[The incidence and primary multiplicity of colon cancer].

Analysis of Moscow cancer register demonstrates a steady growth of colon cancer (CC) incidence and mortality in Moscow, also noted in all large industrial cities of economically developed countries. In Moscow between 1996 and 2001, the incidence of CC had grown 1.5 times (from 19.6 up to 30% per 100,000), and the CC-related mortality had grown twice (from 9.1 up to 19.5% per 100,000). The incidence of CC among women is 1.5 to 2 times higher than that among men. The burst of CC incidence is noted after age 55, and the peak incidence is noted at age 65. Not rare (2.9% of cases) are tumors that develop simultaneously in different divisions of the colon, which are diagnosed during the surgery or are omitted even then. Such synchronous large bowel tumors are found mostly in patients over 60. The analysis show that metachronous tumors (3.4% of cases) usually develop in the colon 8 to 10 years after the first surgery for CC, or some other cancer, and are found mostly in patients over 70. Unlike foreign statistics on multicentric CC cancer, according to which primary-multiple (synchronous and metachronous) cancers occur in 1.24 to 14% of cases, Moscow statistics demonstrate a lower likelihood of such a pathology in Muscovites. To sum up, patients who underwent treatment for CC or any other cancer should keep being under an oncologist's observation due to the likelihood of the development of a metachronous colon tumor 8 to 10 years later.

[Expression and secretion of carcinoembryonic antigen in tumors of the large intestine]. / Ekspressiia i sekretsiia rakovo-émbrional'nogo antigena pri opukholiakh tolstoi kishki.

The correlation between the expression of the carcinoembryonic antigen (CEA) on cell membranes and the intensity of its secretion into the circulation is studied in patients with malignant tumours of the rectum and the transverse colon. With the use of the monoclonal antibodies against CEA and the immunoperoxidase technique on the frozen sections, the localization of the primary tumour, microinvasion and micrometastases in the lymph nodes are shown. The dependence of the serum CEA concentration upon the histologic type of the tumour and the stage of the disease is not established. The trend towards the inverse correlation between the CEA level in the tumour tissue extract and the degree of the tumour cell differentiation is noted. The opinion is expressed of the applicability of the monoclonal antibody anti-CEA-1 for the morphologic differential diagnosis of the colon tumours, the evaluation of the thoroughness of the surgical treatment and for the metastases radioimmunolocalization.

[Morphological aspects of intense preoperative hypoxyradiotherapy in combined treatment of patients with sigmoid colon carcinoma]. / Morfologicheskie aspekty intensivnoi predoperatsionnoi gipoksiradioterapii v kombinirovannom lechenii bol'nykh rakom obodochnoi kishki.

Morphological study has confirmed the advantage of using doses of single radiation doses 5 Gy (total dose 25 Gy) and inhalation of a hypoxic gas mixture vs other methods of treatment. The study of radiation pathomorphosis showed significants devitalization of the tumor cells realized clinically with a fall in the number of postoperative recurrences and metastases.

[Postoperative complications in colonic cancer patients]. / Posleoperationnye oslozhneniia u bol'nykh rakom obodochnoi kishki.

The immediate results of radical surgery in 367 cases of colonic cancer were analysed. The rate of postoperative complications was found to be in correlation with the surgical procedure and certain indexes of homeostasis. Complications developed in 50.4% of cases, pyo-inflammatory ones--in 162 cases. 71.2% of cases of postoperative peritonitis were due to failure of intestinal anastomosis.

[Clinical manifestations and diagnosis of recurrent and metachronous cancer of the colon]. / Klinika i diagnostika retsidivnogo i metakhronnogo raka obodochnoi kishki.

The paper discusses the results of radical surgery of 413 cases of colonic cancer treated at the Center in 1952-1984. Relapse rate appeared to be 1.4% at stage I-II disease and 22.3% at stage III. The said rate was twice that in patients who presented with regional lymph node metastases. Metachronous cancer of the colon was detected in 2.9% of radically operated cases. Early diagnosis of recurrent and metachronous colonic cancer is one of the factors of improvement of long-term results of radical treatment of the disease.

