Extralevatory surgery requires a use of additional techniques for closure of extensive defects of the pelvic floor. This study analyzed the results of 55 extralevatory abdomino-perineal extirpations ...of the rectum using a variety of methods of plastic of defects of the pelvic floor. There were performed 20 simple plastics, 13 alloplastics and 22 myoplastics. Complications in the perineal wound were observed in 10 (50%) cases after a simple plastic, 4 (32%) after plastic using mesh endoprosthesis and 5 (23%) after myoplastic. It is showed that the highest rate of postoperative complications in the perineal wound (up to 50%) occurs in a case of "simple" plastic. Complication rate reduces to 23-32% when alloplastic and myoplastic are used. It is concluded that alloplastic and myoplastic have significant advantages over the simple plastic.
The paper summarizes and analyzes the results of complex treatment of patients with malignant tumors performed in the N.N.Petrov Research Institute of Oncology using perfusion technologies. Safety ...and efficacy data on various chemoperfusion is presented: intraperitoneal chemoperfusion combined with cytoreductive surgery in patients with locally advanced and disseminated gastric cancer, recurrent ovarian cancer and pseudomyxoma peritonei; isolated lung perfusion combined with metastasectomy in patients with lung metastases; isolated limb perfusion with/without cytoreduction in patients with locally advanced skin melanoma and locally advanced soft-tissue sarcoma. The conclusion is made that both intraperitoneal and isolated chemoperfusions are not associated with higher incidence of intra- and postoperative morbidity. However safety of the procedures could be increased through optimizing tactics of surgical procedures prior to chemoperfusions. The use of perfusion technologies provides significant survival advantage in patients who can’t benefit from conservative treatment.
The main treatment option for rectal cancer is surgery, which "gold standard" is the total mesorectumectomy. There are presented literature review and the results of own research devoted to ...comparative analysis of outcomes of laparoscopic and open total mesorectumectomy. Current data and own experience show the oncological adequacy and safety of laparoscopic approach however the controversy of some results reveal the necessity of further investigation.