[UROLOGY LESSONS FOR COLORECTAL SURGEONS].

The anatomical and functional relationship of the pelvic organs is a prerequisite to the development of complications when performing surgical procedures in this anatomical region. Prevention and timely diagnosis of intraoperative injuries of both the urinary system organs and intestine, as well as well-coordinated work of urologist and colorectal surgeon team offer the opportunity to employ optimal tactics for the patient management.

[Early complications after surgery for middle- and lower-ampullar cancer: total mesorectumectomy or "blind" preparation of rectum?].

It was performed a comparative analysis of parameters of early postoperative period in 318 patients with middle- and lower-ampullar cancer of rectum who underwent total mesorectumectomy and "blind" preparation of rectum. All patients were divided into 2 groups. The main group included 202 patients after total mesorectumectomy.

[Survival rate after D3-lymphadenectomy for right-sided colic cancer: case-match study].

Unlabelled: The aim of the study was to compare the effectiveness of D3-lymphadenectomy in compliance with «no-touch» principle and mesocolectomy with traditional hemicolectomy in patients with right-sided colon cancer.

Material And Methods: It is retrospective-prospective comparative case-match study. From prospectively collected database patients with right-sided colon cancer stage I-III treated in 2009-2013 without adjuvant chemotherapy were selected.

[Successful anaesthesia for abdominal reconstructive surgery in a myasthenia gravis patient].

This article presents a clinical case of colon disease surgical treatment in a 34-year old patient with. generalized myasthenia. Perioperative management peculiarities in these patients are clarified.

[Expression of some biomarkers in primary colon adenocarcinomas and their lymph node metastases].

The samples of colon adenocarcinomas (CAC) and their lymph node metastases from 22 patients were studied. The expression of thymidylate synthase (TS), vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR), E-cadherin, beta-catenin, tenascin C (TN), and KAI-1/CD82 in primary CAC and their lymph node metastases was compared using an immunohistochemical method. The expression of TS, VEGF, EGFR, E-cadherin, TNC, and KAI-1 was statistically significant different in primary CAC and involved lymph nodes.

[Surgical treatment of rectocele with the use of mesh implants by the obstructive defecation syndrome].

Unlabelled: The aim of current study was to evaluate in complex the effectiveness of transvaginal mesh implants in women with obstructed defecation (OD) syndrome based on the comparison of preoperative and postoperative results of objective diagnostic tools and quality of life parameters.

Methods: from prospectively collected database of patients treated in our department those who were treated for OD by means of transvaginally placed mesh implants were chosen. The comparison of pre- and postoperative results of objective evaluation (prolapse stage according to POP-Q system, X-ray defecography - XR-DG and MRI defecography - MRI-DG) as well quality of life parameters (Wexner constipation score and validated Russian version of King's Health Questionnaire) was undertaken.

[The paraaortic lymphadenectomy with the lower mesenteric artery sceletonization for the sigmoid cancer treatment].

43 patients with sigmoid cancer stage I--III were operated on. The mean operative time was 206.2±73.

[The primary tumour resection with extended D3 lymph node dissection, metastases of synchronous metastatic colorectal cancer].

The progress in colorectal cancer treatment of IV stage that was shown in last decades was mainly due to modern chemotherapy schemes and aggressive surgical approach towards distant metastatic lesions. Meanwhile less attention is paid to primary tumour treatment - the questions of necessity and volume of its resection are still open. The AIM of this study was to evaluate safety and oncologic effectiveness of primary tumour resection with D3 lymph node dissection in synchronous metastatic colorectal cancer.

[Molecular markers of colorectal adrenocarcinoma progression].

Colorectal adenocarcinoma and its lymph node metastases from 72 patients and 14 control samples were studied. Expression of adhesive molecules - E-cadherin and beta-catenin, antiadhesive molecule - tenascin C and tumor metastasis suppressor KAI-1 (CD82) were studied by immunohistochemistry. The expression of E-cadherin and beta-catenin, tenascin C and KAI-1 was significantly different in adenocarcinoma and control samples.

[The efficacy of the multidisciplinary approach in colorectal cancer surgery in elderly patients].

Publications of the last few years indicate a steady rise of colorectal cancer in the world. Colorectal cancer is on the second place in the structure of oncological mortality in developed countries, including Russia. The majority of colorectal cancer deaths (up to 50%) occur in elderly.

