[Simultaneous resection with the creation of 2 anastomoses in synchronous multiple primary cancer of the large intestine]. / Odnomomentnye rezektsii s nalozheniem dvukh anastomozov po povodu sinkhronnogo pervichno-mnozhestvennogo raka tolstoi kishki.

The authors analysed surgical treatment of 26 patients with primary multiple carcinoma of the large intestine with localization of synchronous malignant tumors in distal parts of the large intestine. Eight of these patients underwent one-stage resection of the large intestine with the creation of two anastomoses. Establishment of primary anastomoses during one-stage resections for synchronous primary multiple carcinoma of the large intestine with an AKA-2 compression anastomosis apparatus and a "Skalpel-1" laser device did not deteriorate the immediate results of treatment of this group of patients. One-stage resections of the large intestine are more physiological than subtotal and total colectomy and are sufficiently radical operative interventions.

[Treatment of colonic cancer with metastases to the lungs]. / Lechenie raka obodochnoi kishki s metastazami v legkie.

The authors analyse 62 patients suffering from carcinoma of the colon with metastases in the lungs. Six patients were operated on not only for primary tumor of the colon but also in solitary metastatic affection of the lungs. The interval during which a solitary metastasis in the lung was detected lasted 18.1 months on average. Palliative resection of the colon when distal metastases were found in the lungs was conducted in 21 patients; in 7 of these patients, metastases in the lungs were recognized before the operation while in 2 the diagnosed solitary metastasis was mistaken for carcinoma of the lung and only during operation for ileus was the tumor of the colon discovered. The postoperative mortality was 23.8%, in 17.7%, death was caused by incompetence of anastomosis sutures.

[Clinical picture, diagnosis and treatment of multiple primary synchronous cancer of the large intestine]. / Klinika, diagnostika i lechenie pervichno-mnozhestvennogo sinkhronnogo raka tolstoi kishki.

Clinical course and procedures for diagnosis of primary multiple synchronous cancer of the colon are discussed on the basis of the data on 52 patients treated at the Institute's Clinic in 1962-1986. In 30.5%, these tumors were accompanied by single or multiple polyps of the colon. A significant role of endoscopy in the diagnosis was demonstrated. As a result of complex examination of the organ, a correct preoperative diagnosis of multifocal cancer was made in 48.1% of patients. Tumor multiplicity was established intraoperatively in 14 cases, at autopsy--in 2 (3.8%) and in the course of gross and histologic examination of the resected material--in 11 patients. Laparoscopy proved effective in 81.8%. Surgery is the major procedure for treatment of these tumors. Radical operation was carried out in 36 cases. The postoperative lethality rate was 13.9%. In the radical surgery group, 3-year survival was 61.7%.

[Carcinoembryonic antigen in multiple primary cancer of the colon]. / Rakovo-émbrional'nyi antigen pri pervichno-mnozhestvennom rake tolstoi kishki.

The paper is concerned with analysis of CEA indices in 43 patients with multifocal colon cancer (22 with synchronous and 21 with metachronous colon cancer). The level of CEA was elevated in the group of patients with metachronous cancer in 85.7%, in the group of patients with synchronous cancer in 90.9%, and in the entire group of colon cancer patients in 88.4%. No correlation between the level of CEA and the presence of the second (third of more) tumor simultaneously was not revealed. CEA can be used as a test for diagnosis of recurrences and metachronous colon cancer during a follow-up of patients subjected to radical treatment for a primary colon tumor.

[Multiple primary cancer of the gastro-intestinal tract]. / O pervichno-mnozhestvennom rake zheludochno-kishechnogo trakta.

Peculiarities of the clinical course of primary multiple malignant tumors of the gastrointestinal tract are discussed. Out of 25 cases of synchronous gastrointestinal malignancies, both stomach and large bowel tumors were found in 10 patients and simultaneous neoplasms in different segments of the large bowel--in 15. In the latter group, radical surgery was performed in 13 patients. Out of 54 cases of metachronous cancer, 28 revealed combinations of stomach and large bowel tumors, while in 26 cases metachronous tumors appeared in succession in different segments of the large bowel. Synchronous single and multiple polyps of the large bowel were detected in 19 out of 54 patients. Radical surgery was carried out in 33 and palliative surgery--in 6 patients.