卷 19, 编号 3 (2014)

Pancreatic tumours are rare at a young age. For malignancies affecting the head of the pancreas the optimal surgical treatment is pancreaticoduodenectomy (PD). Due to the rare experience of pancreaticoduodenectomy in children, most of the information reported in the literature has been provided in the form of isolated case reports. Material and methods. We performed new type of reconstruction after PD in children. Our reconstructive method aims at a complete separation of passage of gastric contents, bile and pancreatic juice. Thus we prevent any types of possible refluxes and related complications (pancreatic leakage, cholangitis, gastric ulceration). Results. The method has been effectively performed is two patients: 5 year girl, 1 year and 10 month boy with a solid pseudopapillary tumour and malignant teratoma in the head of the pancreas. In postoperative period we did not registered any sights of pancreatic fistula. Patients were discharge on days 9 and 11 respectively. Conclusion. In view of the absence of the data about later physiological outcomes after PD in children we propose our method of pancreaticobiliary reconstruction as safe and physiologically appropriable. PD for children should be performed in institutions where experienced hepato-pancreato-biliary surgeons using modern surgical technologies perform a high volume of cases.

The results of different methods of radical and palliative treatment in 26 patients with intrathoracic localization of nehromafinnoy paraganglioma, 24 tumors were located in the front, one - in the posterior mediastinum, and one - in the pericardial cavity. Malignant paragangioma was confirmed morphologically in 25 observed patients. Surgical intervention is undertaken in 17 patients, of whom 12 had surgery as an integral stage of complex or combined treatment, in 3 - self-treatment and 2 - exeprimental thoracotomy. Combined treatment including preoperative radiotherapy (RT) followed by surgery was undertaken by 6 patients. Comprehensive treatment including neoadjuvant chemotherapy (CT) was received by 6 patients and in combination with radiotherapy by 3 patients. In 5 of these patients the technique of regional intra-arterial administration of anticancer chemotherapy was used. Patients with the presence of distant metastases performed palliative treatment: 4 - LT, 5 - HT. Conclusion: for the radical treatment of malignant paraganglioma method of choice should be a comprehensive treatment with neoadjuvant intra-arterial regional chemotherapy.

Last ESMO and NCCN recommendations for the treatment of metastatic colorectal cancer include the use of a triple-component chemotherapy. A study of two modes with the inclusion of irinotecan dose of 120 mg/m2 every 2 weeks, oxaliplatin 85 mg/m2 every 2 weeks, the dose of capecitabine 1600 mg/m2/day in 1-7 days with a 1- week break or 1600 mg/m 2 / day in days 1-14 with a 2-week break. Both modes showed satisfactory tolerance without significant gastrointestinal and hematological toxicity. Plan to further study the development of ternary diagrams for the application of the algorithm implementation in a wide oncological practice.

Aim of this study is to formulate an algorithm based on neural network modelling to calculate the index of individual risk of breast cancer (BC). We examined 1440 women. All subjects aged 18 to 85 years. To achieve the objective used clinical, laboratory and instrumental methods (mammography, ultrasonography). Questionnaire method, methods for constructing artificial neural network models and logistic regression models, as well as the program «oncologist» are based on a neural network. 12 women of 360 clinically healthy women surveyed were assigned to high-risk group. The majority were women 41-50 age group - (75 ± 0,1%). Women aged 51-60 totalled 16,7 ± 0,1%, in 31-40 years - 8,3 ± 0,1%. In the «medium risk» assigned 95 women - 26,4 ± 0,1%, in the « low risk « - 253 women 70,3 ± 0,1%. Statistically significant differences (p < 0,001). Belonging to high-risk groups increases the reliability of the pathological process in 2.2 (CI 1,4-3,5 ) times (p < 0,001). In women at high and medium risk of developing breast cancer as a result of a comprehensive survey found suspected breast cancer one woman (by histological examination - fibroadenoma), fibro-cystosis disease (FCD) in 18 women with one woman - fibroadenoma of the breast. In the low-risk group for breast cancer FCD was detected in 4 women, nodules were not identified. Statistically significant (p < 0,001) risk factors were set up for each age group in the Bukovynskoy region, which make up the largest proportion. An automated system (based on a neural network, which allows you to create « high-risk « of breast cancer and precancerous diseases. Sensitivity of predictive models - 79,8%, specificity - 79,0% with 86,3% diagnostic accuracy.

The article analyzes the modern molecular genetic features pseudomyxoma of the peritoneum in order to find a possible source and causes of disease, identify the factors of tumor growth, as well as identification of ways to improve current treatments.