Correlation of nucleotides and carbohydrates metabolism with pro-oxidant and antioxidant systems of erythrocytes depending on age in patients with colorectal cancer.

AIM: To examine the relationship between metabolic features of purine nucleotides and antioxidant system depending on the age of patients with colorectal cancer. MATERIALS AND METHODS: The activity of adenosine deaminase, xanthine oxidase, glutathione peroxidase, superoxide dismutase and glucose-6-phosphate dehydrogenase, the NOx concentration and the oxidative modification of proteins were determined spectrophotometricaly in 50 apparently healthy people and 26 patients with colorectal cancer stage -III---IV, aged 40 to 79 years. RESULTS: Increase of pro-oxidant system of erythrocytes with the age against decrease in level of antioxidant protection in both healthy individuals and colorectal cancer patients was determined. A significant increase of pro-ducts of oxidative proteins modification in erythrocytes with ageing was shown. Statistically significant correlation between enzymatic and non enzymatic markers pro-oxidant system and the activity of antioxidant defense enzymes in erythrocytes of patient with colorectal cancer was determined. CONCLUSION: Obtained results have demonstrated the imbalance in the antioxidant system of erythrocytes in colorectal cancer patients that improve the survival of cancer cells that is more distinctly manifested in ageing.

[The method of mucosectomy of rectal stump in reconstructive surgery of ulcer colitis].

The method of coloproctectomy performance with formation of a J-like ileal reservoire and ileoanal anastomosis, using welding mucosectomy and protective ileostomy, was proposed. Application of the method guarantees complete excision of the rectal stump mucosa, what excludes the risk of the stump inflammation occurrence, as a sign of residual ulcer colitis in immediate and late postoperative period. Functional results in this setting are not worsen.

[Reconstructive-restoration surgeries for nonspeciphic ulcerative colitis and colonic Crohn's disease].

Results of surgical treatment of 88 patients were presented, to whom radical surgery for nonspeciphic ulcerative colitis and Krohn's disease was performed. In 92% of observations the first-stage operation consisted of subtotal colectomy procedure with formation of separate ileostoma and sygmostoma, which was modified in the clinic. The reconstructive-restoration operation was performed in 61 (69.4%) of patients in 12 months after the first operation. The necessity to estimate the degree of the excluded colon readiness for the reconstructive-restoration operation performance was established, the terms of its application as well as the method and character of the operation were substantiated. The postoperative complications rate was (45,5+/-5,3)%. The result of reconstructive-restoration operation was considered good in 12, fair--in 61, unfair--in 15 patients. All the patients are alive.

[Restoration of the colon continuity in patients with ascendostomy after Gartmann operation with rectal supraanal resection].

Results of performance of reconstructive-restoration operation in 7 patients with ascendostomy were analyzed. Of them in 4 as the first stage supraanal rectal resection was performed and in 3 - Gartmann operation. There was proposed the method for colonic continuity restoration after Gartmann operation performance, in which pancreatic stump is mobilized along its posterior wall, securing nutrient vessels up to highest point and lower surface of the pelvic peritoneum sheet. The pelvic peritoneal sheet is dissected from the peritoneal cavity side under guidance of surgeon hand and the rectoscope tube, introduced into rectal stump. During performance of second stage in all the patients massive adhesions were revealed. Postoperative complications were absent.

[Intraoperative complications in performance of reconstruction-restoration interventions in patients, to whom one-barrel colostomy was constructed]. / Intraoperatsyonnye oslozhneniia pri vypolnenii rekonstruktivno-vosstanovitel'nykh vmeshatel'st u bol'nykh , kotorym nalozhena odnostvol'naia kolostoma.

Results of performance of reconstruction-restoration operations in 208 patients with one-barrel colostomy were analyzed. Earlier operation according to Hartmann procedure modification was performed in 138 (66.3% +/- 3.3%) of them, operation according to Hartmann--in 70 (33.7% +/- 3.3%). There were elaborated and introduced: the method of the intestinal continuity restoration, and also of the colonic anastomosis formation. The most frequent complications during performance of reconstructive operations were: deserosation of small intestine and colon, dissect of the hollow organ lumen, hemorrhage from the small pelvis veins. Cicatricial changes and adhesions in abdominal cavity and cavity of small pelvis were the main causes of the complications occurrence, making the intestinal loops and the colonic stump mobilization difficult, disordering the topographoanatomic arrangement of organs.

[Experience of laparoscopic hernioplasty in the treatment of inguinal hernia]. / Opyt laparoskopicheskoi gernioplastiki v lechenii pakhovoi gryzhi.

For 2001-2003 yrs period laparoscopic prosthesis hernioplasty was performed in 127 patients. Oblique reducible inguinoscrotal hernia had constituted the main nosological form of the disease. Peculiarities of preoperative preparation, anesthesiological support, operative procedures, complications postoperative management and medicinal securing of patients, immediate and late follow-up results of their surgical treatment were lighted on. The advantages of laparoscopic prosthesis hernioplasty were proved, such as the recurrence frequency lowering, social-economic efficacy, associated with reduction of the patients stationary stay, their labour rehabilitation and the recurrence absence.

[Specifics of restorative surgeries in patients with unilateral colostomy]. / Osobennosti vypolneniia vosstanovitel'nykh operatsii u bol'nykh s odnostvol'noi kolostomoi.

In 194 patients with one--barrel colostoma experience of the reconstructive-restoration operations stage) performance was summarized. The surgical tactics was studied depending on the main disease nature, peculiarities and complications of the first operative treatment, presence of accompanying diseases, terms of the restoration operation performance, length of colonic stump. Period from the moment of radical intervention performance to restoration operation had constituted from 5 months to 12 years. It is recommended to apply the end--to the stump side anastomosis after performance of the Gartmann type operation and in presence of a short stump--the colonic descendence into the rectum stump. Method of colonic descendence via the rectum stump after the tunnel formation using perineal access was proposed. The most frequent complications were observed after the Dyuahmel type of operation performance. For successful surgical treatment the authors recommend conduction of measures directed for prophylaxis of purulent--inflammatory complications, application of rational surgical tactics, adequate blood supply of transplant.

[Surgical treatment of combined trans-sphincter and extra-sphincter rectal fistula]. / Khirurgicheskoe lechenie slozhnogo chressfinkternogo i ékstrasfinkternogo svishcha priamoi kishki.

The results of surgical treatment of 600 patients with rectal fistula were analyzed. Intrasphincter fistula was observed in 204 patients (34%), transsphinctered fistula--in 72 patients (12%), extrasphincter fistula--in 324 patients (54%). In order to decrease the rate of recurrence of fistula, during performance of plastics of internal hole of the fistula the graft of all the wall of rectum (not only its mucosa) was mobilized up to the level of anal sphincter. Post-operative complications and recurrence of fistula occurred in 4% of patients.

[Metachronous megacolon and colonic cancer in adults]. / Metakhronnye megakolon i rak tolstoi kishki u vzroslykh.

The experience of treatment of 9 patients with metachronous megacolon and colonic cancer was analyzed. Clinical signs of the disease are diverse. Radical surgical intervention is singularis method of treatment of such patients.