[Non-organ teratoid neoformations of the small pelvis].
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Biomedical subjects
Publications and source records attributed to N G Kononenko.
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Combined operative interventions were performed in 375 (14.6%) out of the 2564 patients operated on radically. In 10 patients, evisceration of the pelvic organs was performed. At the preoperative period, 60% of the patients received the intensive irradiation. Among the postoperative complications, the purulent-inflammatory, urologic and cardiovascular ones were the most frequent. The five-year survival after the combined operations was 45.4%, and with preoperative irradiation--60.4%. The recurrences were noted in 23.9 and 5.6% of the patients, respectively.
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At the department, 138 children with non-Hodgkin's lymphoma of the abdominal cavity and small pelvis were examined. Resulting from the combined and complex treatment, in stage II of the disease, the complete remission was noted in 9 patients; in stage III, the partial remission--in 14, complete remission--39; in stage IV--in 17 and 9, respectively. Sixteen (11.6%) patients died. In non-organic lymphosarcoma spread, the intensive polychemotherapy, with subsequent irradiation of the abdominal cavity at the total dosage of 20 Gr and all the revealed foci of lesion--up to 35--40 Gr is effective. In involvement of the alimentary canal, the extended resection of the affected area with administration after the operation of polychemotherapy and irradiation of the zones of metastatic spreading is indicated.
The case records of 210 patients with malignant extraorganic tumors of the small pelvis are analysed. One hundred and eighty three patients had a primary tumor, 27--tumor recurrence. A classification of the mentioned tumors according to the stages and TNM system is suggested.
Of 86 patients with extra-organic teratomas of the small pelvis, 52 (60.5%) underwent radical operations, 22 children and 30 adults at the age of from 3 mos to 60 years. Benign neoplasms were removed in 33 (89.2%) of 37, malignant--in 19 (38.7%) of 49. In 48% of patients, the lower approaches were used, in 23.1%--the upper, in 28.9%--combined. In 16 (30.7%) patients, the combined interventions were performed. Eighteen (34.6%) patients developed complications. One (1.9%) female patient died. The long-term results of the treatment of teratoblastomas are unsatisfactory.
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The paper discusses the results of examination of 205 cases of extra-organ tumors of the small pelvis carried out in 1967-1986. The study group included 65 pediatric and 140 adult patients, 57 (28%) males and 148 (72%) females, 194 primary and 11 relapsing cases. Patients aged under 4 years (47, i. e. 23%) prevailed. Benign tumors were detected in 83 (40.5%) and malignant ones--in 122 (59.5%) cases. Disease was asymptomatic in 39 (19.0%) patients and presented with multiple symptoms in 166 (81.0%). Rectally, the upper pole of lesion was palpable in 47 (22.9%) while the lower one--in all cases. Tumors which took up as much as two-thirds of the small pelvis cavity were found in 37 (56.9%) pediatric and 31 (22.1%) adult patients. Tumorous or secondary lesions of adjacent organs were detected rectoscopically in 47 of 74 (63.5%) cases: sensitivity (s)-88.6%, specificity (sp)-57.1%; using chromocystoscopy--in 43 of 64 (67.2%): s-89.5%, sp-75.0%; pelvic pneumography-31 of 56 (55.3%): s-68.8%, sp-54.5%; excretory urography-53 of 79 (67.0%): s-88.3%, sp-68.4%; irrigoscopy-55 of 79 (69.6%): s-82.4%, sp-75.0%; angiography-30 of 70 (42.8%): s-90.9%, sp-78.4% and computer tomography--in 42 of 45 (93.3%) patients: s-96.4%, sp-88.2%. Four stages of diagnosis were suggested.
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The paper discusses the results of treatment of 10 male patients who underwent pelvic evisceration for advanced rectal cancer. Surgical technique is described. In 9 cases, an isolated ileocecal "urinary bladder" was formed; in 1 patient urine was passed into a small intestine segment. The involvement of the urinary bladder and/or the prostate were observed in 6 patients. One patient died shortly after surgery, three--within the first 12 months and another 2--during the second year. Four cases have survived over 5 years, 3 of them surviving over 10 years.
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An examination of 16 children suffering from malignancies established marked chemotherapy--induced suppression of endocrine function of the thymus. These findings were in correlation with variations in peripheral blood lymphocytes level in spontaneous rosette-formation test with ovine red blood cells and autoerythrocytes. The levels of E- and A-rosette-forming cells returned to normal following in vitro incubation of peripheral blood lymphocytes with thymostimuline. It is suggested that immunocorrection by means of thymal hormones should be carried out in the course of chemotherapy.
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