Possibility of predicting the results of the surgical treatment of cancer of the thoracic portion of the esophagus

Within a 18-year period in the clinic 273 patients were subjected to radical surgery for cancer of the thoracic esophagus. 206 patients were discharged from the clinic. The survival rate for 5 years and longer was noted in 58 patients. The data and results of the treatment depending on a sum of clinical signs were treated mathematically. It is noted that the patients' survival is influenced by such factors as sex, the stage of the disease, the morphological structure of tumor, the character of course, tumor size and spread, the type of surgical intervention. An advanced course, changes in blood presence of metastases do not seem to be the reason for cancellation of the operation.     

Esophago-intestinal bypass anastomoses for inoperable cancer of the proximal portion of the stomach and abdominal portion of the esophagus]

To lessen a damage and to eliminate the reflux-esophagitis in bypass anastomoses, constructed for inoperable cancer of the stomach and epicardia, it is suggested to create a side-to side enteroesophageal anastomosis by means of an apparatus of the authors' design. The anastomosis is constructed above the tumor via a transperitoneal approach. To prevent regurgitation of the intestinal juice in the esophagus an invagination-valve enteroanastomosis elaborated at the clinic was employed. The immediate results are good.     

The importance of esophagojejunogastroplasty in the surgical treatment of cancer of the proximal stomach]

The study discusses the efficacy of a new method of esophagojejunogastroplasty during subtotal and maximum subtotal proximal resections of the stomach. The surgical technique is described in detail. Seventeen patients aged 47-70 years were operated on for stage II-III cancer of the cardia, subcardia and fundus of the stomach. Extensive sagittal diaphragmotomy was performed in 15 cases whereas two patients were operated on through the combined abdomino-thoracic access. Pancreonecrosis and unrecognized microperforation of the gallbladder accounted for two fatalities whereas the other 15 patients were discharged from the clinic in good condition. They were followed for 1-30 months and, within this period, no postresection disorders such as reflux-esophagitis, cicatricial stricture of esophageal anastomosis or dumping syndrome were observed.     

The use of extraperitoneal colorectal anastomoses in complicated cancer of the rectum and sigmoid]

The paper deals with the issue of primary restoration of intestinal continuity in complicated colorectal cancer using extraperitoneal colorectal anastomoses. The study is based on the experience of treatment of 35 cases of complicated colorectal cancer. It was concluded that, to assure primary restoration of intestinal continuity, the risk of surgery must be weighed with respect to extent of disease, and adequate anesthesiologic and postoperative intensive care is required. The procedure should be performed at a specialized surgical institution.     

Comparative evaluation of surgical and combined treatment of cancer of the proximal region of the stomach

The paper deals with an analysis of the results of treatment of 351 cases of radical surgery for cancer of the proximal part of the stomach (surgery-303, surgery + preoperative large-fractionated radiation-48). It was found that radiation was not followed by increased blood loss during operation nor did it interfere with application of any surgical procedure. Concentrated irradiation did not involve an increment in postoperative lethality and complication rates. Five-year survival rates were 37.4 +/- 8.0 in cases of combined treatment and 20.4 +/- 2.7% in those of surgery. The improvement in survival rates recorded in cases of combined treatment was largely due to a decreased incidence of local recurrences.