[Experience of percutaneous transhepatic rheolytic thrombectomy using in treatment of postresection portal vein thrombosis].

Vessels resection in case of pancreatic head cancer may be associated with portal vein thrombosis. System AngioJet 9000 (Possis Medical Inc.) for rheolytic thrombectomy is one of endovascular device for treatment of patients with venous thrombosis. Descriptions of 3 cases with rheolytic thrombectomy using are presented in the article. Percutaneous transhepatic approach under ultrasound control was used for visualization of portal vein branches. Stent-grafts were implanted in 2 of 3 cases after thrombectomy in zone of portal vein thrombosis. Bleeding from liver puncture site was observed in 1 case in early postoperative period. There was not recurrent thrombosis in long-term postoperative period (31 months after surgery maximally). The authors consider that use of several endovascular techniques such as rheolytic thrombectomy with stenting or without it provides satisfactory clinical results in treatment of patients with postoperative portal vein thrombosis.

[Experience of two-staged liver resection (ALPPS)].

The aim was to estimate single center results of ALPPS. It was performed 5 ALPPS-procedures in our center during the period from February 2013 to March 2014. There were 1 female and 4 males in the age of 58-64 years. The indications for surgery were colorectal cancer metastases in 4 cases, bladder cancer metastases in 1 observation. The operations included 3 right-sided hemihepatectomies, 2 extended right-sided hemihepatectomies. In 3 cases operations were accompanied by additional atypical resection of residuary liver lobe. In 2 observations unsuccessful embolization of the portal vein was done. The waiting time between procedures consisted 18 days in the first case and 6 days in other cases. Final hepatectomy was performed in all observations. Hypertrophy of left liver lobe was more than 50% in all cases. Postoperative complications happened in 3 out of 5 cases. One patient died because of progressive thrombosis of inferior vena cava and developed multiorgan failure. There were 1 complication of level 2 and 1 complication of level 4a according to Dindo-Clavien classification. One patient had biliary fistula after final hepatectomy. It wasn't observed cases of severe liver failure. ALPPS is appropriate method for fast residuary liver lobe hypertrophy. It allows to perform R0-resection of liver but ALPPS has high postoperative complication rate.

[Isolation of circulating tumor cells in blood by means of "Isolation by SizE of Tumor cells (ISET)"].

There is evidence of the importance of circulating tumor cells in bloodstream as a factor of poor prognosis of cancer. The optimum method for isolating and studying of these cells is not defined. The most common methods are either based on the isolation of tumor genetic material from blood or on immune-mediated isolation of epithelial tumor cells. The first group of methods is characterized by a lack of specificity, while the latter do not allow identifying a pool of cells undergone in bloodstream epithelial-mesenchymal transformation. There is presented an overview of results of clinical trials of a new technique of isolation of tumor cells from bloodstream based on the patients' blood filtration through a membrane with defined pore sizes (ISET-Isolation by SizE of Tumor cells).

[The cytological diagnostic of adenocarcinoma of pancreas with technique of size separation of tumor cells circulating in peripheral blood (case report)].

The diagnostic of tumor cells circulating in blood is one of most perspective and actively developing directions in cytology. The most of proposed techniques for this purpose are based on using immune cytochemical or molecular genetic modes to characterize cells. At the samne time, growing spread receives technique of separation of circulating tumor cells based on their larger size in comparison with other blood cells (ISET). The article presents clinical monitoring of application of mentioned technique to verify diagnosis and onset of treatment in female patient with reiterated ineffective diagnostic punctures of pancreas.

[Intraperitoneal ventral hernia plasty: the comparison of prosthetic materials].

Properties of abdominal wall intraperitoneal implants were assessed in vivo on 76 rabbits. Implants of polytetrafluorethilene (PTFE), uncoated mesh polypropylene and polypropylene with one- and two-side collagen coat, oxycellulose and polyoxibutirate coated implants were compared. Animals were extracted from the experiment on 14, 90 and 210 days with further implant assessment. PTFE and collagen-coated prostheses showed the least number of adhesions. Retraction was 5-14%. Prosthetic integration into the abdominal wall varied. PTFE and collagen-coated polypropylene proved to be the most appropriate materials for intraperitonel mesh hernia plasty.

[Enlarged sinistral hemihepatectomy and prosthetic repair of the inferior vena cava in locally disseminated hepatic alveococcosis].

High risk of surgical management for disseminated forms of alveococcosis appears to be associated with invasive growth of the parasite and the related necessity to perform vast resections of the liver and adjacent organs, as well as resections and prosthetic repair of the major vessels. The only alternative method of treatment could be liver transplantation. The purpose of this study was to demonstrate successful prosthetic reconstruction with the an allograft of the hepatic segment of the inferior vena cava in the course of enlarged hemihepatectomy for locally disseminated hepatic alveococcosis with the involvement of the inferior vena cava. The "Goretex" prosthesis was used as an allograft. The immediate postoperative period was accompanied and followed by mild-degree postresection liver insufficiency. During 6 months of dynamic follow up, the prosthesis was patent, with no relapses of the disease on the background of antiparasitic chemotherapy being noted. The use of allografts in vascular prosthetic repair in hepatic alveococcosis appears justified, requiring, however, further investigation.