Immediate Results Of Treatment Research Articles

The method of endoprosthesis deployment in breast cancer surgery

To improve immediate results of treatment in patients with breast cancer using a new method of reconstruction. Prospective study included 215 patients with breast cancer. Patients were treated at the Samara Regional Clinical Oncology Center in 2013-2016. Patients of the control group (n=111) underwent subcutaneous mastectomy followed by conventional endoprosthesis deployment with its complete muscular covering. Patients of the main group (n=104) underwent subcutaneous mastectomy with a new method of single-stage reconstruction. Mean time of operation was 115±15 min in the control group and 90±10 min in the main group (p=0.000). Intraoperative blood loss reached 115±15 ml in the control group, 70±10 ml - in the main group (p=0.000). Duration of postoperative lymphorrhea was 14.6±3.5 days in the control group, 10±3.4 days - in the main group (p=0.000). Postoperative hospital-stay was 17.1±3.7 day in the control group and 14.2±2.4 days in the main group (p=0.001). New surgical approach significantly improves early outcomes in patients with breast cancer in comparison with those who undergo conventional surgical repair.

Структурные особенности флегмон челюстно - лицевой области у жителей Ханты - Мансийского автономного округа

Phlegmon of the maxillofacial region in the Khanty - Mansiysk Autonomous Region is one of the main pathologies of the oral and maxillofacial surgery, accounting for 4.3% of the hospitalized in the Department of oral and maxillofacial surgery (maxillofacial surgery). On the basis of a complete retrospective examination, the results of treatment of 171 patients were analyzed, it was found that the age group of 21-40 years (58.5 0%), male (67.8%) prevails. The main etiological factor is odontogenic causes (76.6%). Among the diseases that form the premorbid background, the presence of HIV infection (4.7%) and diabetes mellitus (4.1%) was noted. Surgical intervention in combination with antibacterial therapy and complex postoperative management of purulent wound allows to achieve satisfactory immediate results of treatment, to exclude lethal outcomes and to reduce the average duration of hospital treatment to 9,0 + 1,3 days.

Аналіз безпосередніх результатів ендоваскулярного ендопротезування інфраренальної частини аорти та лікування періопераційних ускладнень

Мета. Проаналізувати результати ендоваскулярного ендопротезування інфраренальної частини аорти та періопераційні ускладнення в залежності від типу конструкції стент-графту.
 Матеріали і методи. Основою роботи є аналіз результатів лікування 133 пацієнтів, проведеного за період з листопада 2005 по листопад 2018 р. в ендоваскулярному відділенні Інституту. Біфуркаційні ендопротези «Excluder» Gore, що мають інфраренальну фіксацію, імплантували 85 (63,9%) пацієнтам (1-ша група). З листопада 2013 р. 48 (36,1%) пацієнтам були імплантовані ендопротези нового покоління «Endurant-II» Medtronic з додатковою металевою структурою, яка забезпечує супраренальну фіксацію (2-га група).
 Результати. На підставі аналізу безпосередніх результатів лікування констатовано, що із 133 пацієнтів жоден не помер і у жодного не виникли небезпечні для життя ускладнення за умови індивідуального підбору ендопротезу з урахуванням анатомії аневризми. Технічно успішною імплантація була у 98,8% пацієнтів 1-ї та у 100% пацієнтів 2-ї групи. Частота повторних втручань у найближчому післяопераційному періоді становила 2,25%.
 Висновки. Стент-графти останнього покоління, які можливо застосовувати у пацієнтів зі складною анатомією інфраренальної частини аорти, забезпечують значне зниження крововтрати завдяки вдосконаленій системі доставки. Технічний успіх і тривалість операції залежать не тільки від типу ендопротеза, а й від досвіду оператора як загального, так і з використання конкретної моделі.

