[Immediate results of complex treatment of resectable rectal neoplasms of distal localization].

The impact of neoadjuvant chemoradiation on immediate results of treatment of resectable cancer recti, using large-fractionized radiation in combination with endolymphatic chemotherapy, was estimated. Using the method proposed 64 patients were treated (the main group). In control groups there were included 63 patients, to whom a course of a large-fractionized radiation on background of intravenous chemotherapy was applied, and in 91 patients a large-fractionized radiation only was used. The intraoperative complications rate in the main and control groups have had constituted, accordingly, 16, 6.3 and 3.3%. Postoperative complications have had occurred in 12.5% of patients in the main group, and in 15.9% and 14.3% - in the control groups. The abscesses formation was noted in a small pelvis cavity in 4.7% patients of the main, and in 4.8 and 4.4% - in the control groups. Necrosis of the descended gut was revealed in 10 (4.6%).

[Neoadjuvant chemotherapy and radiation therapy of resectable cancer recti of distal localization].

The method of combined neoadjuvant treatment of resectable cancer recti, consisting of preoperative radiaton therapy, using big-fractionized intensive irradiation on the endolymphatic chemotherapy background together with fluorouracil with following surgical intervention (main group), in terms up to 72 h, was elaborated in the clinic. The patients, to whom the chemotherapy and radiation therapy were conducted, were included into control groups. Postoperative complications have had occurred in 8 (12.5%) patients of the main group and in 10 (15.87%) and 13 (14.29%)--in control groups. The five-year survival indices in the main group have constituted (73.5 +/- 6.3)%, and in control groups--(64.6 +/- 5.8) and (64.4 +/- 6.8)%. The local recurrence rate in the main group have constituted (6.2 +/- 3.0)%, and of the remote metastatizing--(15.6 +/- 4.5)%.

[The two-staged intervention for complicated colonic cancer].

The methods of colonic resection and a two-barrel colostomy closure, after performance of modified Mikulicz operation for complicated colonic cancer with formation of a two-staged extraperitoneal invagination duplicature anastomosis, were proposed. Postoperative complicationshave had occurred in 10 (10.9%) patients, including the anastomotic sutures insufficiency--in 2 (2.2%).

[Immediate results of transabdominal rectal resection with the duplicature anastomosis formation].

There were presented immediate results of surgical treatment of 425 patients with the upper ampullar and rectosygmoid portion cancer recti (CR), to whom in 1989-2002 transabdominal rectal resection, using the duplicature anastomosis, was performed. In 93.4% of observations, according to histological investigation data, adenocarcinoma was diagnosed. Concurrent diseases were revealed in 226 (53.2%) patients. The technique of transabdominal CR resection is depicted. There were noted fair immediate results in treatment of the patients: postoperative complications rate have constituted 13.2%, postoperative mortality--2.6%. In structure of postoperative complications purulent-septic one had prevailed, similarly were complications with cardiovascular and respiratory systems affections.

[Remote results of the treatment of proximal rectal cancer].

There were presented the late results of surgical treatment in 425 patients, suffering upper ampullar and rectosygmoid rectal cancers, to whom transabdominal rectal resection with the duplicature anastomosis formation in 1989--2002 yrs was done. In 93.4% of observations, according to histological investigation data, adenocarcinoma was diagnosed. Concurrent diseases were noted in 226 (53.2%) of patients. The postoperative complications rate was 13.2%, postoperative mortality--2.6%. Late result of treatment was fair.

[Application of endolymphatic therapy using catheterization of femoral lymphatic vessels in complex of treatment of oncological diseases]. / Primenenie éndolimfaticheskoi terapii putem kateterizatsii limfaticheskikh sosudov bedra v komplekse lecheniia onkologicheskikh zabolevanii.

Endolymphatic way of the medicinal preparations administration promotes their more effective influence on pathological focus. The experience of conduction of more then 15,000 of the lymphatic vessels catheterization manipulations was summarized, permitting to perform the treatment of patients successfully.

[Treatment of colonic melanoma]. / Lechenie melanomy tolstoi kishki.

The results of treatment of 5 patients with colonic melanoma are presented. Fine-needle biopsy was used for morphological verification diagnosis. It was established that the patients with colonic melanoma are hospitalized in specialized department, as a rule, with nonopertable tumor. In 1 patient explorative laparotomy was done. Conduction of radical operative intervention was impossible because of presence of multiple metastases in liver. In 4 patients conservative treatment was performed. It was not possible to perform radical operation because of the process spreading. The patients life span after conduction of conservative therapy have constituted 14.5 mo at average.

[Restoration of colonic continuity after the Hartmann's surgery]. / Vosstanovlenie nepreryvnosti tolstoi kishki posle vypolneniia operatsii Gartmanna.

