Recurrence Patterns After Surgical Resection of Gastroenteropancreatic Neuroendocrine Tumors: Analysis From the National Comprehensive Cancer Network Oncology Outcomes Database.

OBJECTIVE: Current National Comprehensive Cancer Network guidelines for gastroenteropancreatic neuroendocrine tumors (GEPNETs) recommend complete (R0) surgical resection of the primary tumor and metastases, if feasible. However, large multicenter studies of recurrence patterns of GEPNETs after resection have not been performed. METHODS: Patients 18 years or older who presented to 7 participating National Comprehensive Cancer Network institutions between 2004 and 2008 with a new diagnosis of a small bowel, pancreas, or colon/rectum neuroendocrine tumor (NET) and underwent R0 resection of the primary tumor, and synchronous metastases, if present, were included in this analysis. Descriptive statistics and Kaplan-Meier estimates were used to calculate recurrence rates and time-associated end points, respectively. RESULTS: Of 294 patients with GEPNETs, 50% were male, 88% were White, and 99% had Eastern Cooperative Oncology Group performance status 0 to 1. The median age was 55 years (range, 20-90). The median follow-up time from R0 resection was 62.1 months. Recurrence rates were 18% in small bowel NETs (n = 110), 26% in pancreatic NETs (n = 141), and 10% in colon/rectum NETs (n = 50). The frequency of surveillance imaging was highly variable. CONCLUSIONS: R0 resection was associated with variable risk of recurrence across subtypes. Further research to inform refinement of guidelines for the appropriate duration of surveillance after R0 resection is needed.

Use of synthetic stomata in abdominal carcinomatosis. Case report and literature review.

BACKGROUND: The successful performance of ostomies for the treatment of different diseases has been described since 1706. We report herein the first case of successful ostomy utilizing a synthetic stoma created in a patient with peritoneal carcinomatosis. CLINICAL CASE: A 40-year-old woman presented with abdominal carcinomatosis due to psammomatous papillotubular adenocarcinoma consistent with primary ovarian carcinoma. The patient had negative estrogen and progesterone receptors and Ki-67 proliferative activity was 83%. She was initially treated with cytoreduction therapy, chemotherapy, and hyperthermic intraperitoneal chemotherapy. Because the patient presented with enteric perforations and the extensive tumor invasion and adhesions in all the intestinal segments made it impossible to create autologous decompression stomas, a synthetic stoma was constructed. CONCLUSIONS: Synthetic stomas can be a good treatment option when autologous stomas can not be created.

INTRODUCCIÓN: Desde el año 1706 se han descrito ostomías realizadas con éxito para el tratamiento de diferentes enfermedades; los autores describen el primer caso de éxito en una ostomía sintética en la carcinomatosis peritoneal. CASO CLÍNICO: Mujer de 40 años de edad con carcinomatosis abdominal por adenocarcinoma papilar tubulopapilar psamomatoso más consistente con cáncer primario de ovario, negativo a receptores de estrógenos y progesterona, con marcador Ki-67 al 83% de actividad. De modo inicial se trató con cirugía de citorreducción, quimioterapia, quimioterapia intraperitoneal hipertérmica y por último realización de estomas sintéticos debido a perforaciones entéricas e imposibilidad de realizar estomas descompresivos autólogos por la invasión tumoral extensa y adherencias de todas las asas intestinales. CONCLUSIONES: Los estomas sintéticos pueden ser una buena opción terapéutica cuando es imposible realizar estomas autólogos.

Practice Patterns and Guideline Non-Adherence in Surgical Management of Appendiceal Carcinoid Tumors.

