In the  article  we  describe  the  new  method for  bone  tissue  defect grafting in the metaepiphiseal zone  of   long bones  with allogenous grafts fixed in the  form  of the  letter “T”. Application of the method provides the congruency retention to prevent the deformity of articular surface during surgical treatment of the patients with benign  bone tumors.

The lymph circulatory bed of the axillary area,  peripheral lymph structure and its flow properties of 78 breast cancer patients were studied. Such factors as total protein, albumin, globulin, fibrinogen, bilirubin, cholesterol, urea, creatinine, glucose,  sodium and potassium were defined to estimate the lymph structure influence on its viscosity. The research proved that  during  breast cancer  both  the  quantity of  sentinel  afferent lymph  nodes  and  their diameter increases. Neo-lymphatic angiogenesis is a prognosis factor for  IIIB breast cancer stage.

Experimental  investigation showed that  through short-term after splenectomy the death rate  of  white  rats  was  16,25%.  Morphological investigation indicates  that  animals have  postinfectious  hepatitis  and   the   first  stage of  pulmonary  tissue   inflammation. Mesenteric lymphatic nodes  as the organs of hemoand immune  cytopoiesis  appear to be under  condition of pronounced functional tension in response to inflammation.

The  results  of  treatment of  36  reoperated patients suffering from   alveolar  liver disease  are analyzed  in the article. The patients were operated according to the know-how offered by one of the work writers.  Surgery results and late fate are considered. Palliative liver resections during  reoperations with cryodestruction of the  parasitic  tissue  part  make palliative surgery relatively radical.

Application of the algorithm perioperative rehabilitation in acute  enteric disease in children  with  ksantinol-nikotinate test, where, thanks to the  introduction of  criteria  for  assessing  individual response of autonomic nervous  response of the  patient, as well as the correction of vascular therapy, it was passeble to more accurately affect the early recovery of peristalsis,  and in a timely manner be prevented formation of adhesions in the abdominal cavity, and the ways to manage contact electro-bowel in the postoperative period have developed, improve  outcomes, promote faster recovery  of  intestinal  motility and  reduce length  of  stay  in hospital. Intraoperative physiotherapy denervation diadynamic currents of sympathetic nerve fibers, going along the unpaired visceral branches of the abdominal aorta  can be clearly defined border  between viable and  pathologically altered  bowel  segment  during its necrosis,  as well as to avoid undue  over-resection of the colon healthy.

A new  minimally  invasive  method for  treating pathogenic complex  regional  pain syndrome  is  proposed,  including   cryological   methods  and   medication adjustments. Implementation method showed high efficiency at the  expense of peripheral blood  flow restoration and compensation of vegetative structure.

The method of surgical treatment of pleomorph adenomas of parotid salivary gland with  use  skin-muscular autotransplantante  Is developed. The given  method is the  most comprehensible as reduces risk of occurrence of relapses, Lucy Frej’s syndrome, and  also promotes replacement of forming defect of fabrics, that  provides  good  therapeutic and cosmetic  effect.

In the  article  the  results  of  2650  esophagogastroduodenoscopies of  the  the  high resolution with  NBI (narrow band  imaging) application technology are  presented. In the course  of  research the  author’s  program of  the  automated allocation  of  a pathology of the  esophagus is applied  on  the  basis  of  colour  segmentation of  images.  The authentic improving of NBI endoscopy in diagnosis of the early neoplasies at esophagus is shown. The algorithm of the narrowband endoscopy examination of esophagus, stomach, duodenum with application the automated allocation  of a pathology is also developed.

The results  of the  search  of possible  ways to prevent early thrombotic complications after coronary bypass surgery (CABG) procedure in combination with coronary endarterectomy (CE). The control group included 76 patients retrospectively underwent CABG in combination with the EC, made by traditional methods. Study group comprised 126 patients who had CEA performed after treatment the deendotelisation surface of the coronary  arteries heparin. A comparative clinical evaluation of the  incidence  of perioperative complications in these  two groups  of patients. The advantage of intracoronary administration of heparin after CEA, which significantly  reduces the risk of early thrombosis of endarterectomy zone, which lead to severe  complications perioperative period.  Any hemorrhagic complications associated with intravascular administration of heparin  were observed.

Drug treatment of disseminated non small cell lung cancer  (NSCLC) is an actual  issue today.  Both clinical and economic efficacy analysis is needed for optimal therapy selection. We performed economic efficacy assessment of  gefitinib (G.)  therapy in patients with non operable NSCLC who hase no EGFR mutation using Markov model based  on results of clinical studies  conducted in N.N. Petrov Research Institute of Oncology.

G. increases  overall survival of patients with NSCLC with EGFR mutation by 1,05 year. Cost/efficacy coefficient for  G. in patients with  EGFR mutation is 934  800  rub  per  1 acquired year  of  life. Therapy  with  G just for  patients with  genetically  proven  mutation is dominating strategy when  compared to  therapy for  all NSCLC patients  irrespectively to  mutation status (saving  211600 – 251800  rub per  1  patient taking  into  account equal clinical efficacy). Therapy  with  G. is economically  justifying  strategy when  compared to chemotherapy (additional costs coefficient 960700 – 1010000 rub per 1 gained year of life). Thus, EGFR mutation testing with subsequent G. therapy in non  operable NSCLC patients not only prolongs patient’s life but also has  acceptable level of medical expenses.