Surgical treatment of multiple and concomitant injuries

The objectiveof the study was to conduct a comparative analysis of the results of traditional and modern methods of surgical treatment of patients with severe concomitant injury, accompanied by fractures of the tubular bones of the limbs.Material and methods. The retro-and prospective analysis of the results of surgical treatment of 1033 patients with severe concomitant injury hospitalized in Baku Clinical Hospital № 3 for the period from 2009 to 2015 is presented. The patients were divided into 2 groups for a comparative evaluation of the results of treatment, depending on the effectiveness of the applied medical tactics. The 1st (main) group consisted of 828 (80.2 %) patients who were treated using the tactics of programmed multi-stage surgical treatment in accordance with the concept of «damage control». The 2nd (comparison group) included 205 (19.8 %) patients, who were treated using the traditional tactics of surgical treatment.Results.In a multi-field General surgical hospital, the introduction of the «damage control» program using the tactics of programmed surgical treatment in patients with severe concomitant and multiple injury allowed to increase surgical activity and reduce the mortality rate from 45.9 to 21.6 %.Conclusion.The application of tactics of stage surgical correction of injuries allows to improve the immediate results of treatment of patients with severe concomitant and multiple injury.

Selective chemoembolization of liver arteries as a stage of complex treatment of patients with unresectable cancer metastases (Own Experience)

Purpose: Chemoembolization is one of the methods of local treatment. Due to hydrophilicity and biocompatibility with the tissues of microspheres filled with cytostatics, one can achieve a long-term effect by controlling tumor growth. The differentiation of the sizes of the microcatheter and the microspheres allows them to be injected into the vessels associated with neoangiogenesis and tumor progression. Methods: Between January 2015 and December 2017, 17 patients underwent arterial chemoembolization with drug-saturated microspheres as a part of the treatment of metastatic cancer of various primary localizations. There were 8 men (age from 52 to 75 years, mean 63.6), and 9 women (age from 43 to 68 years, mean 55.3). In 9 cases, femoral artery access was used, and in 8 cases, radial artery access was used. In 15 patients, one vial of HepaSphere (in 6 cases saturated with 50 mg, and in 9 cases of 75 mg of Doxorubicin) was co-administered in the hepatic arteries. Two patients required the introduction of two vials of microspheres. Results: Partial reduction of tumor size was achieved in all patients, that allowed to continue specialized treatment. In 1 case, there was complete regression of the tumor node. In 3 cases, arterial chemoembolization was performed twice at an interval of 197, 329 and 371 days. Conclusion: The method of arterial chemoembolization of the liver with drug-saturated microspheres allows a deep cytotoxic effect on the metastasis of cancer in the liver, improving the immediate results of treatment, manifested in regression and stabilization of the tumor process.

LONG-TERM RESULTS OF THE MICROSURGICAL TREATMENT OF THE CEREBRAL ANEURYSM RUPTURES IN PATIENTS AT A COMPENSATED STATE

Aim. To study the severity of cognitive and psychoemotional disorders in the outcome of treatment of the patients with cerebral aneurysms ruptures, who were admitted in a compensated condition.Materials and methods. 57 cases are analyzed in the article. These are the cases of patients who were operated on in an acute state of aneurysmal subarachnoid hemorrhage. The severity of their state when they were admitted was 1-3 according to the Hunt-Hess scale. Depending on the results of treatment, the patients were divided into 2 groups: the first included 37 patients with excellent immediate results of treatment on the inverted Glasgow outcome scale (GOS 1), the second included 20 patients with moderate and severe disability (GOS 2-3).Results. The patients with moderate and severe disability as immediate results of treatment have a lower quality of life than patients with excellent results, due to the presence of severe headache, anxiety and depression disorders.Conclusion. The decline in the quality of life of patients with moderate and severe disability as immediate results of treatment of the cerebral aneurysms ruptures requires a rehabilitation therapy.

PO-291 The disbalance of the basic cytokines of the immune system in patients with ovarian cancer on the background of immunotherapy

