Vol 26, No 5 (2021)

BACKGROUND: Pancreatic cancer is one of the most aggressive malignant neoplasms, and the results of treatment of which remain extremely unsatisfactory. One of the methods to increase the effectiveness of surgical treatment of pancreatic cancer is selective oil chemoembolization of the pancreatic arteries. Transfemoral access is typically used as a vascular access during this type of intervention, in which complications from the vascular access are often observed.

AIM: This study aimed to analyze the results of the use of transradial and transfemoral approaches for chemoembolization of pancreatic cancer.

MATERIALS AND METHODS: We analyzed the results of chemoembolization of pancreatic arteries in 32 patients with pancreatic cancer. Transfemoral access was used in 16 (50%) patients and transradial access in 16 (50%) patients. According to the main clinical and anamnestic data, both groups were comparable. The endpoints of the study were technical success and complication rate of chemoembolization, total duration of the procedure, time needed for catheterization of the target artery, radiation exposure, and degree of discomfort for the patient.

RESULTS: Chemoembolization of pancreatic arteries was successfully performed in 100% of patients in both groups. Major vascular complications were observed in three (18.8%) patients in the transfemoral access group and in one (6.3%) in the transradial access group (p=0.6). The total duration of the procedure and the time needed for catheterization of the target artery were 54.54±6.61 and 51.30±6.46 min (p=0.17) and 12.7 and 13.25 min (p=0.72), respectively. Radiation exposure was 0.68±0.10 mSv in the transfemoral access group and 0.65±0.10 mSv in the transradial access group (р=0.4). Transradial access was associated with a statistically significant reduction in all parameters of procedural discomfort.

CONCLUSION: In terms of efficiency and safety of use, the transradial approach is not inferior to the traditional transfemoral approach, and in terms of patient comfort, it can be recommended as a priority for chemoembolization of the pancreatic arteries.

Cervical cancer (CC) is a serious health problem all over the world. CC is a fully preventable disease; however, it remains one of the leading causes of death among women with carcinomas. The screening helps to reduce morbidity and mortality. Two tests are used as screening tests in the world: сervical cytology and detection of human papillomavirus (HPV). Cervical cytology (Pap test) is a traditional test of CC screening. Two types of Pap test are used in modern laboratory practice: liquid and traditional methods. HPV testing is now used as the primary screening tool for СС in some countries. However, a key factor in effective screening is the coverage of the population and the organization of the screening. Immunocytochemical examination is an additional method used to improve the accuracy of diagnosis, p16/Ki-67 dual staining. This review focuses on the laboratory methods used in the world practice of screening. The literature search for this review was conducted using PubMed, MedLine and Embase.

The result of radical treatment of locally advanced thyroid cancer with metastases to the regional lymph nodes of the neck on the left, with tissue breakdown and skin fistula formation, is presented. An 84-year-old female patient has severe concomitant pathology, such as ischemic heart disease, widespread atherosclerosis, cardiosclerosis, and permanent atrial fibrillation (tachy form, Grade 2A). A conglomerate of lymph nodes with disintegration in the projection of the external jugular vein and possible profuse bleeding was considered an absolute indication for surgery, which was performed on February 10, 2015. Considering the conglomeration of the lymph nodes of the neck, which displaced the trachea to the right, an endoscopist was called in, who performed tracheal intubation through the nose using a fiberoptic bronchoscope. The surgical treatment included combined thyroidectomy, a Crile’s operation on the left side, and the removal of the conglomerate of the lymph nodes of the neck as well as the adjacent area of the skin in a single block. The postoperative period was uneventful. On the second day after surgery, the patient was examined by an endocrinologist. The prescribed treatment was L-thyroxine 75 mg once a day in the morning. On the fifth day, the patient was discharged with recovery to be treated in the outpatient clinic by an oncologist and an endocrinologist.