CURRENT THERAPIES IN LIVER SECUNDARITIES OF COLORECTAL CARCINOMA IN CZECH REPUBLIC

M. RYSKA, J. PANTOFLICEK, L. LANGER, M. SUCHY, J. PUDIL

Surgery department, 2.Medical School, Charles University and Central Military Hospital, Prague, CZECH REPUBLIC

Introduction: There is the main position of surgery in the cure of colorectal liver metastases carcinoma (LMCRC). 912 – 1.824 patients with CRC present advanced form of disease with synchronous or metachronous metastases who are indicated to liver surgery in Czech Republic every year. Except this patient’s group with CRC in stages IV was operated in last years (prevalence) and we can accept the development of LMCRC.

Aims & Methods: To analyze patients with liver metastases of CRLM who were indicated to liver surgery in the period of 2000 – 2008 on the base of questionnaire and to evaluate 5y survival after R0 resection. These data to compare with data of National oncologic register and National reference center. of Czech Republic. Another aim is to present current possibilities of the treatment in multidisciplinary approach.

Results: 354 liver surgical procedures including 268 liver resections (75 %) were done in 2000 in Czech Republic. Totally 426 patients were cured in surgery departments in that year. 403 liver procedures including 123 major resection were done in 2008, totally 494 patients were cured in surgery departments. 5 years survival wavers between 34 – 49 % in complex oncologic centers. Comparing the number of liver resections and the expectation of number of patients with LMCRC indicating to liver resection there is only 25 – 33 % patients giving the chance to cure.

Conclusion: R0 resection currently presents the method of therapeutic choice with the improvement of patient survival, in Czech Republic wavers between 25 - 33 %. There is no significant difference in the surgical cure of patients with colorectal liver metastases in Czech Republic between last decades. Total number of patients cured by liver surgery is not sufficient.

ENDOSCOPIC DIAGNOSIS OF LARGE INTESTINE AND GASTRIC FISTULAS

B.I. SADIGOV, KH.G. HUSEYNOVA, A.M. ALIYEVA, H.N. HASANOVA

Scientific Center of Surgery named after acad. M.A. Topchubashov, Baku,AZERBAIJAN

Large intestine and gastric fistulas are one of the rarely encountered pathologies. Often the pathology is determined radiographically. But in our practice in two cases such fistulas were found out during gastroscopy.

In the first case the diagnosis of fistula was formed by passing to the descending part of the colon through the hole detected in the gastric fundus.

In the second case, an exophytic formation was found out in the small curvature of the antral part, there was brownish-yellowish content on its top. Soon after washing of the content there appeared new secretion of content. The structure and smell of the content made us to form the diagnosis of gastric-large intestine fistula.

In both of the patients no obstruction was detected during roentgenoscopy of the abdominal cavity. The patients underwent surgical operation. During surgical intervention the diagnosis of gastric-large intestine fistula was confirmed.

For the last decade, in our practice two such cases of gastric-large intestine fistulas were found out during endoscopic examination. In patients in which the obstruction was not confirmed endoscopically, the diagnosis of large-intestine – gastric fistula can be formed based on the signs (smell and color) of passage of large intestine content into stomach, as well as by either passage of endoscope into large intestine through the fistula, or detection of the region of secretion of content on the gastric wall.

LASIDOFILL W M - IN THE TREATMENT OF INTESTINAL DYSBIOSIS

T.G.SALIMOV, E.G.ISAYEVA, Z.M.SHAMKHALOV, L.S. ASLANOVA

Scientific Center of Surgery named after acad. M.A. Topchubashov, Baku,AZERBAIJAN

Objective of the investigation: to study clinical effectiveness of LASIDOFILL WM in the therapy of intestinal diseases complicated with dysbiosis (disbacteriosis).

Materials and methods: 56 patients with different variants of irritated bowel syndrome were observed - in the clinical picture of 32 patients there was diarrhea, pain down the bowel, bloating (I group), 24 patients had constipations (II group). The control group consisted of 16 patients of the 1^st group and 12 patients of the 2^nd group, which were not administered LASIDOFILL WM.

