[Analysis of postoperative complications after pneumo-n-ectomy using thoracic morbidity and mortality (tmm) system in nsclc patients for a 5-year period]. / Analiz posleoperatsionnykh oslozhnenii po sisteme TMM u bol'nykh nemelkokletochnym rakom legkogo posle pnevmonektomii za 5-letnii period.

AIM: Postoperative complications after pneumonectomy for NSCLC depend on the extension of surgery, comorbidities and accurate registration of any adverse event. The aim of the study was to evaluate the short-term results after standard and extended pneumonectomy in NSCLC patients according to the TMM grading system. MATERIAL AND METHODS: We included 216 NSCLC patients consecutively submitted to pneumonectomy at our institution from January 2009 to December 2013 in the retrospective study performed on data prospectively collected in an electronic clinical database. All patients were divided into two different groups: standard (n=142) and extended (n=74) pneumonectomy, where resection of adjacent organs was indicated. The patients undergone extended pneumonectomy were subdivided into single (n=49) and multi-organ resection (n=25) groups. Morbidity and mortality rate was analyzed according to the standard criteria and TMM classification system. RESULTS: Postoperative morbidity and mortality rate after standard pneumonectomy (23,9% and 3,5%) was significantly lower than extended procedure (43,2% and 10,8%) (p=0.02). Multi-organ resection was an independent prognostic factor of unfavourable outcome: morbidity and mortality was significantly higher in the multi-organ group (48,0% and 16,0%), while in the single-organ group it was 40,8% and 8,2% respectively (p=0.01). Major complications rate (grade IIIA and higher according to the TMM) was significantly higher in the multi-organ group (40,0%) than in the single-organ (28,6%) and standard (14,8%) group (p=0.01). CONCLUSION: TMM classification system is more accurate in grading and further analysis of postoperative complications after pneumonectomy in NSCLC patients in compare with standard criteria. Multi-organ resection should be carried out with caution due to unacceptable high morbidity and mortality rate.

[Delayed coloesophagoplasty in difficult clinical situations].

AIM: To improve immediate and long-term results of delayed coloesophagoplasty in cancer patients. MATERIAL AND METHODS: We presented three case reports of coloesophagoplasty in difficult clinical situations including technical impossibility of primary plasty, extraordinary anesthetic situation, transplant necrosis after primary plasty. RESULTS: Gastrointestinal tract integrity was restored in all cases and patients returned to nutrition per os, that provided good quality of life and compensated nutritional deficiencies. Only one patient had bleeding in postoperative period that required relaparotomy. There were no postoperative complications in two other patients. CONCLUSION: Delayed coloesophagoplasty should be performed in all patients who underwent esophagogastrectomy if progression of primary disease is absent. Graft placement and colic segment are chosen individually. However left half of colon with retrosternal location of transplant is preferable for plasty.

[Combined use conventional and videoendosurgery in pediatric oncology].

The autors report original date on the combined use of videosurgery and open surgical intervention in 3 patients. One (1 yr 10 mo) had neuroblastoma in the posterior mediastinum spreading to the retroperitoneal region, another (5 yr) presented with neuroblastoma in the thoracic aperture region spreading to the neck, the third one (14 yr) suffered limphoepithelioma-like cancer of the thymus. The combined treatment permits to optimize the surgical procedure and avoid additional use of thoraco- and laparotomy.

[Endoscopic resection of mucosal and submucosal stomach layers as the diagnostic and medical procedure in oncology].

Owing to introduction in a daily practice of modern medical technologies there was real improvement of duly diagnostics of early forms of a cancer of a gastroenteric path. In this connection interest to endoscopic methods of its treatment has increased. According to the world literature, parameters of a radical resection of a mucous membrane of a stomach in occasion of early cancer vary in a range of 75-98% depending on the macroscopical form of growth and the sizes of a tumors. There is one more very important parameter on which efficiency of a method EMR depends, it is the fact of use of a technique of removal of pathological formation by the uniform block or by parts. As us, with the purpose of all-round studying opportunities of a EMR and ESR was carried out as diagnostic procedure at infiltrative forms of a cancer and lymphomas of stomach.Thus, the purpose of our research is studying true value and the importance of application of EMR and ESR, as with the purpose of specifying diagnostics, and a curative method in oncology.