BACKGROUND: Surgical management of appendiceal carcinoid tumors is heavily debated, despite National Comprehensive Cancer Network guidelines recommending aggressive resection of tumors >2 cm. We investigated national practice patterns and the predictors and impact of guideline non-adherence. STUDY DESIGN: The National Cancer Database was queried for cases of appendiceal carcinoids diagnosed from 2004 to 2015 treated with either appendectomy or hemicolectomy. Multivariable logistic regression, adjusted for demographic and clinical factors, identified associations with the procedure type among patients stratified by tumor size ≤2 cm and >2 cm. Cox Proportional Hazards then identified associations with overall survival among stratified patient groups. RESULTS: Of 3,198 cases of appendiceal carcinoids, 1,893 appendectomies and 1,305 hemicolectomies were identified. Contrary to National Comprehensive Cancer Network guidelines, 32.4% of tumors ≤2 cm were treated with hemicolectomy and 31.3% of tumors >2 cm were treated with definitive appendectomy. Hemicolectomy for small tumors was associated with age 65 years and older (odds ratio [OR] 2.4; 95% CI 1.7 to 3.3; reference group age 18 to 39 years), history of malignancy (OR 2.0; 95% CI 1.6 to 2.6), tumor size 1.1 to 2 cm (OR 2.8; 95% CI 2.3 to 3.4; reference group size ≤1 cm), and lymphovascular invasion (OR 2.2; 95% CI 1.6 to 3.2); appendectomy for large tumors was associated with age 65 years and older only (OR 2.2; 95% CI 1.1 to 4.2). Procedure type was not associated with survival for small or large tumors (hazard ratio 1.0; 95% CI 0.7 to 1.4 and hazard ratio 1.1; 95% CI 0.6 to 2.0, respectively). CONCLUSIONS: Despite well-known size-based treatment guidelines for appendiceal carcinoids, one-third of patients in the US undergo hemicolectomy for small tumors and appendectomy for large tumors. Guideline non-adherence, however, is not associated with overall survival. Reasons for these practice patterns should be explored, and guidelines revisited.

[Primary Small Bowel Tumor with Simultaneous Lung Metastases from Rectal Cancer - A Case Report].

A 56-year-old woman was diagnosed with rectal cancer and liver metastases(Stage IV), and underwent low anterior resection and laparoscopic partial hepatectomy. The patient received adjuvant chemotherapy(mFOLFOX6 for 24 weeks), but developed multiple lung metastases 11 months later. Before undergoing a pulmonary resection, the patient presented with acute small bowel obstruction. Abdominal computed tomography showed small bowel stenosis due to a tumor, and we suspected peritoneal metastases from the rectal tumor. We performed partial resection of the small intestine, and histopathological examination revealed a primary small bowel tumor. The patient was discharged to her home without complications, and later underwent pulmonary resections for bilateral lung metastases. We usually suspect that small bowel obstruction is due to peritoneal metastases in patients with advanced colorectal tumors, but must consider the rare possibility of a separate primary small bowel tumor, especially in patients with a solitary lesion. We report a rare primary small bowel tumor after FOLFOX treatment in a patient with Stage IV rectal cancer.

Upfront surgery of small intestinal neuroendocrine tumors. Time to reconsider?

Small intestinal neuroendocrine tumors (SI-NETs) may demonstrate a widely variable clinical behavior but usually it is indolent. In cases with localized disease, locoregional resective surgery (LRS) is generally indicated with a curative intent. LRS of SI-NETs is also the recommended treatment when symptoms are present, regardless of the disease stage. Concerning asymptomatic patients with distant metastases, prophylactic LRS has been traditionally suggested to avoid possible future complications. Even the current European Neuroendocrine Tumor Society guidelines emphasize a possible effect of LRS in Stage IV SI-NETs with unresectable liver metastases. On the contrary, the 2017 National Comprehensive Cancer Network Guidelines on carcinoid tumors do not support the resection of a small, asymptomatic, relatively stable primary tumor in the presence of unresectable metastatic disease. Furthermore, a recent study revealed no survival advantage for asymptomatic patients with distant-stage disease who underwent upfront LRS. At the aforementioned paper, it was suggested that delayed surgery as needed was comparable with the upfront surgical approach in terms of postoperative morbidity and mortality, the length of the hospital stay and the rate of incisional hernia repairs but was associated with fewer reoperations for bowel obstruction. On the other hand, it is also important to note that some patients might benefit from a prophylactic surgical approach and our attention should focus on identifying this patient population.

Local excision results in comparable survival to radical resection for early-stage rectal carcinoid.