IntroductionThe violation of the balance in the cytokine system is considered as an important mechanism for the development of cancer processes and ovarian cancer (OC). According to scientific confirmation, in the process of neogenesis occurs an imbalance between the production proneoplasticheskih (IL-6) and anti-neoplastic (IFN-γ, TNF-α) cytokines. Despite the improvement of diagnosis, OC treatment remains one of the urgent problems of oncogynecology.Material and methodsThe aim of the study was to evaluate the relations of the main cytokines of the immune system in patients with ovarian cancer stage II-III in the combined treatment on the background of immunotherapy. A total of 174 patients with stage T2–3N0–1M0 OCwere examined and treated at oncogynecology and chemotherapy departments.Depending on the application of immunotherapy methods (EIPHT with the use of the thymus immunotropic drug (thymalin), EIPHT +PPh) in the combined PCT, the patients were divided into following groups: the 1st group - 32 practically healthy individuals; the 2nd group - 36 patients with OC before PCT; the 3rd group - 44 patients with OC after PCT without immunotherapy; the 4th group - 28 patients with OC after PCT combined with EIPHT; the 5th group - 34 patients with OC after PCT combined with EIPHT +PHh.Results and discussionsCytokines were studied by ELISA test (IL-6, IFN-γ, TNF-α) with the ‘Human’ test systems (Germany) in the dynamics of therapy. The following ratios of cytokines were studied: TNF-α/IL-6 and IFN-γ/IL-6.Normally, TNF-α/IL-6 is 0.69 and IFN-γ/IL-6 is 0.7.In the group of patients with ovarian cancer before treatment: TNF-α/IL-6–0.53, and IFN-γ/IL-6–0.58. In patients after chemotherapy without using immunotherapy: TNF-α/IL-6–0.59, and IFN-γ/IL-6–0.22. In the group of patients with combination of PCT and EIPHT: TNF-α/IL-6–0,66; IFN-γ/IL-6 1.46. In the group of patients withcombination of PCT and EIPHT+PHh: TNF-α/IL-6–0,97, and IFN-γ/IL-6–3,22.Consequently, in patients with OC before treatment and after PCT without immunotherapy, there is a pronounced imbalance of cytokines, which is aggravated by PCT.ConclusionThe use of immunotherapy in combination with PCT is, in our opinion, a justified and effective method that leads to normalisation of immunological parameters of the immune system, allows improving immediate results of treatment, to reduce the intoxication caused by disease and makes it possible to carry out a ’full’ amount of therapy.

PO-292 Leukemic T cells stimulate NF-κB signalling in stromal cells through lymphotoxin-β receptor stimulation

IntroductionThe violation of the balance in the cytokine system is considered as an important mechanism for the development of cancer processes and ovarian cancer (OC). According to scientific confirmation, in the process of neogenesis occurs an imbalance between the production proneoplasticheskih (IL-6) and anti-neoplastic (IFN-γ, TNF-α) cytokines. Despite the improvement of diagnosis, OC treatment remains one of the urgent problems of oncogynecology.Material and methodsThe aim of the study was to evaluate the relations of the main cytokines of the immune system in patients with ovarian cancer stage II-III in the combined treatment on the background of immunotherapy. A total of 174 patients with stage T2–3N0–1M0 OCwere examined and treated at oncogynecology and chemotherapy departments.Depending on the application of immunotherapy methods (EIPHT with the use of the thymus immunotropic drug (thymalin), EIPHT +PPh) in the combined PCT, the patients were divided into following groups: the 1st group - 32 practically healthy individuals; the 2nd group - 36 patients with OC before PCT; the 3rd group - 44 patients with OC after PCT without immunotherapy; the 4th group - 28 patients with OC after PCT combined with EIPHT; the 5th group - 34 patients with OC after PCT combined with EIPHT +PHh.Results and discussionsCytokines were studied by ELISA test (IL-6, IFN-γ, TNF-α) with the ‘Human’ test systems (Germany) in the dynamics of therapy. The following ratios of cytokines were studied: TNF-α/IL-6 and IFN-γ/IL-6.Normally, TNF-α/IL-6 is 0.69 and IFN-γ/IL-6 is 0.7.In the group of patients with ovarian cancer before treatment: TNF-α/IL-6–0.53, and IFN-γ/IL-6–0.58. In patients after chemotherapy without using immunotherapy: TNF-α/IL-6–0.59, and IFN-γ/IL-6–0.22. In the group of patients with combination of PCT and EIPHT: TNF-α/IL-6–0,66; IFN-γ/IL-6 1.46. In the group of patients withcombination of PCT and EIPHT+PHh: TNF-α/IL-6–0,97, and IFN-γ/IL-6–3,22.Consequently, in patients with OC before treatment and after PCT without immunotherapy, there is a pronounced imbalance of cytokines, which is aggravated by PCT.ConclusionThe use of immunotherapy in combination with PCT is, in our opinion, a justified and effective method that leads to normalisation of immunological parameters of the immune system, allows improving immediate results of treatment, to reduce the intoxication caused by disease and makes it possible to carry out a ’full’ amount of therapy.

