found to assure better end results. Excision of lymph nodes should be regarded as an indispensable component of extensive surgery given for stomach cancer.

[Ways of improving results of gastro-pancreatoduodenal resection in tumors of the bilio-pancreatoduodenal area]. / Puti uluchsheniia rezul'tatov gastropankreatoduodenal'nykh rezektsii po povodu opukholei biliopankreatoduodenal'noi zony.

The results of treatment of 86 patients who had been subjected to gastro-pancreatoduodenal resection in the period from 1975 to 1992 were studied. The patients were divided into two groups. The main cause of postoperative mortality in the first group was the development of pancreonecrosis and incompetence of the pancreatico-enteral anastomosis. Hypothermia of the pancreatic duct and introduction of 5-fluorouracil into the pancreatic duct reduced postoperative mortality among patients of the second group from 34.9% to 13.9%. It is shown that this method may be applied in wide surgical practice.

[The diagnosis and surgical treatment of metastatic liver tumors]. / Diagnostika i khirurgicheskoe lechenie metastaticheskikh opukholei pecheni.

The authors have carried out 48 resections of liver for it's metastatic injure. The most frequent source of metastatic spread in liver occurred to be colorectal cancer. Right liver lobe was found to be injured by the metastatic tumour more often. After liver resections of various value the frequency of complications was 37.5%, postoperative lethality--2.1%. Presented data evidence the necessity of widening recommendations to perform radical operative interventions in patients with solitary and single metastases in liver.

[A method for creating a pancreatoenteral anastomosis in gastropancreatoduodenal resection for cancer]. / Sposob sozdaniia pankreatoénteroanastomoza pri gastropankreatoduodenal'noi rezektsii po povody raka.

A transverse housing-like anastomosis was tested in 30 dogs and then used in 7 cases in people. There were no lethal outcomes, the functional results were good.

[The surgical treatment of malignant liver tumors]. / Khirurgicheskoe lechenie zlokachestvennykh opukholei pecheni.

From study of the data concerning 133 patients who underwent operation for tumor of the liver the authors found that 43 (32.2%) patients were treated by a radical operation and 34 (25.5%) were subjected to palliative interventions. Among the radical interventions hemihepatectomy was performed on 21 (48.8%) patients. The total number of complications after radical operations was 46.3%, the mortality rate 11.6%. The authors discuss problems of the prevention of some complications, intraoperative hemorrhages in the first place. Different variants of bile diversion accounted for most of the palliative interventions. Survival in radical operations was 38.56 months, in palliative operations 8.34 months, and in exploratory operations 5.9 months.

[Radiation pathomorphosis in intensive preoperative hypoxic radiotherapy of stomach cancer]. / Luchevoi patomorfoz pri intensivnoi predoperatsionnoi gipoksiradioterapii raka zheludka.

The authors presented the results of pathomorphological investigations of surgical specimens of 110 stomach cancer patients following preoperative radiotherapy or hypoxyradiotherapy and radical operation. Single and total focal doses depended on oxygen percentage in the inhaled mixture and were 4-5 and 20-25 Gy, respectively. Radiation pathomorphosis was established in 62.8% of the patients (in 19.1% it was marked, in 13.5% it was absent, unclassified changes were noted in 23.6%). Short-term hypoxia resulted in no tumor "protection". Radiation changes in the stomach mucose in hypoxyradiotherapy were noted 2-3-fold less frequently than in radiotherapy, suggesting predominant "protection" of healthy tissues by hypoxia.

[Experience in the use of the AKA-2 device in the formation of esophago-intestinal anastomosis]. / Opyt ispol'zovaniia apparata AKA-2 dlia formirovaniia pishchevodno-kishechnogo anastomoza.

Two techniques of the compressive anastomosis formation were used. At the early postoperative period, there were no complications. Three months after the operation, 4 patients were examined. In 1, the cicatricial anastomotic stenosis, caused by the errors in technique of the anastomosis creation, was revealed. In the remaining 3 patients, there were no impairment in healing of an anastomosis. In 9 patients, in formation of an anastomosis, all the layers of the intestinal wall and only mucous membrane of the esophagus were stitched. No impairment in anastomotic healing was noted. Of the 16 patients operated on with the use of the AKA-2 apparatus (in all the cases, the compressing rings with a small diameter--20 mm were used), 1 died at day 4 after the operation from ischemic insult of the brain.

[The combined treatment of locally disseminated pancreatic cancer using cryosurgery]. / Kombinirovannoe lechenie mestno-rasprostranennogo raka podzheludochnoi zhelezy s ispol'zovaniem kriokhirurgii.

Experimental cryodestruction of the pancreas performed in 40 dogs served as a basis for selecting the temperature regimen, exposure time and extent of treatment to be subsequently used in man. Cryodestruction and combined cryoradiotherapy were employed in 30 patients with locally advanced pancreatic cancer. The procedure proved effective as it assured alleviation of pain, improvement in performance status and an increase in survival. CA-19-9 level and T-lymphocyte count were followed. These markers may be used to predict progression of pancreatic cancer.