[Blood iron metabolism in patients with stomach cancer].

AIM: To investigate the changes of iron metabolism values in patients with stomach cancer degree II and III within 7 days after surgery. MATERIAL AND METHODS: Levels of ferritin, transferrin, serum iron and unsaturated iron binding capacity were defined in 24 patients with stomach cancer preoperatively and in 1, 3 and 7 days after surgery using biochemical analyzer Cobas Integra 400. Comparison group included donors without cancer. RESULTS: Studied parameters were normal before surgery excluding serum iron and hemoglobin. Level of ferritin significantly increased by 160% and transferrin decreased by 78% in comparison with those in donors in 7 days postoperatively (p<0.05; Mann-Whitney criterion). Total iron binding capacity considerably reduced by 300%. There are significant changes of serum iron values from the 1st to the 7th days postoperatively. It is suggested the supposition about detoxication role of increased level of ferritin as one of the mechanisms explaining efficiency of intraoperative autoplasmachemotherapy.

[Neocystoplasty after pelvic evisceration on the subject of colorectal cancer].

The experience of 104 total pelvic eviscerations, 78 operations on the reason of locally advanced colorectal cancer, was analyzed. The reconstructive stage included urine reservoir formation in all cases. Different organs were used for the purpose. Early postoperative complications were registered in 74,3% of patients. Postoperative death rate was 8,9%, in majority of cases as a reason of the anastomotic insufficiency. Of the recovered patients, 48 survived 1 year after the operation, 16 patients showed the 3 years survival and 6 patients had lived more then 5 years.

[Pathogenetic approach to the treatment of esophageal anastomosis failure].

The original method of esophageal anastomosis failure treatment and prophylaxis was used in 2190 patients. The method involves a device, providing a continuous irrigation of the anastomosis area with antiseptic and prevents contact between the suture line and gastric contents. It allowed to decrease of anastomosis failure to 0,6%. Postoperative lethality after operations performed on account of gastric cancer was 2,2% and 6,5% after operations on account of esophageal cancer. None of the patients had died due to esophageal anastomosis failure during the last 5 years.

[Improvement of immediate results of pancreatoduodenal resection for periampullary cancer].

The immediate results of 454 pancreatoduodenal resections for periampullary cancer are analyzed. The pancreatodigestive anastomosis was performed in all cases. Authors prove the necessity of differential approach to the method of pancreatodigestive anastomosis formation, taking into consideration anatomy of the area, pancreatic blood circulation characteristics, peptic activity of gastrojejunopancreatic complex and results of intraoperative morphologic analysis. Using this approach allowed to reach the postoperative lethality rate of 5.2% for the last 250 operations.

[Total duodenopancreatosplenectomy in surgery of pancreatic and gastric cancer].

The experience of treatment of 23 patients undergone total duodenopancreatosplenectomy was analyzed. Postoperative complications (mainly endocrine pathology) were seen in 21 patients. There were no cases of anastomoses insufficiency. Seven patients died. In group of patients who underwent combined gastrectomy 2 of 5 persons died. There were no lethal outcomes after angiosurgical procedures (5 patients).

[Importance of urgent histological investigation in surgical treatment of biliopancreatoduodenal zone carcinoma]. / Znachenie srochnogo gistologicheskogo issledovaniia v khirurgicheskom lechenii raka biliopankreatoduodenal'noi zony.

Urgent intraoperative investigation allows a surgeon, depending on the morphological conclusion, to conduct individual surgical intervention in the form of anastomosis with penetration into the tissue of the pancreas. The method decreases the rate of surgical complications, improves immediate results of patient treatment and reduces postoperative lethality. This proves the importance of morphology in the surgical treatment of tumours in the zone concerned.

[The prevention and treatment of the incompetence of esophageal anastomoses]. / Profilatika i lechenie nesostoiatel'nosti pishchevodnykh anastomozov.

The main cause of lethal outcomes after operations on the oesophagus and cardia remains failure of esophageal anastomosis. The lack of substantial positive changes in prophylaxis and especially in treatment of this complication is explained by etiological approach to this problem. Pathogenesis of the failure is determined by the only trigger--penetration of infection into the tissues of anastomotic area. The authors have developed and introduced into practice the method and the device to influence the basic link of the pathogenesis. The application of the method of permanent irrigation and sealing of the esophageal anastomosis line in treatment of 917 patients made it possible to cut down lethal outcomes from insufficiency of esophageal anastomosis to 0.1%.