Surgical Treatment Of Malignant Tumors Research Articles

Resection of the chest wall for bone and soft tissue neoplasms in children

Chest tumors are quite rare in children. Among them there are benign and malignant. In all cases, surgical intervention is needed; in malignant tumors, as a stage of treatment, it is aimed at removing the tumor and, if necessary, reconstructing the chest wall. Due to the different localization, local spread and involvement of underlying structures, the surgical approach may involve a large extent of chest wall resection, and a variety of plastic materials and techniques is quite wide. During the period from September 2012 to January 2022, 43 surgical interventions for neoplasms of the chest wall in children were performed in the Department of Oncology and Pediatric Surgery of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology. In 11 (26.8%) cases, neoplasms were benign, 30 (73.2%) patients underwent surgical treatment for malignant tumors of various histogenesis. The surgery of the chest wall consisted of two stages. The first stage was a wide excision of the tumor within healthy tissues, performed en bloc with the involvement of underlying tissues and organs (diaphragm). If a malignant process and lung foci were detected, we simultaneously removed the foci on the affected side. The second stage was the reconstruction of the chest wall and diaphragm with local tissues or with the use of non-absorbable synthetic material (polymer meshes, dermal-derived bioprostheses, titanium meshes) shaped according to the size of the defect with a margin for fixation to the edges of the wound. Overall and relapse-free survival was evaluated. The maximum observation period was 9 years. The operative approach and the extent of surgical intervention depend on the size of the primary tumor site and its spread (multifocal lesion), the involvement of adjacent anatomical structures and are individual in each case. The study was approved by the Independent Ethics Committee and the Scientific Council of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology.

Biomimetic fusion liposomes boosting antitumor immunity and promote memory T cell differentiation to inhibit postoperative recurrence of breast cancer

For most solid tumors, surgery is still the most effective treatment. However, postoperative recurrence is the main reason for the failure of surgical treatment of malignant tumors. It is urgent to develop new nanomedicine systems to inhibit postoperative recurrence. Here, we designed a tumor cell membrane fusion liposome loaded AIE photosensitizer and Metformin named TMFL to inhibit postoperative recurrence. First, thanks to the homing effect of tumor cell membranes, TMFL can enter tumor tissues through active targeting. Under light irradiation, TMFL can produce singlet oxygen (1O2), which promoted immunogenic cell death (ICD) of tumor cells, thereby inducing dendritic cell (DC) maturation and stimulating T cell immunity. Metformin released by TMFL further promoted T cell differentiation into Central Memory T cell (Tcm) and inhibited tumor recurrence. The results of experiments showed that TMFL plus light treatment increased the content of mature DC in lymph nodes. In addition, TMFL can effectively promote the differentiation of T cells into Tcm, increase the content of T cells in recurrent tumor tissue, and inhibit the tumor recurrence. In view of the current major problems such as postoperative tumor recurrence, our TMFL system has a good clinical application potential.

PULMONARY ARTERY INTIMAL SARCOMA MIMICKING PULMONARY EMBOLISM: SURGICAL TREATMENT RESULTS

HighlightsThe article describes a rare case of surgical treatment of pulmonary artery intimal sarcoma. The authors analyzed the causes for incorrect diagnosis of pulmonary embolism in detail, and proposed alternative options for distinguishing the diseases under consideration. Moreover, the authors analyzed different surgical treatment modalities of intracardial sarcomas, and demonstrated the prospect of using molecular hydrogen as a component of an anesthetics during surgical interventions with cardiopulmonary bypass. AbstractThe article describes a rare clinical case of a patient with pulmonary artery sarcoma. The absence of specific symptoms of sarcoma, as well as features of developing cardiovascular and respiratory failure, characteristic of pulmonary embolism, contributed to the incorrect diagnosis. The article analyzes the main problems of primary diagnostics, and proposes new parameters for evaluating manifesting symptoms and the results of additional examination, which should improve the results of surgical treatment of malignant tumors.

