[Ethanol injections in the integrated treatment of non-resectable malignant pancreatic tumor complicated by jaundice]. / Zastosuvannia etylizatsiï v kompleksi likuvannia nerezektabel'nykh zloiakisnykh pukhlyn pidshlunkovoï zalozy, uskladnenykh zhovtianytseiu.

Results of treatment were analyzed in 28 patients with nonresectable pancreatic cancer (III-IV stages) complicated by jaundice, to whom in complex of treatment (biliodigestive shunting, in some of patients with hepatic dearterialyzation, gastroenterostomy, pancreatodigestive shunting) 96% ethanol was injected into the tumor. The complications frequency had constituted 21.4%, mortality--14.3%, the life span of operated patients--9 months at average. Sings of early and late "postethylizational" positive pancreatic cancer pathomorphosis were established.

[Hemocoagulation disorder in patients with destructive pancreatitis: the role in pathogenesis and ways of its correction]. / Porushennia hemokoahuliatsiï pry destruktyvnomu pankreatyti: rol' v patohenezi ta shliakhy korektsiï.

The dynamics of hemocoagulation system changes in patients with different clinical forms of destructive pancreatitis (DP) was evaluated. The necessity of use of directed hemocoagulation therapy and hemocorrection, in particular, the use of low-molecular weight heparins, in complex program of treatment of DP is proved.

[The influence of clexane on the fibronectin content in the blood plasma in patients with destructive pancreatitis]. / Vliianie kleksana na soderzhanie fibronektina v plazme krovi u bol'nykh destruktivnym pankreatitom.

The fibronectin content dynamics in the blood serum was estimated in patients with various clinical forms of an acute pancreatitis. The fibronectin level lowering may be a predictor of occurrence and diagnostical criterion for infective complications in patients with destructive pancreatitis. Application of clexane had promoted the fibronectin level raising in the blood serum in patients with sterile and infected pancreatic necrosis.

[Expediency of the liposuction in surgery of abdominal surgery, abdominal diseases and small organs of the pelvis]. / Tselesoobraznost' osushchestvleniia dermatolipéktomii pri vypolnenii operatsii po povodu gryzhi zhivota, zabolevanii organov briushnoi polosti i malogo taza.

The experience of performance of dermatolipectomy in 124 patients while conducting operative intervention for abdominal hernia and for the abdominal cavity and the small pelvis organs diseases was summarized. The risk degree of the simultant operation performance was estimated while conducting the proper preoperative preparation and the surgical correction volume was planned beforehand. The simultant operation performance did not influence the stationary treatment duration significantly, it also permitted to reduce the duration of temporary disability to shorten significantly the treatment expenses, to stop the stress influence on patient's psychological state caused be the reoperation conduction necessity. Low-molecular heparin fraxiparin (produced by Sanofi firm) was applied for the thromboembolic complications prophylaxis under control of the blood coagulation time and of the coagulogramm indices.

[Choice of surgical strategies in the treatment of multiple postnecrotic pancreatic pseudocysts]. / Vybor khirurgicheskoi taktiki pri lechenii mnozhestvennykh postnekroticheskikh psevdokist podzheludochnoi zhelezy.

The results of treatment of patients with multiple pancreatic pseudocysts are presented. The surgical tactics choice, depending on size, localization of pseudocysts, the state of their wall and connection with pancreatic duct, was substantiated.

[The combined treatment of acute destructive pancreatitis]. / Kompleksnoe lechenie ostrogo destruktivnogo pankreatita.

Extensive resection of the pancreas is shown to be accompanied by a high case-fatality rate and unsatisfactory late results such as formation of postpancreatectomy syndrome. Expediency is proved of employment of conservative treatment (pancreatic secretion blockers, antioxidants, antibiotics, different kinds of extracorporal and intracorporal detoxication etc.). Indications to operative treatment of destructive pancreatitis are determined, which include progressive polyorgan incompetence that does not respond to adequate intensive therapy for 48 to 72 hours, progression of biliary pancreatitis (surgery is performed during the first 24-hour period), infected necroses (at day 15 to 17). The above treatment option was associated with a decline in the general case mortality down to 6.15% and in the postoperative mortality down to 15%.

[Endoprosthesis of mammary glands using hydrogel prosthesis PAAG "Interfall"]. / Endoprotezirovanie molochnykh zhelez s ispol'zovaniem gidrogelevykh protezov PAAG "INterfall".

The results of the mammarial glands endoprosthesis in 60 women patients, of them in 57--with prostheses PAAG "Interfall", applied for the first time, were analyzed. The occurrence frequency for postoperative complications was 19%, including sensitivity disorders of papillo-areolar complex were noted in 14% of observations and seroma--in 5%. Preoperative, intraoperative, postoperative tactic of management of women patients, operated for the first time and with purulent-septic complications occurring after mammoplasty using application of gel and prostheses PAAG "Interfall" was elaborated.

Ukrain (NSC-631570) in the treatment of pancreas cancer.

