[Combined and extended radical operations in colorectal carcinoma patients]. / Kombinirani i razshireni radikalni operativni interventsii pri bolni s kolo-rektalen rak.

This is a report on radical operative interventions performed in 273/385 patients presenting complicated colorectal carcinoma, covering the period 1993 through 1998. Fifty-four patients are subjected to combined and extended operations, distributed as follows: 31 combined and 23 extended. In fifteen patients with abdomino-perineal extirpation the combined interventions include: hysterectomy (6), ovariectomy (8), resection of vagina (7), prostate gland resection (3) and bladder resection (2). In case of resection of rectum after Hartmann, combined intervention is done in five patients--small intestine resection, ovariectomy, appendectomy and cyst extirpation from pelvis minor, respectively. Postoperative lethality amounts to 12.9 per cent, or 7/54 patients with complicated colorectal carcinoma undergoing combined and extended surgical interventions.

[Primary colorectal carcinoma as an underlying cause of obturation of the ileum]. / Obturatsionen debelochreven ileus, predizvikan ot p'rvichen kolo-rektalen rak.

This is a report on 169 patients presenting colorectal carcinoma with complication assuming the form of occlusive ileus, observed over the period 1993 through 1998. Obturation is the commonest complication of colonic carcinoma (48.9%) with the left colon being more often involved (58.3%), recorded in a total of 108 patients. During the same period of time, occlusive ileus against the background of carcinoma of the rectum is diagnosed in 61 cases, representing 37 per cent of complicated forms of this malignant neoplasm. The scope of operative management and the procedure used are largely determined by the location of primary malignancy. The timing of undertaking one or another operative intervention depends on the efficacy of preoperative preparation, degree of occlusive ileus progress, patient's age, concomitant diseases and the like. Failing to comply with or overlooking some of the aforementioned factors invariably exerts an unfavourable effect on the final outcome of treatment. In each patient presenting colorectal-carcinoma-induced occlusive ileus it is mandatory to precisely specify the scope of surgery, consistent with the patient's general condition, and eliminate the underlying cause jeopardizing his life.