[Differential diagnosis of B-cell lymphoma rich in T cells and peripheral T-cell lymphomas]. / O differentsial'noi diagnostike B-kletochnoi limfomy, bogatoi T-kletkami, i perifericheskikh T-kletochnykh limfom.

Clinicomorphological analysis of T-cell-rich B-cell lymphoma in a 50-year-old female and literature data revealed objective difficulties in morphological diagnosis using cytological and histological methods. Large number of epithelioid histiocytes and tumor cells polymorphism resembled Lennert's lymphoma (peripheral T-cell lymphoma). Immunohistochemical study confirmed B-cell origin of tumor cells and large number of reactive T-cells. It is suggested that it would be more correctly to use the term "Lennert-like areas" in such cases with subsequent immunohistochemical study.

[Results of organ-preserving and reconstructive surgery of the mandible in patients with cancer of the oral cavity]. / Rezul'taty organosokhraniaiushchikh i rekonstruktivnykh operatsii na nizhnei cheliusti u bol'nykh rakom polosti rta.

Surgery is the basic procedure of combined therapy for locally-advanced carcinoma of the oral mucosa. It is intended to excise involved mucosa and soft tissues of the oral cavity and to resect the mandible. Rim resection (55) produces good functional and cosmetic results and was followed by 5-year survival in 76.4%. Due to median mandibulotomy (24), optimal access was provided to tumor involving the whole tongue and sitting at the back of the oral cavity (5-year survival--58.3%). Postoperative complication incidence was significantly lowered when titanium miniplates were used for mandibular arch reconstruction. When these miniplates and osteomyocutaneous flaps were used for mandibular reconstruction, following segmental resection, good cosmetic and functional results were recorded in 5 out of 8 cases (5-year survival--75%).

[Surgical treatment of residual or recurrent cancer of the oral cavity organs after radiotherapy]. / Khirurgicheskoe lechenie ostatochnogo ili retsidivnogo raka organov polosti rta posle luchevoi terapii.

The experience of surgical treatment of residual tumor or recurrent carcinoma of the oral cavity at different stages after high-dose (more than 50 Gy) radiotherapy makes a case for wider application of surgery in cases that would be otherwise thought hopeless. Although the overall frequency of local postoperative complications is still high, the use of arterialized myocutaneous or adipose-cutaneous flaps during one-stage reconstructive surgery and effective postoperative management can provide a means to cut down the incidence of such grave complications as acute necrosis of tissues leading to hazardous bleeding and development of extensive defects of mandibular tissues and orostomas. More effort should be made to evolve procedures of surgical treatment to be given after high-dose radiotherapy.

[Choice of the optimal variant of plastic surgery in head and neck tumors]. / Vybor optimal'nogo varianta plastiki pri opukholiakh golovy i shei.

Indications for planning primary and delayed operations for head and neck tumors have been evolved on the basis of our 15-year experience with 667 reconstructive surgeries (550 patients) 425 of which (77%) were conducted in one stage.

[Reconstructive surgery and organ-sparing methods in the treatment of patients with laryngeal and oral cavity tumors]. / Rekonstruktivnye operatsii i organosokhraniaiushchie metody lecheniia u bol'nykh opukholiami gortani i polosti rta.

Some advances have been recently made to improve survival rates among patients with common advanced larynx and oropharyngeal cancer. In this connection, it is essential to improve the quality of such patients' life. A total 382 patients with Degrees III-IV laryngeal and oral cancers were followed up. New approaches to treating these patients by combining various radiation, chemoradiation and surgical treatments, as well wide application of various primary plastic surgeries have yielded good functional and cosmetic results in most patients.

[Primary plastic repair in the surgical treatment of cancer of the anterior portions of the mouth]. / Pervichnaia plastika pri khirurgicheskom lechenii raka perednykh otdelov polosti rta.

An experience with using the method of primary plasty of 54 patients with carcinoma of frontal portions of the oral cavity with muscular-cutaneous flaps is described. Preoperative irradiation (from 30 to 80 Gr) was given to 51 patients. Radical operations on the neck were performed on all the patients (in 15 patients the operations were bilateral). Necroses of the flaps were noted in 27.8% of the patients, mainly after doses of X-ray therapy of 50-80 Gr, suppuration of the wound in 64.8%. Good cosmetic and functional results were obtained in 44 patients (81.3%). The average time of staying at the hospital was 33.7 days.