Evaluation of complications, conversion rate, malignancy rate, and, surgeon's experience in laparoscopic assisted supracervical hysterectomy (LASH) of 1274 large uteri: A retrospective study.

Hysterectomy now belongs to standard gynecological procedures. Moreover, a shift towards laparoscopic techniques is ever more apparent as they provide many advantages such as less traumatization and shorter convalescence. Large uteri are still mentioned as contraindications for laparoscopic hysterectomy even though those patients might benefit from the lower morbidity associated with minimal invasive techniques. In this study, the largest reported so far, we analyzed intraoperative and postoperative complications as well as the surgeon's experience of laparoscopic assisted supracervical hysterectomy (LASH) in patients with a uterus weight over 500 g. The present retrospective study, between June 27, 1998 and August 31, 2019, evaluates 1274 patients with a uterus weight over 500 g who were treated with LASH for benign uterine diseases at the Clinic for Minimal Invasive Surgery (Berlin, Germany). All surgeries were performed by one of four in-house surgeons with experience in LASH: they had performed at least 500 LASH procedures before the study. Patients receiving surgical treatment for malignant tumors were not included in the study. Major and minor intraoperative and postoperative complications were recorded and evaluated. Additionally, medical files were evaluated for demographic data, American Society of Anesthesiologists score (I-IV), name of the surgeon, duration and indication for surgery, history of previous gynecological procedures and concomitant surgical interventions, weight of removed uterine tissue, duration of postoperative hospitalization in patients with complications, intraoperative conversion from laparoscopy to laparotomy, and malignancy rate. The mean age was 47.0 ± 7.3 years and mean body mass index was 25.6 ± 7.1kg/m2 . Average parity was 1.04 ± 1.57. Average uterus weight was 761.8 ± 317.9g (500-4065 g). The mean duration of surgery was 96.9 ± 49.5min; 54% of all patients were treated without concomitant intervention, conversion rate was 2.12%. The malignancy rate was 0.4% and the complication rate was 6.81% with 1.36% intraoperative complications and 5.45% postoperative complications. The overall low complication and malignancy rates observed in this study allow us to present LASH as a safe and efficient alternative laparoscopic approach to remove uteri of any size in the hands of experienced surgeons.

Algorithm of reconstruction combined midface defects after resection malignant tumors