[Role of Pseudomonas aeruginosa in the etiology of infectious complications in cancer patients]. / Rol' sinegnoinykh bakterii v razvitii infektsionnykh oslozhnenii u onkologicheskikh bol'nykh.

The occurrence of Pseudomonas aeruginosa in various pathologic materials and feces from patients with different cancer was compared. The rate of Pseudomonas aeruginosa-associated postoperative complications versus the frequency of intraoperative detection of the organism was studied. The sensitivity of Pseudomonas aeruginosa to antibacterial drugs was assessed. Serotypes of 480 strains isolated from patients and environment were identified. It was inferred that exogenous contamination from the external environment accounts for the majority of cases of Pseudomonas aeruginosa-associated complications.

[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%.

[Immunopharmacokinetics of synthetic beta-carotene]. / Immunofarmakokinetika sinteticheskogo beta-karotina.

The immunopharmacology and pharmacokinetics of synthetic beta-carotene were studied in complex clinico-laboratory investigations after single and repeated per os administrations of various doses of the drug to healthy volunteers and cancer patients. Repeated treatment with beta-carotene at a dose of 30 mg caused no significant changes in the immunological parameters studied. However, treatment with a dose of 250 mg altered the parameters as follows: alteration of beta-carotene content in blood, elevation of the counts of lymphocytes and T lymphocytes forming "active" rosettes, increase in the proliferative response of lymphocytes to the mitogen PWM and activation of natural killers. Single administration of the drug in a dose of 1,000 and 2,000 mg led to short-term reversible immunodepression, appeared as leukopenia, abolition of the proliferative response of lymphocytes to mitogens and inhibition of T suppressors. Kinetics of retinoids and beta-carotene content in blood plasma was studied after single per os administration of drug megadoses.

[Multiple primary cancer of the gastro-intestinal tract]. / O pervichno-mnozhestvennom rake zheludochno-kishechnogo trakta.

Peculiarities of the clinical course of primary multiple malignant tumors of the gastrointestinal tract are discussed. Out of 25 cases of synchronous gastrointestinal malignancies, both stomach and large bowel tumors were found in 10 patients and simultaneous neoplasms in different segments of the large bowel--in 15. In the latter group, radical surgery was performed in 13 patients. Out of 54 cases of metachronous cancer, 28 revealed combinations of stomach and large bowel tumors, while in 26 cases metachronous tumors appeared in succession in different segments of the large bowel. Synchronous single and multiple polyps of the large bowel were detected in 19 out of 54 patients. Radical surgery was carried out in 33 and palliative surgery--in 6 patients.

[Ileotransversoanastomosis end-to-end in right-sided hemicolectomy]. / Ileotransverzoanastomos konets v konets pri pravostoronnei gemikoléktomii.

The results of surgical treatment of 23 patients with cancer of right hemicolon with ileotransversotomy end-to-end are analysed. Advantages of this anastomosis in comparison with anastomosis "end-to-side" and "side-to-side" are shown. There were neither cases of insufficiency of sutures nor functional disturbances at the area of anastomosis in 23 operations.

[Surgical treatment of middle aged and aged patients with complicated and locally invasive forms of cancer of the colon]. / Khirurgicheskoe lechenie bol'nykh pozhilogo i starcheskogo vozrasta s oslozhnenymi i mestnorasprostranennymi formami raka obodochnoi kishki.

The article analyses treatment of 207 patients subjected to surgical intervention at the onco-proctological department of the Moscow City Oncological Dispensary in the period between 1982 and 1986. Most patients in the age group suffered from complicated and locally proliferated forms of cancer. Data are cited in favour of avoiding operations with formation of primary colonic anastomosis when the tumor in this group of patients is found in the left half of the colon.

[Use of Y-shaped anastomosis in complicated cancer of the left half of the colon]. / Primenenie Y-obraznogo anastomoza pri oslozhnennom rake levoi poloviny obodochnoi kishki.

