The Material of the study has formed 78 sick, found on stationary treatment in Republican Scientific Centre Coloproktologii since 1992 on 2010. As it is seen, from table, from 78 sick mans was 58(74,3%), womans 20(25,7%). 19(24,3), sick were at age from 15 before 20 years, 49(60,2%) at age from 21 before 40 years and 13 (16,6%) sick from 41 before 60 years. The Main complaint sick at arrival were a stubborn constipations, which noted beside 70 (89,7%) sick, including absence of the independent chair existed beside 55(70,5%), but beside 54(69,2%) sick were noted periodic stomachache, growing on measure of the absence of the chair. The Ballooned belly existed beside all 78 (100%) sick moreover beside 20(25,6%) of them flatulence was constant. The Sickness and retching existed beside 24(30,7%), weakness, reduction to capacity to work beside 52(66,6%), increasing of the temperature of the body beside 10(12,8%), paradoxical diarrhoeas beside 6(7,6%) sick. Endoskopicheskiy method (rectoromonoscopy, colonoscopy) turned out to be else less informations 51,8% coincidences of the diagnosis. So we biopsy on Svensonu executed beside all sick, entered with suspicion on disease Girshprunga. In our observations from 78 sick beside 42(53,8,1%) were aboveanalni, beside 20(25,6%) sick rectalis, beside 13(16,6%)rectosigmoideys , beside 2(2,5%) leftside and beside 1(1,2%) sick subtotalis form hipoganglios. At biopsies on Svensonu on observations, from 78 sick, beside 44(56,4%) is revealled hipoganglios, but beside 35(44,8%) аganglios rectum. As can be seen from presented tables, from 78 sick beside 68(87,2%) us is executed onemoments radical operation, 10(12,8%) sick is as far as possible made resection hipoor aganglionarnaya of the zone, decompensate part of the large intestine and is formed colostomy. In all events at operations. The Remote results executed radical operation on cause disease Girshprunga traced from 1 before 10 years beside 57(73%) sick. The Results of the surgical treatment were valued on scale Vezika: good, satisfactory and unsatisfactory. In our observations beside 46(80,7%) sick results came in well, beside 10(17,5%) satisfactory and beside 1(1,8%) sick was an unsatisfactory result., Mirzahmedov M. M., Ahmedov M. A., Sapaev D. A., and Literatura
Importance: Treatment of hepatocellular carcinoma remains a topical issue of Clinical Oncology. More than 80% of cases hepatocellular carcinoma develops in the presence of liver cirrhosis. These patients are doomed, many clinics they held only symptomatic treatment and life expectancy of patients is not more than 6 months. The main reason for the refusal of surgeons and Chemotherapeutists of treatment is associated cirrhosis. Purpose: To improve results of surgical treatment of liver cancer developed on cirrhosis Materials and methods: We analyzed the immediate results of treatment of 12 patients with hepatocellular carcinoma developed on a background of liver cirrhosis. From the large size of the tumor and associated liver cirrhosis, these patients the first stage of oil produced by hepatic artery chemoembolization of the affected lobe of the liver tumor. After 2 3 weeks performed liver resection. Results: After analyzing the results, we concluded: chemoembolization reduces tumor volume and weight, increases the physiological regeneration of hepatocytes unaffected tumor fraction, improves functional performance of the liver and does not affect the frequency and severity of postoperative complications., Juraev M.D., Nematov O.N., Yusupbekov A.A., and Literatura
Aim of investigation: to study immediate and remote results of standard and extended lymphodissection in patients with rectal cancer. Material and methods: 132 patients with rectal cancer were performed radical surgery with lymphodissection in D2 and D3 volume according to a height of tumor location. In immediate postoperated period there were noted complications in 4 patients that made up 3,03%. Observation time was 5 years. Tumor recurrence was reported in 5 patients (3,8%). In remote period metastases were revealed in 8 patients (6,6%). 5year total survival rate was 78,5±4,2% at stage II. 5year total survival rate was 56,4±3,7% at stage III. Comparing the results of standard and extended lymphodissection it was noted statistically authentic increase of 5 year survival rate in patients at stage III. Obtained data allow to come to the conclusion about reasonability of performance of different variants of lymphodissection for patients with rectal cancer at stages II and III., Navruzov S. N., Abdujapparov S. B., Akbarov E. T., Navruzov B. S., Islamov H. D., and Literatura
