[Laparoscopic surgery in patients with locally advanced rectal cancer - short-term outcomes]. / Laparoskopicheskie operatsii v lechenii bol'nykh mestno-rasprostranennym rakom priamoi kishki - neposredstvennye rezul'taty.

AIM: To optimize the indications for laparoscopic surgery in patients with locally advanced and prognostically unfavorable rectal cancer after neoadjuvant chemoradiotherapy. MATERIAL AND METHODS: 226 patients with locally advanced rectal cancer underwent combination therapy in A.F. Tsyba Medical Radiological Research Centre in 2003-2016. The patients were divided into two subgroups, depending on the surgical approach. The main group included 55 patients who underwent laparoscopic resections, and the control group included 171 patients - for conventional approach. RESULTS: In the subgroup of patients who underwent laparoscopic resections 42 (76.3%) organ preservation surgery were performed more often in comparison with the control subgroup 74 (43,2%) (p<0.0001). There were no significant differences in the incidence of intraoperative complications in both subgroups. The incidence of postoperative complications was lower in the laparoscopic approach group in comparison with the control group 12 (21.8%) patients and 62 (36.3%), respectively (p=0.0493). Data for local recurrence and dissemination of the process after surgery was not received. CONCLUSION: According to the main clinical and morphological features, laparoscopic resections may be an alternative, and in many cases even superior approach in comparison with the conventional surgery.

[Multiple neoplasms in gastric cancer patients: patterns of development, results of treatment].

Patterns of polyneoplasia development were analyzed in radically operated gastric cancer patients. The second tumors were revealed in 99 of 1255 patients (7,9%) as soon as patients with early gastric cancer manifested primary-multiple malignant tumors almost two times more (15,4%). Among second tumors there were predominantly tumors of the colon, urogenital system, head and neck and also lymphoproliferative diseases. Along with tumors prior to the diagnosis "gastric cancer" there were met mostly lymphoproliferative diseases and breast cancer; of synchronous--cancer of the colon and bladder; among exposed after treatment of gastric cancer-cancer of the colon, pancreas, and skin. Radical surgery because of the second tumor was provided to 77,6% patients, palliative surgery--to 12,6%. In the treatment of second tumors there were most commonly used surgical technique--in 40 (39%) patients, radiotherapy +/- chemotherapy--in 27 (26%), the combined method (surgery+radiotherapy/chemotherapy)--in 22 (21%). Second tumors (both synchronous and metachronous) were the main cause of death of patients. Thus, the occurrence of a second tumor in patients with gastric cancer is constantly increasing the frequency of the event, with the possibility of early detection and curative treatment of synchronous and especially metachronous tumors determine the prognosis in this group of patients. Primary tumor multiplicity is not a contraindication both to a radical, including combined, and palliative treatment of each of the tumors.