[Long-term results of isolated chemoperfusion of the lung with melphalan and cisplatin in combination with metastasectomy in treatment for resectable metastatic lung lesion].

For treatment of metastatic lung lesions there was used the method isolated chemoperfusion of the lung in combination with metastasectomy. The study includes 74 patients with metastases in the lungs who underwent 101 normothermal isolated chemoperfusion of the lung: of these 38 (37,6%) with melphalan and 63 (62,4%) with cisplatin without lethality. In the early postoperative period 1 (1,4%) patient died due to postperfusion lung edema. The period of observation of patients ranged from 2 to 99 months (median 29.3 months). Of 74 patients 53 (71,6%) patients are alive, 2 (2,7%) patients died from causes unrelated to the underlying disease. 43 (58,1%) patients showed progression of disease, what in 18 (41,9%) of them was the cause of death. Repeated appearance of metastases in perfused lung was detected in 30 (40,5%) patients. A 5-year disease-free (in the lungs) and observed survival of patients after isolated chemoperfusion of the lung with metastasectomy was 45% (median 46 months) and 59% (median not reached) respectively. There were established predictors of effectiveness of isolated chemoperfusion of the lung with metastasectomy: DFI> 13 months, ≤5 metastatic nodes in the lungs, the size of the largest metastasis in the lungs ≤20 mm, intralobular location of metastases in the lungs as well as the time of doubling the volume of metastases >64 days for chest computed tomography.

[MINIMALLY INVASIVE ESOPHAGECTOMY].

During the period from April 2012 to December 2014 54 patients aged 29-76 years, 36 (66.6%) males and 18 (33.4%) females, with esophageal cancer underwent minimally invasive esophagectomy as final phase of treatment. Squamous cell carcinoma was diagnosed in 50 patients and adenocarcinoma identified in 4 patients. The disease was staged as follows: IA--5 (9.3%) patients, IB--11 (20.4%) patients, IIA-- (16,.%) cases, III -- (3,.%) cases, IIII --8 (33,.%), IIII -- (14,8%), III -- (1,.%). 37 (68,.%) patients had surgery after induction chemoradiation therapy. Of 54 surgical interventions there were 20 hybrid and 34 minimally invasive operations. 19 (35,.%) patients developed complications, postoperative mortality was 2 (3,.)%. Minimally invasive esophagectomy meets basic oncological principles and leads to tolerable short-term results.

[EPIDURAL ANESTHESIA AND ANALGESIA IN ONCOLOGIC SURGERY ON ABDOMINAL ORGANS].

The use of epidural anesthesia (EA) in 75 patients during abdominal surgery has revealed a number of advantages of EA over endotracheal anesthesia. EA reduces the consumption of analgesics and myorelaxants and the time of postoperative artificial ventilation of lungs as well as offers more qualitative analgesia.

[The efficacy of hepatotropic agent Remaxol in oncological patients with postoperative liver dysfunction].

The study of the efficiency and safety of the hepatotropic drug Remaxol in oncological patients with minimal, subclinical manifestations of liver dysfunction in the postoperative period was performed. It is shown that using of Remaxolcontributes to leveling the biochemical liver dysfunction: decrease of the concentration of total bilirubin, a decrease serum activity of lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase. The unwanted effects of Remaxol were not identified.

[Concurrent chemoradiotherapy with moderate dose brachytherapy as remission induction for patients surgically treated for esophageal cancer].

The locally advanced cancer of thoracic esophagus was treated by induction chemo-irradiation therapy (IHRT) with intraluminal medium dose-rate brachytherapy (IMBT). From July 2009 to February 2012 twenty five patients (mean age 54.3 +/- 1.3 years) were included in the study. The length of the primary tumor was up to 6 cm in 10 pts and more than 6 cm in 15 pts. Induction therapy consisted of three IMBT sessions (7 Gy X 3; q7d) and two cycles of chemotherapy (PF; q28d), 26-31 days later the surgery was performed. Subtotal resection of the esophagus type of I Lewis was performed in 23 pts, transtracheal extirpation of the esophagus was performed in 2 pts.In all the cases 3F lymphodissection was performed. After IHRT in 15 of 25 pts. was obtained complete or partial response, in 10 of 25 pts was obtained disease stabilization. Perioperative complications occurred in 17 (68%) patients receiving conservative treatment, one patient (4%) died of treatment complications. In 6 cases (24%) morphology had shown the complete regression of primary tumor. Thus, the combination of intraluminal medium dose-rate brachytherapy and chemotherapy lead to reduction of primary tumor local spread and can be an efficient factor in improving the results of surgical treatment.

[The use of Oxadol in tablet form for the treatment of chronic pain syndrome in late-stage cancer patients]. / Primenenie tabletirovannogo oksadola dlia lecheniia khronicheskogo bolevogo sindroma u onkologicheskikh bol'nykh pozdnikh stadii zabolevaniia.

Chronic pain management with tablets of oxadol, a non-narcotic central-action analgetic, was studied in 30 patients, focusing on combinations with "basic" drugs of the opiate and opioid group. Combined administration of tramal and oxadol for moderate pain relief raised the analgesic effect and improved certain parameters of quality of life. Possible side-effects and indications in cases of well-advanced tumor were established.

[Role of video-assisted thoracoscopy in diagnosis of neoplasms in mediastinal organs]. / Znachenie videotorakoskopii v diagnostike novoobrazovanii organov sredosteniia.

Diagnostic potential of video-assisted thoracoscopy was evaluated in 66 patients (36 males and 30 females) with neoplasms (aged 24-68 yrs). When used in conjunction with biopsy, it confirmed the following diagnoses: lymph proliferative disease (23), mediastinal malignancies (11), sarcoidosis (21), benign mediastinal tumors (7), Castleman's benign lymphoma (2) and mediastinal cyst (2). Clinical diagnosis was substantially changed in 40 (61%) cases as a result of videothoracoscopy application. It has proved precise, fairly safe and conservative; it has a potential in diagnosis of mediastinal tumors.

[Postoperative oxadol analgesia in oncologic patients]. / Posleoperatsionnoe obezbolivanie oksadolom u onkologicheskikh bol'nykh.

Oxadol (nefopam hydrochloride), a central analgesic, was used for postoperative pain relief in patients operated on the abdominal and pelvic organs for cancer. The analgesic effect of oxadol was sufficient for arresting moderate postoperative pain. Although the drug exerts rather many side effects, none of them notably deteriorated the clinical status of patients.