Introduction. Surgical treatment of malignant tumors of maxilla and midface results to a combined defects of the soft tissues of the face (upper lip, buccal, zygomatic regions), upper jaw, hard and soft palate, retromolar region, orbit, nasoethmoidal complex. This is one of the most difficult localizations in terms of both the possibility of performing radical surgery and reconstruction. The purpose of reconstruction is not only the elimination of cosmetic deformity, but also the restoration of such vital functions as breathing, swallowing, speech and binocular vision. Till that time, no algorithm has been developed for choosing a method for the reconstruction and there is no comparative analysis of the available methods.The study objective is to improve the functional and aesthetic results of treatment patients with malignant tumors of the upper jaw and midface.Materials and methods. For the period from 2014 to 2020 in the Department of Head and Neck Tumors of the N.N. Blokhin National Medical Research Center of Oncology, ministry of Health of Russia microsurgical reconstruction after resections of the upper jaw and midface was performed in 80 patients. most often (25 (31 %) patients) the primary tumor was localized in the maxillary sinus, then hard palate (16 (20 %) patients), soft palate (11 (14 %) patients), retromolar trigone (13 (16 %) patients). primary location at alveolar process of the upper jaw was in 3 (3 %) cases, nasal cavity and cells of the ethmoid labyrinth - in 4 (5 %), frontal sinus - in 5 (6 %), the skin of the cheek and lower eyelid - in 3 (3 %) patients. we defined 4 main types of resection. Type I - combined lower resections of the maxilla and mucosa of the retromolar region, soft palate, lateral wall of the oropharynx (47 (60 %) patients). Type II - total radical maxillectomy (resection of all walls of the upper jaw, including orbital wall) (12 (15 %) patients). In 5 (42 %) cases, the resection was combined and included, in addition to the upper jaw, the skin of the buccal and zygomatic regions. Type III - combined partial resections of the upper jaw (13 (17 %) cases). In 9 (69 %) cases, the block of tissues to be removed included a fragment of the skin of the buccal region, part of the external nose, and lower eyelid. Type Iv - orbitomaxillary resection with orbital exenteration (6 (8 %) patients), including exenteration of the orbit, cells of the ethmoid labyrinth, resection of the frontal bone, medial wall of the orbit, a fragment of the dura mater (4 (67 %) cases), skin of frontal, buccal, zygomatic areas, upper and lower eyelids. for reconstruction of defects in 80 patients we used 82 free flaps. In 76 (93 %) cases, simultaneous resections of the primary lesion and reconstructions were performed, in 6 (7 %) cases, delayed reconstruction after previously performed combined or complex treatment were performed.Results. In type I resection with limited defects excellent functional and aesthetic results were obtained in all cases of using a radialis fasciocutaneous free flap. In case of subtotal and total defects of the hard palate and the alveolar margin of the upper jaw, the best aesthetic (excellent in 5-46 % of patients, satisfactory in 3-27 %) and functional (excellent speech quality in 8 patients) results were obtained with use free scapula tip flap. In type II resections excellent aesthetic results were obtained in 6 (55 %) patients. In all cases, a chimeric free flap consists of tip of the scapula, fragment of serratus muscle and skin of parascapular region was used. In type III resections in patients with limited defects, 5 (71 %) had excellent aesthetic results, and 2 (29 %) had satisfactory aesthetic results. In all cases a radial free flap was used. In case of half defects of the upper jaw anterior-lateral thigh flap and thoracodorsal free flap was used. In all cases satisfactory aesthetic result was obtained. In type IV resections satisfactory aesthetic results were obtained in all patients.Conclusion. Preoperative computer 3D modeling is necessary in planning of reconstruction. This allows to determining the type and volume of the defect, plan optimal method of reconstruction, model the required flap geometry, making a template for harvesting flap, calculating the position and number of titanium plates for fixation, and, if necessary, print an individual mesh of the infraorbital wall.

Surgical treatment of malignant tumors of the cardiac part of the stomach, complicated by bleeding, perforation and stenosis

The aim of the work is improving the results of surgical treatment of malignant tumors localized in the cardiac part of the stomach, complicated by bleeding, perforation and stenosis. In the Kyiv City Center for providing assistance to patients with acute gastrointestinal bleeding on the basis of the "Kyiv City Clinical Hospital No.12" from 2006 to 2020, 766 patients with malignant tumors of the stomach, which were complicated by bleeding, perforation or stenosis, were treated. Including, 292 patients had a tumor localized in the cardiac part of the stomach, including with a transition to the esophagus – in 30 (10.3%), 10 (33.3%) of these patients had stenosis phenomena). The tumor was complicated by bleeding in 285 (97.6%) patients, in 10 (3.5%) by bleeding and stenosis, in 7 (2.4%) by perforation of the tumor, in 2 by perforation and bleeding. Operative treatment was performed in 138 (47.3%) patients out of 292. At the same time, radical operations were performed in 94 (68.1%) patients, 1 (1.1%) of them due to tumor perforation. Palliative and symptomatic operations were performed in 44 (31.9%) patients. Among them, 2 (4.5%) patients were operated on for perforation, 2 (4.5%) for a combination of perforation and bleeding.8 (5.6%) patients underwent emergency surgery at the height of ongoing bleeding and at the height of its recurrence, including 4 (50.0%) radically, 4 (50.0%) non-radically. Of them, 5 (62.5%) also had perforation of the tumor. In the early delayed period (ERP), after adequate preparation and comprehensive follow-up examination, operative treatment was performed in 130 (94.2%) patients, 92 (70.7%) underwent radical surgery, 38 (29.2%) underwent non-radical surgery. The total postoperative mortality was 6.5% (12 patients), while the specific weight of mortality after non-radical surgical interventions was 4.6 times higher in comparison with the mortality rate after radical operations. It is established thatthe specific weight of deaths after radical surgical interventions was 2.2 times lower compared to palliative and symptomatic surgeries. The frequency of performing lymphodissection in volume D2 was higher in 2.8times after radical operations performed in the RVP and amounted to 71.8%. In the case of perforations of malignant tumors, 80.0% were non-radical surgical interventions. Keywords: radical operations, gastrectomy, lymphodissection.