The intestinal continuity restoration after performance of Hartmann's operation in presence of long rectal stump was done using the method of the duplicature anastomosis formation, which was elaborated in the clinic. The frequency of postoperative complications occurrence was 9.8%: In presence of short rectal stump the colon was descended on perineum via submucosal tunnel in rectal stump according to the method, which was elaborated in the clinic. The frequency of the postoperative complications occurrence was 16.7%. The data presented trusts the expediency of application of the methods elaborated in the clinic for restoration of intestinal continuity after performance of Hartmann's operation in presence of long and short rectal stumps.

[Mechanism of early metabolism disorders and immunological reactivity in children with Perthes disease]. / O mekhanizme rannikh narushenii obmena i immunologicheskoi reaktivnosti u detei s bolezn'iu Pertesa.

Submitted in the paper are data to the effect that parameters of certain biochemical indices for blood plasma and cell link of the immune system could allow some judgement about the character of the pathological process in children with Perthes disease. Autoimmune inflammation caused by foci of chronic infection in the organism aggravates the course of aseptic necrosis in the proximal portion of the thighbone or else is a trigger mechanism of its development.

[The restoration of intestinal continuity after the performance of the Miculicz's operation]. / Vosstanovlenie nepreryvnosti kishechnika posle vypolneniia operatsii Mikulicha.

The method of double-barrelled (split) colostomy closure after performance of Miculicz operation, including extraperitoneal formation of the invagination duplicatural anastomosis, was proposed. After application of the proposed method in 21 patients the complications occurred in 2, including 1 case of the anastomotic sutures insufficiency.

[The formation of the transplant for its descending to perineum with the sphincter-salvaging surgery in patients with disseminated sigmoid colon blood supply]. / Formirovanie transplantata dlia nizvedeniia na promezhnost' pri vypolnenii sfinktero-sokhraniaiushchei operatsii u bol'nykh s rassypnym tipom krovosnabzheniia sigmovidnoi obodochnoi kishki.

The methods of the transplant formation in the loose type of the sigmoyd colon blood supply and insufficiency of the over vessel, applied in patients during sphincter-preserving operation performance for cancer recti, was proposed. Satisfactory immediate and late follow up result was noted.

[The use of abdomino-supra-anal resection of rectal cancer]. / Primenenie briushno-nadanal'noi rezektsii priamoi kishki po povodu raka priamoi kishki.

The results of surgical treatment of 193 patients with upper- and middle ampullar cancer recti, to whom the abdominal supra-anal rectal resection was performed, were summarized. The operation procedure performance was depicted. There were no intraoperative complications. Postoperative complications had occurred in 19 (9.8%) of patients, 3 (1.6%) died. Necrosis of the descended intestine was not noted. The anal sphincter function had restored in 1 mo after performance of operative intervention.

[Resection of rectum and bladder for cancer]. / Rezektsiia priamoi kishki i mochemogo puzyria po povodu raka.

In 1970-1997 period 43 patients with cancer recti, invading bladder, were operated on. The base of surgical tactics was performance of primarily-restorational operation as independent procedure and in the complex of treatment as well. There was noted the fair immediate and late follow-up result of treatment.

[The restoration of colonic continuity after Hartmann's operation]. / Vosstanovlenie nepreryvnosti tolstoi kishki posle operatsii Gartmana.

The experience of restorational intervention with formation of duplicature (invagination) anastomosis after Hartmann's operation in 45 patients with complicated cancer recti and colonic cancer was summarized. Complications had occurred in 9.8% of observations, one patient died.

[Methods of inversion closure of transient colostomy]. / Sposob inversionnogo zakrytiia vremennoi kolostomy.

The method of inversive excision of colostomy, securing access to noninflamed tissues of intestine and pericolostomic region for consequent suturing made in accordance to requirements. While using the method purulent-inflammatory complications had occurred in less than 5% of patients and insufficiency of anastomotic sutures--in 3.4%.

[Contemporary aspects of treatment of colonic cancer, complicated by ileus. Part III. Treatment of rectal cancer, complicated by ileus]. / Sovremennye aspekty lecheniia raka tolstoikishki, oslozhnennogo neprokhodimost'iu kishechnika. Chast' III. Lechenie raka priamoi kishki, oslozhnennogo neprokhodimosti'iu kishechnika.

There were operated 331 patients with cancer of rectum, complicated by ileus. Radical operation was performed in 168 patients, palliative--in 57, symptomatic--in 106. Possibility of widening of evidences for performance of primary-restorational, sphincter-preservational operations was proved.

[Intensive therapy and strategy of management of patients with rectal cancer after the colonic descending to the perineum]. / Intensivnaia terapiia i taktika vedeniia bol'nykh rakov priamoi kishki posle nizvedeniia obodochnoi kishki na promezhnost'.

Optimal tactic for management of the patients on various stages of treatment was elaborated together with surgical procedure, basing on the experience of 3500 operations conduction for cancer recti, mainly abdominal resection with colon descendant to perineum. Methods of preoperative preparation and anesthesiological support were stated as well as the tactics of postoperative management of patients.