[Robot-assisted and laparoscopic partial splenectomy for nonparasitic cysts].

21 patients with nonparasitic spleen cysts were operated. Robot-assisted (RA) interventions were applied in 10 cases, laparoscopic--in 11 patients. Men surgery duration was 124 minutes in case of RA-technique and 120 minutes if laparoscopy was used. Blood loss was significantly lower in the group of RA resection (p=0.035). There were no conversions of access in the group of RA-operations while in group of laparoscopy conversion has been required in 1 case. We did not observe complications in case of RA-surgeries. Laparoscopic method was associated with 2 complications (left-sided hydrothorax and fluid accumulation in resection area). Postoperative hospital-stay did not differ in both groups and was 7.1 and 6.4 room-nights in case of RA-interventions and laparoscopy respectively. There were no deaths. Indications for robot-assisted partial splenectomy for nonparasitic cysts include location of mass in upper pole or hilus of spleen, its diameter more than 8 cm, body mass index more than 30 and splenomegaly. Lower pole resection and splenectomy are more advisable using laparoscopic method.

[Complications after radio-frequency thermoablation of liver tumors].

Results of treatment of 124 patients (228 operations) were analyzed. Complication rate was 19.2%, whereas severe complications were observed in 4.3%. Complications, requiring minimally invasive surgery, on the contrary, conservative treatment , as well as risk actors were defined. Possibilities of radio-frequency thermoablation complications prophylaxis were suggested.

[Regional intraarterial chemoimmunotherapy in complex treatment of patients with colon cancer complicated by metastatic lesion of the liver].

Results of combined treatment of 48 colon cancer patients with metastases to the liver are analyzed. Efficacy of regional intraarterial chemoimmunotherapy with recombinant interleukine-2 (ronkoleukine) is evaluated. The results of the treatment demonstrate that regional intraarterial chemoimmunotherapy with recombinant interleukine-2 is a safe and promising method in combined treatment of advanced colon cancer, increases survival and improves quality of life.

[Radio-frequency ablation appliance in resection of the liver]. / Ispol'zovanie apparata radiochastotnoi ablatsii pri rezektsii pecheni.

Pilot experience with "Radionics Cool-Tip RF System" appliance for radio-frequency ablation (RFA) in hepatic resection in the patients with focal lesions of the liver is presented. Advantages of RFA as an alternative method for hemostasis are demonstrated. With this technique bisegmentectomy (II - III) was performed in 4 patients, right-sided hemihepatectomy - in 2 patients. RFA permitted to minimize intraoperative blood loss without increase of surgery time. There were no severe complications during surgery and in early postoperative period. The method permits to perform combined surgeries without a significant increase of surgical risk.

[Regional arterial chemoembolisation and chemoimmunoembolisation in combined treatment of colon cancer with hepatic metastases]. / Regionarnaia arterial'naia khimioémbolizatsiia i khimioimmunoémbolizatsiia v kompleksnom lechenii raka tolstoi kishki s metastazami v pechen'.

Results of locoregional intraarterial treatment with recombinant Interleukine-2 (Ronkoleukine) in patients with hepatic metastases of colon cancer are presented, efficacy of locoregional arterial chemoembolisation and chemoimmunoembolisation in combined treatment of hepatic metastases are evaluated. The drugs were administered through catheter installed in the right or left branch of the own hepatic artery with Selinger method. Endovascular treatment was carried out 6-10 months after removing of primary tumor. In group 1 (8 patients) infusion of 5-fluororuracil during 3 days (2.0 g/day) with subsequent intraarterial immunoembolisation with recombinant Interleukine-2 (Ronkoleukine) 2 mln IU and 10.0 ml lipiodol were performed. In group 2 (13 patients) infusion of 5-fluororuracil during 3 days (2.0 g/day) with subsequent intraarterial chemoembolisation with Doxorubicin 60 mg/kg and 10.0 ml lipiodol were carried out. All the patients underwent cytoreductive surgery on the liver (in the scope from segmentectomy to hemihepatectomy). The patients of group 1 are alive, mean follow-up from removing primary tumor is 22.8 +/- 7.4 months, from start of endovascular treatment--9.2 +/- 2.3 months. Patients of group 2 died due to progression of disease, mean survival from removing primary tumor was 25.7 +/- 4.2 months, from start of endovascular treatment--7.6 +/- 6.3 months. In group 1 postembolic syndrome with transient fever and chill was seen, in group 2--fever, plains in epigastric area, increase of transaminases in blood, abscesses of metastatic tumors (n = 2) and alopecia (in all patients). It is concluded that regional arterial chemoimmunoembolisation is a perspective and safe method in combined treatment of colon cancer with hepatic metastases compared with locoregional chemoembolisation. It increases lifespan and improves quality of life.