Results of surgical treatment of malignant tumors of the pelvis and sacrum.

Background: to present the results of surgical treatment of patients with tumors of the pelvic and sacral bones.

Features of Surgical Treatment of Malignant Tumors of the Heart and Ways to Improve Immediate Results

To date, the issues of surgical treatment of malignant cardiac tumors (MCT) remain relevant and are of particular interest to cardiac surgeons. Hospital mortality of this group of patients is extremely high (20–30%). Finding ways to reduce early postoperative mortality remains an extremely important task of oncocardiac surgery.
 The aim. To analyze the causes of early postoperative mortality based on the data of many years of experience in the surgical treatment of MCT and to propose methods for the prevention of early postoperative complications with the improvement of the immediate results of operations.
 Materials and methods. From 1970 to 01.01.2021, National Amosov Institute of Cardiovascular Surgery has provided surgical treatment of 67 patients with malignant tumors of the heart which amounted to 7.1% of the total number of observed patients with cardiac tumors (949). Of the 67 patients with MCT, 57 (84.9%) were operated using artificial circulation, three operations (4.6%) were emergency. Hospital mortality was 19.4% (13 patients).
 Results. Microscopic examination of the removed tumors revealed the presence of necrosis zones, their mechanical damage leads to significant intoxication of the patient. To prevent tumor intoxication (cause of postoperative mortality) in the operative and postoperative periods, new methods of combating such a factor of hospital mortality were used, which helped to improve the results of treatment of MCT. Hospital mortality reduced from 33.3% (1970–2001) to 5.5% (last 10 years), as a result of use these measures.
 Conclusions. Destruction of the tumor during surgery with artificial circulation leads to the entry of a significant number of tumor cells and toxins into the bloodstream, causing tumor intoxication. Improvement of the immediate results of surgical treatment of MCT depends on their timely diagnosis, which allows for adequate surgery with radical removal of the tumor and the use of detoxification measures, significantly reducing surgical mortality.

Analysis of safety and efficacy of laparoscopic distal pancreatectomy in the treatment of left pancreatic malignant tumors.

ObjectiveDistal pancreatectomy is the most extensive operation to treat malignant tumors of the left pancreas; however, malignant pancreatic tumors are prone to early invasion and metastasis.MethodsThe clinical data of 80 patients undergoing surgical treatment for malignant tumors of the pancreatic body or tail from January 2013 to December 2017 were retrospectively analyzed. The main clinical variables were compared between patients undergoing laparoscopic distal pancreatectomy (LDP) vs. open distal pancreatectomy (ODP).ResultsThere were no significant differences in general patient characteristics, complications, and postoperative survival (χ2 = 0.09) between the groups. The operation time in the LDP group was significantly longer than that in the ODP group; however, the LDP group was superior to the ODP group regarding the length of postoperative hospital stay, diet recovery, and rectal exhaust and ambulation times.ConclusionLDP is a safe and feasible treatment for left pancreatic malignancies, with the same surgical efficacy as ODP. LDP also has the advantages of minimally invasive surgery, such as minimal trauma and enhanced recovery after surgery.

