[Formalized method of deciding on treatment options in clinical oncology].

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.

[One stage skin-sparing breast repair after mastectomy].

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.

[Non-sporulating anaerobic bacteria and anastomosis failure in patients with gastric carcinoma].

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].

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).

[Results of simultaneous resection and plastic surgery of the esophagus with extra-cavitary cervical esophagostomy in esophageal cancer in its thoracic part].

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.

[Endocrine function of the pancreas after radical surgery in esophageal cancer].

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].

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.