ABSTRACT
The impact of neoadjuvant chemoradiation on immediate results of treatment of resectable cancer recti, using large-fractionized radiation in combination with endolymphatic chemotherapy, was estimated. Using the method proposed 64 patients were treated (the main group). In control groups there were included 63 patients, to whom a course of a large-fractionized radiation on background of intravenous chemotherapy was applied, and in 91 patients a large-fractionized radiation only was used. The intraoperative complications rate in the main and control groups have had constituted, accordingly, 16, 6.3 and 3.3%. Postoperative complications have had occurred in 12.5% of patients in the main group, and in 15.9% and 14.3% - in the control groups. The abscesses formation was noted in a small pelvis cavity in 4.7% patients of the main, and in 4.8 and 4.4% - in the control groups. Necrosis of the descended gut was revealed in 10 (4.6%).
Subject(s)
Adenocarcinoma/therapy , Antineoplastic Agents/therapeutic use , Fluorouracil/therapeutic use , Leucovorin/therapeutic use , Neoadjuvant Therapy/methods , Rectal Neoplasms/therapy , Vitamin B Complex/therapeutic use , Adenocarcinoma/mortality , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Antineoplastic Agents/pharmacology , Case-Control Studies , Disease-Free Survival , Female , Fluorouracil/pharmacology , Gamma Rays , Humans , Injections, Intralymphatic , Injections, Intravenous , Intraoperative Complications/pathology , Leucovorin/pharmacology , Male , Middle Aged , Neoplasm Grading , Postoperative Complications/pathology , Rectal Neoplasms/mortality , Rectal Neoplasms/pathology , Rectal Neoplasms/surgery , Vitamin B Complex/pharmacologyABSTRACT
The method of combined neoadjuvant treatment of resectable cancer recti, consisting of preoperative radiaton therapy, using big-fractionized intensive irradiation on the endolymphatic chemotherapy background together with fluorouracil with following surgical intervention (main group), in terms up to 72 h, was elaborated in the clinic. The patients, to whom the chemotherapy and radiation therapy were conducted, were included into control groups. Postoperative complications have had occurred in 8 (12.5%) patients of the main group and in 10 (15.87%) and 13 (14.29%)--in control groups. The five-year survival indices in the main group have constituted (73.5 +/- 6.3)%, and in control groups--(64.6 +/- 5.8) and (64.4 +/- 6.8)%. The local recurrence rate in the main group have constituted (6.2 +/- 3.0)%, and of the remote metastatizing--(15.6 +/- 4.5)%.
Subject(s)
Antimetabolites, Antineoplastic/therapeutic use , Chemoradiotherapy, Adjuvant/methods , Colonic Neoplasms/surgery , Fluorouracil/therapeutic use , Neoadjuvant Therapy/methods , Antimetabolites, Antineoplastic/administration & dosage , Antimetabolites, Antineoplastic/blood , Colonic Neoplasms/epidemiology , Colonic Neoplasms/pathology , Colonic Neoplasms/therapy , Disease-Free Survival , Fluorouracil/administration & dosage , Fluorouracil/blood , Humans , Leucovorin/administration & dosage , Leucovorin/therapeutic use , Neoplasm Metastasis , Neoplasm Recurrence, Local/epidemiology , Neoplasm Recurrence, Local/prevention & controlABSTRACT
The methods of colonic resection and a two-barrel colostomy closure, after performance of modified Mikulicz operation for complicated colonic cancer with formation of a two-staged extraperitoneal invagination duplicature anastomosis, were proposed. Postoperative complicationshave had occurred in 10 (10.9%) patients, including the anastomotic sutures insufficiency--in 2 (2.2%).
