Ebstein's anomaly--is a complex disease of the heart, the main components of which are dysplasia and tricuspid valve malposition, causing hemodynamical disorders. Principal method of correction of this anomaly is surgical one. There are many surgical methods of correction of the anomaly proposed: tricuspid valve prosthesis, plastic operation, palliative methods. Indications for surgical treatment of Ebstein's anomaly is cyanosis, the blood flow insufficiency, severe disorders of the heart rate.
There were analyzed an autopsy protocols of 117 patients with oncological disease, in whom during performance of pathomorphological investigation an acute erosive-ulcerative affection (AEUA) of digestive channel (DCH) was revealed, of them in 69 patients palliative and/or symptomatic treatment for extended forms of cancer was conducted. Structure of principal complications as well as their significance in pathogenesis, localization of affection, influence of different methods of palliative treatment on AEUA DCH occurrence. The data obtained must be taken in account during planning of palliative therapy in such patients.
As many as 36 patients with III-IV-stage ovarian carcinoma exposed to a symptomatic treatment were examined. The analysis of the studies made showed that the use of antioxidants and enterosorption combined in treatment of the above patients results in lessening of endogenous intoxication, provides immunoprotection, and improves the process of lipid peroxidation.
The hepatic polycystosis (HPC) signs are studied up and the disease course stages are formulated. Transcutaneous puncture (TCP) under ultrasonographic investigation guidance with subsequent residual cavity sclerotherapy was applied in 53 patients as a method of palliative treatment of the disease. Indications for the method application, the procedure technique and tactics of the patients management were elaborated. The method of a staged treatment using periodical TCP conduction under ultrasonographic guidance was clinically introduced. Its efficacy was proved as a self-supporting method of palliative treatment of the disease in different stages. The best results were obtained after operative treatment for significant HPC in a compensation stage (the first stage--open or laparoscopic fenestration) with subsequent periodical TCP conduction (second stage - supportive treatment). Such combined tactics we consider the most effective method of HPC palliative treatment.
The cancer recti local recurrence is nonresectable in 50-70% of observations, it is treated using irradiation or chemo-irradiation therapy, which improve the patients quality of life and guarantee the 12-13 mo survival mediana. In subsequent progressing disease cryosurgical method of treatment is applied. The results of it application in 22 patients are presented. The survival mediana had constituted 12 mo, the period of time before subsequent progression of the disease--6 mo. The patients quality of life improvement due to the bleeding stoppage, the tumor destruction, the pain elimination achievement was proved by the ECOG scale changes.
Results were analyzed of diagnosis and treatment of 314 patients with malignant tumours of the liver. Of these, 36 had primary tumours of the liver (PTL), 278 were presenting with metastatic tumours (MTL). In addition, an analysis was carried out in 1236 oncological patients in order that the frequency of metastasizing of tumours into the liver might be determined together with the specific weight of metastases of different locations. The rates of tumours metastasizing to the liver were found out to be 45.7, 33.3, 30.1 percent with the gallbladder, major duodenal papilla, stomach respectively. Ultrasonography is an effective diagnostic tool for malignant tumours of the liver, being of great informative value (sensitivity in PTL--97.2%, MTL--75.7%). Eight (22.2%) patients with PTL and seventeen (6.1%) ones with MTL underwent surgical treatment. The only radical modality of treatment is still anatomical resection of the liver. Investigations are under way designed to study efficiency of thermo-(cryo) destruction of solitary and single liver metastases if surgical resection is beyond the bounds of possibility.