Innovative Approach to Surgical Treatment for Locally Advanced Cancer of Paranasal Sinus and Nasal Cavity

Background. Despite the rapid oncology development, the problem of surgical treatment for locally advanced tumors of the paranasal sinus and nasal cavity is still relevant. The search and development of ways to improve the surgical approach, including modern endovascular methods, appears necessary. Aims development and evaluation of the effectiveness of an innovative approach to the surgical treatment of malignant tumors of the nasal cavity and paranasal sinus with superselective intra-arterial embolization as a preparatory stage. Materials and methods. The study is based on the treatment outcomes of 52 patients with cancer of the nasal cavity and paranasal sinus. The main group included 21 patients receiving treatment with our developed approach including preoperative superselective intra-arterial embolization as a preparatory stage for surgical treatment. The control group included 31 patients receiving standard surgical treatment with traditional ligation of the external carotid artery at the first stage. Estimation of the amount of intraoperative blood loss with gravimetric analysis was considered the primary endpoint of the study. Post-embolization syndrome manifestations were analyzed by evaluating the pain intensity with a visual analogue scale and thermometry. Results. Intraoperative blood loss in patients of the main group varied from 100 to 400 ml, being on average 231.9100.58 ml. In the control group, the blood loss varied from 300 ml to 1000 ml, on average 630.97190.23. The data analysis proved demonstratively the effectiveness of the developed approach to surgical treatment of locally advanced tumors of the nasal cavity and paranasal sinus, since it statistically significantly reduced the amount of intoperative blood loss (p 0.005). Conclusions. Our developed approach to the treatment for malignant tumors of the paranasal sinus and nasal cavity optimized the results of surgical treatment and statistically significantly reduced the amount of intoperative blood loss, compared to the traditional ligation of the external carotid artery, from 630.97190.23 to 231.9100.58 ml (p 0.005), with minimal manifestations of post-embolization syndrome.

History of pancreatic cancer surgery

Abstract. The first mention of pancreatic cancer dates back to 1761, when the six-volume work of the famous Italian anatomist G. Morgagni On the location and causes of diseases discovered through dissection was published. However, the history of surgical treatment of malignant tumors of the pancreas dates back to the end of the 19th century. The accumulated experience of operational techniques and the introduction of aseptic rules created objective prerequisites for performing operations in complex anatomical zones during that period of time. On July 16, 1882, the famous German surgeon F. Trendelenburg, firstly, performed a successful resection of the tail of the pancreas for sarcoma, founding the development of surgery in this field. However, the success in this sphere could not be shifted to a tumor of the head of the gland due to the subsequent separation of the duct system from the duodenum. Over the following years, many outstanding surgeons tried to solve this problem, such as: A. Codivilla, W. Halsted, W. Kaush, until in the early 40s A. Whipple proposed a new method of pancreatoduodenal resection, that became the gold standard for head cancer treatment pancreas. Although it was not possible to achieve significant success in the treatment of cancer in the original method of operation, as a result at various stages of time this procedure wasnt used a lot and was almost forgotten. Today, surgery remains the leading method in the complex treatment of patients with pancreatic cancer. Minimally invasive technologies have been actively introduced into pancreatic surgery in the past two decades. The indications for surgery have been expanded, lymphadenectomy standards have been introduced, thereby increasing the chances of a successful cure.

419P Surgical treatment of malignant tumours and metastatic lesions of the chest wall