BACKGROUND: Controversy exists regarding current National Comprehensive Cancer Network guidelines, which recommend local excision for rectal carcinoids ≤2 cm and radical resection for tumors >2 cm. Given the limited data examining optimal surgical approach for these lesions, we queried a national database to determine the impact of extent of resection on survival. METHODS: Patients undergoing treatment for clinical stage I and II rectal carcinoid (RC) were identified from the National Cancer Data Base (1998-2012). The association between extent of surgery, tumor size, and the likelihood of pathologic lymph node positivity was examined. Kaplan-Meier analysis was used to compare overall survival. RESULTS: In total, 1900 patients were identified, of whom 1644 (86.5%) were treated with local excision, and 256 (13.5%) were treated with radical resection. A significant majority of patients with tumors ≤2.0 cm (89.0%) and nearly half with tumors 2.1-4.0 cm (44.8%) or >4.0 cm (45.8%) underwent local excision. Nodal positivity was correlated with tumor size (7.1% positivity with ≤2.0 cm tumors, 31.3% with 2.1-4.0 cm tumors, and 50.0% with >4 cm tumors). However, 5-y survival was equivalent between surgical approaches for tumors ≤2 cm (93.0% versus 93.0%) and tumors 2.1-4.0 cm (76.0% versus 76.0%). CONCLUSIONS: We demonstrate in early-stage RC that nearly half of intermediate and large tumors are being treated with local excision outside National Comprehensive Cancer Network guidelines. In addition, radical resection does not appear to be associated with improved overall survival for tumors of any size. These findings suggest that the preferred approach to early-stage RCs without aggressive biological characteristics is local excision due to the decreased morbidity and mortality versus radical resection.

Hospital readmission rates and risk factors for readmission following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal surface malignancies.

BACKGROUND: Cytoreductive surgery and Hyperthermic intra-peritoneal chemotherapy (CRS/HIPEC) for peritoneal surface malignancies is associated with high morbidity. The increased numbers of patients undergoing CRS/HIPEC in recent years mandates risk analysis and quality assurance. However, only scarce data exist regarding causative parameters for readmission. The aim of this study was to assess readmission rates and risk factors associated with readmission. METHODS: A retrospective-cohort study including patients from two high-volume centers who underwent CRS/HIPEC surgery between the years 2007-2016 was performed. Patients' demographics, peri-operative data and readmission rates were recorded. RESULTS: 223 patients were included in the study. The 7 and 30-day readmission rates were 3.5% (n = 8) and 11% (n = 25), respectively. Late readmission rates (up to 90 days) were 11% (n = 25). The most common causes of readmission were surgical related infections (35%), small bowel obstruction (17.5%) and dehydration (14%). Post-operative complications were associated with higher readmission rates (p = 0.0001). PCI score was not associated with higher rates of readmission. CONCLUSION: Readmissions following CRS/HIPEC occur mainly due to infectious complications and dehydrations. Patients following CRS/HIPEC should be discharged after careful investigation to a community based continuing care with access for IV fluid replacement or antibiotics administration when required.

Surgical treatment of peritoneal carcinomatosis: current treatment modalities.

BACKGROUND: Selected patients with peritoneal surface malignancies (PSM) have been treated effectively by the combination of cytoreduction surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). PURPOSE: The purpose of this study is to summarize the treatment outcomes and general considerations regarding definitions and staging systems of current CRS and HIPEC modalities in malignant peritoneal mesothelioma and in secondary peritoneal malignancies such as peritoneal metastasis from appendiceal, colorectal, gastric, and epithelial ovarian cancers. CONCLUSION: Disease progression within the peritoneal cavity has in the past been regarded as a terminal event. Accumulating evidence underlines the therapeutic potential and the acceptable morbidity and mortality rates of CRS and HIPEC in selected patients.

[A case report of primary adenocarcinoma of small intestine successfully treated with FOLFOX].

This is an account of a case of primary adenocarcinoma of the small intestine successfully treated with chemotherapy. A 46-year-old man was admitted with a complaint of severe abdominal distension. Abdominal computerized tomography revealed bowel obstruction, and this was found at surgery to be due to a tumor at the jejunum 100 cm distal from the Treitz ligament. Pathological diagnosis of the resected specimen was adenocarcinoma. Although adjuvant chemotherapy with doxifluridine 800 mg/day was given, a recurrent lesion at the abdominal wall was detected 19 months after surgery. Colonoscopy simultaneously revealed stenosis at the descending colon. The patient was subsequently treated with resection of the mass at the abdominal wall, and colostomy was made at the transverse colon to circumvent the stenosis due to peritoneal carcinomatosis. It was not long before another recurrence developed at the abdominal wall with a subsequent rise in tumor markers. mFOLFOX6 (oxaliplatin 85 mg/m2, levofolinate calcium 200 mg/m2, 5-FU 400/2,400 mg/m2) was given, and the patient responded. Primary small intestinal adenocarcinoma is a rare disease with a dismal prognosis. Due to rarity of the disease, clinical trials have not been performed, and little is known about the effect of chemotherapy. The current patient survived for 4 years and 5 months after the diagnosis, owing at least partially to the mFOLFOX6 which was found to be the only active regimen.