[The use of clindamycin and netilmicin for preventing postoperative wound infection in patients with cancer of the upper respiratory and digestive tracts]. / Primenenie klindamitsina i netilmitsina dlia profilaktiki posleoperatsionnoi ranevoi infektsii u bol'nykh rakom verkhnikh dykhatel'nykh i pishchevaritel'nykh putei.

Clindamycin (2.7 g/day) and netilmicin (5.6 mg/kg) were used for 6-10 days in 27 patients with laryngeal and oral cancer versus beta-lactam antibiotics and aminoglycosides received by 56 matched patients to prevent infection of the operative wound. Suppuration was observed in 11.1 and 41.4% of the patients, respectively (p < 0.05), the temperature rose over 38 degrees C in 22.2% and 42.9% of the patients, respectively (p < 0.05). The regimens showed similar toxicity. The findings proved high efficacy of clindamycin combination with netilmicin in infection prophylaxis in patients operated on for upper respiratory and digestive tract cancer.

[Features of surgical intervention in patients with cancer of oral cavity organs after a radical course of radiotherapy]. / Osobennosti khirurgicheskikh vmeshatel'stv u bol'nykh rakom organov polosti rta posle radikal'nogo kursa luchevoi terapii.

The paper is concerned with the results of extended and combined operations on 58 patients, subjected to a previous radical course of beta-beam or combined (external and contact) irradiation for cancer of the oral cavity and oropharyngeal organs. Over 2 years after operation 50% of the patients are alive. Twenty-two patients died of tumor relapse, regional or distant metastases, one patient died of another tumor site, and 6 patients died from intercurrent diseases. The results obtained are indicative of the appropriateness of this kind of operations. The use of plastic surgery simultaneously with the removal of a primary tumor prevents severe postoperative complications.

Applications of islet musculocutaneous flap from the trapezius muscle for primary plastic operations of oral cavity defects.

13 patients after major resection of oral cavity malignancies had primary plastic operation performed using trapezius muscle musculocutaneous flaps to cover the defect. The flaps were mobilized on a vascular pedicle supplied by the superficial cervical artery and drained by the concomitant vein. Partial flap necrosis was seen in two patients--mainly due to thrombosis of the vein of the pedicle. The vein should have an inside diameter of at least 0.4 cm. In the remaining cases, satisfactory functional and aesthetic results were obtained. In the flap mobilization region there is, as a rule, no growth of hair, which is important as the skin layer of the flap provides the inner lining of the oral cavity.

[The need for using single-stage reconstructive operations following the removal of malignant head and neck tumors]. / O neobkhodimosti primeneniia odnomomentnykh vosstanovitel'nykh operatsii posle udaleniia zlokachestvennykh opukholei golovy i shei.

The paper discusses the results of treatment of 102 cases of locally-advanced malignant tumors of the head and neck. Myocutaneous flaps including m.m. platysma, sternocleidomastoideus, trapezius and pectoralis major were used to rectify primary postexcisional defects. Preoperative radiation treatment (30-100 Gy) was given to 92 patients. Primary reconstruction for defects of the head and neck failed to stimulate recurrence development or affect survival as compared to controls. Frequency of complications involved in the said method proved lower while stay at the hospital shorter as compared to other reconstructive procedures. The above method assured a shorter period of rehabilitation and thus saved funds.

[Correction of soft tissue defects of the head and neck with a cutaneo-muscular flap from the greater pectoral muscle]. / Zameshchenie defektov miagkikh tkanei golovy i shei kozhno-myshechnym loskutom s bol'shoi grudnoi myshtsei.

Plasty of defects of head and neck by a flap with musculus pectoralis major is described. In 20 patients the substitution of the defects was fulfilled simultaneously with the main operation. In 12 patients it was performed within 2-12 months. The method described gives a valuable substitution of lack of the soft tissues resulting from oncological operations, gives good cosmetic results and shortens the period of staying at the hospital.