[Immediate results of complex treatment of resectable rectal neoplasms of distal localization].

The impact of neoadjuvant chemoradiation on immediate results of treatment of resectable cancer recti, using large-fractionized radiation in combination with endolymphatic chemotherapy, was estimated. Using the method proposed 64 patients were treated (the main group). In control groups there were included 63 patients, to whom a course of a large-fractionized radiation on background of intravenous chemotherapy was applied, and in 91 patients a large-fractionized radiation only was used. The intraoperative complications rate in the main and control groups have had constituted, accordingly, 16, 6.3 and 3.3%. Postoperative complications have had occurred in 12.5% of patients in the main group, and in 15.9% and 14.3% - in the control groups. The abscesses formation was noted in a small pelvis cavity in 4.7% patients of the main, and in 4.8 and 4.4% - in the control groups. Necrosis of the descended gut was revealed in 10 (4.6%).

[Neoadjuvant chemotherapy and radiation therapy of resectable cancer recti of distal localization].

The method of combined neoadjuvant treatment of resectable cancer recti, consisting of preoperative radiaton therapy, using big-fractionized intensive irradiation on the endolymphatic chemotherapy background together with fluorouracil with following surgical intervention (main group), in terms up to 72 h, was elaborated in the clinic. The patients, to whom the chemotherapy and radiation therapy were conducted, were included into control groups. Postoperative complications have had occurred in 8 (12.5%) patients of the main group and in 10 (15.87%) and 13 (14.29%)--in control groups. The five-year survival indices in the main group have constituted (73.5 +/- 6.3)%, and in control groups--(64.6 +/- 5.8) and (64.4 +/- 6.8)%. The local recurrence rate in the main group have constituted (6.2 +/- 3.0)%, and of the remote metastatizing--(15.6 +/- 4.5)%.

[The two-staged intervention for complicated colonic cancer].

The methods of colonic resection and a two-barrel colostomy closure, after performance of modified Mikulicz operation for complicated colonic cancer with formation of a two-staged extraperitoneal invagination duplicature anastomosis, were proposed. Postoperative complicationshave had occurred in 10 (10.9%) patients, including the anastomotic sutures insufficiency--in 2 (2.2%).

[Perspectives of development of the cancer recti surgery].

The immediate and follow-up results of treatment of 2803 patients, operated for cancer recti in The Donetsk Regional Antitumoral Center in 2001-2010 yrs, were analyzed. Complicated course of cancer recti was noted in 17.2% patients. In 1907 (68.0 +/- 1.1)% patients the most frequent operation of abdominoanal resection was done. In 2703 (96.4 +/- 1.6)% patients the primarily restoration of the gut incontinuity operations were performed. Intraoperative complications have had occurred in 259 (9.2 +/- 0.7)% patients, postoperative--in 392 (14.0 +/- 0.6)%, most frequently the descended bowel necrosis--in 136 (4.9)%. The indices of a five-years survival after radical operations have constituted (76.2 +/- 1.7)%, after palliative operations--(10.6 +/- 5.7)%. The surgical doctrine, adopted in the clinic, permit to achieve oncologically effective level of the specialized aid delivery. The results obtained are comparable with such of the main European and Worldwide clinics, what confirms the expediency of surgical trends elaborated.

[Pathomorphosis of the mammary gland tissue during radical interventions using high-frequency electrosurgical welding].

High-frequency electric welding of a live soft tissues (HFEW LST) is applied widely in all surgical specialties. Its application in surgery of mammary gland cancer constitutes a perspective trend. The impact of HFEW LST and monopolar electrocoagulation on tissues while performing radical operations in patients-women for mammary gland cancer was studied up. Basing on analysis of pathomorphological investigations data, the possibility and perspective of the welding technologies application, while performing radical operations on mammary glands, were established.

[Morphological changes of tissues in formation of a welding suture on the large intestine].

Abdominoanal resection with descending of left colon on perineum, leaving additional part of a descended intestine, was performed. For the hemorrhage arrest the welding sutures were put on intestinal wall. According to morphological investigations data, a damage of intestinal wall in the zone of a welding suture application is a reversible one, it spreads from the electrode branch on 2-3 mm. The presence of undamaged structures witnesses the presence of an active regeneration process in tissues around the welding suture.

[Surgery for cancer of proximal regions of the rectum].

The results of treatment of 1652 patients, operated for proximal cancer recti, were presented. Resectability had constituted (84.0 +/- 0.9)%. In (95.7 +/- 0.5)% patients a primarily-restoration operations were accomplished. In (76.0 +/- 1.1)% patients the standard operations were performed, in (8.9 +/- 0.8)%--the extended operations, in (11.5 +/- 0.9)%--combined and in (5.5 +/- 0.6)%--simultant. All the patients after the simultant operations performance had survived. Eligibility of application of the operation methods, technical manipulations and devices, elaborated in the clinic, for the treatment of this group of patients was proved.

[Postoperative complications after surgical interventions for cancer of proximal regions of the rectum].

The results of surgical treatment, performed in 1986-2005 in 1690 patients, suffering proximal rectum cancer, were studied. Resectability had constituted 84.3%. Primarily-restoration operations were performed in 95.9% patients. Of 1425 patients in 85.6%--radical operations were performed, in 14.4%--palliative and in 11.6%--combined. Intraoperative complications had occurred in 7.6% patients and postoperative--in 15.3%. Anastomotic sutures insufficiency was noted in 1.8% patients. Postoperative lethality had constituted 4.2%.

[Late diagnosis, complications and treatment of gastric cancer].

The literature review is presented and results of observations of their own, concerning analysis of causes, which made gastric cancer diagnosis late and the disease course complicated. Low medical competence of population, insufficient oncological suspicioning of the general medicinal net physicians, the absence of screening programs are the main causes of the patients late turning for care and revealing of neglected forms of distal gastric cancer.

