[Strangulated postoperative diaphragmatic hernia]. / Redkoe nablyudenie ushchemlennoi posleoperatsionnoi diafragmal'noi gryzhi.

We present a rare case of postoperative diaphragmatic hernia in a patient with colon infringement 3 years after surgery for cardioesophageal cancer accompanied by extensive diaphragmotomy. The diagnosis of diaphragmatic hernia with colon infringement was based on a combination of anamnestic, clinical and radiological data, as well as results of diagnostic pleural puncture. This clinical case is of interest due to small incidence of disease and difficult interpretation of clinical and diagnostic data.

[Gastrointestinal stromal tumors: potential of minimally invasive surgical interventions]. / Gastrointestinal'nye stromal'nye opukholi: vozmozhnosti maloinvazivnykh operativnykh vmeshatel'stv.

OBJECTIVE: To analyze the issue of gastrointestinal stromal tumors (GISTs) and potential of minimally invasive surgical interventions. MATERIAL AND METHODS: We analyzed postoperative outcomes in 97 patients with gastric and intestinal GISTs who underwent surgical treatment at the National Medical Research Centre for Oncology between 2015 and 2020. RESULTS: Twenty (24.7) patients with gastric GISTs underwent laparoscopic partial and distal gastric resections. Five (35.7%) patients with GISTs of the small intestine underwent minimally invasive segmental bowel resections. Only minimally invasive interventions were performed in patients with rectal GISTs. Analysis of laparoscopic and open surgeries for GISTs found no significant differences. Analysis of laparoscopic and open surgeries for gastric and small bowel GISTs revealed the obvious advantages of minimally invasive access regarding postoperative outcomes. Indeed, we found no need for nasogastric drainage in 50% of patients (p<0.001), earlier recovery of intestinal motility and oral feeding (p<0.001), lower postoperative morbidity (p=0.036), fast recovery of motor activity (p<0.001) and shorter postoperative hospital-stay (p<0.001). CONCLUSION: Despite small incidence, GISTs are a complex problem in modern oncology. Diagnosis and treatment require a multidisciplinary medical team (morphologists, geneticists, radiologists, surgeons, chemotherapists, gastroenterologists and other specialists) that is possible in a reference center. Minimally invasive interventions for GISTs of the stomach, small intestine and rectum improve postoperative course.

[Esophageal squamous cell carcinoma localized in pharyngeal-esophageal diverticulum]. / Redkii sluchai ploskokletochnogo raka pishchevoda s lokalizatsiei v glotochno-pishchevodnom divertikule.

Squamous cell carcinoma in Zenker's diverticulum was first described in 1933. No large studies have yet been conducted due to rarity of this disease. There are a lot of unresolved issues regarding diagnosis and treatment of this pathology. In the literature, there are only few reports on cancer of Zenker diverticulum. It is only known that clinical symptoms are not specific, and diagnosis of carcinoma is traditionally correlated with age and male sex. Despite esophageal localization of primary tumor, its development can take up to 10 years. The authors report squamous cell carcinoma in Zenker diverticulum, discuss the main difficulties of morphological verification of this disease and choice of surgical approach.

[Short-term outcomes of surgical treatment of gastroesophageal junction cancer]. / Neposredstvennye rezul'taty khirurgicheskogo lecheniia kardioézofageal'nogo raka.

OBJECTIVE: To confirm simplicity, safety and efficacy of stapling devices for gastroesophageal anastomosis (including those formed in mediastinum) in the treatment of gastroesophageal junction cancer. MATERIAL AND METHODS: There were 147 patients with cardioesophageal cancer. Tumors Siewert type II and III were predominant (44.2 and 40.3%, respectively). Simultaneous procedures were performed in 30.6% of cases. RESULTS: Postoperative complication rate was 42.2%. Pneumonia was the most common. Postoperative mortality was 2.7%.

[Combined surgery for locally advanced colorectal cancer]. / Kombinirovannye operativnye vmeshatel'stva pri mestno-rasprostranennom kolorektal'nom rake.

