Трансанальні Ендоскопічні Операції При Пухлинах Прямої Кишки

Vorotyntseva

Degtiarenko

et al. 2022

J Educ Health Sport

Introduction. Rectal cancer is the most widespread form of cancer in different countries of the world, without regard to gender, and reaches 8–9% of the total number of all cancers. It is necessary to further improve and study modern methods of both surgical and combined integrated approach to the treatment of patients with rectal cancer. Lymphatic cancer spread is one of the most important causes of local recurrence of rectal cancer and an unfavorable prognostic. Aim of the study: to study and improve the results of treatment of patients with rectal cancer during transanal endoscopic microsurgery with staining “sentinel” lymph nodes. Materials and methods. In the period from 2009 to 2021, 92 patients with rectal cancer were operated on at the Odessa Regional Clinical Hospital using transanal endoscopic resections. All 92 patients were divided into 2 groups. In group I, 45 patients were diagnosed stage I rectal cancer (T1-2N0M0. In group II, 47 patients were diagnosed stage II rectal cancer (T3N0M0) before surgery. In group I, a standard TEM procedure was performed. In group II, taking into account the presence of stage II RC in patients, and the high possibility of recurrence and metastasis, after performing local excision of tumors using the TEM method, we improved this method. Results. The average time of the hospital stay was (3.4±1.7) days (from 2 to 6 days). The lower edge of the tumor was at the average height of (9.5±4.2) cm from the anal canal (from 5 to 18 cm), the average size of the tumor was from (2.8±1.7) cm (from 1.5 to 4 cm). The average follow-up period ranged from 12 to 60 months. Recurrence of rectal cancer was found in 6 (6.5%) patients, group I. Conclusions. One of the most important prognostic factors of the development of the RC local recurrence is the regional lymph nodes involvement. Identification and target study of the “sentinel” LN in patients with RC most likely make it possible to assess the stage of the disease and apply an adequate scheme of the complex treatment.

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confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

See 3 more Smart Citations

Results of transanal endoscopic resections in rectal cancer

Vorotyntseva

Degtiarenko

et al. 2022

J Educ Health Sport

Complications of transanal endoscopic resection in cancer recti

Vorotyntseva

Degtyarenko

et al. 2022

Objective. To study іntra- and postoperative complications in transanal endoscopic resection in patients, suffering cancer recti and to reduce this quantity. Materials and methods. Through the period 2009 - 2021 yrs on the base of Odessa Regional Clinical Hospital 184 patients, suffering cancer recti, were operated, using transanal endoscopic resection. The patients’ age was from 42 to 86 yrs old. The patients were distributed into two groups. In 90 patients of the first group the cancer recti diagnosis of stage I (T1-2N0M0) was established. In 94 patients of the second group the diagnosis of cancer recti stage ІІ (T3N0M0) was established. Results. Purulent-septic, thromboembolic and urological complications were absent in all 184 patients, as well as severe intraoperative complications and mortality. The average stationary stay of the patients have constitited (3.4 ± 1.7) days (from 2 to 6 days). The average lower edge of the tumour was situated at a distance (9.5 ± 4.2) cm (from 5 to 16 cm) from the anal channell, and the average dimensions of tumour - (2.8 ± 1.7) cm (from 1.5 to 4 cm). While studying of the histological investigations results there was noted, that in all the patients the tumour was excised in the healthy tissues borders in accordance to oncological technique. Period of follow-up have constituted from 12 to 60 mo. Cancer recti recurrence was revealed in 12 (13.3%) patients of the first group. Cancer recurrence have had occur in patients, who have rejected from conduction of chemo- and radiotherapy. The patients with recurrences were reoperated, using classic low anterior rectal resection with total mesorectumectomy. Conclusion. While conduction of preoperative neoadjuvant chemo- and radiotherapy the tumour dimensions are reduced significantly, as well as quantity of іntra- and postoperative complications in performance of transanal endoscopic resection. The disease prognosis for cancer recti depends directly on presence of metastases in regional «sentinel» lymphatic nodes.

Efficiency of detection of lymph nodes in breast cancer

2022

RHW

Self Cite

The objective: improve the quality of sentinel lymph nodes detection in patients with malignant neoplasms of the mammary glands.Materials and methods. At the period from 2009 to 2016, 400 patients with T1-T3N0M0 breast cancer were operated in Odessa Regional Clinical Hospital, using two dyes Patent Blue and ICG.The patients who had mastectomy with sentinel lymph node biopsy were diagnosed T2-T3N0M0 breast cancer more frequently. The exceptions were T3-T4 tumors, tumor diameter > 5 cm, invasion into the skin and chest wall, palpable axillary lymph nodes, 3 or more affected lymph nodes during sentinel lymph node biopsy.100 patients in the first group had sentinel lymph node biopsy. Lymph node staining was performed using Patent Blue dye.In the patients in the second group, sentinel lymph node biopsy was performed using Patent Blue dye and another fluorescent ICG dye, which was injected intravenously into the arm on the affected side of the mammary gland, along the outflow from the arm to the mammary gland.Results. The total five-year survival after axillary lymph node dissection and sentinel lymph node biopsy was 91 % and 92 %, respectively. The five-year recurrence-free survival after axillary lymph node dissection was approximately 82.2 %, and after the sentinel lymph node biopsy – 83.9 %. Regional recurrence in the sentinel lymph nodes on the affected side was determined only in 1.1 %. The time of observation of the patients was from 60 to 180 months. The recurrence was registered in 0.2 % patients as isolated metastases into the axillary lymph nodes. Not a single case of lymphostasis of the upper limbs from the side of the biopsy was registered. Conclusions. The simplicity of fluorescent dyes usage makes it possible to implement this method in the everyday work of oncologists-surgeons, the advantages of which are the absence of radiation exposure and quick intraoperative detection of lymph nodes.