Tumors of the chest wall are relatively rare. Malignant tumors of the chest wall make up 4% of the structure of cancer and 1-2% of all primary tumors. Malignant tumors of the ribs and sternum made up 13% of the number of patients with bone tumors. The main treatment for chest wall tumors is surgical treatment. Unlike primary, metastatic bone tumors occur 2-4 times more often. From 2010 to 2019, in KazIOR provide operations for 78 patients with chest wall tumors, in which 60(76.9%) malignant bone tumors (chondrosarcoma 26(33.3%) and osteogenic sarcoma 34(43.6%), 2(2.6%) metastatic bone lesions, 16(20.5%) soft tissue tumors. The average age was 46.4years, the ratio of men and women 1: 1. 16(20.5%) patients underwent resection of the sternum (manubrium 2(2.6%), body 5(6.4%), xiphoid process 3(3.9%), middle third of the sternum 2(2.6%), the sternum and clavicle 2(2.6%), the xiphoid process of the sternum+costal arch of both sides+diaphragm and peritoneum in 1(1.2%) patient, middle third of the sternum+clavicle+3 ribs 1(1.2%)) and 62(79.5%) resection of the ribs (1 rib 14(17.9%), 2 ribs 12(15.5%), 3 ribs 3(3.9%), 4 ribs 3(3.9%), 5 ribs 1(1.2%), costal arch 1(1.2%), 28(35.9%) patients combined resection of ribs with nearby bones of the chest wall, various structures of the mediastinum and visceral organs. After resection of 3 ribs or more along the anterolateral surface and total or subtotal resection of the sternum 39(50%) patients underwent reconstructive plastic surgery. In 25(32%) cases used prolene mesh, in 2(2.6%) a displaced skin-fat flap, in 2(2.6%) a thoracodorsal flap (TDL), in 2(2.6%) a greater omentum and in 8(10.2%) combined plasty (prolene mesh+rectoabdominal flap in 2(2.6%) patients, prolene mesh+displaced pectoral flap in 4(5.1%), prolene mesh+TDL in 1(1.2%), prolene mesh + skin-fatty flap in 1(1.2%). Due to the radical removal of the tumor in combination with the reconstruction of postoperative extensive defects of the chest wall, the quality of life of patients is improved and good functional results are achieved - ease of construction and at the same time the required rigidity of the frame. Despite a significant amount of experimental work research in this area is ongoing.

Обзор оценочных шкал и классификаций метастатических поражений позвоночника, используемых при оперативном лечении

It is known that metastases in the spine are detected in more than 70% of cancer patients, and in 10% of such patients, compression of nerve structures and severe neurological disorders develop. The role of surgery for metastatic tumors of the spine is in the focus of attention, since the operation can improve mechanical stability, decompress nerve structures and reduce the intensity of pain. However, what role the operation plays in increasing life expectancy and how to correctly assess the results of treatment remains controversial and the opinions of specialists are controversial, since the assessment is often made by oncologists, but it is the surgeon who more fully evaluates the potential risks and benefits of surgical interventions. Therefore, it is important for surgeons to understand what prognostic factors affect the quality and duration of life. This article presents the most cited classifications and assessments before 2009, as well as all classifications and assessments obtained after 2010 regarding metastatic lesions of the spine, as well as classifications used to develop treatment tactics obtained from the electronic databases PubMed, MEDLINE, articles, monographs, abstracts, dissertations and other sources of scientific and medical information. 57 main publications with II and III levels of evidence were selected, 6 classifications and 24 rating scales were considered. In order to construct the necessary tactics of the surgical strategy, the classification / assessment methods were divided into anatomical classification / assessment methods, neurological symptom / instability assessment methods, and assessment systems for predicting life expectancy. The study showed that in the surgical treatment of metastatic tumors of the spine, it is important to use the same rating scales and classifications to select indications and assess the results of surgical treatment, as well as to achieve meaningful comparisons between published series. Conclusion. The classifications and rating scales used for metastatic lesions of the spine do not fully reflect the type of surgical treatment: there is no algorithm for restoring the support ability of the spine, which is very important for this category of patients

Malignant Tumors of the Hand

Primary malignant tumors in the hand are rare as compared to benign lesions; however, it is essential for orthopeadic surgeons to be familiar with their clinical presentation. The approach to working up a mass in the hand must be methodical and thorough, and clinicians must maintain high index of suspicion when evaluating these lesions. Successful identification and treatment of malignant tumors of the hand may include referral to a sarcoma center for staging, workup, and multidisciplinary treatment. Surgical treatment of malignant tumors in the hand is uniquely complicated by the increased number of critical structures that may be in close proximity to the tumor. It is therefore imperative to understand the principles of diagnosis, staging, biopsy, resection, and amputation before treating malignant tumors of the hand.

