[Rationale for early rehabilitation of patients with uterine corpus cancer]. / Obosnovanie rannei reabilitatsii bol'nykh rakom tela matki.

OBJECTIVE: To study the dynamics of hemorheologic changes and the frequency of early complications of laparoscopic radical hysterectomy in patients with uterine corpus cancer depending on conducting rehabilitation activities in the early postoperative period. MATERIAL AND METHODS: The number of patients with uterine corpus cancer equal 49 (mean age 54.8±2.2 years), divided into 2 comparable groups, was examined: experimental group - 23 patients, who received local magnetotherapy since the first day after surgery for 5-6 days, and control group - 26 patients without physiotherapy. Comparative group included 24 healthy women. The basic rheological parameters, namely blood viscosity at high and low shear rate, hematocrit, erythrocytes' aggregation and deformability, erythrocytes and platelets electrophoretic mobility, were evaluated in all patients initially, on the 1st and 5th days after surgery and in comparison group. RESULTS: There were changes in the rheological properties of the blood before surgery in patients of both groups: increase of blood viscosity, enhancement of aggregation activity of its formed elements, decrease of erythrocytes' deformability properties. The laparoscopic radical hysterectomy was accompanied by the exacerbation of these disorders. The early magnetotherapy in patients reduced hemorheological abnormalities up to the preoperative parameters (p<0.05) for 5 days, as well as reduced the incidence of early postoperative complications by 2.4 times compared to the control group. CONCLUSION: The application of local low-frequency low-intensity magnetotherapy since the first postoperative day allows to reduce the level of postoperative hemorheological abnormalities up to the level of preoperative parameters, as well as the frequency of early postoperative complications.

[Laparoscopic subtotal distal gastrectomy for distal gastric cancer]. / Opyt vypolneniya laparoskopicheskoi subtotal'noi distal'noi rezektsii v lechenii bol'nykh rakom antral'nogo otdela zheludka.

OBJECTIVE: To analyze the primary results of laparoscopic distal gastrectomy in patients with distal gastric cancer. MATERIAL AND METHODS: There were 21 laparoscopic distal gastrectomies in patients with distal gastric cancer. Mean age of patients was 63.7±6.3 years. According to TNM staging system, cancer stage 1 was detected in 90% of patients (n=19), stage 2a - in 10% (n=2) of patients. RESULTS: Time of distal gastrectomy was 190.4±51.6 min, blood loss - 90.3±51.2 ml. The number of excised lymph nodes was 21.2±5.1. We were able to achieve R0 resection edge in all patients. Length of hospital-stay was 7.6±2.3 days, incidence of postoperative complications - 23.8%. Complications Clavien-Dindo grade IIIb-V were observed in 9.5% of patients (n=2). Overall postoperative mortality was 4.7% (n=1). No progression of the underlying disease has been revealed in any patient throughout the follow-up period (since May 2018). To date, the maximum median follow-up is 25 months of overall and disease-free survival. CONCLUSION: Laparoscopic subtotal distal resection is an appropriate intervention ensuring R0 resection edge in most cases.

[Laparoscopic subtotal distal resection for distal gastric cancer]. / Opyt vypolneniya laparoskopicheskoi subtotal'noi distal'noi rezektsii v lechenii bol'nykh rakom antral'nogo otdela zheludka.

OBJECTIVE: To analyze the primary experience of laparoscopic distal gastrectomy in patients with distal gastric cancer. MATERIAL AND METHODS: There were 21 laparoscopic distal gastrectomies in patients with antrum malignancies. Mean age of patients was 63.7±6.3 years. According to TNM staging system, cancer stage I was detected in 90% of patients (n=19), stage IIa - in 10% (n=2) of patients. RESULTS: Duration of distal gastrectomy was 190.4±51.6 minutes, blood loss - 90.3±51.2 ml. The number of harvested lymph nodes was 21.2±5.1. We were able to reach R0 resection edge in all patients. Length of hospital-stay was 7.6±2.3 days, incidence of postoperative complications - 23.8%. Complications Clavien-Dindo grade IIIb-V were observed in 9.5% of patients (n=2). Overall postoperative mortality was 4.7% (n=1). No progression of the underlying disease has been revealed in any patient throughout the follow-up period (since May 2018). To date, the maximum median follow-up is 25 months of overall and disease-free survival. CONCLUSION: Laparoscopic subtotal distal resection is appropriate intervention ensuring R0 resection edge in most cases.