PATHOPHYSIOLOGICAL MECHANISMS OF DEHISCENCE OF ANASTOMOSE SUTURES IN PATIENTS WITH ONCOPATHOLOGY

It should be recognized that the creation of optimal conditions for healing of intestinal sutures is the main reserve for improving the results of surgical intervention on the organs of the gastrointestinal tract. The urgent issues of pathophysiology associated with oncopathology remain the inability of seams of anastomosis and stomaty. The purpose of the work is to determine the pathophysiological mechanisms and criterion-significant indicators of inability to sew anastomosis. In the study of this issue, an analysis of the immediate results of treatment of 74 patients, which was a test group, which operative treatment was performed in a radical volume. Patients were divided into two groups according to the anastomosis failure: Group Іa - patients who had been operated on for gastric cancer and who had anastomosis failure - 16 patients, II group 58 patients - who had been surgically inoperative and had not been diagnosed insolvency The patients of each group were divided into four subgroups, depending on the presence of instability of microsatellites in the locuses of the VAT-25, VAT-26. The presence of Streptococcus Bovis stomach cancer patients may be an early marker of disease progression. The leading metabolic profile of microbiocenosis in the development of stomach cancer is the significant accumulation of biogenic amines. The analysis of the results of the study shows that the failure of anastomosis in patients with gastric cancer is accompanied by profound disorders of the metabolism of connective tissue and is confirmed by increased activity of elastase, collagenolithic activity of blood serum and its content of glycosaminoglycans. The activity of elastase and glycosaminoglycans may be a prognostic criterion for insufficiency of seams in the course of treatment.

РЕАБІЛІТАЦІЯ ХВОРИХ ІЗ ОСТЕОХОНДРОЗОМ ХРЕБТА

Вступ Надання кваліфікованої допомоги Хворов при наявності у них неврологічніх проявів вертебрального остеохондрозу (ВО) є однією з остаточно НЕ вірішеніх, найбільш складних та багатоплановіх проблем сучасної науки, а отже, важлівім завдання сучасної медичної РЕАБІЛІТАЦІЇ.Мета дослідження : Візначіті ефективність впліву ЗАСОБІВ фізичної РЕАБІЛІТАЦІЇ комплексного! Застосування удосконалення методик лікувального масажу комплексу лікувальної гімнастікі статико-дінамічніх вправо та вправо на дошці Євмінова на Хворов з остеохондрозом шийно-грудного відділу хребта.Матеріали и методи Обстежено 50 пацієнтів ВІКОМ від 25 до 55 років, Які проходили обстеження и лікування в університетській лікарні.Хворі розподілені на 2 групи: контрольну та експериментальну. Во время дослідження Використано різноманітні методи дослідження стану опорно-рухової системи - ортопедичне и неврологічне обстеження, что включало як суб'єктивні методи дослідження (Скарги, анамнез), так и об'єктивні методи дослідження (огляд, пальпаторно обстеження, діагностика зон шкірної гіперестезії, тригерних зон та функціональніх блокад хребтових-рухового сегментів).Результати ДОСЛІДЖЕНЬ та їх Обговорення. В обох групах у залежності від віку, характеру, локалізації и стадії захворювання, інтенсівності больового синдрому, актівності процесса, симптоматики, супутніх захворювань Хворі пройшли курс фізичної РЕАБІЛІТАЦІЇ. А в експеріментальній групі, разом з комплексом лікувальної гімнастікі статико-дінамічніх вправо, як и в основній групі, додатково застосовувалісь лікувальний масаж, вправі на дошці Євмінова.Висновки . Аналіз безпосередніх результатів лікування довів, что комплексна система виявило більш ефективного у знікненні або зменшенні больового та міотонічного сіндромів, поліпшенні функціонального стану хребта, стану психо-емоційної сфери, підвіщенні якості життя пацієнтів.

