[The prevention of hemorrhagic and suppurative complications in the abdominoperineal extirpation of the rectum]. / Profilaktika gemorragicheskikh i gnoinykh oslozhnenii pri briushno-promezhnostnoi ékstirpatsii priamoi kishki.

A special two-walled latex balloon on a draining tube was introduced into the perineal wound in the abdomino-perineal extirpation for locally spread tumor in 36 of 68 patients. This tamponing device allowed to make simultaneous hemostasis, irrigation of the wound with antiseptics and its valuable drainage. As a result, postoperative blood loss was greatly reduced (up to 80-100 ml) as well as the amount of suppurations (from 56.3 to 5.6%). The average postoperative stay at the hospital became shortened from 38 to 22 days.

[Organ-preserving principle in the surgical treatment of primary multiple cancer of the large intestine]. / Organosokhraniaiushchii printsip v khirurgicheskom lechenii pervichno-mnozhestvennogo raka tolstoi kishki.

This paper presents the analysis of 193 surgical cases of multifocal cancer of the colon. The choice of the radical surgery in synchronous tumors depended on the involved portions of the colon, distance between the lesions, cancer dissemination and general condition of the patient. Out of radical interventions, extensive colon resections (atypical and subtotal) made up 18% only (16 of 89 patients). In metachronous cancer, colon resection (n-67) was performed with due consideration of the second tumor site and lymph outflow from the affected zone (39 typical radical operations and 28 resections with removal of interintestinal anastomosis). Postoperative lethality in synchronous cancer reached 11.2%, in metachronous 10.4%, 5-year survival was 59.3% and 57.7%, respectively. The latter figures appeared only a little lower that in solitary colon cancer (63%).

[Clinico-morphological aspects and treatment of polyps associated with cancer of the large intestine]. / Kliniko-morfologicheskaia kharakteristika i lechenie polipov, soputstvuiushchikh raku tolstoi kishki.

Among 218 patients with cancer of the large intestine, in 56 (25.7%), a tumor was associated with single, or multiple polyps. In morphological study, considerable dysplasia of glandular epithelium was revealed in 43.7%, and malignization--in 9.2% of accompanying polyps. Considering association of cancer with adenomas as one of the forms of large intestinal polyneoplasia, the authors recommend to perform in such patients typical radical operations in combination with endoscopic polypectomy, and extend the volume of resection only in polyp malignization with invasion of the tela submucosa, or diffuse polyposis.

[Quantitative evaluation of the degree of edema in edematous-infiltrative breast cancer]. / Kolichestvennaia otsenka stepeni oteka pri otechno-infil'trativnom rake molochnoi zhelezy.

Water receptivity test after McClure-Aldrich was used to assess edema of the mammary gland affected by edematous-infiltrative carcinoma. Fifty-five patients with said pathology as well as 20 nodular carcinoma and 22 mastopathy patients in control were examined. Patients failing to respond to a combination of polychemo- hormono-therapy and irradiation showed the following pattern of test parameters: initial time of resolution of a blister produced by intradermal physiologic salt solution injection ranged 3-10 minutes. After treatment, it increased by less than 5 minutes or even decreased. An 81.8 +/- 8.2% remission rate was seen in patients in whom the said indexes were 11-50 minutes and a less than 5 minute increase, respectively. High predictive value of the test was confirmed mathematically.

[Complications of a biliodigestive anastomosis in tumors of the organs of the pancreatoduodenal area]. / Oslozhneniia biliodigestivnogo anastomoza pri opukholiakh organov pankreatoduodenal'noi zony.

To prevent from an ascendant infection of biliary tract the authors apply a maximally large (8--9 cm) cholecystojejunoanastomosis through the excision of a part of the gallbladder wall. Such an anastomosis eliminates the ballbladder cavity, and its function approximates that of an excretory canal. The patients operated upon by means of this surgical method developed cholangitis 4 to 5 times less than those who underwent cholecystojejunostomy through the apparatus PKS-25.

[Selection of pancreato-intestinal anastomosis in pancreatoduodenal resection]. / Vybor pankreato-kishechnogo anastomoza pri pankreato-duodenal'noi rezektsii

41 pancreatoduodenal resections with 11 lethal issues (26.8 plus or minus 7%) were analysed. In 21 cases an end-to-end pancreatointestinal anastomosis was employed, in 12 cases an end-to-side one with peritonization of a suture line with the jejunal wall after the A. A. Shalimov technic, but in 8 cases- the technic of pancreatojejunostomy elaborated by the author, an end-to-end side type enveloping the anastomosis with a cecal segment of the jejunum. This method of peritonization does not impede passage of the intestinal content, thus rendering unnecessary the production of enteroenterostomy. Suture divergency of the end-to-end pancreatointestinal anastomosis was noted postoperatively in 6 of 21 patients (28.6 plus or minus 10%). Whereas, among 20 pancreatojejunostomies with peritonization of sutures by the jejunal wall after the A. A. Shalimov technic or in the author's modification this complication was noted only in 2 cases (10 plus or minus 7%).