Subject(s)
Colectomy/methods , Colonic Neoplasms/surgery , Intestinal Obstruction/surgery , Palliative Care/methods , Peritonitis/surgery , Plastic Surgery Procedures/methods , Adult , Aged , Anastomosis, Surgical , Colectomy/statistics & numerical data , Colonic Neoplasms/complications , Colonic Neoplasms/epidemiology , Disease-Free Survival , Female , Humans , Intestinal Obstruction/epidemiology , Intestinal Obstruction/etiology , Male , Middle Aged , Palliative Care/statistics & numerical data , Peritonitis/epidemiology , Peritonitis/etiology , Plastic Surgery Procedures/statistics & numerical data , Young AdultSubject(s)
Digestive System Surgical Procedures , Intestine, Large/surgery , Postoperative Complications , Suture Techniques , Wound Healing , Anastomosis, Surgical/methods , Anastomosis, Surgical/standards , Anastomosis, Surgical/statistics & numerical data , Digestive System Surgical Procedures/methods , Digestive System Surgical Procedures/standards , Digestive System Surgical Procedures/statistics & numerical data , Humans , Postoperative Complications/epidemiology , Postoperative Complications/prevention & control , Suture Techniques/standardsABSTRACT
There were presented immediate results of surgical treatment of 425 patients with the upper ampullar and rectosygmoid portion cancer recti (CR), to whom in 1989-2002 transabdominal rectal resection, using the duplicature anastomosis, was performed. In 93.4% of observations, according to histological investigation data, adenocarcinoma was diagnosed. Concurrent diseases were revealed in 226 (53.2%) patients. The technique of transabdominal CR resection is depicted. There were noted fair immediate results in treatment of the patients: postoperative complications rate have constituted 13.2%, postoperative mortality--2.6%. In structure of postoperative complications purulent-septic one had prevailed, similarly were complications with cardiovascular and respiratory systems affections.
Subject(s)
Colon, Sigmoid/surgery , Intraoperative Complications/epidemiology , Postoperative Complications/epidemiology , Rectal Neoplasms/surgery , Rectum/surgery , Anastomosis, Surgical/adverse effects , Anastomosis, Surgical/methods , Humans , Intraoperative Complications/etiology , Postoperative Complications/etiology , Rectal Neoplasms/epidemiology , Suture Techniques , Treatment OutcomeABSTRACT
There were presented the late results of surgical treatment in 425 patients, suffering upper ampullar and rectosygmoid rectal cancers, to whom transabdominal rectal resection with the duplicature anastomosis formation in 1989--2002 yrs was done. In 93.4% of observations, according to histological investigation data, adenocarcinoma was diagnosed. Concurrent diseases were noted in 226 (53.2%) of patients. The postoperative complications rate was 13.2%, postoperative mortality--2.6%. Late result of treatment was fair.
Subject(s)
Adenocarcinoma/surgery , Anastomosis, Surgical , Digestive System Surgical Procedures/methods , Rectal Neoplasms/surgery , Rectum/surgery , Adenocarcinoma/mortality , Aged , Disease-Free Survival , Humans , Middle Aged , Rectal Neoplasms/mortalityABSTRACT
Endolymphatic way of the medicinal preparations administration promotes their more effective influence on pathological focus. The experience of conduction of more then 15,000 of the lymphatic vessels catheterization manipulations was summarized, permitting to perform the treatment of patients successfully.
Subject(s)
Catheterization/methods , Lymphatic System/surgery , Humans , Retrospective StudiesABSTRACT
The results of treatment of 5 patients with colonic melanoma are presented. Fine-needle biopsy was used for morphological verification diagnosis. It was established that the patients with colonic melanoma are hospitalized in specialized department, as a rule, with nonopertable tumor. In 1 patient explorative laparotomy was done. Conduction of radical operative intervention was impossible because of presence of multiple metastases in liver. In 4 patients conservative treatment was performed. It was not possible to perform radical operation because of the process spreading. The patients life span after conduction of conservative therapy have constituted 14.5 mo at average.
Subject(s)
Colonic Neoplasms/surgery , Intestine, Large/surgery , Melanoma/surgery , Female , Humans , Male , Middle AgedABSTRACT
The intestinal continuity restoration after performance of Hartmann's operation in presence of long rectal stump was done using the method of the duplicature anastomosis formation, which was elaborated in the clinic. The frequency of postoperative complications occurrence was 9.8%: In presence of short rectal stump the colon was descended on perineum via submucosal tunnel in rectal stump according to the method, which was elaborated in the clinic. The frequency of the postoperative complications occurrence was 16.7%. The data presented trusts the expediency of application of the methods elaborated in the clinic for restoration of intestinal continuity after performance of Hartmann's operation in presence of long and short rectal stumps.