ОЦЕНКА ФУНКЦИИ КОЛЕННОГО СУСТАВА У ПАЦИЕНТОВ ПОСЛЕ ЭНДОПРОТЕЗИРОВАНИЯ С ПРИМЕНЕНИЕМ ШКАЛЫ KOOS

The goal was to evaluate the immediate results of treatment and knee function in patients after total knee replacement.Material and methods. The study included: questioning of patients, analyzing the medical records of inpatients, analyzing the features of surgical intervention and treatment during the postoperative period. We examined 81 patients with grade 3 gonarthrosis according to Ahlbäck. The patients underwent an examination of an orthopedic traumatologist with clinical assessment of their state by the KOOS scale (The Knee injury and Osteoarthritis Outcome Score).Results. A significant reduction in the pain syndrome was observed in the period from 30 to 180 days, ranging from 38.07 (11.1-50.0) points to 86.88 (72.2-97.2) points, respectively, which in turn speeded up the rehabilitation time after endoprosthetics (p <0.05). The severity of the pain syndrome in the period of 30-90 days after surgery was significantlylower in patients with rotation-endoprosthesis (50.0 - 66.4 points) than in those with modular endoprosthesis (38.07 - 60.6 points), respectively (p <0.05). The severity of symptoms throughout the period of observation of patients after surgery was significantly lower in patients with rotation-endoprosthesis (50.0 - 65.6 - 88.8 - 92.06 points) than inthose with modular endoprosthesis (35.1 - 56.9 – 82.9 - 86.2 points), respectively (p <0.05). Conclusions. The evaluation of the knee joint function restoration after endoprosthetics using the KOOS scale isvery detailed, which justifies its wider use in this category of patients.

Сombined radiotherapy for cervical cancer with the use of polyradiosensitization with cisplatin and gemcitabine - immediate trial results of Azerbaijan national center of oncology

Aim. Study of immediate results of chemoradiotherapy of locally advanced cervical cancer with the use of polyradiosensitization with cisplatin and gemcitabine. Methods. The article analyzes diagnostic and treatment results of 128 patients with IIA-IIIB stage cervical cancer. The age of patients varied between 31 and 76 years. External beam radiotherapy was performed with 1.8 Gy fraction up to a total dose of 45 Gy, high dose rate brachytherapy consisted of four 7.0 Gy fractions. Patients from group 1 received weekly infusions of cisplatin (40 mg/m2) and from group 2 - polyradiosensitization with cisplatin (40 mg/m2) and gemcitabine (75 mg/m2). Results. Chemoradiotherapy with the use of polyradiosensitization compared to standard chemoradiotherapy allowed significant improving of immediate results of treatment of patients with locally advanced cervical cancer, which was particularly prominent in such unfavorable cases as cervical adenocarcinoma and IIIB stage of the disease. Early toxicity of the treatment was higher in group 2 but effectively resolved with symptomatic supportive treatment and did not lead to interruptions in radiotherapy. Conclusion. Combination of conformal external beam radiotherapy, high dose rate intracavitary brachytherapy and concurrent polychemotherapy with cisplatin and gemcitabine is feasible and reasonably safe; chemoradiotherapy with the use of polyradiosensitization improves immediate results of the treatment of cervical cancer with acceptable level of toxicity.

РЕЗУЛЬТАТЫ МОДИФИЦИРОВАННОЙ РЕВЕРСИВНОЙ ПЛАСТИКИ С ИСПОЛЬЗОВАНИЕМ ЛОСКУТА ЛЕВОЙ ПОДКЛЮЧИЧНОЙ АРТЕРИИ У ПАЦИЕНТОВ ПРИ КОАРКТАЦИИ АОРТЫ

Вступление. Коарктация аорты (КА) составляет от 5 до 8% всех врожденных пороков сердца, часто ассоциируется с другими врожденными аномалиями, в частности, гипоплазией дуги аорты (ДА). Непосредственные результаты лечения больных значительно улучшены, однако отдаленные результаты нельзя назвать удовлетворительными. Клинические проблемы после коррекции КА включают повторную КА, персистирующую артериальную гипертензию, аневризму аорты и цереброваскулярных сосудов, раннюю ишемическую болезнь сердца. Высокую частоту осложнений связывают с выбранной методикой коррекции КА и вариантом формирования анастомоза. В настоящее время нет проспективных рандомизированных исследований, однозначно доказывающих преимущества того или иного способа коррекции КА с гипоплазией дистальной части ДА.
 Целью проспективного исследования было сравнение двух методов: модифицированной реверсивной пластики (І група) и формирования «extended» анастомоза (ІІ група).
 Материалы и методы. Приведены результаты оценки хирургического лечения 64 пациентов раннего возраста по поводу КА в сочетании с гипоплазией дистальной части ДА в период с 2011 по 2015 г.
 Результаты. Анализ отдаленных результатов проведен у 62 (98,8%) пациентов в сроки до 48 мес.
 Совокупный показатель выживаемости в сроки до 4 лет составил 95,9% - в I группе, 95,6% - во ІІ группе. Диаметр перешейка аорты у пациентов ІІ группы в отдаленном периоде составлял (0,98 ± 0,4) мм, І группы – (1,2 ± 0,86) мм. В І группе повторной КА в отдаленном периоде не было у 98,2% пациентов, во ІІ группе – у 96,3%.
 Выводы. Метод модифицированной реверсивной пластики с использованием лоскута левой подключичной артерии воспроизводимый и безопасный, о чем свидетельствовало отсутствие фатальных осложнений как в раннем, так и отдаленном периоде после выполнения вмешательства.
 Ключевые слова: коарктация аорты; гипоплазия дуги аорты; хирургическая коррекция; повторная коарктация аорты.