The aim of this study was to investigate the effects of Ukrain in the treatment of pancreatic cancer. Most patients with advanced pancreas cancer experience pain and have to limit their daily activities because of tumor-related symptoms. Currently, there is no satisfactory treatment for pancreas cancer. The 12-month survival rate is approximately 18% for patients treated with gemcitabine and only around 2% for those treated with 5-fluorouracil. Between January 1, 1996 and December 31, 1999 42 patients with advanced symptomatic pancreas cancer were randomly assigned to receive either vitamin C (5.4 g every second day, repeated 10 times) and Ukrain (10 mg every second day, repeated 10 times) (21 patients), or vitamin C (5.4 g every second day x 10) and normal saline (10 ml) (control group, 21 patients). The primary measure of efficacy was overall survival. Other evaluation criteria included change in body weight, pain intensity (measured by analgesic consumption) and Kamofsky performance status. The one-year survival was 81% in the Ukrain group compared with 14% in the control group. The 2-year survival was 43% in the Ukrain group compared with 5% in the control group. In a recent study of 126 patients treated with gemcitabine or 5-fluorouracil, none of the patients survived beyond 19 months. The longest survival in the Ukrain group was 54 months after the start of therapy (from March 1996 to date). The last follow-up of other patients was on September 6, 2000. Median survival was 17.17 months for Ukrain-treated patients and 6.97 months for the control group and mean survival was 21.86 and 8.92 months for the Ukrain and control groups, respectively (p = 0.001). Ukrain treatment was well tolerated. We conclude that Ukrain prolongs survival of pancreas cancer patients. To determine whether and to what extent this drug can be used as standard therapy in pancreas cancer, a phase III study should be carried out.

[Current approaches to the treatment of acute destructive pancreatitis]. / Sovremennye podkhody k lecheniiu ostrogo destruktivnogo pankreatita.

The experience of treatment of 2740 patients with an acute pancreatitis (AP) in 1973-1998 years was summarized. The efficacy of an active-surgical, active-temporizing and conservative tactics was estimated, the basic components of conservative therapy, indications to surgical treatment of an AP were considered.

Comparison of chemotherapy and X-ray therapy with Ukrain monotherapy for colorectal cancer.

Ninety six colorectal carcinoma patients were included in a randomised study, 48 were treated with Ukrain monotherapy (15 with metastatic and 33 with nonmetastatic colorectal carcinoma) and 48 with 5-fluorouracil (5-FU) and X-ray therapy (the same randomised groups). The results of therapy including clinical, haematological, immunological and biochemical parameters show that Ukrain has favourable properties in the treatment of colon and rectal cancer as a monotherapy because of its malignotoxic and immunomodulating action. Objective response rate in the group of metastatic colorectal cancer treated by Ukrain was 40%. There was no registered tumour regression in the group treated by 5-FU. Operability is strongly facilitated by pretreatment with Ukrain. The survival rate (up to 21 months) in the Ukrain-treated patients with nonmetastatic colorectal cancer was 78.6% and 33.3% in a corresponding control group. Ukrain is a new effective drug in the therapy of colorectal cancer. It can be useful both for the therapy of metastatic colorectal cancer and for neoadjuvant therapy of nonmetastatic colorectal cancer.

[The initial experience of using the preparation Ukrain in treating cancer patients in Ukraine]. / Pershyi dosvid zastosuvannia preparatu "Ukrain" v likuvanni onkolohichnykh khvorykh v Ukraïni.

The chair of general surgery and the chair of oncology of the Ukrainian State Medical University have made a study into the use of the preparation "Ukrain" in the treatment of oncological patients. Early results of therapy of 23 patients confirm the evidence suggesting to us that "Ukrain" is endowed with cancerostatic activity, has immunopotentiating effect with no toxicity.

[Reoperations in patients with pyloroduodenal ulcers]. / Povtornye operatsii u bol'nykh piloroduodenal'nymi iazvami.

From analysis of the results of treatment of 35 patients who underwent previously unsuccessful operations for pyloroduodenal ulcers, the authors discuss the term and the most adequate method of surgical correction. Poor results in the early period after the operation are mainly due to technical errors made during the performance of the first operation. Affection of organs adjacent to the stomach prevail in the later periods. The use of methods of surgical correction suggested by the authors made it possible to achieve adequate medical, social, and occupational rehabilitation in 26 patients.

[The pathomorphogenetic characteristics of the wall of the common bile duct in cholestasis]. / Osobennosti patomorfogeneza stenki obshchego zhelchnogo protoka pri kholestaze.

Data are presented on the reversibility of pathological changes of the common bile duct, causes and criteria of reversibility. Consideration of four stages of pathomorphogenesis of the common bile duct wall may be of help in the choice of surgical tactics in surgical intervention on the common bile duct.

[A new approach to the intraoperative diagnosis of cholangitis and to the choice of surgical procedure in operations on the bile ducts]. / Novyi podkhod k intraoperatsionnoi diagnostike kholangita i vyboru khirurgicheskoi taktiki pri operatsiiakh na zhelchnykh protokakh.

The authors have developed a prompt and informative method for assessment of the depth and reversibility of the morphofunctional changes in the common bile duct (CBD) wall with the use of staining by hematoxylin basic, fuchsin-picric acid. Four types of the morphologic changes in CBD wall, which characterize the different degree of reversibility, were established. Depending of presence of these types, the corresponding surgical tactics is recommended.

[Surgical treatment of biliary cyst]. / Khirurgicheskoe lechenie biliarnoi kisty.

The experience with surgical treatment of 21 patients with a biliary cyst who underwent 25 operations has been analysed. The authors came to a conclusion about unexpediency to use the walls of a cyst in creation of the cystodigestive anastomosis. The operations with complete removal of the cystic wall are recommended.

[Diagnostic accuracy in acute pancreatitis in the prehospital and early hospital stages]. / Tochnost diagnostiki ostrogo pankreatita na dogospitalnom i rannem gospitalnom etape.

The results of the analysis of diagnosis of acute pancreatitis on the basis of studying 3634 case records are presented. Errors in the diagnosis of acute pancreatitis at the prehospital stage were established in 61.9%, at the early hospital stage--in 32.35% of cases, usually in the form of hyperdiagnosis of the disease.