[One stage skin-sparing breast repair after mastectomy]. / Odnomementnaia rekonstruktsiia molochnoi zhelezy posle mastéktomii s sokhraneniem kozhi.

Breast-conserving therapy has become very popular in the past 20 years. This treatment is beneficial only for early stages of breast cancer. When breast-conserving therapy is not indicated, skin-sparing mastectomy with immediate breast reconstruction using silicone implants or autogenous tissue is the surgical method of choice. The authors have analyzed the results obtained at three hospitals of Moscow, Novosibirsk, and Tula. A total of 58 breast repairs, including 23 with silicone expanders, 35 with TRAM-flaps were performed by February 2000. They accomplished different designs of skin incisions in relation to the size and site of a tumor and to the shape of the breast. These groups comprised patients with breast cancer T1-2No-1Mo. The follow-up averaged 25.8 months (range 5-52 months). All the patients underwent combined and complex treatments. The median of overall survival was not not achieved. One patient died from dissemination. Two-year acturial survival was 86.8% (one local recurrence). The incidence of postoperative complications was 34.7% in the implant group and 14.2% in the TRAM-flap group.

[Formalized method of deciding on treatment options in clinical oncology]. / Formalizatsiia vybora metoda lecheniia v klinicheskoi onkologii.

A method of constructing a "tree of problem solving" is suggested to work out viable and economical strategies of clinical therapy of tumors. The algorithm is illustrated by solving a hypothetical problem. A clinico-economic index is used to compare different modalities of tumor therapy, its lowest value representing the best regimen.

[Non-sporulating anaerobic bacteria and anastomosis failure in patients with gastric carcinoma]. / Nesporoobrazuiushchie anaéroby pri razvitii nesostoiatel'nosti anastomozov u bol'nykh rakom zheludka.

Cases of anastomosis suture failure within the period from 1977 to 1987 and from 1988 to 1998 in 139 patients after various surgical operations for gastric carcinoma were analyzed. Infection in the cases of the anastomosis sUture failure at the early terms was mainly due to representatives of Enterobacteriaceae and at the later terms the failure was mainly due to non-sporulating anaerobes belonging to Bacteroidaceae. The data are indicative of the fact that the use of antimicrobials requires a differential approach.

[Specifics of endocrine regulation of digestion in patients with esophageal neoplasms after esophagogastroplasty]. / Osobennosti éndokrinnoi reguliatsii pishchevareniia u bolnykh rakom pishchevoda posle ézofagogastroplastiki.

In 67 patients with esophageal cancer, the peculiarities of endocrine regulation of alimentation after resection and plasty of the esophagus, using an isoperistaltic gastric tube were studied. Of these patients, 15 underwent correction of the disorders revealed. Accelerated evacuation of the content from a gastric transplant is accompanied by atony of the pylorus and is due to relative incompetence of neuroendocrine elements in gastric and duodenal mucosa (presence of a small amount of EC- and P-cells). Use of pentagastrin at the early postoperative period permits to accelerate the process of formation of the compensatory-adjusting mechanisms in the system of alimentation due to increase in functional activity of EC- and I-cells.

[Results of simultaneous resection and plastic surgery of the esophagus with extra-cavitary cervical esophagostomy in esophageal cancer in its thoracic part]. / Rezul'taty odnomomentnoi rezektsii i plastiki pishchevodas vnepolostnymanastomozom na shee pri rake grudnogo otdela pishchevoda.

The work analyses the results of one-stage resection and plastics of the esophagus with a tube formed from the greater curvature of the stomach and creation of an ++extra-cavitary anastomosis on the neck in combined and surgical treatment of carcinoma of the thoracic esophagus in 279 patients. Various complications occurred in 181 (64.8%) patients. The mortality was 19.3% (16.8% among patients who underwent radical operation and 25.6% among those treated by a palliative operation). The number of complications in the groups of surgical and combined treatment was approximately equal. The results of 5-year survival were better in the group with combined treatment. Postponed + extra-cavitary anastomosis was formed in 65.2% of cases. One-stage resection and plastics of the esophagus with ++extra-cavitary anastomosis is an adequate operation from the oncological standpoint in the treatment of carcinoma of the thoracic esophagus. Its further perfection is necessary for improvement of the immediate and late-term results of treatment.

[Endocrine function of the pancreas after radical surgery in esophageal cancer]. / Endokrinnaia funktsiia podzheludochnoi zhelezy posle radikal'nykh operatsii pri rake pishchevoda.

Postoperative levels of insulin and morphological pattern of beta-cells of islets of Langerhans were studied in 27 esophageal cancer patients following one-stage esophageal resection or repair with the gastric pedicle graft and extracavitary cervical shunt. There is a postoperative inhibition of secretory activity of the insulin pancreatic apparatus which recovered on 120 postoperative day. These shifts resulted from dystrophy of the beta-cells.

[Possibilities for the early detection of lung cancer recurrences and metastases]. / Vozmozhnosti rannego vyiavleniia retsidivov i metastazov raka legkogo.

The results of surgical treatment in 260 lung cancer patients are analysed. The purposeful dynamic examination of patients by modern technics enabled a recognition of progressive tumor growth in 112 of 137 patients (81,75%) during the first 18 months after the operation. To reveal subclinical recurrences and metastases in the chest organs roentgenological and bronchological methods, positive 67Ga-citrate scintigraphy seem to be preferable. In skeletal involvement scanning findings are mostly indicative in this respect. Scanning of the organs in operable patients as a mandatory investigation is unlikely to be rational.