[Current principles of diagnosis and surgical treatment of non-organ retroperitoneal tumors]. / Sovremennye printsipy diagnostiki i khirurgicheskogo lecheniia neorgannykh zabriushinnykh opukholei.

The data on surgical treatment of 455 patients operated on for primary and recurrent non-organ retroperitoneal tumors (NRT) are discussed. 64.2% of tumors were resected; postoperative lethality was 8.2%. Particular emphasis is placed on the complex nature of diagnosis and an algorithm of examination is suggested. The sequence of main procedures and stages are described; 43% of radical procedures were performed in combination with one another. NRTs tended to relapse and malignant tumors recurred most frequently within the first 18 months. In the course of 182 operations, 54.4% of NRTs were resected: postoperative lethality was 11.1%. The end results were determined by a number of factors, primarily, nature of tumor (benign or malignant), tumor process (primary or recurrent), tumor size and histological pattern. Because of the poor end results, surgical procedures should be improved and their range should be extended.

[Surgical treatment of adrenal gland tumors]. / K voprosu o khirurgicheskom lechenii opukholei nadpochechnikov.

The data on surgical treatment of 146 patients with adrenal gland malignancies as well as literature on the problem are discussed.

[Submerged esophago-intestinal anastomosis in surgical treatment of gastric cancer]. / Pogruzhnye pishchevodno-kishechnye anastomozy v khirurgicheskom lechenii raka zheludka.

The short-term results of 1,605 gastrectomies performed for stomach cancer, using different types of esophagoenterostomy, are discussed. Anastomotic leakage is the main criterion for a choice of the most optimal procedure of forming an anastomosis. The contribution of the first and second rows of sutures to leakage is evaluated. An analysis of data on anastomotic leakage incidence points to the advantages offered by application of submerged esophagus-related anastomosis. A new modification of procedure of formation of muffle-type of esophagoenterostomy is presented. Leakage was registered in 1.3% which was due to technical errors during surgery. The non-reflux properties of the anastomosis are emphasized, with particular emphasis on its reliability, good functional characteristics, simplicity and wide range of application. The clinical applications are described.

[The diagnostic information value of determining tumor-associated antigen Ca-19-9 in pancreatic cancer]. / Diagnosticheskaia informativnost' opredeleniia opukholeassotsiirovannogo antigena Ca-19-9 pri rake podzheludochnoi zhelezy.

Clinical utility of radioimmunologic assessment of blood tumor-associated CA-19-9 antigen level was evaluated in 225 cases of various biliopancreatoduodenal pathology. The levels exceeded the discriminating value of 40 U/ml in 96.4% of patients with pancreatic cancer (mean - 641.7 U/ml), specifically, in those radically operated on for tumors 3 cm in diameter or larger. Application of this noninvasive method for screening for resectable pancreatic carcinoma is justified.

[Clinical assessment of the complex diagnosis of pancreatic cancer]. / Klinicheskaia otsenka kompleksnoi diagnostiki raka podzheludochnoi zhelezy.

Ultrasound examination, X-ray computed tomography, endoscopic retrograde pancreatocholangiography and angiography offer an effective means for pancreatic cancer diagnosis. Precise topic diagnosis and extent of tumor lesion cannot be established by application of either method. Preoperative diagnosis can be improved and lesion extent assessed by the complex use of said procedures. Complex examination saves time and allows the choice of a rational treatment modality.

[Ultrasonic tomography in the diagnosis of pancreatic cancer]. / Ul'trazvukovaia tomografiia v diagnostike raka podzheludochnoi zhelezy.

The results of an ultrasonic tomographic study of 77 patients are presented. Cancer of the pancreas was identified in 50 patients. The diagnosis was verified by a complex examination and surgical evidence. The histological pattern of tumor was identified in 28 cases. The diagnosis of pancreatic carcinoma was confirmed by ultrasonic tomography in 42 cases, the sensitivity of the procedure being 88%, specificity-81%. In cases of chronic pancreatitis, the sensitivity proved 70%, thus requiring a complex approach to differential diagnosis between the two pathologies.

[Computerized tomography in the differential diagnosis of cancer of the body and tail of the pancreas]. / Komp'iuternaia tomografiia v differentsial'noi diagnostike raka tel i khvosta podzheludochnoi zhelezy.

Computer tomography with the 3d generation apparatus was used for the examination of 35 patients. It was shown that the method could detect tumors as little as 2 cm and make topical diagnosis. Main topographic symptoms of tumors of the gland and of other diseases are described.

[Chemoradiation treatment of pancreatic cancer]. / Khimioluchevoe lechenie raka podzheludochnoi zhelezy.

Chemoradiotherapy was recommended to 40 pancreatic cancer patients following exploratory and palliative operations. To raise radiosensitivity of tumors, 22 patients received simultaneous chemotherapy with i. v. injection of 5-fluorouracil, 250 mg, 30-40 min prior to irradiation (2 Gy). A short-term therapeutic effect was obtained in 12 patients who received high (60 Gy) or moderate (40 Gy) irradiation doses and 4-7 g of 5-fluorouracil. The summation of a side effect of radio- and chemotherapy was marked. The administration of 5-fluorouracil did not enhance pancreatic tumor radiosensitivity. The mean lifetime of the patients after treatment was 11.3 mos. To 11 patients before operation 5-fluorouracil was administered i. v., 500 mg, twice a week or 1 g once a week (the mean summary dose 7.5 g). Radiotherapy was given after 2-8 weeks (the optimal time of 4-6 weeks) at a mean dose of 47.8 Gy. The mean lifetime after treatment was 18.7 mos. Chemotherapy to 7 patients was given after radiotherapy which was discontinued at doses of 24-36 Gy because of a grave general state of the patients 5-fluorouracil was administered i. v., 500 mg, twice a week (the mean summary dose 3 g) or 1-3 courses of polychemotherapy were given. The mean lifetime after treatment was 9.4 mos. The mean lifetime of all 40 patients after treatment was 13 mos., the therapy was effective in 24 (60%) patients. Thus simultaneous or consecutive chemoradiotherapy is not indicated for pancreatic cancer patients in a grave condition.

[A method of radiation and combined treatment in inoperable cancer of the pancreas]. / K metodike luchevogo i kombinirovannogo lecheniia neoperabel'nogo raka podzheludochnoi zhelezy.

Methods of topometry , radiation and combined treatment of pancreatic cancer are discussed. The best results were obtained by application of X-ray contrast clips (type K-45) superimposed on tumor during laparotomy. The clips were intended for exposure field formation and radiation treatment using longitudinal 18-25 Mev bremsstrahlung. Radiotherapy procedures and results are presented.