[Peculiarities of colonic cancer metastasis to the ovaries and the role of prophylactic ovariectomy]. / Osobennosti metastazirovaniia raka obodochnoi kishki v iaichniki i rol' profilakticheskoi ovariéktomii.

Colonic tumor dissemination to the ovaries was registered in 3%. The likelihood of such dissemination in locally-advanced cancer of the sigmoid colon was higher which in turn supports the hypothesis on colonic tumor dissemination to the ovary via transperitoneal implantation. The patients' condition improved and survival increased following excision of involved ovaries both during and at different stages after radical surgery. Preventive bilateral ovariectomy failed to improve 5-year survival.

[The removal of colostomies in patients with cancer of the large intestine]. / Ustranenie kolostom u bol'nykh rakom tolstoi kishki.

Issues involved in closure of double-barreled and lateral colostomies in patients with cancer of the large bowel were analysed to find out whether the latter disease is a risk factor in reconstructive surgery. The analysis included 215 patients. In 77 (35.8%) of them, colostomy was formed in the course of treatment for large bowel cancer. Two groups of patients were compared by some parameters of patient's preoperative condition, time of closure, method of preparation and type of surgery. Comparison of early postoperative complications following closure revealed significant difference in the frequency of complications on the part of anastomosis. The latter were observed in 11 (14.3 +/- 3.9%) patients with large bowel cancer and 6 (4.4 +/- 1.7%) cases of nontumor pathology (P = 0.023). The rate of development of those complications was shown to depend on the method used to restore the continuity of the bowel. It was concluded that cancer of the large bowel was not a direct factor of risk in closure of double-barreled and lateral colostomies.

[Complex evaluation of the healing of intestinal anastomoses in the early postoperative period]. / Kompleksnaia otsenka zazhivleniia kishechnykh anastomozov v rannem posleoperatsionnom periode.

Eighty-six patients were subjected to complex examination in the immediate postoperative period to check the condition of intestinal anastomoses. In 58 (67.4%) patients inflammation in the zone of the anastomosis was found to be negligible and produced no specific clinical manifestations; 28 (32.6%) patients had marked inflammatory changes in the region of the anastomosis. This condition, interpreted as anastomositis, is favourable for the development of incompetence of the sutures of the anastomosis, which was diagnosed in 4.7% of patients. Timely diagnosis of anastomositis and application of a complex of nonoperative measures is conducive to reduction of the frequency of postoperative complications and mortality.

[Restoration of natural intestinal passage after Hartmann's operation]. / Vosstanovleniie estestvennogo kishechnogo passazha posle operatsii Gartmana.

From 1972 to 1988 restorative operations were carried out at the Institute of Proctology on 252 patients after resection of the colon by Hartmann's technique. Analysis showed that restoration of natural intestinal passage after Hartmann's operation for resection of the colon is a complex and dangerous surgical intervention. When undertaking such intervention, the surgeon should take into account not only the patient's wish to be relieved from the colostomy, but also correct appraisal of the possibility of accomplishing the restorative operation from the standpoint of the patients' somatic condition, the technical conditions for restoration of intestinal continuity, and his own professional possibilities. In cases of a short rectal stump, various modifications of Duhamel's operation are the most safe and technically executable method for restoration of the natural intestinal passage. Such restorative-reconstructive operations should be carried out in specialized coloproctological clinics.

[Possibility of intraoperative reinfusion of blood in coloproctology]. / Vozmozhnos't intraoperatsionnoi reinfuzii krovi v koloproktologii.

The possibility of conducting intraoperative reinfusion of blood in coloproctology is appraised on the basis of complex microbiological, cytological, and biochemical study of blood of patients who underwent operation for various diseases of the large intestine. It was found that blood escaping into the abdominal cavity during operations on the large intestine is hemolized to a great measure and contains many bacteria, and therefore such blood cannot be used for transfusion. At the same time, if blood is collected directly from the pulsating vessel its contamination, marked distortions of its formed elements, and hemolysis above admissible values can be avoided. The dependence on the time of blood collection, whether before or after the intestine is opened, has not been established.

[Healing of the anastomoses in restorative-reconstructive surgery of the large intestine]. / Zazhivlenie anastomozov v vosstanovitel'no-rekonstruktivnoi khirurgii tolstoi kishki.

An analysis of healing the intestinal anastomoses in 52 patients after restorative-reconstructive operations on the colon is presented. In 36.5% of the cases a complicated course of the early postoperative period was observed: anastomositis--in 28.8% and incompetence of the anastomosis sutures--in 7.7%. Such complications were mainly observed in patients older than 60 years of age with a concomitant pathology, with a one-trunk colostoma and when forming low colorectal anastomoses.