The method of Y-shaped anastomosis in complicated carcinoma of the sigmoid colon is described. It is shown that a primary colonic anastomosis can be formed by this method in intestinal obstruction.

[Intensive preoperative hypoxic radiotherapy in combined treatment of patients with cancer of the colon]. / Intensivnaia predoperatsionnaia gipoksiradioterapiia v kombinoravannom lechenii bol'nykhs rakom obodochnoi kishki.

Efficacy of combined treatment (203 patients) and surgical treatment (200 patients) alone was analyzed. In combined treatment either radiation therapy (RT) in the dose 20 Gy over 5 days (group 1) or hypoxyradiotherapy (HRT) in the same doses but in combination with hypoxia (10% oxygen and 90% nitrogen--hypoxic gas mixture HGM-10--group 2) were used in preoperative period. In group 3 HGM-9 (9% oxygen and 91% nitrogen) was used as radioprotector in preoperative period but in increased by 25% radiation doses: total 25 Gy, 5 Gy for 5 days. In the control group only radical surgical treatment was performed. Preoperative irradiation didn't increase the rate of postoperative complications. At the same time the 5-year survival rate was higher in all the groups of patients on combined treatment than in the group of patients on surgical radical treatment. In the group with HGM-9 and increased by 25% radiation doses postoperative complications rate was lower, recurrences and distant metastases occurred less frequently.

[Antibiotic prophylaxis of postoperative infective complications in patients with rectal and colonic cancers]. / Antibiotikoprofilaktika infektsionnykh posleoperatsionnykh oslozhnenií u bol'nykh rakom priamoí i obodochnoí kishki.

The results of operative use of clindamycin and netilmycin (1st group), piperacillin (2d group), in comparison to the standard protocol (carbenicillin and its combination with gentamicin) in 103 patients operated on rectal and colonic cancer are discussed. The rate of postoperative complications was 2.3% (1st groups), 5.3% (2d groups) vs. 37.1% (control group). The authors advocate the proposed protocols of antibacterial prophylaxis of rectal and colonic cancer.

[Repeat operations in recurrent cancer of the large intestine]. / Povtornye operatsii pri retsidive raka tolstoi kishki.

Results of reoperations for recurrent cancer of the large bowel in 164 patients are analyzed. Radical operations were performed in 110 patients (67.0%). The main operations used were resections of the malignized segment of the bowel (48 patients) and abdomino-perineal extirpation of the bowel with the anastomosed portion of the colon or its stump after the Hartmann operation (38 patients). Postoperative complications were noted in 27.6% of the patients. Lethality after radical operations was 10%. The follow-up analysis has shown that of all the discharged patients 40.7% survived more than 3 years, 31%--more than 5 years.

[Management of the perineal wound in the postoperative treatment of patients with cancer of the rectum]. / Vedenie promezhnostnoi rany v posleoperatsionnom lechenii bol'nykh rakom priamoi kishki.

The material showing causes of the appearance of purulent complications of the perineum would after extirpation of the rectum for cancer is presented. The pathogenes of the purulent infection were found to be polyresistant staphylococcus and gram-negative intestinal flora in most cases. The authors recommend using antibiotic therapy directly at the time of performing the operation, good drainage of the postoperative wound, irradiation of the postoperative wound by a laser radiation of a harmless intensity.

[Prevention of hemostatic disorders at different stages of surgical treatment in patients with colonic cancer]. / Profilaktika narushenii sistemy gemostaza na razlichnykh étapakh khirurgicheskogo lecheniia bol'nykh rakom tolstoi kishki.

The status of the hemostasis system was studied in 40 patients with colonic cancer before, during, and after surgery, who were administered no treatment before the operation, and in 30 ones administered depogen with heparin in the preoperative period. Preoperative treatment with depogen had a favorable effect on both coagulation and platelet components of the hemostasis system. Administration of depogen together with heparin reduced the intensity of subacute chronic intravascular blood coagulation during and after surgery in patients with colonic cancer and was conducive to a reduction of the incidence of postoperative complications.