Microbiological investigations were conducted vaginal cervix and vulva in 150 women with cancer of the vulva, of which 34 were the main group, 116-control. In order to prevent purulent-septic complications after surgery ectomy  of the vulva women “at risk” a method for  using  medicinal  herbs  that  have  anti-inflammatory, antibacterial, wound-healing effect.  Application  of this technique allowed  to reduce   postoperative complications of the inflammatory nature of 2.6 times.

Many  researches made  prove  that  the  improvement of  colorectal  cancer  treatment results has been recently related  with changing in surgery techniques. The goal of the work is to determine peculiarities  of lymphogenic colorectal  cancer  metastasis of patients with I-II cancer  stages living on the territory  of the Russian Federation. These peculiarities  were determined on the  basis of the  study  of lymph nodes  got  from  removed specimens after radical resection with completion lymph-node dissection.

This research deals with colorectal  cancer  patients without distant metastasis treated gradually. These patients were subjected to D3 lymph-node dissection radical surgery.

The average number of  lymph-nodes got  from  the  colorectal  cancer  specimen of patient of the  Russian Federation makes  39. The average metastasis index of the  studied patients group is not big (0,13) and proves a great  volume of lymph-node dissection. It also may have fundamental prognostic value.

Work objective-determination of pathological fracture frequency caused  by malignant tumors in locomotor system, indications and possible treatment study. The analysis of treatment of 44 patients was made. It is shown, that  the frequency of this kind of pathology is 0.4%. 70.5%  of patients were female, 29.5%male. The average age of patients was 53 years. The primary tumor  wasn’t found in 34%  of cases.  The most frequent segment of  metastasis spread was  femoral bone84.4%.  Operative therapy included exsection of the tumor followed by endoprosthesis replacement (15 cases), defect replacement with artificial materials (6), segment shortening (9), fracture stabilization only (11), biopsy (3).  Pathologic  fractures occurred due to breast cancer  metastasis in 16 cases (36,3%). 19 (43,2%) people died in a year after the surgery. 14 (31,8%) during the second year. 15.9% (7 people) lived for thee years and 4 patients (9.1%) lived for more than 5 years after the surgery. All operated  patients were   socially  adapted, fully  self-maintaining,  had   no  pain syndrome caused  by operated extremity.

Due to this experience of pathologic fractures treatment we recommend active surgical approach. The surgery doesn’t affect the disease outcome, but makes patients more socially adopted for a considerable period of time.

The results  of endoscopic diode   bursoomentoskopy, “drug” abdominisation of pancreas  in acute  pancreatitis in 63 patients out  of 123 patients were  studied. A reduction in postoperative mortality, septic  complications, shorter hospitalizations. Sanatorium rehabilitation in the early postoperative period contributes to the restoration of cytokine status, regression of dyspeptic disorders.

The  article  describes   a  clinical  case  of  successful treatment  of  the   patient  with synchronous multiple  primary  esophageal cancer  and  cancer  of  the  left  kidney.  Singlestage extended 3-field lymph node Lewis operation and left nephrectomy were performed in  Thoracic  and  Abdominal  Surgery  Department of  the  Volgograd   Regional  oncologic dispensary clinic. The article stresses the  possibility of a single-stage combined surgery  of the esophagus and kidney.

The  aim  of  the   study   is  to  individualize  prevention of  thrombosis in  abdominal surgery,  using  assessment of  hemostasis functional state. The key  sign  of  hemostasis functional state is the  character of  the  blood  clot  depends on  thromboelastography or electrocoagulography. Medication for prevention of thrombosis may be started over 6 to 8 hours  after the end of surgery  in hemorrhagic variant  of hemostasis subcompensation. In this case anticoagulant of choice is unfractionated heparin given in continuous infusion 100-500  units/hour (1-5 units/kg/hour). As blood  clot is stabilized, anticoagulation changeover to low molecular weight heparin, the drug of choice is the dalteparin. In those  patients who receive prolonged antithrombotic therapy, length  of preoperative bridge therapy may vary, according the structural features of formed clot (based on the electrocoagulography data obtained directly prior to routine anticoagulant injection). In the presence of dense clot (i.e., in thrombotic variant of haemostasis subcompensation) last injection of low molecular weight  heparin  may be done in 12 hours before surgery without risk of bleeding.

The article presents the possibilities of optimizing nutritive supports in the postoperative period  of  patients after the  expanded combined operations in urology  by assessing of biochemical  indicators of blood and microcirculation with laser Doppler flowmetry.

This lecture  is devoted to  problems of  usage   of  evidence-based medicine  rules  in oncologic researches. The basic criteria of evidential standards in oncology were presented. Authors pointed out the general  recommendations for planning, realization  and analyze of results of researches.