[Hyperthermic intraperitoneal chemotherapy for the treatment of peritoneal carcinomatosis arising from gastric cancer]. / Chimiohyperthermie intrapéritonéale dans le traitement des carcinoses péritonéales d'origine gastrique.

Since 20 years, treatment of peritoneal carcinomatosis has been developed in expert centers. Cytoreductive surgery and perioperative intraperitoneal chemotherapy, especially hyperthermic intraperitoneal chemotherapy, was assessed by many nonrandomised studies for the treatment of peritoneal carcinomatosis arising from gastric cancer. Results described increased survival, especially for the most favourable cases: limited carcinomatosis and complete cytoreductive surgery. A strict selection of the patients is necessary because of the important morbidity of those treatments. Only patients with good general health, able to tolerate a threatening treatment, with possible complete cytoreduction, may benefit from those treatments. Many japanese studies had demonstrated the efficacy of hyperthermic intraperitoneal chemotherapy for the prophylactic treatment of carcinomatosis in advanced-gastric cancers. These results have to be confirmed by european randomised studies.

Primary small intestinal malignant tumors: survival analysis of 48 postoperative patients.

BACKGROUND: Primary small intestinal malignant tumor is relatively uncommon compared to gastric and colorectal cancer. It is difficult to make an early diagnosis due to the atypical primary symptoms and lack of effective diagnostic methods. GOALS: To analyze the relationship between the prognoses, histologic type, and therapeutic strategy in postoperative patients with small intestinal tumor. STUDY: The parameters that affect survival were evaluated using multivariate Cox analysis in 48 cases of small intestinal tumor (confirmed by operation and pathology) for the past 10 years. RESULTS: The overall survival (OS) of all 48 cases after surgery was 28 months. The 5-year postoperative survival rate for all of the 48 cases was 27.1%. The median OS for all the 20 stage II/III patients who received adjuvant chemotherapy was 28 months, whereas the median OS for the 15 patients who did not receive the therapy was 37 months (P=0.276). The median time to progression for 8 patients with adenocarcinoma who received 5-fluorouracil or platinum-based palliative chemotherapy was 7 months, whereas for the patients who did not receive the therapy it was 3 months (P=0.06). The result of multivariate analyses showed that only the clinical stage was significantly correlated with OS (P<0.001). CONCLUSIONS: The prognosis for small intestinal malignancies is associated with clinical stage, and palliative chemotherapy with a 5-fluorouracil or platinum-based regimen offers a potential benefit to patients with adenocarcinoma. Postoperative adjuvant chemotherapy seems to hold no therapeutic or survival benefit for patients with primary small bowel malignancies.

Effects of a preincisional 14-day course of valerian on natural killer cell activity in Sprague-Dawley male rats undergoing abdominal surgery.

INTRODUCTION: The American Cancer Society estimated that more than 1 million new cancer cases were diagnosed in 2005 and a majority of these patients died from metastatic spread. The standard for treating solid tumor cancer is surgical resection. However, it has been suggested that surgical resection may, in fact, promote metastasis. One of the body's natural defenses to combat metastasis is the activity of natural killer (NK) cells. NK cells serve as a vital mediator of detection during the early innate immune response and destruction of aberrant cells. It has been demonstrated that benzodiazepines may ameliorate surgery-induced suppression of NK cell activity. We examined the effect of a 14-day course of valerian, a herbal anxiolytic, on NK cell activity in Sprague-Dawley rats. METHODS: Thirty-five rats were assigned to 1 of 3 groups: (1) surgical animals administered research grade valerian, 15 mg/kg solubilized in peanut oil; (2) surgical animals administered peanut oil (vehicle); and (3) anesthesia-only animals administered valerian. One day before the 14-day course of valerian, blood was drawn to assay baseline NK cell activity. On experimental day, all animals were administered isoflurane anesthesia. Surgical animals underwent a standard laparotomy whereas anesthesia-only rats were anesthetized for the same period of time as the surgical rats. Twenty-four hours postexperiment animals underwent a second blood draw to assay NK cell activity. RESULTS: Analysis of covariance (ANCOVA) was used to analyze NK cell activity (measured in lytic units). Our results suggested that there was no difference (P = .9) in suppression within or between groups. CONCLUSIONS: Clinical studies with valerian have been published but with small numbers and some ambiguity. Further research regarding valerian's effectiveness as a modulator of NK cell activity and whether dosage or route of administration is a factor in modulation is still warranted.

