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PubMedDate not supplied

Percutaneous placement of self-expandable metallic biliary stents in malignant extrahepatic strictures: indications of transpapillary and suprapapillary methods.

OBJECTIVE: To compare the efficacy of suprapapillary and transpapillary methods of transhepatic biliary metallic stent placement in malignant biliary strictures and to specify the indications of each method applied. MATERIALS AND METHODS: Stents were placed in 59 patients. Strictures were categorized as type A (within 3 cm of the ampulla, n = 27), type B (over 3 cm from ampulla, n = 7), type C (within 3 cm of the bending portion, n = 9), or type D (over 3 cm above the bending portion, n = 16). The stenting method was suprapapillary in 34 cases and transpapillary in 25. The rates of initial and long-term patency and of early recurrence were compared. RESULTS: Initial patency rates for the suprapapillary and transpapillary methods were 1/7 (14.3%) and 20/20 (100%) respectively for type A (p <0.0001), 4/5 (80.0%) and 2/2 for type B, 3/7 (42.9%) and 2/2 for type C, and 15/16 (93.8%) and 0/0 for type D. Early recurrence rates were 7/30 (23.3%) using the suprapapillary method and 4/29 (13.8%) using the transpapillary method (p = 0.51). The long-term patency rate did not differ significantly according to either type (p = 0.37) or method (p = 0.62). CONCLUSION: For good initial patency, the transpapillary method is recommended for strictures of the distal extrahepatic duct near the ampulla and just above the bending portion. Long-term patency is not influenced by the stenting method employed.

Bile Duct Neoplasms↗
PubMed2004

National cancer registry to assess trends after the Chernobyl accident.

The National Cancer Registry has been operational in the Republic of Belarus since 1973: information on all new cases of malignant tumours is registered. The data are kept in a computer database and used for assessing the oncological status of the population, and for epidemiological studies. We compared findings before the Chernobyl accident of April 26, 1986 (Chernobyl) and findings between 1990 and 2000. The overall comparison on the changes in the incidence of cancer morbidity in Belarus is presented. The increase is statistically significant for all regions, but significantly greater in the most chronically radiation-contaminated region: the Gomel oblast. The paper presents a comparative analysis of the incidence of cancer morbidity in the population of two regions of Belarus, selected for the greatest difference in their radioactive contamination following Chernobyl. The highest contamination occurred in the Gomel region and is mainly due to high levels of radiocaesium (137Cs) in the soil and in the alimentary chain, especially in rural areas. A relatively low radioactive fallout was noticed in the Vitebsk region, considered here as the "control" area. We compare the situation before and after Chernobyl in the two regions. The overall cancer morbidity rate in all organs including colon, urinary bladder and thyroid, was significantly higher in the Gomel region than in Vitebsk. In populations living in two areas with high 137Cs contamination (oblast of Gomel and Mogilev), the peak incidence rates of breast cancer were already reached between the ages of 45-49 years, 15 years earlier than in the Vitebsk region. Belarussian "liquidators" who were mobilised to clean up the most contaminated territory and build the sarcophagus around the destroyed atomic plant, received the highest radiation doses. They had a significant excess of incidence of cancers of colon, urinary bladder, and thyroid gland, when compared with a corresponding adult population of the Vitebsk region. The Relative Risk (RR) of lung cancer among "liquidators" in 1997-2000 significantly exceeded 1, while in the control population it remained stable.

Breast Neoplasms↗
PubMed1999

[Tactics and operative methods in treating complicated colorectal cancer].

Over the period 1993-1998, a total of 385 patients with complicated colorectal cancer are subjected to treatment in the clinic of emergency surgery--University Hospital "Queen Giovanna", Sofia. Obturation is the commonest form of complication--43.8 per cent, perforation within the tumor or diastasis noted in 27 cases (7.01%), paratumor abscesses and infiltrates--in 8.3 per cent and rectohemorrhage--in 4.2 per cent. The therapeutic and operative approach, and the scope of surgery are dependent on a multitude of factors which should be given due consideration by the surgeon. In each patient presenting complicated colorectal carcinoma it is mandatory to make a precise and individual choice of the extent of operative intervention, consistent with the patient's general condition and contributing to eliminate the life-endangering underlying cause.

Colorectal Neoplasms↗
PubMed1999

[Discussion and preliminary application on standard for comprehensive efficacy assessment of traditional Chinese medicine in treating malignant tumor].

OBJECTIVE: To establish a comprehensive efficacy assessment standard on premise of patients' survival period and referring to the response of tumor and host to traditional Chinese medicine (TCM) therapy. METHODS: A standard was established by taking change of tumor size, tumor related symptoms, Karnofsky scoring and body weight of patient as criteria for evaluation. The standard was used to evaluate the comprehensive effect on advanced tumor patients, received various therapeutic regimen of TCM treatment in Xiyuan Hospital from March 1997 to August 1998, and compared with that evaluated by objective response rate (RR) of tumor. RESULTS: By the new standard, comprehensive therapeutic effect of 55 advanced tumor patients was: effective in 17 cases (30.91%), stable in 10 (18.18%) and exacerbative in 28 (50.91%), while by RR, it was completely response in 0, partial response in 3 (5.45%), no change in 41 (74.55%) and progressive disease in 11 (20.00%). Results of evaluation made by the two standard was different significantly, P < 0.005. The median survival period of 18 cases of advanced lung carcinoma patients was 11.5 months. Patients survived longer than the median survival period, mostly were tumor-bearing survival, were attributed to no change by RR, but were listed as effective by the new standard. CONCLUSION: The new standard laid more stress on quality of life than the RR, it reflects better response of tumor and host to treatment, and the prognosis of patients, and associated with the survival period, therefore, it could be conducted as the standard for comprehensive efficacy assessment in treating advanced malignant tumor in clinical practice after further improving.

Adult↗
PubMed2002

[Ways to improve tolerance to gastro-pancreatic-duodenal resection].

Immediate results of 125 gastropancreatoduodenal resection (GPDR) performed for cancer of the pancreatoduodenal zone are presented. Despite extended surgery volume (15 GPDR were extended, in 14 patients resection of the major vessels was performed) postoperative lethality decreased to 1.6% due to lowered rate of severe postoperative complications (first of all insufficiency of pancreato- and biliodigestive anastomosis). Ways of prophylaxis of these complications consist in conduction of percutaneous puncture transhepatic cholangiostomy as the method of choice for billiary decompression before surgery in patients with tumor obstructive jaundice, precise surgical technique, creation of pancreatogastroanastomosis on reconstructive stage of GPDR.

Adolescent↗
PubMedDate not supplied

Primary adenocarcinoma arising in esophageal colon interposition: report of a case.

Colon interposition has become a favored technique for esophageal reconstruction. We report a 79-year-old man with primary adenocarcinoma arising in the interposed colon 30 years after esophageal reconstruction for esophageal cancer. The occurrence of a carcinoma in a colon removed from its natural location and serving a different function suggests this rise in incidence may result from the action of carcinogens on colonic cells over an increasing period.

Adenocarcinoma↗
PubMed1990

[The count of the large granule-containing lymphocytes of the peripheral blood and the natural killer activity in patients with malignant tumors].

The authors investigated the quantity of large granule-containing lymphocytes and natural killer activity in donors, in patients with malignant and benign diseases of the lungs, mammary gland and digestive tract at admission to the hospital; 234 examinations were carried out. Results of the investigation revealed an inhibition of the natural resistance in patients with diseases of the mammary gland, lungs, digestive tract. A positive correlation has been revealed between the natural killer activity and content of large granule-containing lymphocytes in donors and in patients at admission.

Breast Neoplasms↗