Surgical treatment of non-small cell lung cancer in the conditions of a new coronavirus infection pandemic (COVID-19)

To prevent infection of patients in the perioperative period and, in case of infection, to prevent the severe course of COVID-19. In the conditions of the COVID-19 pandemic within two months (March-April 2020) 138 patients underwent surgical treatment for malignant tumors, including 22 videothoracoscopic operations: 3 (13.6%) segmentectomies, 16 (72.7%) lobectomies, and 5 (22.7%) bilobectomies for non-small cell lung cancer. Following the principles that ensure the prevention of infection and the prevention of severe COVID-19, we managed to avoid the first stage of the pandemic (March-April 2020) cases of infection with a new coronavirus infection in patients who underwent surgical treatment for lung cancer.

Application of Perioperative Transfusion Trigger Score in Patients Undergoing Surgical Treatment of Malignant Tumor.

The present study aimed to investigate the clinical effects of the brand new perioperative transfusion trigger score (POTTS) system in patients undergoing malignant tumor surgeries. 442 cases of patients diagnosed with malignant tumor were randomly selected (from January 2012 to December 2016) from Zunyi Medical University and were divided into 3 experimental groups. Patients in the POTTS group were transfused by the POTTS guideline perioperatively, while patients in the 7-10g group were treated by the traditional transfusion guidelines existed (restrictive transfusion strategy), patients in the 10g group should be transfused to keep the Hb level no less than 10g/dL (liberal transfusion strategy). Baseline information, operation time, bleeding volume, transfusion amount, incision healing time, postoperative complications, metastasis and recurrence were observed and recorded. Postoperative short-term mortality was comparable of the 3 groups, 3 cases of death all occurred in 10g group, there was no significant difference in the incidence of postoperative complications, including infectious complications and coagulation related complications. Follow-up to date, there were 25 cases, 29 cases and 29 cases of tumor recurrence and metastasis in the three groups, but no statistical difference observed. The present findings show that the POTTS transfusion system is more advantageous with regard to save blood and relieve economic burdens of patients, and does not affect the long-term recurrence and metastasis rate of malignant tumor.

Efficacy of Single Transverse Neck Incision for Modified Radical Neck Dissection.

To assess the viability of the single transverse neck incision(STNI) for modified radical neck dissection and to analyze the yield of lymph nodes using this approach. We conducted a prospective observational study in the Department of Head and Neck Surgical Oncology at our Tertiary Cancer Care Centre from November 2013 to May 2017. A total of 257 patients underwent surgical treatment for malignant tumors of the head and neck which included 265 modified radical neck dissections (eight bilateral and 249 unilateral). Average of total dissected nodal yield was 37.07. Average yield of positive neck nodes was 2.78. Single transverse neck incision is an acceptable technique for modified radical neck dissection as it provides adequate surgical exposure for achieving optimal nodal clearance with little technical difficulty.

An acellular tissue matrix-based drug carriers with dual chemo-agents for colon cancer growth suppression

Background/aimsRelapse, metastasis, and chemo-resistance are the main factors responsible for the failure of surgical treatment of malignant tumors, and typically are the main obstacles to effective cancer treatment. Although significant advances have been made in the field of cancer chemotherapy, many patients still receive inadequate treatment due to the severe adverse effects of these drugs, resulting in an inability to reach therapeutic concentrations at the tumor site with systemic chemotherapy. Thus, a biological patch loaded with chemotherapeutic drugs could be an ideal strategy for the treatment of cancer at the tumor site. MethodsWe developed an acellular matrix using the submucosa of porcine jejunum, then loaded this matrix with different amounts of 5-fluorouracil (5-FU) and rapamycin nanoparticles. Cell proliferation and apoptosis were analyzed by flow cytometry and related markers were evaluated using real-time PCR and western blotting. The patches were evaluated in vitro to characterize their release kinetics and therapeutic feasibility. We then analyzed the therapeutic efficacy and systemic toxicity of these patches in vivo by using them in a mouse model of colon cancer. ResultsThe patches delivered 5-FU and rapamycin in a controlled manner for more than 8 weeks, arrested the cell cycle of LoVo cells and sw480 cells at G2/M phase, and induced apoptosis in vitro. The patches also suppressed the growth of xenografted tumors in vivo with lower adverse effects than typically observed with systemic administration of these drugs. ConclusionWe demonstrated that patches loaded with 5-FU-RAPA-PLA-NP significantly inhibited the growth of colon cancer in vitro and in vivo. These results demonstrated the feasibility of the use of a multi-effect biological patch for cancer treatment.