AIM: To study the types and early outcomes of combined interventions for locally advanced colorectal cancer. MATERIAL AND METHODS: Since 2009 four hundreds and ninety eight patients underwent surgery in the Rostov Research Institute of Oncology for locally advanced colorectal cancer. Most cases of surgical procedures on adjacent organs included resection of small intestine (23.69%), supravaginal hysterectomy (16.47%), resection of bladder (12.25%), total hysterectomy (11.45%). RESULTS: Postoperative complications occurred in 178 (35.7%) patients. Their incidence was significantly lower in case of laparoscopic approach (12.5%). Functional-sparing interventions on bladder followed by its augmentation with enteric graft improves rehabilitation. CONCLUSION: Laparoscopic approach and functional-sparing surgery improve the results of locally advanced colorectal cancer management.

[Epigenetic markers of esophageal cancer: DNA methylation]. / Épigeneticheskie markery malignizatsii tkanei pishchevoda: metilirovanie DNK.

Adenocarcinoma and squamous cell carcinoma are the most common types of esophageal cancer with a constant tendency to increase the incidence of growth on the background of the high mortality, which makes particularly the development of new biomarkers that complement and improve the early diagnosis of this disease. Despite the impressive number of studies in routine clinical practice is used only marker of esophageal cancer - ERBB2/HER2 status. This review summarizes data on the identified epigenetic markers of the aberrant methylation of the genome, which may be useful for early detection of esophageal cancer, prognosis estimation and / or prediction of response to treatment. The development of new high-tech genome-wide screening, such as beadarray and immunoprecipitation sequencing method used for the wideband genotyping, but for the analysis of transcriptome and metilom, provides a comprehensive picture of genetic and epigenetic changes during tumorigenesis. Note the need to verify the most biomarkers on large representative samples for the development of valid diagnostic panels, suitable for large-scale screening of risk groups.

[The outcomes of different pancreatodigestive anastomoses in pancreatoduodenectomy].

AIM: To compare early results after pancreaticoduodenectomy depending on variant of pancreatico-digestive anastomosis. MATERIAL AND METHODS: It was analyzed early results of 207 pancreaticoduodenectomies for cancer which were performed for the period 2010-2014. Pancreatointestinal and pancreatogastric anastomoses were applied in 165 and 42 patients respectively. RESULTS: Complications were observed in 73 (44.2%) and 18 (38.3%) patients after pancreatointestinal and pancreatogastric anastomoses respectively. Six patients died after pancreatointestinal anastomosis. At the same time there were no deaths in the group of pancreatogastric anastomosis. Differences were significant. Postoperative hospital-stay was similar in both groups.

[[Gender Differences in Tissue Cascade of Activation of Plasminogen and PAI-1 in Esophageal Squamous Cell Carcinoma].]

AIM: comparative analysis of uPA-Ag, uPA-act, tPA-Ag, tPA-act, PAl--Ag and PAl-i-act in tissues of esophageal squamous cell carcinoma (ESCC) in men (M) and women (W) to clarify some pathogenesis issues. MATERIAL AND METHODS: Tumor tissue of ESCC and its perifocal area (19 M and 8 menopausal W aged 38-72 years, st 1I, G2, T,3N M0) were studied by ELISA using standard test kits. RESULTS: ESCC tissue of M showed an increase in both uPA types from the resection line (RL), while in W only uPA-act was increased. tPA-Ag was decreased in tumors of W, tPA-act - in tumors of all patients. Levels of both PAl-- types were higher in ESCC of M than in W. in M, tPA-Ag in perifocal area was lower than in RL, while in W, on the contrary, it was higher. tPA- Ag/tPA-act coefficient in M tumors was 5.7 times higher than in W; in perifocal area it was reduced in all patients, being at the same time in M lower than in W. Both PAl- types were increased in malignant tissues of all patients, prevailing in M tumors, and PAl-i-Ag in peritumoral tissue was higher in M than in W. CONCLUSIONS: Significant gender differences were found in expression of uPA, tPA and PAl-i in tissues of esophageal squamous cell carcinoma. Presence of tumor-associated uPA, PAH and tPA in men and uPA and PAl-i in women is possible in tumor tissue of esophageal squamous cell carcinoma and its perifocal area. Determination of plasminogen regulation system in tissues of esophageal squamous cell carcinoma can be used for the selection and individualization of postoperative treatments.