Results: In all the surveyed there were detected various degrees of intestinal dysbiosis. The basic treatment of a half of the surveyed (18 patients of the 1^st group and 12 patients of the 2^nd group) was added LASIDOFILL WM, 2 capsules a day, two times within 20 days. Repeated examination was conducted a 1 month, and revealed improvement in the state of patients – bloating and pains down the bowel significantly decreased, 18 of 15 patients who took the drug had normalized stool. In the 2^nd group disappearance of constipation and melo occurred in 8 12 patients and only in 5 patients of the control group. It should be noted both in the 1^st and in the 2^nd group of patients that took LASIDOFILL WM, there was detected significant increase of bifidobacteria and lactobacilli, as well as mixing of enterococci. In the control group of patients, changes in the values ​​of dysbiosis were not observed.

Conclusions: The involvement of patients with bowel disease, in this case with irritated bowel syndrome, in complex therapy with probiotics - LASIDOFILL WM - can significantly increase the effectiveness of treatment in these patients, as well as improve picture of the intestinal flora.

LARGE PICTURE FRAME PHOTOROENTGENOGRAPHY UNDER THE TELEVISION CONTROL AS A METHOD OF DIAGNOSTICS IN THE STUDY OF PATIENTS WITH COLONIC PATHOLOGIES

T.G.SALIMOV, I.A. RUSTAMLI, R.T. SALIMOVA, N.S.MAGALOVA

Scientific Center of Surgery named after acad. M.A. Topchubashov, Baku,AZERBAIJAN

To determine capacities of large picture frame photoroentgenography (LPFP) in the study of colon, we carried out roentgenofluorographic study of 2000 patients with various diseases of the gastro intestinal tract. This group included daily flow of patients who were at hospital, ambulatory and preventive examination for certain complaints of the colon.

The study was conducted in the domestic roentgenodiagnostic complex RUM-20M equipped with URI and “Grant-MT₂” camera. All studies were performed by retrograde staining in different modifications.

At the first stage the task was to compare the results of conventional X-ray investigations and simultaneously carried out LPFP on 100 patients. Of them, 89 patients were conducted fiberoptic colonoscopy on the 3^rd day. Further primary examination was carried out only by the LPFP with further purposeful examination of the patients with colonic changes.

Conducted clinical roentgenofluorographic, endoscopic and surgical comparisons allow to say that television LPFP is a valuable diagnostic method in the study of the colon. According to the resolution and picture quality, this method does not only approaches to the normal x-ray examination, but in many aspects outstrips it.

As a highly-efficient and informative method, LPFP under television control can be widely used at the initial examination of large population groups.

TIMELY DIAGNOSTICS OF TUMOR DISEASES OF COLON

R.T.SALIMOVA, N.S.MAGALOVA, I.N.GASIMOVA, SH.S. MAMEDOVA

Scientific Center of Surgery named after acad. M.A. Topchubashov, Baku,AZERBAIJAN

The aim of the study: in recent years there has been a significant increase in chronic diseases of colon, it necessitates the relevance of timely diagnosis and treatment of this disease.

Methods and materials: 2500 outpatients and 1800 case histories were studied for the purpose of detailed analysis of the spread of colonic diseases according to appealability data. Methods of diagnosis - clinical, laboratory, radiographic, ultrasonic, endoscopic, as well as in vivo morphological study of colonic mucosa.

Results: according to preliminary data, 0.3% of the detected patients had malignant tumors of the colon, 7.9% - polyposises of colorectal cancer. More frequently polyposises were located in rectum and sigmoid colon - 60.1%, in descending - 16.2%, and transverse colon - 16.6%, in the cecum and ascending colon - 7.1%.

Conclusions: thus the main place in the prevention of tumor diseases of the colon is given to timely dynamic examination. Conducted studies allow to offer the following patter of prophylactic medical examination: 1) The necessity of periodic prophylactic examination of the population. 2) Sending of the identified patients for examination and further observation. 3) The inclusion of a patients with single and multiple polyps, ulcerative colitis, Crohn's disease, as well as patients who underwent operations for cancer of the colon, to a separate high-risk group of patients,

Date: 2014-12-28; view: 1002