[Prophylaxis of postgastrectomy complications in patients with gastric cancer].

There are presented the results of surgical treatment of 447 patients. suffering gastric cancer, in whom gastrectomy was performed. Esophago-initestinal anastomosis was performed according to method of G. V. Bondahr. Interintestinal anastomosis (IIA) was formed using traditional Braun method and also was applied the longitudinal-transversal method, elaborated in the clinic. Usage of the method proposed did not worsen the immediate and late results, but have promoted significant improvement of the gastrectomy functional results. The method application secures the trustworthy lowering of the postgastrectomy complications rate while performing gastrectomy (dumping syndrome, reflux-esophagitis, the adduced loop syndrome) comparing with such, using Braun IIA--accordingly 30.5 and 52.8% (P = 0.016); fair, good and excellent the patients quality of life--accordingly in 67.8 and 47.2% (P = 0.024). The elaborated procedure of the IIA formation constitutes the method of choice while performing gastrectomy.

[Immediate results of transabdominal rectal resection with the duplicature anastomosis formation].

There were presented immediate results of surgical treatment of 425 patients with the upper ampullar and rectosygmoid portion cancer recti (CR), to whom in 1989-2002 transabdominal rectal resection, using the duplicature anastomosis, was performed. In 93.4% of observations, according to histological investigation data, adenocarcinoma was diagnosed. Concurrent diseases were revealed in 226 (53.2%) patients. The technique of transabdominal CR resection is depicted. There were noted fair immediate results in treatment of the patients: postoperative complications rate have constituted 13.2%, postoperative mortality--2.6%. In structure of postoperative complications purulent-septic one had prevailed, similarly were complications with cardiovascular and respiratory systems affections.

[Remote results of the treatment of proximal rectal cancer].

There were presented the late results of surgical treatment in 425 patients, suffering upper ampullar and rectosygmoid rectal cancers, to whom transabdominal rectal resection with the duplicature anastomosis formation in 1989--2002 yrs was done. In 93.4% of observations, according to histological investigation data, adenocarcinoma was diagnosed. Concurrent diseases were noted in 226 (53.2%) of patients. The postoperative complications rate was 13.2%, postoperative mortality--2.6%. Late result of treatment was fair.

[Surgical treatment of wide spread cancer of the stomach distal segment]. / Khirurgicheskoe lechenie rasprostranennogo raka distal'nogo otdela zheludka.

Immediate and late follow-up results of surgical treatment of the stomach distal portion cancer in 942 patients were studied. The wide spread form of cancer was diagnosed in 119 patients: in 70 distant metastases were revealed, in 49 the tumor extended on adjacent organs and tissues. The treatment efficacy, performed using the method, elaborated by the authors, was estimated. Complications and causes of mortality were analyzed.

[Radical combined colonic resection for cancer recurrence]. / Radikal'naia kombinirovannaia rezektsiia tolstoi kishki po povodu retsidiva raka.

Experience of reoperative radical combined colonic resection for colonic cancer in 9 patients was presented. There were no complications, nor mortality. The preoperative radiation therapy and chemotherapy conduction had permitted to create an optimal conditions for the surgical intervention performance, which promoted the patients life span increase and improved its quality significantly.

[Treatment of colonic melanoma]. / Lechenie melanomy tolstoi kishki.

The results of treatment of 5 patients with colonic melanoma are presented. Fine-needle biopsy was used for morphological verification diagnosis. It was established that the patients with colonic melanoma are hospitalized in specialized department, as a rule, with nonopertable tumor. In 1 patient explorative laparotomy was done. Conduction of radical operative intervention was impossible because of presence of multiple metastases in liver. In 4 patients conservative treatment was performed. It was not possible to perform radical operation because of the process spreading. The patients life span after conduction of conservative therapy have constituted 14.5 mo at average.

[Restoration of colonic continuity after the Hartmann's surgery]. / Vosstanovlenie nepreryvnosti tolstoi kishki posle vypolneniia operatsii Gartmanna.

The intestinal continuity restoration after performance of Hartmann's operation in presence of long rectal stump was done using the method of the duplicature anastomosis formation, which was elaborated in the clinic. The frequency of postoperative complications occurrence was 9.8%: In presence of short rectal stump the colon was descended on perineum via submucosal tunnel in rectal stump according to the method, which was elaborated in the clinic. The frequency of the postoperative complications occurrence was 16.7%. The data presented trusts the expediency of application of the methods elaborated in the clinic for restoration of intestinal continuity after performance of Hartmann's operation in presence of long and short rectal stumps.

[The restoration of intestinal continuity after the performance of the Miculicz's operation]. / Vosstanovlenie nepreryvnosti kishechnika posle vypolneniia operatsii Mikulicha.

The method of double-barrelled (split) colostomy closure after performance of Miculicz operation, including extraperitoneal formation of the invagination duplicatural anastomosis, was proposed. After application of the proposed method in 21 patients the complications occurred in 2, including 1 case of the anastomotic sutures insufficiency.

[The formation of the transplant for its descending to perineum with the sphincter-salvaging surgery in patients with disseminated sigmoid colon blood supply]. / Formirovanie transplantata dlia nizvedeniia na promezhnost' pri vypolnenii sfinktero-sokhraniaiushchei operatsii u bol'nykh s rassypnym tipom krovosnabzheniia sigmovidnoi obodochnoi kishki.

The methods of the transplant formation in the loose type of the sigmoyd colon blood supply and insufficiency of the over vessel, applied in patients during sphincter-preserving operation performance for cancer recti, was proposed. Satisfactory immediate and late follow up result was noted.