Metastatic tumors of pancreas — whether and when surgical intervention is gainful for diseased people. Retrospective analysis of data from three surgery centers

Introduction. Metastatic tumors in the pancreas constitute a small (2–5%), but steadily growing percentage of all neoplasms of this organ. The aim of the study was to analyze the surgical treatment of metastases in the pancreas, in particular its effectiveness and the risk of surgical complications. Material and methods. The retrospective analysis was performed on 21 patients treated surgically in three surgical centers. This group included 16 women (76%) and 5 men (24%). The median age at the time of diagnosis of the underlying disease was 55.5 years (41–71). We analyzed the location of secondary lesions, their size, number, type and radicality of surgical intervention, histopathological diagnosis of the disease, as well as the occurrence of postoperative complications. Results. The starting point for metastatic lesions in 16 patients (76%) was renal cell carcinoma (RCC), in other cases — skin melanoma, eyeball melanoma, adenocarcinoma of the rectum, non-small-cell bronchi carcinoma. R0 radical surgery was performed in 15 patients (74%) and perioperative mortality was 5% (1 patient died). The median total survival time was 151 months (10–342), with 168 months for RCC (25–344) and 62 months for the remaining cancers (10–241). Conclusions. The main factor that determines the patient’s future fate is the type of primary neoplasm and surgical treatment of metastatic tumors in the pancreas is the best solution for selected RCC cases.

Adrenal metastases: clinical manifestations and surgical outcomes

Background. The adrenal glands are one of the most common sites of metastases in malignant disease, particularly lung cancer. The frequency of adrenal metastasis in patients with breast cancer and lung cancer reaches 39 and 35 % respectively.Materials and methods. A total of 156 patients with adrenal tumors underwent surgical treatment in the Siberian State Medical University between December 1998 and July 2017. The study included 16 (10.2 %) patients (9 males and 7 females) with adrenal metastases. The mean age of study participants was 57.6 years (range: 44–73 years).Results. By the moment of surgery, the mean metastatic adrenal tumor size was 4.9 ± 3.0 cm (range: 1.0–10.2 cm). Thirteen out of 16 patients had adrenal metastases from renal cell carcinoma, one patient – from colon cancer, one patient – from lung cancer, and one patient – from breast cancer. Nine patients had left-sided adrenal metastases, whereas six patients had right-sided adrenal metastases. Synchronous adrenal metastasis was detected in two cases: one patient had adrenal metastasis at the side of the renal tumor; the other one had bilateral renal cell carcinoma with both adrenal glands affected.We identified three main variants of the disease course according to prevailing clinical manifestations of adrenal metastasis: no manifestations, pain syndrome, and arterial hypertension.Seven participants had no clinical manifestations; of them, 6 patients had renal cell carcinoma, whereas 1 patient had breast cancer. The mean time between surgical removal of the primary tumor and detection of adrenal metastases was 24.1 months; the mean tumor size was 4.5 cm.Pain syndrome was observed in 5 patients. In three of them, adrenal metastases derived from renal cell carcinoma, in one patient – from lung cancer, and in one patient – from colon cancer. The mean time between removal of the primary tumor and detection of adrenal metastases was 19.8 months; the mean tumor size was 5.4 cm.Arterial hypertension was diagnosed in four patients. The mean time between removal of the primary tumor and identification of adrenal metastases was 27.3 months; the mean tumor size was 4.1 cm. The five-year overall survival rate in operated patient was 47.8 %.Conclusion. Regular examinations of patients after surgical treatment of malignant tumors are needed to detect adrenal metastases; surgery can extend the patient’s life. can extend the patient’s life.