Efficiency of application of radiation techniques to treat patients with localized prostate cancer in one hospita

Objectives. Analyzed short-and long-term results of radiation therapies (brachytherapy 125 I, conformal radiation therapy, stereotactic robotic radiotherapy) of patients with prostate cancer. Materials and methods . In each treatment the patients were divided into 2 groups received the combined treatment in combination with neoadjuvant hormone therapy without its implementation. The immediate results of treatment were assessed according to the level of total prostatic specific antigen, prostate volume, residual urine, change according to the International Prostatic Symptom Score (IPSS). Results . The dynamics of these indicators comparable in both groups, which is reflected in the regression of the primary tumor, as well as the quality of life of patients. Five-year overall survival and oncospecific survival in the group of patients after stereotactic radiotherapy is 100 %, the remaining groups – of more than 90–95 %. Conclusion . The obtained results testify to the effectiveness of the proposed methods of treatment of patients with localized prostate cancer.

Photodynamic therapy with photosensitizer photolon for oral leukoplakia

The objective – to assess tolerability, safety and immediate results of treatment of patients with oral leukoplakia using photodynamic therapy (PDT) with a photosensitizer photolon. The study included 40 patients (7 men, 33 women) with morphologically verified leukoplakia of the oral mucosa. The average age – 55±14 years. Number of treated foci – 109 (1 to 8). Photolon was administered intravenously at doses of 1.7-2.5 mg/kg. Photoirradiation («UPL PDT», Belarus, λ = 660±5 nm) was performed 2.5-3 h after administration: light exposure dose varied from 25 to 100 J/cm2, power density of 0.07 to 0.32 W/cm2, the duration of one field photoirradiation – from 2 to 13.5 min and according to its linear dimensions. The effectiveness of treatment was assessed 1-2 months after PDT by clinical data. Complete regression of foci recorded in 95% of cases (n=38), partial – in 5% (n=2).The follow-up period varied from 1 to 30 months. Full-epithelialization of the wound defect occurred within the period of 3-6 weeks after treatment. Photodynamic therapy may be recommended for patients with circumscribed or widespread oral leukoplakia as a simple, well-tolerated and effective option. Keywords: photodynamic therapy, photolon, oral leukoplakia.

ROBOTIC RADIOSURGERY AS A TREATMENT OPTION FOR PATIENTS WITH LOCALIZED PROSTATE CANCER

The article analyzed the immediate and long-term results of treatment of patients with prostate cancer receiving treatment method – robotic radiosurgery. The data of the immediate results of treatment are evaluated on the following criteria: level of total PSA, prostate volume, residual urine, changes on the international scale IPSS. The dynamics of the above indicators shows the regression of the primary focus, and the absence of pronounced radiation reactions affect the quality of life of patients. Three-year disease-free survival in patients receiving radiation therapy is 88.8 %. Overall survival, cancer-specific survival as well as 100 %.

A NEW METHOD OF DECOMPRESSION BY MALIGNANT LARGE BOWEL OBSTRUCTION

Purpose: improve the immediate results of treatment of patients with acute colonic obstruction of tumor genesis through the use of a new method of colon decompression. Materials and methods: the study included 35 patients who were divided into 2 groups. The control group consisted of 9 patients who were formed from a double-barreled colostomy minimal access without removing the contents of the large intestine and the rehabilitation of its lumen.The main group consisted of 26 patients,which after the application of double-barreled loop ileostomy through minimal access for the removal of intestinal contents was used a new method of colon decompression. Results: in the main group was noted more rapid normalization of basic clinical and laboratory parameters, as well as indicators of abdominal pressure. Complications were found in the main group in 1 (3.8%) patient, in the control group in 3 (33.3%) patients. Summary: а new method reduces the number of complications and deaths compared with conventional double-barreled ileostomy,due to forced removal of colon content and readjustment of its lumen, leading to a more rapid normalization of the major clinical and laboratory parameters as well as parameters of intraabdominal pressure.