[Effect of previous analgesia of scalp acupuncture on post-operative epidural morphine analgesia in the patient of intestinal cancer].

OBJECTIVE: To probe the effect of previous analgesia of scalp acupuncture. METHODS: Sixty cases of radical operation of intestinal cancer were randomly divided into 2 groups: a scalp acupuncture plus epidural analgesia (scalp acupuncture group) and an epidural analgesia group, 30 cases in each group. The scalp acupuncture group received scalp acupuncture from 20 min before operation to the end of the operation, and epidural analgesia at the end of the operation. The epidural analgesia group only received epidural analgesia at the end of the operation. Recovery of VAS scores, BCS scores and gastrointestinal function after operation were investigated to probe into effects of scalp acupuncture on epidural morphine analgesia after operation in the patient of intestinal cancer. RESULTS: The VAS scores at 6 h, 12 h, 24 h and 48 h in the scalp acupuncture group were lower than the epidural analgesia group, with significant differences at 6 h and 12 h between the two groups (P < 0.05). BCS scores at the 4 time points in the scalp acupuncture group were lower than the epidural analgesia group with significant differences between the two groups (all P < 0.05). The scalp acupuncture group in recovery of bowel sound, exsufflation from the anus in the scalp acupuncture group was faster than the epidural analgesia group (P < 0.01). CONCLUSION: Scalp acupuncture has a certain previous analgesic effect, reducing discomfort of the patient after operation and promoting the recovery of gastrointestinal functions.

A case of laparoscopic surgery for blue rubber bleb nevus syndrome.

A 33-year-old woman had presented with some cutaneous and gastrointestinal hemangiomas with iron deficiency anemia three years previously and blue rubber bleb nevus syndrome was diagnosed. Although she had taken an iron supplement for three years, she hoped to discontinue it and underwent laparoscopic surgery for nine gastrointestinal hemangiomas. She was discharged on the ninth postoperative day without any complications. She has been fit without iron deficiency anemia for a year since the operation. Blue rubber bleb nevus syndrome is a rare disease accompanied with cutaneous and gastrointestinal vascular malformations and about 150 cases have been reported. To the best of our knowledge, this is the first report of blue rubber bleb nevus syndrome with small and large intestinal lesions that were treated with laparoscopic surgery.

[Effects of scalp acupuncture on regulative ability of oxidative stress reaction at operation stage].

OBJECTIVE: To study on regulative action of scalp acupuncture on oxidative stress reaction at operation stage. METHODS: Fifty two cases selected for radical operation of intestinal cancer were randomly divided into a scalp acupuncture plus general anesthesia (scalp acupuncture group) and a simple general anesthesia group (general anesthesia group), 26 cases in each group. The scalp acupuncture group were treated first with scalp acupuncture for 20 min, followed by general anesthesia, with scalp acupuncture lasted till the end of operation. The general anesthesia group were treated only with simple intratracheal anesthesia. Effects of scalp acupuncture on malondialdehyde (MDA) level and superoxide dismutase (SOD) activity at the operation stage were observed. RESULTS: After operation, MDA levels decreased significantly (P < 0.05) in the two groups, but with no difference between the two groups in the different values of MDA before and after treatment (P > 0.05); there was no significant change in SOD before and after treatment in the scalp acupuncture group, and significantly decreased in the general anesthesia group (P < 0.05). There was a significant difference between the two groups in the different value of SOD before and after the operation (P < 0.05). CONCLUSION: Scalp acupuncture can inhibit the decrease of SOD activity, reducing oxidative stress reaction at operation stage.

Combination chemotherapy in advanced small bowel adenocarcinoma.

