[Laparoscopic surgery in treatment for colon cancer].

There are presented results of treatment of 347 patients with colorectal cancer. Laparoscopic surgery had been planned for 92 (26.5%) patients (study group). In 79 (85.9%) patients surgery was performed completely by laparoscopy, 13 (14.1%) patients underwent conversion. In 255 (73.5%) patients surgery was carried out from an open access (control group). The authors showed the effectiveness of the use of minimally invasive techniques in treatment for colorectal cancer.

[Postoperative intraperitoneal complications in colon cancer surgery].

The authors studied the clinical characteristics and terms of the development of postoperative intraperitoneal complications in patients undergoing colon cancer surgery. It was stated, that the diversity of clinical data depended on complication characteristics. Results of investigation allowed defining of the most dangerous terms of intraperitoneal complications and risk factors.

[Fulminant acute pancreatitis. Are there objective criteria of the disease?].

A retrospective analysis has been made of the results of the diagnosis and treatment of 71 patients having severe pancreatitis. As a result, factors were revealed which restrict the possibilities of conservative treatment associated with pessimistic prognosis of the disease. Among them there are pancretitis-specific organic abnormalities (pulmonary, cardio-vascular, renal dysfunctions), diffused pancreonecrosis and infection of destructive zones. All the parameters in question are included in the proposed model of prognosis of the fulminant course of pancreatitis having high diagnostic accuracy up to 88.3%.

[Measures of prevention of diffuse peritonitis after operations for colorectal cancer].

An experience with treatment of postoperative complications in patients with colorectal cancer in specialized and surgical hospitals and an analysis of results of treatment of patients with incompetent intestinal anastomoses depending on the surgical strategy have shown that reoperations for exclusion of the gut with the incompetent anastomosis with the first symptoms of a developing complication allows prevention of possible complication.

[Abdomino-anal resection of the rectum (indications, technique, immediate and long-term results)]. / Briushno-anal'naia rezektsiia priamoi kishki (pokazaniia, tekhnika, neposredstvennye i otdalennye rezul'taty).

Abdomino-anal resection of the rectum with the descending is not an alternative variant of the intra-abdonimal resection with suturing devices. Each of these methods has indications and contraindications. In treatment of rectum carcinoma the observation of oncological principles is thought to be principal. The abdomino-anal resection of the rectum with the descending gave best results when the tumor was localized at the level of 6-7 cm from the anus. The application of the proposed modification might reduce the number of complications and lethality.

[Intraoperative colonic sorption dialysis in colonic cancer complicated with colonic obstruction]. / Intraoperatsionnyi tolstokishechnyi sorbtsionnyi dializ pri rake tolstoi kishki, oslozhnennom tolstokishechnoi neprokhodimost'iu.

The data on treatment 84 patients with large bowel carcinoma aggravated by occlusion ileus are discussed. The study group included 49 patients who received intraoperative sorption dialysis of large bowel (ISDLB). Intraoperative lavage of large bowel (ILLB) was given to 35 patients who were in control. A significantly higher detoxication effect of ISDLB was recorded by hematological and biochemical index dynamics analysis. Lethality dropped to 6% in the group receiving ISDLB (11%). The latter patients spent 15 +/- 4 days in hospital as compared to 25 +/- 4 days in control. The postoperative complication rates were 14 and 29%, respectively. ISDLB should be indicated in complex therapy of bowel carcinoma aggravated by occlusion ileus because of its cleansing effect which significantly reduces end-genuous intoxication.

[Use of enterosorption in biliary tract cancers complicated with mechanical jaundice]. / Primenenie énterosorbtsii pri rake zhelchevyvodiashchikh putei, oslozhnennom mekhanicheskoi zheltukhoi.

Enterosorption using polyphepan in experimental mechanical jaundice was followed by improvement of the course of the disease, lower mortality and improvement in endotoxemia indices. The therapeutic effect of enterosorption is due to enhanced transfer of metabolites and toxins through the intestinal wall and subsequent excretion via the gastrointestinal tract. Enterosorption performed in 60 patients with malignancies of the bile tracts and mechanical jaundice was followed by a more rapid improvement in general condition and reduction in the indices of endotoxemia, as compared with 60 controls. Postoperative complication frequency and mortality showed a significant decrease.

[Experimental and clinical validation of using enterosorption in mechanical jaundice]. / Eksperimental'no-klinicheskoe obosnovanie primeneniia énterosorbtsii pri mekhanicheskoi zheltukhe.

Experiments in 119 rats with the model of mechanical jaundice have shown the efficiency of enterosorption with polyphepan. The development of the pathological process was found to improve, lethality of the experimental animals to decrease. Favourable changes of the laboratory indices characteristic of endotoxemia were noted. The mechanism of medical action of enterosorption is realized by means of intensification of transfer of masses of metabolites and toxins through the intestine wall and their excretion through the gastrointestinal tract. One of important mechanisms of the medical action of enterosorption is the stimulation of intestinal peristalsis which is confirmed by data of the dynamics of bioelectrical activity. Enterosorption performed in 60 patients with mechanical jaundice was followed by a more rapid improvement of the general state, decrease of the indices characteristic of endotoxicosis as compared with 60 patients of the control group. The frequency of postoperative complications and lethality were reliably lower.

[Expert system of selecting the therapeutic approach in hemorrhagic stomach cancers]. / Ekspertnaia sistema vybora lechebnoi taktiki pri krovotochashchem rake zheludka.

A computer-based expert system for selecting strategies of treating cancer-associated stomach bleeding has been worked out. Its application has contributed to a significant improvement of short-term results of therapy.

[Surgical tactics (cecostomy or artificial anus?) in colonic cancer complicated by acute intestinal obstruction]. / Khirurgicheskaia taktika (tsekostoma ili iskusstvennyi anus?) pri rake obodochnoi kishki, oslozhnennom ostroi kishechnoi neprokhodimost'iu.

On the basis of an analysis of results of the treatment of acute intestinal obstruction resulting from carcinoma of the left part of the colon the authors recommend performing decompression by creation of the two-trunk anus after Maydl. Cecostomy gives twice greater postoperative lethality.

[Diagnosis of obstruction of the large intestine]. / Diagnostika neprokhodimosti tolstoi kishki.

In 96 out of 367 investigated patients with diagnosis of acute obturation large intestine ileus was confirmed. These patients were subjected to urgent operations. In another group of patients (64) with an obscure clinical picture urgent rectoromanoscopy was fulfilled after rentgenography. Five patients were found to have stenozing tumours of the distal part of the sigmoid intestine. Urgent irrigoscopy was performed in all the 64 patients of this group after rectoromanoscopy. A mechanical obstacle was revealed in the large intestine of 34 patients. In 28 patients the suspicion of a mechanical large-intestine ileus was rejected which prevented unnecessary laparotomy.