ROBOTIC RADIOTHERAPY IS IN THE TREATMENT OF PATIENTS WITH ONCOUROLOGICAL PATHOLOGY

The authors Analyzed the immediate and remote results of treatment of patients with prostate cancer treated by the method - a robotic radiotherapy. Immediate results of treatment were estimated on the level of total PSA, prostate volume, residual urine, change according to the international scale IPSS. The dynamics of the above indicators showed regression of the primary lesion, and the absence of pronounced radiation reactions affect the quality of life of patients. We analyzed the results of overall, relapse-free survival and oncospecific. Three-year disease-free survival in patients receiving radiation therapy is of 88.8%. Overall survival, as well as oncospecific survival rate is 100%. Also presents first experience of using stereotactic radiotherapy in patients of renal cell carcinoma. Treatment received two (one patient carried out the irradiation of both kidneys). In one patient, complete tumor resorption of the right kidney and a decrease in the size and reduction of contrast enhancement of the tumor of the left kidney. Renal function did not deteriorate. The second patient decreased the size of the tumor, but preserved the contrast enhancement in the vascular phase. The only function of the kidney has not deteriorated.

Diagnosis and immediate results of treatment of patients with non-epithelial tumors of upper gastrointestinal tract

We presented an experience of treatment of 225 patients with non-epithelial tumors of upper gastrointestinal tract. Complicated disease's course was observed in 24% of cases. Tactical approaches are discussed depending on localization, dimensions and nature of tumor growth. Also indications for minimally invasive operations are defined. It was operated 102 (45.3%) of above-mentioned patients. Conventional surgical interventions were performed in 49 (48.0%) cases, laparoscopic operations - in 11 (10.8%) observations, endoscopic techniques using flexible endoscope - in 42 (41.2%) patients. One hundred and twenty-three (54.7%) patients were under dynamic observation. Technical features of the performed operations are described in the article. Complications were diagnosed in 8 patients including intraoperative in 3 cases and postoperative in 5 cases. Postoperative mortality was 2.0% (2 of 102 died). Overall mortality was 1.3% (3 of 225 patients died). Gastrointestinal stromal tumor (38) and leiomyoma (29) were the most frequent findings among removed tumors.

Comparative analysis of the effectiveness of second-line bevacizumab plus chemotherapy in second-line therapy in metastatic colorectal cancer.

619 Background: Advances in molecular biology and a wide introduction to the practice of targeted therapies have improved outcomes and significantly affect the overall survival of patients. To investigate the efficacy and safety of bevacizumab (BEV) beyond first progression combined with chemotherapy (CT) in patients with metastatic colorectal cancer. Methods: 68 patients with mCRC who received chemotherapy treatment at the Department of the Kazakh Research Institute of Oncology and Radiology. Selecting second-line chemotherapy based on oxaliplatin or irinotecan depended of an earlier first-line therapy (FOLFOX, FOLFIRI). The survival rate was calculated by Kaplan-Meier, comparison of survival curves was performed by log-rank. Results: The study included 68 patients, who were randomized from February 2009 to November 2011(to 33 [48.5%] BEV + CT and 35 [51.5%] to CT alone). Analysis of the immediate results of treatment showed that in neither case was not achieved complete response of the tumor. Partial regression in group 1 – 11 (33.3 ± 8.2)%, and group 2 - in 9 (25.7 ± 7.3)%. Stabilization is achieved in 20 (60.6 ± 8.5)% and 23 (6.7 ± 8.0)% of cases, respectively. The progression of the disease was observed in the group 1 in 2 (6.1 ± 4.1)% and 3 (8.6 ± 4.7)% of cases. Median progression-free survival (PFS) and overall survival (OS) was 11.5 months (7-16) and 12.2 months in group 1, and 9.7 months (6-13.2) (PFS), 9.1 months(OS) in group 2, respectively. The adverse event profile was consistent with previously reported data for BEV + CT. BEV-related significant adverse events included bleeding grade 3-4 (1.5 %) and venous thrombosis (2.3 %). Conclusions: Our findings demonstrate that BEV + CT continued beyond progression significantly prolong OS and PFS in second-line therapy mCRC.