[Recurrent hemangioendothelioma of the lower and middle segments of inferior vena cava with spread to previously installed prosthesis]. / Retsidivnaya gemangioendotelioma nizhnego i srednego segmentov nizhnei poloi veny s rasprostraneniem na ranee ustanovlennyi protez.

We report surgical treatment of a 65-year-old patient with recurrent hemangioendothelioma of inferior and middle segment of inferior vena cava with spread to previously established prosthesis. Advanced resection of inferior vena cava and right-sided nephrectomy were not followed by complications and resulted R0 resection. Surgery time was 180 min. Inferior vena cava cross-clamping time was 30 min. Total blood loss was 300 ml. Hemangioendothelioma is a rare tumor with unpredictable potential for malignant transformation and obligatory indications for surgical treatment. Resection and reconstruction of inferior vena cava and renal veins with a synthetic conduit is effective and safe procedure.

[Use of polytetrafluoroethylene grafts for reconstruction of major veins of mesenteric-portal system]. / Ispol'zovanie protezov iz politetraftorétilena dlia rekonstruktsii magistral'nykh ven mezenteriko-portal'noi sistemy.

Surgical management of patients with tumour invasion of major veins by means of their resection and simultaneous reconstruction is an actively developing trend in modern surgery. The article describes a clinical case report concerning treatment of a patient presenting with disseminated neuroendocrine cancer of the pancreatic head and subjected to pancreatoduodenal resection with a complicated variant of mesenteric-portal reconstruction and the use of a graft made of porous polytetrafluoroethylene, followed by relapse-free survival of more than 5 years. In our case report, despite complexity of forming a proximal anastomosis, the findings of multislice computed tomography with 3D-reconstruction 4 months after the operation demonstrated uneven circular thickening of the graft's wall by 1-2 mm, which might be interpreted as neointimal hyperplasia. The maximum thickness amounted to 2 mm in the area of the distal anastomosis. Thus, the internal diameter of the graft varied from 8 to 9 mm. The minimum thickness was observed in the middle portion of the graft, amounting to 1 mm. The findings of computed tomography at 60 postoperative months demonstrated no evidence of the disease's progression, the portal system of the liver contrasted evenly, the mesenteric-portal graft fully patent, showing parietally a thin uneven low-density strip 1-2 mm thick (with the maximum thickness observed in the area of anastomoses and the minimum thickness in the centre of the graft). Thus, the obtained findings are suggestive of high efficacy, safety, and feasibility of using polytetrafluoroethylene grafts for reconstruction of major veins in clinical practice. More randomized studies are necessary to confirm our conclusions.

[Comparative results of use liver protecting drugs for prophylaxis of the liver failure after extensive resections of the liver]. / Sravnitel'nye rezul'taty primeneniya gepatoprotektorov dlya profilaktiki pechenochnoi nedostatochnosti pri obshirnykh rezektsiyakh pecheni.

After 100 extensive resections of a liver for excision of metastasises of a colorectal cancer, the different drugs protecting a liver were used for prophylaxis of a liver failure. MATERIAL AND METHODS: Patients were distributed on 2 equivalent groups. Patients of the first group received Ademetionin in a dosage 400 mg 2 times a day within 7 days. Patients of the second group received Remaxol in a dosage 400 ml within 7 days once a day. RESULTS: Frequency of cases of an acute liver failure in the first group of patients was 38%, in the second group of patients - 20% (p<0.05). Patients of the second group had milder course of an acute liver failure (by criteria of ISGLS, 2011) in comparison with patients of the first group. Postoperative bed - days in the first group of patients lasted 13 (11-15) days, in the second group of patients - 11 (10-13) days (p<0.05). There was no postoperative lethality.