The article is a review of the literature on new systems for assessing the severity and predicting the outcomes of acute pancreatitis. The authors cite current literature data on the effectiveness of various new scales, as well as information on developed systems that undergo a clinical information test in determining the severity of acute pancreatitis.
The article presents modern views on the tactics and methods of surgical treatment for gastric cancer complicated by perforation and the authors own experience in the treatment of this pathology.
The aim of this study was to evaluate the effect of the chemoradiation therapy on the incidence of postoperative complications and mortality rate in patients with locally advanced tumors of the thoracic esophagus.The study included men and women over 18 with histologically verified squamous cell carcinoma of the thoracic esophagus with TNM stage cT3-4aN0-3M0. Patients were divided into two groups: patients in a main group (n=26) received a complex treatment, patients in a second group (n=30) undergoing only surgical treatment.The first stage of treatment was performed for all 26 patients and included 2 courses of preoperative chemotherapy, followed by a chemoradiation therapy with a 44–46 Gy with weekly injections of chemotherapy. Surgical procedure (R0) was performed for 24 patients (92.3 %) in the main group and for 26 (86.6 %) in a second group.Therapeutic complications were developed in 17 (65 %) patients in a first group, while in a second group this rate was in 18 (60 %) patients from 30. The incidence of surgical complications was slightly higher in a group of patients received a complex treatment –7 (26.92 %) patients. In the surgical group such complications was noted in 6 (20 %) patients. The only death in an early postoperative period was in 1 (3.84 %) patient from the main group. The cause was sepsis and the development of multiple organic failure. There were no lethal outcomes in a surgical group.Estimating the incidence of complications, it should be noted that the use of chemoradiation therapy in the neoadjuvant regimen does not significantly affect the course of the postoperative period. The mortality rate was slightly higher in in the group of patients received complex treatment. At the same time, improvement of the ostoperative period and a reduction of mortality rate in group ofpatients undergoing complex treatment is possible due to optimization of preoperative preparation, postoperative management and competent selection of patients.
The aim of the study: the aim of this study was to compare the immediate and long-term results of treatment of patients with non-small cell lung cancer with involvement of tracheal bifurcation, which were underwent pneumonectomy with resection of the tracheal bifurcation or radical chemo-radiation therapy (CRT). Materials and methods. We conducted a retrospective non-randomized clinical study with following groups of patients: 1) 65 patients who underwent pneumonectomy with resection of the tracheal bifurcation; 2) 30 patients to whom CRT was performed. Evaluation of the effectiveness of immediate and long-term results was carried out by statistical processing using the Statistic 6.0 program. A case-control analysis was performed to compare two groups. The time of the operation, intra- and postoperative complications was estimated depending on the type of resection of the tracheal bifurcation. Results. The complication rate was 46.1% in the surgical group. In the CRT group complications developed in 13 (43.3%) patients. The overall 1-, 3-, 5-year survival rate in the group of patients with surgical treatment was 56.92, 31.7 and 26.1%, respectively. The median overall survival was 14.5 months. Indicators of 1-, 3-, and 5-year survival in the group of patients who underwent radical CRT were 31.6, 24.4, 16.2%.
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