To improve the results of radiotherapy for cervical cancer used local and systemic radiomodification drugs. Materials and methods: 1984 patients with locally advanced cervical cancer (2b 3a stage), which at one stage of complex treatment by a course indoarterial of regional longterm polychemotherapy (EARDPHT) mode: methotrexate 50 mg/m2, the first 12 hours, fluorouracil 1000 mg/m2, over the next 12 hours and cisplatin 100 mg/m2, for 48 hours, 2 stage surgical treatment in the volume expanding hysterectomy 3 type (modification of Wertheim Meigs). Results: The results of treatment of locally cervical cancer using VADRPHT, depending on the unilateral and bilateral tumor invasion in parametrial tissue showed that under unilateral lesion of parametrium results of treatment were higher than for the bilateral involvement of parametrium. Medical pathomorphosis in tumors of different severity was observed in 86.9% of patients, metastasis to regional lymph nodes were detected in 36% of operated patients, and also studied the degree of therapeutic pathomorphosis in lymph nodes. There was revealed that the complete regression of tumors, 5 year survival rate is 98%, whereas in tumor regression of more than 50% of the original volume 78.5%, with stabilization of tumor no more than 58.4%. Conclusion: The study of molecularbiological parameters of the tumor cells show the effectiveness of conducted neoadvent indoarterial chemotherapy and play an important role in further treatment and prediction of disease., Navruzova V. S., Yuldasheva N. Sh., and Literatura
The article analyses a surgical treatment of 506 patients taking inpatient treatment in the Center for colon proctology. All the patients underwent a comprehensive examination including radiological and tool test methods in addition to conventional clinical and laboratory ones. On the basis of the complex study, indications, volume and terms of surgery performance were determined. Performance of preand postoperative management of patients is substantiated in details. Postoperatively, 28 (5.5%) had postoperative wound pyesis in the region of the previous colostomy. In the postoperative period 2 (0.4%) deaths of patients were caused with peritonitis which occurred due to incompetence of anastomosis sutures. Rehabilitation of stomed patients is one of challenges in colorectal surgery. Positive results treatment can be obtained only at carrying out of a comprehensive outpatient and inpatient preoperative preparation including recommendations in diet, colostome care, hydrogymnastics of the disconnected part of the intestine and prevention of infectious complications., Isakulov T. U., Mamatkulov Sh. М., Rahmanov S.T., Matkarimov S. R., and Literatura
Kontinuální tvorba výpotků jakékoliv etiologie zásadním způsobem ovlivňuje kvalitu života nemocných. Akumulace tekutiny v pleurální dutině postupně komprimuje plicní parenchym. Prvním příznakem bývá progrese námahové dušnosti, později se přidává i klidová dušnost. S nárůstem výpotku dochází ke kompresi plicního parenchymu s rozvojem plicní atelektázy. Nemocný je ohrožen vznikem zánětového onemocnění plic v nevzdušném plicním parenchymu. U diagnózy maligního onemocnění je riziko zánětových komplikací výrazně vyšší vzhledem k předchozí chemoterapii či radioterapii, která zásadním způsobem snižuje imunitu. Opakovaná tvorba výpotku se výrazně podílí na rozvoji terminálního stavu nádorové kachexie. Efektivní metodou léčby je chemická pleurodéza, která se užívá u vybraného spektra nemocných. Principem je navození aseptické pleuritidy. Nejefektivnější cestou aplikace léčiva je videotorakoskopie. V souboru bylo 47 nemocných, 29 (61,7 %) mužů a 18 (38,3 %) žen, s cytologicky prokázaným recidivujícím maligním pleurálním výpotkem. Věkové rozmezí 42–80 let, Ø věk 65 let. Cílem práce bylo objektivizovat průběh celkových a lokálních zánětových změn po talkáži. Efekt léčby nebyl ovlivněn základním typem nádorového onemocnění. U obou skupin nebyly významně odlišné pooperační komplikace, což dokládá bezpečnost zvolené metody a podporuje správně zvolený algoritmus léčby., Continuous pleural effusion production of any aetiology can significantly affect the quality of patients life. Chronic effusion accumulation in the pleural cavity can lead to lung parenchyma compression. The first symptom of this entity is a progressive exertional dyspnea, which can later turn in dyspnea at rest. With the increase of the pleural effusion volume, pulmonary atelectasis can develop due to chronic parenchycha compression. The patient is at risk of inflamatory complications from the territory of non-ventilated parenchyma. Patients with a diagnosis of malignant disease have this risk considerably higher due to their previous chemotherapy or radiation, which substantially affect the immunity system. Repeated pleural effusion formation can significantly take part in the development of the terminal status of cancer cachexia. An effective method of palliative treatment is a chemical pleurodesis, which is used in selected patients. The principle is inducing aseptic inflammation. The most effective way of application is via videothoracoscopy. In a group of 47 patients, there were 29 (61.7 %) men and 18 (38.3 %) women with cytologically diagnosed recurrent malignant pleural. The age ranged between 42 and 80 with average age of 65 years. The aim was to assess the course of local and systemic inflammatory changes after talc application. The effect of treatment was not influenced by the type of malignancy . In both groups there was no significant difference in postoperative complications. This proves the safety of the selected procedure and also supports the correctness of the chosen algorithm of treatment., Petr Habal, Nedal Omran, Karolina Jankovičová, Kateřina Kondělková, Jan Krejsek, Jiří Manďák, and Literatura