Subject(s)
Colon/surgery , Colonoscopy/methods , Aged , HumansABSTRACT
Submitted in the paper are data to the effect that parameters of certain biochemical indices for blood plasma and cell link of the immune system could allow some judgement about the character of the pathological process in children with Perthes disease. Autoimmune inflammation caused by foci of chronic infection in the organism aggravates the course of aseptic necrosis in the proximal portion of the thighbone or else is a trigger mechanism of its development.
Subject(s)
Legg-Calve-Perthes Disease/immunology , Legg-Calve-Perthes Disease/metabolism , Blood Cell Count , Child , Humans , Immunity, Cellular/immunology , Legg-Calve-Perthes Disease/blood , Lipids/blood , Phagocytosis/immunology , Phosphoric Monoester Hydrolases/blood , Proteins/metabolism , RNA/blood , Severity of Illness Index , T-Lymphocytes/immunology , Transaminases/bloodABSTRACT
The method of double-barrelled (split) colostomy closure after performance of Miculicz operation, including extraperitoneal formation of the invagination duplicatural anastomosis, was proposed. After application of the proposed method in 21 patients the complications occurred in 2, including 1 case of the anastomotic sutures insufficiency.
Subject(s)
Anastomosis, Surgical/methods , Adult , Aged , Colostomy/methods , Female , Humans , Male , Middle Aged , Postoperative Complications/epidemiologyABSTRACT
The methods of the transplant formation in the loose type of the sigmoyd colon blood supply and insufficiency of the over vessel, applied in patients during sphincter-preserving operation performance for cancer recti, was proposed. Satisfactory immediate and late follow up result was noted.
Subject(s)
Colon, Sigmoid/blood supply , Colon, Sigmoid/transplantation , Perineum/surgery , Rectal Neoplasms/surgery , Salvage Therapy/methods , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
The results of surgical treatment of 193 patients with upper- and middle ampullar cancer recti, to whom the abdominal supra-anal rectal resection was performed, were summarized. The operation procedure performance was depicted. There were no intraoperative complications. Postoperative complications had occurred in 19 (9.8%) of patients, 3 (1.6%) died. Necrosis of the descended intestine was not noted. The anal sphincter function had restored in 1 mo after performance of operative intervention.
Subject(s)
Abdomen/surgery , Rectal Neoplasms/surgery , Surgical Procedures, Operative/methods , Female , Humans , Male , Middle AgedABSTRACT
In 1970-1997 period 43 patients with cancer recti, invading bladder, were operated on. The base of surgical tactics was performance of primarily-restorational operation as independent procedure and in the complex of treatment as well. There was noted the fair immediate and late follow-up result of treatment.
Subject(s)
Rectal Neoplasms/surgery , Urinary Bladder Neoplasms/surgery , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
The experience of restorational intervention with formation of duplicature (invagination) anastomosis after Hartmann's operation in 45 patients with complicated cancer recti and colonic cancer was summarized. Complications had occurred in 9.8% of observations, one patient died.
Subject(s)
Colon/surgery , Intestinal Obstruction/surgery , Anastomosis, Surgical , Colonic Neoplasms/complications , Humans , Intestinal Obstruction/etiologyABSTRACT
The method of inversive excision of colostomy, securing access to noninflamed tissues of intestine and pericolostomic region for consequent suturing made in accordance to requirements. While using the method purulent-inflammatory complications had occurred in less than 5% of patients and insufficiency of anastomotic sutures--in 3.4%.
Subject(s)
Colonic Neoplasms/surgery , Colostomy/methods , Adult , Aged , Humans , Middle Aged , Time FactorsABSTRACT
There were operated 331 patients with cancer of rectum, complicated by ileus. Radical operation was performed in 168 patients, palliative--in 57, symptomatic--in 106. Possibility of widening of evidences for performance of primary-restorational, sphincter-preservational operations was proved.
Subject(s)
Colonic Neoplasms/complications , Colonic Neoplasms/surgery , Intestinal Obstruction/etiology , Intestine, Large/surgery , Colonic Neoplasms/pathology , Colonoscopy/methods , Humans , Intestinal Obstruction/surgery , Intestine, Large/pathology , Salvage Therapy/methodsABSTRACT
Optimal tactic for management of the patients on various stages of treatment was elaborated together with surgical procedure, basing on the experience of 3500 operations conduction for cancer recti, mainly abdominal resection with colon descendant to perineum. Methods of preoperative preparation and anesthesiological support were stated as well as the tactics of postoperative management of patients.