[Immunity and cytokine status after surgeries on the large intestine].

The aim of our study was to examine the effect of individual schemes of multimodal analgesia on indicators of immunity and inflammation markers after operations on the colon. Patients of group 1 (n=15) received paracetamol, lornoxicam and epidural ropivacaine, 2nd group of patients (n=15)-paracetamol, epidural ropivacaine and tramadol. Comparison group (n=10) patients underwent patient controlled analgesia by promedol.

[The combined abdomenotranssacral access for the extralevator rectum extirpation].

Technique of the extralevator abdomenoperineal rectum extirpation with the use of the combined abdomenotranssacral access is thoroughly described in the article. The radicality of the procedure and the immediate results has been evaluated in 27 patients with the lower ampullary rectum and anal canal cancer. The average blood loss was 625±288 (300-3500) ml.

[Simultaneous coronary bypass grafting and hemicolectomy].

The simultaneous surgical treatment of ischemic heart disease (coronary bypass grafting) and ascending colon cancer (right hemicolectomy) is described. Literature review showed that these simultaneous surgical heart and colon procedures are reasonable and should become a method of choice for such patients.

[Molecular-genetic analysis of clonal intratumoral heterogeneity on colorectal adenocarcinomas].

We have examined the existence of intratumoral genetic heterogeneity for LOH on chromosomes 9p21 (p16, p15, p19), 13p14 (RB1), 10q23 (PTEN), 17p (TP53), microsatellite instability and K-RAS point mutations on four different segments of sporadic colorectal cancers. The intratumoral genetic heterogenity was detected in 9/11 (81%) colorectal adenocarcinomas and morphologically validated. These results show that colorectal cancer is highly heterogeneous for these molecular markers.

[Methodology of clinical studies in surgery].

Results of clinical studies recently became the guidelines in decision making in medicine including surgical practice. Results of each study could be used generally only if all methodological requirements are fulfilled. In this paper the principles of clinical studies design particularly in surgery and medical publications analysis are described and discussed.

[Expression of type 1 and type 2 mucins in colonic epithelial tumors].

Expression of MUC-1 and MUC-2 was investigated with immunohistochemical staining (PAP-method) in 5 cases of adenomas and in 60 cases of colorectal adenocarcinomas. The expression of MUC-1 and MUC-2 can be useful for diagnosis and prognosis in patients with colorectal carcinoma.

[Nerve-preserving operations in surgery of rectal cancer].

Forty-eight patients underwent surgery for rectal cancer. In all the patients total mesorectumectomy was combined with one of the types of nerves-preserving surgeries. Three groups were divided depending on types of this surgery: 1-- complete preservation of elements of autonomic nervous system (n=31), 2 -- partial preservation (n=16), 3 -- complete ablation (n=1).

[Potentialities of modern clinical X-ray radiology in the differential diagnosis of tumor and other obstructive diseases of the large bowel].

The misdiagnosis rate in defining the cause of obstructive colonic disease is 8.2-24.4%.

[Short- and long-term results of sphincter preserving operations with creation of colonic J-reservoir].

The aim of this study was to evaluate short- and long-term results of sphincter preserving operations with forming a colonic J-reservoir. This study examined the results of the treatment of 63 patients with medioampullary carcinoma of the rectum. Sphincter preserving operations with forming a reservoiroanal anastomosis were made in 34 patients (test group), 29 patients had sphincter preserving operations with forming coloanal and supraanal colorectal anastomoses (control group).

[Transanal resection of rectum with mesorectumectomy].

The possibility of sparing resection of the rectum in cancer is considered. The results of treatment in 27 patients with cancer of rectal lower ampulla (T1-10 patients, T2-12, T3-5) by transanal resection of distal part of the rectum are presented. The technique of operation, which provides the removal of all layers of rectal wall with surrounded tissues, e.

[Surgical treatment of paracolostomu hernias and prolapses].

The results of surgical treatment for paracolostomy hernias and prolapses in 71 patients show insufficient effectiveness of this method for surgical correction of such paracolostomy complications as paracolostomy hernias and prolapses: the rate of their relapses reaches 50%. The authors have developed a new effective method for surgical treatment of complicated colostomy: intraabdominal reconstruction of colostomy with retroperitoneal pull and laying of prestomal segment of the sygmoid colon.