ABSTRACT
The modification of the reconstructive stage of gastropancreatoduodenal resection aims to increase the security of the pancreatojejunoanastomosis by minimizing the impact of such aggressive substances as bile and pancreatic juice. The modification represents the isolated pancreatojejunoanastomosis on the Roux-en-Y intestinal loop and gastro- and hepaticojejunoanastomoses on the second intestinal loop, separated with the use of the stub. Thus, the method allows the separate passage of pancreatic juice, bile and gastric contents, excluding their impact on other anastomoses. The described modification was performed in 6 patients. There were no cases of the anastomotic insufficiency. The mean hospital stay was 10,5 days. Thus. The method proved to be effective and safe, providing good initial results.
Subject(s)
Anastomosis, Roux-en-Y , Anastomotic Leak , Bile Reflux , Duodenum/surgery , Pancreas/surgery , Pancreatic Neoplasms/surgery , Postoperative Complications , Stomach/surgery , Adult , Anastomosis, Roux-en-Y/adverse effects , Anastomosis, Roux-en-Y/methods , Anastomotic Leak/etiology , Anastomotic Leak/prevention & control , Bile Reflux/etiology , Bile Reflux/prevention & control , Female , Humans , Male , Middle Aged , Pancreas/pathology , Pancreatic Neoplasms/pathology , Pancreaticojejunostomy/adverse effects , Pancreaticojejunostomy/methods , Postoperative Complications/etiology , Postoperative Complications/prevention & control , Plastic Surgery Procedures/adverse effects , Plastic Surgery Procedures/methods , Treatment OutcomeABSTRACT
After combined treatment of 74 patients for colorectal cancer using preoperative neoadjuvant intraarterial selective polychemotherapy (IAPCT) three-year survival index have constituted (77.0 +/- 5.2)%, the cancer recurrence have occurred in (10.8 +/- 2.8)%, distant metastases were revealed in (17.5 +/- 4.2)%. Using verapamil as a IAPCT modifier in 54 patient three-year survival have increased by 11.8%, the frequency of distant metastases occurrence have reduced by 10.1%.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Colorectal Neoplasms/drug therapy , Vasodilator Agents/administration & dosage , Verapamil/administration & dosage , Chemotherapy, Adjuvant , Colorectal Neoplasms/mortality , Colorectal Neoplasms/surgery , Humans , Infusions, Intra-Arterial/adverse effects , Infusions, Intra-Arterial/methods , Preoperative Care/methodsABSTRACT
The combined treatment of 53 patients with colonic cancer, using neoadjuvant intraarterial polychemotherapy (IAPCT), was conducted. The trustworthy lowering of the catheterized artery thrombosis occurrence rate, the tumor recurrence-by 7%, distant metastases-by 13.9%, two-year survival increase-by 15.5% was promoted by verapamil application as a IAPCT modifier.