Cíl: Zhodnotit první zkušenosti s prováděním transarteriální radioembolizace (TARE) jaterních nádorů mikročásticemi s obsahem 90-yttria Metodika: V průběhu 6 měsíců jsme provedli u šesti nemocných TARE s aplikací skleněných mikročástic TheraSphere®. U čtyř nemocných šlo o metastatické postižení jater kolorektálním karcinomem, u dvou nemocných hepatocelulárním karcinomem. U nemocných jsme sledovali peri- a postprocedurální průběh, výskyt komplikací, WHO performance status a časný efekt léčby. Výsledky: Ani u jednoho z nemocných jsme nezaznamenali závažné komplikace léčby, při sledování účinků léčby bylo po 6 týdnech zjištěno, že u jedné nemocné došlo k rapidnímu zlepšení WHO performance status o tři kategorie, u ostatních byl status zachován, ani u jednoho nemocného v časném horizontu nebyla zaregistrována jaterní progrese onemocnění. Závěr: První zkušenosti s TARE ukazují i u nemocných s neresekabilním jaterním postižením dobrou toleranci léčby a slibné výsledky terapie., Aim: To evaluate an early experience with transarterial radioembolisation of liver tumors with microspheres with 90-yttrium. Method: During 6 monnths, we performed 6 months TARE with the application of glass-microspheres TheraSphere®. In 4 patients.colorectal carcinoma metastases were treated, in 2 hepatocellular carcinoma respectivelly In patients, the peri- and post-procedural disease development was surveyed according complications, WHO performance status an early effect of therapy. Results: No severe complication was noted, during 6 weeks was noted only one extreme improvement of WHO performance status with decrease by 3 grades, in rest of patients the performance status was unchanged. No progression in liver was noted within 6 weeks. Conclusion: Our early experience with TARE showed high safety, therapy is well tolerated and the therapy results are promising., Jiří Ferda, Petr Duras, Vladislav Třeška, Tomáš Skalický, František Šlauf, Alexander Malán, Jaroslav Havel, Jindřich Fínek, and Literatura
Trombóza ledvinné žíly je vzácné onemocnění novorozeneckého věku. Jeho incidence je nízká, pohybuje se na úrovni 2,2 na 100 000 živě narozených dětí. Následky onemocnění jsou však časté a dosti závažné. Vzhledem k nízkému výskytu onemocnění nemáme v dostupné literatuře jednoznačná a jednotná terapeutická doporučení opírající se o randomizované studie. V tomto článku autoři předkládají svojí zkušenost s invazivní léčbou tohoto onemocnění u čtyřdenního novorozence., Renal vein thrombosis is a rare condition of neonatal age. Its incidence is low, 2.2 per 100,000 live births. The consequences of the disease are common and quite serious. Due to the low incidence of the disease, there are no clear and consistent therapeutic recommendations in literature based on randomized trials. In this article, the authors present their experience with invasive treatment of this disease in the four-day newborn., Polovinčák M, Černý M, Bláhová K, Roček M., and Literatura
Incidence karcinomu prostaty se celosvětově zvyšuje. I přes rozvoj postupů, jako jsou aktivní sledování a zlepšování metod neoperačních, zůstává radikální prostatektomie důležitou formou léčby karcinomu prostaty, která má u většiny mužů kurativní efekt. V posledních letech je stále více používána také samostatně nebo jako součást multimodální léčby u pacientů s vysoce rizikovým karcinomem prostaty. V průběhu let jejího používání došlo k výraznému posunu v chápání neuroanatomie prostaty, což umožnilo zvýšení bezpečnosti, snížení perioperační morbidity a zlepšení funkčních výsledků. Článek pojednává především o výsledcích onkologických. Nicméně ty nelze od funkčních zcela oddělit, protože kvalita života po radikální prostatektomii je velmi důležitým aspektem, který je součástí racionální diskuze s pacienty s diagnostikovaným karcinomem prostaty. I přes dostupnost techniky otevřené nebo minimálně invazivní radikální prostatektomie nesmíme zapomenout, že nejdůležitější proměnnou k dosažení optimálních onkologických a funkčních výsledků je osoba zkušeného operatéra, který přihlíží k individuálním parametrům onemocnění a preferencím pacienta., Incidence of prostate cancer increases worldwide. Despite progress in techniques such as active surveillance and improvement in non-surgical methods, the radical prostatectomy remains an important form of prostate cancer management alone or as apart of multimodal therapy in patients with high risk prostate cancer. During years of its use, there was a significant change in the understanding of prostate neuroanatomy, which improved its safety, decreased perioperative morbidity and improved functional results. The article refers mainly to oncological results. Despite we cannot completely devide them from the functional ones, because quality of life following radical prostatectomy is an important aspect, which is unseparable part of discussion with patients with diagnosed prostate cancer. Regardless the availability of open and minimally invasive radical prostatectomy we should not forget that an experience surgeon taking into consideration individal cancer factors and patient’s preferences remains the most important variable in order to achieve optimal results., Petr Macek, and Literatura