OBJECTIVE: To assess the efficacy of 5-fluorouracil (5-FU) and either platinum compounds or irinotecan in patients with advanced small bowel adenocarcinoma (SBA), for whom data on the efficacy of chemotherapy are scarce. METHODS: We reviewed data on all patients with advanced SBA who received chemotherapy over a 9-year period at our institution. RESULTS: Twenty patients with advanced SBA received a median of 6 cycles (range 2-15) of chemotherapy with 5-FU and either cisplatin (n=15), carboplatin (n=2), or oxaliplatin (n=3). The overall response rate was 21%, and median progression-free and overall survival 8 and 14 months, respectively. Toxicity was moderate. Second-line chemotherapy with 5-FU and irinotecan resulted in disease stabilization in 4 (50%) of 8 patients (median progression-free survival: 5 months), and in a biological complete response in another patient with non-measurable peritoneal carcinomatosis, allowing surgical cytoreduction surgery and hyperthermic intraperitoneal chemotherapy. No tumor response or disease stabilization was seen among the patients who received protracted venous infusion of 5-FU (n=4) or infusional 5-FU and cisplatin (n=1) as second-line chemotherapy. CONCLUSION: Chemotherapy with 5-FU and platinum compounds seems effective and well-tolerated in patients with advanced SBA. 5-FU-irinotecan combination chemotherapy deserves further investigation in the first-line setting.

[Small bowel metastases from lung cancer]. / Le metastasi del piccolo intestino da neoplasie pleuro-polmonari.

Lung cancer is usually diagnosed at an advanced stage and metastases are present in 50% of patients. Small bowel metastases from lung cancer are rare, being more frequent in patients with melanoma, uterine, ovarian, kidney or gastrointestinal cancer, or osteosarcoma. From November 1998 to August 2003, 740 cases of lung cancer (641 non-small-cell lung cancer and 99 neuroendocrine tumours) were diagnosed. We also observed 64 patients with malignant pleural mesothelioma and performed 23 pleuropneumonectomies. Over the same period we admitted 4 patients (one recurrent) with small bowel metastases, three from lung cancer and one from malignant mesothelioma. The clinical symptoms were bowel occlusion and intestinal bleeding. Radiological techniques such as small bowel enema and CT enteroclysis were used with positive results. In one patient with intestinal bleeding capsular endoscopy revealed a bleeding metastasis. All patients were operated on. Neither mortality nor morbidity were observed. All patients were discharged after a median stay of 10 days. One patient is still alive and disease-free 39 months after the first intestinal surgery for metastases. Intestinal metastases from lung cancer are rare and the diagnosis is often late. In some cases the clinical manifestations of the metastases are observed before those of the primitive tumour. However, in the presence of small bowel occlusion and intestinal bleeding of uncertain origin, clinical history-taking is very important and diagnostic procedures must be performed to exclude a secondary pathology.

Invaginaciones intestinales en el adulto de causa tumoral / Adult intestinal invaginations of tumoral origin

Propósito: Destacar la importancia de la patología neoplásica como una de las causas más fundamentales de las invaginaciones intestinales en el adulto.• Material y Métodos: Estudio descriptivo restrospectivo de invaginaciones intestinales en nuestro Centro de 1996 a 2000.• Resultados: Se presentaron once casos de invaginaciones (7 mujeres: 4 hombres) con una edad media de 54 años. La clínica más frecuente resultó la obstrucción intestinal, y el diagnóstico preoperatorio fue llevado a cabo en 6 casos, lo más habitual por medio de enema opaco. El tratamiento fue la laparotomía, demostrándose 6 lipomas, 2 adenocarcinomas, un leiomiosarcoma, una metástasis de melanoma cutáneo y un hematoma mural. En 10 casos se realizó resección intestinal según criterios oncológicos.• Conclusiones: En las invaginaciones intestinales en el adulto, son de gran importancia una adecuada sospecha clínica y diagnóstica, porque la correcta terapéutica quirúrgica llevará a su resolución, en cuyo origen subyace muchas veces una patología neoplásica. (AU)

[Intraoperative local electrostimulation of interintestinal anastomoses]. / Intraoperatsionnaia lokal'naia élektrostimuliatsiia mezhkishechnykh anastomozov.

The article deals with the diagnosing and correction of reversible ischemia of the intestine. The method of local electrostimulation of interintestinal anastomoses is described, the results obtained in the clinic and experiments are generalized and a comparison of the parameters of homomotor dynamics prior to and after electrostimulation has been made.