[Effectiveness of neoadjuvant chemoradiotherapy of locally advanced rectal cancer in conjunction with local hyperthermia and metronidazole].

Our study included 36 patients with hard fixed rectal tumors (T3, T4) who had received combined treatment at the Center's Clinics. On irrigoscopic evidence, lesions were more than 10 cm long. Radiotherapy was conducted thrice a week, STD of 4 Gy--TTD of 40 Gy; capecitabine, per os, 650 mg/m2 twice a day, days 1-22; oxaliplatin, 50 mg/m2, intravenously, days 3, 10 and 17; metronidazole in polymer composition, intrarectally, 10 mg/m2, twice, days 12 and 17 of radiotherapy; local hyperthermia (the <> installation), 460 mHz, 41-45 deg. C, 60 min, days 8, 12, 15 and 17. Diarrhea (stage III) was reported in 3 (8.3%); no toxicity (grade IV). Radical surgery was carried out in 35 (97.2%); sphincter-saving operation--20 (55.5%). Therapy-related pathomorphism (grade III-IV) was detected in 15 (42.8%). Combined neoadjuvant chemoradiotherapy plus polyradiomodification featured low toxicity and good tolerability and immediate effect.

[Definition, classification and combined treatment of locally invasive rectal neoplasms]. / Opredelenie, klassifikatsiia i kompleksnoe lechenie mestnorasprostranennogo raka priamoi kishki.

From analysis of 490 case records of patients with stage IV A rectal carcinoma, 3 groups of patients were distinguished according to the size of the tumor and the degree of its fixation to the surrounding tissues and growth into the adjacent organs. Such locally spread tumors of the rectum must be subjected to combined treatment: preoperative large-fractional radiotherapy in concurrent local SHF-hyperthermia followed by operation 24-48 hours later. If resectability of the tumor is doubtful, a relieving colostoma is formed in the first stage and distance gammatherapy is applied in a dose of 4 Gy twice a week to a total dose of 32 Gy auring medication with metronidazole and local SHF-therapy. Concurrent intraarterial chemotherapy with 5-fluorouracil (15 mg/kg body weight) has been lately introduced into practice in the treatment of such patients. The results of this complex treatment are evaluated 3-4 weeks after the course is completed.

[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.

[Palliative resections in cancer of the colon]. / Palliativnye rezektsii pri rake obodochnoi kishki.

The paper presents the results of palliative resection of a segment of the colon for cancer in 39 patients with distant metastases or considerable local extension of tumor. Postoperative complications, mostly pyo-inflammation in the abdominal cavity and surgical wound, were registered in 30.7%, the postoperative lethality was 5.1%.

[Computed tomography of the normal male and female lesser pelvis]. / Osobennosti komp'iuternoi tomografii muzhskogo i zhenskogo malogo taza v norme.

The paper is concerned with an analysis of transverse slices of male and female small pelvis in CT-images. A high CT resolution in the characteristics of topical interrelationships of the pelvic organs was shown. A variability of the interrelationships of the pelvic organs with respect to their condition and the value of this factor for correct interpretation of tomograms were shown. A thorough preparation of patients for examination of the pelvic organs is very important for establishing diagnosis, topical characteristics and determination of a degree of dissemination of a pathological process.

[Compression anastomoses in the surgery of transverse colon cancer]. / Kompressionnye anastomozy v khirurgii raka obodochnoi kishki.

The design and operation of the newly-developed AKA-2 intestine suture appliance for forming circular compression enterostomy are discussed. The advantages offered by application of the device over those of a clip appliance are considered. The results of its application in 86 operations on the transverse colon are presented. The procedure failed in 46% of cases, postoperative lethality rate was 2.3%. The said procedure should be recommended for a wider integration with clinical practice.