[Optimization of the operative access for reduction of intraoperative trauma in surgical treatment of gastric cancer].

Results of treatment of 100 patients with gastric cancer who were subjected to gastrectomy with M. Z. Sigal's and A. I. Lisin's retractor are described. In 50 of them an additional glass of the authors' construction was used. A comparative analysis has shown that the additional glass gives the optimal spatial interrelations in the wound, reduces the length of the laparotomy incision, prevents postoperative complications and thus shortens the time of operative interventions, relieves the severity of the operative trauma, minimizes the untraoperative blood loss, decreases the number of postoperative complications.

[Alpha-fetoprotein immunotherapy as a stage of combined treatment of cancer patients].

The paper discusses the preliminary findings on alpha-feto-protein (AFP) treatment of 58 patients with stage III-IV malignancies of different localizations. No influence on neoplastic processes was registered in poorly differentiated cell tumors, nor were any immunological mechanisms of antitumor action triggered on. However, in moderately- and well-differentiated cell tumors, several foci of acute immune inflammation were induced. It is suggested that AFP is responsible for tumor cell apoptosis by freeing antigenic determinants from shielding antibodies via elimination of <> of tumor growth.

[Economic aspects of specialized preventive screening for breast cancer]. / Ekonomicheskie aspekty spetsializirovannykh mammologicheskikh profilakticheskikh osmotrov organizovannogo zhenskogo nasileniia.

Economic problems involved in specialized mammographic screenings carried out among the workers of the City of Perm and the region were studied. The investigation was funded on a contract basis and no budget money was used. During 9 years, 61,276 women aged 17-72 (up to 20 years old--2.3%; 21-31--16.9%; 31-40--34.5%; 41-50--29.4%; 51-60--14.2%, and older than 60 years--2.7%) were examined. The costs of examination of all the patients by mammologist ran up to Rbl.464,251; mammography (MG)--Rbl.13,374; ultrasound (US)--Rbl.26,880, and aspiration biopsy--Rbl.14,852. The total cost was Rbl.716,490, or Rbl.11.7 ($0.4) per screenee. Cancer was diagnosed in 62 (stage I-II--90.3%). Each detection cost Rbl.11,556 ($398), or less by 33% (Rbl.7,727; $266) if the costs of MG and US, which failed to make any significant contribution, are subtracted. Also, 1,638 precancerous benign tumors were identified (each case--Rbl.437; $15). It is suggested that the actual costs of tumor detection make a case for further application of mass screenings.

[Clinical results of specialized prophylactic mammography screenings of industrial workers]. / Klinicheskie rezul'taty spetsializirovannykh mammologicheskikh profilakticheskikh osmotrov organizovannogo zhenskogo naseleniia.

Specialized mammographic screenings of 61,276 industrial workers of the City of Perm and Perm Region were carried out in 1991-1999. Examinations included palpation, mammography and ultrasound (in some patients), aspiration biopsy and cytological analysis of nipple discharge, if necessary. Various pathological sites were identified in 9,126 (14.9%). Diffuse mastopathies were diagnosed in 7,286 (11.9%), mostly in women aged 31-50 (5,239; 72%). Nodal tumors (cancer, localized fibrocytic disease, fibroadenoma, cysts and lymphomas) were detected in 1,840 (3%). Their frequency ranged 2.6-3.3% in all age-brackets: causation by fibroadenoma--in the younger women, cancer--elderly women. Breast cancer was reported in 62 (0.1% of all screenees; 0.7% of patients, and 3.4% of patients with locally-advanced tumors). Cancer stage I was identified in 31 (50%), stage II--25 (40.3%), and stage III--6(9.7%). Hence, it may be assumed that early-onset cancers accounted for 90.3% while tumor process remained localized within the gland in 72.2%. Out of 509 patients followed-up after surgery for benign tumors, 207 (40.5%) revealed signs of proliferation and 12 (2.4%)--dysplasia. These findings point to the prophylactic and therapeutic value of mammography for breast cancer control.

[Organ-saving operations in different localization of breast cancer]. / Organosokhraniaiushchie operatsii pri razlichnykh lokalizatsiiakh raka molochnoi zhelezy.

Two methods of filling breast defects after radical resection for nodular cancer located in inner and low quadrants were developed allowing to perform axillary lymphadenectomy without additional axillary approach (patents No. 2125408 and No. 2127552). The methods are based on transposition of breast skin flaps. These methods have been used in 43 patients: in 31 women with T1-2N0 M0 stage, in 12 women T1-2N1-2M0, and with breast size B(2)--in 8, C(3)--in 30, D-E(4-5)--in 5 patients. Flap's marginal necrosis was in 3 patients only. Cosmetic results were excellent and good in 72.1% of operated patients.

[Economic aspects of laparoscopy in a cancer clinic]. / Nekotorye ékonomicheskie aspekty laparoskopii v onkologicheskoi klinike.

The role of laparoscopy in reduction of the number of explorative laparotomies in cancer patients was studied. Laparoscopy was performed in 862 cases of whom 338 (39%) revealed definite signs of tumor dissemination which made potentially hazardous explorative laparotomy unjustified. The number of laparotomies was reduced by 78%. The laparotomized patients stayed in the hospital for the average of 15.86 +/- 0.76 days whereas those undergoing laparoscopy--3.56 +/- 0.14 days provided stage IV was diagnosed. Laparoscopy saved 12.30 days and 203 roubles for each case of stage IV cancer, and 3737 and 62,000 roubles for the entire group of 862 patients.